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2015-02-12Regular February 2015 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held February 12, 2015 BE IT REMEMBERED, that on this 12th day of February, A.D., 2015 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissioner, Precinct #4 Josie Sampson Deputy Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation, Commissioner Finster led the Pledge to the US Flag, and Commissioner Fritsch led the Pledge to the Texas Flag. APPROVE THE MINUTES OF THE FOLLOWING COURT MEETINGS: NOVEMBER 13, 2014, NOVEMBER 24, 2014, DECEMBER 11, 2014, DECEMBER 15, 2014, DECEMBER 22, 2014, JANUARY 1, 2015, JANUARY 8, 2015, JANUARY 21, 2015 AND JANUARY 22, 2015: Commissioner Galvan made a motion to approve the minutes of the following Court meetings: November 13, 2014, November 24, 2014, December 11, 2014, December 15, 2014, December 22, 2014, January 1, 2015, January 8, 2015, January 21, 2015 and January 22, 2015. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Regular November 2014 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held November 13, 2014 BE IT REMEMBERED, that on this 13th day of November, A.D., 2014 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 Pfeifer CountyJudge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Nell Fritsch Commissioner, Precinct #3 Farleigh Sutton Deputy Clerk Commissioner Finster was not present. Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Lyssy led the Pledge to the US Flag and Commissioner Lyssy led the Pledge to the Texas Flag. RECOGNITION OF RETIRING ELECTED OFFICIALS: JUSTICE OF THE PEACE #2 JAMES DUCKETT AND COUNTY CLERK ANITA FRICKE: Commissioners' Court recognized James Duckett, Justice of the Peace #2 and also presented him with a clock. Regular November 2014 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held November 24, 2014 BE IT REMEMBERED, that on this 24th day of November, A.D., 2014 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissioner, Precinct #4 Farleigh Sutton Deputy Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge to the US Flag and Commissioner Fritsch led the Pledge to the Texas Flag, RECOGNITION OF RETIRING ELECETED OFFICIAL: JUSTICE OF THE PEACE #3, JUDGE GARY NOSKA: N/A Regular December 2014 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held December 11, 2014 BE IT REMEMBERED, that on this 11th day of December, A.D., 2014 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Kenneth Finster Commissioner, Precinct #4 Farleigh Sutton Deputy Clerk Commissioner Fritsch was not present. Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge to the US Flag and Commissioner Lyssy led the Pledge to the Texas Flag. AWARD BIDS FOR FUEL TO BE DELIVERED FOR THE PERIOD DECEMBER 16, 2014 THROUGH JANUARY 15, 2014: Commissioner Finster made a motion to accept the bid from Diebel Oil for Diesel Fuel $2.73 and Regular Unleaded $2.27. Commissioner Lyssy seconded his motion, Commissioners Galvan, Lyssy, Finster and Judge Pfeifer all voted in favor. SPECIAL MEETING December 2014 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held December 15, 2014 BE IT REMEMBERED, that on this 15th day of December, A.D., 2014 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 Special Meeting 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct 42 Neil Fritsch Commissioner, Precinct #3 Kenneth W. Finster Commissioner, Precinct #4 Farieigh Sutton Deputy Clerk CANVAS RETURNS OF SENATE DITRICT 18 SPECIAL ELECTION: Commissioner Fritsch made a motion to accept Canvas returns of Senate District 18 Special Election. Commissioner Lyssy seconded his motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor, Regular December 2014 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held December 22, 2014 BE IT REMEMBERED, that on this 22nd day of December, A.D., 2014 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissioner, Precinct #4 Farleigh Sutton Deputy Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge to the US Flag and Commissioner Fritsch led the Pledge to the Texas Flag. RECOGNITION OF RETIRING CALHOUN COUNTY EMPLOYEE: Judge Nancy Pomykal recognized Ms. Betty Morgenroth who has been working with Judge Pomykal the past couple of years and has been working with Calhoun County for 29 years and will now be fully retiring. Judge Pomykal presented Ms. Morgenroth with a plaque. Regular January 2015 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held January 11 2015 BE IT REMEMBERED, that on this 1st day of January, A.D., 2015 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 Pfeifer CountyJudge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissioner, Precinct #4 Anna Goodman County Clark Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation. APPROVE BONDS FOR NEWLY ELECTED AND RE-ELECTED COUNTY OFFICIALS - Commissioner Galvan made the motion to approve bonds for newly elected and re-elected county officials. Commissioner Finster seconded that motion. SWEAR IN NEWLY ELECTED AND RE-ELECTED COUNTY OFFICIALS - Judge Michael Pfeifer swore in newly elected and re-elected County officials. PUBLIC DISCUSSION OF COUNTY MATTERS - There were no County matters discussed at this time. MEETING WAS AJOURNED AT 10:20 AM. Regular January 2015 Term Held January 8, 2015 THE STATE OF TEXAS § COUNTY OF CALHOUN § BE IT REMEMBERED, that on this 8th day of January, A.D., 2015 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissioner, Precinct #4 Farieigh Sutton Deputy Clerk Commissioner Lyssy was not present. Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge to the US Flag and Commissioner Fritsch led the Pledge to the Texas Flag. HEAR REPORT FROM MEMORIAL MEDICAL CENTER: Jason Anglin, CEO Memorial Medical Center: Mr. Anglin stated November's financial results were positive with a net income of $35,000 with a net income for the year of $596,000. Mr. Anglin stated he had attended the waiver conference In Houston. A payment of $322,000 for uncompensated care was received. A payment of $784,000 is anticipated in January and will be deposited in the construction account to fund the clinic project. Mr. Anglin stated that a tentative construction schedule is attached to the CEO report with an anticipated completion date of August 2015. With the Clinic Operations, they are actively recruiting for multiple physicians at this time. Dr. Fillingaine will be leaving at the end of the month. They are moving to change the electronic medical records to new software in February. The flu testing method for the flu is being changed, ultimately Increasing reimbursement by $87,000 per year, The phone system and IT infrastructure are being updated as both are out of date. A fiber optice line will be installed and will be used in connection with the new clinic. They are purchasing a new ultrasound machine to be used by the OB/GYN, Diane Moore, CFO Memorial Medical Center: Ms, Moore stated there was a low volume as to admissions in November, except in respiratory, but the month was profitable. Cash in the bank totals $4,000,000 with $1,300,000 in the Clinic account, With the $780,000 anticipated payment there should be a balance of $2.1 million in February, which will take care of their funding portion of the clinic. Revenue YTD is up $8,000,000 over last year. Mr. Anglin thanked Ms. Moore for her service as she is resigning to accept another position to further her career. Special Meeting January 2015 Term Held January 21, 2015 THE STATE OF TEXAS § COUNTY OF CALHOUN § BE IT REMEMBERED, that on this 21st day of January, A.D.; 2015 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 Special Meeting 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 Pfeifer County Judge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Hnster Commissioner, Precinct #4 Josie Sampson Deputy Clerk Thereupon the following proceedings were had: WORKSHOP TO DISCUSS AN OVERVIEW OF THE NURSING HOME UPL PROGRAM WITH MEMORIAL MEDICAL CENTER PERSONNEL: Jason Anglin, CEO Memorial Medical Center: Mr. Anglin stated they have been working with a company called Cantex and the company has five facilities in Region 3 (RHP 3 - in the Houston area) and approximately 30 facilities across the state. Mr. Anglin reviewed the Summary UPL Impact Report with the Court and stated that one funding cycle, from the time we start funding to receipt of the last payment, is approximate eighteen months, The projected date to get into the program is February 1, 2015. Participation would be under the old NH UPL Program for one month. He anticipates an Inter - Governmental Transfer of $350,000 on March 15, 2015, with a return of $850,000 on April 15, with a net return of $500,000 (return of $850,000 less our IGT of $350,000 = $500,000). Fifty percent of the net return would benefit the hospital and fifty percent would benefit the nursing home. Judge Pfeifer asked If the Mr. Anglin stated the new program requires more funding up front. The first payment would start in September, 2015 and would require a full quarter IGT plus an 10% fee required by the state. The additional 10% would be returned by the State at a later date. The initial IGT would need to be $1.1 million. A second IGT of $1.1 million would be due in December 2015 with receipt of monthly payments beginning in February 2016. The third IGT of $1.143 million would be payable In March 2016 and at that point the County would have invested $2.8 million, In June 2016 the fourth IGT would be payable. By September 2016 all the money Invested has been returned and there would be a positive cash position. Mr. Anglin that as the program is today, the program is scheduled to do four quarters of funding and after that, the program is scheduled to be discontinued. He also stated his personal opinion is that the program is not costing the State any money and is generating funds for health care in Texas for the nursing home industry so he envisions the program will be renewed on that basis. If the program Is not renewed, there would still be a benefit of $2.9 million for this funding cycle. Regular January 2015 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held January 22, 2015 BE IT REMEMBERED, that on this 22nd day of January, A.D., 2015 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 Pfeifer CountyJudge Roger Galvan Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Neil Fritsch Commissioner, Precinct #3 Kenneth Finster Commissloner, Precinct #4 Josle Sampson Deputy Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation, Commissioner Finster led the Pledge to the US Flag, and Commissioner Fritsch led the Pledge to the Texas Flag. AWARD BIDS FOR FUEL TO BE DELIVERED FOR THE PERIOD FEBRUARY 16, 2015 THROUGH MARCH 15, 2015: Commissioner Fritsch made a motion to award bids for fuel to be delivered for the period February 16, 2015 through March 15, 2015. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. CINDY MUELLER COUNTY AUDITOR, CALHOUN COUNTY COUNTY COURTHOUSE ANNEX - 202 S ANN ST, STE B PORT LAVACA, TEXAS 77979 (361)553-4610 MEMORANDUM TO: JUDGE PFEIFER & SUSAN RILEY COUNTY JUDGE'S OFFICE FROM: AUDITORS OFFICE - PEGGY HALL RE: AGENDA ITEM — FEBRUARY 12, 2015 AGENDAITEM ►Consider and take necessary action to award bid for Fuel to be Delivered for the period beginning February 16, 2015 and ending March 15, 2015. (CM) Fuel -Bulk Delivered Diesel Fuel — Diebel Oil Company Inc was the Only Bid N � C W A y N 0 m M m O c C z mr D m m a G) D O r z m o w m e m M � r 0 F 0 0 z 0 T w G m N O o a -1 c m r 0 C r m r_ m m 0 a C C O O T r" 01 /28/2015 12:13 (FAX) P.0021004 CALHOUN COUNTY, TEXAS BID SHEET- FUEL BULK DELIVEBED I T Am T 106"Imin T 0 R 10 BIDDER BIEBEL OIL CO III SAM OUR PO BOX 71 PORT LAVACA TX 77070 BID ITEM FUEL -BULK BELIIIEBED PERIOD TNOM; FEBRUARY 16, 2015 PUM TO. MARCH 16, 2015 YOU ARE INVITED TO SUBMIT A BID ON THE ABOVE ITEM TOi MICHAEL JPfE1FER, CALHOUN-COUNrYJUDG£, 211 SANN ST JRO aOOR, ROOH301, PORT LAVACA TX 77979 BIDS SHOULD BE SUBMITTED IN A SEALED ENVELOPE PLAINLY MARKED: SEALED AIP- F=-HULK EL1V£RED BIDS ARE DUE AT THE JUDGE'S OFFICE ON OR BEFORE; 10. ,, THURSDAY, FEBRUARY5, SOTS BIDS WILL BE AWARDED AT THE COMMISSIONERS' COURT MEETING ON; THURSDAY, FFJRUARY 12, 201S THE CLOCK IN THE COUNTY JUDGE'S OFFICE IS THE OFFICIAL CLOCK THAT WILL BE USED IN DETERMINING THE TIME THAT A BID IS RECEIVED AND THE TIME THAT BIDS WILL BE OPENED, BIDS RECEIVED AFTER THE OPENING TIME WILL BE RETURNED UNOPENED TO BIDDER. THE COMMISSIONERS' COURT RESERVES THE RIGHT TO WAIVE TECHNICALITIES, REJECT ANY OR ALL BIDS, TO ACCEPT THE BID DEEMED MOST ADVANTAGEOUS TO CALHOUN COUNTY AND TO BE THE SOLE JUDGE IN DETERMINING WHICH BIDS WILL BE MOST ADVANTAGEOUS TO THE COUNTY, THE COUNTY OF CALHOUN, TEXAS IS AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER. THE COUNTY DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, RELIGION, AGE OR HANDICAPPED STATUS IN EMPLOYMENT OR #In/TAM: PUBIL-BULK DELIVERED JR&PARTMONYi VARIOUS DEL/VERY F013 COUNTYFUELTANKS 09$77V47YON VARIOUS ____—e_________.______________"------„v—__e----,_- I s7l.oiz.Ipll IN,1110 J? >>DELIVERY must be made within 24 hours after receiving order from the County Department In the quantity ordered, If vendor cannot deliver within 24 hours or refuses to deliver, the County Department will order from the next lowest bidder. »PRICE Per Gallon MUST INCLUDE all fees and charges Including ell Taxes/Fees the County to not exempt from (for example: $0,20 State Excise Tax, State Delivery/Environmental Fees, Federal Oil Spill Recovery Fees and Federal LUST Tax) >>FREE FROM WATER AND SUSPENDED MATTER UNIT UNIT LOICE ------- GALLON sPEcrFicanaNs: REGULAR UNLEADED GASOLINE >>DELIVERY must be made within 24 hours after receiving order from the County Department In the quantity ordered. If vendor cannot deliver within 24 hours or refuses to deliver, the County Department will order from the next lowest bidder, >>PRICE Per Gallon MUST INCLUDE all fees and charges including all Taxes/Fees the County Is not exempt from (for example; $0.20 State Excise Tex, State Delivery/Environmental Fees, Federal Oil Spill Recovery Fees and Federal LUST Tax) >>FREE FROM WATER AND SUSPENDED MATTER AND A MINIMUM OCTANE OF 87 (AVERAGE METHOD) UNIT GALLON DATE Of W. AUIHDAQED SICTUBE TITLE PAINT NAME S� 1gw,, N s UNIT PRICE Q,Q TELEPHONE PLEASE LIST ANY EXCEPTIONS TO THE ABOVE SPEOICATIONS: Wednesday, January 28, 2015 BM BIEBELOLODU HEAR REPORT FROM MEMORIAL MEDICAL CENTER: Jason Anglin, CEO Memorial Medical Center: Mr. Anglin stated the hospital had a positive financial outcome for the month of December, 2014 with a net income of $174,000. Income for the year totaled $1,171,000. This was the third positive year in a row for the hospital. He stated that monthly volume as to admissions, clinic activity, ER visits, lab and radiology had increased. Surgery volume remained the same. For the month of November 2014, ER volume was up. Mr, Anglin stated that $325,000 had been received in disproportionate share funds and was recognized as income at the end of the year. The January census remained strong and the ER volume rose to approximately 940 visits. For the month of February, the average daily census is over 16. The new clinic project is moving along. The project had been running approximately 30 days behind due to rain. Mr. Anglin stated he has on -site interviews to fill the positions of Family Practitioner as well as Obstetrician toward the end of the month. Memorial Medical Center - Port Lavaca, Texas CEO Report January 21, 2015 Financial Results: In December we had a Net Income of $174,044 increasing the Net Income for the year to $1,171,061 compared to last year's Net Income of $810,324. NH UPL program We continue to work on finalizing the legal documents and setup for the Nursing Home Upper Payment Limit program. Our planned start date in the program is February 1s12015. With a start date of February 11t MMC will participate in for 1 month in the "old NH UPL program" and then begin participation in the new program March V. On Wednesday January 2111 1 attended a NH UPL Budget workshop at Commissioner Court. Commissioner Court approved loaning MMC up to $2 million to help support MMC participation in the program. New Clinic Project This past week we held a construction meeting with K&T construction. At this time as a result of recent weather K&T reported that we are approximately 30 days behind schedule. K&T plans to make up part of the schedule by installing the metal building structure in phases as the sections of the foundation is completed. Please see construction committee minutes on other highlights Staffing Diane Moore, CFO has accepted a CFO position at another hospital. I have engaged John G Self Executive Search firm for an executive search to fill the CFO position. Since Diane's tenure was less than two years John Self will conduct the replacement search for expenses and no placement fee. At this time I'm not planning on using an Interim CFO. I'm planning on performing dual roles as CEO/CFO until the CFO position is filled. Physician Recruitment Activity This past week we had a phone conference with a family practice candidate and anticipate a site visit in the next 30 days. Information on Board Items: 1. Anesthesia Agreement- Currently, The Service Organization of Houston contracts with Centrix for anesthesia services provided by CRNA's for MMC. At this time we recommend changing the anesthesia service company thru SOH to TriGent. Over the past year we have entertained proposals from multiple companies to provide anesthesia services to MIMIC. One of our objectives to help grow our surgery services is for the anesthesia providers to be able to provide certain nerve blocks needed for certain procedures. TriGent will allow us to expand our services with providers who have this skillset. 2. ER Subsidy Agreement— Victoria Medical Professional Consultants (VMPC) is contracted with The Service Organization of Houston to provide emergency room physician coverage at our hospital. VMPC has requested the monthly subsidy increase from $45,000 to $60,000 effective July 2015. I am pleased with the quality of services provided by VMPC and recommend approving the increased subsidy. 3. Safety/Security enhancements- In assessing our operations our safety committee recommends enclosing the emergency room reception and switchboard desk areas with "safety" glass. f Jason Anglin, CEO Memorial Medical Center Memorial Medical Center Financial Report For the Month of: December 2014 Overview: The hospital's bottom line for December was a profit of $174,044. The fiscal year to date total net income is $1,171,061. December's month was driven by: ® Overall Volume was up from December in Admissions, MC Clinic, Women's Clinic, Emergency Room Visits, Specialty Clinic Visits, Laboratory, Radiology and Respiratory ® Overall Volume was down in Observations, Outpatient Visits, and Physical Therapy, ® Surgery volume was the same as November, 85 in December compared to 85 in November ® ER visits were up from November, 849 in December compared to 755 in November ® ER Private Pay as a percentage of revenue was down from November to 19.0% compared to 20.9% in November - Total ER Private Pay for December $312,892 ® DSH Monies in the amount of $325,178 Statistics: Overall volume was up for Inpatient Admissions, and the total patient days were higher than November. The revenue for ER was higher in December. The revenue was up for Outpatient. Average daily census was up 4.5%to 14.84 from 14.20 in November. ER volume was up 12.5%with 849 visits, in comparison to November's 755. Hospital outpatient visits were down 4.3%with 1,946 visits. Radiology Procedures increased to 1,437 in December from November's 1,398 an increase of 39 procedures, an increase of 2.8%. The total of laboratory procedures increased for December to 27,974 compared to November's 26,549, an increase of 5.4%. The number of babies born at Memorial Medical Center in December was 6. The total newborns born at Memorial Medical Center for 2014 is 113. Balance Sheet Highlights: Bank Accounts Overall cash increased from $4,069,017 to $4,865,027. Cash funds consist of $2,450,473 in operating cash, $584,556 in Private Waiver 1115 Clearing Account, $1,329,998 in MMC Clinic Construction and $500,000 in CD investments. This provides total cash on hand of 84.91 days of cash on hand. Excluding the Private Waiver 1115 Clearing Account funds and the MMC Clinic Construction, the day's cash on hand equals 51.49 days Accounts Receivable A/R aggregated $8,948,290, which decreased from the prior month by $954,542. Gross revenue tied up in accounts receivable decreased from 54.2 to 49.8 days. Net accounts receivable was $2,502,688, which is less than the prior month by $405,035. Net accounts receivable days decreased from 43.8 days to 38.5 days. Accounts Receivable — Other The total in this account is $2,756,953 most of this consists of the DSRIP component of the Waiver program and the Uncompensated Care program in the amount of $2,720,150. The remaining balance is due to both Indigent funds and a few small balances of miscellaneous accounts. Receivable Est. 3`d Party Paver Settlements Our books reflect a net due from third party payers of $0. This account was reconciled and consolidated with the Accounts Receivable - Other. LIABILITIES Accounts Payable The hospital owed $618,630 to vendors for open accounts payable at the end of the month. This is an increase from the prior month by $13,322. Accrued Expenses Our books reflect accruals for payroll taxes and amounts due employees for benefit hours. These items total $1,120,780. Accrue expenses were up $74,696 from the prior month. The accrual is based on the payroll of December. Accrued Intergovernmental Transfers Our books reflect accruals of $1,725,596 for UCC payments and Waiver Projects and to support the Private Uncompensated Care program. Accounts Payable SOH —Our books reflect $0 for expected collections on professional fees to be remitted to SOH under the Private Uncompensated Care program. The monies were paid in December. Accrued Payable— Est 3rd Party Payor—Our books reflect $607,952, which is an estimated amount due to Medicare for our current fiscal year, this is based on our monthly mini -cost report and BKD's interim cost report for 2014. Notes Payable The hospital has a note payable to Calhoun County for $500,000. This amount was borrowed in 2011 to purchase CT, Nuclear Medicine, and other equipment under operating leases. Leases Payable The hospital has $602,757 in outstanding capital leases classified $230,200 as current and $372,557 long term debt. Current Ratio The ratio between our current assets and current liabilities was 2.30. For Critical Access Hospitals the benchmark target is 2.3. Income Statement: Gross patient revenue showed an increase of $212,731 from November 2014. Our total revenue was $5,560,735. Revenue Deductions were at 66.0%compared to 65.5%for the year. The Emergency Department Private Pay charges were 20.9%, or $312,892 of the total ER Charges. Total operating expenses were lower than November by $76,917. This was driven by: ® Payroll cost were down by $1,767 ® Benefits and PR Taxes cost were up by $50,964 ® Professional Fees were down by $30,655 ® Purchased Services were up by $15,795 ® Supplies were down $20,038, 11.3% of Net Patient Revenue ® Insurance was down by $2,812 ® Utilities were down by $1,729 ® Other Expenses were down by $86,675 o a F e 6 R e m 6m' 4 n m o fnv' n S ryry N �. 8 n$.. �& R F ^ m A o m y 6 m v 4 r & o m o� m�N mdm Pam ol$f7 v 'rvR' p. �'3_ $ Cm a o m 6 o F 6 m e e G ov m C w m oqo mmw m� x a�P� $ as r 2 n.-F H n N o F m m m NS ^ e S S G N o C m e m vi N � m m m F{ = rc w ^ o w rc ^ rv} U 5 ° m W mQ F O p z p N F 0 U W W w U F Z GWI O w 6 U w m� 6 tt N ¢ W n i U O O qj zG° `d aF= aka rcrcao u a¢ �9°z is �d�oaia a¢a _1_ Memorial Medical Center Income Statement For the Month Ended December 31, 2014 Current Period Revenue Fiscal Year To Date Actual This Budget This Last Year- Last Year YTD - Month Month Audited Actual YTD Budget YTD Audited $1.315,868 $1,347,074 $1,270,111 Inpatient Revenues $15,330,208 $16,164,888 $14,699,415 $2.542,555 $4,223,480 $2,898,080 Outpatient Revenues $28,512,793 $50,681,760 $39,230,149 $1,702,312 $0 $219,331 ER Revenues $19,788,285 $0 $219,331 $5.560,735 $5,570,554 $4,387,522 Total Patient Revenue $63,631.286 $66,846,648 $54,148,895 Revenue Deductions $3,543,202 $2.229,163 $2,359,888 Contractuals $33,519,786 $26,749,956 $26,050,779 $104,076 $88,598 $74,425 Charity $1,056.253 $1,063,176 $922,943 $47,548 $41,356 $9,596 Indigent Care $582,643 $496,272 $638,942 -$424,915 $0 -$1,622,143 DSH/Waiver -$2,418,756 $0 -$2,945,495 $398,750 $835,578 $724,157 Bad Debt $8,911,380 $10,026,936 $8,148,815 $3,668,661 $3,194,695 $1,545,923 Total Revenue Deductions $41,651,306 $38,336,340 $32,815,984 $1,892,074 $2,375,859 $2.841,599 Net Patient Revenue $21,979,980 $28,510,308 $21,332,911 $65,374 $40,158 $18,351 Other Operating Revenue $567.442 $481,896 $691,420 $1,957,448 $2,416,017 $2,859,950 Total Operating Revenue $22,547,422 $28,992,204 $22,024,331 Current Period Actual This Budget This Last Year - Month Month Audited $752,374 $859,717 $660,905 $285,287 $248,344 $235,331 $308,158 $642,439 $337,111 $143,481 $158,200 $115,591 $221.645 $277,189 $235,671 $1,159 $5,065 $4,559 $41,368 $46,849 $36,924 198 $110,120 $76,948 $105,219 Operating Expenses Salaries & Wages Employee Benefits & PR Taxes Professional Fees Purchased Services Supplies Insurance Utilities Depreciation Fiscal Year To Date Last Year YTD - Actual YTD Budget YTD Audited $8,732,801 $10,316,604 $8,187,337 $2,653,810 $2,980,128 $2,547,066 $4,025,937 $7,709,268 $4,158,354 $1,700,320 $1,898,400 $1,726,254 $2,814.128 $3,326,268 $2.745,941 $48,822 $60,780 $50.173 $536,067 $562,188 $453,462 $743.929 $1.359.156 $743.546 $964,772 $923,376 $952,347 $1,886,318 $2,428,014 $1,640,833 Total Expenses $22,220,586 29,136,168 $21,564,480 $71,130-$11,997 $1.219,117 Net Operating Income / (Loss) $326,836-$143,964 $459,851 Non Operating Income / (Exp) $778 $291 $24 Investment Income $1,233 $3,492 $6,217 -$7,258 -$1,333 -$7,122 Interest Expense -$29,576 -$15,996 -$21,541 $37.605 $2,558 $84,384 Contributions and Grants $45,555 $30,696 $84,504 -$167,509 -$459,853 -$559,588 IGT Expense -$1,553,890 -$5,518,236 -$2,629,588 $239,298 $512,002 $138,067 Service Contribution by SOH $2,380,903 $6,144.024 $2,910,881 $102,914 $53,665 -$344,235 Total Non -Operating Revenue $844,225 $643,980 $350,473 $174,044 $41,668 $874,882 Total Net Income / (Loss) $1,171.061 $500,016 $810,324 -2- Memorial Medical center Accounts ReceNable Dec-14 Aging 1 0-30 1 31-60 1 61-90 1 91-120 121-150 151-I80 1 191-365 1 Tolul Crass % Ovarl20Dms % Oser9ODnps Total Jan-14 4,067,457 1,695,136 1,318,974 855,896 380,365 182,075 917,820 9,317,723 14.8% 24.0% Feb-14 4,154,944 1,924,441 1,264,244 1,077,415 546,042 318,746 881,w 10,167,879 17.2% 22.8% Mar-14 3,856,422 1,669,853 1,325,909 586,314 294,165 334,4M 852,959 8,920,006 16.6% 23.2% Apr-14 4,096,197 1,726,119 1,102,525 726,306 410,228 207,999 890,976 9,16g328 16.5% 24.4°% May14 4,128,001 1,917,931 1,242,596 846,267 689,093 340,050 985,411 10,149,349 19.8% 28.2% Jun 14 4,413,61D 1,830,486 1,493,096 822,851 440,826 400,953 919,763 10,321,S90 17.1% 25.0% Jul 14 3,851,6D2 1,903,191 1,397,299 976,109 422,944 220,639 1,037,530 9,809,313 17.1% 22.1% Aug-14 3,762,257 1,655,095 1,259,442 672,653 521,105 219,938 820,MG 8,961,430 18.0% 25.5°% Sep 14 4,318,233 1,559,467 1,091,047 591,725 353,120 367,323 $34,550 9,115,465 17A% 23.6% Oct-14 4,209,213 1,776,814 1,197,644 514,857 319,393 221,896 970,350 9,209,156 16.4% 22.0% Nov -14 4,157,799 1,899,222 1,192,857 294,431 401,470 202,057 1,115,010 9,762,835 17.6'% 25.7% Dec-14 3,682,451 1,662,826 1,263,049 660,955 355,926 184,378 946,841 8,761,426 17.0% 24.5% \ledieare Jan 14 1,685,508 259,663 130,718 52,923 34,865 23,056 56,056 2,247,839 5.1% T6% Feb-14 1,814,259 327,432 136,171 53,457 18,861 12,614 42,629 2,410,423 3.3% 5.5% Mar-14 1,652,990 229,723 159,734 106,544 28,OD2 14,995 42,123 2,244,119 3.8% 8,5% Apr-14 1,766,935 301,289 165,905 120,389 64,308 24,302 57,130 2,S00,263 5.8% 10.6% May 14 1,839,296 352,421 162,330 62,413 104,651 33,6S9 SO,OS4 2,609,824 7.2% 9.9% Jun 14 3,962,250 450,445 241,737 115,399 61,530 91,020 55,590 2,922,961 7.0% 10.9% Jut 14 1,480,178 476,703 260,241 249,734 20,969 44,413 94,122 2,626,259 7.8% 17.2% Aug 14 1,578,916 289,160 241,151 22,454 67,186 32,223 125,203 2,411,M3 9.5% 12.5% Sep-14 1,866,407 372,097 147,475 129,956 32,230 35,260 98,247 2,682,172 G.2°% 11.0% OR-14 1,815,331 441,511 238,441 88,396 41,412 13,014 100,080 2,738,191 5.6°% 8.9% Nov-14 1,943,820 288,941 117,955 85,220 58,161 11,406 96,969 2,603,023 6.4% 9.2% Dec-14 1,514,858 317,405 99,209 44,590 33,105 5,246 71,490 2,085,9D2 5 3% 7.4% Medicaid Jan-14 486,543 157,143 90,007 123,129 82,511 26,771 16,859 987,963 13.3°% 25.7% Feb-14 S02,824 203,167 59,051 62,803 89,385 22,039 32,111 1,026,380 19.3% 25.5% Mar-14 437,607 140,382 20,425 45,588 30,592 69,691 74,125 968,410 20.1% 25.3% Apr-14 405,798 127,990 56,142 23,965 30,613 6,983 58,664 715,036 115% 17.5% May 14 409,280 115,190 56,845 30,197 22,574 1,103 62,089 70Z278 12.9% 1T2% Jun 14 455,109 82,197 42,258 12,371 19,091 20,3ri 25,214 661,581 9.8% 118% Jul-14 527,222 73,741 41,535 12,594 7,146 552 38,673 702,018 6.6°% 8A% Aug-14 533,632 139,297 40,613 16,783 10,470 2,385 39,485 782,665 6.2% 8.8% Sep 14 508,446 48,593 83,609 38,070 11,057 9,163 - 698,937 2.9% 9.3% Oct -14 469,795 157,268 29,707 22,412 15,160 11,833 5,731 711,906 4.6% 7.2% Nov-14 476,662 163,655 94,369 19,941 9,035 8,424 12,535 789,622 4.4% 7.0% Dec-14 535,712 129,765 123,291 73,056 13,378 8,369 9,416 941,694 3.2% 10.9% BCBS Jam 14 479,463 187,939 42,230 18,638 19,454 1,346 1,125 755,194 2.9% 5.4% Feb.14 572,505 153,838 23,302 37,177 12,824 11,255 3,991 864,942 3.3% 7.S% Mar-14 554,72E 243,439 87,229 33,046 15,859 14,030 19,057 967,482 5.1% 8.5% Apr14 526,498 106,862 46,048 26,420. 17,928 10,142 9,225 743,123 5.0% 8.6% May-14 484,606 90,296 52,341 19,221 16,212 2,563 8,546 629,790 4.8% 7J% Jun-14 675,265 79,489 41,821 28,081 990 11,223 2,010 843,879 2.3% 5.6% Ju1-14 555,195 131,470 28,559 29,425 6,032 2,023 9,28E 762,490 2.3% 6.2% Aug 14 515,329 116,914 92,569 22,816 4,455 3,138 13,046 768,166 2.7% 5.7% Sep-14 469,133 28,10E 18,417 25,564 10,253 4,501 13,195 618,170 4.5% 8.7% OR-14 414,059 88,986 37,823 25,390 39,760 ))90 8,835 622,693 9.1°% 13.1% Nov-14 396,014 96,688 36,428 5,756 13,612 33,396 18,185 595,080 11.8% 12.8% Dr.14349,012 53,951 8,211 29,523 8,889 18,429 12,913 480,878 8.4% 14.5% Commercial Jan-14 658,13E 389,891 183,782 118,352 66,247 16,510 61,349 1,494,768 9.7% 17.6% Feb -14 666,80E 348,452 213,251 105,514 59,286 44,450 51,220 1,489,480 10.4% ITS% Mar 14 624,394 351,451 162,843 109,119 45,650 57,191 76,346 1,431,9M 12.5°% 20.1% Apr-14 746,645 375,265 137,998 56,690 65,927 33,805 115,032 1,531,411 14.0°% 17.7% May 14 767,338 384,267 143,725 89,932 38,825 6g583 129,422 1,614,092 14.2% 19.2% Jun-14 745,195 331,58E 98,320 75,039 44,442 40,35E 157,607 1,492,59E 16.2% 21.3% Jut 14 229,169 301,413 119,831 55,522 49,421 23,099 167,662 1,496,167 16.1°% 19.8% Aug 14 674,759 323,068 93,886 116,932 45,519 19,144 30,222 1,304,530 7.4°% 16.3% Sep 14 729,675 318,600 101,421 30,990 65,262 9,954 24,913 1,281,315 7.9°% 10.3% O,t 14 751,329 300,266 174,996 62,743 24,611 44,021 28,049 1,386,015 7.0% 11.5% Nov-14 837,730 4E2,142 126,290 98,081 5E,341 5,931 69,126 1,6E1,642 7.9°% 13.8% Dec-14 695,638 439,089 252,058 57,031 55,483 51,114 22,886 1,589,299 8.5% 12.2% Private Pay Jan 14 757,806 700,501 867,238 537,805 171,787 114,392 682,430 3,831,960 25.3% 39.3% Feb14 599,549 891,552 E82,969 818,464 365,636 168,388 E51,096 4,376,654 29.4% 48.1% Mar-14 576,651 E04,858 840,628 292,01E 1E4,062 178,577 641,208 3,408,G02 29.2% 3E.E% Apr-14 650,321 814,E23 696,431 493,941 231,403 232,E52 GSO,923 3,670,495 2E.E% 41.1°% May-14 627,481 925,25E 82E,355 639,504 501,331 237,13E E35,300 4,543,365 32.4% 46.5% Jun-14 5E5,E91 886,2E8 1,053,910 591,9E1 314,E73 238,002 674,34E 4,345,572 28.2% 41.9% Jul14509,289 919,864 94E,132 629,835 289,42E 150,54E E2E,285 4,172,380 28.0% 43.0% Aug-14 459,622 E86,256 791,223 443,668 392,4E5 15E,498 662,984 3,694,226 32.8°% 44.8% Sep 14 E45,5E3 E42,020 E40,124 36E,145 233,813 303,445 69E,695 3,834,871 32.3°% 41.9% Oct-14 258,699 788,783 716,627 315,916 197,434 145,23E 827,656 3,750,351 31.2% 39.VA Nov-14 513,562 872,796 817,915 584,882 258,320 142,900 913,195 4,103,469 32.0% 46.3% Dec-14 592,226 672,71E 780,280 446,705 244,370 101,220 826,135 3,653,653 32.0% 44.2% -3- MEMORIAL MEDICAL CENTER PATIENT ACCOUNTS RECEIVABLE DECEMBER 2014 AGED TRIAL BALANCE: CURRENT FINANCIAL CLASS SOURCE: ATB BY FINANCIAL CLASS FINANCIAL CLASS < 30 31 > 60 61 > 90 91 > 120 > 121 TOTAL MEDICARE $ 1,438,118 320,719 99,690 45,639 110,321 2,014,486 % 71.4% 15.9% 5.0% 2.3% 5.5% 22.5% MEDICAID $ 540,946 193,610 132,343 76,142 59,061 1,002,102 % 54.0% 19.3% 13.2% 7.6% 5.9% 11.2% BOBS $ 369,785 57,410 13,081 33,617 26,477 500,370 % 73.9% 11.5% 2.6% 6.7% 5.3% 5.6% COMMERCIAL $ 751,976 422,509 256,760 69,827 131,197 1,632,268 % 46.1 % 25.9%1 15.7%1 4.3% 8.0%1 18.2% PRIVATE $ 650,827 700,860 787,248 451,484 -1,217,926 3,808,344 % 17.1% 18.4% 20.7% 11.9% 32.0% 42.5% TOTAL $ 3,751,652 1,695,107 1,289.122 676,709 1,544,982 8,957,571 % 41.9% 18.9% 14.4% 7.6% 17.3% 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: GROSS DECEMBER 2013 1 JANUARY FEBRUARY MARCH APRIL MAY JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 1 53.28 1 50.12 1 51.621 52.29 1 54.20 49.76 AGED TRIAL BALANCE: ORIGINAL FINANCIAL CLASS SOURCE: ATB BY FINANCIAL CLASS FINANCIAL CLASS < 30 31 > 60 61 > 90 91 > 120 > 121 TOTAL MEDICARE $ 1,630,371 489,172 191,513 125,730 365,051 2,801,837 % 58.2% 17.5% 6.8% 4.5% 13.0% 31.3% MEDICAID $ 550,763 200,750 134,674 86,045 66,487 1,038,718 53.0% 19.3% 13.0% 8.3% 6.4% 11.6% BCBS $ 407,575 131,890 94,083 135,570 284,710 1,053,828 % 38.7% 12.5% 8.9% 12.9% 27.0% 11.8% COMMERCIAL $ 685,618 509,002 365,473 143,443 399,836 2,103,372 % 32.6%1 24.2%1 17.4%1 6.8%1 19.0%1 23.5% PRIVATE $ 477,325 364,293 503,380 185,921 428,898 1,959,817 24A% 18.6% 25.7% 9.5% 21.9% 21.9% TOTAL $ 3,751,652 1,695,107 1,289,122 676.709 1,544,982 8,957,571 41.9% 18.9% 14.4% 7.6% 17.3% 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. Qii MEMORIAL MEDICAL CENTER CAPITAL ACQUISITIONS FOR PERIOD ENDEO 12131114 I MONTHI DESCRIPTION I BUILDING IEQUIPMENT I TOTAL I WA4 IMMTRAG INTERFACE -10%DOWN PAYMENT 500 500 HOSPITAL RENOVATION 11,892 - 11,892 SU3TOTALJANUARY 11892 500 12392 - 14.137 14,137 OV14 CPSI- PAC$ IMAGE SERVER FURNITURE, WAND FLOORING BEHAVIORAL HEALTH - 12.191 12.191 PLATELET INCUBATOR & AGITATOR - 9,299 9,299 HOSPITAL RENOVATION 72,912 - 72,912 CLINIC-CIP 1,020 - 1.020 SUBTOTAL FEBRUARY 73932 35627 109559 9.472 9.472 0/14 CLINIC-CIP MEANINGFUL USE STAGE 2-10%DOWN PAYMENT - 11.595 11,596 MICROSCOPE OPTICS -OPU - 0,099 9,999 FLOOR BURNISHER- BU80020ST WALK BEHIND - 6,396 6.396 LIGHT SOURCE L9000 6,397 6.397 DOSE CAURRATORAVELL COUNTER - 7,156 7,156 CIP-INTERFACE S DIRECT MESSAGING EQUIPMENT - 4,250 4.250 P0840 VENTILATOR -PAV UPGRADE KIT - 2,080 2.080 CAST IRON WATERPIPE 7,045 7,645 RUNNING WIRE FOR PHARMACY REMODEL 890 - 806 SUB TOTAL MARCH 18015 4]8]5 65890 500 - 500 04114 FINAL INSPECTION FEE FOR PHARMACY REMODEL ACUDOSE MAINS, TOWERS &CARTS - 8,e77 8,8]] CLINIC - CIP - PROJECT MONT SELECTION 1.328 - 1.328 CLINIC-CIP- ACI DESIGN DEVELOPMENT 6.300 - 6.300 ACUDOSE SYSTEM - 327.463 327.463 SUBTOTALAPBIL 8128 336,140 344265 12.632 - 12.632 05114 CLINIC - CIP -ACI DESIGN DEVELOPMENT TSYSTEM REV CYCLE INTERFACE -10%DOWNPAYMENT - 500 50D IF SYNDROMIC SURVEILLA-MEANINGFUL USE - 5,000 5,000 INFOBUTTON- MEANINGFUL USE - 641 641 EXAM TABLES -THREE TABLES - 5,574 5,574 TELEMERY SYSTEM - 81,929 81,929 HOSPITAL RENOVATION- FINAL CONSTRUCTION FEES 30,913 - 30,913 SUB TOTAL MAY 43545 93644 137189 780 - 780 DB/14 HOSPITAL RENOVATION -ACl/OOLAND FEES REMOVAL OF OLD FENCE ON CLINIC PROPERTY 5.000 - 5,D00 CLINIC-CIP- ACI DESIGN DEVELOPMENT 29,885 - 29,866 OROTHO WORKSTATION -LAB - 5,03D 5.030 SUNRX- CLINIC INTERFACE - Q75D 6,750 SUBTOTALJUNE 35666 1178D 47446 - - 0]/14 SUBTOTALJULY 14,500 - 14.590 OW14 CLINIC - CIP - G&W ENGINEERS CLINIC - CIP- CALHOUN COUNTY -DIRT REMOVAL 1,000 - 1,000 DYNATRONICS CORPORATION- PT EQUIPMENT 1 OF 5 - 11,31D 11.310 CPSI - PITY DOC SOFTWARE - 42,097 42,O97 SUB TOTAL AUGUST 15500 53407 689D7 5,488 - 5.458 09114 GHAPELREMODEL DYNATRONICS CORPORATION- PT EQUIPMENT 2 OF 5 - 11,310 11,310 CPSI - PITY DOG SOFTWARE - 14,032 14,032 CPSVRECONDO INTERFACE -10%OOWNPAYMENT - 500 500 CLINIC-CIP- ACI PROFESSIONAL FEE 75,368 - 75,368 SUBTOTAL SEPTEMBER 60055 25843 106698 4,500 - 4,500 10114 CLINIC - CIP - ACI PROFESSIONAL FEE DYNATRONICS CORPORATION- PT EQUIPMENT 3 OF 5 - 11.310 11.310 CPSI-PHYOOCSOFTWARE - 14.032 14.032 TELEMERY SYSTEM - ADDITION - 7,100 7,100 REFERENCE LAB - 3.100 0.100 TSYSTEM REVENUE CYCLE - 4.500 4,500 NURSE CALL SYSTEM - 140.234 14D,234 SUB TOTAL OCTOBER 4500 185276 189]]6 54,346 - 54346 11114 CLINIC-CIP- ACI PROFESSIONAL FEE CLINIC-CIP- KBT CONSTRUCTION FEE 4,0]] - 4.0]] CLINIC - CIP - FOAM BOARD FOR PRESENTATION 75 75 CLINIC-CIP- K&T CONSTRUCTION FEE 104.266 - 104.266 DYNATRONICS CORPORATION- PT EQUIPMENT 4 OF 5 - 11.310 11.310 DYNATRONICS CORPORATION- ADDL PT EQUIPMENT - 3,151 3,151 CPSI-PHYDOCSOFTWARE - 14.032 14.032 SUBTOTAL NOVEMBER 162763 20494 191257 51801 - 5.807 1VU CLINIC -CIP- ACI PROFESSIONAL FEE DYNATRONICS CORPORATION- AT EQUIPMENT 5 OF 5 - 11,310 11310 WEBPTING.-PTSOFTWARE - 5.582 5,582 2014 COMPUTER UPDATE - 28.855 28.858 SUB TOTAL DECEMBER 580] 45]W 5155] TOTAL S 460604 S 864336 S 1324940 -5- " 4 3 § MO ! }(§ �§ ) /(! § ! ]\-/ ,! !a ;§ _ ` ` ° : ! ]<,§ f/;§§ (\ § § § - \ E ,!]!il.§ Mm r]»!/// \\\§ !} —6— ❑ d .-� n - m o m m o m m ry m o o m l0 d d n N w o n a ry Vl m 'n M N F N N O N °1 O N N l0 •-1 O e� m O VI VI N (D Vl N W N '-I °t % rl R n N O N O N Vl V1 ti O rl m N O OJ N O DJ M V 1n 'i 01 N O VI rl N Ol N N rl rl m N N V M eni �-1 'M'1 rl N �1 Vl N N LL O M O N N T d d °1 1D n m N N 'i vl V O n O M N O N n tD N m O M d O] rl O l0 ri n lO m m N M O N d D] d d d m n m N ei O lD O m M n �-1 V OI m N l0 C `� d N O N d d m `� T M V m n N N N •i d O N M M W (� R N rl e1 N O n 10 O M O l0 N n VI V M VI N Vl Ol N et l0 Ol N N O] N N °1 1' M OJ d 1° N I lO N O N �° N l0 m W o M vl °t M d Vl ei d O 'i T M tO O tO d N N d N O N d N rtl n �-1 O N n M Vl n N N 'i �4 m Ol N N "1 O N W W m O d j O •i N Z Ol M� d M. W t n m d d Vl tD d d l0 °1 d' a 'i N n d O c0 O n W m ut O n W O CO N d m W m ei 1D v) O N W 'i ei T n n n W N N N N l0 l0 U Q CO n N n n O M Ol vl M d ri V lD M d O W 10 N d t° m n O °� V fl V W n O VI N 'i tp N d lO T O d M ei T Ol l0 d N ei vt n N N N m O W lD Vl W N V CO d OI d l-1 dy rl f'. ul rtl °l „I N W V 'i m n N N rl d CO cl I -I ri VI Nro O fi N d N fi rl N N vl O d Ol V N m O d tD N ei tD O m N n n y al b M m W O ei N O DJ O OJ M m n N N et d % � N ei ry Q n M W N m O d n d N m N OI M N W m N N M d Ol V IO m m lD .-1 lO Ol Ol d Ol � �-1 N CO Ol m LQ N rl M Ol Vl .-I W O W M O N Ol d O ti lD Rl VI n r1 N W N m N Ol n n M lO n a-1 N '-I fi N rl Ol N n OJ Ol m O1 .-i N N N ry N ei el W O N 'J N O l0 O n O n .-I O Ol O N °t V 01 W M N n m 1(1 N M n W M M OJ rl rl 1O e1 O n n N Ol �-I OJ Vl VI W m W OI m m y O N N a-i N d CO •4 °1 Ol O ei O rl M O n OI O d O O N M m m T ti N O] N N rl VI n m O N M M N 'C .-I rt N N N M O O __ .. — d W N b W N O N O vl N W W M M M O N M O d �-1 ei ei O m n vt m C n T d m 00 N A M p N fi 'i N o r y g monoM o0 000lnmmm mmlo moa .iMd Nn d rvlom mmd�n N W O � Y❑ � Q N 'i N N rl N w a Q CO 'i rl d lO N N lD V1 O d W d N t0 N O d N m N� n N N �4 W l° O N l0 M O\ O r 1 n N V m ti n O N N W Ol Ot N Vl n °l n O W n W O l N N 14 ei � T lD n W d W n R N ti N N l° Ol m �-I rl CO Ol '1 d rl O W Ol n d N 01 N vt I m m m tD W W tp O CO N v1 N In vl Ol n .-I fl 'i n OI Ol d O ei .-I Ill w. n m n M n 10 N m N a M rl N n d IO Vl n M rl rl N O N M ll lO r VI pa-i N rl rl r1 N W O lO y LL vl IO d N n O1 W „1 O 'i n O O r1 d m Ol N OJ W vl 01 to vl O O1 n CO M n m O ul N N n M lD IO m .-i l0 O cl M y O N d N O N n d Ol M N v� N Ol d V m M OI N ei m d O O N M 10 u1 OJ d V n 'i R m O O Ol Vl VI O Y1 d O Vl CO IO N W N 1+1 n m VI N ei M N m n W �-1 °l M N rl N Ill M m a -I n d N l0 Ol m m r1 N m Vl Ol 10 m O N M OI OI l0 d d O N N M M M m OJ V 1A lO •i rl rl N m O1 rl O Ij .-I rl ei N rl �ti r1 a-1 Oi n K � ❑ u u Q p '> ° o n r 12 o h ou_ I aTo s ° m t0 w c0 C ❑ e0 ❑ m > « C ?-H' V m o z• Y O I0 .� LL i, 1-O aa6 Q ma a 2a u w "' mmvl '9 0❑ v o E� C N w n� E �a m Q R w a V F u� o o > 3 0 0° E n o o o o i« Y w- o r m °,r a�o�,rr Oz �3owmr12 mzm�i r M �r LLaoa Memorial Medical Center YTD YTD YTD 12/31/2014 _ _ Statistical Comparison 12/31/12 12/31/13 12/31/14 OVER (UNDER) % OF (12 months) (12 months) (12 months) 12/31/2013 CHANGE Total Admissions 1,256 1,086 1,324 238 21.9% ERAdmissions 734 653 921 268 41.0% Total Patient Days 5,322 4,914 5,205 291 5.9% AVERAGE DAILY CENSUS Medical/Surgical/ICU 12.20 10.02 1.25 12.4% Obstectrics 0.90 0.89 __11.27 0.91 0.02 2.2% Swing Bed 2.78 2.55 2.08 (0,47) -18.4% TOTAL AVG DAILY CENSUS 15.89 _ _ 13.46 _ 14.26 0.80 5.9% TOTAL AVG LOS-Acute care 3.70 3.89 3.60 (0.30) -7.6% Observation - Patients 156 285 468 183 64.2% _ Newborns - Births 114 123 113 (10) -8.1% MIA Clinic Visits 0 5,705 9,060 3,355 N/A Women Clinic Visits 0 0 819 819 N/A Outpatient Visits 15,782 18,906 24,139 5,233 27.7% Emergency Room Visits 10,932 10,461 10,202 (259) -2.5% Specialty Clinic Visits 5,274 5,287 5,159 (128) -2.4% Total Surgery & Endoscopy 895 1,017 1,150 133 13.1% Total Laboratory Procedures 264,836 291,818 329,020 37,202 12.7% Radiology Procedures 9,434 9,380 9,469 (232) -27.5% Bone Density 107 141 151 10 7.1% Nuclear Medicine 183 172 216 44 25.6% Ultrasound 2,205 1,786 2,284 498 27.9% CTScans 2,193 2,584 2,911 327 12.7% MRI 1,030 1,003 1,184 181 Mammograms 987 1,128 1,057 (71) _ _18.0% -6.3% Total Radiology Procedures 16,139 16,194 17,272 1,078 6.7% Respiratory Therapy lP Procedures 10,974 14,420 11,208 13,954) -35.1% Stress Test 36 52 100 48 92.3% EKG Exams 2,907 2,934 3,557 623 21.2% EEG Exams 20 11 14 3 27.3% Sleep Studies 0 0 102 102 N/A Total Respiratory 13,937 17;417 14,935 (2,482) -14.3% Physical Therapy Total 19,786 26,847 25,029 (1,818) -6.8% Pharmacy Total 147,197 124,999 115,585 (9,414) -7.5% Dietary Total 73,882 88,350 126,805 38,455 43.5% Pounds of Linen 0 0 257,432 257,432 N/A M-M VN V1 I9 tli w i9 W P T m m m h m P P' N r r O O m m b Ip V M h W U W O w m w w W J O 2 f9 W M N gym mIn eo o �om`°'n Ie� mm o a moo NCIn I- U O w w w w <wro6o�n.- F N P ^ ^ a W N (A Vi m N O N IO N O N T C m N^ .- ✓j .- w Oi 6 m Io V N a^ vOI' Ur Io P N P f J Q ei W N M �- J m W f9 W J N N K C � Hf W W t9 m \ e e e m m O '^. 0 0 O! 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N b a -- `C - U 12 m 12 W - -- U' z O O z m Payer Mix Memorial Medical Center As of December 31, 2014 Jan run rvtaicn Mpm rv,ay Jolla awry ,vug Dept va rvuv uec Medicare 40.1 43.4 43.1 45.4 40.9 39.9 38.1 42.2 41.6 43.8 45.0 43.5 Medicaid 13.9 12.7 11.4 10.4 10.8 11.0 13.5 13.3 12.4 11.5 11.6 13.3 Blue Cross 14.5 17.6 18.9 17.5 17.3 22.6 19.5 18.1 16.0 15.1 14.7 17.3 Commercial 10.8 9.7 10.5 11.0 11.7 9.4 12.1 11.9 12.0 12.4 14.8 13.0 Private 17.5 13.4 12.0 12.2 15.6 12.9 12.8 11.9 14.7 13.8 9.9 10.9 Other 3.2 3.2 4.1 3.5 3.7 4.2 4.0 2.6 3.3 3.4 4.0 2.0 Physician Revenue Trend Memorial Medical Center As of December 2014 December 2014 2014 YTD PRIOR YEAR TD Memorial Medical Center Clinic 011005 William Crowley $ 325,961 $ 5,890,827 $ 4,622,507 041743 Angela Dobbins $ 38,419 $ 169,037 $ - 009292 Charles Fillingane $ 166,828 $ 2,309,610 $ 663,780 $ 531,208 $ 8,369,473 $ 5,286,287 10% 13% 9% Memorial Women's Center 009293 Serina Danielson $ 176,040 $ 1,050,819 $ - 944200 Michael Diclemente $ - $ - $ 539,468 $ 176,040 $ 1,050,819 $ 539,468 3% 2% 1% Port Lavaca Clinic 013000 Don Paul Bunnell $ 510,154 $ 5,462,912 $ 5,395,767 050001 John Wright $ 420,459 $ 3,925,556 $ 4,081,231 019000 Ric Arroyo -Diaz $ 237,062 $ 3,485,753 $ 2,854,243 013001 Leigh Anne Falcon $ 198,153 $ 1,850,931 $ 1,618,463 008800 Nirtas Kwi Timu $ 231,503 $ 2,235,864 $ 2,117,485 001500 Jewel Lincoln $ 122,502 $ 2,022,284 $ 392,616 320001 Shanna Odonnell $ 47,594 $ 401,261 $ 387,609 012000 Jeannine Griffin $ 7,571 $ 318,978 $ 286,539 700003 Bludua/Bunnell $ - $ 27,622 $ 15,257 610000 Craig Shaffer $ - $ 3,296 $ 9,117 $ 1,774,997 $ 19,734,456 $ 17,158,327 33% 31% 30% Specialty Clinic 022000 Peter Rojas $ 153,954 $ 1,501,101 $ 1,598,002 012100 Donald Breech $ 81,648 $ 972,342 $ 878,051 000404 Ayo Ad $ 69,556 $ 905,582 $ 415,678 070002 Richard Steinberg $ 2,918 $ 134,936 $ 230,730 525225 Azhar Malik MD $ 8,213 $ 169,282 $ 134,790 900026 Benjamin Wilson $ - $ - $ 145,859 900000 Dakshesh Parikh $ 828 $ 42,063 $ 35,640 057006 A Qadri $ - $ 113 $ 115,963 $ 317,117 $ 3,725,419 $ 3,554,713 6% 6% 6% -11- Physician Revenue Trend Memorial Medical Center As of December 2014 December 2014 2014 YTD PRIOR YEAR TO Coastal Medical Clinic 011000 Tim McFarland $ 44,748 $ 769,453 $ 1,481,170 903700 Siver McFarland $ - $ 432 $ 146,983 000806 William McFarland $ 28,516 $ 28,516 $ - $ 73,264 $ 798,401 $ 1,628,152 1% 1% 3% Independent 006000 M 5 Lin $ 142,417 $ 2,424,131 $ 2,261,999 004000 G A Williams $ 18,978 $ 1,348,491 $ 1,272,665 310001 Michelle Cummins $ 114,542 $ 647,278 $ 666,754 330000 Nhi Le MD $ 4,091 $ 159,025 $ 226,907 004002 Laura Deming $ - $ 52,492 $ 126,396 $ 280,028 $ 4,631,418 $ 4,554,721 5% 7% 8% Other Medical Staff 065002 George Boozalis $ 19 $ 183,877 $ 212,381 075000 Laborator Ramos $ - $ 10,087 $ 32,999 $ 19 $ 193,964 $ 245,379 0% 0% 0% Total E/R Physicians $ 1,660,540 $ 19,144,695 $ 20,218,823 $ 1,660,540 $ 19,144,695 $ 20,218,823 31% 30% 35% Other Ordering Physicians Other Ordering Physicians $ 351,322 $ 3,497,182 $ 3,283,448 004004 Neese/Twin Foun $ 73,647 $ 620,904 $ 517,747 000359 Earnest Alsop $ - $ 125,111 $ 192,088 000080 Marcus Caughron $ - $ 25,196 $ 192,492 807077 Nilesh Patel $ 84,000 $ 715,691 $ - 800003 Bryan Kestler $ - $ 37,421 $ 93,485 900327 Dharmendr Verma $ 23,402 $ 135,458 $ 53,151 000413 Marjorie Cerny $ - $ - $ 59,309 000077 Scott Stein $ - $ 28,132 $ 68,985 900116 Sabbagh Mohamme $ 21,594 $ 42,888 $ 64,279 012102 lerr Followwill $ - $ 99,716 $ 142001 Greg Cowart $ - $ 10,017 $ $ 553,965 $ 5,337,716 $ 4,524,985 10% 8% 8% Totals $ 5,367,180 $ 62,986,361 $ 57,710,855 -12- 0 RUN DATE:01/20/15 IM-IORIAL MEDICAL CENTER TIME:17:25 CHECK REGISTER 12/01/14 TURD 12/31/14 CODE NUMBER DATE AMOUNT PAYEE A/P 000548 12/01/14 254.78 MCKESSON A/P 000549 12/01/14 1, 591. 82 MCKESSON A/P 000550 12/01/14 1,484.12 MCKESSON A/P 000551 12/02/14 6,199.04 BANK OF THE NEST A/P 000552 12/09/14 420.66 . NCKESSON A/P 000553 12/09/14 314.0 14CKESSON A/P 000554 12/09/14 523.65 MCKESSON A/P 000555 12/15/14 116.73 MCKESSON A/P 000556 12/15/14 771.13 14CRESSON AN 000557 12/15/14 457.75 IICKESSON A/P 000558 12/23/14 232.17 MCKESSON A/P 000559 12/23/14 1,007.27 MCKESSON A/P 000S60 12/23/14 435.22 MCKESSON A/P 000561 12/30/14 326.37 MCKESSON A/C 000562 12/30/14 2,248.33 MCKESSON AID ' 000563 12/30/14 896.94 MCKESSON AIM 159817 12/02/14 32,185.77 NOBLE AMERICAS ENERGY AID 159818 12/02/14 45,023.67 194C EMPLOYEE BENEFIT PLAN AIM 159819 12/02/14 8,170.00 NOVITAS SOLUTIONS - PART A A/P IS9820 12/04/14 .00 VOIDED A/P 159821 12/04/14 12,307.00 MORRIS & DICKSON CO, LLC A/P 159822 12/04/14 750.00 THE GREELEY COMPANY A/P 159823 12/04/14 104,265.99 K & T CONSTRUCTION, CO., INC. A/P 159824 12/04/14 6,299.00 TEXAS MUTUAL INSURANCE CO A/P 159825 12/11/14 2,626.58 PHILIPS HEALTHCARE A/P 159826 12/11/14 8,670.27 US FOOD SERVICE A/P 159827 12/11/14 478.66 PHARMEDIUM SERVICES LLC A/C 159828 12/11/14 3,770.50 GE HEALTHCARE AN 159829 12/11/14 18,333.34 HITACHI MEDICAL SYSTE148 A/P 159830 12/11/14 22,688.57 SUNTRUST EQUIPI•IENT FINANCE A/P 159831 12/11/14 2,079.59 CENTURION 14RDICAL PRODUCTS A/P IS9832 12/11/14 801.63 DEWITT COLN & SON A/C 159833 12/li/14 598,96 PRECISION DYNA14ICS CORP (PDC) A/P 159834 12/11/14 400.00 WILLIAM E HEIKhMP, TRUSTEE A/P 159835 12/11/14 .00 VOIDED A/P 159836 12/11/14 11,977.27 MORRIS & DICKSON CO, LLC A/P 159837 12/11/14 69.23 PLATINUM CODE A/P 159838 12/11/14 20,175.00 CPP NIOUND CARE 928,LLC A/P 159839 12/11/14 12,936.82 BKD, LIP A/C 159840 12/11/14 1,570.50 GE HEALTHCARE DEC A/P 159841 12/11/14 2,007.02 FIVE STAR STERILIZER SERVICES A/P 159842 12/11/14 3,701.77 ASI BUSINESS GROUP A/P 159843 12/11/14 233.40 STRYKER SUSTAINABILITY AIM 159844 12/11/14 600.00 V11C SIGNS, INC A/P 159845 12/11/14 63.00 MAGAW MEDICAL A/P 159846 12/11/14 679.29 MOOR CONTROL SERVICES, INC A/P 159847 12/11/14 3,165.34 NOVA BI014EDICAL A/P 159848 12/11/14 17,500.00 STUDER GROUP A/P 159849 12/11/14 80.00 PROCESSOR & CH94ICAL SERVICES A/P 159850 12/11/14 1,587.09 OIAGEN INC PAGE 1 GLCKREG -13- RUN DATE:01/20/15 JE14ORIAL MEDICAL CENTER TIME:17:25 CHECK REGISTER 12/01/14 TRES 12/31/14 BANK--CHECK------------------------------------------ CODE NUMBER DATE AMOUNT PAYEE A/P 159851 12/11/14 1,854.65 PHYSICIAN SALES & SERVICE A/P 159852 12/11/14 6,776.80 WAGEY•IORKS A/P 159853 12/11/14 2,592.00 TEXAS PEN PAGE 2 GLCKREG A/P 159854 12/11/14 657.50 14 G TRUST A/P 159855 12/11/14 425.00 SHIFTHOUND A/P 159856 12/11/14 1,944.00 TRUSTAFF A/P 159857 12/11/14 2,965.64 CST LEASING INC A/P 159858 12/11/14 634.40 DERRI HART A/P 159859 12111/14 4,750.00 RECONDO A/P 159860 12/11/14 8,097.75 ➢IAMOND HEALTHCARE WEST A/P 159861 12/11/14 116.40 GULF COAST HARDWARE / ACE A/P 159862 12/11/14 18.95 ACTION LUMBER A/P 159863 12/11/14 248,95 ANERISOURCEBERGEN DRUG CORP A/P 159864 12/11/14 2,112.93 AIRGAS-SOUTHWSST A/P 159865 12/11/14 195.15 CAREFUSION A/P 159866 12/11/14 392.00 ALPHA TIC SYSTEMS INC A/P 159867 12/11/14 2,698.63 CARDINAL HEALTH 414,LLC A/P 159868 12/11/14 MOO ANNOUNCEIIENTS PLUS TOO AGAIN A/P 159869 12/11/14 522.40 ARROW INTERNATIONAL INC A/P 159870 12/11/14 2,674.59 BAXTER HEALTHCARE CORP A/P 159871 12/11/14 10,086.03 ➢ECEILAN COULTER INC A/P 159872 12/11114 458.00 BOSTON SCIENTIFIC CORPORATION A/P 159873 12/11/14 63536 CABLE ONE A/P 159874 12/11/14 25.00 CAL C014 FEDERAL CREDIT UNION A/P 159875 12YI1114 1,304,00 CAD SOLUTIONS, INC A/P 159876 12/11/14 21.00 CALHOUN COUNTY WASTE ITGMT A/P 159877 12/11/14 142,50 CENTRAL DRUGS A/P 159878 12/11/14 5,367.78 CITY OF PORT LAVACA AID 159879 12/11/14 119.76 CONI4ED CORPORATION A/P 159880 12/11/14 1,161,07 CD11 GOVERNMENT, INC. A/P 159881 12/11/14 36,049.39 CPSI A/P 159882 12/11/14 407.43 SI124ENS HEALTHCARE DIAGNOSTICS A/P 159883 12/11/14 122.61 C R BARD, INC A/P 159884 12/11/14 335.55 DIG PAPER & PACKAGING A/P 159885 12/11/14 150.50 DYNATRONICS CORPORATION A/P 159886 12/11/14 475.00 PAU SERVICES INC A/P 159887 12/11/14 78.88 STACIE EPLEY A/P 159888 12/11/14 8.88 FEDERAL EXPRESS CORP. A/P 159889 12/11/14 9,597.93 FISHER HEALTHCARE A/P 159890 12/11/14 300.00 GULF COAST DELIVERY A/P 159891 12/11/14 224.92 GULF COAST PAPER COMPANY A/P 159892 12/11/14 300.00 GOLDEN CRESCENT RAC A/P 159893 12/11/14 3,355.85 HOLOGIC INC A/P 159894 12/11/14 153.70 INDEPENDENCE MEDICAL A/P 159895 12/11/14 2,254.67 WERFEN USA LLC A/P 159896 12/11/14 4,136.62 J & J HEALTH CARE SYSTEMS, INC A/P 159897 12/11/14 28.00 JECKER FLOOR & GLASS A/P 159898 12/11/14 1,022.70 SHIRLEY KARNEI A/P 159899 12/11/14 6,120.00 KONICA MINOLTA 14EDICAL IMAGING A/P 159900 12/11/14 89.60 CONNED LINVATEC A/P 159901 12/11/14 41.09 LOWE'S HOME CENTERS INC -14- RUN DATE:01/20/15 MEMORIAL MEDICAL CENTER TIME:17:25 CHECK REGISTER 12/01/14 THRU 12/31/14 CODE NUMBER DATE AMOUNT PAYEE PAGE 3 GLCKREG A/P 159902 12/11/14 372.93 MAKES PLUMBING PARTS A/P 159903 12/11114 181.88 MARKETLAB, INC A/P 159904 12/11114 11.99 CARRIE LYNN MARSHALL A/P 159905 12/11/14 362.43 MCKESSON MEDICAL SURGICAL INC A/P 159906 12/11/14 310.50 MMC AUXILIARY GIFT SHOP A/P 159907 12/11/14 258.52 RETLIFE A/P 159908 12/11/14 1,699.06 14ERRY X-RAY/SOURCEONE HEALTHCA A/P 159909 12/11/14 1,325.83 NEDIVATYIRS A/P 159910 12/11/14 216.10 NATIONAL BUSINESS FURNITURE A/P 159911 12/11/14 3,000.00 NUTRITION OPTIONS A/P 159912 12/11/14 .00 VOIDED A/P 159913 12/11/14 .00 VOIDED A/P 159914 12/11/14 12,658.83 OWENS & 14INOR A/P 159915 12/11/14 - -26.56 POWER ELECTRIC A/P 159916 12/11/14 500.00 RADIOLOGY UNLIMITED, PA A/P 159917 12/11/14 408.60 RECEIVABLE MANAGEMENT, INC A/P 159918 12/11/14 1,232.40 EVOQOA LATER TECHNOLOGIES LLC A/P 159919 12/11/14 198.50 SANOFI PASTEUR INC A/P 159920 12/11/14 233.52 SHERWIN WILLIAMS A/P 159921 12/11/14 79.10 SIEMENS INDUSTRY, INC A/P 159922 12/11/14 1,465.58 SIEMENS MEDICAL SOLUTIONS INC A/P 159923 12/11/14 1,000.00 SOUTHEAST TEXAS HEALTH SYS A/P 159924 12/11/14 1,238.50 SMITH & NEPHEW A/P 159925 12/11/14 8,068.00 SO TEX BLOOD & TISSUE CENTER A/P 159926 12/11/14 204.84 STRYKER SALES CORP A/P 159927 12/11/14 1,075.31 SYSCO FOOD SERVICES OF A/P IS9928 12/11/14 1,972.66 TLC STAFFING A/P IS9929 12/11/14 1,875.00 TOSHIBA AI4ERICA MEDICAL SYST. A/P 159930 12/11/14 106.08 TG A/C IS9931 12YI1114 78.88 DEBRA TR &IELL A/P 159932 12/11/14 70.13 DNIFIRST HOLDINGS A/P 159933 12/11/14 211.94 UNIFORM ADVANTAGE A/P 159934 12/11/14 5,001.71 UNIFIRST HOLDINGS INC AN 159935 12/11/14 394.49 UPS A/P 159936 12/11/14 1,000.00 US POSTAL SERVICE A/P 159937 12/11/14 310.55 VERIZON SOUTERIEST AN 159938 12/11/14 161.38 VERIZON WIRELESS A/P 159939 12/11/14 750.00 CAP14EII C. ZAPATA-ARROYO A/P 159940 12/11/14 303.00 CENTRIX GROUP A/P 159941 12/11/14 28,689.74 HEALTHSURB INSURANCE SERVICES A/P 159942 12/19/14 18.20 AGNES BUTNER A/P 159943 12/19/14 242.17 SUPERIOR HEALTH PLAN ME A/P 159944 12/19/14 51.55 TMHP A/P 159945 12/19/14 290.47 ESCALERA CYNTHIA A A/P 159946 12/19/14 183.80 MSC 410836 A/P 159947 12/19/14 10.00 OLASCUAGA FRANCES C A/P 159948 12/19/14 115.10 OLVERA ELISEO A/P 159949 12/19/14 36.03 At-DAR ROSA A/P 159950 12/19/14 188.53 WILSON CLIFTON A/P 159951 12/19/14 153.32 I7HITE GLENNA A/P 159952 12/19/14 253.80 CHARLOTTE FITZGERALD -15- RUN DATE: 01/20/15 104ORIAL MEDICAL CENTER TINE:17:25 CHECK REGISTER 12/01/14 THRU 12/31/14 BANK --CHECK--- ------------------------------------- CODE NUMBER DATE AMOUNT PAYEE 159953 12/19/14 23.83 WPS/TRICARE 159954 12/19/14 36.70 DEBORD REBECCA 159955 12/19/14 300.00 IRIZARRY VAZQUEZ ANDRE 159956 12/19/14 65.11 GASKANP WANDA 159957 12/19/14 33.67 I-]ENSKE KE14NETH 159958 12/19/14 1,216.00 SUPERIOR HEALTHPLAN 159959 12/19/14 20.13 LEONARD NORA M 159960 12/19/14 26.76 TNHP 159961 12/19/14 152.64 AETNA 159962 12/19/14 35.00 CATER DOUGLAS 159963 12/19/14 49.95 PENA THOMAS 159964 12/19/14 923.40 ROBINSON LORRAINE 159965 12/19/14 26.70 DIETRICH BETTY IS9966 12/19/14 20.00 ESCOBEDO MANUEL SR 159967 12/19/14 192.72 A•HIP 159968 12/19/14 9.18 TPHIP 159969 12/19/14 69.80 ROME TONY 159970 12/19/14 254.20 COLONIAL PEEN 159971 12/19/14 548.72 T14HP 159972 12/19/14 12.96 SANDERS LAURA 159973 12/19/14 54.29 NGUYEN THIRD THI 159974 12/19/14 50.00 REEVES LYINV 159975 12/19/14 469.80 ATTN: MSC 410836 159976 12/19/14 12.96 LEONARD NORA M 15997712/19114 241.15 T1•RiP 159978 12/19/14 241.15 TI4HP 159979 12/19/14 97.29 DAVENPORT JA14ES 159980 121l9/14 815.56 SPRINGFIELD SERVICE CEN 159981 12/19/14 20,00 RODRIGUEZ 14ELISSA 159982 12/19/14 30.00 BUTCHER TIFFANY 159983 12/19/14 249.00 HUTCHISON TOMMY LEE 159984 12/19/14 30.51 PARDO JOSE A 159985 12/19/14 252,00 TNHP 159986 12/19/14 24.58 KE11PER CAROL JEAN 159987 12/19/14 44.12 TEND 159998 12/19/14 308.18 GONZALES RANDY 159989 12/19/14 50.00 JENNINGS HEATHER 159990 12/19/14 44.71 CHEN ZHIXIAN 159991 12/19/14 88.67 MEYER KAYLA NICOLE 159992 12/19/14 200.00 NGUYEN THUY 159993 12/19/14 119.60 PERTHUIS DAVID 159994 12/19/14 50.00 LENNART TYLER 159995 12/19/14 18.20 STANGER ALFRED 159996 12/19/14 129.00 HUNT SHERRY 159997 12/19/14 10.00 PROCYK-ADA14E TIARA AN4 159998 12/19/14 42.86 BARNETT GLYNIS 159999 12/19/14 295.38 MONCADA GONDA 160000 12/19/14 254.00 GARRETT MELVIN F 160001 12/19/14 100.58 PINA-NARVAEZ LUIS 160002 12/19/14 113.70 WETTELAND BEVERLY 160003 12/19/14 51.20 LEDEZ14A JOSEFINA MARIA PAGE 4 GLCKREG -16- RUN DATE:01/20/15 104ORIAL MEDICAL CENTER TIME:17:25 CHECK REGISTER 12/01/14 THRU 12/31/14 BANK--CHECK------------------------------------------ CODE NUMBER DATE AUGUST PAYEE A/P 160004 12/19/14 27.87 SHED ANDREYI A/P 160005 12/19/14 25.00 BARBER HENRY A/P 160006 12119/14 85.00 JAMES ROSS S A/P 160007 12/19/14 48.34 BATES SCOTT A/P 160008 12/19/14 100.00 PEREZ ANTONIO A/P 160009 12/19/14 19.47 BATES SCOTT A/P 160010 12/19/14 265.25 NGUYEN HANN THI A/P 160011 12/19/14 50.00 SMITH JESSICA A/P 160012 12/19/14 173.50 DUDLEY JO ANNE A/P 160013 12/19/14 146.08 ZAMARRIPA PETER A/P 160014 12/19/14 395.00 DAVIS JEFF A/P 160015 12/19/14 50.59 SANDERS SAI4UEL R A/P 160016 12/19/14 236.35 WENSKE KE14NETH A/P 160017 12/22/14 44,433.44 M11C EMPLOYEE BENEFIT PLAN AID 160019 12/22/14 29.00 DIAMOND INSPECTIONS A/P 160019 12/22/14 119.80 DONN STRINGO A/P 160020 12/22/14 452.16 PHILIPS HEALTHCARE A/P 160021 12/22/14 181.40 ERBE USA INC SURGICAL SYST24S A/P 160022 12/22/14 280.00 CHRIS KOVAREK A/P 160023 12/22/14 12,912.25 US FOOD SERVICE A/P 160024 12/22/14 36.42 NATUS MEDICAL INC A/P 160025 12/22/14 249.55 PHARI4EDIU4 SERVICES LLC A/P 160026 12/22/14 688.81 T&R MECHANICAL A/P 160027 12/22/14 125.40 MOLESALE ELECTRIC SUPPLY A/P 160028 12/22/14 150.00 AMIERICAN COLLEGE OF A/P 160029 12/22/14 517.86 HEALTH CARE LOGISTICS INC A/P 160030 12/22/14 256.57 CENTURION MEDICAL PRODUCTS A/P 16003E 12/22/14 .00 VOIDED A/P 160032 12/22/14 1,292.72 DEVITT BOTH & SON A/P 160033 12/22/14 400.00 WILLIAM E DEMAND, TRUSTEE A/P 160034 12/22/14 783.34 GE HEALTHCARE IITS USA CORP A/P 160035 12/22/14 289.53 JASON ANGLIN A/P 16003612/22114 2,266.00 DA&E AN 160037 12/22/14 6,644.96 ALERE NORTH AMERICA INC A/P 160038 12/22/14 .00 VOIDED A/P 163039 12/22/14 .00 VOIDED A/P 160040 12/22/14 12,080.47 MORRIS & DICKSON CO, LLC A/P 160041 12/22/14 327.51 PLATINUll CODE A/P 160042 12/22/14 1,086.26 REPUBLIC SERVICES 0847 A/P 160043 12/22/14 2,955.84 LUMINANT ENERGY COMPANY LLC A/P 160044 12/22/14 2,400.00 TELE-PHYSICIANS, P.A. (TX) A/P 160045 12/22/14 257.56 CENTURYLINK A/P 160046 12/22/14 495,00 FASTHEALTH CORPORATION A/P 160047 12/22/14 1,590.00 SIGN AD, LTD. A/P 160048 12/22/14 875.00 LIFESOURCE EDUCATIONAL SRV LLC A/P 160049 12/22/14 758.67 PARAGARD DIRECT A/P 160050 12/22/14 9,579.00 TEXAS HOSPITAL ASSOCIATION A/P 160051 12/22/14 433.28 VICTORIA 14EDICAL FOUNDATION A/P 160052 12/22/14 2,127.38 LCA BANK CORPORATION A/P 160053 12/22/14 295.00 OSCAR TORRES AID 160054 12/22/14 6,781.28 CLINICAL PATHOLOGY PAGE 5 GLCKREG RUN DATE:01/20/15 i4EMORIAL MEDICAL CENTER PAGE 6 TIME:17:25 CHECK REGISTER GLCKREG 12/01/14 THRU 12/31/14 CODE NUMBER DATE AMOUNT PAYEE A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P A/P 160055 12/22/14 140.00 WAGENORKS 160056 12/22/14 2,839.19 ACl/BOLAND, INC. 160057 12/22/14 196.45 RECALL SECURE DESTRUCTION SRV 160058 12/22/14 100.00 INTEGRATED HEALTHCARE STRATEGI 160059 12/22/14 26.00 STUDER GROUP 160060 12/22/14 80.00 PROCESSOR & CHEMICAL SERVICES 160061 12/22/14 387.95 DIANE MOORE 160062 12/22/14 325.36 PHYSICIAN SALES & SERVICE 160063 12/22/14 476.57 GENESIS DIAGNOSTICS 160064 12/22/14 1,334.36 NAGEF;ORKS 160065 12/22/14 13,114.09 HUNTER PHARMACY SERVICES 160066 12/22/14 1,400.00 ACUTE CARE INC 160067 12/22/14 5,724.00 TEXAS PEN 160068 12/22/14 657.50 14 G TRUST 160069 12/22/14 2,421.95 REVCYCLE+, INC. 160070 12/22/14 2,052.00 NURSES PROFESSIONAL SERVICES 160071 12/22/14 733.50 DERRI HART 160072 12/22/14 200,00 SHERIFF DEPARTMENT MAGNETS 160073 12/22/14 539.74 THE GALLERY COLLECTION 160074 12/22/14 1,929.15 ADVANCED COi•R•MNICATIONS 160075 12/22/14 109.85 GULF COAST HARDNARE / ACE 160076 12/22/14 295.10 AMERISOURCEBERGEW DRUG CORP 160077 12/22/14 2,511.81 AIRGAS-SOUTMIEST 160078 12/22/14 477.00 ALCON LABORTORIES INC 160079 12/22/14 199.55 ALCO SALES & SERVICE CO 160080 12/22/14 205.00 APIC 160081 12/22/14 18.83 AQUA BEVERAGE COMPANY 160082 12/22/14 248.01 ARRO:.4 INTERNATIONAL INC 160083 12/22/14 100,00 TSICP 160084 12/22/14 7.07 AUTO PARTS & 11hCHINE CO. 160085 12/22/14 3,329.99 BARTER HEALTHCARE CORP 160086 12/22/14 8,907.63 BEC199N COULTER INC 160087 12/22/14 1,408.43 CABLE ONE 160088 12/22/14 25.00 CAL CON FEDERAL CREDIT UNION 160089 12/22/14 2,091.17 CHANNING L BETE CO INC 160090 12/22/14 2,482.98 CM9 GOVERNMENT, INC. 160091 12/22/14 41,155.86 CPSI 160092 12/22/14 1,253.93 SIE E14S HEALTHCARE DIAGNOSTICS 160093 12/22/14 1,012.50 RITA DAVIS 160094 12/22/14 4,217.82 FISHER HEALTHCARE 160095 12/22/14 530,00 FORT BEND SERVICES, INC 160096 12/22/14 454.73 GULF COAST PAPER COMPANY 160097 12/22/14 1,415,34 H E HUM GROCERY 160098 12/22/14 678.25 HAYES ELECTRIC SERVICE 160099 12/22/14 2,187.24 HUBERT COMPANY 160100 12/22/14 5,163.00 RICOH USA, INC. 160101 12/22/14 1,947.00 14ERFEN USA LLC 160102 12/22/14 495.44 J & J HEALTH CARE SYSTEMS, INC 160103 12/22/14 877.30 SHIRLEY KARNEI 160104 12/22/14 53.00 LABCORP OF AMERICA HOLDINGS 160105 12/22/14 190.80 LANGUAGE LINE SERVICES I". RUN DATE:01/20/15 MEMORIAL MEDICAL CENTER TIME:17:25 CHECK REGISTER 12/01/14 TURN 12/31/14 BANK--CHECK------------------------------------------ CODE NUMBER DATE AMOUNT PAYEE PAGE 7 GLCKREG A/P 160106 12/22/14 229.05 LOWE'S HOME CENTERS INC A/P 160107 12/22/14 649.82 NARKS PLUMBING PARTS A/P 160108 12/22/14 305.00 MEDELA INC A/P 160109 12/22/14 412.73 NMC AUXILIARY GIFT SHOP A/P 160110 12/22/14 1,382.86 MERRY X-RAY/SOURCEONE HEALTHCA A/P 160111 12/22/14 298.25 MICRO ASSIST, INC A/P 160112 12/22/14 555.42 14EDIVATORS A/P 160113 12/22/14 3,750.00 NUTRITION OPTIONS A/P 160114 12/22/14 .00 VOIDED A/P 160115 12/22/14 1,611.16 OP7F.NS & MINOR A/P 160116 12/22/14 44.00 PALACIOS BEACON A/P 160117 12/22/14 3,950.00 PREMIER SLEEP DISORDERS CENTER A/P 160118 12/22/14 66.51 POWER ELECTRIC A/P 160119 12/22/14 364.70 CULLIGAN OF VICTORIA A/P l6012O 12/22/14 37.50 RED HAWK UP 160121 12/22/14 70.00 RADIOLOGY UNLIMITED, PA A/P 160122 12M/14 26.00 SHIP SHUTTLE TAXI SERVICE A/P 160123 12/22/14 1,000.00 SOUTHEAST TEXAS HEALTH SYS A/P l60124 12/22/14 4,079.00 SO TEX BLOOD & TISSUE CENTER A/P 160125 12/22/14 340.00 STANFORD VACUUM SERVICE A/P 160126 12/22/14 906.67 SYSCO FOOD SERVICES OF A/P 160127 12/22/14 904.10 STERICYCLE, INC A/P 160128 12/22/14 3,033.74 TLC STAFFING A/P l60129 12/22/14 600.00 TARHC A/P 160130 12/22/14 137.90 TEXAS WIRE➢ MUSIC INC A/P 160131 12/22/14 129.53 IG A/P 160132 12/22/14 4,107.00 T-SYSTEM, INC A/P 160133 12/22/14 221.79 UNIFIRST HOLDINGS A/P 160134 12/22/14 .00 VOIDED A/P 16013E 12/22/14 8,939.69 UNIFIRST HOLDINGS INC A/P l60136 12/22/14 1,000.00 US POSTAL SERVICE A/P 160137 12/22/14 942.53 VERIZON SOUTH19ST A/P l60138 12/22/14 940.94 THE VICTORIA ADVOCATE A/P 160139 12/22/14 640.00 VICTORIA RADIOWRKS, LTD A/P 160146 12/22/14 364.30 GRAINGER A/P 160141 12/22/14 364.84 MCCLAIN JI194Y A/P 160142 12/22/14 23.67 14EZA 14ARIBEL TOTALS: 851,450.79 -19- RUN DATE:01120/15 MEMORIAL MEDICAL CENTER PAGE 8 TINE:17:25 CHECK REGISTER GLCKREG 12/01/14 TURD 12/31/14 CODE NUMBER DATE ICP 011638 12/30/14 ICP 011639 12/30/14 ICP 011640 12/30/14 ICP 011641 12/30114 ICP 011642 12/30/14 ICP 011643 12/30/14 ICP 011644 12/30/14 ICP 011645 12/30/14 ICP 011646 12/30/14 ICP 011647 12/30/14 ICP 011648 12/30/14 TOTALS: f?Aiilift 46.73 .00 6,895.78 22,612.92 540.60 143.61 98.98 186. 58 1,093.49 99,97 872.70 32.591.36 PAYEE NAU-SHONG LIN, N.D. PORT LAVACA CLINIC ASSOC, PA MEMORIAL MEDICAL CENTER MEMORIAL 14EDICAL CENTER HEM PHARMACY PORT LAVACA ANESTHESIA LLC VICTORIA PROFESSIONAL 14EDICAL GEORGE A OSUCHUKWU, 14. D. PORT LAVACA CLINIC ASSOC, PA RADIOLOGY UNLIMITED PA REGIONAL EMPLOYEE ASSISTANCE -20- RUN DATE: 01/20/15 1040RIAL MEDICAL CENTER PAGE 9 TI1(E:17:25 CHECK REGISTER GLCKREG 12/01/14 THRU 12/31/14 CODE 04BER DATE AMOUNT PAYEE PR- 061727 12/05/14 524.07 PAY-P.11/14/14 11/27/14 PR- 061728 12/08/14 304.29 PAY-P.11/28/14 11/27/14 PR- 061729 12/18/14 1,774.78 PAY-P.11/28/14 12/11/14 PR- 061730 12/18/14 1,678.73 PAY-P.11128/14 12/11/14 PR- 061731 12/18/14 466.55 PAY-P.11/28/14 12/11/14 PR-' 061732 12/22/14 276.88 PAY-P.11/28/14 12/11/14 PR- 99999912/04/14 467,641.72 TOTALS: 472,667.02 _21_ RUN DATE: 01/22/15 ME14ORIAL MEDICAL CENTER PAGE 1 TIME: 08:39 DEFAULT FORI4AT FROM DBO19 PRTitle PRDeptName REGISTERED NURSE EMERGENCY ROOM DEPARTMENTAL ASSIST 14AINTENANCE CS TECHNICIAN CENTRAL SUPPLY CENTRAL STERILE TECH SURGERY PURCHASING SUPERVISR CENTRAL SUPPLY SHIFT SUPERVISOR DIETARY IP/EH/RM NURSE INFECTION PREVENTION REGISTERED NURSE MED/SURG FOOD SERVICE STAFF DIETARY 0 R AIDE SURGERY REGISTERED NURSE EMERGENCY ROOM TRAUMA COORDINATOR EMERGENCY ROOM RN-PERIOPERATIVE SURGERY SHIFT SUPERVISOR-AFf ENVIRONMENTAL SERVICES MANAGER-SURGERY-OPC SURGERY PAYROLL CLERK ACCOUNTING REGISTERED NURSE MED/SURG LICENSED VOCATIONAL OBSTETRICS LICENSED VOCATIONAL MED/SURG REGISTERED NURSE OBSTETRICS REGISTERED NURSE EMERGENCY ROOM DIRECTOR OF INPT SVC MED/SURG REGISTERED NURSE OBSTETRICS LICENSED VOCATIONAL MED/SURG ADMINIST ASSISTANT ADMINISTRATION REGISTERED NURSE EMERGENCY ROOM REGISTERED NURSE ICU PRE-AD14ISSION NURSE SURGERY REGISTERED NURSE ICU REGISTERED NURSE SPECIALTY CLINIC LICENSED VOCATIONAL SURGERY REGISTERED NURSE EMERGENCY ROOM RADIOLOGICAL TECH DIAGNOSTIC IMAGING RADIOLOGICAL TECH DIAGNOSTIC I14AGING MICRO PPP LABORATORY MEDICAL LAB TECH LABORATORY LAB DIRECTOR LABORATORY LAB ASSISTANT LABORATORY MEDICAL LAB TECH LABORATORY LAB SECRETARY LABORATORY MEDICAL TECHNOLOGIST LABORATORY REGISTERED NURSE EMERGENCY ROOM PT TECH II PHYSICAL THERAPY REGISTERED NURSE MED/SURG TRANSCRIPTIONIST-RIC HEALTH INFORMATION MANAGEMENT REGISTERED NURSE OBSTETRICS REGISTERED NURSE OBSTETRICS ED MANAGER EMERGENCY ROOM REGISTERED NURSE MED/SURG REGISTERED NURSE OBSTETRICS REGISTERED NURSE OBSTETRICS CNO-DIRECTOR OF QA QUALITY ASSURANCE REGISTERED NURSE SURGERY REGISTERED NURSE MED/SURG PRTotGross {b `CQ yo, b � ¢1. �U /'/ 4680.66 2439.15 2067.12 2840.23 2244.00 2202.29 5578.46 2773.25 1517.28 1560.82 851.79 4559.90 1059.04 2036.76 6555.70 3478.70 7425.69 3071.74 3298.83 3565.40 5925.57 5947.64 4730.66 2133.19 3395.40 360.50 5423.52 3164.86 6060.30 5946.91 3509.01 4424.80 5143.58 484.21 924.50 366.75 5419.00 3504.54 4024.14 2275.55 3677.36 3966.40 2117.73 2981.75 1991.71 5015.79 4573.95 6098.80 1572,75 394.69 3773.85 6680.20 5214.48 3576,08 -22- RUN DATE: 01/22/15 MEMORIAL MEDICAL CENTER TIME: 08:39 DEFAULT FORMAT FROM DB019 PRTitle PRDeptName PRTotGross -------------------------------------------------------------------- LICENSED VOCATIONAL MED/SURG 1351,88 PRACT ADMINISTRATOR MEMORIAL MEDICAL CLINIC 7219.00 REGISTERED NURSE ICU 4846.36 MEDICAL LAB TECH LABORATORY 344.88 LICENSED VOCATIONAL MED/SURG 409.13 SUPERVISOR LVN/RPhT PHARMACY 3077.69 REGISTERED NURSE MED/SURG 1816.63 CASE MANAGER/UR/DP UTILIZATION REVIEW 3988.59 REGISTERED NURSE MED/SURG 4071.86 REGISTERED NURSE MED/SURG 5389,30 CERTIFIED NURSE AIDE MED/SURG 1503.21 REGISTERED NURSE MED/SURG 5460.64 LICENSED VOCATIONAL NED/SURG 2214.13 REGISTERED NURSE MED/SURG 1993.25 REGISTERED NURSE MED/SURG 5744.56 REGISTERED NURSE MED/SURG 1952.00 REGISTERED NURSE MED/SURG 2696.50 REGISTERED NURSE OBSTETRICS 6461.19 CERTIFIED NURSE AIDE MED/SURG 1644.74 REGISTERED NURSE MED/SURG 4336.44 REGISTERED NURSE ICU 1983.31 REGISTERED NURSE EMERGENCY ROOM 3968.15 REGISTERED NURSE MED/SURG 3199.01 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 2112.38 LICENSED VOCATIONAL MED/SURG 690.63 REGISTERED NURSE OBSTETRICS 372.25 REGISTERED NURSE B14ERGENCY ROOM 4651,90 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 2344.40 CERTIFIED NURSE AIDE MED/SURG 1246.65 CERTIFIED NURSE AIDE MED/SURG 2729.56 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 2779.09 CERTIFIED NURSE AIDE ME➢/SURG 1718.18 REGISTERED NURSE MED/SURG 1645.25 REGISTERED NURSE ICU 24.00 REGISTERED NURSE ICU 4094.09 REGISTERED NURSE EMERGENCY ROOM 5406.54 REGISTERED NURSE ICU 2912.45 REGISTERED NURSE ICU 4228.06 REGISTERED NURSE ICU 3943.12 REGISTERED NURSE ICU 6149.30 REGISTERED NURSE ICU 5027.62 RN -OR SCRUB NURSE SURGERY 4297.43 REGISTERED NURSE SURGERY 5358.71 0 R TECH SURGERY 2736.13 REGISTERED NURSE SURGERY 5310.09 OUT -PT PACO NURSE SURGERY 2585.82 PRESCRIPTION CLERK INDIGENT CARE PROGRAM 1773.23 PURCHASINGBUYCOURIER TRANSPORTATION 1767.43 COURIER -CS TECH TRANSPORTATION 730.00 OP COORDINATOR SPECIALTY CLINIC 2079.00 REGISTERED NURSE EMERGENCY ROOM 2983.57 UNIT SECRETARY MED/SURG 1810.22 REGISTERED 14URSE EMERGENCY ROOM 4438.79 REGISTERED NURSE EMERGENCY R0014 2211.84 MT TECH SUPERVISOR LABORATORY 4142.79 PAGE 2 -23- RUN DATE: 01/22/15 ME140RIAL MEDICAL CENTER TIME: 08:39 DEFAULT FORMAT FROM DB019 PRTitle PRDeptName PRTotGross -------------------------------------------------------------------- MEDICAL TECHNOLOGIST LABORATORY 3633.60 REGISTERED NURSE MED/SURG 3905.28 MEDICAL LAB TECH LABORATORY 3454.75 MEDICAL LAB TECH LABORATORY 3429.97 LABORATORY ASSISTANT LABORATORY 300.75 LABORATORY ASSISTANT LABORATORY 748.88 LAB ASSISTANT LABORATORY 2157.61 MEDICAL TECHNOLOGIST LABORATORY 581.88 MEDICAL TECHNOLOGIST LABORATORY 776.50 LAB ASSISTANT LABORATORY 906.50 LAB ASSISTANT LABORATORY 2163.53 MEDICAL LAB TECH LABORATORY 3265.00 MEDICAL TECHNOLOGIST LABORATORY 124.00 MEDICAL LAB TECH LABORATORY 4061.68 LAB ASSISTANT LABORATORY 2675.79 REGISTERED NURSE MED/SURG 908.00 LICENSED VOCATIONAL MED/SURG 226.13 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 2050.34 REGISTERED NURSE EMERGENCY R00M 4382.95 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 5369.86 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 411.75 RECEPT/SECRETARY DIAGNOSTIC IMAGING 1974.70 DIRECTOR DIAGNOSTIC IMAGING 6321,54 DIAG IMAG SUPERVISOR DIAGNOSTIC IMAGING 6460.75 RADIOLOGY TECH DIAGNOSTIC IMAGING 5890.75 RADIOLOGICAL TECH DIAGNOSTIC I14AGING 3295.93 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 4117.92 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 3633.88 RADIOLOGY TECH DIAGNOSTIC IMAGING 405.00 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 3064.29 REGIST PHARMACY TECH PHARMACY 2178.81 LVN-CHG-CHART AUDITR PHARMACY 2884.15 REGIST PHARMACY TECH PHARMACY 2958.74 REGISTERED Ph TECH PHARMACY 1913.75 INSURANCE FU CLERK MEMORIAL MEDICAL CLINIC 2025.15 RECEPT/MEDICAL ASST MEMORIAL MEDICAL CLINIC 1845,79 MEDICAL ASSISTANT MEMORIAL MEDICAL CLINIC 530.71 INSURANCE FU CLERK MEMORIAL MEDICAL CLINIC 2128.18 RECEPTIONIST-OPERATR MEMORIAL MEDICAL CLINIC 1603.01 PHYSICIAN ASSISTANT MEMORIAL MEDICAL CLINIC 7566.40 SECRETARY/RECEPTION IE140RIAL MEDICAL CLINIC 526.69 RECEPTIONIST/OPERATR MEMORIAL MEDICAL CLINIC 1572.94 PT ASSISTANT PHYSICAL THERAPY 3443.52 PT ASSISTANT PHYSICAL THERAPY 3985.23 PT SECRETARY PHYSICAL THERAPY 1835.07 DIRECTOR OF PT PHYSICAL THERAPY 7783.80 PHYSICAL THERAPIST PHYSICAL THERAPY 7576.25 PT OPERATION MANAGER PHYSICAL THERAPY 7561.20 PT TECH 1 PHYSICAL THERAPY 835.25 CERTIFIED NURSE AIDE MED/SURG 1654.62 THERAPIST BEHAVIORAL HEALTH 3846.15 CIHCP COORDINATOR INDIGENT CARE PROGRP14 1728.00 BR -ER CODING SPCLST HEALTH INFORMATION MANAGEMENT 2030.23 IMAGING TECH -CLERK HEALTH INFORMATION MANAGEMENT 1435.00 IMAGING TECH/CLERK HEALTH INFORMATION MANAGEMENT 82.65 PAGE 3 -24- RUN DATE: 01/22/15 MEMORIAL MEDICAL CENTER TIME: 08:39 DEFAULT FORMAT FROM DBO19 PRTitle PRDeptName PRTotGross -------------------------------------------------------------------- OP CODER/DC ANALYST HEALTH INFORMATION MANAGEMENT 2479.71 TRANSCRIPTIONIST HEALTH INFORMATION MANAGEMENT 2597,30 ROI / RI TECHNICIAN HEALTH INFORMATION MANAGEMENT 1468.56 ES AIDE ENVIRONMENTAL SERVICES 857.28 FOOD SERVICE STAFF DIETARY 1477.84 FOOD SERVICE STAFF DIETARY 1640.24 SHIFT SUPERVISOR DIETARY 1788.33 FOOD SERVICE STAFF DIETARY 1604.28 FOOD SERVICE STAFF DIETARY 1647,50 FOOD SERVICE STAFF DIETARY 1584.56 FOOD SERVICE STAFF DIETARY 1470.88 DIRECTOR OF DIETARY DIETARY 3641.80 GROUNDSKEEPER-PAINTR MAINTENANCE 2096.00 SECURITY OFFICER SECURITY 670.94 BIO-MED TECHNICIAN BIO MEDICAL ENGINEERING 255.00 BIO-NED TECHNICIAN BID MEDICAL ENGINEERING 4359.40 SUPERVISOR MAINTENANCE 3651.57 SECURITY SUPERVISOR SECURITY 2328.76 FLOOR TECHNICIAN ENVIRONMENTAL SERVICES 1842.93 ES MANAGER ENVIRONMENTAL SERVICES 3215.65 DIE OF PLANT SERVICE MAINTENANCE 5840.40 ES AIDE ENVIRONMENTAL SERVICES 1934.21 ES AIDE ENVIRONMENTAL SERVICES 2189.25 ES AIDE ENVIRONMENTAL SERVICES 1951.54 ES AIDE ENVIRONMENTAL SERVICES 1343.90 ES AIDE ENVIRONMENTAL SERVICES 1512.25 ES AIDE ENVIRONMENTAL SERVICES 1792.58 CERTIFIED NURSE AIDE MED/SURG 1724.80 ES AIDE ENVIRONMENTAL SERVICES 1079.49 ES AIDE ENVIRONMENTAL SERVICES 2162.53 FLOOR TECHNICIAN ENVIRONMENTAL SERVICES 620.32 ES AIDE ENVIRONMENTAL SERVICES 1498.34 SECURITY OFFICER SECURITY 1758.00 PLANT OPS SPECIALIST 1AINTENANCE 3216.00 INSURANCE ADJUDICATR MEMORIAL MEDICAL CLINIC 1724.22 OFFICE MANAGER MEMORIAL WOMEN'S CENTER 2295.18 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 1701.96 INSURANCE COORDINATE PATIENT FINANCIAL SERVICES 1941.92 CASHIER -SWITCHBOARD PATIENT FINANCIAL SERVICES 1688.49 SECRETARY/RECEPTION ME140RIAL MEDICAL CLINIC 1932.81 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 1562.56 TEAM LEADER PATIENT FINANCIAL SERVICES 2331.00 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 2152.55 PFS DIRECTOR PATIENT FINANCIAL SERVICES 3204.20 REGISTRATION CLERK PFS - REGISTRATION 1137.44 REGISTERED NURSE EMERGENCY ROOM 838.57 INSURANCE COORDINATE PATIENT FINANCIAL SERVICES 1612.00 PT TECHNICIAN PHYSICAL THERAPY 1504.80 CLINICAL IT SPECIALI ADMINISTRATION -CLINICAL SERVIC 4085.72 REGISTRATION CLERK PFS - REGISTRATION 1071.59 SECURITY OFFICER SECURITY 2021.18 TEAM LEADER PATIENT FINANCIAL SERVICES 2336.25 DIRECTOR OF HIM HEALTH INFORMATION MANAGEMENT 2817.80 SELF PAY CLERK PATIENT FINANCIAL SERVICES 1554.64 REGISTRATION CLERK PEG - REGISTRATION 1565.5E PAGE 4 -25- RUN DATE: 01/22/15 MEMORIAL MEDICAL CENTER PAGE 5 TIME: 08:39 DEFAULT FORMAT FROM DH019 PRTitle PRDeptName MEDICARE COORDINATOR PATIENT FINANCIAL SERVICES REGISTERED NURSE EMERGENCY ROOM RADIOLOGICAL TECH DIAGNOSTIC IMAGING REGISTRATION CLERK PFS - REGISTRATION REGISTRATION CLERK PFS - REGISTRATION I.T. DIRECTOR INFORMATION TECHNOLOGY IT SYSTEM ANALYST INFORMATION TECHNOLOGY REGISTERED NURSE EMERGENCY ROOM ACCOUNTANT ACCOUNTING C.F.O. ADMINISTRATION ASSIST ADMINISTRATOR ADMINISTRATION C.E.O. ADMINISTRATION ADMIN ASST TO AA-CNO ADMINISTRATION -CLINICAL SERVIC SPEC PROJECTS COOED ADMINISTRATION Grand totals Total lines = 233 PRTotGross 2136.14 3364.74 3847.06 1611.97 1532.78 5611.80 4308.56 5307.22 3968.60 12751.20 10119.16 13923.84 2220.61 2606.00 694523.03 -26- (DINS Source 'Totals Report Issued 01/13/15 Calhoun Indigent Health Care 12-1-14 through 12-31-14 For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 13,484.30 3,235.59 01-2 Physician Services -Anesthesia 1,645.00 169.69 02 Prescription Drugs 1,274.84 1,274.84 05 Lab/x-ray 460.00 64.42 08 Rural Health Clinics 2,036.00 1,233.44 11 Reimbursements -46.36 -46.36 13 Mmc - Inpatient Hospital 39,700.48 19,453.24 14 Mmc - Hospital Outpatient 43,919.00 14,932.46 15 Mmc - Er Bills 2,964.00 1,007.76 Expenditures 106,052.04 41,939.86 Reimb/Adjustments -614.78 -614.78 Grand Total 105,437.26 41,325.08 Fiscal Year $693,655.94 Payroll/Expenses $6,225.89 Credit from Medicaid $8,307.52 Calhoun County Indigent Care Coordinator —27— 2013 Calhoun Indigent Care Patient Caseload Approved Denied Removed Active Pending Jan 5 12 5 55 28 Feb 4 22 7 51 26 Mar 5 17 3 56 17 Apr 6 10 4 59 21 May 4 12 6 58 28 Jun 4 10 10 53 41 Jul 5 20 12 46 35 Aug 2 17 4 46 25 Sept 0 6 5 42 31 Oct 5 15 2 43 24 Nov 4 14 3 46 6 Dec 2 5 8 39 29 YTD 46 160 69 594 311 Monthly Avg 4 13 6 50 26 2014 Calhoun Indigent Care Patient Caseload Approved Denied Removed Active Pending Jan 2 8 6 37 34 Feb 3 8 0 41 35 Mar 5 0 8 43 32 Apr 3 1 1 43 33 May 4 11 4 43 32 Jun 10 5 1 47 Jul 3 12 4 49 33 Aug 5 10 3 50 35 Sept 7 9 3 49 32 Oct 5 3 2 51 29 Nov 4 2 2 54 36 Dec 2 6 5 53 38 YTD 53 75 39 560 369 Monthly Avg 4 6 3 47 31 -28- 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 3 11 3 40 17 Jun 10 12 5 46 15 Jul 6 15 5 48 22 Aug 10 21 1 59 20 Sept 5 17 4 59 19 Oct 7 18 5 61 34 Nov 4 15 9 57 30 Dec 4 23 7 54 32 YTD 59 190 49 574 250 Monthly Avg 5 16 4 48 21 -29- CONSIDER AND TAKE NECESSARY ACTION ON RESOLUTION REGARDING RURAL COUNTY MEDICAID WAIVER AND AUTHORIZE COUNTY JUDGE TO SEND LETTER TO TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES: Judge Pfeifer stated the resolution would read "Rural County Medicaid Waiver. Whereas Calhoun County Commissioners' Court has determined that additional long term care beds would benefit the citizens of Calhoun County. Now, therefore, be it resolved that Calhoun County Commissioners' Court notify the Texas Department of Aging and Disability Services of its intent to obtain and verify its eligibility for a Rural County Medicaid Waiver to provide an additional 120 beds for the Long Term care needs of the residents of Calhoun County." Paul Swacina, representative of Port Lavaca Nursing and Rehab, stated they have gone through the process of attempting to determine the demographic needs of the county with regard to additional nursing home beds. According to their research, there is substantial growth in the area and there is a need for additional Medicaid beds. Mr. Swacina stated they are asking the Commissioners' Court to send a letter to Texas Department of Aging and Disability Services (TDADS) to request a Rural County Waiver. Calhoun County is a county that qualifies under the Rural County Waiver proposal. It has less than 100,000 people, it has one Medicaid facility which they are currently operating, and so it is eligible. He stated he has spoken with TDADS and no other County has applied this year. There are a total of 500 beds available and Mr. Swacina requested that the County send a notification to TDADS, based on the resolution, requesting verification that the County is eligible. He further stated that once that comes back, the process of a hearing before Commissioners' Court is initiated and a proposal of projects be made. The Commissioners' Court will have an opportunity to confirm the need, choose one of the projects, and make a recommendation to TDADS that the project move forward increasing the number of Medicaid beds for residents of Calhoun County by another 120. Commissioner Galvan made a motion to authorize the County Judge to send a letter to Texas Department of Aging and Disability Services on a resolution regarding a Rural County Medicaid Waiver. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. m W Q FM Z D 0 V J Q D Q H a LU W O Z 0 F O N N 0 C O C 0 N N C J 0 q £ C £ 19 o a u Z' U Q p C O you u W N j C 3v u C C N " 0 U c V v oCp g J OEE E C 0 C W o " E o m E Z J ? 3 O V N W p e0 m c N y e c v 0 y o N N uull II'"' N C y0 C o;�9 3s A Z V O n U a V f �8�� dR a�boF �Va� �la`.�b7ydun 9v¢p 0 °°_E?>enty3>`'3:3.i38€5Y9" �_ 3' O �b x x° .... 4 a ab° 1 O CL 21 .ayj U-1 s s a XL 8 dO a ma G£ .gn�F9z N i J3 E Taa.j ,�gsz" e M •�€ t om �b a, PR > jea v ba.pg a p `oF o C.0 ,G b aga do . ji "a gus 42n jig g°� Rg '0: y lg&.�. 8 ¢F '•ao H I la 2 MPP M a s U A N L LJ z 0 0 Z Z O z V U LU H. LL 00 C) LU O LU H 0 U LU Z 0 to t1 0 _ W � z 0 z 00 W F- LL 0 W J 0 it 2 H M. r Z W a W �wSTATe oFFFi' O 4.11 dddP�I.rEddd� Calhoun County judge V= 211 S. Ann Street, Suite 301 - fort Lavaca, Texas 77979 (361) 553-4600 ry Fax (361) 553-44..44 - Email: mike.pfeifer@calhounco€:x.org February 12, 2015 Mr. Bobby Schmidt Regulatory Services E-342 Texas Department of Aging and Disability Services P.O. Box 149030 Austin TX 78714-9030 Re: Rural County Waiver for Calhoun County Dear Mr. Schmidt, Please accept this letter as notification from the Calhoun County Commissioners' Court of its intent to consider a Rural County Waiver. On behalf of the Calhoun County Commissioners' Court, I am requesting verification from the Texas Department of Aging and Disability Services that Calhoun County complies with the statutory definition of "rural county." If you need additional information, please contact my office. Thank you for your consideration of our request. Sincerely, Michael J. Pfeifer Calhoun County Judge MJP/sr www.cafhouncoix.org WHEREAS, Calhoun County Commissioners' Court has determined that additional Long Term care beds would benefit the citizens of Calhoun County; NOW THEREFORE, BE IT RESOLVED: that the Calhoun County Commissioners' Court notify the Texas Department of Aging and Disability Services of its intent to obtain and verify its eligibility for a Rural County Medicaid Waiver to provide an additional 120 beds for the Long Term care needs of the residents of Calhoun County. SIGNED AND SEALED this the 121h day of February, 2015. Commissioner, Precinct 2 ATTEST: Anna Goodman By: Josie Sampson, Deputy % MigdiadJ. Pfeifer alhoun County Judge ,quoaf-,Z�-a Neil/E. Fritsch Commissioner, Precinct 3 Kenneth W. Finster Commissioner, Precinct 4 r'l Starr County Request for Comments and Proposals: Additional Medicaid Beds Department of Aging and Disability Services (DADS) rule 40 TAC §19.2322(h)(7) permits the County Commissioners Court of a rural county with a population of less than 100,000 and no more than two Medicaid -certified nursing facilities to request that DADS contract for additional Medicaid nursing facility beds in that county. This may be done without regard to the occupancy rate of available beds in the county. The Starr County Commissioners Court is considering requesting that DADS contract for additional Medicaid nursing facility beds in Starr . County. The Commissioners Court is soliciting public input and com- ments on whether the request should be made. Further, the Commis- sioners Court seeks omoosals from Qualified persons or entities inter - County If you wish to make comments in this regard or if you wish to make a proposal to the Commissioners Court, these comments and/or pro- posals must be submitted in writing on or before April 10, 2014, to the Starr County Judge's office at 100 N. FM 3167, Rio Grande City, Texas 78582. TRD-201400416 Becky L. Venecla Secretary Starr County Filed: January 31, 2014 0 Texas Department of Transportation Aviation Division - Request for Qualifications for Professional Architectural/Engineering Services Presidia County, through its agent, the Texas Departmenf of Trans- portation (TxDOT), intends to engage an Aviation Professional Engi- neering Firm for services pursuant to Chapter 2254, Subchapter A, of the Government Code, TxDOT Aviation Division will solicit and re- ceive qualifications for professional aviation engineering design ser- vices for the current project as described below. Current Project: Presidio County; TxDOT CSJ No.: 1424MARFA. Scope: Provide engineering/design services to: 1. Mill, overlay and mark RW 13-31 and 'Taxiway from RW 31 to Terminal. Apron 2. Reconstruct & Expand Terminal Apron 3. Rehabilitate TW A 4. Replace MIRL and Signs RW 13-31 5. Install PAPI-2 RW 13-31 The HUB goal for the design ofthe curremproject is 6%. The goal will be re -set for the construction phase. TxDOT Project Manager is Ryan Hindman. The following is a listing of proposed projects at the Marfa Municipal Airport during the course of the next five years through multiple grants. Future scope work items for engineering/design services within the next five years may include the following: Rehabilitate and mark RW 4-22; rehabilitate and mark TW and Apron; construct additional apron, hangar; hangar access TW; parking lot; airport access road and drainage improvements. Presidia County reserves the right to determine which of the above scope of services may or may not be awarded to the successful firm and to initiate additional procurement action for any of the services above. To assist in your qualification statement preparation the criteria, 5010 drawing, project diagram, and most recent Airport Layout Plan are available online at http://www.t cdot.gov/inside-txdot/division/avi- ation/projectsJunal by selecting "Marta Municipal Airport." The qualification statement should address a technical approach for the current scope only. Firms shall use page 4, Recent Airport Experience, to list relevant past projects for both current and future scope. Interested fines shall utilize the latest version of Form AVN-550, ti- tled "Qualifications for Aviation ArchitecturaVEngineering Services." The form may be requested from TxDOT, Aviation Division, 125 E. LOT (74568). The form may be emailed by request or downloaded from the TxDOT web site at http://www.txdot.gov/inside-txdot/divi- sion/aviation/projects.himl. The form may not be altered in any way. All printing most be in black on white paper, except for the optional il- lustration page. Firms most carefully follow the instructions provided on each page of the form. Qualifications shall not exceed thenumber of pages in the AVN-550 template. The AVN-550 consists of eight 8 1/2" x I I" pages of data plus one optional illustration page. The optional illustration page shall be no larger than 11"x 17" and may be folded to an 8 1/2" x I I" size. A prime provider may only submit one AVN-550. If a prime provider submits more than one AVN-550, that provider will he disqualified. AVN-550s shall be stapled but not bound or folded in any other fashion. AVN-550s WILL NOT BE ACCEPTED IN ANY OTHER FORMAT. ATTENTION: To ensure utilization of the latest version of FormAVN- 550, firms are encouraged to download Form AVN-550 from the Tx - DOT website as addressed above. Utilization of Form AVN-550 from a previous download may not be the exact same format. Form AVN-550 is a PDF Template. Please note; Seven completed copies of Form AVN-550 must be received by Tx - DOT, Aviation Division at 150 East Riverside Drive, 5th Floor, South Tower, Austin, Texas 78704 no later than March 11, 2014, 4:00 p.m. (CDST). Electronic facsimiles or forms sent by email will not be ac- cepted. Please mark the envelope of the forms to the attention of Kelle Chancey. The consultant selection committee will be composed of local govern- ment members. The final selection by the committee will generally be made following the completion of review of AVN-550s. The commit- tee will review all AVN-550s and rate and rank each. The Evaluation Criteria for Engineering Qualifications can be found at http://www.tx- dot.gov/inside-txdotidivision/aviation/piojects.html under the Notice to Consultants link. All firms will be notified and the top rated firm will be contacted to begin fee negotiations. The selection committee does, however, reserve the right to conduct interviews for the top rated firms if the committee deems it necessary. If interviews are conducted, selection will be made following interviews. Please contact TxDOT Aviation for any technical or procedural ques- tions at 1-800.68-PILOT (74568). For procedural questions, please contact Relic Chancey, Grant Manager. Fortechnical questions, please contact Ryan Hindman, Project Manager. TRD-201400450 17V ADDITION February 14, 2014 39 TexReg 1031 Starr County Town Crier Feb. 5, 2014 1eApea •Aa b'+FumYRslt `ANF"F.wv Nun 'Aa Bt FumrBNt Cfl%V t4me� A!m arose. 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L T.73deII1R TemT6]£2 x r Undated Pronerh• Tax Information Susan Riley From: Paul Swacina <pswacina@regencyhealthcare.com> Sent: Wednesday, February 04, 2015 11:11 AM To: 'Susan Riley' Cc: Judge Pfeifer; 'Shannon Salyer'; Jessie Rodriguez Subject: RE: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 Attachments: Star County Public Notices.PDF Susan I was just going to call you about that. It's up to you, but we probably should draft a resolution, something along the lines of: Resolved: that the Calhoun County Commissioner's Court notify the Texas Department of Aging and Disability Services of its intent to obtain and verify its eligibility for a Rural County Medicaid Waiver to provide an additional 120 beds for the Long Term care needs of the residents of Calhoun County. Or something along those lines. I have confirmed that there have been no other requests for a rural county waiver this year. The notice letter should be sent to Bobby Schmidt not Joe Armstrong I have also attached a copy of the notices that were used in Star County after TDADS verifies the county's eligibility to pursue the rural county waiver and puts it on the agenda some months down the line. From: Susan Riley [maiito:susan.riley@calhouncotx.org] Sent: Wednesday, February 04, 2015 9:55 AM To: Paul Swacina Cc: Judge Pfeifer Subject: RE: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 Mr. Swacina, Will you be sending a resolution for the agenda next week? Or is the letter the only item for the agenda? Susan Susan Riley Administrative Assistant to Calhoun County Judge Michael J. Pfeifer and Commissioners' Court 361-553-4600 Phone 361-553-4444 Fax From: Paul Swacina [maiito:pswacina@regencvhealthcare.com] Sent: Friday, January 30, 2015 9:43 AM To:'Susan Riley' Subject: RE: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 Here is a copy of the letter that I will be preparing that TDADS has provided, that was submitted by Tyler County From: Susan Riley fmailto:susan.rilev@calhouncotx.orgI Sent: Friday, January 30, 2015 9:29 AM To: Paul Swacina Subject: RE: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 I've got it, Paul! Looking forward to working with you on the Program. Susan Susan Riley Administrative Assistant to Calhoun County Judge Michael J. Pfeifer and Commissioners' Court 361-553-4600 Phone 361-553-4444 Fax From: Paul Swacina fmailto:pswacina@regencyhealthcare.com] Sent: Friday, January 30, 2015 9:20 AM To: 'susan.riley@calhouncotx.org' Cc: 'Shannon Salyer'; Debra K. Rossi; Donna Conti Subject: RE: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 Here is another try, hope I have the dots right! From: Paul Swacina Sent: Friday, January 30, 2015 8:52 AM To: 'susan.riley@calhoun.co.tx.org' Cc: 'Shannon Salyer'; Debra K. Rossi; Donna Conti Subject: Calhoun County Rural Medicaid Waiver- Feb. 12, 2015 Susan: Please confirm that you have received this email Paul Swacina 101 W. Goodwin Ave. Suite 520 Victoria, Texas, 77901 SBOT# 19542700 Direct: (361)894-0184 Office: (361) 580-2400 Mobile: (361)774-7801 Fax: (361) 580-2402 Office email: pswacina@regencvhealthcare.com Personal email: pswacina@rnct.com Board Certified Medical Malpractice Specialist * American Board of Professional Liability Attorneys Board Certified Civil Trial Specialist * National Board of Trial Advocacy Board Certified Personal Injury Trial Law * Texas Board of Legal Specialization Fellow: American College of Board Certified Attorneys STATEMENT OF CONFIDENTIALITY: This email is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521 and is legally privileged. The comments in and attached to this message are intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering communication, viewing is strictly prohibited. If you have received this communication in error, please notify the Law Office of Paul J. Swacina, LLC.. immediately by telephone at 361-580-2400 or by return electronic transmission to (pswacina@rnct.com) and then immediately delete this transmission, including all attachments, without copying, distributing or disclosing same. £ • • Countyjud, - August 17, 2012 Joe Armstrong Regulatory Services E-342 Texas Department of Aging and Disability Services P. 0. Box 149030 Austin, Texas 78714-9030 RE: Rural County Waiver for Tyler County Dear Mr. Armstrong: Please accept this letter as notification from the Tyler County Commissioners Court of its intent to consider a Rural County Waiver. On behalf of the Tyler County Commissioners Court, I am requesting verification from the Texas Department of Aging and Disability Services that Tyler County complies with the statutory definition of "rural county." If you need any further information, please contact me. Thank you for your consideration of our request. Respectfully, Oacques Blanchette JLB/amp HEAR AND ACCEPT ANNUAL REPORT FROM THE CALHOUN COUNTY HISTORICAL COMMISSION: Mary Belle Meitzen, Chair of the Calhoun County Historical Commission, addressed the Court and stated the Commission has spent about $4,000. Ms. Meitzen presented the summary of a report she completed for the Guadalupe Victoria Chapter National Society Daughters of the American Revolution. Ms. Meitzen gave a review of the activities of the group in regard to education and preservation. Ms. Meitzen said the focus for 2015 will be to re -vamp publicity, reaching out to the audience, targeting families and targeting Indianola and the activities that took place there. She stated the Calhoun County Museum completely re -worked their displays for Texas Archaeology Month. Displays focused on home life and farm and ranching life during early Texana days. There were also arts and crafts of the past. There was a blacksmith demonstration which was very successful. There were four historical markers dedicated, each one targeting a different audience and each one had 100 or 100+ people attending. The Chihuahua Trail dedication brought in people from Fort Davis and Brackettvil le. On Juneteenth, the Sgt. William H. Barnes marker was dedicated. There was a speaker and an exhibit. Sgt. Barnes actually died at Indianola and we think he was the first Black federal soldier to receive a Medal of Honor in the Civil War. The WWII exhibit was on Memorial Day with the City of Port Lavaca and the American Legion, this was a joint effort. Mary Beth Rabenaldt whose family was displaced during WWII when Camp Indianola was set up was a speaker. Judge Gallemore Hartzog was honored and the featured speaker was Jerry Patterson of the General Land Office. Ms. Meitzen stated she received a note from Mr. Patterson stating how much he enjoyed the day and that it was one of the best, well-rounded activities that he had ever attended. The following markers were received and will or have been installed: the Camel Corps, Port O'Connor Cemetery, Martin DeLeon, Sunlight Girls and Dr. Edward Knipling. Dedication ceremonies for each will be coming up. The jail bricks were moved to an indoor location for preservation until use in the new county museum. The Lavaca Bombardment Silhouette was installed at the Bayfront Peninsula. The Half Moon Lighthouse was repaired and painted and was featured on a two-hour PBS program. The County Fair exhibit was excellent. Programs have been presented to several organizations including Texas Retired Teachers, Alcoa Retirees, Daughters of the Republic of Texas and United Daughters of the Confederacy. Volunteer service hours total 3,403 @ $22.57 per hour, with a total of $76,805.71 in county monies saved. Ms. Meitzen stated the Commission also has a Facebook page. Ms. Meitzen stated Texas Independence Day will be celebrated with a reading on March 3, 2015 at noon at the County Museum. This is a brown bag lunch. Judge Pfeifer asked what the Commission plans to do with the jail house bricks. Ms. Meitzen stated they fall under Jan Regan with the new museum. Commissioner Finster asked about the old wooden phone booths that were in the Courthouse. Ms. Meitzen stated one is at the museum. Calhoun County Historical Commission Officers 2015 Chairman: Mary Belle Meitzen mmeitzen@cableone.net Vice Chairman: Jonathan Kassner Secretary: Walter Spiller Treasurer: Gary Ralston Appointed: Marker Chair: Gary Ralston Parliamentarian: George Anne Cormier Sgt. Of Arms: Florine Windham Clif Baccus jnkassn@cableone.net walterspiller@cableone.net gary@indianolatx.com gary@indianolatx.com director@calhouncountymuseum.org flodwin@msn.com cliftonbaccus@msn.com Susan Riley From: JOHN MEITZEN <mmeitzen@cableone.net> Sent: Wednesday, January 14, 2015 4:08 PM To: Susan Riley Cc: Thomae Sue; Gary Ralston; John Kassner; Phil Thomae Subject: End of year report Attachments: CCHC 2014 Summary.docx Hello, Attached is a condensed version of the end of year report for the Calhoun County Historical Commission to be sent to Commissioners Court on January 22, 2015. Sue Thomae will be sending you the 2015 List of Commission Members and Addresses. The new officers will be elected on January 27,2015 after the 2015 Historical Commission list has been accepted. The officers will appear on the first Commissioners Court meeting agenda in February. Hopefully, I will have the 15 page Texas Historical Commission End of Year Report competed in time for attachment to the January 22 agenda. Thank you, Mary Belle Meitzen Calhoun County Historical Commission 2014 Compiled by Mary Belle Meitzen, Chair Historical Preservation and Education highlighted the 2014 activities of the Calhoun County Historical Commission appointees. Student centered historical education included Calhoun County third graders touring the historic Port Lavaca Cemetery, Ranger Cemetery, and the Civil War Half Moon Reef Lighthouse. Seventh grade Texas history students were targeted with the Calhoun County Historical Scavenger hunt which used computers, phones, and hand on activities to solve puzzles in the scavenger hunt. The Texas Historical Commission Texas Archeology Month was celebrated two October weekends with the Calhoun County Museum featuring "Crafts of the Past" and "Blacksmithing." Youth also attended the four Historical Marker dedications. Each dedication targeted a different out of town audience and averaged one hundred at each dedication. The marker dedications for 2014 included: Chihuahua Trail, Sgt. William Henry Barnes, Calhoun County Participation WWII, and Judge Howard Gilmore Hartzog. Chihuahua Trail featured the active trail crew. Sgt. William Barnes, a black Federal soldier who received the Medal of Honor during Civil War, was dedicated on Juneteenth with help from Calhoun County Citizens in Action. The WWII marker dedication was held within the Memorial Day Celebration of the American Legion and City of Port Lavaca. Judge Howard Gilmore Hartzog's featured speaker was General Land Office Jerry Patterson with participation from the Daughters of the American Revolution. The following markers were received and will or have been installed: Camel Corps, Port O Connor Cemetery, Martin DeLeon, SunLight Girls, and Dr. Edward Knipling. Stiernberg Cemetery was recorded and preserved. Deed research was completed on Little Mary's grave. Mission Refugio was the research title for the 2014 Marker Story. This mission was the last mission established. After seven years, it was moved to Refugio. The historic jail bricks were moved to an indoor location for preservation until use for the new county museum. The Lavaca Bombardment Silhouette was purchased and installed at the Port Lavaca Bayfront Peninsula, close to the original battery which defended the town from two Federal warships which attacked Lavaca on October 31, 1862. The Silhouette ownership, approved by Commissioners Court was transferred to the City of Port Lavaca. Members of the Daughters of Confederacy and Sons of the Confederacy Dixie Grays attended the transfer ceremony. Civil War Half Moon Lighthouse outside was repaired and painted. It was featured on PBS two hour program. The Commission participated with a County Fair Educational display. These pictures will be mounted at a Magnolia Beach Kiosk to educate the public. Members also presented power point programs to the Rotary Club, Texas Retired Teachers, Alcoa Retirees, Model T Club Victoria, Daughters of the Republic of Texas and United Daughters of the Confederacy. A small group of about sixteen volunteers complete and attend the Calhoun County Historical Commission activities. On November 11, 2014, the Commission had volunteered over 3,403 hours @$22.57, giving a total of $76,805.71 county monies saved. Additional activities and photos may be found on calhouncountyhc.com or Indianola, Tx.com. The Commission also has a Facebook page, along with the Calhoun County Museum 2014 CHC Annual Report #38 C OMtxL lT Collector: Web Link 1 (Web Link) Started: Monday, January 19, 2015 9:27:21 AM Last Modified: Tuesday, February 03, 2015 5:53:53 AM Time Spent: Over a week IP Address: 174.126.220.136 � Please enter the name of your county. Calhoun Q"; Enter your primary CHC contact below as requested. List a co-chair if one exists; to clarify, we do not consider vice-presidents to be co -Chairs. Name of 2014 CHC chair Mary Belle Meitzen Name of 2015 CHC chair --comment if new chair not Mary Belle Meitzen selected to date Enter information if you have an official space, room, or building; please DO NOT ENTER a personal address or phone number. Address of CHC office 202 S. Ann Suite A, Port Lavaca, Texas 77979 We will direct inquiries about reporting answers to the person who fills out this report unless you direct us otherwise. Enter contact information as requested --name, email address, and phone number. Contact info for person filling out report =m r Mary Meitzen,mmeitzen@cableone.net, 361-552-5931 )s_s: How many volunteer hours were contributed to CHC meetings, projects, and programs in 2014? Please enter numbers only for your answer; do not use symbols or text. If you do not keep track of hours, enter an approximate number of hours. Enter the number "0" if your CHC is inactive. Volunteer hours 3403 Provide the number of individuals appointed to your CHC in 2014. Please enter numbers only for your answer; do not use symbols or text; a comma is considered a symbol. # of CHC appointees 36 c..'O Provide any comments/clarifications about the volunteer hours you entered above. Please skip this question if you have no comments/clarifications. Although the Commission has 36 members, the majority of the hours are compiled by 16 members who enjoy" working and preserving in the field". Both the secretary and chairman feel the hours are under reported. 1 119 2014 CHC Annual Report t) s Indicate the number of full commission meetings your CHC hold in 2014. Indicate the number of CHC committee meetings held separate and apart from full commission meetings.Both questions must be answered using numbers only; do not use symbols or text. Enter the number "0" in both boxes, if your CHC was inactive in 2014 (i.e., did not provide services to the county,) CHC full commission meetings in 2014 10 CHC committee meetings in 2014 '19 �9You must have a majority of appointees present to constitute a QUORUM. Check the circle next to the percentage that best reflects how often a QUORUM was present for your full commission meetings in 2014. Clicking a circle places a check the circle; clicking again will uncheck the circle. 100% of full commission meetings had a quorum $�.'3-(!En h. }E. "Iona!d.}.Eai 5 ie I7na[t a 't"Pi}j;I�Y[Efs ) f H ir: Check the percentage that best reflects the number of CHC members who have completed Open Meetings/Records training. Who/what is the repository for CHC money? Check each answer that applies to your CHC. 1-25% of our CHC appointees have taken Open Meetings training County treasury 2/19 2014 CHC Annual Report `__ Enter the amount of money provided to your CHC next to each line item. Use numbers for the DOLLAR amount; please round down/up to the nearest dollar when necessary. Do not use symbols or text; commas and decimals are considered to be symbols.Each box requires an amount; enter the number "0" if no monies are associated with the line item. Balance carried over from 2013: Annual county allocation for 2014 (not including money 4003 for museums): County money allotted for museums in 2014: 0 Any other money issued by county during 2014 (one- 0 time amount for a special project, etc.): CHC fundraising proceeds (events, book sales, etc.) 0 during 2014: Grant money provided to CHC in 2014: 1500 Partner/nonprofit money donations made it) 2014: 400 "Membership" dues (though not recommended, some 0 CHCs do request dues): Any other money amounts for 2014 not already 288 included above; do not include CHC appointee out-of- pocket expenses, which will be requested later in the report: Provide any comments/clarifications about the above amounts. Please skip this question if you have no comments/clarifications. Trull Foundation gave a $1,000 grant to be used for the Lavaca Artillery Silhouette. Formosa Plastics Trust Fund gave $400.00 for the Historical Scavenger Hunt. Members and Coastal Plains Exploration contributed $400 for Scavenger Hunt. Donations were received from UDC, DIRT, DAR, Chamber of Commerce, Camel Corps, Marker Dedications and Christmas party guests. The Commission has memorial Savings which have built up over the years. These monies help support preservation activities and pay a part time employee entering former commission chair George Fred Rhoades research files at the CC Museum. In reality, the Commission total outflow was $6,334.37. __ ,<, If your county employs an individual as a CHC liaison or as some other support position, please let us know if their salary comes out of the CHC county allocation or from some other budgetary line item. Also, let us know what responsibilities have been assigned to this individual. This information is frequently requested by CHCs. The County Judge's secretary posts the Historical Commission on the Commissioners Court agenda as part of her job with the County Judge. 3/19 2014 CHC Annual Report Check each of the IN -KIND DONATIONS that was given to your CHC in 2014 by your COUNTY (county government),IN-KIND donations are goods and/or services provided to your organization at no charge. ,'in Check each of the IN -KIND DONATIONS that was given to your CHC in 20'14 by individuals or organizations (other than your COUNTY). Include in - kind donations made by CHC appointees. "'in Y ,k :.i� dBdrr F£.'ENi Meeting and/or office space for CHC, Space for a CHC sponsored exhibit (history, projects, photographs, etc.) Utilities associated with any spaces mentioned above Exterior maintenance or heavy equipment, Project/event supplies and/or equipment, Administrative supplies or services --postage, paper, ink, copier, etc. Assistance from county staff --posting meetings, financial reports, legal consultations, etc. Professional expertise of county staff (for any subject/need) Meeting and/or office space for CHC, Exterior maintenance or heavy equipment, Project/event supplies and/or equipment, Administrative supplies or services --postage, paper, ink, copier, etc. Computer hardware or software, Internet access, Marketing/graphic design/creative professional services Professional services of a historian, Professional services of an archeologist ` Considering the IN -KIND answers checked in $1,000 - $2,500 the previous questions, check the dollar range that best represents the amount of in -kind services and donations provided to your CHC. 4/19 2014 CHC Annual Report ,;, ? V, Check the dollar range that best represents the $550 - $1,000 amount of out-of-pocket expenses incurred by your CHC appointees in 2014. A work plan defines project tasks, Updated annually participants, time estimates, and a schedule. Check the option that best reflects how often is your CHC work plan updated. G Check each of the parties who participates in CHC chair, CHC officers, CHC appointees your CHC planning process. ov ..:,i, PMN 4i, ..t �_'y !z .,., fi 3>*vt i4E flSl er E$- ro X9..31 3 j Check the statement that best reflects your No survey but CHC keeps inventories of county county's involvement with survey work. Please historic properties reread the survey description above to ensure that you are providing an accurate answer. (,rs:' If you have a historic and cultural resources Electronic format in Word or similar type of survey, check the formats that apply to your survey. software ::� a sari �, .,e;u� b 1rtE if' is i i .•r c' {:-;.a�i'+ak 3Y9�: £tt Check the box if your CHC keeps track of the A list of ENDANGERED cultural and historic specified information. resources in your county A list of cultural and historic resources DEMOLISHED in 2014 :_ `.s r Enter your county name and the names and locations of the endangered resources in your county --properties under threat of demolition, that are structurally unstable, that are in areas of encroachment, etc. Please skip this question if your CHC does not keep this information. Calhoun County: Bindewald Cemetery, 506 S. Virginia Indianola Home, Green Lake '1861 Federal Civil War' Camp Sites, Indianola Federal Headquarters, Camp Sites, ramparts & cemeteries,1926 La Salle Monument, Matagorda Lighthouse, Matagorda Island Confederate Civil War ramparts, 303 Randle 1906 Rasmussen House, 1920 Quick Freezing Plant, WWII Camp Indianola, Green Lake Native American Burial/hidden Sites 5/19 2014 CHC Annual Report Enter your county name and the names and locations of the cultural and historic resources demolished in your county in 2014. Skip this question if your CHC doesn't keep this information. Calhoun County: Built before 1899, George Town Addition, Grace Montier Rogers' Home located at 206 N. Commerce. Built with square nails; has below ground cistern for catching rain water. New owner verbally agreed to save the oyster shell concrete cistern. House continues to be demolished. The Magnolia Beach/ Indianola beaches continue to erode, moving closer to the La Salle Monument and the two Indianola oyster shell cisterns. Lots have been sold and a road bulldozed through the Indianola Federal ramparts. Matagorda Light House needs repainting due to rust. 'F�.' a It' i�1+•� ,➢ �, ,. _:R + •St ,�§i,� ixk�$Il et, tt'n'a'` a <ek _/ (4: ?3P°k3 il;2a_}� 6/19 2014 CHC Annual Report _: Check the work items in which your CHC was Reviewed applications for historical MARKERS, actively involved during 2014. Maintain an inventory of subject MARKERS in your county Periodically assess the condition of subject MARKERS in your county Cleaned or repaired MARKERS, Provided an inventory of subject MARKERS for public use (brochure, website posting, etc.) Maintain an inventory of properties that are DESIGNATED by Texas or the Secretary of the Interior as historic (i.e., National Register, Historic Texas Cemetery, Recorded Texas Historic Landmark, or State Archeological Landmark) Periodically assess the condition of properties DESIGNATED by Texas or the Secretary of the Interior as historic Provided an inventory of properties that are DESIGNATED as historic for public use (brochure, website posting, etc.) Maintain an inventory of CEMETERIES in your county Periodically assess the condition of CEMETERIES in your county Cleaned or repaired objects in CEMETERIES, Provided an inventory of CEMETERIES for public use (brochure, website posting, etc.) Maintain an inventory of CEMETERY ORGANIZATIONS in your county Compared THC's current inventory of ROSENWALD schools with your county inventory 7/19 2014 CHC Annual Report a,i 1, `,�I,s t - , , '�iIl'? { 3 .ra .... srd3 _.- =�E�. i� .P�ItckP ,� • .gyp, 4 a -. rJ'.:� < Check the box next to each work item in which Identified and/or researched areas of your CHC was actively involved during 2014. development within your county that could impact cultural and historic resources Identified and/or researched historic highways, roads, and trails in your county Identified and/or researched historic farms and ranches in your county Identified and/or researched historic bridges and/or bridge types in your county Identified and/or researched waterways, dams, irrigation districts, etc. in your county Identified and/or researched parks and/or open spaces Other work involving countywide cultural landscape themes: There is ongoing research every time a member drives through our county .Water erosion, private, and industrial development along three sides of the county peninsula endangers cultural and historic locations, monuments, and cemeteries. Three members are farmers and ranchers with sixth generation ties who orally list historic farms and ranches. An archeology steward has traced and follows the Chihuahua Trail from Indianola . German wagon trails, early rail beds destroyed by hurricanes,and Civil War bridges have been located on old maps and explored. Tx Dot contacted the commission and the Steward cleared the area for a new bridge. The Causeway was listed in a Post 45 Bridge Mitigation. As mentioned, CCHC is a Green Lake Stake Holder with Calhoun County and helped to obtain a National Park Service Grant for the lake . There is a small Texas State Park which holds the La Salle Statue and the Camel Silhouette. Every known county cemetery has been added to Find A Grave. Two members research and add additional photographs every year so the cemeteries are up to date. 8/19 2014 CHC Annual Report Check the box next to each work item in which Researched or pursued repair for a historic your CHC was actively involved during 2014. school complex/campus Other work involving specific cultural landscapes: One member is developing a Calhoun County School portfolio book. She is obtaining a list of individuals for interviews. The closed Wilkins School is a Rosenwald School. A second marker was placed on its property honoring the Sunlight Girls Club. The county is south of the El Camino Real; instead the LaSalle Odyssey, a tour of the museum artifacts, and the La Salle monument are explained to visitors. There is not a public plaza in our county. Instead, the City of Port Lavaca is developing a bay front peninsula. The historical commission purchased and deeded a Lavaca Bombardment Silhouette to be placed on the peninsula. Provide a list of the different landscapes that were involved in your 2014 body of work. A sample response to this request would be if Kaufman CHC noted that they pursued funding to maintain and promote interpretation of the Kaufman County Poor Farm. Calhoun County has two lighthouses. 'The Commission owns the Half Moon Reef Lighthouse, which was darkened during the Civil War. This year the Lighthouse was assessed and repaired after third grade tours. From goggle earth, we assessed The Matagorda Lighthouse which has rusted from Salt Air and requires painting. The National Aransas Wildlife Refuge was contacted and is working to obtain funding for the repairs. After the Texas Parks and Wildlife ferry burned, there is no public transport to the island. The commission has recorded the three cemeteries on the island at an earlier trip provided by the National Aransas Wildlife Refuge. X3.;t. How familiar is your CHC with the following topics? The role a CHC can have in a federal Section 106 Somewhat review The Secretary of the Interior's Standards for the Somewhat Treatment of Historic Properties The Certified Local Government Program Very THC's review authority over publicly -owned historic Minimally property 9/19 2014 CHC Annual Report � 311 Check the box next to each of the comments CHC participated as a consulting party in a that apply to your CHIC's 2014 body of work. federal Section 106 undertaking review Tell us more about your CHC's involvement in the areas checked above. Skip commenting if no boxes are checked. There is no zoning in Calhoun County. However, both the City of Port Lavaca and the County Commissioners have worked with the Commission to preserve historic and cultural areas. Calhoun County has purchased the largest natural fresh water lake in Texas with a grant from the National Park Service. The historical commission chair wrote a letter of recommendation supporting the purchase. Commission members have completed an on line assessment for park use. At a public meeting, the chair asked for information on the Antiquity study. The THC had provided an earlier antiquity study which listed only a few Indian sites. The caretaker who lived on the site recorded several additional areas to be evaluated. The Greenlake area is the site for the 1861 Federal Exodus. Earlier, when asked for help to identify camp grounds, the THC Military Aide could not provide us with a Civil War antiquities contact. The National Park representative explained the antiquity study would only be the area required for development. The disturbance of the Indian and Civil War artifacts over the area is a concern when the park is open for public use. "L+ii wgitiv' o';L'§'v aiiun pl2m i')r eya: 5_ e_a5at 3: Imple€:w `olicies and ince n ives (coniinned) Check the box if the statement applies to your CHC. If your CHIC has a role, please enter the name of your county and explain the extent of your review authority for COUNTY historic tax exemptions or incentives. Currently, the county does not offer tax exemptions for historic properties. Please offer training sessions to commissions. :erEti+t f�fc,. ��u#=, kYs f. ; ;.3'f P €,. ..3 d ss,it `: I s xf rns3: i..:3n rai3s €°C_tl F�f@;)9 ns)F➢i''s➢E'I' if3r 1'6�; e e 3 Bs?pi 10/19 2014 CHC Annual Report Check the box for each work item in which Promoted historic and cultural sites to develop your CHC was actively involved in 2014. and sustain heritage tourism initiatives Secured private grant money to fund or partially fund a CHC project Tell us a bit more about your CHC's involvement in the areas you have checked above. Through advertisement with 3 newspapers,THC site,face-book, CCHC developed historical tourism through its 4 marker dedications, Lavaca Bombardment Silhouette, which also received $1,000grant, and Historical Scavenger Hunt, which received $900. The City of Port Lavaca is responsible for the hotel/motel tax. A new economic development coordinator and city manager are in the process of being hired. The chair plans to bring the advantages of a Main Street Program to them. 0:14 List the public entities or private organizations that have provided grants or funding opportunities for your preservation projects. Skip this question if it does not apply to your CHC. Trull Foundation, Formosa Plastics, Russell Cain Real Estate ( storage for old jail bricks), Coastal Plains Exploration ;'s: i-earn .'ikIf €.itpt 11/19 2014 CHC Annual Report Check the box for each work item in which your CHC was actively involved in 2014. Provided educational events/presentations/information on historic preservation and local history to audiences outside your CHC Provided educational events/presentations/information on historic preservation and local history geared toward youth/schools Initiated projects to diversify interpretation of historic and cultural resources Participated in a regional preservation or tourism event (Texas Archeology Month event, Preservation Month event, history conference, cultural heritage festival, etc.) Provided tours of other historic buildings and/or sites within the county CHC appointees volunteered at a historic site that is open to the public at large List events in which your CHC was involved that are associated with boxes checked above. Provide details for selected activities in the Project Description section at the end of this report. Educational presentations to: United Daughters of Confederacy, Daughters of the Republic of Texas, Daughters of the American Revolution , Victoria Genealogical Society, 2 separate presentations for Rotary Club, Alcoa Retirees, Texas Retired Teachers, Marker Dedications: WWII, Judge Hartzog, Chihuahua Trail, Sgt. William Bryant Junior Historians:Two period costumed members guided 200 students through Historic Ranger Cemetery, Half Moon Reef Lighthouse, and CC Museum. For Texas Archeology Month, CCMuseum presented "Steppin Back in the Past", Blacksmithing" Historic Tours: Civil War Joe D. Brett Home to Daughters of the Confederacy and Victoria Antique Car Club Diversification: Participated in Calhoun County Fair with booth, held "Certified Paleo Hunter" scavenger hunt for 7th graders, Designed Magnolia Beach Kiosk featuring Historical Markers in the Indianola area. Attended Texas Independence Day Refugio, Texas 1 +P ' `5's ,'x 'vide Pi, In 6" t „il r,. =t3n9 w r_ omloct t'r, servatiY €P W", Rel"Oed 12/19 2014 CHC Annual Report it: Partnering is more than just attending meetings of other organizations. Effective partnerships build a stronger and more diverse preservation community.Check each of the individuals and organizations with which your CHC partnered during 2014. <: Check the boxes that reflect your CHC's role with museums. County officials, City officials, Local law enforcement, Local businesses, Educational institutions (school districts, community colleges, universities) Libraries, Museums, Cemetery organizations, Archeology organizations, Texas Archeology Stewardship Network (work with the stewards) Tourism organizations / visitors bureau / chambers of commerce / downtown business association Other nonprofit organizations not already listed above (societies, associations, etc.) CHC appointees volunteer with museum/s -' Enter your county name and provide the name and location for each of the museums your CHC operates. Please skip this question if your CHC does riot operate museums. The Calhoun County Museum ,301 S. Ann, Port Lavaca, is funded by the county in a separate line item. The director is a member of the Historical Commission and gives a report each month. The commission and museum director work hand in hand. There has been an excellent Civil War, Indianola, Matagorda Light House, Native American display along with Marker dedication Judge Hartzog memorabilia. The museum purchased the materials for the hands on Texas Archeology Month celebration. The chairman attended in period costume. The museum had a scavenger hunt for 7th graders and participated in the final ceremony. When considering your overall workload, 1-25% of CHC time spent on museum related check the range that applies to your CHC. work F+ 13/19 2014 CHC Annual Report C,i4 R' Check each way your CHC officially reported Presented summary of 2014 accomplishments to 2014 activities to your county officials, county commissioners court in late 2014/early 2015 tE.fe.a Check the elected officials that your CHC regularly invited to events and activities in 2014. Presented to county commissioners court about a particular project/s Attended county commissioners court regularly, Met with the county judge, Met with county commissioners, Submitted a CHC budget, Submitted CHC treasury reports, Submitted CHC bylaws, Provided suggested CHC appointments County judge, County commissioners, Mayor/s of cities in your county, City council members from cities within your county School board members, Law enforcement officials, State legislators, U.S. legislators Please enter your county name and the names of elected officials who attended one or more of your CHC events in 2014. Skip this question if no elected officials attended your events. Calhoun County Judge Michael Pfeifer, Commissioner Roger Galvan, CC District Attorney Dan Heard, CC Ass.District Attorney Shannon Salyer, Mayor Jack Whitlow, City Manager Bob Turner, Sheriff George Aleman, CC Librarian Naomi Cruz, City Council Jim Ward, City Council Rosie Padron, Coastal & Marine Agent Rhonda Cummins, CC Navigation District J.C. Melcher, CC School Board Steve Marwitz, Invited & received proclamations from: Representative Geanie Morrision, Todd Hunter, Honorable Blake Farenthold '.O? =i, o. . a7s 3-t , s" ` :rsV734i4oi.+s Pt. ?s 91 se:6ilr7€.tki 14 / 19 2014 CHC Annual Report Check the activities and communications Issued information to the public at large -- undertaken by your CHC in 2014 in support of Texas newsletters, email, press releases, etc. history and preservation. Submitted articles and/or letters to media outlets, Invited key decision -makers to celebratory preservation events Wrote letters/email to state legislators, Wrote letters/email to federal legislators V , ,.r, a1 +f. ai`d 4 ha r'Ir<4k Ft 1, ,.c3.> .. 34 i i.LPii 3 _fit ,.ae r) ! i:F a It, e£.i'f `rl'. 369 3aii t3 k5n dif4 Check all of the ways in which your CHC tried to build up appointees in 2014. Nimchzdmu ,tom t n .,'day :at3f i:s; [r i' r,[ iri'.• 'st .., s. 'k*f'suntt om, rmiawy tmws You ,tavf( 4_3 !! o*1 `s 10',,e-• s. ip i th i{6Pzk t F k x F3p PSF ar, +1¢.ti3p` Provided educational presentations for your CHC appointees Used the THC website information to educate appointees Used the CHC Handbook to educate appointees frespondvw nkq)j)vd this quoNf)I t:;tr?. _ List workshops that your CHC hosted in 2014, including information on the educational topic.Please skip if the question does riot apply to your CHC. Calhoun County will be happy to host a workshop for this area. k° =.t f •'�. E „i's ,>°R i f s j$If It.itkQt? t sak3=..€nFE?-tr 15/19 2014 CHC Annual Report '. Reflecting 2014 activity, enter the number of CHC appointees that attended the training or a training offered by the organization listed. Please use numbers only; do not use text or symbols. THC regional workshop 0 THC marker workshop 2 THC cemetery workshop 0 rHC oral history workshop 0 THC Archeology Steward workshop/training 3 THC/Friends of the THC grant writing workshop 0 THC/Texas Archeology Month event 4 THC/Texas Association of Museums (TAM) 0 Texas Heritage Trails Program 0 Texas Main Street Program 0 Texas Association of Museums (other than THC 0 partnered training listed above) Texas Archeological Society (TAS) 3 Texas State Historical Association (TSHA) 0 American Association for State and Local History 0 (AASLH) National Trust for Historic, Preservation conference 0 Preservation Texas (PT) event 0 Preserve America workshop 0 Local/regional historical association educational 14 opportunity Any other history -related opportunity that was offered 6 locally/regionally sg s :? fF,A I''fr :-, ,ze •;a is Ua`s ,r� �a ofAtl tc-fi Rank the degree to which select THC services have helped your CHC expand their programming. CHC listsery weekly messages Helped a little General THC website information Helped a lot THC website information specific to CHCs Helped a lot Historical marker webinars Helped a lot 16/19 2014 CHC Annual Report t:=u Share your thoughts on THC services that have helped your CHC. Please offer additional webinars and how to register events for the THC calendar. Out of county travel is very hard for older members and working individuals. The information offered for preparing the budget was helpful and helped us to obtain additional tunding. Even with the practice page, the annual report requires a great deal of time to complete and for the THC to assess. F: i Check the ways in which your CHC made concerted efforts in 2014 to improve work relative to previous years. CHC planning, Bylaws, Membership and attendance, Preservation education for appointees, Partnerships, Community outreach to adults, Community outreach to young people, Presence of CHC and/or county history on Internet Relationship with county commissioners court, Initiated a new CHC project, Improved an ongoing effort Project Description #1--- Expand upon your answers to question 51 about improving your CHC during the 2014 year of service. Describe the efforts made to improve an aspect of your CHC. Include the following: — your county name;-- the specific area of improvement;-- why the improvement effort was made;-- what actions were taken to make improvements; and-- the results of those actions.Successful efforts are preferred but your efforts may not have immediate or fruitful results. Regardless of degree of success, use this answer to document your ability to evaluate CHC work, explore ways to be more effective, and learn from the results.lf you were not able to make improvements in 2014, document your challenges and what improvements you'd make if you had the time, manpower, or money required. Calhoun County used planning workshops to design and initiate a new project involving seventh grade Texas history classes to help reinforce their Texas history. A concentrated history from prehistoric to Civil War using computers, word searches, phones and hands on activities to solve riddles was posed to each participant. The Calhoun County Museum and the Coastal Bend Museum along with the seventh grade Texas History Teachers and Commission members were involved with the activities. To introduce the "Paleo Hunter Scavenger hunt, period costume commission members visited the classrooms. Although a great deal of time and energy was expended, very few students and parents participated. In 2015, the commission is offering the Scavenger Hunt to 7th graders with a focus on Indianola. With the initial outline in place, planning sessions should be effective and fewer. There will be paid publicity along with a newspaper article, class visits and student hand outs to increase publicity and registration. � !µ� 1i �i 3V. "f :�!„hN 1 ;�t� s .. � `�3` ij ceF• Srr ,! �� i� c3{fCiji �3i�c��, 17/19 2014 CHC Annual Report t;,'2K Project Description #2--- Expand upon your CHC's contribution to heritage tourism efforts in your region. Refer to question 35 for heritage tourism examples.Highlight your most effective heritage tourism effort in 2014:-- your county name;-- describe event and your role in it;-- partners and community involvement in planning and/or implementation; and-- impact of the event (attendance, participation, profit, etc.) Calhoun County hosted four Historical Marker Dedications. Each dedication targeted a different audience and involved partners in planning and implementation. Each dedication had an average of 100 people or more who attended and filled the motels. The chair conducted the ceremonies, but the commission as a whole implemented the dedications. The World War II Marker was dedicated at the Memorial Day Remembrance sponsored by The City of Port Lavaca, Joint Veterans Council, and the CCHC. U.S. Rep. Blake Farenthold was key note speaker. The unveiling was by a family whose property was confiscated by the U.S. government for Camp Indianola. The Federal Sgt. William Barnes Marker was dedicated at the Juneteenth Celebration, hosted by the Calhoun County Citizens in Action. Marker was unveiled at the Indianola Cemetery in the area where the first black soldier who received a Medal of Honor was buried. A Buffalo Soldiers display was exhibited by the guest speaker. The Chihuahua Trail Marker unveiling at Indianola was preceded by a power point of the crew travels from the crew chief. Dinner and Lunch were hosted for the crew at Indianola where the trail ended. Judge Howard Hartzog's Marker dedication took place at the CC Courthouse with Texas Land Commissioner Jerry Patterson giving the key note address. The CCHC was assisted by The Daughters of the Republic of Texas and The Daughters of the American Revolution. The CC Museum hosted a reception along with a Hartzog display. 1 S (E l 3) for .-Th,'P+ H, fl om city.€i{. 054. Project Description #3--- Share a project, effort, or service that shows the best of how your CHC interacts with the public. Please include your county name in the answer.Project, effort, or service must adhere to the following requirements:-- its primary association is with historylpreservation; -- it has broad CHC appointee support (rather than the participation of only 1 or 2 people); and-- is an ongoing effort or one that was completed in 2014. The Lavaca Artillery Battery Silhouette reflects Major Shea's defense of Lavaca against Federal Steamers on October 31, 1862. The Calhoun County Historical Commission first researched the original battery location. The research spurred a request for a Steel Silhouette Design by Brian Norwood of New Mexico to emphasize the historical bombardment. An inner local agreement between the City of Port Lavaca and Calhoun County was confirmed. The historical commission purchased the Silhouette with help from the Trull Foundation and the City provided the location and installation. The Daughters of the Confederacy, The Sons of the Confederacy, and the Texas Dixie Grays Artillery Reenacting Company participated with the Commission and the City of Port Lavaca Mayor and City Manager in the transfer ceremony. The Police and Fire Department were on duty at the event. The research, design, transportation, and program encompassed at least sixteen committee members and was completed within 2014. About eighty people attended the transfer dedication. Cars were parked around the area and guests sat under the covered pavilion. 18/19 2014 CHC Annual Report Please let us know more about your preservation successes and/or challenges. Calhoun County HC has three cemeteries, Little Mary, Stiernberg, and Sonnaman ready to be submitted for the Historic Texas Cemetery award. Although the Cemetery Committee works well in the field to preserve cemeteries, they are not writers. Hopefully the Chair can train a new appointee to complete the forms. Two cemetery committee members are working with the Port O Connor Cemetery Association on its marker dedication program. This was a year of firsts. A check for underground utilities had to be obtained before the SunLight Girls Club Marker could be installed by the Calhoun County School District at Wilkins School. The Ed Bell Marker was broken off at the base and a donation was received to replace the pole. The Commission used technology with its Paleo Scavenger Hunt. The Chair now can photo a 'Selfie" A Face Book page was set up for the Commission along with its web site. The web master also maintains 'IndianolaTx" which has commission photos on it. A committee was formed to select three trees from Calhoun County to submit to the Texas Historic Tree Coalition. Although the web site is available, It is difficult to obtain the required submission form. Thanks to a strong Marker Committee there are four more markers waiting to be dedicated: Camel Corps, Sunlight Girls, Martin De Leon and Dr. Edward Knipling. The marker dedications in 2014 involved a great deal of effort from the commission. The Citizens in Action hosted the Juneteenth Celebration where families return to Port Lavaca for its program to celebrate their freedom. It was the first time for many to see a joint program honoring a Federal Black Soldier. Several families with children rode the bus to Indianola to unveil the marker. The Chihuahua Trail Marker dedication brought the trail crew from West Texas who is traveling and recording the original route. It was the first time for them to see the ending point, Lavaca Bay. The Hartzog dedication had about 125 guests with class mates, out of state family members, commission, local public and county officials. The mailing list for this marker dedication brought the largest public participation in eight years. Each of the historical commission members have special historical fields where they excel. They are members of the Texas Archeology Society and participate in digs and field exploration such as Fannin State Park and Gonzales cannon site. One person researches deeds and has completed two books on early Lavaca. Two serve at the Coastal Bend Museum in Victoria. One is a member of four heritage societies and is a liaison for the Genealogical Society. From May to November, the commission had two large events scheduled each month. The members worked together to make them successful. The short time period was stressful and in the future, only one event will be scheduled in a month. In December, a steak dinner was cooked by members as a reward well deserved. A power point program highlighted the dedications. 19/19 Complete this spreadsheet and email completed excel document to Madeline.Clites@thc.state.tx.us. 2015-2016 Term of Service for County Historical Commissions (CHC) CHC Chair MUST have at least one telephone number listed and should have an email listed if at all possible. Marker Chair (if your CHC has one) MUST have an email address _ _Last Name _ _ _ _ _ _ _ _First -Name _ _ A_ddress_ _ _ _ _ _ City _ _ _ _ _ _County _ _ _ _ _ _Zip -Code_ —Home Phone _Mobile Phone_ Primary Email _ _ _ _ _ _ _ _ _ CHC Meitzen Mary 305 Glenbrook Port Lavaca Calhoun 77979 361 552 5931 361 649 0723 mmeitzen@cableone.net Chair Marker Ralston Gary 211 Oakglen Dr. Port Lavaca Calhoun 77979 361-649-9186 garv@indianolatx.com Chair _-_-_-_-_---_---_-_-------_-_---_-_-_-_-_---_-_-_-_-_-_-_---_-_-_-___-_-_- Please list the remaining appointees in alphabetical order. --------------------------------------------------------------------------------------------------------- Baccus Clif 506 Ridgecrest Port Lavaca Calhoun 77979 361746 0460 cliftonbaccus@msn.com Brett Clay 6608 US Hwy 87 Port Lavaca Calhoun 77979 361482 9018 cbrett6@vahoo.com Brett Joe D. 194 FM 1679 Port Lavaca Calhoun 77979 361482 9225 ibrett404@hotmail.com Cormier George Anne 301 S.Ann Port Lavaca Calhoun 77979 361 553 4689 361482 7256 director@calhouncountvm use um.org Dobbins Peggy 8942 State Hwy 316 Port Lavaca Calhoun 77979 404 523 6685 peRdobbins@Rmail.com Foester . John 2421 State Hwy 238 Port Lavaca Calhoun 77979 361-552-1224 361-484-4885 foester@tisd.net Gaines Peggy 501-B Sgt Rodney Taylor Seadrift Calhoun 77983 361920 1743 lionpeggyg@gmail.,com Kassner Jonathan 2110 Oren Port Lavaca Calhoun 77979 361552 4280 361482 6403 Inkassn@cableone.net Kepler Vicky 8530 State Hwy 316 Port Lavaca Calhoun 77979 979 639 1524 vickvkepler@yahoo.com Koch Steve P.O. Box 1583 Port Lavaca Calhoun 77979 361935 5686 lastko@earthlink.net Loflin Robert P.O. Box 1343 Port Lavaca Calhoun 77979 361 652 6180 rmloflin@gmail.com Marek Nelson 1258 School Road_ Port Lavaca Calhoun 77979 361552 1192 mare@tisd.net Meitzen John 305 Glenbrook Port Lavaca Calhoun 77979 361552 5931 mmeitzen@cable ane.net Munro Jim P.O. Box 205 Port Lavaca Calhoun 77979 361 676 3414 ilmsenior.munro@gmail.com Regan Jan 201 S. Colorado Port Lavaca Calhoun 77979 361 552 6313 361 552 5734 Ian@russellcain.com Sassman Avril 100 Saluria Port Lavaca Calhoun 77979 361552 0162 onemsdaisev@cableone.net Schulte Thomas 204 WillowBend Dr. Port Lavaca Calhoun 77979 361 552 0108 832 928 0610 tschulte00@vahoo.com Spiller Walter 1202 Brookhollow Dr. Port Lavaca Calhoun 77979 361 676 0823 361 676 0823 walterspiller@cableone.net Stovall Debbie P.O. Box741 Port Lavaca Calhoun 77979 3616763630 dlstovall@gmail.com Thomae Philip P.O. Box 268 Port Lavaca Calhoun 77979 361 552 2735 psthomae@tisd.net Thomae Sue P.O. Box 268 Port Lavaca Calhoun 77979 361 552 2735 ssthomae@tisd.net Windham Florene 506 Ridgecrest Port Lavaca Calhoun 77979 361 552 9565 flodwin@msn.com CONSIDER AND TAKE NECESSARY ACTION ON TEXAS COMMUNITY DEVELOPMENT BLOCK GRANT APPLICATION. AUTHORIZE COUNTY JUDGE TO SIGN ALL NECESSARY DOCUMENTS, TO INCLUDE INTERLOCAL AGREEMENT WITH SOUTH CENTRAL CALHOUN COUNTY WCID #1, RESOLUTION AUTHORIZING THE SUBMISSION OF A COMMUNITY DEVELOPMENT BLOCK GRANT APPLICATION, EXEMPTION DETERMINATION FOR ADMINISTRATIVE AND ENGINEERING SERVICES, APPLICATION FOR TXCDBG ASSISTANCE, AND PRE -AGREEMENT COST APPROVAL FOR ADMINISTRATIVE AND ENGINEERING ACTIVITIES AND ANY OTHER DOCUMENTS WHICH MAY BE DEEMED NECESSARY: PASS CONSIDER AND TAKE NECESSARY ACTION ON REQUEST BY EMS FOR AUTHORIZATION TO APPLY FOR CREDIT ACCOUNT WITH PORT LAVACA DODGE: Judge Pfeifer stated all ambulances in use now are Dodge and at times they are in need of repair or maintenance. Commissioner Finster made a motion to authorize EMS to apply for a credit account with Port Lavaca Dodge. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. 01/20/2015 10:32 3615534800 CALHOUN COUNTY EMS PAGE 02/03 b '6qZ APPLICATION' FOR CREDIT eAlhmCdPt Co. e s - MAME.Or FIRM OR IN91VIDVAL_ ADDRESS Ap/2T Lirw e"Y CITY. STATE. ZIP HEREBY applies for credit in accordance with the terms and conditions of: Port Lavaca .Qed[�t> Wendy Renken 1101 hwy 35 S ACCOUNTS RECIVIBLE Port lvaca , TX 77979 Net 10 OUR NORMAL CREDIT TERMS formation must be providod. It will be held in the Check here if tnoorpordted within the past 13 months �°uicl�tirac,a- NAMESOrPjiNCIPI-M COMPLETE ADDRESS a BDSINES$NAM1E COMPLETE ADDRESS PHONE PHONE 3-1i-rsz-/i040 E3Check here If Cash sales are okay until credit is approved We certify that all the information on this form is Correct. We fully understand your credit terms and agree to the proper payment in consideration o> ten ecredit , I ' Signature , r�aaav-k& or�y5 Date Title PLEASE DO N07 WRITE ON THE SPADE BELOW CHECKED BY 01/20/2015 10:32 3615534800 CALHOUN COUNTY EMS PAGE 03/03 ^� areas (aax> mod. (Rw.HO7B) TEXAS SALES AND USE TAX EXEMPTION CERTIFICATION ne of purmo'w; gam a agency CALHOUN COUNTY Phwne PORT LAVACA TX 77979 [,the purchaser named above, claim an exemption from payment of sales and use Wes (for the purchase of iaxable Items described below or on the attached. order or invoice) from: Seller. Street address: Description of items to bo purchaeO or on the attached order or invoice: City, state, ZIP PRODUCTS ANDlOR SERVICES FOR THE EXCLUSIVE USE OF CALHOUN COUNTY. purchaser claims this exemption for the following reason: EXCLUSIVE USE OF CALHOUN COUNTY, A POLITICAL. SUBDIVISION OF THE STATE OF TEXAS_ I understand that I will be liable for payment of all state and local sales or use taxes which Wray.becurne due for failure to comply with the provisions of the Tax Code and/or all applicable law. I undorstan d &a t it is a cdminalof onse to give an exemption corhWceteto the selterfortaxab/o Rom$ tttatI kMw, at the atm ofpumhase, win be used in a manneratherthan that expromma(in this oerfiPrcats, and dslos)x ngon.the anxzrtrrtaffax evaded; fhe.o&naemeyrange from a Class C misdemeanor to a felony of the second degree. For: Cindy Mueller, County Auditor NOTE: This certificate cannot be issued for the purchase, lease, or metal of a motor vehicle. 7His cER7ifiCA7E DDES NOT RFouiRiw A NUMBER TO BE vAUo. 74-6t)QIgn Sales and Use Tax °Exemption Nurno.W or "Tax. Eaiempr Numbers do not exist This.certificate should be furnished to. the supplier., Do not send the Completed certificate to tha Cornptroger of Public Accounts, CONSIDER AND TAKE NECESSARY ACTION ON TECHNICAL SERVICE SUPPORT AGREEMENT WITH PHYSIO CONTROL AND AUTHORIZE COUNTY JUDGE TO SIGN: Judge Pfeifer stated this is the same agreement they have every year. Commissioner Fritsch made a motion to authorize the County Judge to sign the Technical Service Support Agreement with Physio Control. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Riney From: Henry Barber <hbarber@cableone.net> Sent: Monday, January 26, 2015 8:40 AM To: 'Susan Riley'; 'henry barber'; 'Carl king' Subject: FW: Calhoun county Attachments: Calhoun CTY EMS SC-0385 1 yr.pdf Susan, Please place this contract on the agenda for signatures (judge) Thanks Henry From: Flowers, Michael [mailto:michael.flowers@physio-control.com] Sent: Thursday, January 22, 2015 1:37 PM To: 'hbarber@cableone.net' Subject: FW: Calhoun county Henry, Here is the adjusted copy of your service agreement. From: RS SEA Service Contracts Sent: Thursday, January 22, 2015 9:17 AM To: Flowers, Michael Subject: RE: Calhoun county Hi Mike, I have updated the contract to 1 yr. A copy of the contract has been uploaded to sharepoint and the contract details have been updated as well. Thank you, M Suhmiin Chern Contract Coordinator) Physlo-Control, Inc, r13'I.I Willows Road NE, Redmond WA 98052 D: 800.442.1142 Option 1 Extension 74757 1 w: www.physlo_control_com From: Flowers, Michael Sent: Tuesday, January 20, 2015 1:29 PM To: RS SEA Service Contracts Subject: Calhoun county Hi, Customer explained to me that they are not allowed to sign more than one year agreements per their commissioners court. Can you convert it to a one year agreement'? [CONFIDENTIALITY AND PRIVACY NOTICE] Information transmitted by this email is proprietary to Physio-Control and is intended for use only by the individual or entity to which it is addressed, and may contain information that is private, privileged, confidential or exempt from disclosure under applicable law. If you are not the intended recipient or it appears that this mail has been forwarded to you without proper authority, you are notified that any use or dissemination of this information in any manner is strictly prohibited. In such cases, please delete this mail from your records. To view this notice in other languages you can either select the following link or manually copy and paste the link into the address bar of a web browser: http://www,physio-controLcom/emalldisdaimer_ Contract Number: End User # 02211901 CALHOUN C'fY EMS 705 CTY RD 101 PORT LAVACA, TX 77979 Bill To # 02211901 CALHOUN CTY EMS 705 CTY RD 101 PORT LAVACA, TX 77979 This Technical Service Support Agreement begins on 2/1/2015 and expires on I/31/2016. The designated Covered Equipment and/or Software is listed on Schedule A. This Technical Service Agreement is subject to the Terms and Conditions on the reverse side of this document and any Schedule B, if attached. If any Data Management Support and Upgrade Service is included on Schedule A then this Technical Set -vice Support Agreement is also subject to Physio-Control's Data Management Support and Upgrade Service Terms and Conditions, rev 7/99-1. Price of coverage specified on Schedule A is $8,882.00 per tens, payable in Annual installments, r ems 15% DISCOUNT ON ACCESSORIES 15% DISCOUNT ON ALL ELECTRODES Accepted: Physio-Control, Inc. Customer: Calhoun dusty By: By: Title:,,,,, s� a, Print: Michael J. Pf.ifer Date: t,2(10J2J ^ Title: Calhoun County Judea Date: Febrnary 12, 2015 Purchase Order Number. Territory Rep: WECC57 Customer Contact: Michael Flowers Henry Barber, Dir. of EMS Phone: Phone: 361-552-1140 FAX 800.772-3340 FAX: 361-5534800 Reference Number: SC-0385 Renewal Printed: 1/22l2015 Page I of 6 PHYSIO-CONTROL, INC, TECHNICAL SERVICE SUPPORT AGREEMENT TERMS AND CONDITIONS Customer's signature on Oils Agreement ore valid purchase order referencing this Technical Service Support Agreement Is required prior to Physio-Contrors acceptance and performance of this Agreement. This Agreement covers only the equipment listed on Schedule A ("Covered Equlpmamr). These terms constitute the complete agreement between the parties and they shall govern over any other docurnents, Including Customer's purchase order, These terms may not be revised in any manner without the prior written consent of Physlo-Control, SERVICES. The Services provided under this Agreement are set forth an Schedule A. Physlo-Control strives, but does not guarantee, to return service calls within two (2) hours and to resolve service issues within (wanly-four(24) hours. Following Services, Physlo-Control will provide Cuslomerwhh a written report of actions taken or recommended and Identification of any materials replaced or recommended for replacement. The following Services are available and further described as they relate to each spec Physlo-Control device on Schedule B: 'Repair Plus ServW or "RepaltOnly Somko' means repairs. Battery Replacement Service, parts and labor necessary to restore Covered Equipment to original specifications, subject to Exclusions (as set forth below). "Preventative Maln orisnce" or "Inspection Only Service" means Inspection and adjustment to maintain Covered Equipment In satisfactory operating condition. Inspections Include tests, measurements, and a thirty -point evaluation of Covered Equipment. Covered Equipment is property calibrated, mechanical operations are checked and adjusted, If necessary, and output measurements are verified to function property. Electrical safety checks are also performed In accordance with National Fire Protection Association (NFPA) guidelines. Preventative Maintenance and Inspection Only Service are subject to Exclusions. "Comprehensive Service" or "Repstr B Inspect Service" means repairs, Battery Replacement Service, parts and labor necessary to restore Covered Equipment to original specifications, and Inspections to verfry proper device calibration, mechanical operations and output measurements, electrical safety check in accordance with NFPA guidelines, and Updates (as set forth below), subject to Exclusions. "Battery Replacement Service' means replacement of batteries on a one•for-one, Ilke-for-llm basis, up to the number of batteries and/or devices hated In Schedule A. Only batteries manufactured or distributed by Phyato-Control are eligible for replacement Battery replacement is available upon Customer notification to Physla•Conbol of the occurrence of: (I) battery failure as determined by Customar's performance testing and evaluation in accordance with the applicable Operating Instructions: or (it) as recommended in the applicable device's Operating Instructions - At the discretion of Phyeb-Control, battery replacement shall be effected by shipment to Customer and replacement by Customer, or by on4te delivery and replacement by a Physio-Control Service Ter hitich n, Upon Customer's receipt of e replacement battery, the battery being replaced shall become the property of Physio�Controi, and Customer must return the battery being replaced to Physic -Control for proper disposal. In the event that Physlo-Control does not receive the battery being replaced, Physlo-Contml will Invoke Customer the then -current rate for the repiacensnt battery. "OnSRe Service" means that a Physlo-Control factory -trained technician will provide Services at Customers location. Services will be performed between 8:00am and 5:00pm local time, Monday through Friday, excluding holidays. Customer is to ensure Covered Equipment Is available for Services at scheduled times. Some Services may not be completed On-SHe. Phyalo-Control will cover travel and/or round-trip freight for Covered Equipment that must be sent to our designated facility for repair. "Snip -In Sarvka" means that Services will be perforated at Phyalo-Contrors designated facility, Physic -Control will cover round-trip freight for Covered Equipment that is sent to our designated facility for Services. If Covered Equipment Is not available when Services am scheduled or Customer requests services or goods not covered by this Agmement or outside of designated Services frequency or hours, Physlo-Control will charge Customer for such services at 10%of Physio-Controre standard rates (including overtime, if appropriate) and applicable travel costs In addition to the contract price. Repair parts required for such repairs will be made available at 15%off the then -current list price. EXCLUSIONS. Unless otherwise specified, Services do not include the following Exclusions: • supply or repair of accessories or disposables • repair of damage caused by misuse, abuse, abnormal operating conditions, operator armors, arts of God, and use of batteries, electrodes, or other products not distributed by Physio-Control • case changes • repair or replacement of Hems not originally distributed or installed by Physio-Control • Upgrades, and Installation of Upgrades • battery maintenance, performance testing, evaluation, removal, and recycling LOANERS, 0 Covered Equipment must be removed from use to complete Services. Physlo-Control will arrive to provide Customer with a similar loaner device until the Covered Equipment lv returned. Customer assumes complete responsibility for the loaner and shall return the loaner at Customer's expense to Physio-Control In the sans condition as received, upon the earlier of the return of the Reference Number: SC-0385 Renewal Printed: 1/22/2015 Page 2 of 6 removed Covered Equipment or Physlo-Contrors request UPDATES, 'Update" means a change to a device to enhance its current features, stability, or software. If Comprehensive Service or Repair & Inspect Service Is designated for Covered Equipment on Schedule A, Physlo-Control will Install Updates at no additional cost provided such Updates are installed at the time of regularly scheduled Services. Updates Installed on Covered Equipment designated on Schedule A as Repair Plus Service, Repair Only Service, Preventative Maintenance Service, Inspection Only Service, or at a time other than regularly scheduled Comprehensive Service or Repair & Inspect Service, will be billed on a separate Invoice at 20% off the then -currant list price of the Update. For all Service plans, g parts must be replaced to aeeemmodate installation of new software, such parts may be purchased at a rate of 30%off the then -current list price, UPGRADES. 'Upgrade" means a major, standalone version of software or the addition of features or capabilities to a device. For all Service plans, Upgrades must be purchased separately and are not provided under this Agreement. Upgrades are available at a rate of 17% off the than -current list price. PRICING. Pricing is set forth on the first page of this Agreement, on the Quote for Services, and/or on the Invoice for the Services Purchased, Prices do not Include lazes, Sales, service or use taxes will be Invoiced In addition to The price of the goods and Services covered by this Agreement unless Physic -Control receives a copy of a valid exemption certificate. If the number or configuration of Covered Equipment changes during the Term, pricing shall be pro -rated accordingly. For Preventative Maintenance Service, Inspection Only Service, Comprehensive Service, and Repair & Inspect Service, no pricing deduction will be made for removal of Covered Equipment If preventative maintenance and Inspection have already been performed during the Term and no further preventative maintenance and Inspection are scheduled to ocour. Discounts may not be combined with other special terms, discounts and/or promotions. PAYMENT. Payment is due within thirty (30) days or Invoke dale. WARRANTY. Physlo-Control warrants Services performed under Ihis Agreement and repair/replacement parts provided in performing such Services against defects in material and wod m mshlp for ninety (SO) days from the date Services were performed or a repekheplacemenl part was provided. Customer's sole remedy shall be reservlclng the affected Covered Equipment and/or replacement of any part determined to be defective, without additional charge, provided Customer notifies Physlo-Conbol of any allegedly detective cenditton within ton (10) calendar days of Its discovery by Customer. Physlo-Conlml makes no other warranties, express or Implied, Including, without limitation, NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND IN NO EVENT SHALL PHYSIO.CONTROL BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR OTHER DAMAGES, TERM. The Tenn of this Agreement Is set forth on the first page of 1hls document, or In the Quote and/or Invoke for the Services purchased. This Agreement shall automatically renew unless terminated by either partywith written notice thirty (30) days prior to the expiration of the then -current Tenn. Prices are sub)ect to change upon renewal. TERMINATION. Either party may terminate this Agroamant for material breach by the other party by providing thirty (30) days' written notice to the other party, and provided such breach is not cured within the notice period, In addition, either parry may lannlnate this Agreement at any brae upon sixty (60) days' prior writtan notice to the other party. In the event of such early lamination by Customer, Customer shall be responsible for the portion of the designated price which corresponds to the portion of the Term prior to the effective date of termination and the Ilst-price cost of any preventative maintenance, Inspections, or repairs rendered during the Tenn. DELAYS. Physio-Control will not be liable for any loss or damage of any kind due to its failure to perform or delays In its performance resulting from any cause beyond Its reasonable control, Including, but not limited To, ads of God, labor disputes, labor shortages, the requirements of any governmental authority, war, civil unrest, delays In manufacture, obtaining any required license or permit, and Phys"ontrors Inability to obtain goods from Its usual sources. Any such delay shall not be considered a breach of Physk -Controls obligations and the performance dales shall be extended for the length of such delay, DEVICE INSPECTION BEFORE ACCEPTANCE. Any device that is not covered by either a Physic -Control Limited Warranty or a current Physlo-Control Technical Service Support Agreement must be Inspected and repaired (If necessary) to meet original specifications at customer's cost at the then -current Not prime priorto being covered under a Technical Service Support Agreement Physlo-Control reserves the right to refuse to support any device that has been remonufadured by a company other than Physlo-Control. MISCELLANEOUS. (a) During the Term of this Agreement and for one (1) year following its expiration, without Physio-Conlrnrs prior written consent, Customer agrees to not to solicit or offer employment to anyone who is employed by Physic -Control to provide Services such as those described In this Agreement (b) this Agreement, and any related obligation of other parry, may not be assigned In whole or in part without the prior written consent of the other party; ® this Agreement shall be governed by the laws or the Slate In which the Services are provided; (d) all costs and expenses Incurred by the prevailing party related to the enforcement of its rights under this Agreement, including reasonable shomay's fees, shall be reimbursed by the other party, Reference Number: SC-0385 Renewal Printed: 1/222015 Page 3 of 6 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE A Contract Number Servicing Rep: Michael Flowers, WECC57 District: SOUTHWEST Phone: FAX: 800-772-3340 Equipment Location: CALHOUN CTY EMS, 02211901 705 CTY RD 101 PORT LAVACA, TX 77979 Scope Of Service On Site Preventative Maintenance; Ship In Repair Plus Ref. Effective Expiration Total Model Part Number Serial Number Line Date Date Inspections LIFEPAKS 12 VLP12-02-005013 32333378 1 2/1/2015 1/31/2016 1 LIFEPAKS 12 VLP12-02-005013 32333372 2 2/1/2015 1/31/2016 1 LIFEPAK® 12 VLP12-02-002936 32114019 3 2/1/2015 1/31/2016 1 LIFEPAK® 15 V15-2-001566 40256032 4 2/1/2015 1/31/2016 t LIFEPAK©15 VIS-2-001566 40228319 6 2/1/2015 1/31/2016 1 LIFEPAK® 15 VIS-2-001566 40157516 6 2/1/2015 1/31/2016 1 LIFEPAK® 15 V15-2-001566 40157517 7 2/1/2015 1/31/2016 I ** Denotes an inventory line that has changed since the last contract revision or addendum. Reference Number: SC-0385 Renewal Printed: 1/22/2015 Page 4 of 6 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B LIFEPAK® 15 Monitor/Defibrillator Services LIFEPAK© 15 Monitor/Defibrillator Comprehensive Service • Inspections at intervals set forth on Schedule A • Parts and labor necessary to restore device to original specifications, subject to Exclusions • Standard detachable hard paddles repair or replacement • REDI-CHARGED battery charger (Catalog# 11141-000115) repair or replacement of one for each LIFEPAK 15 Monitor/Defibrillator listed in Schedule A and as determined necessary by Physio-Control • Power Adapter repair or replacement • Battery Replacement Service o For each LIFEPAK 15 listed on Schedule A, replacement of up to three (3) LIFEPAK Lithium -ion batteries in accordance with the device Operating Instructions, or upon battery failure • Updates installed at no additional cost, provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. LIFEPAK® 15 Monitor/Defibrillator Repair Plus Service • Parts and labor necessary to restore device to original specifications, subject to Exclusions • Standard detachable hard paddles repair or replacement • REDI-CHARGE® battery charger (Catalog# 11141-000115) repair or replacement of one for each LIFEPAK 15 Monitor/Defibrillator listed in Schedule A and as determined necessary by Physio-Control • Power Adapter repair or replacement • Battery Replacement Service o For each LIFEPAK 15 listed on Schedule A, replacement of up to three (3) LIFEPAK Lithium -ion batteries in accordance with the device Operating Instructions, or upon battery failure • Updates installed at 20% off the then -current list price provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. LIFEPAK® 15 Monitor/Defibrillator Preventative Maintenance Service • Inspections at intervals set forth on Schedule A • Updates installed at 20% off the then -current list price provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. Reference Number: SC-0385 Renewal Printed: 1/22/2015 Page 5 of 6 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULER LIFEPAK® 12 Defibrillator/Monitor Services LIFEPAK® 12 Defibrillator/Monitor Comprehensive Service • Preventative maintenance and inspections at intervals set forth on Schedule A • Parts and labor necessary to restore device to original specifications, subject to Exclusions • Standard detachable hard paddles repair or replacement • REDI-CHARGE® battery charger (Catalog# 11141-000115) repair or replacement of one for each LIFEPAK 12 Defibrillator/Monitor listed in Schedule A and as determined necessary by Physio-Control • Power Adapter repair or replacement • Battery Replacement Service o Replacement of failed internal coin cell batteries; and o For each LIFEPAK 12 listed on Schedule A, replacement of up to four (4) Physio-Control FASTPAK® batteries, FASTPAK 2 batteries, LIFEPAK SLA batteries, LIFEPAK NiCd batteries in accordance with the device Operating Instructions, or upon battery failure; or 0 For each LIFEPAIC 12 listed on Schedule A, replacement of up to three (3) LIFEPAK Lithium -ion batteries in accordance with the device Operating Instructions, or upon battery failure • Updates installed at no additional cost, provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. LIFEPAK® 12 Defibrillator/Monitor Repair Plus Service • Parts and labor necessary to restore device to original specifications, subject to Exclusions • Standard detachable hard paddles repair or replacement • REDI-CHARGE® battery charger (Catalog# It 141-000115) repair or replacement of one for each LIFEPAK 12 Defibrillator/Monitor listed in Schedule A and as determined necessary by Physio-Control • Power Adapter repair or replacement • Battery Replacement Service o Replacement of failed internal coin cell batteries; and o For each LIFEPAK 12 listed on Schedule A, replacement of up to four (4) Physio-Control FASTPAIC® batteries, FASTPAK 2 batteries, LIFEPAK SLA batteries, LIFEPAK NiCd batteries in accordance with the device Operating Instructions, or upon battery failure; or o For each LIFEPAK 12 listed on Schedule A, replacement of up to three (3) LIFEPAK Lithium -ion batteries in accordance with the device Operating Instructions, or upon battery failure • Updates installed at 20% off the then -current list price provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. LIFEPAK® 12 Defibrillator/Monitor Preventative Maintenance Service • Preventative maintenance and inspections at intervals set forth on Schedule A • Updates installed at 20%off the then -current list price provided such Updates are installed at the time of regularly scheduled Services. If parts must be replaced to accommodate installation of new software, such parts may be purchased at a rate of 30% off the then -current list price. Reference Number: SC-0385 Renewal Printed:1/22/2015 Page 6 of 6 Josie Sampson From: Susan Riley <susan.riley@calhouncotx.org> Sent: Tuesday, February 17, 2015 1:37 PM To: Josie Sampson Cc: Cindy Mueller Subject: FW: Physio Control Attachments: Calhoun County EMS.pdf From: Henry Barber [mailto:hbarber@cableone.net] Sent: Tuesday, February 17, 2015 12:49 PM To: 'Susan Riley'; 'henry barber'; 'Carl king' Subject: FW: Physio Control Susan Here is the completed physio contract with all signatures Henry From: US Contracts [mailto•USContractsCalih sisio-control.comj Sent: Tuesday, February 17, 2015 12:09 PM To: hbarberC&cableone.net Cc: RS SEA Service Contracts; US Contracts; Flowers, Michael Subject: RE: Physio Control Good morning Mr. Barber, Per your request, please find attached a copy of the Service Agreement fully executed. If additional assistance is needed, please don't hesitate to reach us back. Regards, 9 Alexandra Carvalho Contract Analyst Physio-Control, Inc. 11811 Willows Road NE, Redmond WA 98052 D: 425.867,4003 I W: uscontracts(c)physio-control.com From: RS SEA Service Contracts Sent: Tuesday, February 17, 2015 10:01 AM To: US Contracts Subject: FW: Physio Control From: Flowers, Michael Sent: Monday, February 16, 2015 12:33 PM To: RS SEA Service Contracts Subject: Fwd: Physio Control This customer needs this agreement signed by us. Sent from my Whone Begin forwarded message: From: "Henry Barber" <hbarber a,cableone.net> To: "Flowers, Michael"<michael.flowers2cphysio-control.com>, "'henry barber"' <hbarbernc cableone.net> Subject: FW: Physio Control PLEASE GET SIGNED AND RETURN From: Susan Riley [mailto:susan.riley@n calhouncotx.org] Sent: Friday, February 13, 2015 3:15 PM To: 'Flowers, Michael' Cc: 'Henry Barber; Cindy Mueller Subject: Physio Control Attached please find Part one of the Service Agreement approved by Commissioners' Court on February 12, 2015 and signed by Judge Pfeifer. I've had to send in two parts due to size restrictions of our email server. Please return one signed copy to my email for our records. Susan Susan Riley Administrative Assistant to Calhoun County Judge Michael J. Pfeifer and Commissioners' Court 361-553-4600 Phone 361-553-4444 Fax [CONFIDENTIALITY AND PRIVACY NOTICE] Information transmitted by this email is proprietary to Physio-Control and is intended for use only by the individual or entity to which it is addressed, and may contain information that is private, privileged, confidential or exempt from disclosure under applicable law. If you are not the intended recipient or it appears that this mail has been forwarded to you without proper authority, you are notified that any use or dissemination of this information in any manner is strictly prohibited. In such cases, please delete this mail from your records. To view this notice in other languages you can either select the following link or manually copy and paste the link into the address bar of a web browser: http://www.physio-control.com/emaildisclaimer/ CONSIDER AND TAKE NECESSARY ACTION ON 2015 NEW LEASE AGREEMENT FOR PRECINCT #1 WITH RICOH IN THE AMOUNT OF $178.23 A MONTH ON A NEW COPIER AND THE PICK- UP OF OLD UNIT AND AUTHORIZE COUNTY JUDGE TO SIGN: Commissioner Finster made a motion to authorize the County Judge to sign the 2015 new lease agreement for Precinct #1 with Ricoh in the amount of $178.23 a month on a new copier and the pick-up of old unit. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ROGER C. GALVAN Calhoun County Commissioner Precinct #1 211 S. Ann Port Lavaca, TX 77979 (361) 552-9242 January 19, 2015 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: Please place the following item on the next Commissioner's Court Agenda. rinraraly Fax (361) 553-8734 Pager (361) 579-7915 Mobile (361) 935-3552 e Consider and take necessary action to approve 2015 New Lease Contract with Ricoh in the amount of $178.23 a month on a new copier and the pick= up of the old unit and authorize Judge Pfeifer to sign. Ricoh USA, Inc. 70 Valley Stream Parkway Malvern, PA 19355 Product Schedule Master Lease Agreement Number: This Product Schedule (this "Schedule") is between Ricoh USA, Inc. ("we" or "its') and CALHOUN, COUNTY OF as customer or lessee ("Customer" or "you'). This Schedule constitutes a "Schedule," "Product Schedule," or "Order Agreement," as applicable, under the (together with any amendments, attachments and addenda thereto, the "Lease Agreement") identified above, between you and . All terms and conditions of the Lease Agreement are incorporated into this Schedule and made a part hereof. if we are not the lessor under the Lease Agreement, then, solely for purposes of this Schedule, we shall be deemed to be the lessor under the Lease Agreement. It is the intent ofthe parties that this Schedule be separately enforceable as a complete and independent agreement, independent of all other Schedules to the Lease Agreement. CUSTOMER INFORMATION CALHOUN, COUNTY OF ROGERGALVAN Customer(Bill To) Billing Contact Name 101 COUNTY RD 201 W AUSTIN ST Product Location Address Billing Address pbrdlprooay.m /.,.Ilan address) PORTLAVACA TX 77979 PORTLAVACA TX 77979-42I0 City County State Zip City County Stale Zip Billing Contact Telephone Number Billing Contact Facsimile Number Billing Contact E-Mail Address (361)552-9242 cogecgalvanreicalhouncotx.org PRODUCT/EQUIPMENT DESCRIPTION "Product" Qty Product Description: Muke&Model 1 RICOH MPC2503 PAYMENT SCHEDULE Minimum Term loczahs) 60 Minimum Payment QVahow Tax) $ 178.23 Giamori eed Minimum lunges"° 1,000 Color 0 Qty Product Description: Make&Model Minimum Payment Billing Frequency ❑ Monthly ❑ Quarterly ❑ Other: Cast ofAdditional images° Color $0.0116 $0.0919 * Based upon Minimum Payment Billing Frequency, ° Based upon standard 8 %" x 1I"paper size. Paper razes greater than 8 %" x I I"maycouat as mom than one image. Sales Tax Exempt: +❑ YES (Attach Exemption Certificate) Customer Billing Reference Number (P.O.#, etc.) Addendum(s) attached: ❑ YES( check ifyes and indicate total numberefpages:� Advance Payment ❑ 1"Payment ❑ 1a&Lanpeymom ❑ Other: Meter Reading/Billing Frequency ❑ Monthly ❑✓ Quarterly ❑ Other- TERMS AND CONDITIONS 1. The first Payment will be due on the Effective Date. If the Lease Agreement uses the terms "Lease Payment" and "Commencement Date" rather than "Payment" and "Effective Date," then, for purposes of this Schedule, the tern "Payment" shall have the same meaning as "Lease Payment," and the tend "Effective Date" shall have the same meaning as "Commencement Date." 01/19/2015 09:50 AM 16093039 0 111 INq VIP,W.M MY10 N I I II LSEADD PS -IMP 04.12 Ricoh® and the Ricoh Logo arc registered trademarks of Ricoh Company, Ltd. Page I of 2 2. You, the undersigned Customer, have applied to us to use the above -described Product for lawful commercial (non -consumer) purposes. THIS IS AN UNCONDITIONAL, NON - CANCELABLE AGREEMENT FOR THE MINIMUM TERM INDICATED ABOVE, except as otherwise provided in any non -appropriation provision of the Lease Agreement, if applicable. If Nye accept this Schedule, you agree to use the above Product on all the terms hereof, including the terms and conditions on the Lease Agreement. THIS WILL ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THIS SCHEDULE AND THE LEASE AGREEMENT AND HAVE RECEIVED A COPY OF THIS SCHEDULE AND THE LEASE AGREEMENT. You acknowledge and agree that the Ricoh service commitments included on the "linage Management Phis Commitments" page attached to this Schedule (collectively, the "Commitments") are separate and independent obligations of Ricoh USA, Inc. ("Ricoh") governed solely by the terms set forth on such page. If we assign this Schedule in accordance with the Lease Agreement, the Commitments do not represent obligations of any assignee and are not incorporated herein by reference. You agree that Ricoh alone is the party to provide all such services and is directly responsible to you for all of the commitments. We are or, if we assign this Schedule in accordance with the Lease Agreement, our assignee will be, the party responsible for financing and billing this Schedule, including, but not limited to, the portion of your payments under this Schedule that reflects consideration owing to Ricoh in respect of its performance of the Commitments. Accordingly, you expressly agree that Ricoh is an intended party beneficiary of your payment obligations hereunder, even if this Schedule is assigned by us in accordance with the Lease Agreement. 3. Image Charges/Meters: In return for the Minimum Payment, you are entitled to use the number of Guaranteed Minimum Images as specified in the Payment Schedule of this Schedule. The Meter Reading/Billing Frequency is the period of time (monthly, quarterly, etc.) for which the number of images used will be reconciled. If you use more than the Guaranteed Minimum Images during the selected Meter Reading/Billing Frequency period, you will pay additional charges at the applicable Cost of Additional Images as specified in the Payment Schedule of this Schedule for images, black and white and/or color, which exceed the Guaranteed Minimum Images ("Additional Images"). The charge for Additional Images is calculated by multiplying the number of Additional Images by the applicable Cost of Additional Images. The Meter Reading/Billing Frequency may be different than the Minimum Payment Billing Frequency as specified in the Payment Schedule of this Schedule. You will provide us or our designee with the actual meter reading(s) by submitting meter reads electronically via an automated meter read program, or in any other reasonable manner requested by us or our designee from time to time. If such meter reading is not received within seven (7) days of either the end of the Meter Reading/Billing Frequency period or at our request, we may estimate the number of images used. Adjustments for estimated charges for Additional Images will be made upon receipt of actual meter reading(s). Notwithstanding any adjustment, you will never pay less than the Minimum Payment. 4. Additional Provisions (if ally) are: THE PERSON SIGNING THIS SCHEDULE ON BEHALF OF THE CUSTOMER REPRESENTS THAT HE/SAE HAS THE AUTHORITY TO DO SO. None: Accepted by: RICOH USA, INC. By: Authorized Signer Signorine Printed Name: Title: Date: O1119/2015 09:50 AM 16093039 ill r1P1 , 1ft l HI LSEADD PS -IMP 04.12 Ricoh® and the Ricoh Logo are registered trademarks of Ricoh Company, Ltd. Page 2 of 2 Ricoh USA, Inc. RICOH RICOH USA, INC. 70 Valley Sfremn Parkway IMAGE MANAGEMENT PLUS COMMITMENTS Malvern, PA 19355 The below service commitments (collectively, the 'Service Commitments') am brought to you by Ricoh USA, Inc, an Ohio corporation having it principal place of business at 70 Valley Stream Parkway, Mai PA 19355 ('Ricoh/. The words you and your'refer to you, our customer. You agree that Ricoh alone Is the party to provide all of the services set forth below and is fully responsible to you, the customer, for all of the Service Commitments. Ricoh or, if Ricoh assigns the Product Schedule to which this page is attached In accordance with the tease Agreement (as defined in such Product Schedule), Ricohe assignee, Is the party responsible for financing and billing the Image Management Plus Product Schedule. The Service Commitments are only applicable to the equipment ('Product') described in the Image Management Plus Product Schedule to which these Service Commitments are attached, excluding fasimile machines, single-Nnc6on and wide - format printers and production units. The Service Commitments am effective on the dale the Product is accepted by you and apply during Riceh's normal business hours, excluding weekends and Ricoh mcognired holidays. They mmain in effect forthe Minimum Tenn so long as no ongoing default exists on your part TERM PRICE PROTECTION The Image Management Minimum Payment and the Cost ofAdditienal Images, as described on the Image Management Plus Product Schedule, will not increase in price during the Minimum Tenn of the Image Management Plus Product Schedule, unless agreed to inwdtlng and signed by both parties. PRODUCT SERVICE AND SUPPLIES Ricoh will provide full coverage maintenance services, including replacement pads, drams, labor and all service calls, during Normal Business Hours, 'Normal Business Hours' arc between 8.00 a.m. and 5.00 p.m., Monday to Fdday excluding public holidays. Ricoh will also provide the supplies required to produce images on the Producteovered under the Image Management Plus Product Schedule (other than nonmelem l Product and softmefered Product). The supplies will be provided according to manufacturers specifications. Optional supply items such as paper, staples and transparencies are of included. RESPONSE TIME COMMITMENT Ricoh will provide acomedy average response Tune of 2 to 6 business hours for all service calls located within a 30-mile radius of any Ricoh office, and 4 to 6 business hours for ranges calls located within a 31-60 mile radius forthe lens of the Image Management Plus Produd Schedule. Response time is measured in aggregate for all Product covered by the Image Management Plus Product Schedule. UPTIME PERFORMANCE COMMITMENT Ricoh will service the Product to he Operational with a quarterly uplime average of 96% during Normal Business Hours, excluding preventative and interim maintenance time. Downtime out begin at the time you place a service call to Ricoh and will end when the Pmducf is again Operational. You agree to make the Product available to Ricoh for scheduled prevenialive and interim maintenance. You further agree N give Ricoh advance notice of any offal and specific upOme needs you may have As that Ricoh can schedule with you interim and preventative maintenance in advance of such needs. As used in these Sewhe Commitment,'Operational' means substantial compliance with be manufacturers specifiaafons and/or performance standards and excludes customary end userconecfve actions. IMAGE VOLUME FLEXIBILITY AND PRODUCT ADDITIONS At any time after the expiration ofthe initial ninety day period of the original tram of the Image Management Plus Product Schedule to which these Service Commitments relate, Ricoh will, upon your request review your Image volume. If the image volume has moved upward or downward in an amount sulfidenl for you to consider an Alernative plan, Ricoh will present pricing options to conform to a new image volume. if you agree that addiional product is required to satisfy your irroreased image volume requirements, Ricoh will include the product in the pricing options. The addition of product and/or increasesldecreases to the Guammfeed Minimum Images requires an amendment ('Amendmenh to the Image Management Plus Produd Schedule that must be agreed to and signed by both paNes to the Schedule. The term of the Amendment may not be less than the remaining term of the existing Image Management Plus Product Schedule but may extend the remaining Tenn of the existing Image Management Plus Product Schedule for up to an additional 60 months. Adjustment to the Guaranteed Minimum Images commitment and/or the addition of product may resin in a higher or lower minimum payment Images decreases are limited to 2FA ofthe Guaranteed Minimum Images in effect at the time ofAmendment PRODUC f AND PROFESSIONAL SERVICES UPGRADE OPTION Al any time after the expiration of one half of the original Tenn ofthe Image Management Plus Product Schedule to which these Service Commitments relate, you may mconfiguco the Product by adding, exchanging, or upgrading to an Rem of Product with additional tatums or enhanced technology. A new Image Management Plus Product Schedule or Amendment must be agreed to and signed by the parties to the Schedule, fora ten not less than the remaining term of the existing Image Management Plus Product Schedule but may, in the case of an Amendment extend the remaining (an of the existing Image Management Plus Product Schedule for up N an additional 60 months. The Cost of Additional Images and the Minimum Payment of the new Image Management Plus Product Schedule will be based on any obligations remaining on the Product the added product and new image volume commitment Your Ricoh Account Executive will be pleased to wore with you on a Technology Refresh prior to the end of your Image Management Pins Product ScheduleorAmendment 01/19/2015 09:50 AM PERFORMANCE COMMITMENT Ricoh Is committed to performing these Service Commitments and agrees to perform its services in a manner frneffib ntwith the applicable manufacturers specifcallons. i(Rkoh fails to meet any Service Commitments and in the unlikely event that Ricoh is notable to remlithe Product in your office Ricoh, at Ricoh's election, will provide to you either the delivery Ate temporary loaner, for use while the Product Is being repalmd at Meaux service center, or Ricoh will mplace such Product with comparable Product of equal or greater capability at no additional charge. These am the exclusive remedies available to you under the Service Commitments. Customer's exclusive remedy shall be for Ricoh to re -perform any Services not In compliance with this warranty and brought to Ricoh's attention in waling within a reasonable time, but in no event mom than 30 days after such Services are performed. if you are dissafefied with Ricoh's performance, you must send a registered letter outlining your concems to the address specified below in the'Qualily Assurance' section. Please allow 30 days for resolution. ACCOUNT MANAGEMENT Your Ricoh sales professional will, upon your request be pleased to review your product performance marks on a quadedy basis and at a mutually convenient dare and time. Ricoh will follow up within 8 business hours of a call or e-mail to one of Riori account management ream members recurring a meiks review. Ricoh will, upon your request be pleased to annually review your business environment and discuss ways in which Ricoh may Improve efficiencies and reduce costs relating to your document management processes. . QUALITY ASSURANCE Please send Al offespondence relating to the Service Commitment via registered letterto the QuailtyAssurence Department located at: 3920 Arkwrght Road, Macon, GA 31210, Attn: Quality Assurance. The Quality Assurance Department will coordinate resolution of any performance issues concerning the above Service Commitments with your local Ricoh order. If either of the Response Time or Upfine Performance Commitments is not met acne -time credit equal to 3% of your Minimum Payment Invoice trial will be made available upon your request Grand requests must be made in writing via registered lelterta the address above. Ricoh is ocmmiied to responding to any questions regarding invoiced amounts for the use of the Product relating to the Image Management Plus Product Schedule within a 2 dayfineforma. To ensure the most ile elyresporse please call 1-8882754566, MISCELLANEOUS These Service Commitment do not over repairs resultlng fmm misuse Cinctuding without Reflation improper voltage or environment or the use of supplies that do not conform to the manufacturers spe0oamr sk subjective matters (such as color coproduction accuracy) or any other factor beyond the reasonable onlrol of Ricoh. Ricoh and you each acknowledge Nat these Service Commitments represent the anger understanding of the parties with respect to the subject matter hereof and that your sole remedy for any Service Commitments not performed in accordance with the foregafng is as sal forth under the section hereof entitled Performance Commitment'. The Service Commitment made herein are service and/or maintenance warranties and are not product warmntim. Except as expressly set forth herein, Ricoh makes no warranties, express or implied, Including any Implied wananfes of memhantability, fitness for use, or fitness for a paNcularpurpose. Neither party hereto shall be liable to the other for any consequential, indirect punitive or special damages. Customer expressly acknowledges and agrees that in connection with the security of accessibility of information stored In or recoverable fmm any Produd provided or serviced by Ricoh, Customer is solely responsible for ensuring its own compliance with legal requirement or obligations to third parties pertaining to data security, Interim and protection. To the extent allowed by law Customer shall indemnify and hold hamrless Ricoh and it subsidiaries, directors, officers, employees and agents fmm and against any and all costs, expenses, liabilities, claims, damages, losses, judgment or fees (including reasonable allomeys' fees) arising from it failure to comply win any such legal requirements or obligations. These Service Commitments shall be governed according to the laws of the Commonwealth of Pennsylvania vinoul regard to it conflicts of law precipice. These Service Commitments are not assignable by the Customer. Unless otherwise staled in your Implementation Schedule, yourpredud will ONLY be serviced by a Ricoh Ceded Technician. You acknowledge and agree that in connection with it performance of its obligations under these Service Commitment, Ricoh may place automated meter reading units on imaging devices, including bin eat handed to the Product at your location in order to facilitate the tlmety and efficient collection of accurate meter read data on a monthly, quarterly or annual basis. Ricoh agrees that such unit wN be used by Ricoh solely for such purpose. Once transmitted, all meter read data shall become the sole property of Ricoh and will be uilired for billing purposes. its as of RICOH USA, INC. By: _ Name: _ Tie: 16093039 ilk INR lip, W.NN WHO I 1111 LSEADD PS-IMPC 04.12 Rieoh00 and the Ricoh Logo are registered trademarks of Ricoh Company, Ltd. Page 1 of 1 EQUIPMENT REMOVAL/BUYOUT AUTHORIZATION Customer Name: CALHOUN, COUNTY OF Contact Name: GALVAN,ROGER Phone: (361)552-9242 Address: 101 COUNTY RD City: PORT LAVACA State: TX I Zip: 1 77979 Fax/Email: roger.galvan@calhouncotx.org �t Make ; Model Senai Number; MPC2551 V9814900501 This Authorization applies to the equipment identified above and to the following Removal/Buy Out Option This Authorization will confirm that Customer desires to engage Ricoh USA, Inc. ("Ricoh") to pick-up and remove certain items of equipment that are currently (i) owned by Customer or (li) leased from Ricoh or other third party (as specified below), and that you intend to issue written or electronic removal requests (whether such equipment is identified in this Authorization, in a purchase order, in a letter or other written form) to Ricoh from time to time for such purpose. Such removal request will set forth the location, make, model and serial number of the equipment to be removed by Ricoh. By signing below, you confirm that, with respect to every removal request issued by Customer (1) Ricoh may rely on the request, and (2) the request shall be governed by this Authorization. Notwithstanding the foregoing, the parties acknowledge and agree that Ricoh shall have no obligation to remove, delete, preserve, maintain or otherwise safeguard any Information, images or content retained by, In or on any Item of equipment serviced by Ricoh, whether through a digital storage device, hard drive or similar electronic medium ("Data Management Services"). If desired, Customer may engage Ricoh to perform such Data Management Services at Its then -current rates. Notwithstanding anything in this Authorization to the contrary, (I) Customer is responsible for ensuring its own compliance with legal requirements pertaining to data retention and protection, (ii) it is the Customer's sole responsibility to obtain advice of competent legal counsel as to the identification and interpretation of any relevant laws and regulatory requirements that may affect the customer's business or data retention, and any actions required to comply with such laws, (iii) Ricoh does not provide legal advice or represent or warrant that its services or products will guarantee or ensure compliance with any law, regulation or requirement, and IN) the selection, use and design of any Data Management Services, and any and all decisions arising with respect to the deletion or storage of any data, as well as any loss of data resulting therefrom, shall be the sole responsibility of Customer, and Customer shall indemnify and hold harmless Ricoh and its subsidiaries, directors, officers, employees and agents from and against any and all costs, expenses, liabilities, claims, damages, losses, judgments or fees (including reasonable attorneys' fees) (collectively, "Losses") arising therefrom or related thereto. OEquipment Removal (Leased by Customer). In addition to the terms and conditions set forth above, the following terms and conditions shall apply for equipment removals of equipment leased by Customer: Except for the obligations of Ricoh to pick up and remove the identified equipment, Ricoh does not assume any obligation, payment or otherwise, under any lease agreement, which shall remain Customer's sole responsibility. As a material condition to the performance by Ricoh, Customer hereby releases Ricoh from, and shall Indemnify, defend and hold Ricoh harmless from and against, any and all claims, liabilities, costs, expenses and fees arising from or relating to any breach of Customer's representations or obligations In this Authorization or of any obligation owing by Customer under its lease agreement. CUSTOMER RICOH USA, INC. By: (^a ' 2 By: if U�l J�_oT Name iJji,f, 1 1 • LI; �_ .1 Name Title (" ;, , s / 3j TA / i---�' Title Date Date 63109v3 Page # 1 , y e q ' CONSIDER AND TAKE NECESSARY ACTION ON REVISED LIBRARY BEHAVIOR POLICY: Noemi Cruz, Library Director, addressed the Court and stated the only change to be made is the addition of E-Cigarettes to the behavior that is not allowed at the Library. Commissioner Galvan made a motion to add E-Cigarettes as a prohibited item on the Library Behavior Policy. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Riley From: Noemi Cruz <ncruz@cclibrary.org> Sent: Thursday, January 29, 2015 5:16 PM To: 'Susan Riley' Subject: Agenda Item #2 Attachments: --POLICY MANUAL --LIBRARY BEHAVIOR - REVISED 2015--- DONE.doc Susan, Please add the following to the next Commissioners' Court meeting: - To approve revised Library Behavior Policy -Thanks Noemi Cruz, Library Director Calhoun County Public Library 200 W.Mahan Port Lavaca, TX 77979 Phone 361.552.7250 ext. 23 Fax 361.552.4926 Email ncruz@cclibrary.org Web ww_w.cclibrary.orq Calhoun County Public Library System Library Behavior Policy The Calhoun County Public Library System encourages people of all ages to visit the library. Those using the library and its resources have the right to expect a safe, comfortable environment that supports appropriate library services. The Calhoun County Public Library System seeks to foster a quiet and orderly environment that is conducive to reading, acquiring information, and study. People entering the library are expected to respect the rights of other patrons to use the library. No person shall harass or annoy others by being noisy or boisterous, by playing audio equipment so that others can hear it, or by behaving in a manner that reasonably can be expected to disturb other persons. People demonstrating disruptive behavior will be required to leave the library after one warning from library staff. Disruptive behavior includes, but is not limited to, noisy, boisterous actions; inappropriate behavior, including eating, smoking (includes e- cigarettes), running, or loud talking; misuse of library property; uncooperative attitude; or actions that deliberately annoy others or prevent the legitimate use of the library and its resources. Abusive language and behavior toward staff will not be tolerated. Personal appliances, such as computers, audio devices, and calculators, may be used if the noise level is low and use does not interfere with others. Because of the lack of outlets and concern for electrical overload, all appliances must be battery -powered and may not be plugged into library outlets without staff approval. Staff will attempt to locate a suitable workstation in the public areas but cannot guarantee that an electrical outlet will be available. Cellular telephones and pagers should be turned off or switched to a non -audible signal and should be answered outside the library. Young children may not be safe when left unattended in the library. Staff will not know if children are leaving with a parent, a friend, or a stranger. Library staff will not deliberately seek out unattended children; however, unattended children frequently become disruptive when they become bored. Parents are responsible for ensuring the appropriate behavior of their children while in the library. If a parent or other responsible adult cannot be located, unattended children who are disruptive will be placed in the care of Port Lavaca Police Department. Under no circumstances will library staff take a child out of the building or transport children to another location. Library Board Approved 3/10/11 Commissioners' Court Approved 4/14/11 CONSIDER AND TAKE ACTION ON THE FOLLOWING LEASE AGREEMENTS FOR THE CALHOUN COUNTY LIBRARY WITH XEROX: $105.37 PER MONTH AND $138.26 PER MONTH AND AUTHORIZE COUNTY JUDGE TO SIGN: Commissioner Finster made a motion to authorize the County Judge to sign lease agreements for the Calhoun County Library with Xerox for copiers in the amount of $105.37 per month and $138.26 per month. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Riley From: Noemi Cruz <ncruz@cclibrary.org> Sent: Thursday, January 29, 2015 4:43 PM, To: 'Susan Riley' Subject: Agenda Item Attachments: Xerox Lease Agreement.pdf Susan, Please add the attached 2 lease agreement contracts to the agenda for next Commissioners' Court meeting. -Thanks Noemi Cruz, Library Director Calhoun County Public Library 200 W. Mahan Port Lavaca, TX 77979 Phone 361.552.7250 ext. 23 Fax 361.552.4926 Email ncruz@cclibrary.org Web www.cclibrary.org customer. CALHOUN COUNTY SiIITo: COUNTY OF CALHOUN Install: COUNTY OF CALHOUN LIBRARY LIBRARY 200 W MAHAN ST 200 W MAHAN ST PORT LAVACA, TX 779793327 PORT LAVACA, TX 779793327 State or Local Government Negotiated Contract: 072579700 Customer admoWedges receipt at the terms of Ikly agreement which wnslsls 612 pages including this face page. Signer: Michael J. Pfeifer ryry Phone: (361)553�4600 �1 1 Signature: ut o1 i, ' Data: 3 Thank You for your business! ThisAgreementisproudlypresentedbyXeroxandHarvey Brewer (361)575.5939 FZ—'4ftjr:rt Far information on your Xerox Account, go to ww�exeroxxomyAwowtManauement 0 2 4 2 1 9 7 0 1 0 0 1 0 0 2 0 INTRODUCTION: 1. NEGOTIATED CONTRACT. The Products are subject solely to the terms in the Negotiated Contract identified on the face of this Agreement, and, for any option you have selected that is not addressed in the Negotiated Contract, the then -current standard Xerox terms for such option. GOVERNMENT TERMS: 2. REPRESENTATIONS & WARRANTIES. This provision is applicable to governmental entities only. You represent and warrant, as of the date of this Agreement, that: (1) you are a State or a fully constituted political subdivision or agency of the State in which you are located and are authorized to enter into, and carry out, your obligations under this Agreement and any other documents required to be delivered in connection with this Agreement (collectively, the 'Documents'); (2) the Documents have been duly authorized, executed and delivered by you in accordance with all applicable laws, rules, ordinances and regulations (including all applicable laws governing open meetings, public bidding and appropdaltons required in connection with this Agreement and the acquisition of the Products) and are valid, legal, binding agreements, enforceable in accordance with their terms; (3) the person(s) signing the Documents have the authority to do so, are acting with the full authorization of your governing body and hold the offices indicated below their signatures, each of which are genuine; (4) the Products are essential to the Immediate performance of a governmental or proprietary function by you within the scope of your authority and will be used dudng the Tenn only by you and only to perform such function; and (5) your payment obligations under this Agreement constitute a current expense and not a debt under applicable state law and no provision of this Agreement constitutes a pledge of your tax or general revenues, and any provision that is so construed by a court of campetent Jurisdiction Is void from the Inception of this Agreement. 3. FUNDING. This provision is applicable to governmental entities only. You represent and warrant that all payments due and to become due during your current fiscal year are within the fiscal budget of such year and are included within an unrestricted and unencumbered appropriation currently available for the Products, and it is your Intent to use the Products for the enfre term of this Agreement and make all payments required under this Agreement. It your legislative body does not appropriate funds for the continuation of this Agreement for any fiscal year after the first fiscal year and has no funds to do so from other sources, this Agreement may be terminated. To effect this termination, you must, at least 30 days prior to the beginning of the fiscal year for which your legislative body does not appropriate funds, notify Xerox in writing that your legislative body failed to appropriate funds. Your notice must be accompanied by payment of all sums then owed through the current fiscal year under this Agreement. You will return the Equipment, at your expense, to a location designated by Xerox and, when returned, the Equipment will be to in good condition and free of all liens and encumbrances. You will then be released from any further payment obligations beyond those payments due for the current fiscal year (with Xerox retaining all sums paid to date). PRICING PLANIOFFERWG SELECTED: 4. FIXED PRICING. If 'Pricing Fixed for Term' Is identified in Maintenance Plan Features, the maintenance component of the Minimum Payment and Print Charges will not increase during the initial Tern of this Agreement. GENERAL TERMS & CONDITIONS: 5. REMOTE SERVICES. Certain models of Equipment are supported and serviced using data that is automatically collected by Xerox or transmitted to or from Xerox by the Equipment connected to Customer's network ('Remote Data') via electronic transmission to a secure off -site location ('Remote Data Access'), Remote Data Access also enables Xerox to transmit to Customer Releases for Software and to remotely diagnose and modify Equipment to repair and correct malfuncilons. Examples of Remote Data include product registration, meter read, supply level, Equipment configuration and settings, software version, and probiem/fauhcode data. Remote Data may be used by Xerox for billing, report generation, supplies replenishment, support services, recommending additional products and services, and product improvement/development purposes. Remote Data will be transmitted to and from Customer in a secure manner specified by Xerox. Remote Data Access will not allow Xerox to read, view or download the content of any Customer documents or other Information residing on or passing through the Equipment or Customer's Information management systems. Customer grants the right to Xerox, without charge, to conduct Remote Data Amass for the purposes described above. Upon Xerox's request, Customer will provide contact Information for Equipment such as name and address of Customer contact and IF and physical addresses/locations of Equipment. Customer will enable Remote Data Access via a method prescribed by Xerox, and Customer will provide reasonable assistance to allow Xerox to provide Remote Data Access. Unless Xerox deems Equipment incapable of Remote Data Access, Customer will ensure that Remote Data Access is maintained at all times Maintenance Services are being performed. 0 2 4 2 1 9 7 0 1 0 0 2 0 0 2 1 1. WC5335PT (WC5335 PRINTR(TANDESO -1-line Emb Fax Kit - Postscript 3 - Customer Ed - Analyst Services Lease Term: 60 months Xerox WC5135 SIN VXW004813 W/2015 Purchase Option: FMV I Trade -In as of Payment 60 1. WC5335PT $138.26 1: Meter 1 1 •5,000 Included Consumable Supplies Included for all prints 5,001+ $0.0050- PricingFixedforTerm Total $138.26 Minimum Payments (Excluding Applicable Taxes) Customer acknowledges receipt of the turn; of this agreement whichwnsislsof2pages Including [his face page. Thank You for your businessl This Agreement is proudly presented by Xerox and --- ®® - Signer. Michael J. Pffefer Phone: (351)553-4600 x23 Harvey Brewer (361)575-5931 /{ (1 't 'I For intonation on your Xerox A=unt, go to c7�gRgyTE ( f —"--- Signature: )' �' ;r r Nate wuwr.xerox.comtAocounlManadement v " 0 2 4 2 2 0 0 0 1 0 0 1 0 0 2 0 INTRODUCTION: d. NEGOTIATED CONTRACT. The Products are subject solely to the terms in the Negotiated Contract identified on the face of this Agreement, and, for any option you have selected that is not addressed in the Negotiated Contract, the then -current standard Xerox terms for such option. GOVERNMENT TERMS: 2. REPRESENTATIONS & WARRANTIES. This provision Is applicable to governmental entities only. You represent and warrant, as of the date of this Agreement, that: (1) you are a Stale or a fully ronsthuted polHlcal subdivision or agency of the State in which you are located and are authorized to enter Into, and carry out, your obligations under this Agreement and any other documents required to be delivered in connection with this Agreement (collectively, the `Documents'); (2) the Documents have been duly authorized, executed end delivered by you in accordance with all applicable laws, rules, ordinances and regulations (including all applicable laws governing open meetings, public bidding and appropriations required In connection with this Agreement and the acquisition of the Products) and are valid, legal, binding agreements, enforceable in accordance with their terms; (3) the person(s) signing the Documents have the authority to do so, are acting with the full authorization of your governing body and hold the offices indicated below their signatures, each of which are genuine; (4) the Products are essential to the immediate performance of a governmental or proprietary function by you whhin the scope of your authority and will be used during the Term only by you and only to perform such function; and (5) your payment obligations underthis Agreement constitute a current expense and not a debt under applicable slate law and no provision of this Agreement constitutes a pledge of your tax or general revenues, and any provision that is so construed by a court of competent jurisdiction is vold from the inception of this Agreement. S. FUNDING. This provision is applicable to governmental entities only. You represent and warrant that all payments due and to become due during your current fiscal year are within the fiscal budget of such year and are Included within an unrestricted and unencumbered appropriation currently available for the Products, and it is your Intent to use the Products for the entire tern of this Agreement and make all payments required under this Agreement. If your legislative body does not appropriate funds for the continuation of this Agreement for any fiscal year after the first fiscal year and has no funds to do so from other sources, this Agreement may be terminated. To effect this termination, you must, at least 30 days prior to the beginning of the fiscal year for which your legislative body does not appropriate funds, notify Xerox in writing that your 4 xerox^ry._ legislative body failed to appropriate funds. Your notice must be accompanied by payment of all sums then owed through the current fiscal year under this Agreement. You will return the Equipment, at your expense, to a location designated by Xerox and, when returned, the Equipment will be to in good condition and free of all lions and encumbrances, You will then be released from any further payment obligations beyond those payments due for Via current fiscal year (with Xerox retaining all sums paid to dale). PRICING PLAN/OFFERING SELECTED: 4. FIXED PRICING. It "Pricing Fixed for Term' is identified In Maintenance Plan Features, the maintenance component of the Minimum Payment and Print Charges will not increase during the Initial Tenn of this Agreement GENERALTERMS & CONDITIONS: S. REMOTE SERVICES. Certain models of Equipment are supported and serviced using data that is automatically collected by Xerox or transmitted to or from Xerox by the Equipment connected to Customer's network ('Remote Date) via electronic transmission to a secure off -site location ('Remote Data Access'). Remote Data Access also enables Xerox to transmit to Customer Releases for Software and to remotely diagnose and modify Equipment to repair and correct malfunctions. Examples of Remote Data include product registration, meter read, supply level, Equipment configuration and settings, software version, and problem/fault cede data. Remote Data may be used by Xerox for billing, report generation, supplies replenishment, support services, recommending additional products and services, and product improvement/development purposes. Remote Data will be transmitted to and from Customer in a secure manner specified by Xerox. Remote Data Actress will not allow Xerox to read, view or download the content of any Customer documents or other Information residing on or passing through the Equipment or Customer's information management systems. Customer grants the right to Xerox, without charge, to conduct Remote Data Access for the purposes described above. Upon Xerox's request, Customer will provide contact Information for Equipment such as name and address of Customer contact and IP and physical addresses/locations of Equipment. Customer will enable Remote Data Access via a method prescribed by Xerox, and Customer will provide reasonable assistance to allow Xerox to provide Remote Data Access. Unless Xerox deems Equipment Incapable of Remote Data Access, Customer will ensure that Remote Data Access is maintained at all times Maintenance Services are being performed. 0 2 4 2 2 0 ACKNOWLEDGE THE DECREASE OF THE CALHOUN COUNTY SHERIFF'S OFFICE FORFEITED PROPERTY FUND — BEGINNING CASH BALANCE (2860-001-40010-999) $9450.00, CAPITAL OUTLAY (2860-999-70750-999) ($4725.00) and CAPITAL OUTLAY VEHICLE (2860-999- 74050-999). THE NET EFFECT OF THIS TRANSACTION IS ZERO: Commissioner Lyssy made a motion to acknowledge the decrease of the Calhoun County Sheriffs Office Forfeited Property Fund — Beginning Cash Balance (2860-001-40010-999) $9450.00), Capital Outlay (2860-999-70750-999) ($4725.00) and Capital Outlay Vehicle (2860-999-74050-999), the net effect of this transaction being zero. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553-4668 MEMO TO: MIKE PFEIFER, COUNTY JUDGE SUBJECT: Decrease the Forfeited Property Fund in 2015 Budget DATE: January 29, 2015 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR FEBRUARY 12, 2015 To acknowledge the decrease of the Calhoun County Sheriff's Office - Forfeited Property Fund —Beginning Cash Balance (2860-001-40010-999) $9450.00, Capital Outlay (2860-999-70750-999) ($4725.00) and Capital Outlay Vehicle (2860-999-74050-999) ($4725.00). The net effect of this transaction is zero. cerely, 4,40ve- , George Aleman Calhoun County Sheriff CALIIOUN COUNTY, TEXAS Summary Budget Comparison - Unposted Transactions Included In Report 2860 - SHERIFF FORFEITED PROPERTY FUND From I/I/2015 Through 1/31/2015 This is the actual cash balance on 1/1/15 Percent Account.. Account Title CarrActual YTDActual YTD Budget Variance Remaining A ESTIMATED BEGINNING CASH 40010 ESTIMATED BEGINNING CASH 0.00 0.00 15 559.00 (15 559.00) 100.00% Total ESTIMATED BEGINNING CASH 0.00 0,00 15,559.00 (15,559.00) 100.00% F FINES 45060 FORFEITURES -OTHER 0.00 0.00 2.00 (2.00) I00.000/ Total F FINES 0.00 0.00 2.00 (2.00) 100.00% G INTEREST INCOME 46010 INT INC-GENERAL 0.00 0.00 1.00 (1.00) 100.00% GOVERNMENT 46030 INT INC-PUBLIC SAFETY 0.00 0.00 1.00 (L00) 100.00% Total G INTEREST INCOME 0.00 0.00 2.00 (2.00) 100.00% I MISCELLANEOUS REVENUES - - 49010 REBATES -PREVIOUS EXPENSES 0.00 0.00 1.00 (1.00) 100.00% Total I MISCELLANEOUS REVENUES 0.00 0.00 1.00 (1.00) 100.00% Q SUPPLIES 53430 LAW ENFORCEMENTSUPPLIES 0.00 0.00 2,001.00 2,001-00 100.00% 53992 SUPPLIES -MISCELLANEOUS 0.00 0.00 2,501.00 2,501.00 100.00% Total Q SUPPLIES 0.00 0.00 (4,502.00) 4,502.00 100.00% R SERVICES 60360 AUTOMOTIVE REPAIRS 0.00 0.00 1,00 1.00 100.00% 60580 BUY MONEY 0.00 0.00 5,001.00 5,001.00 100.00% 63920 MISCELLANEOUS 376.43 376.43 3,001.00 2,624.57 87.46% Total R SERVICES (376.43) (376.43) (8,003,00) 7,626.57 95.30% S CAPITAL OUTLAY 70750 CAPITAL OUTLAY 0.00 0.00 6,501.00 6,501.001'77(P 100.00% 74050 VEHICLE 0.00 0.00 6,001.00 6001.00 JAI(0 100.00% Totals CAPITAL OUTLAY 0.00 0.00 (12,502,00) 12,502.00 100.00% Total 2860 - SHERIFF (376.43) (376.43) (9,443.00) 9,066.57 96.01% FORFEITED PROPERTY FUND Report Difference (376.43) (376.43) (9,443.00) 9,066.57 96.01% Expense line item budgets must be reduced by $9,450 because cash will not cover the budgeted expenses.. My suggestion is to reduce 70750 and 74050. If Sheriff agrees, you will need to put an item on agenda for 2112 meeting for acknowledgment of the change in budget. If forfeiture revenue is received during the year, expense line items can be increased accordingly. Date: 112L1511:30:01 Ado Pege: 1 CONSIDER AND TAKE NECESSARY ACTION ON REQUEST BY INGLESIDE ETHYLENE, LLC (IELLC) TO BORE IN THEIR CORRIDOR UNDER FOESTER RD, KEMPER RD, AND HENGST ROAD: Commissioner Lyssy stated they are adding another pipeline to their existing corridor and just want permission to bore under the roads. Commissioner Fritsch made a motion granting the request by Ingleside Ethylene, LLC (IELLC) to bore in their corridor under Foester Road, Kemper Road and Hengst Road. Commissioner Lyssy seconded the motion. Commissioner Galvan asked if a pipe was to break under the road, would the company just come in and destroy the road without permission. Commissioner Lyssy stated they generally ask for permission, and as to the last two instances, everything was repaired the same as, if not better, than it was before. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County Commissioner, Precinct #2 n<[ of r 5812 FM 1090 Port Lavaca, TX 77979 eG�rY OF CF'JOJ February 5, 2015 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for February 12, 2015. • Consider and take necessary action to allow Ingleside Ethylene, LLC (IELLC), to bore in their corridor under Foester Rd, Kemper Rd, and Hengst Rd,. Sincere] Vern Lyssy VL/Ij Eric Johnston Permitting Agent 500 N. Shoreline Boulevard, Suite 612, Corpus Christi, TX 78401 Office: 361-687-2776 Cell: 832-928-5437 Email: eric.johnston@contractlandstaff.com ®xr Occidental Chemical Corporation ®xyChemm P.O. Drawer CC, Ingleside, Texas 78362-0710 A subsidiary of Occidental Petroleum Corporation 4133 Hwy. 361, Gregory, Texas 78359-6240 Phone 361.776.6050 Fax 361.776.6240 January 20, 2015 Calhoun County Commissioner's Court 211 S. Ann St. Ste. 301 Port Lavaca, TX. 77979 Re: Authorization to install a pipeline across county road right of way To whom it may concern: The purpose of the letter is to notify you that Ingleside Ethylene, LLC (IELLC) is proposing to install an eight (8) inch pipeline that will cross beneath Calhoun County road right of way (ROW) in three locations. The purpose of this project is to transport ethylene from the OxyChem site near Ingleside, Texas to a new facility near Clemville in Matagorda County, Texas. This pipeline will cross under Forester Rd, Kemper Rd, and Hengst Rd by boring beneath the roads with uncased pipeline. The minimum boring depth under each road will be five(5) feet. The bore length will be from county ROW line to county ROW line. Please see the attached typical drawings and Barlow Formula. IELLC requests approval to install this pipeline and will provide any additional information as needed. For additional information please contact Mark Evans at (361)775-7292 or Eric Johnston at (832)928-5437. Sincerely, Mark R. 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M4846PTLA AND AUTHORIZE ALL APPROPRIATE SIGNATURES: Commissioner Lyssy stated this is an annual grant that we get for maintenance which helps us recoup our expenditures. Commissioner Fritsch made a motion to authorize the Texas Department of Transportation Grant for routine maintenance program (TxDOT) Project No. M4846PTLA and authorizing all appropriate signatures. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 January 29, 2015 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for February 12, 2015. • Consider and take necessary action regarding Texas Department of Transportation Grant for Routine Airport Maintenance Program (TxDOT Project No. M4846PTLA) and authorize all appropriate signatures. Sincerely, Vern Lyssy VL/Ij s 5' Af TexasIparfd2111s4vn.t o Transportation AVIATION DIVISION 125 E. 11TH STREET > AUSTIN, TEXAS 78701-2483 - 512/416-4500 ^ FAX 512/416-4510 September 18, 2013 Mr. Vern Lyssy, Commissioner Pot. 2 County of Calhoun 5812 FM 1090 Port Lavaca, Texas 77979 Dear Commissioner Lyssy: TxDOT CSJ No.: "7 1�L�c t't �� 15 ?'Y-LJ`t We are pleased to return to you the completed fiscal year 2014 Grant for Routine Airport Maintenance Program between the County of Calhoun and the Texas Department of Transportation. By receipt of this letter the County of Calhoun is given notice to proceed for work as described on Attachment A — Scope of Services of the grant. Under this new agreement all work described in Attachment A shall be accomplished by August 31, 2014. The Scope of Services of the grant has been updated again this year to include more items in the generic list of normal airport maintenance or service items under "General Maintenance" to try and reduce the number of amendments necessary to complete the grant. Special projects such as construction of new improvements or items that are not normal maintenance or services will need to be listed separately under the appropriate category, and any new special project that comes up during the grant year will need an approved amendment to be included on the Scope of Services. A reimbursement request form is attached along with a project summary table - please list all invoices by date, description, related project, and amount on the attached table, or submit this information in your own spreadsheet or table. Be sure to include invoices (please do not include purchase orders and check copies) with the reimbursement request, and remember that we cannot pay for invoices dated before the grant is executed by the state. Reimbursement requests can be e-mailed to me at Meaan.Caffall(a).TXDOT.gov or mailed to TxDOT Aviation Division, Arm. Megan Caffall, 125 E. 11 °i Street, Austin, Texas 78701-2483. Jim Pohl, Yoakum District; is the RAMP Coordinator for the grant work and will handle all technical and management aspects of the airport routine maintenance performed by the TxDOT District. We look forward to the successful completion of this maintenance grant at the Calhoun County airport. If you need any further information or assistance, please call me at 1-800-687-4568 (800-68-PILOT) or e-mail me at nleaan.caffall�.txdot,yov_ . Sincerely, Maw Megan Caffall RAMP Program Manager cc: Jim Pohl, Yoakum District Enclosures TEXAS DEPARTMENT OF TRANSPORTATION GRANT FOR ROUTINE AIRPORT MAINTENANCE PROGRAM (State Assisted Airport Routine Maintenance) TxDOT CSJ No.: M1513PTLA Part I - Identification of the Project TO: The County of Calhoun, Texas FROM: The State of Texas, acting through the Texas Department of Transportation This Grant is made between the Texas Department of Transportation, (hereinafter referred to as the "State"), on behalf of the State of Texas, and the County of Calhoun, Texas, (hereinafter referred to as the "Sponsor"). This Grant Agreement is entered into between the State and Sponsor shown above, under the authority granted and in compliance with the provisions of the Transportation Code Chapter 21. The project is for airport maintenance at the Calhoun County Airport. Part II - Offer of Financial Assistance 1. For the purposes of this Grant, the annual routine maintenance project cost, Amount A, is estimated as found on Attachment A, Scope of Services, attached hereto and made a part of this grant agreement. State financial assistance granted will be used solely and exclusively for airport maintenance and other incidental items as approved by the State. Actual work to be performed under this agreement is found on Attachment A, Scope of Services. State financial assistance, Amount B, will be for fifty percent (50%) of the eligible project costs for this project or $50,000.00, whichever is less, .per fiscal year and subject to availability of state appropriations. Scope of Services, Attachment A, of this Grant, may be amended, subject to availability of state funds, to include additional approved airport maintenance work. Scope amendments require submittal of an Amended Scope of Services, Attachment A. Services will not be accomplished by the State until receipt of Sponsor's share of project costs. 09/01/2014 Page I of 12 Only work items as described in Attachment A, Scope of Services of this Grant are reimbursable under this grant. Work shall be accomplished by August 31, 2015, unless otherwise approved by the State. 2. The State shall determine fair and eligible project costs for work scope. Sponsor's share of estimated project costs, Amount C, shall be as found on Attachment A and any amendments. It is mutually understood and agreed that if, during the term of this agreement, the State determines that there is an overrun in the estimated annual routine maintenance costs, the State may increase the grant to cover the amount of the overrun within the above stated percentages and subject to the maximum amount of state funding. The State will not authorize expenditures in excess of the dollar amounts identified in this Agreement and any amendments, without the consent of the Sponsor. Sponsor, by accepting this Grant certifies and, upon request, shall furnish proof to the State that it has sufficient funds to meet its share of the costs. The Sponsor grants to the State the right to audit any books and records of the Sponsor to verify expended funds. Upon execution of this Agreement and written demand by the State, the Sponsor's financial obligation (Amount C) shall he due in cash and payable in full to the State. State may request the Sponsor's financial obligation in partial payments. Should the Sponsor fail to pay their obligation, either in whole or in part, within 30 days of written demand, the State may exercise its rights under Paragraph V-3. Likewise, should the State be unwilling or unable to pay its obligation in a timely manner, the failure to pay shall be considered a breach and the Sponsor may exercise any rights and remedies it has at law or equity. The State shall reimburse or credit the Sponsor, at the financial closure of the project, any excess funds provided by the Sponsor which exceed Sponsor's share (Amount C). 4. The Sponsor specifically agrees that it shall pay any project costs which exceed the amount of financial participation agreed to by the State. It is further agreed that the Sponsor will reimburse the State for any payment or payments made by the State which are in excess of the percentage of financial assistance (Amount B) as stated in Paragraph II-1. Scope of Services may be accomplished by State contracts or through local contracts of the Sponsor as determined appropriate by the State. All locally contracted work must be approved by the State for scope and reasonable cost. Reimbursement requests for locally contracted work shall be submitted on forms provided by the State and shall include copies of the invoices for materials or services. Payment shall be made for no more than 50% of allowable charges. 09/01/2014 Page 2 of 12 The State will not participate in funding for force account work conducted by the Sponsor. 6. This Grant shall terminate upon completion of the scope of services. Part III - Sponsor Responsibilities 1. In accepting this Grant, if applicable, the Sponsor guarantees that: a. it will, in the operation of the facility, comply with all applicable state and federal laws, rules, regulations, procedures, covenants and assurances required by the State in connection with this Grant; and b. the Airport or navigational facility which is the subject of this Grant shall be controlled by the Sponsor for a period of at least 20 years; and C. consistent with safety and security requirements, it shall make the airport or air navigational facility available to all types, kinds and classes of aeronautical use without discrimination between such types, kinds and classes and shall provide adequate public access during the period of this Grant; and d. it shall not grant or permit anyone to exercise an exclusive right for the conduct of aeronautical activity on or about an airport landing area. Aeronautical activities include, but are not limited to scheduled airline flights, charter flights, flight instruction, aircraft sales, rental and repair, sale of aviation petroleum products and aerial applications. The landing area consists of runways or landing strips, taxiways, parking aprons, roads, airport lighting and navigational aids; and e. it shall not enter into any agreement nor permit any aircraft to gain direct ground access to the sponsor's airport from private property adjacent to or in the immediate area of the airport. Further, Sponsor shall not allow aircraft direct ground access to private property. Sponsor shall be subject to this prohibition, commonly known as a "through -the -fence operation," unless an exception is granted in writing by the State due to extreme circumstances; and f. it shall not permit non -aeronautical use of airport facilities without prior approval of the State; and g. the Sponsor shall submit to the State annual statements of airport revenues and expenses when requested; and h. all fees collected for the use of the airport shall be reasonable and nondiscriminatory. The proceeds from such fees shall be used solely for the development, operation and maintenance of the airport or navigational facility; and i. an Airport Fund shall be established by resolution, order or ordinance in the 09/01/2014 Page 3 of 12 treasury of the Sponsor, or evidence of the prior creation of an existing airport fund or a properly executed copy of the resolution, order, or ordinance creating such a fund, shall be submitted to the State. The fund may be an account as part of another fund, but must be accounted for in such a manner that all revenues, expenses, retained earnings, and balances in the account are discernible from other types of moneys identified in the fund as a whole. All fees, charges, rents, and money from any source derived from airport operations must be deposited in the Airport Fund and shall not be diverted to the general revenue fund or any other revenue fund of the Sponsor. All expenditures from the Airport Fund shall be solely for airport purposes. Sponsor shall be ineligible for a subsequent grant or loan by the State unless, prior to such subsequent approval of a grant or loan, Sponsor has complied with the requirements of this subparagraph; and j. the Sponsor shall operate runway lighting at least at low intensity from sunset to sunrise; and k. insofar as it is reasonable and within its power, Sponsor shall adopt and enforce zoning regulations to restrict the height of structures and use of land adjacent to or in the immediate vicinity of the airport to heights and activities compatible with normal airport operations as provided in Tex. Loc. Govt. Code Ann, Sections 241.001 et seq. (Vernon and Vernon Supp.). Sponsor shall also acquire and retain aviation easements or other property interests in or rights to use of land or airspace, unless sponsor can show that acquisition and retention of such interest will be impractical or will result in undue hardship to Sponsor. Sponsor shall be ineligible for a subsequent grant or loan by the State unless Sponsor has, prior to subsequent approval of a grant or loan, adopted and passed an airport hazard zoning ordinance or order approved by the State. 1. mowing services will not be eligible for state financial assistance. Sponsor will be responsible for 100% of any mowing services. 2. The Sponsor, to the extent of its legal authority to do so, shall save harmless the State, the State's agents, employees or contractors from all claims and liability due to activities of the Sponsor, the Sponsor's agents or employees performed under this agreement. The Sponsor, to the extent of its legal authority to do so, shall also save harmless the State, the State's agents, employees or contractors from any and all expenses, including attorney fees which might be incurred by the State in litigation or otherwise resisting claim or liabilities which might be imposed on the State as the result of those activities by the Sponsor, the Sponsor's agents or employees. 3. The Sponsor's acceptance of this Offer and ratification and adoption of this Grant shall be evidenced by execution of this Grant by the Sponsor. The Grant shall comprise a contract, constituting the obligations and rights of the State of Texas and the Sponsor with respect to the accomplishment of the project and the operation and maintenance of the airport. 09/O1/2014 Page 4 of 12 If it becomes unreasonable or impractical to complete the proj cut, the State may void this agreement and release the Sponsor from any further obligation of project costs. 4. Upon entering into this Grant, Sponsor agrees to name an individual, as the Sponsor's Authorized Representative, who shall be the State's contact with regard to this project. The Representative shall receive all correspondence and documents associated with this grant and shall make or shall acquire approvals and disapprovals for this grant as required on behalf of the Sponsor, and coordinate schedule for work items as required. By the acceptance of grant funds for the maintenance of eligible airport buildings, the Sponsor certifies that the buildings are owned by the Sponsor. The buildings may be leased but if the lease agreement specifies that the lessee is responsible for the upkeep and repairs of the building no state funds shall be used for that purpose: 6. Sponsor shall request reimbursement of eligible project costs on forms provided by the State. All reimbursement requests are required to include a copy of the invoices for the materials or services. The reimbursement request will be submitted no more than once a month. The Sponsor's acceptance of this Agreement shall comprise a Grant Agreement, as provided by the Transportation Code, Chapter 21, constituting the contractual obligations and rights of the State of Texas and the Sponsor with respect to the accomplishment of the airport maintenance and compliance with the assurances and conditions as provided. Such Grant Agreement shall become effective upon the State's written Notice to Proceed issued following execution of this agreement. PART IV - Nomination of the Agent The Sponsor designates the State as the party to receive and disburse all funds used, or to be used, in payment of the costs of the project, or in reimbursement to either of the parties for costs incurred. 2. The State shall, for all purposes in connection with the project identified above, be the Agent of the Sponsor. The Sponsor grants the State a power of attorney to act as its agent to perform the following services: a. accept, receive, and deposit with the State any and all project funds granted, allowed, and paid or made available by the Sponsor, the State of Texas, or any other entity; b. enter into contracts as necessary for execution of scope of services; c. if State enters into a contract as Agent: exercise supervision and direction of the project work as the State reasonably finds appropriate. Where there is an 09/01/2014 Page 5 of 12 irreconcilable conflict or difference of opinion, judgment, order or direction between the State and the Sponsor or any service provider, the State shall issue a written order which shall prevail and be controlling; d. receive, review, approve and pay invoices and payment requests for services and materials supplied in accordance with the State approved contracts; e. obtain an audit as may be required by state regulations; the State Auditor may conduct an audit or investigation of any entity receiving funds from TxDOT directly under this contract or indirectly through a subcontract under this contract. Acceptance of funds directly under this contract or indirectly through a subcontract under this contract acts as acceptance of the authority of the State Auditor, under the direction of the legislative audit committee, to conduct an audit or investigation in connection with those funds. An entity that is the subject of an audit or investigation must provide the state auditor with access to any information the state auditor considers relevant to the investigation or audit. f. reimburse sponsor for approved contract maintenance costs no more than once a month. PART V - Recitals 1. This Grant is executed for the sole benefit of the contracting parties and'is not intended or executed for the direct or incidental benefit of any third party. 2. It is the intent of this grant to not supplant local funds normally utilized for airport maintenance, and that any state financial assistance offered under this grant be in addition to those local funds normally dedicated for airport maintenance. This Grant is subject to the applicable provisions of the Transportation Code, Chapters 21 and 22, and the Airport Zoning Act, Tex. Loc. Govt. Code Ann. Sections 241.001 et seq. (Vernon and Vernon Supp.). Failure to comply with the terms of this Grant or with the rules and statutes shall be considered a breach of this contract and will allow the State to pursue the remedies for breach as stated below. a. Of primary importance to the State is compliance with the terms and conditions of this Grant. If, however, after all reasonable attempts to require compliance have failed, the State finds that the Sponsor is unwilling and/or unable to comply with any of the terms of this Grant,' the State, may pursue any of the following remedies: (1) require a refund of any financial assistance money expended pursuant to this Grant, (2) deny Sponsor's future requests for aid, (3) request the Attorney General to bring suit seeking reimbursement of any financial assistance money expended on the project pursuant to this Grant, provided however, these remedies shall not limit the State's authority to enforce its rules, regulations or 09/O1/2014 Page 6 of 12 orders as otherwise provided by law, (4) declare this Grant null and void, or (5) any other remedy available at law or in equity. b. Venue for resolution by a court of competent jurisdiction of any dispute arising under the terms of this Grant, or for enforcement of any of the provisions of this Grant, is specifically set by Grant of the parties in Travis County, Texas. 4. The State reserves the right to amend or withdraw this Grant at any time prior to acceptance by the Sponsor. The acceptance period cannot be greater than 30 days after issuance unless extended by the State. 5. This Grant constitutes the full and total understanding of the parties concerning their rights and responsibilities in regard to this project and shall not be modified, amended, rescinded or revoked unless such modification, amendment, rescission or revocation is agreed to by both parties in writing and executed by both parties. 6. All commitments by the Sponsor and the State are subject to constitutional and statutory limitations and restrictions binding upon the Sponsor and the State (including Sections 5 and 7 of Article 11 of the Texas Constitution, if applicable) and to the availability of funds which lawfully may be applied. 09/01/2014 Page 7 of 12 Part VI - Acceptances Sponsor The County of Calhoun, Texas, does ratify and adopt all statements, representations, warranties, covenants, agreements, and all terms and conditions of this Grant. Executed this 12 day of February 20 15. The County of Calhoun, Texas Sponsor Witness Signature Sponsor Signat tle e I Administrative Assistant Calhoun County Judge Witness Title Sponsor Title Certificate of Attorney 1 Shannon Salyer , acting as attorney for the County of Calhoun, Texas, do certify that I have fully examined the Grant and the proceedings taken by the Sponsor relating to the acceptance of the Grant, and find that the manner of acceptance and execution of the Grant by the Sponsor, is in accordance with the laws of the State of Texas. Dated at Port Lavaca Texas, this ,_._ o- day of February 20 15 Witness Signature ttorney's Signature Administrative Assistant Witness Title 09/01/2014 Page 8 of 12 Acceptance of the State Executed by and approved for the Texas Transportation Commission for the purpose and effect of activating and/or carrying out the orders, established policies or work programs and grants heretofore approved and authorized by the Texas Transportation Commission. STATE OF TEXAS TEXAS DEPARTMENT OF TRANSPORTATION 09/O1/2014 Page 9 of 12 Attachment A Scope of Services TxDOT CSJ No.:MISI3PTLA Eligible Scope Item: Estimated Costs Amount A State Share Amount B Sponsor Share Amount C GENERAL MAINTENANCE $20,000.00 $10,000.00 $10,000.00 Special Project $0.00 $0.00 $0.00 Special Project $0.00 $0.00 $0.00 Special Project $0.00 $0.00 $0.00 Special Project $0.00 $0.00 $0.00 Special Project $0.00 $0.00 $0.00 TOTAL $20,000.00 $10,000.00 $10,000.00 Accepted by: The County of Calhoun, Texas h gignatbl-e Title: Calhoun County Judge Date: February 12, 2015 GENERAL MAINTENANCE: As needed, Sponsor may contract for _services/ purchase materials for routine maintenance/improvement of airport pavements signage drainage AWOS systems approach aids lighting systems utility infrastructure fencing herbicide/application sponsor owned and operated fuel systems hangars terminal buildings and security ystems• urofessional services for environmental compliance, approved oroiect design. Special projects to be determined and added by amendment. Only work items as described in Attachment A, Scope of Services of this Grant are reimbursable under this grant. 09/O1/2014 Page 10 of 12 CERTIFICATION OF AIRPORT FUND TxDOT CSJNo.: M1513PTLA The County of Calhoun does certify that an Airport Fund has been established for the Sponsor, and that all fees, charges, rents, and money from any source derived from airport operations will be deposited for the benefit of the Airport Fund and will not be diverted for other general revenue fund expenditures or any other special fund of the Sponsor and that all expenditures from the Fund will be solely for airport purposes. The fund may be an account as part of another fund, but must be accounted for in such a manner that all revenues, expenses, retained earnings, and balances in the account are discernible from other types of moneys identified in the fund as a whole. The County of Calhoun, Texas (Sponsor) By:�,�{� Calhoun County Judge Date: February 12,.2015 Certification of State Single Audit Requirements I Cynthia Mueller , do certify that the County of Calhoun will comply with all (Designated Representative) requirements of the State of Texas Single Audit Act if the County of Calhoun spends or receives more than the threshold amount in any grant funding sources during the most recently audited fiscal year.- And in following those requirements, the County of Calhoun will submit the report to the audit division of the Texas Department of Transportation. If your entity did not meet the threshold in grant receivables or expenditures, please submit a letter indicating that your entity is not required to have a State Single Audit performed for the most recent audited fiscal year. �M,,H-JL� Si nature Calhoun County Auditor Title 1100 I Date 09/01/2014 Page 11 of 12 DESIGNATION OF SPONSOR'S AUTHORIZED REPRESENTATIVE TxDOT CSJNumber: M1513PTLA The County of Calhoun designates, Vern .Lyssy, Commissioner Precinct #2 (Name, Title) as the Sponsor's authorized representative, who shall receive all correspondence and documents associated with this grant and who shall make or shall acquire approvals and disapprovals for this grant as required on behalf of the Sponsor. The County of Calhoun, Texas (Sponsor)] By: O� r i9 z�-. Title: Calhoun County Judge February 12, 2015 DESIGNATED REPRESENTATIVE Mailing Address: 5812 FM 1090 Port Lavaca TX 77979 Overnight Mailing Address: SAME Telephone/Fax Number: 361-552-9656 PH 361-55336664 fax Email address: vern.lyssy@calhouncotx.org 09/01/2014 Page 12 of 12 CONSIDER AND TAKE NECESSARY ACTION ON SMARTSIGHT AGREEMENT WITH COMDATA FOR INSTALLATION OF UPDATED FUEL SYSTEM AT THE AIRPORT, AUTHORIZE COUNTY JUDGE TO SIGN CONTRACT: Commissioner Lyssy stated this is an upgrade to the fuel system, basically the card reader and the software. The present company will no longer support the system, so it has to be upgraded. Commissioner Finster made a motion to accept the SmartSight Agreement with Comdata for installation of updated fuel system at the Airport and authorizing the County Judge to sign the contract. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 January 29, 2015 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for February 12, 2015. • Consider and take necessary action to sign SmartSight Agreement with Comdata to install updated fuel system at the Airport. Sincerely, Vern Lyssy VL/Ij ® W ®`.r Payment Innovation SMARTSIGHTTM AGREEMENT Calhoun County Company Name 4876 FM 3084 Address Port Lavaca, TX 77979-5230 City, State, Zip Code 361-552-1228 Telephone No. and Fax No. Effective Date Account Code Corporate Code Chain Code THIS SMARTSIGHTTM AGREEMENT (the "Agreement') is made and entered into as of the Effective Date set forth above, by and between COMDATA INC., a Delaware corporation with its principal offices at 5301 Maryland Way, Brentwood, Tennessee 37027 ('Comdata'), and the Company identified above ("Customer'), and sets forth the terms and conditions of Customer's purchase and license of Comdata's SmartSightTM system. 1. Scope of Agreement. Once executed by Customer, this Agreement shall apply to each order of a SmartSightTM system and components ("System") by Customer on the initial or any subsequent order form ('Order Form') signed by Customer and accepted by Comdata. This Agreement, together with the Order Form or Forms and any Exhibits to this Agreement (the terms of the Order Form or Forms and Exhibits hereby being incorporated into this document by reference), constitutes the entire Agreement between the parties. 2. Payment. The purchase price for the System and the payment terms are set forth on the Order Form. Software support fees are set forth on the Order Form and are subject to an annual increase. Customer shall remit payments in accordance with invoice terms. Customer shall pay all sales, use or other such taxes required by applicable law. A late fee of 1.5% per month, or the maximum allowed by law, whichever is less, will be assessed on any balances which remain unpaid when due and payable according to the terms hereof. In addition, each time Customer's check or other payment method is dishonored when presented for payment at Customer's bank, Customer shall pay to Comdata a service charge of $20.00 or the maximum amount allowed by law, whichever is less. If Customer fails to pay any amounts when due and payable hereunder, Comdata shall have the option, in addition to all other available rights and remedies, to accelerate and declare the entire purchase price as immediately due and payable by Customer as a liquidated sum and proceed against Customer by all legal means for payment of such sum. 3. SmartSightTM Software License. (a) License Grant. Effective as of the date of System setup and subject to Customer's compliance with all obligations set forth in this Agreement, Comdata does hereby grant to Customer a non-exclusive, non -transferable, (except as expressly permitted hereunder) license ("License") for the use of the proprietary software program as included in the System, including any future versions, updates, enhancements and modifications thereof, to the extent Customer is entitled to same and including all materials and documentation relating thereto (the "Software"). Customer agrees to use the Software in accordance with the terms hereof. (b) Scope and Use. (1) This License shall apply to the Software included in Customer's current System and any and all future upgrades and/or replacements of such System. The License is a license providing for use of the Software solely in connection with the System at the Customer's location identified on the Order Form, and each single copy of the Software licensed to Customer hereunder shall be used on not more than 1 single site controller. Customer shall use the Software solely in connection with its internal business operations and for no other purpose and shall not move the Software to a location other than that previously identified without the prior written consent of Comdata. (2) No right to use, copy, display or print the Software, in whole or in part, is granted to Customer, except as expressly provided in this Agreement. (3) Customer may not use any unauthorized software in connection with the Software. Customer must obtain the prior written consent of Comdata to install on the System or use in connection with the Software any software or hardware that was not supplied by Comdata. (4) Customer shall not sublicense, rent, lease, assign, grant a security interest in, or otherwise transfer rights to the Software, except as expressly permitted hereunder. Customer agrees to respect, and not to remove, obliterate or cancel from view any copyright, trademark or confidentiality notice, mark, or legend appearing on the Software or the output generated therefrom. Further, Customer agrees not to reverse assemble, engineer, or decompile the Software in whole or in part. (c) Title. Customer acknowledges and agrees that all copies of the Software are licensed copies only, and that this Agreement does not transfer title to such copies to Customer, but only the right to use such copies pursuant to this Agreement. Comdata, or its third party vendors or suppliers, as applicable, retains all rights, title and interest in and to the Software, including, without limitation, any and all proprietary rights, copyrights, patents, trade secrets and confidential information rights associated therewith. (d) Confidentiality. Customer acknowledges and agrees that the Software and the terms of this Agreement constitute and contain valuable proprietary products and trade secrets of Comdata, or its third party vendors or suppliers, as applicable, embodying substantive creative efforts and confidential information, ideas, and expressions. Accordingly, Customer agrees to treat (and to take precautions to ensure that its employees treat) the Software as confidential and not to discloses such confidential information to any third party while this License is in effect and thereafter for so long as such confidential information and trade secrets shall be entitled to confidential treatment as provided by law. SmartSightTM Agreement and Order Form December 2013 Page 1 of 5 (a) Termination. The License will terminate automatically if Customer fails to comply with the terms and conditions described in this Agreement and/or any Order Form. Upon termination of this Agreement, Customer shall immediately destroy or return to Comdata all copies of the Software, including any materials or documentation related thereto. (f) Audit Rights: Comdata shall have the right to audit Customer for compliance with the provisions of this Agreement during normal business hours upon reasonable prior notice. 4. Delivery and Installation. Comdata will ship the System to the location designated by Customer, and Customer will be billed for the shipping and handling charges. All shipments will be made F.O.B. point of shipment. Customer is responsible for installation of all System hardware and equipment. Comdata can be available to assist Customer in locating a qualified installer. 5. Software Support Services. (a) As part of its System purchase, Customer agrees to enroll in the SmartSighP software support program. In consideration of Customer's payment of the annual software support fee, Comdata will provide the following support services: (1) Software Support. Customer shall be entitled to receive routine updates to the Software that from time to time may be developed and incorporated into the System and made available to Comdata's customers. (2) Comdata Modifications. Comdata shall have the right to make substitutions and modifications to the Software, provided that such substitutions or modifications shall not adversely affect the overall System performance in any material respect. (3) Technical Support. This support shall provide Customer with access to a Comdata representative for answers to problems relating to the System or Software. Emergency calls are handled 24 hours a day, 7 days a week. Non -emergency situations must be handled during regular business hours (8:00 a.m. to 5:00 p.m. (CST) Monday through Friday). If a routine or non -emergency call is received after regular business hours, then Comdata reserves the right to defer assistance and require the caller to contact the office on the following business day. Customer agrees to make a reasonable effort to resolve problems relating to the System before calling Comdata. (b) Customer enrollment in the software support program will renew automatically on an annual basis unless Customer provides Comdata with written notice of cancellation 30 days prior to Comdata's invoicing of the renewal. 6. System Warranty. (a) Warranty on System Hardware. Comdata's sole obligation and liability with respect to hardware and equipment warranties shall be to pass through any eligible warranties from the manufacturer to Customer, and Customers exclusive remedy shall be to enforce such warranties against the manufacturer. (b) Warranty on System Software. Comdata warrants, for the benefit of Customer only, that the Software will materially conform to the written specifications for the SmartSighP for a period of 90 days from the date of System setup and training. Comdata's sole obligation and liability under this warranty, and Customer's exclusive remedy, shall be to repair or replace defective Software that is returned to Comdata within said 90 day period. (c) Disclaimer. THE WARRANTIES SET FORTH HEREIN ARE EXCLUSIVE AND IN LIEU OF ANY AND ALL OTHER WARRANTIES EITHER EXPRESS OR IMPLIED OR WHICH MAY ARISE UNDER LAW OR EQUITY, INCLUDING, WITHOUT LIMITATION, THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON -INFRINGEMENT OF THIRD PARTIES' RIGHTS. WITHOUT LIMITATION, NO WARRANTY IS GIVEN THAT THE SOFTWARE WILL MEET LICENSEE'S REQUIREMENTS OR THAT THE SOFTWARE WILL BE UNINTERRUPTED OR ERROR -FREE. 7. Risk of Loss and Insurance. (a) The System. Customer shall bear the entire risk of loss or damage to the System and shall maintain adequate insurance against risks of loss or damage from any cause whatsoever. Customer shall be responsible for all payments due hereunder even in the event of loss or damage to the System. (b) Data Files. Customer is responsible for maintaining, backing up and staring in a safe and secure location backup copies of all data files Customer may place in the System. In no event shall Comdata be liable for loss or destruction of Customer's data files so long as such loss or destruction is not due to or caused by the gross negligence or wanton and willful misconduct of Comdata, its employees, agents or contractors. 8. Limitation of Liability. (a) Unless further limited elsewhere in this Agreement, the entire liability of Comdata, and Customers exclusive remedy for damages from any cause related to or arising out of this Agreement, regardless of the form of the action, whether in contract or in tort, shall be limited to the total System price actually received by Comdata from Customer pursuant to this Agreement. (b) IN NO EVENT SHALL COMDATA OR ITS VENDORS AND LICENSORS, AS APPLICABLE, BE LIABLE FOR ANY INDIRECT, CONSEQUENTIAL, SPECIAL, INCIDENTAL PUNITIVE OR EXEMPLARY DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF USE, REVENUES, PROFITS OR SAVINGS, EVEN IF COMDATA OR ITS VENDORS OR LICENSORS, AS APPLICABLE, KNEW OR SHOULD HAVE KNOWN OF THE POSSIBILITY OF SUCH DAMAGES. 9. Indemnification. Customer agrees to indemnify, defend and hold harmless Comdata from any and all liability and claims whatsoever for any injury to persons or property or for any loss, damage or expense incurred by any of Customers employees, agents, customers or invitees or by any other person or party (except Comdata's employees or agents) arising as a result of Customers acquisition or use of the System, unless the same was caused by or resulted from the gross negligence of Comdata, its agents or employees. Customer's obligations under this Section shall survive the termination of this Agreement, regardless of whether any such liabilities arise before or after the Effective Date of this Agreement. 10. Force Maieure. Comdata shall not be responsible for delays or failures in its performance resulting either from acts or omissions beyond its reasonable control or from events or circumstances attributable to the manufacturers of either the System hardware or the media devices included in the Software. 11. Right of Setoff. Comdata shall have the right to setoff and apply any amounts owing by Comdata to Customer (including for settlement of Comdata transactions) against any past due amounts owing from Customer to Comdata pursuant to this Agreement (including amounts owed pursuant to the support and maintenance program purchased by Customer). 12. Monitoring and/or Recording Communication. Customer understands and agrees that Comdata may in its discretion, but is not obligated to, monitor and/or record any of Customer's telephone calls with it without any further notice for quality control purposes and SmartSightTM Agreement and Order Form December 2013 Page 2 of 5 for its own protection. Comdata may also monitor, record, and/or make a record of any other communications between Customer and Comdata without any further notice, and Comdata may use the resulting information for internal purposes or as may be required by applicable law. Customer hereby consents to Comdata's monitoring and/or recording of any telephone calls and communications with Customer. Customer acknowledges and understands Comdata may not record all telephone calls or communications, and Comdata does not guarantee that recordings of any particular telephone calls or communications will be retained or be capable of being r6trieved. 13. Miscellaneous. This Agreement may not be changed or modified except by an instrument in writing, duly executed by each of the parties. In no event shall sales literature or brochures be considered part of this Agreement. This Agreement, and all rights and licenses granted hereunder, may not be assigned, sublicensed or transferred, in whole or in part, by Customer without the prior written consent of Comdata, provided however, that Customer agrees that it must assign this Agreement to any successor in connection with a merger, sale of assets or other change of control. The Parties are independent contractors. No partnership or joint venture is intended to be created by this Agreement, nor any principal -agent or employer -employee relationship. Neither Party has, and neither Party shall attempt to assert, the authority to make commitments for or to bind the other Party to any obligation. If any provision of this Agreement is deemed unenforceable, then such provision shall be inoperative and the remainder of this Agreement shall remain binding upon the parties. This Agreement shall be construed in accordance with the laws of the State of Tennessee without reference to the choice of law rules of such state. Any action to enforce or interpret this Agreement may be brought in the appropriate judicial forum in Davidson County, Tennessee (or the appropriate federal court located in Davidson County, Tennessee) and the parties hereby consent to such jurisdiction and waive any objections thereto. Customer agrees to pay reasonable attorney's fees to Comdata in the event that Comdata shall engage an attorney to enforce, protect, preserve or defend any rights it might have under this Agreement. IN WITNESS WHEREOF, the undersigned, being duly authorized representatives of the parties, have executed and delivered this Agreement on this _ day of 20 Calhoun County COMDATA INC. Customer Name By:1'Y 0__P9 By: / Signature o Signature 0(-Atz e l Zr r-VZ, Please Type or Print Name Please Type or Print Name Title: r_i!u . fm Ttj i SmadSightTm Agreement and Order Form December 2013 Page 3 of 5 SMARTSIGHTTM SYSTEM AND SUPPORT ORDER FORM Customer Name: Calhoun County Airport Location Address: 4876 FM 3084 Port Lavaca TX 77979-5230 (Address, City, ST and Zip) Customer hereby orders the SmartSight'"' System, Additional Components, and Software Support selected below for the Location identified above subject to all of the terms of this Order Form and to that certain SmartSightTM11 Agreement between Comdata Inc. and Customer and all Exhibits to that Agreement to which this Order Form relates. The terms of the Agreement and any Exhibit(s) to the Agreement are hereby incorporated by reference into this document. Quantity SmartSight System and Components Purchase Price Total Amount Due _ SmartSight'"' PX System (PX Head Unit, Pedestal, & Modem) ❑ Interface Type:_ $— $— _ SmartSight'"' HX Site Controller ❑ Interface Type: — $— $ 1 SmartSight'"' FX System (FX Head Unit, Pedestal, & Modem) —Pedestal: ® Wide ❑ Narrow $77500 $7,500.00 Dispenser Options 4-Hose Internal MPC (FX Only) $3,i 275 $3,275.00 8-Hose Internal MPC $— $- 16-Hose Internal MPG $— $- 8-Hose External Remote MPC $— $- 16-Hose External Remote MPC $— $— PIE Fuel Direct Pump Loop ❑ Gilbarco ❑ Wayne ❑ Tokheim ❑ Bennett $— $— PIE Fuel Direct GRIND/Pump Loop ❑ Gilbarco ❑ Wayne ❑ Tokheim ❑ Bennett $— $— Additional Products Receipt Printer $— $— External Dial -Backup Modem $— $- 1 Comdata Firmware Module $— $included Card Network Software ❑ NBS ❑ BuyPass ❑ None $— $included MultiTech rCell 3G Cellular Modem $— $— Pinhole Camera (PX Only) $— $— '� Host Setup Fee $250 $250.00 Upgrade Fee $— $— TOTAL SYSTEM AND COMPONENTS $11,025.00 Quantity Service Platform Annual Fees Total Amount Due _ SmartSightM PX Annual Support & Secure Gateway $_ per unit $— per additional unit $ _ SmartSightTm HX Annual Support& Secure Gateway $—per unit $_ 1 SmartSightW FX Annual Support & Secure Gateway $780.00 per unit $_ per additional unit $780.00 _ Cellular 3G Connectivity Fee ❑ $700 Annually ❑ $60 Monthly $ 1 Web Portal Access Fee $included per site $included TOTAL ANNUAL FEES 1 $780.00 PAYMENT TERMS: Total Purchase Price for System & Components $11,026.00. Total Annual Support $780.00. Method of Payment Check For System and Components, total due and payable within 30 days of date of shipment subject to Comdata's acceptance and approval of Customer's credit application. Equipment will not be shipped until all necessary documentation has been received and approved by Comdata. For Support, the total amount shown on each invoice is due and payable by the due date shown on the invoice. A change in the above indicated method of payment will result in additional charges to Customer equal to 1% of the Total Purchase Price. ABOVE AMOUNT DOES NOT INCLUDE SHIPPING AND HANDLING CHARGES OR APPLICABLE SALES/USE TAXES. SUCH AMOUNTS WILL BE INCLUDED ON THE INVOICE. By signing below, Customer accepts and agrees to the terms set forth above for the purchase of the SmartSight''" System and Support and further agrees that the equipment identified above will be shipped upon execution of this Agreement and approval from Comdata's Credit Department. Agreed to this —day of—, 20—. Authorized Signature SmartSightnd Agreement and Order Form December 2013 Page 4 of 5 SMARTSIGHTT°° SYSTEM SPARE PARTS Customer Name: Calhoun County Airport Location Address: 4876 FM 3084 Port Lavaca, TX 77979-5230 (Address, City, ST and Zip) Customer hereby orders the SmadSightTM System Spare Pads selected below for the Location identified above subject to all of the terms of this Order Form and to that certain SmartSight Agreement between Comdata Inc, and Customer and all Exhibits to that Agreement to which this Order Form relates. The terms of the Agreement and any Exhibit(s) to the Agreement are hereby incorporated by reference into this document. Quantity SmartSight Spare Parts Purchase Price Total Amount Due Pegasus IV Door Assembly - Complete $ $— PegasuslVDoorAssemblyw/Camera — Complete $ Door Assembly W/O Membrane $ $— Power Supply Assembly $ $- 10.4" LCD Display Assembly $ $— Comm Board Assembly w/Modem $ $_ Pegasus 4 Keypad Overlay $ $_ PX Printer $ $® PX Secure Card Reader $ $— PXCameraAssembly-Replacement $ $- 8-Hose MPC $ $- 1 Petroleader $1,795,00 $included I= ear Onsite Install and Training $2,500.00 $2.500.00 TOTAL SPARE PARTS $2.500.00 PAYMENT TERMS: Total Purchase Price for Spare Parts $2,500.00. Method of Payment Check For Spare Parts, total due and payable within 30 days of date of shipment subject to Comdata's acceptance and approval of Customer's credit application. Equipment will not be shipped until all necessary documentation has been received and approved by Comdata. A change in the above indicated method of payment will result in additional charges to Customer equal to 1 % of the Total Purchase Price. ABOVE AMOUNT DOES NOT INCLUDE SHIPPING AND HANDLING CHARGES OR APPLICABLE SALESlUSE TAXES. SUCH AMOUNTS WILL BE INCLUDED ON THE INVOICE. By signing below, Customer accepts and agrees to the terms set forth above for the purchase of the SmartSightm Spare Parts and further agrees that the equipment identified above will be shipped upon execution of this Agreement and approval from Comdata's Credit Department. Agreed to this _ day of _, 20_ By: Authorized Signature SmadSightTM Agreement and Order Form. December 2013 Page 5 of 5 CONSIDER AND TAKE NECESSARY ACTION ON APPLICATION FOR GOVERNMENT CREDIT APPLICATION WITH COMDATA, AND AUTHORIZE COMMISSIONER LYSSY TO SIGN CREDIT APPLICATION: Commissioner Lyssy stated this credit is just a formality to receive the cards, there will not be anything on credit. Commissioner Finster made a motion to authorize Commissioner Lyssy to sign the Government Credit application with Comdata and authorize Commissioner Lyssy to sign the credit application. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Payment Innovaimm January 29, 2015 Calhoun County Attn: Vern Lyssy 4876 FM 3084 Port Lavaca, TX 77979-5230 Subject: Comdata Agreement, Government Credit Application, Wire Instructions, Dear Vern: Enclosed is a copy of the agreement, government credit application and wire instructions (or a check can be sent). After the board meets and a decision is made please return the completed paperwork in the enclosed FeclEx envelope so it will reach me in a timely manner. Sincerely, Cathy Par #sh 615-370-7608 5301 Maryland Way Brentwood, TN 37027 Comdata Network, Inc. Application for Government/Public Sector Applicants OnIV A"licantlnformation- Agency/ Organization 41971 FM 329 © _L l 72g7 Address City State Zip .912— G /090 PdA2i M-,_,k %V 797 Billing Address (If different from other) City State Zip Business Phone Business Fax Cell Phone Email Address / ss / Contact Person Billing Attention to // Federal Tax ID #-744L)o% z �� Annual Budget $ 7,9j A90 Business Type: _State Agency Local Government # of Cards 1Z, Municipalities School Non- Profit Other Have you ever had or applied for a Comdata account? Yes or No (circle one) (Please Read Carefully and Sign) By signing below, Applicant hereby authorizes its banking reference to release its credit history and credit information to Comdata Network, Inc. for purposes of credit evaluation, and Applicant gives Comdata permission to obtain credit reports to check Applicant's credit standing. Please attach a copy of Applicant's current financial statement/budget. If requested by Comdata, Applicant agrees to furnish additional financial information. All financial information will be kept confidential. This application does not entitle Applicant to receive an extension of credit from Comdata. By signing below, each individual affirms that all information stated in this application is true and correct to the bestofhis/her knowledge. x x Signature ZTIfle ( ency/ Organization) Name (fdrinted) & Date Please complete this application In Its entirety. Failure to do so will delay the processing of this application. Comdata offical use only, This section to be completed by -Comdata. ❑ Purchase Card ❑ Travel & Entertainment ❑ Fleet Card ❑ eCash / Debit Card ❑ TSD Please select all transaction types above that apply and monthly estimate of spend dollars below. $0 P-Card $0 T & E Card $0 Fleet Card $0 a -Cash Method of Payment: Credit Line Requested: $ Payment Schedule: # Of Cards Requested Comdata Corporation Version: 615-370-7000 5301 Maryland Way Brentwood, TN 37027 5.09.2006 COMDATA CORPORATION Merchant Solutions How to Make Your Payment by ACH and Bank Wire Receiving Bank: Regions Bank, 2090 Parkway Office Circle, Birmingham, AL 35244 ABA Routing Number: 062000019 BNF= Comdata Network, Inc., Acct. Number: 0082680086 ORG= Your company name and address OBI= Your Comdata account code typed between double asterisks. Wire all payments before 12:00 noon (CDT) For prompt and accurate credit to your account, you must include your company name and address on the "ORG=" line of the wire and your Comdata Account Code (2 alpha/3 digit #) typed between double asterisks on either side of it in the "OBI=" line of the wire. For your convenience, simply write your company name and address in the ORG= line and your Comdata account code between the asterisks on the form below. Your Comdata account code is a 2alpha/3 digit #. Then fax it to your bank. Ask them to set up a recurring wire for you so you only have to give them this information one time. Step 2: Send your detailed back up for each wire and each account to Comdata within 24 hours: Fax To: Comdata Network, Inc. Cash Balancing Department (615)370-7373 or (615)370-7700 Be Sure To Include: Mail To: Comdata Network, Inc. Cash Balancing Department 5301 Maryland Way Brentwood, TN 37027 1. Your Comdata Account Code (2alpha/3digit #) 2. Date your bank sent the wire 3. Total dollar amount of the wire E-mail To: cashapp@comdata.com Any questions? If you have any questions regarding the payment of your account, please call our Credit Department at: 800-226-3866. WIRE INSTRUCTIONS Receiving Bank: Regions Bank, 2090 Parkway Office Circle, Birmingham, AL 35244 ABA Routing Number: 062000019 BNF= COMDATA NETWORK, INC., Act #0082680086 ORG= Company Name, Address, City, State, Zip OBI= "Account Codex* Version 9/23/10 gem Request for Taxpayer Give Form to the (Rev.December identification Number and Certification =neester.0onot Tre) of the Treasury send to the 1R5. are alien) Internal .1a201 Revenue Service Name (as shown on your income tax return) THE COUNTY OF CALHOUN TEXAS N Business namoldisregarded entity name, if different from above m rn o' Cheek appropriate box for federal tax classification: c o ❑Individual/sole proprietor U GCorpomtion ❑ SCorporation ❑ Partnership ❑ Tmst/estate N SC O 'o ❑ Limited liability company. Enter the tax classification(C=C corporation,S=s corporation, P=partnership)> El Exempt payee 02 is N c Q Other (see lnstructions)P GOVERNMENT !E Address (number, slrect, and apt. or suite no.) Requester's name and address (optional) a m 202 S ANN ST City, state, and ZIP code m ro PORT LAVACA TX 77979 List account numbers) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name' line i social security number However, for re avoid backup withholding. For individuals, this is your social security numberpage resident alien, sole proprietor, or disregarded entity, see the Fart I instructions onn page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to pet a TIN on page 3. Employer Note. If the account is In more than one name, see the chart on page d for guidelines on whose _ identification number number to enter. 7 4 — 6 0 0 1 9 1 2 1 3 0-M Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that 1 am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U.S. person (defined below) Certification instructions. You must areas out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return, For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on papa A. Here6�,-L(/ 2/yt General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only If you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business note®��w-Z/ Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person If you are: • An individual who is a U.S. citizen or U.S. resident alien, o A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, " An oeude (other than a foreign estate), or A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, In certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S, person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income, is not subject to the withholding tax on foreign partners' share of effectively connected income. Cat. No. 1023'I X Form W-9 (Rev. 12-201 in ACCEPT REPORTS OF THE FOLLOWING COUNTY OFFICES: Judge Pfeifer made a motion to accept reports for the following County offices: Revised August 2014 report from the Calhoun County Tax Assessor/Collector, December 2014 Tax Assessor/Collector report, January 2015 report from Justice of the Peace #5, January 2015 report from Justice of the Peace #1, January 2015 report from Justice of the Peace #2, January 2015 report from the Extension Service, Inmate Cost Comparison reports for September 2014, October 2014, November 2014 and December 2014 from the Adult Detention Center SHP Medical. Commissioner Fritsch seconded the motion. 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Thank you, eaidgc PftwP44 The information contained in the facsimile message is confidential, intended only for the use of the individual or entity named, If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver said message to the intended recipient, you are hereby notified that any dissemination, distribution, copying or the taking of any action in reliance on the contents of this communication is strictly prohibited. If you have received this communication in error, please immediately notify us by telephone and return the original message to us at the above address via the U. S. Postal Service, 02-02-15;10:35AM;Frorn:Calhoun County JP5 To:5534444 ;3619832461 # 2/ 8 Money Distribution Report L UPR 5 JANUARY 2015 Receipt aaua./D,gondant codma\Amon to TOCal 375391 1404-0226 01-05-2015 FINE 90.00 GIPSON, RATHRERN NICOLE 60.00 LEI WO OC * MUS,01T,"ER D ... ;..! . 4:, 0. C', 375393 09050190 01-05-2015 as P 3.00 CCC 40,00 CHS 4.00 LAP 5.00 WRNT 50, 00 520.00 RASMUSSEN, BRADLEY SHANE TF 4.00 DPSC 30.00 JCSF 1.00 JPAY 6,00 IDF 2.00 C 0 t a 61 FIN 5 0 8B 0 C 2 0 7, Ol Ol "OF '3 0 CC", "00 0 0 F 4 C 0' Y' "10 00 P - ' �l 11., ' 4' -.9 OD 2 0 3753951412 0 4 7 0 Ol""-201S asp 4.00TFC 3.00 CCC 40.00 .00 a].I$ 3.00 LAP • 1 9 1. 0 . 0 275.00 L jo t MAG OW ARK 8LVH IF I ' MARK 4 100 JCSF 1.00 JPAY6 .00 IDP 2.00 mvp MoneyOrder, SU C TP�F -00 r YNE 1!4.. 47 015 C K, 0 ON .20.00 d C r ...... 37S397 14 2.0 7 -2 1 3 397 1412- 4i3 0 5 EXRF 0 0 2 0 . . . . . . . . . p. . . . . . . . . . PECK, P RAN CIO SIDON 20.00 Credit Card -,-TFC ;061 ?PECK111 j.,4,t: OD 227 00 .... . ... ... . . ... k SOBOs, ... , .... ..;_; - J�PA�. 6-;- OW:- FINE,. :.X p 0". 37.5399 1412-0400 01-05-2015 EXRF 10.00 STEPHAN, TREVOR RicHARn BERNARD 10.00 Credit Card �1 40 :1015_TSp 0 TEC-3.00. )1�16CC1 t , 'W : , I RRVARD" .... It! V%:- .. VAX;': 0 -,o, v 5bo 0�t Card; '�l �407-'O�'303 I . J 754 01-06-2015 TFC 3.00 CHS 00 L" A r 9.00 WRNT 50.60 TF 4.00 GUTIERREZ, DANXET, DDSC 30.00 JCSF 1,60 TPDr 2.00 FINE 257.DO C$RV 115.50 500.50 Personal Chsck SUBC 10.00 "D 0 2 v `0 15 0 0�' is. CCC, 50a; gCD,.. i:.-- 42.. 06 lit RT CM 06s; WANT'; ' , .. , :f i 50 TF C e C 4DO 0 E 375403 3- 0 1 0 TF 5 0 3 05-0 060 0 -06-2 15 C 3 .00 CCC 4 0.00 CHS3. 00 LAY' 5.00 WRNT 50.00 357,50 P LAN. JOSS AT A RT TP �Bu 0 .00 PSC 4 D n -OQ PIN, 110. 00 CORV 02.00 SOW 30.00 .di, Card 375405 1411-0465 01-00-2015 J91? 1.01 TFC MELENDEZ-CRUZ, FRANUISCO TIME 6.60 TF 375407 1408-0400 OOnRLIT7, BILLY 0.79 CCC 10.5$ CHS 1.06 JCSF 0.26 JPAY 01-12-2015 FIND SOIDD CSRV 116.10 SUBC 30.00 0.79 LAP 1.50 TDF 1.32 33.00 0,53 375409 2502-0103 ol-13-2015 Jj;p 4.00 TrC 3.00 CCC 40.00 CHS 3.00 SAP 5,00 BORSTMAYRR, RICHARD EATON Tr 4.00 JCSF 1.00 JPAY 6.00 IDP 2.00 MVP 108.00 Money. Order SUE)c 30.00 TPDF ........ .. . 2100 DDC 7,90 0.10 ... . ... ......... 376410:' ":fcasA fill. I I 34 275421 1501-0116 01.10-2015 17sp 4.00 CCC 40.00 CBS 3.00 •4.00 MrNDEZ-RAMIREZ, MARTHA ALICIA JCSF 1�00 JPAY 6.00 LAF IDF 2.00 T?Dr TV 167.00 Ceah 2.00 FIND 100.00 WRNT;,SO,; i,'; ';234: OLM As; Dmx, jCS0, 00 bo ..... ... .... . ...,CSRV,,.,. ... ... voo";,; NU - 375413 1501-0107 01.26-2015 �Fsp 4,00 TFC 3.00 CCC 40.00 CBS 3.00 LAP 5.00 MCHANrY, STEPHEN NEIL TF 4,00 JCSF 1.00 JPAY 6.00 lDr 2.00 MVF 0.10 110,0 0 Personal Chock Sunc 30.00 TpDF 2.00 DDC 9.90 -2015 Page I 02-02-15;10:35AM;From:Calhoun County JP5 To:6634444 ;3619832461 # 3/ 8 money Distribution Report =QZ NANCY POMYXAL 7PR 8 JAVUAXY 2013 Raceipt Cauffe/Defend..t 7 ------ 2 1 AO T F. 0 'FIN .00 375415 1501-0120 01-2�-2016 j9p 4.00 CCC 40.00 CHS 3.00 LAF 5.00 TI? 4.00 167.00 MARTINU-MORENO, aosE 17asr 1.00 ITPAY 6.00 Tnv I nn anon --I.- --- . �'Il 0 .#0 Dag& 2 02-02-15;10:35AM;From;Calhoun County JP5 To:5534444 ;3619832461 # 4/ 8 Money Distribution Report JbOGE NANCY pOMXXAL JPR 5 JANDAAX 2015 gyps Coda Description Count Retained Diaburued M y T t l The following tOtAIO represent - Cash and Checks Collected COST CCC CONSOLIDATED COURT COSTS 10 37.05 COST CH6 COURTHOUSE SECURITY 11 333.50 370.55 COST CMI CORRECTIONAL MANAGEMENT INSTITUTE 0 30.79 0.00 30.79 COST CVC COMPENSATION TO VICTIMS OF CRIME 0 0.00 0.00 0.60 COST DPSC OPS PAILDRC TO APPEAR /OMNI FEES 1 0.00 0100 0.00 COST FA FUGIVITE APPREHENSION 9.90 20.10 30.00 COST IDF INDIGENT bEFENSE FUND D 10 0,00 O,OD 000 . COST JCD JUVENILE CRIME AND DELINQUENCY 0 1.05 16.60 1.00 53 COST JCPT JUDICIAL AND COURT PERSONNEL TRAINING 0 0100 0,00 0.00 0.00 COST JCSF JUSTICE COURT SECURITY FUND 11 O.OD 0.00 COST JPAY JUDGE PAY RAISE FEE 10.26 0.00 10.26 COST JSF JUROR SERVICE PUNb 1D 5,SG $0.02 5555..50 50 COST LAP SHERIFF'S FEE 10 3.70 33.35 COST MVP MOVING VIOLATION FEE 9 41.32 0.00 41.32 COST PWAF TEXAS PARKS & WILDLIFE 6 0.05 0.48 0.53 COST SAF PPS 0 0.00 0.00 0.00 0.00 COST SUDC BUD TITLE C 2 0.00 10.00 COST TF TECHNOLOGY FUND 8 218.00 17.91 0,00 210.00 COST TFC TFC 1 0.00 41.06 COST TIME TIME PAYMENT FCC 7 18.79 0.00 18,79 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 11 3.30 3.30 6.60 COST WRNT WARRANT FEE 0.00 20.53 2 53 FEES CSRV COLLECTION SERVICES FEE 1 50.00 0,00 0 FEES DDC DRIVER SAFETY COURSE - 2013 2 250.0 0.00 2500.,,53 31.600 FEES DPF DEFERRED FEE 3 27.70 0.00 27 FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00 FINE FINE FINE 1 10.00 0.00 ,00 FINE WSF WATER SAFETY FINE 9 1,055.00 0.00 11055,00 1 15.00 85,00 100,00 Money TOCnls 15 1,819.64 564.96 2�38A,60 The following totaln represent _ Txansfera Collected COST CCC CONSOLIDATED COURT COSTS 0 COST CHS COURTHOUSE SECURITY 0,00 0,00 0,000 COST CHI CORRECTIONAL MANAGEMENT INSTITUTE. 0 0.00 0.00 0.00 COST CVC COMPENSATION TO VICTIMS Or, CRIME 0 0,00 0.00 0 00 COST DPSC CPS FAILURE TO APPEAR /OMNI FEES 0 0.00 0,00 0..00 COST FA FUGIVITE APPREHENSION 0.00 0,00 0,00 COST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0,00 COST JCD JUVENILE CRIME AND DELINQUENCY 0 0 0.00 0.00 0.00 COST JCPT JUDICIAL AND COURT PERSONNEL TRAINING 0.00 0.00 0.000 COST JCSF JUSTICE COURT SECURITY FUND 0 O,OD 0,00 0.00 COST JPAY JUDGE PAY RAISE FEE 0.00 0.00 0.00 COST JSF JUROR SERVICE FUND 0 0,00 0.00 0.00 COST LAP SHERIFF'S FEE 0 0.00 0.00 0.00 COST MVF MOVING VIOLATION FEE 0 0 0.00 0.00 0,00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAF OPB 0.00 0.00 040 COST SUBC BUD TITLE C 0.00 0100 D.00 COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00 COST TFC TFC 0 0'00 0100 0.00 COST TIME TIME PAYMENT FEE 0.00 0,00 0,00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 0 0.00 0.00 0.00 COST WRNT WARRANT FEE 0.00 0.DO 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00 FEES DDC DRIVER SAFETY COURSE - 2013 0 0 0.00 0,00 O.OD FEES DPF DEFERRED FEE 0,00 0,00 0 00 FREE EXRF EXPIRATION RENEWAL FEE 0 0.00 , 000 0.00 FINE PINE FINE 0 0.00 0.00 0.00 FINE WSB WATER SAFETY FINE 0 0 0100 0100 0.00 O.OD 0.00 0.00 Transfer Totals 0 0.00 0.00 D.00 The !showing totaln represent - Jai1 Cxodit and Community aarjoo =OST CCC CONSOLIDATED COURT COSTS 3 OOST CHS COURTHOUSE SECURITY 3 12.00 100.00 120.00 11.00 0.00 11.00 J2.02-2015 02-02-15;10:35AM;From;Calhoun County JP5 To;5534444 ;3619832461 # 5/ 8 Money Diotributioa Repose JUDtlE NANCY PDMYKAL JpR 5 JANDARY 2015 Typo Code DeeCriHtion Dotnt Retained Dioburued Mone-TOtale COST CHI CORRECTIONAL MANAGEMENT INSTITUTE 0 COST CVC COMPENSATION TO VICTIMS OF CRIME 0 O.DO 0.00 0.00 COST DPSC DES FAILURE TO APPEAR /OMNI FEES 3 0.00 0.00 0.00 COST FA FUGIVITE APPREHENSION 0 29.70 60.30 90.00 COST SDP INDIGENT DEFENSE FUND 3 0.00 0.00 0.00 COST JCD JUVENILE CRIME AND DELINQUENCY 0 0.60 8.40 6.00 COST JCPT JUDICIAL AND COURT PERSONNEL TRAINING 0 0.00 0.00 0100 COST JC3F JUSTICE COURT SECURITY FUND 3 0.00 0.00 0.00 COST JPAY JUDGE PAY RAFEE ISE 3.00 0.00 .00 3.00 COST JSF JUROR SERVICE FUND 3 1.80 1G.20 1 COST LAP SHERIFF'S FEE 3 1.00 9.00 1000 COST MVP MOVING VIOLATION FEE 3 15.00 0.00 15.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0 0.00 0.00 0.00 COST SAP UPS 0.00 0.00 0.p0 COST SUBC SUB TITLE C 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00 COST TFC TFC 3 12.00 0.00 12.00 COST TIME TIME PAYMENT FEE 0 0,00 0,00 0.00 COST TPAF TRUANCY PREVENTION & DIVERSION FUND D 0 0.00 0.00 0.00 COST WANT WARRANT FEE 0.00 0,00 0.00 FEES CGRV COLLECTION SERVICES FEE 3 150.00 0.00 150.00 FEES CDC DRIVER SAFETY COURSE - 2013 3 208.00 0.00 208.00 FEES OFF DEFERRED FEE 0 0.00 0.00 0.00 FEES EXRP EXPIRATION RENEWAL FEE 0 0.00 0.00 000 FINE FINE FINE 0 0.00 0,00 0..00 FINE WSF WATER SAFETY FINE 3 525.00 0.00 525,00 0 0,00 0100 0.00 Credit Totals 3 1,049.10 190.90 1,248.00 The f0110wing tOtalo represent - Credit Card Payments COST CCC CONSOLIDATED COURT COSTS 5 COST CHS COURTHOUSE SECURITY 17.70 159.30 177.00 COST CHI CORRECTIONAL MANAGEMENT INSTITUTE 5 1 15.00 0.00 15.00 COST CVC COMPENSATION TO VICTIMS OF CRIME 0.05 0.45 0.501 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 1.50 13,50 55,00 COST FA FUGIVITE APPREHENSION 2 1 19,00 40.20 50.00 COST IDF INDIGENT DEFENSE FUND 0.50 4,50 5 ,p0 COST JCD JUVENILE CRIME AND DELINQUENCY 3 0.60 5.40 5,0.40 .00 COST TCPT JUDICIAL AND COURT PERSONNEL TRAINING 3 1 0,05 0.50 COST JCSF JUSTICE COURT SECURITY FUND 3 0.20 1,80 2.00 COST JPAY JUDGE PAY RAISE FEE 3.00 0.00 3,00 COST JSF JUROR SERVICE FUND 3 1,30 1G.20 10.00 COST LAP SHERIFF'S FEE 10,80 12.00 COST MVF MOVING VIOLATION FEE 3 15.00 0.00 15.00 COST PWAF TEXAS PARKS & WILDLIFE 3 1 0.03 0.27 0.30. COST SAP DFS 400 1.00 5.00 COST SUEC SUB TITLE C 00 1.00 5,00 COST IF TECHNOLOGY FUND 4 120.OD 0.00 120,00 COST TFC TFC 20 D.00 20.00 COST TIME TIME PAYMENT RGE 4 12.00 0.00 12.00,00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 3 0.00 0.00 0,00 COST WRNT WARRANT FEE 0,00 6.00 6.00 FEES CSRV COLLECTION SERVICES FGE 2 100.00 0,00 100.00 FEES DDC DRIVER SAFETY COURSE - 2013 2 0 184.0 0.00 134.50 FEES OFF DEFERRED FEE 0.00 0,00 0.00 FEES EXPIRATION RENEWAL FEE 1 96.90 0.00 06.90 FINE FIFIN¢ INE FINE 3 50.00 0.00 50,00 FINE WSF WATER SAFETY FINE 4 569,80 0.00 569.00 0 0.00 0,00 0.00 Crod10 Totala 0 1,227,63 260.07 11408.50 The following tot'a1p represent - Combined Money and Credits COST CCC CONSOLIDATED COURT COSTS 10 COST CHS COURTHOUSE SECURITY 66.75 600.00 667.55 COST CHI CORRECTIONAL MANAGEMENT INSTITUTE 19 1 $6.79 0.00 56.79 COST CVC COMPENSATION TO VICTIMS OF CRIME 1 0.05 0,45 0.50 COST DPSC CPS FAILURE TO APPEAR /OMNI FEES 6 1.50 13.50 15,00 COST FA FUGIVITE APPREHENSION 59.40 120.60 0. 1800 _DST SDF INDIGENT DEFENSE FUND 1 16 0.50 4.50 5.0.00 3.05 27.d0 30.53 Page 02-02-15;10:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 6/ 8 Money Diatribution Report TYPA Cgla Deacri tion JUDCE NANCY POMYXAL JPR 5 JANUARX 2015 COST JCD JUVENILE CRIME AND D¢LINOUENCY Count Retainod Dinbureed Money -Totele COST JCFT JUDICIAL AND COURT PERSONNEL TRAINING 1 0,05 0.45 0.50 COST JCSF JUSTICE COURT SECURITY FUND 1 0.20 1.00 2.00 COST JPAY JUDGE PAY RAISE FEE 17 16. 26 0.00 16,26 COST JSF JUROR SERVICE FUND 16 9.16 02.42 91.50 COST LAP SHERIPr,S FEB 16 S•�o $3.16 59.0$ COST MVP MOVING VLOLATION FEE 15 71.32 0.009 71.32 COST PWAF TEXAS PARKS & WILDLIPE 0.09 0.75 0.83 COST SAP DPS 1 4.00 1,00 5.00 COST SUBC SUB TITLE C 3 12.00 3.00 15.00 COST IF TECiiNOLOOY FUND 12 337.91 0.00 337,91 COST TFC TFC 19 73.06 0.00 73.06 COST TIME TIME PAYMENT FEE 11 30.79 0.00 10.79 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 3.30 3.30 6.60 COST WENT WARRANT FEE 14 0.00 26.53 25.53 FEES CSRV COLLECTION SERVICES FEE 6 300.00 0.00 300.00 FEES DDC DRIVER SAFETY COURSE - 2013 7 704,10 0.00 704.10 FEES DFF DEFERRED FEE 3 27,70 0.00 27.70 FEES EXRF EXPIRATION RENEWAL PER 1 86.90 0.00 06.90 PING FINE FINE 4 60.00 0.00 40.00 FINE WSP WATER SAFETY FINE 16 2,350.90 0.00 2,150.60 1 15,00 6S.00 100.00 Report Total& 26 4,096.37 1,024.71 5,121.10 Dage 02-02-15;10:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 7/ 8 Money Distribution Report JNDOR NANCY PONYRAL CPR 5 OANOARY 2015 Date Payment Type Pines Court Coots Roes bonds Restitution 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 & Transforo 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 0.09 09-01-1991 Cash & Checks Collected 0.00 0.00 0.00 0.00 0100 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0100 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 D.00 0.00 0,00 0.00 09.01-1993 Cash & Chocks 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 & Tranofer0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOC41 of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-2999 Cash & Chocks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Crodito & 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 & Chocks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail credits & Comm sorvico 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & TYanafors 0.00 0.00 0.00 0100 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 & Chocks Colleeted 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 & Chocks Collected 0.00 0.00 0100 0.00 0.60 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Tranefers 0.00 0100 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-2003 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0100 0.00 Total of all Collections 0100 0.00 0.00 0.00 0.00 0.00 0.00 01-01.2004 Cash & Cheoko Collected 1,100.00 959.50 249.30 0.00 0.00 0.00 2,304.60 Jail Credits & Comm Service $25.00 435.00 208.00 0.00 0.00 0.00 1,248.00 Credit Cards & Tranogero 569.80 S97.30 121.40 0.00 0.00 0.00 11488.50 Total of all Collections 2,250.50 1,991.80 878.70 0,00 0.00 0.00 5,121.10 TOTALS Cash & Checks Collected 1,1S5.80 959.90 269,30 0.00 0.00 0.00 21384.60 Jail Credits & Comm Service 525.00 435.00 288.00 0.00 0.00 0.00 1,248.00 Credit Cards F. Transfers 569,80 $97.30 321,40 0.00 0.00 0.00 1,488.50 Total of all Collections 2,250.60 11991.80 878.70 0.00 0.00 0.00 5,221.10 02-02.2019 Pepe G 02-02-15;10:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 8/ 8 Money Distribution Report Description JUDGE NANCY POMrChL Court JPR 5 Collected TAIMARY 2015 Retairiod Di0buraed State of Texas Quarterly Reporting Totals State Comptroller Coat and Fees Report Section I: Report for OICenooa Committed 01-91-04 Forward 32 90a.46 908,46 0.00 09-01-01 - 12-31-03 0 0.00 0.00 0.00 08-31-99 - 00-31-01 0 0100 0.00 0.00 09-01.97 08-30-99 0 0.00 0.00 09-01-91 - 08-31.97 0 0.00 Dail Dond FOo 0 0.00 0.00 0.00 DNA Testing Fee - Convictions 0 0.00 0.00 0.00 DNA Testing Pee - Comm Supvn 0 0100 0.00 O.OD 0.00 DNA Testing Fee - Juvenile 0 0.00 0.00 0.00 EMS Trauma Fund (EMS) 0 0.00 0.00 0.00 Juvenile Probation Diversion Fees 0 0,00 0.00 0100 Jury ReimbUraoment Fee l3 0.00 0.00 Indigent Defense Fund 13 49.05 4.90 44.15 Moving Violation Foos 9 24,53 2.45 22.00 State Traffic Fine 0 0.03 0.00 0.75 0100 0.00 0.00 Section II: he Applicable Peace officer Fees 4 20,00 16.00 Failure to Appear/Pay Fee, 3 4.00 Judicial Fund - COnst County Court 0 90.00 29.7o 60.30 Judicial Fund • Statutory County Court 0 0,00 0.00 0.00 0,00 Motor Carrier Weight violations 0 0.00 0.00 Time Payment Pees 0.00 0,00 0.00 Driving Record Fee 1 0 6.60 340 3.30 Judicial Support Fee 040 else 0100 Truancy Prevention and Diversion Fund 13 0 73.50 7,36 69.22 Report Sub Total 60 0.00 0.00 0.00 1,173.05 972,25 200.00 State Comptroller Civil Fees Report Cr- Dirth Certificate Feee 0 CF: Marriage Licenoo Foos 0 0.00 0,00 0.00 CF: Declaration of Informal Marriage 0 0.00 0.00 0.00 0.00 CF: NondiscloeUC0 Foos 0 0.00 0,00 CF, Juror Donations 0 0100 0.00 0.00 CF. Justice Court Indig Filing Fees 0 0.00 0.00 else CF: Stat Prob Court Indig Filing Fees 6 0.00 0.00 0.00 Cr! Stat Prob Court Judie Filing pass 0 0.00 6.00 0.00 Cr! Stat Cnty Court Indig Filing Fees 0 0.00 0.00 0.00 CF: 8tat Cnty Court Judie Piling Foos 0 0.00 0.00 0.00 CF: Cost Cnty Court Indig Filing Foos 0 0.00 0.00 0.00 CF: Cnat Cnty Court Judic Filing Foes 0 0.00 0100 0,00 CF; Dist Court Divorce a Family Law 0 0.00 0.00 0.00 CP, Diet Court Other Divorce/Family Law 0 0.00 0,00 0.00 CF: Diet Court Indig Legal Services 0 0.00 0.00 0.00 CF, JudiCial Support Fee 0 0.00 0.00 0.00 Report Sub Total 0.00 0.00 0-.00 0 0.00 0.00 D.00 Total Due For This Period 88 1,173.05 912.25 200.$0 ENTER COURT NAME: -: JUSTICE OF PEACE NO. 1 ENTER MONTH OF REPORT !JANUARY ENTER YEAR OF REPORT 2015 4UOE AMUUNT: CASH BONDS 0.00 12/8/2014 ADMINISTRATION FEE-ADMF 0.00 BREATH ALCOHOL TESTING - BAT 0.00 CONSOLIDATED COURT COSTS-CCC 1,328.40 COURTHOUSE SECURITY -CHS 132.81 CJP 0.00 CIVIL JUSTICE DATA REPOSITORY FEE -CJDR 2.02 CORRECTIONAL MANAGEMENT INSTITUTE -CMI 0.00 CR 0.00 CHILD SAFETY -CS 0.00 CHILD SEATBELT FEE-CSSF 0.00 CRIME VICTIMS COMPENSATION -CVC 0.00 DYSC/FAILUREiTOAPPEAR -OMNI-DPSC 107.44 ELECTRONIC FILING FEE -EEF 0.00 FUGITIVE APPREHENSION -FA 0.00 GENERAL REVENUE -GR 0.00 CRIM - IND LEGAL SVCS SUPPORT -IDF 66.39 JUVENILE CRIME & DELINQUENCY- JCD 0.00 :JUVENILE CASE MANAGER FUND -JCMF 6.23 JUSTICE COURT PERSONNEL TRAINING -JCPT 0.00 JUSTICE COURT SECURITY FUND, JCSF 0.00 JUROR SERVICE FEE JSF 132.81 LOCAL ARREST FEES - LAF 30.35 LEMI 0.00 LEDA 0.00 LEDO 0.00 OCL 0.00 PARKS & WILDLIFE ARREST FEES - PWAF 7.11 STATE ARREST FEES - SAF 128.66 SCHOOL CROSSING/CHILD SAFETY FEE -SCF 0.00 SUBTITLE C-SUBC 580.52 TABC ARREST FEES TAF 0.00 1 TECHNOLOGY FUND -TF- 132.81 TRAFFIC TFC 58.17 TIME PAYMENT TIME 682.41 TRUANCY PREVENTION/DIVERSION FUND -TPDF 58.45 LOCAL& STATE WARRANT FEES WRNT 247.49 COLLECTION SERVICE FEEMVBA-CSRV 733.20 DEFENSIVE DRIVING COURSE -CDC 31.60 DEFERRED FEE -OFF 209.80 DRIVING EXAM FEE- PROV DL 0.00 FILING FEE -FFEE 125.00 FILING FEE SMALL CLAIMS- FFSC 0.00 JURY FEE -JF 0.00 COPIES/CERTIFED COPIES -CC 0.00 '.. INDIGENT FEE-CIFF or INDF 30.00 JUDGE PAY RAISE FEE -JPAY 215.43 SERVICE FEE -SFEE 225.00 OUT-OF-COUNTYSERVICE FEE 0.00 ELECTRONIC FILING. FEE -EEFCV 50.00 EXPUNGEMENTFEE-EXPG 0.00 EXPIRED RENEWAL -EXPR 20.00 ABSTRACT OF JUDGEMENT- A03 0.00 +. ALI.WRITS-WOP/WOE 0.00 DPS FTA;FINE -DPSF 0.00 LOCAL FINES -FINE 3,360.20 LICENSE & WEIGHT FEES -LWF 0.00 PARKS & WILDLIFE FINES PWF 151.00 SEATBELT/UNRESTRAINED CHILD FINE -SEAT 0.00 OVERPAYMENT ($10&OVER) -OVER 0.00 OVERPAYMENT (LESS THAN .$10)-OVER 0.00 RESTITUTION - REST o.00 PARKS .& WILDLIFE -WATER SAFETY FINES-WSF 0.00 _MARINE SAFETY PARKS & WILDLIFE -MSO 0.00 TOTAL ACTUAL MONEY RECEIVED $8,863.20 TYPE; AMOUNT TOTAL WARRANT FEES 247.49 ENTER LOCAL WARRANT FEES 14.93 RECORDON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT 1 STATE WARRANT FEES $232,55 RECORDON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT DUE TO OTHERS; AMOUNT DUE TO CCISD-50% of Fine on JV cases 0.00 PLEASE INCLUDE On REQUESTING DISBURSEMENT DUE TO DA RESTITUTION FUND 0.00 PLEASEINCLUDE D.R. REQUESTING DISBURSEMENT REFUND OF OVERPAYMENT$ 0.00 PLEASEINCLUDE D.R REQUESTING DISBURSEMENT OUT-QF-COUNTY SERVICE FEE 0.00 PLEASEINCLUDE D.R REQUESTING DISBURSEMENT CASH BONDS OAO PLEASEINCLUDE D.R REQUESTING DISBURSEMENT(IF REQUIRED) TOTAL DUE TO OTHERS ' $0.00 TREASURERS RECEIPTS FOR MONTH: AMOUNT CASH, CHECKS, M.0 S & CREDIT CARDS $8.853.20 Calculate from ACTUAL Treasurers Receipts '. TOTAL TREAB RECEIPTS - $8853.20 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/3/2015 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: JANUARY YEAR OF REPORT: 2015 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 3,382.85 CR 1000-001-44190 SHERIFF'S FEES 339.86 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 31.60 CHILD SAFETY 0.00 TRAFFIC 58.17 ADMINISTRATIVE FEES 229.80 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 319.57 CR 1000-001-44010 CONSTABLE FEES -SERVICE 225.00 CR 1000-001-44061 JP FILING FEES 125.00 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 733.20 TOTAL FINES, ADMIN. FEES & DUE TO STATE $5,125.48 CR 2670-001-44061 COURTHOUSE SECURITY FUND $99.61 CR 2720-001-44061 JUSTICE COURT SECURITY FUND $33.20 CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $132.81 CR 2699-001-44061 JUVENILE CASE MANAGER FUND $6.23 STATE ARREST FEES DPS FEES 72.22 P&W FEES 1.42 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 73.65 CR 7070-999-20610 CCC-GENERAL FUND 132.84 CR 7070-999-20740 CCC-STATE 1,195.56 DR 7070-999-10010 1,328.40 CR 7860-999-20610 STF/SUBC-GENERAL FUND 29.03 CR 7860-999-20740 STF/SUBC-STATE 551.49 DR 7860-999-10010 580.52 CR 7950-999-20610 TP-GENERAL FUND 341.21 CR 7950-999-20740 TP-STATE 341.20 DR 7950-999-10010 682.41 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 1.50 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 28.50 DR 7480-999-10010 30.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/3/2015 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: JANUARY YEAR OF REPORT: 2015 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 6.64 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 59.75 DR 7865-999-10010 66.39 CR 7970-999-20610 TL/FTA-GENERAL FUND 35.81 CR 7970-999-20740 TUFTA-STATE 71.63 DR 7970-999-10010 107.44 CR 7505-999-20610 JPAY - GENERAL FUND 21.54 CR 7505-999-20740 JPAY - STATE 193.89 DR 7505-999-10010 215.43 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 13.28 CR 7857-999-20740 JURY REIMB. FUND- STATE 119.53 DR 7857-999-10010 132.81 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.20 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 1.82 DR 7856-999-10010 2.02 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 58.45 DR 7998-999-10010 58.45 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 50.00 DR 7403-999-22889 50.00 TOTAL (Distrib Req to OperAcct) $8,724.85 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FEE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 128.35 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $128.35 TOTAL COLLECTED -ALL FUNDS $8,853.20 LESS: TOTAL TREASUER'S RECEIPTS $8,853.20 #### OVER/(SHORT) $0.00 Page 2 of 2 CALHOU N DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 42038 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Hope Kurtz Address: Title: Justice of the Peace, Pct. 1 City: State: Zip: Phone: ACCOUNT NUMBER DESCRIPTION AMOUNT 7541-999-20759.999 JP1 Monthly Collections - Distribution $8,724.85 JANUARY 2015 V# 967 TOTAL. 8,724.85 Signature of Official Date ENTER COURT NAME: '- JUSTICE OF PEACE NO. 2 ENTER MONTH OF REPORT JANUARY ENTER YEAR OF REPORT' 2015 CUUE AMUUNL:.. CASH BONDS 0.00 RevisedP1218/14 ADMINISTRATION 4FEE -ADMF 0.00 BREATH ALCOHOL TESTING - BAT 0.00 CONSOLIDATED COURT COSTS -CCC 1,844.95 COURTHOUSE SECURITY -CHS 184409 CJP 0.00 CIVIL JUSTICE DATA REPOSITORY 'FEE -CJDR 2.43 CORRECTIONAL MANAGEMENT INSTITUTE -CMI 0.00 CR 0.00 CHILD SAFETY -CS 0.00 CHILD SEATBELTiFEE -CSBF 0.00 :CRIME VICTIMS COMPENSATION - CVC 0.00 DPSC/FAILURE TO APPEAR -OMNI-DPSC 199.16 'ELECTRONIC: FILING FEE 60.00 FUGITIVE APPREHENSION -FA 0.00 GENERAL REVENUE -GR 0.00 GRIM- IND LEGAL SVCS SUPPORT -IDF 92.28 JUVENILE CRIME& DELINQUENCY -JCD 0.00 JUVENILE CASE MANAGER FUND -JCMF 10.00 JUSTICE COURT PERSONNEL TRAINING -JCPT 0.00 JUSTICE COURT SECURITY FUND. JCSF 0.00 JUROR SERVICE FEE -JSF 183.76 LOCAL ARREST FEES -LAF 102.78 LEMI 0.00 LEDA 0.00 LEOC 0.00 OCL 0.00 PARKS& WILDLIFE ARREST FEES -PWAF 83.94 STATE ARREST. FEES- SAF 43.97 SCHOOL CROSSINGICHILD SAFETY FEE -SCF 0.00 SUBTITLE C SUBC 650.59 TABC ARREST FEES -TAF 0.00 TECHNOLOGY FUND -TF 184.09 TRAFFIC -TFC. 65.09 TIME PAYMENT -TIME 266.57 TRUANCY PREVENTIDIVERSION FUND -TPDF 87.12 LOCAL & STATE WARRANT FEES -WRNT 393.97 COLLECTION SERVICE FEE-MVBA-CSRV 633.50 DEFENSIVE DRIVING COURSE DDC 31.60 DEFERRED FEE -DFF 84.90 DRIVING EXAM FEE- PROV DL 0.00 FILING'.. FEE -FFEE 150.00 FILING FEE SMALL CLAIMS FFSC' 0.00 COPIES/CERTIFED COPIES -CC 0.00 INDIGENT FEE -CIFForINDF 36.00 JUDGE PAY RAISE FEE - PAY 276.71 SERVICE :FEE -SFEE 300.00 OUT -OF -COUNTY SERVICE FEE 0.00 EXPUNGEMENT,FEE-EXPG. 0.00 EXPIRED RENEWAL -EXPR 20.00 ABSTRACT OF JUDGEMENT-AOJ 6.00 ALL WRITS -WOP /WOE 0.00 DPSFTAFINE -DPSF 0.00 LOCAL FINES -FINE 3,746.00 LICENSE & WEIGHT FEES-LWF 0.00 PARKS& WILDLIFE FINES -PWF 1,473.00 SEATBELT/UNRESTRAINED CHILD FINE -SEAT 0.00 ''' OVERPAYMENT ($10&OVER) -OVER 200.00 ` OVERPAYMENT (LESS THAN $10) - OVER 0.00 RESTITUTION - REST 0.00 PARKS & WILDLIFE -WATER SAFETY FINES-WSF 0.00 WCR 0.00 TOTAL ACTUAL MONEY RECEIVED $11,411.50 TYPE: AMOUNT: TOTAL WARRANT FEES 393.97 '. ENTER LOCAL WARRANT FEES 199.01 RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT $TATEWARRANT FEES $194.90. RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT DUE TO OTHERS: AMOUNT[ DUE TO CCISD - 50% of Fine On JV Gases 0.00 PLEASE INCLUDE RR REQUESTING DISBURSEMENT DUE TO DA RESTITUTION FUND 0.00 PLEASE INCLUDE UR REQUESTINGDISBURSEMENT REFUND OF OVERPAYMENTS 200.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT OUT -OF -COUNTY SERVICE FEE 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT CASHBONDS 0.00 PLEASE INCLUDE RR REQUESTING DISBURSEMENT (IF REQUIRED) TOTAL DUE TO OTHERS $200.00 '. TREASURERS RECEIPTS FOR MONTH: AMOUNT CASH, CHECKS, M.Os &CREDIT CARDS $11,411.50 Calculate from ACTUAL Treasurers Receipts TOTAL TREAS. RECEIPTS 11,411.50 Z;o L a6ed 00,9E 0L00L-666-087L NO 0Z'7£ 31ViS-]VE)2 11NDEWINI -1IAI0 07L0Z-666-087L 210 09'L ClNn-d'N3J--IV0AIINAOIONI-1IA10 0L90Z-666-087L 80 L9'99Z 0L006-666-096L Na 8Z'E£L 31V1S-di 07L0Z-666-096L 80 6Z'££L aNfld "1VN3N39-dl 019OZ-666-096L ?10 69'099 0 LOO L-666-099L Na 90'819 31V1S-08f1S/d1S 04L0Z-666-098L 80 E9'ZE aNfld lVN3N3J-081IS/d1S 0L90Z-666-098L 210 964,78'6 MOM-666-0L0L N0 97'099' L 31V1S-000 07L0Z-666-0L0L 80 67'78L aNnj-lVH3N3EJ-000 0L90Z-666-0L0L NO L9179 S33d 1S3NNV 31V1S 1H101 OhL0Z-666-0Z0L 80 00'0 S33d 08V1 6L'9L S33d AA'8d 6L'L7 S33d Sd0 53331S32INb' 31V1S 00'03 ONnl 830VNVN 3SVO 3-IINAAnr Z9077-L00-669Z 80 601783 aNf1dA90l0NH0311Nf100Aousnl Z9077-L00-6LLZ HO Z0'97$ aNfld AlINf103S 18f10O 30I1Sflf Z9077-L00-0ZLZ 80 L0'8E3 aNn=i Aii8nO3S 3snOH1Nf100 Z90ti7-L00-0L9Z 210 £L'LL8'9$ 31V1S01Ana '8833d'NINOV'S3NIdlV101 09'E£9 A3N8Ol1V SN0110A1100 df Ol 3na 0LL0Z-666-000L 80 00'0 SANId 1HE)I3M89A0-31V1S 01 Am 97L0Z-666-000L 80 00'0 33d 1-1381V3S (IIIHO-31V1S Ol Alta 97L0Z-666-000L 210 00'0 S3NId 1i381V3S-31V1S Ol Ana 77L0Z-666-000L 80 00'0 33d NVX3 EJNIAI8a-31V1S Ol 3na L7L0Z-666-000L NO 00'0 33d A19AVS aIIHO/ONISSONO lOOHOS 97L77-L00-000L 80 00'0 (03NVH1SS3l)S1N3WAVdH3AO 0LL67-L00-000L 80 00'0 SAId00 a31dI1N3O / S31dOO 06077-LOO-000L NO 00'99L S33d JNilld df Z9077-L00-000L 80 00,00E 301A83S-S33d A19ViSN00 0L077-LOO-000L N0 6910Z S33d 3AI1VHiSININaV 1V101 Z9£77-L00-000L 80 00'0 Sf103NVll3OSIN 00'0 S33d 1N3N3EJNndX3 06170L S33d 3AIIV8ISINIWOV 60'99 0IddV81 00'0 A13dVS OIIHO 09'LE ONINNa 3AISN3d3a -S33d AAI LV6f LSIN/W0V 60'099 S33d S.ddIN3HS 06L77-00-000L 80 96'996'E S3NId ZL097-L00-000L 210 1Nnowv 3WVN 1NL1000tl N3awnN 1NL1000tl SM :1NOd3N j0 NV3A ANVLINvr :1NOd3N d0 H1NOW Z *ON 30V3d d0 30usnr :3WVN 1Nf10D 9L0Z/E/Z SN011n9211S1a (MV SN011037700 JO IH0d3HA7HIN0W CALH®UN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 460 A42038 PAYEE Name: Calhoun County Oper. Acct. Address: City: State: Zip: Phone: PAYOR Official: Title: Calvin Anderle Justice of the Peace, Pct. 2 ACCOUNT NUMBER DESCRIPTION AMOUNT 7542-999-20759-999 JP2 Monthly Collections - Distribution $9,959.45 JANUARY 2015 V# 967 Signature of Official Date TOTAL 9,959.45 ADM 2.6 Reprint - 2.81 D-843 EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT Miles traveled: 561.8 rl.,J u" 00 1 E- Selected major activities since last report January 2: Cummins was invited to be the guest speaker at the Noon day Rotary Club. Twenty-three Rotarians in attendance and participated in an abbreviated Texas Community Futures Forum. Their input will be added to the information gained by the county wide meeting. January 8: "Your Area's Knowledge" (YAK) winter lecture series began in Port O'Connor. Eleven people attended the kick off session and saw the video "State of the Gulf: America's Sea". The series is being offered through the POC Chamber of Commerce and organized by Cummins. January 8: Mariner 4-H "Rockets to the rescue" project was completed as the students finished the design and testing phase of the stomp rockets. Seventeen youth participated. January 9: Cummins organized middle school students at Our Lady of the Gulf Catholic School to help with the monofilament recovery and recycling program. They processed over 56 pounds of destroyed gill net donated by TPWD. That is a LOT of used fishing line! January 12: Cooking with Seafood returned with a slow -cooker shrimp and sausage gumbo cooked by Cummins. The eleven attendees viewed the "State of the Gulf. America's Sea" video. This video produced by Texas Parks and Wildlife is part of the education efforts by Extension on the importance of water. January 14: Cummins organized a Pond Management Workshop that was taught by Peter Woods. Practical information for landowners wishing to construct, manage or stock fish in ponds on their property was provided. The workshop also cover pond site selection, construction and maintenance, fish stocking and fish population management, how to control aquatic vegetation, and what to do about fish kills. Two CEU's were given, one IPM and one General. Melstan Feed & Hardware generously sponsored our afternoon refreshments. January 15: The second YAK winter lecture was presented by Nicole Pringle of TPWD on oysters. Twenty- five people attended the program and Mary Jo Walker donated fresh shucked oysters for our eating pleasure. January 21: Cummins attended a Sea Grant meeting in Rockport. Josh Gunn provided administrative updates and Arm Weaver from NOAA's Office for Coastal Management taught a class on the logic model and writing SMART objectives. January 22: The third YAK winter lecture was on the local watershed presented by GBRA's Stephanie Shelly. Fifteen people attended the program. January 28: Cummins delivered 108 donated cool weather plants, pots, and soil to JR Elementary school for their curriculum enrichment program. She is working with Asst. Principal Caylor to start a Junior Master Gardener Group on their campus. The plants were donated by Bonnie and the other supplies were given by the Mataeorda Countv Birdinn and Nature Center. January 29: The fourth YAK winter lecture had eleven attendees. TPWD's Leslie Hartman gave a presentation on why freshwater inflows are important to Matagorda Bay. January 29: Cummins started a youth garden at the Sea Greens Apartment Homes with donated plant and soil, The property manager Lydia Jones is interested in having ajunior master gardener group for the residents. Three mothers and six children planted 54 plants. Direct Contacts by: Office:15 E-mail/Letters:873 Site:114 Newsletters:1,222 Phone:68 Volunteers:81 Major events for next month — February 2015 February 3: Performance review February 5: Fifth YAK winter lecture February 5: Mariner 4-H meeting February 7: National Ocean Science Bowl, Loggerhead Challenge February 9: Cooking with Seafood February 11: Sixth YAK winter lecture February 16: TCFF planning meeting February 19: Seventh YAK winter lecture February 20: oyster meeting February 21: JMG February 23: Board meeting, San Antonio Bay Foundation February 26: Last YAK winter lecture February 28: National Ocean Science Bowl, Dolphin Challenge Rhonda Cummins Name CEA -CMR Title County January 2015 Date (Month -Year) Texas A&M AgriLife Extension The Texas A&M University System College Station, Texas O �O �O �O 00 00 •.1 �I D\ O O �O O� O\ w A W �J � �J o �.. u � W w w w w w w w w w w w w w w w w w w to w w w w .�-. w .�-. w w w w w w N_ � r n• a. C ems+' H' N ti l9 N• N .N... ti A N I! _ » _ A _ n /L'i. K �. • O � 'y .N. • �. R " �J A � A 1 w n 1 < 1 �' !•}' � Y7 �' � � � � � � �o, � e�Vi � °' � �• �(q p� O�Q .`l i) p ii 1 d1 o PI d1 61 11 M o r r a• o _ ' ro a� 1 `�°� w ^o C �' ro ro o "' ro O< b b e n o, • �o w u� ro o y �'s• too a n n < ro .d n w C< C � C ttl �3 o N y A <� rn x 0 O A w C 4/ ? t4J GO In IJ U i1J �O 'O iJl Oa A W 00 IJ O lJ tJ N p O C T 00 C N 1 N N N 5 a ao m a 8 � 5 A S O � n 3 c Om 7 ro m c :3 3 0, m o D m a ADM 2.6 Reprint - 2.81 D-843 EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT Miles traveled : 622.91 Selected major activities since last report- January 2015 January 2&3: Tina attended the District 11 Food Challenge in La Grange, TX. Food Challenge is a contest for youth that resembles Iron Chef. We had a Junior and Intermediate team from Lakeside 4-H compete in the contest. Jan.5: Tina meet with her Texas Extension Educators Association (TEEA) and they discussed upcoming programs for the year. January 7: Tina attended the Greenlake/Long Mott 4-H Club where she did a program with the 4Hers on Leadership and Teamwork. January 8:Tina went to Victoria to look for places along with the Victoria 4-H Agent to hold district Fashion Show, Round Up, Consumer Decision Making Contest that will be in April. January 12: Tina meet with Signey Sizer the Wesley Nurse at First United Methodist Church along with Kathy Dietzel from the Calhoun County Health Department. They meet to discuss upcoming programs like step up to scale down and continued diabetes education. Tina also held a meeting for all the kids planning on committing in the Houston Rodeo Food Challenge in March. January 13: Tina held a Lunch N Learn for County Employees where they had 17 employees attend. Tina also attended the Clothing and Textile where they had 20 kids attended and make Decorative Pillows. January 20: Tina alongside Kathy Dietzel meet with the Director of Food Services from MMC(Memorial Medical Clinic) to possibly partner with to offer nutrition programs at the hospital. January 21: Tina worked with her Junior/ Intermediate Food Challenge team to start getting ready for Houston Rodeo. January 27: Tina held a Senior Food challenge meeting where she worked with them on basic nutrition needs and serving sizes. Tina then also attended the Pala (Parent Adult Leader Association) Meeting where they discussed upcoming fundraiser ideas. January 29: Tina attended a seminar at Memorial Medical Center about Infant Nutrition and benefits. January 30: Tina meets with Signey Sizer the Wesley Nurse at First United Methodist Church along with Kathy Dietzel from the Calhoun County Health Department. They are in the planning stages of upcoming programs. Direct Contacts: Phone:40 E-mail/Letters:160 Office:15 Site:2 Website/News a er:4700 Major events for next month —February 2015 Childcare Conference in La Grange Sale( San Anotnio Livestock and Rodeo) Food Challenge Step up to scale down with First United Methodist Travel(Personal Vehicle) In County Mileage: 15.78 Walmart(3):15.78-1/12/15,1 /21115,1/27/15 Health Department: 9.04:1/12/2015,1/2012015 MMC:4.18,1 /29/2015 Out of County Mileage:359.67 La Grange:432.12:1/2/15,1/3/15 Victoria : 61.79-1/8115 Tina Trevino fh� full', Calhoun Name County County Extension Agent -Family and Consumer Science February 2015 Title Date (Month -Year) Texas A&M AgriLife Extension Services - College Station, Texas AA-F �1 liJ1 411 EXTENSION g Calhoun County Extension Office January 2035 Report to Commissioner's Court January e — Town & Country 4-H Club Meeting Katelynn attended the 'Town and Country 4-H club meeting. She talked and handed out papers talking about upcoming District 11 Photo contest, scholarship opportunities, and to get ready to get started on working on their record books. There meeting was nice and short they talked about what they were going to do at next month's meeting. January 5"' - All Around 4-H Club Meeting Katelynn attended the All Around 4-H club meeting. She talked and handed out papers talking about upcoming District 11 Photo contest, scholarship opportunities, and to get ready to get started on working on their record books. There meeting was nice they made dog toys to take over to the Calhoun County Humane Society. January 8'' - Quiz Bowl Training- in Rosenberg Katelynn attended a quiz bowl training class in Rosenberg to learn how they game is played and to get a set of study material so she can come back and teach the 4-Hers. The study material has a set of books that go over all four of the quiz bowl categories Food and Nutrition, Beef, Swine and Horse. She also got buzzers to practice with. January l e&ll°v — Shooting Sports Coaches Training Katelynn went to Victoria to help train the new coaches for the rifle club. They learned how to interact with the 4-Hers when teaching them the ways to shoot at rifle matches and what are all the rules that need to be enforced when shooting in 4-H. January 8"i, 1P, 2e —Ritle Club Meetings Katelynn helped put on the rifle club meetings along with Mr. Boyd and Mr.Wehmayer. At the meetings the 4-Hers learned the shooting positions that are done in 3P shooting matches. We also talked about shooter safety and range commands. There is over 30 4-Hers in this club and it keeps growing at every meeting. January 13"' — Clothing and Textile Meeting Katelynn and Tina attended the clothing and textile meeting. At this meeting the 4-Hers made pillows. The agents went around and helped anyone who needed help. There were about 20 4- Hers who came to sew, learn an new craft and have a good time with friends and family. January 16 — Nueces Co Livestock Judging Contest Katelynn traveled with the junior livestock judging team to Robstown, so they could participate in the Livestock Judging Contest. One junior team went and placed 91h and tow members of the team placed in the top 25%. They all did very good I as very happy with how it turned out. January 20 — Junior Livestock Committee Meeting Katelynn facilitated the January meeting of the Junior Livestock Committee. The committee discussed changes to rules, judges, judge format, and show protocol. The event was attended by 8 committee members; all were given the opportunity to voice their opinion regarding changes that should be made. January 27 h — County Council Meeting Katelynn joined in on the Council meeting to talk about what was expected of them as council officers and what the requirements were. Council also discusses upcoming business items. They talked about ideas on where they would like to go on a record book trip, who show be awarded on achievement night and what the theme should be. January 28"' — Project visit Katelynn went to check on a 4-Hers hogs that is going to the San Antonio livestock show and the Houston livestock show. The hogs are growing up nicely and look good at this point of the game. January 291" — Major show Birds pick up Katelynn traveled to College Station to pick up major show birds for a 4-Her to show at Houston Livestock show in March. All 25 birds look good and I have high hopes for them. Upcoming Events 2/2 — Intercostal 4-H club meeting 2/3 — Office evaluations 2/6 — Forth work steer show 2/9 & 2/17 - livestock judging practice 2/18-2/20 — San Antonio Heifer show 2/22- 2/26 — San Antonio Market Barrow Show 2/23-2/24 — San Antonio and Market Steer Shows Travel In County PV- Project visit-20 mi Out of County PV- Robstown, TX — 186.3 mi PV- College Station, TX- 354 mi PV- Rosenberg, TX — 193 mi Total Miles Driven 753.3 miles Contacts Site - 1 Telephone - 250 Emails - 200 451 Total Contacts Katelynn Curry CEA 4-H and Youth Development Calhoun County Oh cn m * p W V A O rt W 0 � z 0 3 0_ -O 0 'a 0 m OO o V n °-' N m vi z °-�' O (D 7 j 3 vC—i rD O O 00 I I(D�� CD (D r O W v m - C� m --I A I--� O t 00 O — ,y, 3 A ti W h A 00 v' Q X v �*. C 3 3 0 n Z rn w o° ° n o n 3 Q' o m o w AO O o O N m 0 0 W 's" `" o z �O C it M . 1 V). E O O O W II N Z 1 W W P. Iv m C c 0 < D Nl 7 WW u, v u, m Q m W m (D O v^« m o W M N 00 3 3 o �` m m v, m ♦y 0 A ®. O p' N N m X A m * m O w fD S W 7 O a G 1-+ t/� W O 7 N in `--� O LO H Q 01 W m 0 V)n N V N J O t� o -L * 0 --A�. 00 m -a 00 cn to 0 00 Ln '0 H 00 W N N (n O O O 0 In Ol O O O In Ol Ln m 7® (D M � v D M 70 Ili (D m (D W A Z a C p m g r v 0 D � -, r 7A p m p = N 0 0 1� N m N Z W m z rt 0 M 3 Q1 A N A A s II s d -i V in O 00 O 0 W Or s o 6 m N m00 v° o CD %® z o u l O m (D n MQ N 0 O RO O o Q < m 0 A, I OJ cAi d m 7 (j (D W +� cn x W 00 o m %o N V c in (D N (D o � o 0 3 d 2 3 m s EH W O O O 0 0 0 11 O 0 0 0 0 0 O C a �T IV N 0 0 cr 'glut. Southern Health Partners Your Partner In Affordable Inmate Healthcare PROFESSIONAL RECORD FORM For use by SHP Medical Team Administrator in reporting time worked by your Medical Provider(s) within your medical unit. Please report this information along with your Monthly Statistical Report by the 5th of each month. Fax the completed form to our corporate office at 423-553-5645. If your site uses multiple providers, you can report all of their time on this one form. /,J , /1 Site N Site Code: 7005 Site Citv:l- 612—T "V ro(1) V State: 7� The following is a listing of the dates and times professional medical services were performed by the Medical Provider/Independent Contractor at the medical unit within the jail on behalf of Southern Health Partners, Inc. Please use one line for each date visited. Medical Provider's Last Name/Group Name Profession (MD 1 DDS I Psych I etc) Date Visited Total Time On - Site Per Date Visited alm (56Ld M D 9-t3 / /A/e Nr a)J1bdMdPaJ& M d 9 : /0-/ 56 1-77: TOTAL VISITS THIS MONTH: q This time report is rep!oaed as true orre by pla/ci your signature below. MTA's Signature: L-�' " Date: Confidential Work Product o SHP SHP Form 12106; Updated 812009 Corporate Office: 2030 Hamilton Place Blvd., Ste, 140, Chattanooga, TN 37421 Phone: 423-553-5635 Southern Health. MONTHLY REPORT OF MEDICAL SERVICES Partners .'_vi :'nr:ner n'�Aifu-dnhio- SHP Site Number and Name/State: / 3 0S - Month / Year of this Report: Please enter the TOTAL number for the month of services you are reporting. Fax this report to the corporate office 423-553-5645 by/before the 5th of the current month. The VITA may also give a copy of this report to the Jail Administrator as a reporting mechanism. Keep your supporting documentation (Daily Report of Services)with this TOTAL Form in your Confidential File. HOSPITAL ADMISSIONS �/'�EMERGENCY ROOMX/IDE PNT MEDICAL VISITS (includes any appls)' %t,Yysician ��ly/�//SE X-RAY SERVICES (consider multiple views) .fin # SEEN ON -SITE BY MENTAL HEALTH C/ # SEEN BY PHYSICIAN andlor PHYSICIAN PROVIDERS # SEEN BY DENTIST (Includes cn-site and off -site) 22 # OF RECEIVING SCREENINGS BY MEDICAL STAFF # SEEN AT SICK CALL - # OFH&Ps DONE # OFRPRs DONE # OF OTHER SEXUAL TRANSMITTED DISEASES TREATED N # OF MEDICAL REFUSALS # OF BLOOD SUGAR CHECKS # OF BLOOD PRESSURE CHECKS - # OF TB SCREENS ANDIOR PPD TESTS # OF STAPH I MRSA PATIENTS IN-HOUSE ' # OF PREGNANT FEMALES # OF HIV PATIENTS IN-HOUSE -JJ # OF INMATES PLACED ON SUICIDE WATCH - �CjlJf . # OF INMATE DEATHS # OF INMATES ON DETOX PROTOCOLS Average Daily Population for the Month (lake your total % �i ann divided the number of days In the month) - �N SHP MEDICAL ADMINISTRATOR'S SIGNATURE: Please check off the following as complete for this month: RL QI Criteria completed and faxed to corporate by the 15th Monthly Nurse's Meeting completed and minutes taken All billing statements mailed to corporate Monthly Training Topic reviewed and signature sheet faxed Monthly Provider Time Sheet faxed to corporate Jeed to know the number of patients treated for sexually transmitted diseases Jeed to know the number of patients treated for Staph Infections/MRSA Infections Need to know the total number of pregnant females in the Jail this month - Need to know the known number of HIV patients in. the Jail this month Need to know the number of patients placed on Suicide Watch this month Need to know the number of patients placed on Detox Protocols this month. 1911,17 6 3r.9 3� Sam am No I a 12 1 CA MOMMI NMI am 1-00 1 Elm AM low 2 Bill IMIR NI Mille a BERM 2 3113210 ION ZOOM '11111114131 miasma 1811111111 Imams millNO,��-,� \,I��©a,�,-B i ll 1 w z:N v o a �N r o 3 M O v Z � 0 U CD w M (7 m U) W idY- 'V} V O -f S -7 in 3 n -I to Yk Vn U O O 00 ® -A o m 0 in 'B c o .' o 0 0, 2 'a ° 'a O W h-� n = W � _ N D o K N — o o — — O ® O O_ 3 (D -n vi in rt "s W 'G -+. a� "'fi O w W f iY O O N i n rt z O; 0 rt N �+ 3 O ,y. (D ,y. l0 W C). 00 N ,.+.. N• 3, d nn a oa M 3 O �, �, N V n0 Ql Q I"' ® N ® 0 O O_ vOi O v p V® O II 7 +' 011 w 0 (D O(D 0) 09 II n O- ,nrt ro tD $ \ N dl {/T (i0 (Dp a O ^ P * n N V N O < fD N w0 (D O C =r Q' m N ® W G fu 00 (AO W v-`i !V N m m X O a)0 (3 w 713 y CL (D 0 o0. p : N W m N O N Ln w �' V i� W W N g 3• ® N iR tn. W 61 O Ol lD O O Ih, U9 to N W A lD r-F —N - TI V N ll N ® V1 O Vi O to cn o n O W cn J (D rt W O � ;a � � rP O ® O O a rt ® G N �• A U) mn O N El Q X < 2 A 0 O 'S 0 N W Z v rr rt 'O ® m oc7i m G 3 an Fv W W "� Z N rt O i9 Voo 7 A N II 3 N n' (D3 N 3Ul O 6 W 00 O p m (D O O r ® fp7 (D CL n a o r RD 0 n N [ p N vl� O n (D (D N O + < (D wN 3 3 (OD 61 y/t go Ln X Ind A 3 ® N C A W N D 4a �< Ln Ui rD O rD Oo z n n n O � n n n a'a 0 0 In 0 0 r 3 O O 00 Health Partners. four Earner In Acerdabl=Inmate Healdiare MEDICAL PROVIDER/IN DEPENDENT CONTRACTOR PROFESSIONAL TIME RECORD FORM For use by SHP Medical Team Administrator in reporting time worked by your Medical Provider(s) within your medical unit. Please report this information along with your Monthly Statistical Report by the 5th of each month. Fax the completed form to our corporate office at 423-553-5645. If your site uses multiple providers, you can report all of their time on this one form. Site Name: /IL Site Code:__ Site City:/ (J L IdV �� State: C The following is a listing of the dates and times professional medical services were performed by the Medical Providendependent Contractor at the medical unit within the r/I jail on behalf of Southern Health Partners, Inc. Please use one line for each date visited. Medical Provider's Last Name/Group Name Profession (MD 1 DDS 1 Psych I etc) Date Visited Total Time On - Site Per Date Visited M �.11;Q1 ��olle14P mD Id-,U-1 t i tir TOTAL VISITS THIS MONTH: This time report is reDorte44 as true d correct by placing your signature below.. MTA's Signature:Date: / Confidential Work P uct of SH SHP Form 12106; Updated 8I2009 Corporate Office: 2030 Hamilton Place Blvd., Ste, 140, Chattanooga, TN 37421 Phone: 423-553-5635 southeTra E$�al�fz. Partners nber and Name/State: o� - nn1� MONTHLY REPORT OF MEDICAL SERVICES :rater the TOTAL number for the month of services you are reporting: eport to the corporate office 423-553-5645 bylbefore the 5th of the current month. i A may also give a copy of this. report to F Mail Administrator as a reporting mechanism. it supporting documentation (Daily Report of Services) with this TOTAL Forin In your Confidential File. s# ; i.: # OF PATIENT HOSPITAL ADMISSIONS US ENT TO EMERGENCY.ROOM # OF OUTSIDE MEDICAL VISITS (includes any speciality physician appis)` - �Y (% # OF IN-HOUSE X RAY SERVICES (consider multiple viers) / #SEEN ON -SITE BY MENTAL HEALTH # SEEN BY PHYSICIAN andlor PHYSICIAN PROVIDERS - # SEEN BY DENTIST (includes on -site and off -site) #OFFRECEIVING SCREENINGS BY MEDICAL STAFF # SEEN AT SICK CALL #OF H&Ps DONE #OF RPRs DONE /�(© ice/ # OF OTHER SFXUALTRANSMITTED DISEASES TREATED - - # OF MEDICAL REFUSALS -- UGAR CHECKS -ESSURE CHECKSS ELOOD AND/OR PPD TESTS IRSA PATIENTS IN-HOUSENT FEMALES # OF HIV PATIENTS IN-HOUSE # OF INMATES PLACED ON SUICIDE WATCH # OF INMATE DEATHS # OF INMATES ON DETOX PROTOCOLS i Average Daily. Population for the Month (take your total and divided the number of days in themontit) SHP MEDICAL ADMINISTRATOR'S SIGNATUR Jeed to know the number of patients treated for Staph Infections/MRSA Infections Veed to know the total number of pregnant females in the Jail this month Veed to know the known number of HIV patientsIn the Jail this month Need to know the number of patients placed on Suicide Watch this month Need to know the number of patients placed on Detox Protocols this month. u i ae a as o r o o m p m Ao m o y➢ ➢ � � v � � � O m o o m < Om � m m m m � y m A O ➢ c � OZ OT. �Z_i m xp> � � -D ZZi .Z�1 m � G) f�i1 --� m m ➢ ��i { "� Z .➢j � � m D zo A A � � F m � m m � X O OC � Z v Cmi OT. mo V7 S m O o a O m ti _ � a T .VA 2 E RN o m O O rn v m m � 9 D% Qpp O fn (p m P? Im cn N u z O � � m d m m E N O Q e m O O n rJ H 6 w N w c rn 3 o m g 6 a o N S 0 j o w O C N N ni n� ®n o m m b LI MIN v , � N J' all RN LV 11 m m 10 0 n cn m G 0 m cn 9 w 4jk. iii- ua O -I 2 -q vt 3 n -1 :n In x to U CD O 0 00 (D h<< n p O .3+ 3 rt 3 (D ® ® �' \ O N �' 3 � C O O (D N. 7 Ul 3 C(D N00 Q. :;a 0 rt N 7.7 N ((DD C ®M go® O O ® ® w w II V} S o �II 3 ( II {n. ( a �. 0 o p 0 A II X CD z 30 N ^' CD m V -rA o® c n -4 IV Q1 < `^ o N. I-� (A W N LO j m C rt 3 N l0 Uf 4 m O LD m :0 m 0 n w o ,� w o C O w -V, N t/* 0 ® in w �4 O O i-+ W NJ 00 (n ® n -h Oo O O O p W W O -6 !D rt O 61 1p h O O O O p- O W lO p O O N W LO W O m 0 cu W N rt w z W a d O H ® C m N m, rt oIA 0 z < _ � o 0 o v r2 < Z (Doj }� ®' N r« O W N m 3 ® Ql- N 3 j O Q. O ® 00 3 3 cr W rD O O rD ul z ® Q ° o 3 0 o N v m g' 2 O N Di V 3 Ln ffDD x O o m c w V W 'o ®1 ` w (D m (D 3 � d 3 00 C) D r O C z n O C z D C m m m z z m m z m m z D m rn K m n D r c� O (i O D N O z O Ln m m W m z For use by SHP Medical Team Administrator in reporting time worked by your Medical Provider(s) within your medical unit. Please report this information along with your Monthly Statistical Report by the 5th of each month. Fax the completed form,to our corporate office at 423-553-5645. If your site. uses multiple providers, you can report all of their time on this one form. Site Name: � ° ` V WY' � � �1 l Site Code: Site City:_ �V t56�! State: The following is a listing of the dates and times professional medical services were performed by the Medical Provider/Independent Contractor at the medical unit within the jail on behalf of SouthernHealth Partners, Inc. Please use one line for each date visited. Medical Provider's Last Name/Group Name Profession (MD I DDS 1 Psych I etc) Date Visited Total Time On. . Site Per Date . Visited CPaw i° aMD TOTAL VISITS THIS MONTH: This time report.is reported as true and correct by placing your signature below. MTA's Signature: Date: ) Confidential Work Product of SHP SHP Form 12106; Updated 812009 Corporate Office. 2030 Hamilton Place Blvd., Ste. 140, Chattanooga, TN 37421 Phone: 423-553-5635 N • LIN IN mip" O t \srail �V �` ��i \i- d'��'+',��'. ��,�� O. �'� fit• �d�01. Qi `\ \�I �� ,r �� ` � ..OR NSA' z D D O m 0 0 9 m O a ScOtad-tern. Hea€tf0 MONTHLY REPORT OF MEDICAL SERVICES ouo cao nln..hor and Name/Elate' 0� Month / Year of this .Report: .- Please enter the TOTAL number for the month of services you are reporting. - Fax this report to the corporate office 423-553-5645 by/before the 5th of the Current month. The MTA may also give a copy of this report to the Jail Administrator as a reporting mechanism. Keep your supporting documentation (Daily Report of Services) with this TOTAL Form in your Confidential File. #OFPATIENT HOSPITAL ADMISSIONS # SENT TO EMERGENCY ROOM # OF OUTSIDE MEDICAL VISITS (includes any speciality physician apple)' it OF IN-HOUSE X-RAY SERVICES (consider multiple views) # SEEN ON -SITE BY MENTAL HEALTH # SEEN BY PHYSICIAN and/or PHYSICIAN PROVIDERS # SEEN BY DENTIST (includes on -site and off -site) # OF RECEIVING SCREENINGS BY MEDICAL STAFF # SEEN AT SICK CALL # OF H$Ps DONE •/ li " # OF RPRs DONE # OF OTHER SEXUAL TRANSMmED DISEASES TREATED t # OF MEDICAL REFUSALS �n # OF BLOOD SUGAR CHECKS C� # OF BLOOD PRESSURE CHECKS ANDIOR PPD TESTS Q AH / MRSA PATIENTS IN-HOUSE FEMALES vpNANT N�(ATIENTS MREENS IN-HOUSE X/TES PLACED ON SUICIDE WATCH DEATHS (�TE ""ATES ON DETOX PROTOCOLS Average Daily Population for the Month (take your total and divided the number of days in the month) jSHP MEDICAL ADMINISTRATOR'S SIGNATUR Please check off the following as complete for this month: QI Criteria completed and faxed to corporate by the 15th Monthly Nurse's Meeting completed and minutes taken All billing statements mailed to.corporate ElMonthly Training Topic reviewed and signature sheet faxed Monthly, Provider Time Sheet faxed to corporate lend to know the number of patients treated for sexually transmitted diseases geed to know the number of patients treated for Staph Infections/MRSA-infections Need to know the total number of pregnant females In the Jail this month Need to know the known number of HIV patients In the Jail this month Need to know the number of patients placed on Suicide Watch this month Need to know the numb r of atients placed on Detox Protocols this month. 3C) _ .4P3.2-- �F o Y Y Y F+ F+ Y O O O O O O O O O O O O O O O O N N Y Y N N O O W V V V W W O1 m m Ol Ol Ol Ol Ol W N W \ \ \ \ \ \ \ W W W O O N N \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ Y W N O Y Y N N N Y O O N N Ol Ol N N N N N N N T Y N T N N t0 t0 Oo N O O O W Y T N N N N N N N N N N N N N N N N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y< A A A A A A A A A A A A A A A A A A A A A A A p Z Z- w33, M m m = m m 3 D F F d > N 2 T n > s m <aa- 19 2Q n n n < 3 < < < < < < z < < < < < < < < < a 0 3 0 0 0 0 0 0 0 5.0 0 0 0 0 0 mm 0 0 0 of ° of o of of ei of ni o ni of of of w -o of �m 0 0 o m d m °.� m m m m m m m m m m m m m �' m m m n .Gi M fD fD j (D tU fD fD tU 3 N fD fD m m m M N lU N < 3 m a m 3 m m m m m 3 m m m m m m O m m m n n n^ n n n n Q Q n « Z N fD N D D -1 y � V m O o o o o o o o m m m m m m m m m m m m c c c c c c c c 3 3 3 3 3 3 3 3 3 3 3 3 N n n N N N rt Et G d m <<< rt M M M M M M M n n n n n n n O O n O n N N 0 0 0 0 0 0 0 0 0 0 0 0 O n p 0 0 0 0 0 0 0 0 0 0 0 0 3 3 3 3 3 3 3 3 3 3 3 3 .e m o d 3 fD K P N 1 3 m cP � W Y O w o m f+ A A m D_ D 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 M � N N h < W i/� N iR 3 W T 001 N N A o lVD tWJt UOi l00 m VOi N m m m ON m A 1�11 W m W wY ee W N w A V lA A O Ol O N O w IJ O O l0 V LV l0 O O, W lD N Vn A Ol Ol Ol O W Y O N 0 01 00 V Ol Ol O V A O1 J 0 Y O V U1 A IV --I Q in W $y9• W in V W 00 O -1 � o a:• m •4 0 to N O >= 0 n 0 -I 0 x W to zft v} cn O 3k O � O '� A � 0 ® Vl CD O fD rt < <, n Op O , rt m py 00 Z gIr ® Ci Fa O =h W O A (1G Q 3 00 0 y h .�. W 00 O ®1� ® no N � RO (D n .O+ W ®. ul °O Q �, U9 00 O O '� V ® II '+' n n 0 rt 2 O rD if v�i 0 O 0 W O 3 } ®�,�*� 00 o �m o N� Q 3- ® !N p Ul 7 m (ND O v-i' CD I—' m = iz AA_M '� cA m n W � m :0 - o D? ®Ng 0 O m X lip �r N p W k ® S CL ® C o 0 -„� d w m w ® ® 0 as S Q 3• M win W yr N v N (Drn to N + tq Q �' 0 ® n (A 00 I -A m N to yr ID N A to W , R tJ� N tD n PO f� r-t m ei ® '-WS O ;f, L9 W V W V 0 0 V 1-� W Ol O O N F-+ z n M � mrD (pa A to cn Oo A to 00 A W w �+ C N n .n ®. N M N h N N o ® W A R = ® •V) ® ® n N Q C e (n Ln A C n CZ`A N 'A in Nr N m o in0 '�' m r) X r < cn m A n 0 n O cn = W C ®® '* N p m 9 tr o z m 'o < =+ 3 m w 4%h W N `" v m ? �� 00 m 3 A n j � m n o00 W cz m n O W Q m aC 3 VI O W rt (D p C O (D hi O Q O a n Q o N (D O O n W D z F n (D N VI OQ x ® 'Cf4 3 n y < of o �N AUQ W 3 3 Lnn N X ® M fO, o � W N O A W � (DrD O 7 fD (D Q. DQ D r S O C Z n O C Z D C 0 mm Z O Z n m Z m z D m m 0 D r n O Ln O 'O D A cn O z -n O 0 m n m w m z k \ \ Q_ \ \ \ . 0 \ 0 0 § { } \ \ 2 El a � � O m 3 0 = N 3 0 w < O O O � O c Q fr N m � < 3 v3 m Z � � n o o m T. Q < o o Q 3 O N o 3. o �• O O O 3 rr rh m � a 00 m O o h a 91 3 o fD �. 0 O O 'G N n � O n 3 n m � M 0 N Oq O N < 3 d � m O Q d 3 � or Q 0 3 O w O � 6 O a m v o n O O O Ory m r°o imif O) O Q 3 0 m o 'F a S <, j < O 3 m p� Q m Q. N � N n a j fp• < -- G A A n N < y N N p�j w n n w w � o o v m O L9 O v N O W W 0 ti n 0 cWD W v Ort a• P Q n Z 'o ^ ri• fp o 0 vn 'g (9 0 -3-n• N P m i, .k 0 O 0 n m t' ° w o,' IT n9W"n C Q cn rt 3 ! ru N 0 N� Q j- �= 3 T rt fD M S fTl m G `< v Oq N i z r' O d -O N N C O m O x m (OD a w 0 r=Y : (D Q (D C 0 + n a Q v o 0 0 0 ((D 3 w m n m o 3 U) c m 3 0 Z 3 -« p O fOD n O< m n m o m a 3 � g � p O M O 0 C n n mm N r m m O a O O m > n S o o fn n 0 S 0 m O m r� O m m m `c' o o O N 0 ft < N u C <. O d n Q m O m Q C O O a m vmi v rr Gl m 3 4q 0 N O O n _ o M m .* 3 m x N O �, N m O a S W o o n O A < a N w S � N O Q f' m m m � •' N N — � A m u0 3 N W O W 0 m p O o N fU � � Southern Health Partners Your PaiTnzr In A..ordablz Inmz�e Healthcare �- " 1. •� � i � :_. Y �- • �1. _ � • 1; i �i �. PROFESSIONAL •.i -IME RECORD •,. • 7. XD� 190 For use by SHP Medical Team Administrator in reporting time worked by your Medical Provider(s) within your medical unit. Please report this information along with your Monthly Statistical Report by the 5th of each month. Fax the completed form to our corporate office at 423-553-5645. If your site uses multiple providers, you can report all of their time on, this one form Site Name: I �� Site Code: Site City: State: Ix The following. is a listing of the dates and times professional medical services were performed by the Medical Provider/Independent Contractor at the medical unit within the jail on behalf of Southern Health Partners, Inc. Please use one line for each date visited. Medical Provider's Last Name/Group Name - Profession (MD I DDS / Psych //e}�ttc) Date Visited Total Time On - Site Per Date y/� /�/ / �Visited . V ✓ m 1 f'lor 1�1 TOTAL VISITS THIS -MONTH.- This time report is orted as true nd correct by placing your signature below. MTA's Signature: LA Date: Confidential Work Product of SHP SHP Form 12/06; Updated 8 009 Corporate Office: 2030 Hamilton Place Blvd., Ste. 140, Chattanooga; TN 37421 Phone: 423-553-5635 twto�,-3il U Southern Health. MONTHLY REPORT OF MEDICAL SERVICES Partners SHP Site Number and Name/State: Month / Year of this Report: 1 11v7U v / Please enter the TOTAL number for the month of services you are reporting. Fax this report to the corporate office 423-553-5645 by/before the 5th of the current month. The MTA may also give a copy of this report to the Jail Administrator as a reporting mechanism. Keep your supporting documentation (Daily Report of Services) with this TOTAL Form in your Confidential File. # OF PATIENT HOSPITAL ADMISSIONS d� # SENT TO EMERGENCY ROOM # OF OUTSIDE MEDICAL VISITS (includes any �( speciality physician appls)' S!J # OF IN-HOUSE X-RAY SERVICES (consider multiple views) # SEEN ON -SITE BY MENTAL HEALTH # SEEN BY PHYSICIAN and/or PHYSICIAN PROVIDERS # SEEN BY DENTIST (includes on -site and off -site) # OF RECEIVING SCREENINGS BY MEDICAL STAFF - #BEEN AT SICK CALL r # OF HBPs DONE # OF RPRs DONE # OF OTHER SEXUAL TRANSMITTED DISEASES TREATED # OF MEDICAL REFUSALS W # OF BLOOD SUGAR CHECKS # OF BLOOD PRESSURE CHECKS 3 # OF T8 SCREENS ANDIOR PPD TESTS - # OF STAPH I MRSA PATIENTS IN-HOUSE - # OF PREGNANT FEMALES # OF HIV PATIENTS IN-HOUSE # OF INMATES PLACED ON SUICIDE WATCH I # OF INMATE DEATHS �/ Please check off the following as complete for this month: QI Criteria completed and faxed to corporate by the 15th Monthly Nurse's Meeting completed and minutes taken All billing statements malted to corporate 11 Monthly Training Topic reviewed and signature sheet faxed 12 Monthly Provider Time Sheet faxed to corporate Jeed to know the number of patients treated for sexually transmitted diseases Veed to know the number of patients treated for.Staph Infections/MRSA infections Need to know the total number of pregnant females In the Jail this month Need to know the known number of HIV patients In the Jail this month - Need to know the number of patients placed on Suicide Watch this month # OF INMATES ON DETOX PROTOCOLS Need to know the number of patients placed on Detox Protocols this month. Average Daily Population for the Month (take yourtolal and divided the number of days In the month) - SHP MEDICAL ADMINISTRATOR'S SIGNATURE: • PNMI me 0 3 Sol N 0 0 N O 1 \V I limp I minim 11 w � t� h\,� 1 � li►�Ba i ll MERE v r 3111111111 1311111 1111211mo M .. EM® 112\\ 81_ 1 O „_\ 11 f \` M\V `S 2 1111121111121111 11111111312111MIME h 1p l� 4.� • • � J 'ci0. � �F'1 y S Z Y `s. \✓ }C 5 n n n G g < A < G G _< _< < < < < < _< �+ _G _G < 0 0 0 0 0 0 0 0 0 0 0 o m o 0 0 m m v w of o w a w d w o W of m m. p a Q m d m2� m m m m MEm m m m m m m m m c c c 3 m 3 m 3 3 3 3 3 3 m 3 3 m n 3 3 3 0 0 0 0o a oa — oa a'o a'c oa oo — oo a'c o0 00 oc w O w' as w' c c m m 3 m m m m m 3 m m m m m m m m m v rp m m m. V v v n v v v v m r m v v O m 0 0 0 0 0 0 0 0 m m m m m m m m m m m m o o s s s c c c c c c c c 3 3 3 3 3 3 3 3 3 3 3 3 an d a,o n v a -o a v v m m m m m m m m m m m m a 3 3 3 Z m w ro M m m mm m m>>>>> c^ c c c 0 N 0 0 0 0 0 0 0 0 0 0 0 0 o n 0 o 0 0 0 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 m 3 � N pO � O W 1-� Q N N O ry F{ A N i/? N iR iR VL i/F N NF i/n {/T V! Sn iR lR VL i? iR LF 0 0 0 0 0 0 0 0 0 0 p 0 0 0 0 0 0 0 0 0 p 0 0 p 0 p 0 O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 v. N ih ih {!� w w O o Uf w w 0 m V W O O lD 1p m tD m O � [n N to V CG m m m : A VI N m F� A O lD lli In l0 m U1 F` m m m N W m W m 4.1 N Ui A V In A O Ol O IJ O w N O O tO V W tp O m W w N A 0 m m O W 0 N 0 m w V m m 0 V A m V 0 F O V W I T APPROVAL OF PAYROLL: Commissioner Fritsch made a motion to approve the following payrolls for January 2015: • January 2, 2015 $ 229,439.61 • January 16, 2015 262,244.34 • January 30, 2015 259,312.05 TOTAL $ 750,996.00 Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. CALHOUN COUNTY PAYROLL 2015 MONTH / JANUARY Payroll through 01-02-2015 Payroll through 01-16-2015 Payroll through 01-30-2015 $ 229,439.61 $ 262,244.34 $ 259,312.05 APPROVED TOTAL PAYROLL $ 750,996.00 The items listed above have been pre -approved by all Department Heads and I certify that funds were available to pay the obligations. I certify that the above is true and correct to the best of my knowledge February 9, 2015. ED 12 N dJ ONDA S. KOKENA, CALHOUN COUNTY TREASURER ACCEPTED AND APPROVED THIS THE I L*L DAY OF 1bra , 2015 IN THE CALHOUN COUNTY COMMISSIONERS' COURT, PORT LAVACA, TEXAS 77979. APPROVAL OF BILLS: Commissioner Fritsch made a motion to pay 2014 County bills in the amount of $35,066.71, no transfers between funds. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Commissioner Fritsch made a motion to pay 2015 County bills in the amount of $3,241,218.45, no transfers between funds. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. February 12, 2015 2015 APPROVAL LIST - 2014 BUDGET 45 COMMISSIONERS COURT MEETING OF 02/12/15 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 44 $ 33,522.75 FILTER TECHNOLOGY A/P $ 1,361.59 VERIZON SOUTHWEST A/P $ 182.37 TOTAL VENDOR DISBURSEMENTS: $ 35,066.71 TOTAL TRANSFERS BETWEEN FUNDS: S - TOTAL AMOUNT FOR APPROVAL: $ 35,066.71 February 12, 2015 2015 APPROVAL, LIST - 2015 BUDGET 50 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 49 $ 2,700,590.33 FICA P/R $ 43,567.18 MEDICARE P/R $ 10,189.14 FWH P/R $ 36,110.11 AFLAC P/R $ 5,058.06 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 2,870.48 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 1,205.01 PRINCIPAL FINANCIAL GROUP P/R $ 3,861.73 TEXAS ASSOCIATION OF COUNTIES HEBP P/R $ 182,532.73 TEXAS COUNTY & DISTRICT RETIREMENT SYSTEM P/R $ 193,049.93 TMPA P/R $ 308.00 UNITED WAY OF CALHOUN COUNTY P/R $ 18.00 AT&T A/P $ 49.76 BEN E KEITH FOODS A/P $ 5,708.85 CABLE ONE A/P $ 732.22 CENTERPOINT ENERGY A/P $ 250.45 CITY OF POINT COMFORT A/P $ 82.31 CITY OF PORT LAVACA A/P $ 2,788.64 CITY OF SEADRIFT A/P $ 210.14 CONSTELLATION NEW ENERGY A/P $ 21,753.86 CPL RETAIL ENERGY A/P $ 24.41 DIANA STANGER A/P $ 10,449.02 GBRA A/P $ 185.98 JACKSON ELECTRIC COOP, INC. A/P $ 568.61 LA WARD TELEPHONE EXC. INC. A/P $ 299.60 MCI MEGA PREFERRED A/P $ 266.91 MIRELES CONSTRUCTION A/P $ 7,600.00 PORT O'CONNOR MUNICIPAL UTILITY DISTRICT A/P $ 696.31 REPUBLIC SERVICES #847 A/P $ 1,345.59 SPRINT A/P $ 180.59 TISD, INC A/P $ 407.81 VERIZON SOUTHWEST A/P $ 5,594.59 VICTORIA ELECTRIC CO-OP A/P $ 2,662.10 TOTAL VENDOR DISBURSEMENTS: $ 3,241,218.45 TOTAL TRANSFERS BETWEEN FUNDS: $ - TOTAL AMOUNT FOR APPROVAL: $ 3,241,218.45 CONSIDER AND TAKE NECESSARY ACTION TO ACCEPT DONATIONS TO CALHOUN COUNTY: N/A CONSIDER AND TAKE NECESSARY ACTION TO REMOVE BACKHOE/LOADER CLG766-III, SNGLG00766PAS000514, INVENTORY #23-0233, AND TRADE-IN FOR CAT 420F, S/N OSKR04654: Commissioner Lyssy made a motion to remove Backhoe/Loader CLG766-III SNGLG00766PAB000514, Inventory #23-0233, and Trade-in for CAT 420F, S/N OSKR04654. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. 0 PRECINCT 3 24627 State Hwy. 172 --- Olivia, Poii Lavaca, Texas 77979 — Office (361) 893-5346 -- Fox (361) 893-5309 Neil E. Fritsch, Commissioner, Pct. 3 Email: neil.fritsch@calhouncotx.orc3 January 28, 2015 To: Honorable Judge Michael Pfeifer From: Neil Fritsch Re: Agenda Item Please place the following item on the Commissioner's Court Agenda for February 12, 2015: "Consider and Take Necessary Action to remove Baekhoe/Loader CLG766-III, SIN CLG00766PAB0005I4, inventory # 23-0233, and trade-in for Cat 420F, S/N OSKR04654. " Respectfully, % &..ewe Xr;7.'`i cc: Roger Galvan Vern Lyssy Kenneth Finster Susan Riley CONSIDER AND TAKE NECESSARY ACTION TO DECLARE AN HP LASER JET PRINTER 3015, SN VNB3SOOA58IN THE OFFICE OF JUSTICE OF THE PEACE #4 AS WASTE AND AUTHORIZE DISPOSAL OF SAME: Commissioner Finster made a motion to declare an HP Laser Jet Printer 3015, SN VNB3SOOA58 in the office of Justice of the Peace #4 as waste and authorize disposal of same. Commissioner Fristch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: JUSTICE COURT PCT. 4 DEPT. # 480 Requested By: NANCY POMYKAL — JUDGE PRO TEM 361-983-2351 Inventory Number Description Serial No. Reason for Waste Declaration TI P LASER IET PRINTER 1011 VNB3SOOA58 THIS PRINTER DOES NOT WORK. IT CANNOT BE REPAIRED. NEED TO DESTROY. DATE: 12-30-14 NANCY POMYKAL RECEIVED BY: CONSIDER AND TAKE NECESSARY ACTION TO DECLARE THE FOLLOWING ITEMS AS SURPLUS IN THE OFFICE OF JUSTICE OF THE PEACE #5 AND REMOVE FROM INVENTORY (REPLACED BY ALL IN ONE COPIER/FAX/SCANNER XEROX WORK CENTRE): 1. Brother Facsimile SN U565831FK760030 2. Xerox Copy Centre SN RYR391947 Commissioner Galvan made a motion to declare the following items as surplus in the office of Justice of the Peace #5 and remove from Inventory (replaced by All in One Copier/Fax/Scanner Xerox Work Centre): Brother Facsimile SN U565831FK760030 and Xerox Copy Centre SN RYR391947. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: NANCY POMYKAL JUSTICE OF THE PEACE PCT. 5 DEPT. 490 Requested By: Judge Nancy Pomykal Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration BROTHER FACSIMLE U565831FK760030 THIS MACHINE WAS REPLACED BY AN ALL IN ONE COPIER/FAX/SCANNER. XEROX WORK CENTRE XEROX COPYCENTRE RYR391947 THIS MACHINE WAS REPLACED BY AN ALL IN ONE COPIER/FAX/SCANNER XEROX-WORK CENTRE Receiv b Judge Nancy Pomyka101/9/2015 CONSIDER AND TAKE NECESSARY ACTION ON THE MATTER OF DECLARING CERTAIN ITEMS OF COUNTY PROPERTY AS SURPLUS/SALVAGE: PASS CONSIDER AND TAKE NECESSARY ACTION TO TRANSFER HP ENVY 23" INTEL COMPUTER FROM PRECINCT #4 ROAD AND BRIDGE INVENTORY TO 3P #4 INVENTORY: Commissioner Finster made a motion to transfer HP Envy 23" Intel Computer from Precinct #4 Road and Bridge Inventory to JP #4 Inventory. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Kenneth W. Finster County Commissioner County of Calhoun Precinct 4 February 2, 2015 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: Please place the following item on the Commissioners' Court Agenda for February 12, 2015. Discuss and take necessary action to transfer HP Envy 23" Intel Computer from Pct. 4 Road & Bridge inventory to JP #4 Inventory. Sincerely, Kenneth W.Finster KWF/at P.O. Box 177"Seadrift, Texas 77983"email: kfinster@calhouncotx.org"(361) 785.3141"Fax (361) 785-5602 Inventory Number Calhoun County, Texas PA R! r -*I i �. E Requested By: April Townsend, Pct. 4 Serial No. Transfer HP ENVY 23" INTEL 3CR40706CN Dept. 570 R&B #4 to 1P #4 COMPUTER CONSIDER AND TAKE NECESSARY ACTION TO TRANSFER THE FOLLOWING ITEMS OF PROPERTY FROM THE OFFICE OF JUSTICE OF THE PEACE NO. 4 TO THE CALHOUN COUNTY MAIN LIBRARY: HP COMPAC COMPUTER TOWER, SN2UA9250QWK, AND KEYBOARD AND MOUSE: Commissioner Finster made a motion to transfer the following items of property from the office of Justice of the Peace No. 4 to the Calhoun County Main Library: HP Compaq Computer Tower, SN 2UA9250QWK, and keyboard and mouse. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested ByJUDGE WESLEY HUNT/NANCY POMYKAL J.P.4 DEPT 361-983-2351 p/- ,! J - /)94�--Z)1-1- I Inventory Number Description Serial No. Transfer From/To CONSIDER AND TAKE NECESSARY ACTION TO TRANSFER THE FOLLOWING ITEMS OF PROPERTY IN THE OFFICE OF JUSTICE OF THE PEACE #5 TO THE CALHOUN COUNTY MAIN LIBRARY (SEE LIST): Judge Pfeifer stated the list includes computer towers, keyboards, and mouse. Commissioner Finster made a motion to transfer the following items of property in the office of Justice of the Peace #5 to the Calhoun County Main Library (see list). Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested ByODGE NANCY POMYKAL, J.P. 5 DEPT. 490 361-983-2351 Inventory Number Description Serial No. Transfer From/To Department HP COMPAC COMPUTER TOWER MXL 91103NC J.P. 5 TO CALHOUN CO. MAIN LIBRARY RECEIVED BY: 01-23-15 CONSIDER AND TAKE NECESSARY ACTION TO TRANSFER A 2004 CHEVROLET SILVERADO PICKUP WITH LIFT GATE, VIN 1GCTC24U74Z160778 FROM WASTE MANAGEMENT TO PRECINCT #2: Commissioner Lyssy made a motion to transfer a 2004 Chevrolet Silverado pickup with Lift Gate, VIN 1GCTC24U74Z160778 from Waste Management to Precinct #2. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Riley From: Patricia K <sugsplk57@yahoo.com> Sent: Monday, February 02, 2015 4:19 PM To: susan.riley@calhouncotx.org Cc: cindy.mueller@calhouncotx.org Subject: agenda Will you please place an item on the agenda for Commissioner's Court for Waste Management? I will be transfering our pickup to Precinct 2 once our new truck arrives. I will transfer a 2004 Chevrolet Silverado with lift gate (only). Vin # 1GCGC24U74Z160778 Thank you. Patricia Kalisek Site Supervisor Calhoun County Solid Waste/Recycling 1 ®Feb 03 2015 4:30PM HP LRSERJET FRX P,1 February 2, 2015 Susan Riley, Please put an item on the agenda for Waste Management. I will be transferring our 2004 Chevrolet Silverado pickup, Vin It 1GCGC24U74Z160778 to Precinct 2 as soon as our new truck arrives. The 2004 pickup also comes with a lift gate( only). Thank you Patricia Kalisek Waste Management CONSIDER AND TAKE NECESSARY ACTION ON MATTER OF TRANSFERRING CERTAIN ITEMS OF COUNTY PROPERTY FROM ONE COUNTY DEPARTMENT TO ANOTHER COUNTY DEPARTMENT: N/A CONSIDER AND TAKE ACTION ON ANY NECESSARY BUDGET ADJUSTMENTS: Commissioner Finster made a motion to accept any necessary budget adjustments. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. FUND NAME GENERAL FUND FUND NO: 1000 III I I [11111111111111 IIH I I uulH I I mill 11II1III 1[Hill 1 I I MI 111111111111111111111111[1111I II In I III III111111IH I I I I I I III] I [11111 HIIH 11111111111111111111111111111111111111111111111111111I1111111111111111111 [1111111111] 1 [1111111 DEPARTMENT NAME: COUNTY CLERK DEPARTMENT NO: 250 JAMENDMENTNO: 3890 I REOUESTOR:AUD/TORS OFFICE/ OVERDRAWNACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND DAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTNO ACCTNAME GRANT NO CRANTNAME INCREASE DECREASE INCREASE DECREASE IUECREASEI 51545 PART-TIME EMPLOYEES 999 NO GRANT $0 $0 $1,200 $0 ($1,200) 53020 OFFICE SUPPLIES 999 NO GRANT $0 $0 $0 $1,200 $1,200 AMENDMENT NO 3890 TOTAL $0 $0 $1,200 $1,200 $0 COUNTY CLERK TOTAL $0 $0 $1,200 $1,200 $0 I I I 11 ( I I I I I I I I IIIIIII I I I I I I I I I I IIII I I I 111 I I I I I IIIII I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1111111111 I I IIIIIII I I I I I I I I I I I I I I IIIIII I I I I I I I I I I I I 111111111 I I I I I I I I 111 I I 1111111111 I I I I I I I I I I I I I I I I I I I I I I I I i l I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: HISTORICAL COMMISSION DEPARTMENT NO: 130 AMENDMENT NO: 3887 1 REOUESTOR. HISTORICAL COMM/SS/ON AMENDMENT REASON: ILINE ITEM TRANSFER FUND UAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ACCT NAME GRANT No GRANT NAME INCREASE DECREASE INCREASE DECREASE NECREASEI 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $0 $99 $99 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $99 $0 ($99) AMENDMENT NO 3887 TOTAL $0 $0 $99 $99 $0 HISTORICAL COMMISSION TOTAL $0 $0 $99 $99 $0 11111111111111II11111111111111111111111111111111I11111111111111111111111111111111111111111111II1111111111II11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 AMENDMENTNO: 389D REQUESTOR:AUD/TORSOFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: JOVERORAWN ACCOUNTS REVENUE REVENUE EXPENDITURE EXPENDITURE INCRLASL ACCTNO ACCTNAME GRANT NO CRANTNAME INCREASE DECREASE INCREASE DECREASE [DECREASE] Wednesday, Febmary 11, 2015 Page 1 0( 3 FUND NAME GENERAL FUND FUND NO: 1000 [III IIIIIII [III] III0II III 1I I I IIIII till[ 11111111 II I H I I [III l l [IIII I I I I I I I IIIIIII III] III] I IIIIIII I III III I [III III III] IIIII III ( [ I I I I I I I I I I I I I I I I I I I I] I I I I I I I OI I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I1I ( I I I IIIII III I DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 AMENDMENTNO: 3890 1 REQUESTOR:AUDITORS OFFICE/OVERORAWNACCOUNTS (AMENDMENT REASON: IOVERDRAWN ACCOUNTS I REVENUE REVENUE EXPENDITURE EXPENDITURE IRURLASE ACCTNO ACCTNAME CRANTNO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE( 51620 ADDITIONAL PAY -REGULAR RAT 999 NO GRANT $0 $0 $220 $0 ($220) 51630 COMP TIME PAY 999 NO GRANT $0 $0 $0 $220 $220 AMENDMENT NO 3890 TOTAL $0 $0 $220 $220 $0 JAIL TOTAL $0 $0 $220 $220 $0 IIIII I II I11111111I I I111111(III I I I IIIII I III II I I III I IIIII I11111II111111II I I I II II IIIIIIRIIIII I I (III I I II I I I IIIII I IIIIII I1111(i11111111I I I I I111111I (III ( I I I11111111111111111IIIIIII I I I I I I II II I1111111II III (IIII I (IIIIII (III (ill I I I (III II III I DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #1 DEPARTMENT NO: 540 AMENDMENT NO: 3889 77TIFEQUESTOR: COMMISSIONER PRECINCT 9 AMENDMENT REASON: ILINE ITEM TRANSFER TO COVER BILLS FUND DAL REVENUE REVENUE EXPENDITURE EXPENORURE INCREASE ACCTNO ACCTNAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASO 53580 PIPE 999 NO GRANT $0 $0 $3,000 $0 ($3,000) 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $0 $3,000 $3,000 AMENDMENT NO 3889 TOTAL $0 $0 $3,000 $3,000 $0 ROAD AND BRIDGE-PRECINCT#1 TOTAL $0 $0 $3,000 $3,000 $0 I I I11I ( I I I IIIIII I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IIIIIII I I I I I I I I I (I I I I I I I I1111111111I (I ( I I I I I I I I I (I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I (I I I I I I I I I I I I I IIIIII I I I I I (I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IIIIII I I I I I I I I I I I IIIIII ( I I I IIIIII ( I I I I I I I DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #2 DEPARTMENT NO: 550 AMENDMENTNO: 3888 1 REQUESTORe COMM/SS/ONER PRECINCT2 AMENDMENT REASON: TRANSFER FOR LEADERSHIP CONFERENCE FUNDRAI REVENUE REVENUE EXPENDITURE EXPENDRIME INCREASE ACCTNO ACCTNAME GRANT NO CHANT NAME INCREASE DECREASE INCREASE DECREASE [UECREASE] Wednesday, February 11, 2015 Page 2 0( 3 FUND NAME GENERAL FUND FUND NO: 1000 111 f111f11 I III] III I I1111f 1[11111111 In III 11111 111111f1 11[loll I1 I I III I I I I III I uuu if IHII l l luf III l l lfll111ff I I I I HIII l 11111f1f III 11f1111111111 lllluunn if III 111111111111111111111111111111111111111111111111111111 HIf I1111111III I II DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #2 DEPARTMENT NO: 550 AMENDMENT NO: 3888 1 REQUESTOR: COMM/SS/ONER PREC/NCT 2 AMENDMENT REASON: ITRANSFER FOR LEADERSHIP CONFERENCE IUNDRAI REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTNO ACCT NAME CHAIR NO CRANTNAME INCREASE DECREASE INCREASE DECREASE IDECREASO 64370 OUTSIDE MAINTENANCE 999 NO GRANT $0 $0 $0 $2,500 $2,500 66498 TRAVEL OUT OF COUNTY 999 NO GRANT $0 $0 $2,500 $0 ($2,500) AMENDMENTNO386B TOTAL $0 $0 $2,600 $2,600 $0 ROAD AND BRIDGE-PRECINCT#2 TOTAL $0 $0 $2,600 $2,600 $0 FUND TOTAL FUND NAME POC COMMUNITY CENTER FUND NO: 2736 uuu I 11111111 Ili I l uuu llD 11111fff III 111111111loll]] null I I l[III III III I uuu III llff II I III If Illl] 11111111I111111[1[111111111111111111 If uuu I I I I I u11I 11111111111]1111f1n 11fl l nil 1111111111111111ui1]]lo I IIIII1111I III] nl llll DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 JAMENDMENTNO: 3890 1 REQUESTORrAUDITORSOFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND RAE REVENUE REVENUE EXPENDRURE EXPENUITURE INCREASE ACCTNO ACCT NAME GRANT NO CRANTNAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $176 $0 ($176) 66616 UTILITIES-POC COMMUNITY GEN 999 NO GRANT $0 $0 $0 $176 $176 AMENDMENTNO3890 TOTAL $0 $0 $176 $176 $0 NO DEPARTMENT TOTAL TOTAL $176 $176 $0 Grand Total $0 $0 $7,195 $7,195 $0 Wednesday, February 11, 2015 Page 3 of 3 FUND NAME GENERAL FUND FUND NO: 1000 II I IIIII1I11111111111111111111111111111]]111111nnnnu till]]tinII[IIIII I 1111111i11 I1111III 1111111 HUH 11111111 uuu till]] I I 11111111111111111111111111111111111111111[fill I If III II]]III] IIIII I11111111111111 RItill] I null[11111 DEPARTMENT NAME: BUILDING MAINTENANCE DEPARTMENT NO: 170 'AMENOMENTNO: 3891 1 REQUESTOR:AUD/TORS OFFICE/ OVERORAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ACCTNAME GRANT No GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASFI 53610 BUILDING SUPPLIESIPARTS 999 NO GRANT $0 $0 $1,677 $0 ($1,677) 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $72 $0 ($72) 65454 REPAIRS -COURTHOUSE AND JAI 999 NO GRANT $0 $0 $9,352 $0 ($9,352) 66605 UTILITIES -JAIL 999 NO GRANT $0 $0 $0 $11,101 $11,101 AMENDMENTNO3891 TOTAL $0 $0 $11,101 $11,101 $0 BUILDING MAINTENANCE TOTAL $0 $0 $11,101 $11,101 $0 III IIIIIII] I I IIII I IIIiIIII I III]]I I1111111If III III I till 1111IIII111111111111IIIIIIIIII 111111111111111 IIII III IIIII I fill]]IIIIIIII[IIII]I III fill]] till] II I I till IIIIIII III III I I till 111111111 IIIII IIIIIII [IIII III] IIIIII I I IIIII IIII 1111111 fill DEPARTMENT NAME: CONSTABLE -PRECINCT #4 DEPARTMENT NO: 610 jAMENOMENTNO: 3891 1 REQUESTOR:AUD/TORS OFFICE/OVERDRAWN ACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND DAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASEI 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $0 $61 $61 71650 EQUIPMENT 999 NO GRANT $0 $0 $61 $0 ($61) AMENDMENTNO3891 TOTAL $0 $0 $61 $61 $0 CONSTABLE-PRECINCT#4 TOTAL $0 $0 $61 $61 $0 Iilll I I I I I I IIIII IIII I I I I I I it IIIIII] I I IIIII Till IIIII I IIIII IIIIII I I1111IIIIII I I1111111111111111111I I II IIII I I I I1111IIIIII I I I IIIIII III IIII I I I IIIII I1111I1] I IIIIII I111111111111IIIII I IIII I I I I I111I111111I IIIIIIII I IIIIII I I IIII IIII I IIIIII11i1 DEPARTMENT NAME: CONTINGENCIES DEPARTMENT NO: 240 Wednesday, Pebmary 11, 2015 Page 1 of 10 FUND NAME GENERAL FUND FUND NO: 1000 Ilnunutill MnIInnnnn0U[lilt nuuIIII III ulilt III 01mIII III nnnunnn00unnnnnII[III uun1111uunllu11nu1111utill] uuu11nu011]11 nn 1nnunnnunn11U011nnnalilt III MI DEPARTMENT NAME: CONTINGENCIES DEPARTMENT NO: 240 �AMENOMENTNO: 3891 1 REQUESTOR:AUDITORS OFFICE/OVERORAWNACCOUNTS AMENDMENT REASON: JOVERORAWN ACCOUNTS FUND BAI REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ARE NAME URANTND CRANTNAME INCREASE DECREASE INCREASE DECREASE (DECREASE] CONTINGENCIES TOTAL $0 $0 $0 $33 $33 I11I I111111I I I III I I IIIIIII I11111111111I I II II II1111111111I IIIIII IIIIII I111111In11 I I I I IIII II I I IIII I I I IIII I I II IIII I11111111111111I ll Illl III IIIII11111111Intl I1IIIIII II Ilil I11II I I I I I11I I II I I II I III IIIIIII III I II I111111111111111111111I I I I DEPARTMENT NAME: COUNTY COURT -AT -LAW DEPARTMENT NO: 410 AMENOMENTNO; 3891 I REQUESTOR:AUDITORS OFFICE/OVERORAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS ACCTND ACCTNAME GRANT NO CRAW NAME 63070 JUVENILE ASSIGNED -ATTORNEY 999 NO GRANT 66192 TELEPHONE SERVICES 999 NO GRANT 72350 EQUIPMENT -OFFICE 999 NO GRANT REVENUE REVENUE INCREASE DECREASE $0 $0 $0 $0 $0 $0 EXPENDITURE INCREASE $0 $0 $33 EXPENRRURE DECREASE $3 $30 $0 FUND BAI INCREASE (DECREASE] $3 $30 ($33) AMENDMENTNO3891 TOTAL $0 $0 $33 $33 $0 COUNTY COURT -AT -LAW TOTAL $0 $0 $33 $33 $0 11 I I I I I I I I I I I I I I IIIIIII I I I I I I I 111 ( I I I I I I I IIIIIII I I I I I I IIII I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IIIIIII ( I I I I I I I IIIII I I I I I I I I I 111111111 I I I I I I I I I I I I I I I I I I I I IIIIIII I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1111111111111 I I I I I I I I I I I I I I I I DEPARTMENT NAME: EMERGENCY MEDICAL SERVICES DEPARTMENT NO: 345 AMENOMENTNO: 3891 I REQUESTOR: AUDITORS OFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS ACCTND ACCT NAME GRANT NO GRANTNAW REVENUE REVENUE INCREASE DECREASE EXPENDRURE INCREASE EXPENDITURE DECREASE FUND BAI INCREASE (DECREASE) Wednesday, Febuary 11, 2015 Page 2 of 10 FUND NAME GENERAL FUND FUND NO: 1000 uuuuuuuuuuuuuuuuuuunuuuuuuuunuuuuuuuuuuunnuuununununuuuununnuuununnuunnnnnnnuuunnunnuununun0uuuunnuuuuunuuuuuuuuuuuu DEPARTMENT NAME: EMERGENCY MEDICAL SERVICES DEPARTMENT NO: 345 �AMENOMENTNOa 3891 1 REQUESTOR:AUD/TORS OFFICE/ OVERORAWNACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND UAL REVENUE REVENUE EXPENDRURE EXPENDRURE INCREASE ACCT NO ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 53610 BUILDING SUPPLIES/PARTS 999 NO GRANT $0 $0 silo $0 ($110) 61710 DEPARTMENTAL REPAIRS 999 NO GRANT $0 $0 $0 $134 $134 63220 LEASE/RENTAL 999 NO GRANT $0 $0 $24 $0 ($24) AMENDMENTMO3891 TOTAL $0 $0 $134 $134 $0 EMERGENCY MEDICAL SERVICES TOTAL $0 $0 $134 $134 $0 III I I IIII I I II III IIII I I I I IIIIII I IIIIIII I III IIII I I IIII I I I I IIII I IIIIII I I IIII IIIIII I Illill l llllllllll II I I I IIIIIIIIIiII I Iill llllllll l ll trill l lllill l IIII 111 trill I l llllllllll l l l l llllillill llllll l 111 lllll llllll l l l l IIII l lillll l l ll trill l l IIII DEPARTMENT NAME: EXTENSION SERVICE DEPARTMENT NO: 110 AMENOMENTNOr 3891 REQUESTOR:AUDITORSOFF/CE/OVERDRAWNACCOUNTS REVENUE REVENUE EXPENDITURE EXPENDRURE INCREASE ACCT NO ACCT NAME CHANT NU GRANT NAME INCREASE DECREASE INCREASE DECREASE (DECREASE] 53310 PROGRAM SUPPLIES 999 NO GRANT $0 $0 $86 $0 ($86) 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $0 $86 $86 AMENDMENT NO 3891 TOTAL $0 $0 $86 $86 $0 EXTENSION SERVICE TOTAL $0 $0 $86 $86 $0 I II I I IIII II IIII I IIfl I I till If 1111111111111 III 1111111111111f 111111111 H If 1111111111111111111111I11III [III 11I IIIII1[III 1 11111111111111111 till 11111111111111]Ililff 11111111111111111111111111 till if III I I 1111111111111111111111111111111111 DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 Wednesday, February 11, 2016 Page 3 of 10 FUND NAME GENERAL FUND FUND NO: 1000 III IInuIII nlnuIII nnnnuuununnnnnORuunuUluullluIII uIII unuuuuununnHIIIII nnnuuuunuulllnn[oil unuuuuuluuIII llnuu0nu0Hill III III uR1Iuu0Uu0nu0III DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 AMENDMENTNO. 3891 I REOUESTOR:AUD/TORS OFFICE/ OVERDRAWN ACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND DAL REVENUE REVENUE EXPENORURE EXPENDRURE INCREASE ACCTNO ACCTNAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 53955 GROCERIES 999 NO GRANT $0 $0 $980 $0 ($980) 64790 POSTAGE 999 NO GRANT $0 $0 $1,000 $0 ($1,000) 65835 SOFTWARE MAINTENANCE (ANN 999 NO GRANT $0 $0 $0 $1,980 $1,980 AMENDMENTNO3891 TOTAL $0 $0 $1,980 $1,980 $0 JAIL TOTAL $0 $0 $1,980 $1,980 $0 III IIII I I I I I I I I I 0 0111111 I I I I I I I I I I I I i l I IIIIIII I I IIIIII I I I I I I I I I I I I I IIII I I I I I I I IIII I I I I I I 111111111 I I I IIIIIII I IIIIIII I I I I I I I I I I IIIII I I I I I O 111 I IIIIIII 1111111111 I I I I I I I I I IIIIII I I I I I I I I I I I I I I I I I I 1111111111111 I I I I I I I I I 1111111111 I I i l l l l DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #2 DEPARTMENT NO: 460 AMENOMENTNOr 3891 1 REQUESTOR. AUD/TORS OFFICE /0VERDRAWNACCOUNTS REASON: REVENUE REVENUE EXPENORURE EXPENDITURE INCXEASE ACCTNO ACCTNAME GRANT NO GRANT NAME INCREASE RECREASE INCREASE DECREASE [DECREASO 64790 POSTAGE 999 NO GRANT $0 $0 $33 $0 ($33) AMENDMENT NO 3891 TOTAL $0 $0 $33 $0 ($33) JUSTICE OF PEACE-PRECINCT#2 TOTAL $0 $0 $33 $0 ($33) IIIII I11I IIII IIII I IIIIII II11111IIIIIII I II I11I I IIIIII I I IIIlillil I I I I IIII IIIII II III I IIII II III III I II IIIIII IIIIIII II IIIIII I I I IIIIII I II IIIII I I I I I I III IIIIIIIIIIiII IIII I I IIIIIII II III (IIII I I I IIIIOIIII I111111111111I11IIIIII IIIlilllll I IIIIII DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #4 DEPARTMENT NO: 480 AMENOMENTNO: 3999 1 REOVESTOR:AUD/TORS OFF/CE/OVERDRAWNACCOUNTS AMENDMENT REASON: (OVERDRAWN ACCOUNTS I REVENUE REVENUE EXPENDITURE EXPENDITURE INUAEAR ACCTNO ACCTNAME GRANT NO CRANTNAME INCREASE DECREASE INCREASE OECREASE IDECREASO Wednesday, February 11, 2015 Page 4 o(10 FUND NAME GENERAL FUND FUND NO: 1000 111]] III III I III] I IIIIII] I III III I IIIIIIIIIIIIII IIIIII IIIII 111]]]IIIIIIII[IIIIIIIIIIII III] I IIIII I It H IIIIIII I I I I III HIM III IIII] III IIIIIII II I I I I III] IIIIIIII f111 IIIIII I IIIII IIIII H I I 11111111111111111111111111111111] IIIIIII IIIII III III[ DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #4 DEPARTMENT NO: 480 AMENDMENTNO: 3891 1 REQUESTORaAUDITORS OFFICE/OVERORAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND RAI DEIRDRE REVENUE EXPENORURE EXPENDITURE INCREASE ACCTND ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE (DECREASE) 64230 OMNIBASE PROGRAM SERVICES 999 NO GRANT $0 $0 $0 $183 $183 66192 TELEPHONE SERVICES 999 NO GRANT $0 $0 $183 $0 ($183) AMENDMENTNO3891 TOTAL $0 $0 $183 $183 $0 JUSTICE OF PEACE-PRECINCT114 TOTAL $0 $0 $183 $183 $0 I11I I111I I I IIII] 11I I I I II Illilllll I I I I IIII1111I II I II I I I I IIIIII11111I111111111111I IIII I IIII I I IIIIIRI I II IIIIIII I I I IIIIIII III I I I IIIIII I II III]III] I IIIIIII I11I I I IIIIIIIIII II I I1111111III I I I I IIIIIII II IIIIIII I II I11IIf 1IIf IIII] I II I IIIIIII I I I DEPARTMENT NAME: LIBRARY DEPARTMENT NO: 140 AMENDMENTNO: 3891 1 REQUESTORsAUDITORS OFFICE/ OVERDRAWNACCOUNTS IAMENDMENT REASON: IOVERDRAWN ACCOUNTS REVENUE REVENUE EXPENDURIE EXPENDNURE INCHLAR ACCTNO ACCTNAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE IDECREASEI 53030 PHOTO COPIESISUPPLIES 999 NO GRANT $0 $0 $46 $0 ($46) 71650 EQUIPMENT 999 NO GRANT $0 $0 $0 $46 $46 AMENDMENTN03891 TOTAL $0 $0 $46 $46 $0 LIBRARY TOTAL $0 $0 $46 $46 $0 III IIIII I III] I III IIIIIII I I [III IIIIIIII I I I IIIIII IIIIIII I I I I I I I I I I I I] 11 I I I I I I I I I I I I I I I I I I I I I I Mill I IIIII I I IIIII I I I III 1111111111 I IIIII I 111111111111 I I I I I I I I I I I IIIIIIII IIII I I I III I I IIII I I I I I III III I I I i I I I I I III I I I I I I I I I I I I I I I I IIIIIII I I I I I1 DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #1 DEPARTMENT NO: 540 (AMENOMENTNO; 3891 1 REQUESTOReAUDITORSOFFICE/OVERDRAWNACCOLINTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND RAI REVENUE REVENUE EXPENORURE EXPENORURE INCREASE ACCTND ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE IOECREASEI Wednesday, February 11, 2015 Page 5 of 10 FUND NAME GENERAL FUND FUND NO: 1000 [III III 0011111100 uR110nne] III [lite III 0 n 0 ullu OOOOiteI 001111111] lite 1 R01111111] 111111]] 11111111111111111111 firm 0itilli 000111[11110011110lite 00 unnel0 nn1] 10110nle 0 fill II title 1III III III III DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #1 DEPARTMENT NO: 540 'AMENDMENTNO; 3891 1 REQUESTOR:AUD/TORS OFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTNO ACCTNAME GRANT No GRANT NAME INCREASE DECREASE INCREASE DECREASE (DECREASE] 53610 BUILDING SUPPLIES/PARTS 999 NO GRANT $0 $0 $0 $135 $135 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $135 $0 ($135) 66192 TELEPHONE SERVICES 999 NO GRANT $0 $0 $44 $0 ($44) 66476 TRAVEL IN COUNTY 999 NO GRANT $0 $0 $0 $44 $44 AMENDAlENTN03891 TOTAL $0 $0 $179 $179 $0 ROAD AND BRIDGE-PRECINCT#1 TOTAL $0 $0 $179 $179 $0 III [III III IIIII I III] IIIIII II I IIIIII I I111] 1111111 little]] 11111 IIIIIIIIII IIIII III IIIII I III I I I lite II ]III I RURII 11111111111111111 lite] III I I [fill 111111111 II I III ]III ]III IIIII III little] I I III IIIII I ]III I I III III] III] I ]III III III III IIIIIIIIII DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #2 DEPARTMENT NO: 550 JAMENDMENTNO: 3891 1 REOUESTOR;AUD/TORSOFF/CE/OVERDRAWNACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS IUNDDAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCT NO ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE IDECREASO 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $0 $28 $28 66498 TRAVEL OUT OF COUNTY 999 NO GRANT $0 $0 $28 $0 ($28) AMENOMENTNO3891 TOTAL $0 $0 $28 $28 $0 ROAD AND BRIDGE-PRECINCT#2 TOTAL $0 $0 $28 $28 $0 Iilll I II I III]IIIIIIIIII] I I1111111II III I11I III I IIIII I II IIIIIII I I II II II ]IIIIIIIIII ]IIIIIIII I I I I ]III II I111I I I I I111 ]III III I11111111I11111111111IIIII II II IIIII I I ]III IIIII1I11IIIIIIII1111I I I I11111111111I I IIIIII I ]III I11111111111I I11111111II DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #3 DEPARTMENT NO: 560 Wednesday, Febmary 11, 2015 Page 6 of 10 FUND NAME GENERAL FUND FUND NO: 1000 I tell I111]] I I III III] I I I I [II] III II]] I I I I IN pill tell] I I I lu] 1] nun]] I I I I III 111111111111111n111111111111n1III I I III III] I tell I I I [III I III I II I I I unu I tell III I III 11111 IIII111111I III 1111111111111 [tell [1111]I I [[tell I loll]] I111111111IIIH DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #3 DEPARTMENT NO: 560 JAMENDMENTNO: 3899 1 REQUESTOR:AUDITORS OFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS EUNDRAE REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ACCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE IDECREASEI 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $0 $106 $106 53995 UNIFORMS 999 NO GRANT $0 $0 $106 $0 ($106) AMENDMENTNO3891 TOTAL $0 $0 $106 $106 $0 ROAD AND BRIDGE-PRECINCT#3 TOTAL $0 $0 $106 $106 $0 I kill I III ill 111111111111111] III [little III I III I I [III III III] I I I [hello I [tell] I I III life]] 1111111little] I 111111111111 IIIII I I I III] 111111111111111 IIIIII I I I I I I III III title III I [tell little 111111111111111111111111111111111 [III II loll [III I IIIIII DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #4 DEPARTMENT NO: 570 JAMENDMENTNO: 3899 I REQUESTOR:AUDITORS OFFICE/OVERORAWNACCOUNTS AMENDMENT REASON: OVERDRAWN ACCOUNTS FUNDRAL REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTND ACCT NAME GRANT No GRANTNAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $218 $0 ($218) 66600 UTILITIES 999 NO GRANT $0 $0 $0 $3,827 $3,827 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $3,609 $0 ($3,609) AMENDMENT NO3891 TOTAL $0 $0 $3,827 $3,827 $0 ROAD AND BRIDGE-PRECINCT#4 TOTAL $0 $0 $3,827 $3,827 $0 I [III [IIIIII I I1111111I I I [III III [III I I II1111111111I I I1111I1111111111I I IIIIIIIIII I111111111I I111111II IIIII I [IIIIII illl [IIIIII [IIIIII IIIII I IIIIIIIIIIIIillll I I IIIIII [III III I I I II II II [III I I II IIIIII [IIIIII IIIIII II IIIII I I IIIIII1111111I I [III DEPARTMENT NAME: SHERIFF DEPARTMENT NO: 760 Wednesday, February 11, 2015 Page 7 of 10 FUND NAME GENERAL FUND FUND NO: 1000 IIIH 111111111111111111111111111111111111111111111111] 111111111111111111IIIIII III I I I III] III III I111111U1111III I I IIII III IIIM [III III 111]11 it If II I III nnuu I 11111111111111111113111111111 UIII 11111111111111111111111 I IH IIIH III I I HU DEPARTMENT NAME: SHERIFF DEPARTMENT NO: 760 AMENDMENT NO: 3S84 I REQUESTOR: SHERIFF OFFICE AMENDMENT REASON: ILINE ITEM TRANSFER FUND UAL REVENUE REVENUE EXPENDRURE EXPENDRURE INCREASE ACCTND ARE NAME SRANTND GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 50365 DEPUTY SHERIFF 999 NO GRANT $0 $0 $0 $6,498 $6,498 60365 DEPUTY SHERIFF 999 NO GRANT $0 $0 $0 $5,800 $5,800 62570 FAX RENTALS 999 NO GRANT $0 $0 $0 $120 $120 64790 POSTAGE 999 NO GRANT $0 $0 $120 $0 ($120) 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $5,800 $0 ($5,800) 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $6,498 $0 ($6,498) AMENDMENT NO 3884 TOTAL $0 $0 $12418 $12418 $0 SHERIFF TOTAL $0 $0 $12,418 $12,418 $0 FUND NAME AIRPORT FUND FUND NO: 2610 uu000unOmuOunnunn00unu011uu0uuu0nnnuunn0u0unn0uu00u0un00unOnnuunuu0U000uuuuu000unnnnu0HIM nn00011nnnuu0nuunu0nnnuuuunul DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 AMENOMENTNO: 3859 I REQUESTORaAUDITORS OFFICE/OVERDRAWNACCOUNTS AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDRURE EXPENDRURE INCREASE ACCTND ACCT NAME GRANT NO SHARE NAME INCREASE UECREASE INCREASE DECREASE [DECREASE] 60520 BUILDING REPAIRS 999 NO GRANT $0 $0 $0 $898 $898 65180 RADIO MAINTENANCE 999 NO GRANT $0 $0 $898 $0 ($898) AMENDMENTN03891 TOTAL $0 $0 $898 $898 $0 NO DEPARTMENT TOTAL $0 $0 $898 $898 $0 Wednesday, Feboary 11, 2015 Page 8 of 10 FUND NAME APPELLATE JUDICIAL SYSTEM FUND FUND NO: 2620 DEPARTMENT NAME; NO DEPARTMENT DEPARTMENT NO: 999 AMENDMENTNO; 3885 I REgUESTOR: APPELLATE JUDICIAL SYSTEM (AMENDMENT REASON: IAS NEEDED PER GOVT CODE 22.214 1 REVENUE REVENUE EXPENDRURE EXPENDRURE INCNLAR ACCT NO ACCT NAME ORANTNO ORANTNAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 60195 APPELLATE JUDICIAL SYSTEM E 999 NO GRANT $0 $0 $295 $0 ($295) AMENDMENT NO 3885 TOTAL $0 $0 $295 $0 ($295) NO DEPARTMENT TOTAL $0 $0 $295 $0 ($295) DEPARTMENT NAME: REVENUE DEPARTMENT NO: 1 AMENDMENTNO: 3B85 I REQUESTOR:APPELLATEJUDICIAL SYSTEM REVENUE REVENUE EXPENDRURE EXPENDRIRE IN9RLAR ACCTNO ACCT NAME CRANTNO GRANT NAME INCREASE DECREASE INCREASE DECREASE IBECREASD 44030 FEES -COUNTY CLERK-GEN GOV 999 NO GRANT $285 $0 $0 $0 $285 44055 FEES -DISTRICT COURT -JUDICIAL 999 NO GRANT $10 $0 $0 $0 $10 AMENDMENT NO 3885 TOTAL $295 $0 $0 $0 $295 REVENUE TOTAL $295 $0 $0 $0 $295 APPELLATE JUDICIAL SYSTEM FUND TOTAL $295 $0 $295 $0 $0 FUND NAME JUSTICE COURT TECHNOLOGY FUND FUND NO: 2719 DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 Wednesday, February11, 2015 Page 9 0! 10 FUND NAME JUSTICE COURT TECHNOLOGY FUND FUND NO: 2719 11 I I III I] I I I III [III] I I I I I I It III I I I I I I I I I I I I I I I I I III] I I I I I I I I I I I I I 1111111 lilt] III III I I III I I 11111 I I I I I I I I I I I I III ) I I I I RI) lilt III I I [III I l l l l I I I I I I I I I I I I I I I I I I I I I I 11111111111111 ] 1[lilt I l I l I 1111111111111 1111 III I I I I I I I I lilt I I I I I I I I I I I III I DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 �AMENDMENTNO, 3886 ( REQUESTOR:✓UST/CECOURTTECHNOLOGYFUNO AMENDMENT REASON: ADJUST BUDGET FOR DECEMBER 2014 REVENUE FUND BAE REVENUE REVENUE EXPENDITURE EXPENDRURE INCREASE ACCTNO ACCT NAME CRANTNO GRANT NAME INCREASE DECREASE INCREASE DECREASE (DECREASE) 70751 CAPITAL OUTLAY -JP PCT #1 999 NO GRANT $0 $0 $116 $0 ($116) 70752 CAPITAL OUTLAY -JP PCT 92 999 NO GRANT $0 $0 $183 $0 ($183) 70753 CAPITAL OUTLAY -JP PCT #3 999 NO GRANT $0 $0 $94 $0 ($94) 70754 CAPITAL OUTLAY -JP PCT #4 999 NO GRANT $0 $0 $179 $0 ($179) 70755 CAPITAL OUTLAY -JP PCT #5 999 NO GRANT $0 $0 $61 $0 ($61) AMENDMENT NO 3886 TOTAL $0 $0 $633 $0 ($633) NO DEPARTMENT TOTAL $0 $0 $633 $0 ($633) 11I I I I i l 111111111I I I111111I11I I)IIIII) I I I I I I I I I I1111I I11I) ) I I I I I I11I I I I I I I I I I I1111111111I I I) I I I I I I I I I I I I I I I I I I I I (I ( I I I I I I) ) I I I I1111I i l l l l IIIII) I I I I I I I I I I I I I i l l l l l I I I I I I I I I)III) I I I111111(IIIII) I I I) I I I I I I I I111111I) I I I) I I I I11) I I I I I I I I I DEPARTMENT NAME: REVENUE DEPARTMENT NO: 1 AMENDMENT NO: 3888 LIESTOR: JUSTICE COURT TECHNOLOGY FUND AMENDMENT REASON: JADJUST BUDGET FOR DECEMBER 2014 REVENUE FUND RAI REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCTNO ACCTNAME GRANT III GRANT NAME INCREASE DECREASE INCREASE DECREASE (DECREASE) 44061 FEES -JUSTICE OF PEACE-PRECI 999 NO GRANT $114 $0 $0 $0 $114 44062 FEES -JUSTICE OF PEACE PRECI 999 NO GRANT $181 $0 $0 $0 $181 44063 FEES -JUSTICE OF PEACE PRECI 999 NO GRANT $93 $0 $0 $0 $93 44064 FEES -JUSTICE OF PEACE PRECI 999 NO GRANT $177 $0 $0 $0 $177 44065 FEES -JUSTICE OF PEACE PRECI 999 NO GRANT $60 $0 $0 $0 $60 46020 INT INC-JUSTICE SYSTEM 999 NO GRANT $8 $0 $0 $0 $8 AMENDMENTNO3886 TOTAL $633 $0 $0 $0 $633 REVENUE TOTAL TOTAL $0 $0 $633 $31,113 $0 Wednesday, February 11, 2015 Page 10 of 10 § � B z k a = §2/^§. ■m■ 7mmm k ) z k k U) § § 2 ■■§ / &� Ez § ■ /� _ �■ (LLI a §7&2a g§ | § / §(§% § ) \\� I j § _ § §2 _\\( ` k !§ )z §� .z |� .z .o |© ■ \k w\ !z |� C ) !z §/ )§ R (� )2 )§ O O P Z Z WC3 M M M03M O M O O 69 M M M M O O o M O _ yX pXOC �Lri =z =_z _W=W w kid WNW =W ag Zs a a �°, =G Q �wLU 00 0�y0000 a =G Q W = W = W 8 ti =W CW1 W Oti OH V W Oti O =_ V 14 Q = W W co Q Z �fi Q M M 3 W c 2 w =3 c 2 ¢ =y p Q VJ O Z 00 =Q Q VJ 000 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