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2020-08-19 CC PACKETCommissioners' Court —August 19, 2020 CA L]H[OUN COUNTY C®MMISSION ERS' C®U]l T REGULAR 2020 TERM 0 AUGUST 19, 2020 BE IT REMEMBERED THAT ON AUGUST 19, 2020, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. I. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 2. ROLL CALL THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Clyde Syma Gary Reese Anna Goodman Catherine Sullivan County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Deputy County Clerk 3. INVOCATION & PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3) Invocation — Commissioner David Hall Pledge to US Flag & Texas Flag — Commissioner Gary Reese/Vern Lyssy Page 1 of 7 Commissioners' Court —August 19, 2020 4. General Discussion of Public matters and Public Participation. N/A S. Hear report from Memorial Medical Center. Pass 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) On the Resolution and Agreement accepting the grant awarded to Calhoun County by the County Transportation Infrastructure Fund Grant Program Administered by the Texas Department of Transportation pursuant to Chapter 256 of the Texas Transportation code. (RM) Resolution RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Agreement RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 2 of 7 Commissioners' Court —August 19, 2020 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To direct the Chief Appraiser of the Calhoun County Appraisal District or his/her designee to calculate the voter -approval tax rate for Calhoun County for the year 2020 tax year, in the same manner as provided for a special taxing unit as authorized by the Texas Property Tax Code Sec. 26.04(c-1) and 26.04 (C)(2)(4) due to Calhoun County being declared a disaster area by the Governor of the state of Texas. (Voter -Approval Tax Rate = (no new reve- nue maintenance and operations rate x 1.08) plus the current debt rate.) Jesse Hubbell of the Calhoun County Appraisal District gave the presentation. No action taken at this time. S. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To amend and update the Bauer Exhibit Exempt list. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To accept a donation of $25.00 from Joyce and John Rhyne to the Calhoun County Sheriff's office. This donation is to be deposited into our motivation Account 2697-679. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 7 Commissioners' Court —August 19, 2020 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To authorize Commissioner Reese to enter into and sign a Service Agreement with Legacy Disposal & Sanitation for portable sanitation stations at Bill Sanders Memorial Park at Swan Point. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Clyde Syma, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To vacate Lot 13 of the re -plat of Outlot i in Outblock 12 of Port O'Connor, Texas, recorded in Slide No. 598B of the Calhoun County Plat Records. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To approve the Preliminary Plat of Marlin Azul Villa's Subdivision, a replat of Lot 13 of the re -plat of Outlot 1 in Outblock 12 of Port O'Connor, Texas, recorded in Slide No. 598B of the Calhoun County Plat Records. (GR) Motion was made to include that *County not liable for roads/ditches*. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 7 Commissioners' Court —August 19, 2020 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13) To vacate Tract 6 and a part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) To approve the Preliminary Plat of Saltwater Haven Subdivision, a replat of Tract 6 and part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. (GR) Motion made to include *County is not liable for streets/ditches*. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To accept the attached list of donations to the Calhoun County Library. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 5 of 7 Commissioners' Court —August 19, 2020 16. CONSIDER AND TAKE NECECESSARY ACTION (AGENDA ITEM NO. 16) To declare the attached list as Surplus/Salvage and authorize their disposal by the Librarian. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 17. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 17) To declare the attached list of Waste and authorize their disposal by the Librarian. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) To pre -approve expenditures by incumbent County or Precinct Officer(s) under Calhoun County's Policy of Compliance with LGC 130.908. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 19. Accept report from the following County office: 1. Justice of the Peace, Pct 4 - July 2020 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 7 Commissioners' Court —August 19, 2020 20. Consider and take necessary action on any necessary budget adjustments. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 21. Approval of bills and payroll. Indigent RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County/Payroll RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Adjourned: 10:32 am Page 7 of 7 AT a. FILED O'CLOCK � M OCT 12 2020 CCU TY C ERKNCALHOHN COUNTY TEXAS By J EPUTY �ont acts e�,..�,.,.;. II Agenda Items Properly Numbered _ Completed and Signed �AII 1295's Flagged for Acceptance (number of 1295's -I -) All Documents for Clerk Signature Flagged On this a day of C Ue'L w 2020 a complete and accurate packet for AL of �< 2020 Commissioners Court Regular Session Day Mo t o was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoufilo� nty ]u a s§istant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOTICE OF MEETING-8/19/2020 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Clyde Symaa, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, August 19, 2020 at 10:00 a.m. in the Commissioners' Courtrooms in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA CC�j� �� FfLED ATE. HILIEO'COC The subject matter of such meeting is as follows: AUG 14 2020 1. Call meeting to order. ANNA �ooCOMq�n� COUNTY LERK, CA HO N UN Y, TEXAS 2. Invocation. By. '�-_— D�� Ef-TIN 3. Pledges of Allegiance. 4. General Discussion of Public Matters and Public Participation. 5. Hear report from Memorial Medical Center. 6. Consider and take necessary action on the Resolution and Agreement accepting the grant awarded to Calhoun County by the County Transportation Infrastructure Fund Grant Program administered by the Texas Department of Transportation pursuant to Chapter 256 of the Texas Transportation code. (RM) 7. Consider and take necessary action to direct the Chief Appraiser of the Calhoun County Appraisal District or his/her designee to calculate the voter -approval tax rate for Calhoun County for the 2020 tax year, in the same manner as provided for a special taxing unit as authorized by the Texas Property Tax Code Sec. 26.04(c-1) and 26.04(c)(2)(A) due to Calhoun County being declared a disaster area by the Governor of the state of Texas. [Voter -Approval Tax Rate = (no new revenue maintenance and operations rate x 1.08) plus the current debt rate.] (RM) 8. Consider and take necessary action to amend and update the Bauer Exhibit Exempt list. (DH) Page 1 of 3 NOTICE OF MEETING-8/19/2020 9. Consider and take necessary action to accept a donation of $25.00 from Joyce and John Rhyne to the Calhoun County Sheriff's office. This donation is to be deposited into our motivation account 2697-679. (RM) 10. Consider and take necessary action to authorize Commissioner Reese to enter into and sign a Service Agreement with Legacy Disposal & Sanitation for portable sanitation stations at Bill Sanders Memorial Park at Swan Point. (GR) 11. Consider and take necessary action to vacate Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, Texas, recorded in Slide No. 598E of the Calhoun County Plat Records. (GR) 12. Consider and take necessary action to approve the Preliminary Plat of Marlin Azul Villa's Subdivision, a replat of Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, Texas, recorded in Slide No. 598B of the Calhoun County Plat Records. (GR) 13. Consider and take necessary action to vacate Tract 6 and a part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. (GR) 14. Consider and take necessary action to approve the Preliminary Plat of Saltwater Haven Subdivision, a replat of Tract 6 and a part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. (GR) 15. Consider and take necessary action to accept the attached list of donations to the Calhoun County Library. (RM) 16. Consider and take necessary action to declare the attached list as Surplus/Salvage and authorize their disposal by the Librarian. (RM) 17. Consider and take necessary action to declare the attached list as Waste and authorize their disposal by the Librarian. (RM) 18. Consider and take necessary action to pre -approve expenditures by incumbent County or Precinct Officer(s) under Calhoun County's Policy of Compliance with LGC 130.908. (RM) 19. Accept report from the following County Office: I. Justice of the Peace, Precinct 4 — July 2020 20. Consider and take necessary action on any necessary budget adjustments. (RM) 21. Approval of bills and payroll. (RM) Richard Meyer, County Calhoun County, Texas Page 2 of 3 NOTICE OF MEETING-8/19/2020 A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda" for any official court postings. Page 3 of 3 w Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award STATE OF TEXAS § COUNTY OF TRAVIS COUNTY TRANSPORTATION INFRASTRUCTURE FUND GRANT AGREEMENT THIS AGREEMENT is made by and between the State of Texas, acting by and through the Texas Department of Transportation, called the "State", and Calhoun County, acting by and through its duly authorized officials, called the "County." WITNESSETH WHEREAS, Transportation Code, Chapter 256, Subchapter C allows for the Texas Department of Transportation to make grants to counties for transportation infrastructure projects located in areas of the state affected by increased oil and gas production; and WHEREAS, The County has submitted its application for the Grant funding from the State and its application was approved; and WHEREAS, state law requires counties to meet certain contract standards relating to the management and administration of State funds; and WHEREAS, the Governing Body of the County has approved entering into this agreement by resolution or ordinance which is attached to and made a part of this agreement as Attachment A; and NOW THEREFORE, the State and the County agree as follows: AGREEMENT I. Agreement Period. This agreement becomes effective when signed by the last party whose signing makes the agreement fully executed. This agreement shall remain in effect until the Projects are completed or unless terminated as provided below. 2. Scope of Work. The County shall complete the transportation infrastructure projects as proposed in its List of Transportation Infrastructure Projects defined in 3. below. The County shall place the transportation infrastructure projects on the county road system. 3. List of Transportation Infrastructure Projects. The County is responsible to review the list of projects listed on its previously submitted application for a grant from the fund and create a List of Transportation Infrastructure Projects prioritizing its choice of projects which can be performed with the grant amount awarded to the County by the State. Within thirty calendar days after final execution of this agreement, the County shall submit to the State this List of Transportation Infrastructure Projects (in a format specified by the State). This List of Transportation Infrastructure Projects shall include an estimated month and year of starting construction and completing construction for each funded project including the estimated project cost for each project. During the term of this agreement, updates to the List of Transportation Infrastructure Projects may be made by the County. Updates can include changes in priority, changes in estimated cost, changes in month or year of starting or County Transp Infra Fund Grant Agrmnt Page 1 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award completing construction, or adding or deleting projects. Any proposed new projects shall include the same information as was required for projects submitted as part of the application for a grant from the fund. Updated List of Transportation Infrastructure Projects or a statement of no material change to the previously submitted list shall be submitted to the State no less than semi-annually. Any update to the List of Transportation Infrastructure Projects requires written concurrence from the State to the County. 4. Project Sources, Uses of Funds, and Reimbursement. a. The State has authorized the total amount of grant award from the fund as shown in Attachment B, Amount of Grant Award and Funding Commitments, which is attached to this agreement. The expected cash contributions from the State, the County, or other parties are shown in Attachment B. The State will reimburse only for allowable project costs for this program in accordance with 43 TAC § 15.192. The County must be in compliance with the requirements of this agreement to receive reimbursement of project costs. b. The County shall submit monthly billing statements or statement that no construction or maintenance work was performed during the previous month, in accordance with procedures defined by the State, accompanied by a certification of work performed during the previous month. Along with the billing statements submitted by the County, it shall submit copies of all paid invoices and/or force account documentation. Within thirty (30) days of receipt of a complete billing statement and supporting documentation, the State will reimburse the County. c. The County shall not commence construction of a funded transportation infrastructure project prior to receipt of written approval from the State in accordance with procedures defined by the State. d. If the County commences performance on a transportation infrastructure project but fails to complete the project, the State may seek reimbursement of all money received by the County for that individual transportation infrastructure project. e. For each transportation infrastructure project located on the State highway system, the County shall contribute to the State (from the amount awarded to the County from the fund and the County's matching funds) an amount equal to the allowable costs incurred by the State for that project, such as inspection of the project and any other indirect State costs. f. The County may submit in writing to the State a proposed amendment during the term of this agreement changing the order of projects on its List of Transportation Infrastructure Projects or identifying additional project(s) or extended limits on an approved project that contains all information required by rule for that project. If funds are available within the amount awarded to the County, the State may execute the proposed amendment allowing the County to use the available funds in the revised order, for the additional project(s), or for extended limits on an approved project in the County. g. The state auditor may conduct an audit or investigation of any entity receiving funds from the State directly under this agreement or indirectly through a subcontract under this agreement. Acceptance of funds directly under this agreement or indirectly through a subcontract under this agreement 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 County Transp Infra Fund Grant Agrmnt Page 2 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award or investigation must provide the state auditor with access to any information the state auditor considers relevant to the investigation or audit. 5. Project Responsibilities. The County is responsible for all aspects of the work constituting this Project or projects appearing on the list provided by the County unless otherwise indicated in this agreement. In order to obtain reimbursement for eligible expenses from the State, the County shall certify to the State in accordance with procedures defined by the State that it has complied with all program requirements and applicable federal, state, and local laws and regulations. 6. Final Inspection. The County shall perform final inspection and acceptance of each transportation infrastructure project when it is complete. The County shall send a copy of a document evidencing inspection and acceptance of the project to the State within thirty days after the inspection is completed. 7. Right of Way and Real Property Acquisition. The County shall comply with all the requirements of Title II and Title III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, Title 42 U.S.C.A. Section 4601 at seq. 8. Suspension. If the State determines that the County has not been complying with 43, TAC, Part I, Chapter 15, Subchapter O, the State may prohibit the County from continuing with all projects on the List of Transportation Infrastructure Projects until the County complies. 9. Termination of this Agreement. This agreement shall remain in effect until the transportation infrastructure projects identified in the most current List of Transportation Infrastructure Projects with concurrence from the State are completed and accepted by all parties, or: a. the Agreement is terminated in writing with the mutual consent of the parties; b. the Agreement is terminated because the County has breached the agreement for Failure to Comply, as stated in Paragraph 16; or c. a period of five years has passed since the anniversary date of the grant award to the County. 10. Environmental Permitting and Regulatory Issues. a. The County must comply with all applicable federal, state, and local environmental laws and regulations and permitting requirements. b. The County is responsible for coordination and environmental clearance. c. The County is responsible for identification and assessment of any environmental problems associated with the project(s) and for the cost of any environmental problem's mitigation and remediation. d. The County is responsible for providing any required public meetings or public hearings for assessing and mitigating environmental issues. e. The County shall provide the State with written certification by a qualified professional that all identified environmental problems have been remediated and that all required permits and clearances from appropriate regulatory agencies have been obtained. 11. Compliance with Texas Accessibility Standards and ADA. The County shall ensure that the plans for and the construction of the transportation infrastructure projects subject to this agreement are in compliance with the Texas Accessibility Standards (TAS) issued by the Texas Department of Licensing and Regulation, under the Texas Government Code, Chapter County Transp Infra Fund Grant Agrmnt Page 3 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Protect: Calhoun Co 2020 CTIF Award 469, Elimination of Architectural Barriers. The TAS establishes minimum accessibility requirements to be consistent with minimum accessibility requirements of the Americans with Disabilities Act (42 U.S.C. Section 12101 at seq.). The County shall provide written certification to the State of compliance, or non -applicability, for each transportation infrastructure project. 12. Project Maintenance. The County shall maintain any roadway on the County system constructed under this Agreement after completion of the proposed work. 13. Historically Underutilized Business (HUB) Program Requirements. The County shall comply with all applicable requirements of the Comptroller of Public Accounts (CPA) Historically Underutilized Business (HUB) Program. 14. Grant Management Standards. The County must comply with the Uniform Grant Management Standards promulgated by the Office of the Governor under 34 TAC Part 1, Chapter 20, Subchapter I — Comptroller. 15. Certification. Within sixty (60) days after the completion of a listed transportation infrastructure project, the County must submit a written certification to the State in accordance with procedures defined by the State that it has complied with the requirements for this grant awarded under 43 TAC, Part 1, Chapter 15, Subchapter O, including a certification that the project has been constructed in accordance with all applicable requirements, laws, rules and requirements. The Certification must describe the allowable costs for the project and the amount reimbursed from the fund. 16. Failure to Comply. a. If the State determines that the County has not complied with one or more material requirements of the grant rules, the State may prohibit the County from participating in the program. b. The prohibition from participating may continue until the State determines that the County has complied with all material requirement of the applicable rule. c. The State may remove the County's project or projects from participation in the program if the project(s) is not let or begun as force account work within three years of the execution of this agreement or within another reasonable period agreed to by the State and the County. d. Prior to exercising any remedies above or the remedy regarding reimbursement in 4.d., the State will provide a written notice to the County identifying the applicable requirement and specifying the failure to comply. e. The County may respond in writing to the State with a reasonable schedule for the County's timely compliance with the applicable requirement, or if compliance is not practical, with an alternative proposal that is acceptable to the State. Should the County fail to deliver an acceptable response to the State within thirty days after the date that the County received the notice, the State may proceed with the applicable remedies allowed by rule. 17. Amendments. An amendment to this agreement must be in writing and executed jointly by the State and the County. County Transp Infra Fund Grant Agrmnt Page 4 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award 18. Remedies. This agreement shall not be considered as specifying the exclusive remedy for any agreement default, but all remedies existing at law and in equity may be availed of by either party to this agreement and shall be cumulative. 19. Notices. All notices to either party by the other required under this agreement shall be delivered personally or sent by certified or U.S. mail, postage prepaid, addressed to the party at the following addresses: County: Calhoun County Attn: County Judge 211 S Ann St, Ste 301 Port Lavaca, Texas 77979 State: Texas Department of Transportation Director — Contract Services 125 E. 11th Street Austin, Texas 78701-2483 All notices shall be deemed given on the date delivered or deposited in the regular mail, unless otherwise provided in this agreement. Either party may change the above address by sending written notice of the change to the other party. Either party may request in writing that notices shall be delivered personally or by certified U.S. mail and the request shall be honored and carried out by the other party, 20. Legal Construction. In case one or more of the provisions contained in this agreement shall for any reason be held invalid, illegal, or unenforceable in any respect, that invalidity, illegality, or unenforceability shall not affect any other provisions and this agreement shall be construed as if it did not contain the invalid, illegal or unenforceable provision. 21. Responsibilities of the Parties. a. The State and the County agree that neither party is an agent, servant, or employee of the other party and each party agrees it is responsible for its individual acts and deeds as well as the acts and deeds of its contractors, employees, representatives, and agents. b. To the extent permitted by law, the County agrees to indemnify and save harmless the State, its agents and employees from all suits, actions or claims and from all liability and damages resulting from any and all injuries or damages sustained by any person or property in consequence of any neglect, error, or omission in the performance of the design, construction, maintenance or operation of the Project by the County, its contractors, subcontractors, agents and employees, and from any claims or amounts arising or recovered under the Workers' Compensation Laws; the Texas Tort Claims Act, Chapter 101, Texas Civil Practice and Remedies Code; or any other applicable laws or regulations, all as from time to time may be amended. c. The parties expressly agree that this project is not a joint venture or enterprise. However, if a court should find that the parties are engaged in a joint venture or enterprise, then the County agrees to pay any liability adjudicated against the State for acts and deeds of the County, its employees or agents during the performance of this Project. County Transp Infra Fund Grant Agrmnt Page 5 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Protect: Calhoun Co 2020 CTIF Award d. The County shall also indemnify and save harmless the State from any and all expense, including, but not limited to, attorney fees which may be incurred by the State in litigation or otherwise resisting any claim or liabilities which may be imposed on the State as a result of activities by the County, its agents, or employees. e. Should the County's transportation infrastructure project require the County or its contractor to perform any work on State right of way, the County, by contract, shall require each: (1) contractor and subcontractor it may hire to secure a policy of insurance in the maximum statutory limits for tort liability, naming the State as an additional insured under its terms; and (2) contractor it may hire to indemnify and hold harmless the County and the State from all claims, liability, and damages resulting from the contractor's performance under a contract to do work. f. If at any time after the award of funding to the County for any approved infrastructure project the County receives other funding for the work or uses other County funding for the work, the County shall notify the State of that fact within 45 days after becoming aware of the new funding. The State may, in its discretion, reduce the amount of the grant award to the County by the amount received from the other source. 22. Ownership of Documents. Upon completion or termination of this agreement, all documents prepared by the State shall remain the property of the State. All data prepared under this agreement shall be made available to the State without restriction or limitation on their further use. All documents produced or approved or otherwise created by the County shall be made available to the State upon request by the State. The originals shall remain the property of the County. 23. Compliance with Laws. The parties shall comply with all federal, state, and local laws, statutes, ordinances, rules and regulations, permitting requirements, and the orders and decrees of any courts or administrative bodies or tribunals in any manner affecting the performance of this agreement. When required, the County shall furnish the State with satisfactory proof of this compliance. 24. Sole Agreement. This agreement constitutes the sole and only agreement between the parties and supersedes any prior understandings or written or oral agreements respecting the subject matter of this agreement. 25. Retention of Records and Inspection. The County shall keep a complete and accurate record to document the performance of the work and to expedite any audit that might be conducted. The County shall maintain all books, documents, papers, accounting records and other documentation relating to costs. Records shall include, but not be limited to, diaries, materials received (invoices), test reports, manufacturer's certificates, warranties, change orders, and time extensions. The County shall make those materials available to the State or its duly authorized representatives for verification, review, and inspection at its office during the contract period and for seven years from the date the final payment is received by the County or until any impending litigation or claims are resolved. County Transp Infra Fund Grant Agrmnt Page 6 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award 26. Signatory Warranty. Each signatory warrants that the signatory has the necessary authority to execute this agreement on behalf of the entity represented. Each party is signing this agreement on the date stated under that party's signature. THE COUNTY Signature Richard Meyer, County Judge Printed Name and Title Date THE STATE OF TEXAS Signature Kenneth Stewart Typed or Printed Name Director of Contract Services Title Date County Transp Infra Fund Grant Agrmnt Page 7 of 7 March 2020 Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award ATTACHMENT A Resolution or Ordinance Page 1 of 1 Attachment A Contract # CTIF 02 029 District # 13 Code Chart 64 # 50029 Project: Calhoun Co 2020 CTIF Award ATTACHMENT B Amount of Grant Award and Funding Commitments County of: Amount of Grant Funds Awarded by State: Minimum amount of County Matching Funds*: Calhoun $ 199,619 22,180 * The State Share will be 90% for those counties determined to be "economically disadvantaged" by Transportation Code 222.053. These counties will have a minimum of 10% county matching funds. The State Share will be 80% for those counties not determined to be "economically disadvantaged" by Transportation Code 222.053. These counties will have a minimum of 20% matching funds. Page 1 of 1 Attachment B IN THE CON IISSIONERS COURT OF CALHOUN COUNTY, TEXAS RESOLUTION AND ORDER APPROVING THE COUNTY TRANSPORTATION INFRASTRUCTURE FUND GRANT PROGRAM AGREEMENT WHEREAS, Calhoun County has received a Notice of Eligible Grant Award Allocation from the Texas Department of Transportation ("TxDOT") in the amount of $199,619; and WHEREAS the Commissioners Court of Calhoun County has determined that it is in the best interests of the citizens of Calhoun County to enter into an Agreement with TxDOT concerning the County Transportation Infrastructure Fund Grant Program; and THEREFORE, IT IS ORDERED, ADJUDGED AND DECREED that the TxDOT Grant Agreement standard form, hereby attached as County Transportation Infrastructure Fund Grant Program Agreement ("Agreement), has been reviewed, and is approved by way of this Resolution and made a part thereof as Attachment A, is hereby accepted and approved as to form and further that the Calhoun County Commissioners Court hereby authorizes the County Judge to execute the Agreement on behalf of the County. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Calhoun County designates each of the following Calhoun officials as a County Authorized Representative with the authority to sign all Grant and project -related documents on behalf of the County, including any required certifications: 1. County Judge 2. County Auditor 3. Any other official or employee who may be given such authority by the County Judge IT IS FURTHER ORDERED ADJUDGED AND DECREED that the Commissioners Court of Calhoun County makes the following findings in the exercise of discretion and authority extended to said Commissioners Court by Texas Law, and such findings are made upon due inquiry and satisfactory proof that such findings are factual and based upon commonly accepted practices and standards by Texas Counties: IT IS THE FINDING OF THIS COMMISSIONERS COURT that the county has experience in the construction and maintenance of all county roads currently in the County road maintenance inventory, that the county has suitable equipment, experience and personnel to Resolution and Order of Commissioners Court Approving TxDOT Grant Agreement Page 1 properly repair such roads without the utilization of outside contractors, or, if such contractors are required, the lowest and best bidders shall be selected, after following all applicable requirements for competitive bidding, as required. In this regard, the County has suitable design standards, specifications and quality assurance procedures in place to assure that resulting road maintenance projects are properly constructed with suitable materials and that appropriate safety and environmental procedures will be utilized. IT IS THE FURTHER FINDING OF THIS COMMISSIONERS COURT that all road right-of-way involved in projects identified for funding under this grant is presently within the county road maintenance inventory and no new right of way is required. IT IS THE FURTHER FINDING OF THIS COMMISSIONERS COURT that Calhoun County will notify all public utilities, water supply corporations, and common carriers of record of their plans to repair, renovate or construct the project roads identified in the Grant application, and will cooperate with the said utilities and common carriers for protection of such infrastructure. It is not anticipated that any relocation of utilities will be required, but notification will none -the -less be provided. The County Authorized Representative is hereby expressly authorized to certify to such. IT IS THE FURTHER FINDING OF THIS COMMISSIONERS COURT pursuant to 40 C.F.R. §1500, and specifically §1508.4 et seq, 23 CFR 771.117 and 33 U.S.C. §1344, (f)(1)(B) and (C), and 43 TAC 2.81 that county road maintenance projects are generally entitled to a Categorical Exclusion, and are not prohibited by the National Environmental Protection Act (NEPA), nor the Water Pollution Prevention and Control Act, and that as a categorical exclusion, such projects pose no significant effect on the human or natural environment, and which this Court finds to have no such adverse impact, and therefore do not require an environmental impact assessment of the projects contemplated in this grant, in that no federal funds are being used by the County in meeting the grant requirements. The County shall comply with applicable state environmental standards, as applicable, such as 30 TAC § 111.147, and as such, this finding further authorizes the County Authorized Representative to make certifications regarding compliance with environmental requirements of the Grant, which is expressly approved by this Commissioners Court. IT IS THE FURTHER FINDING OF THIS COMMISSIONERS COURT that as a public roadway, open to all residents for use as a public road designed for vehicular traffic, as Resolution and Order of Commissioners Court Approving TxDOT Grant Agreement Page 2 defined by statute and other applicable law, that the road projects subject to this grant are in full compliance with the Texas Accessibility Standards and the Americans with Disabilities access standards, as the same may apply, and the County Authorized Representative is hereby expressly authorized to certify to such. FINALLY, IT IS THE FURTHER FINDING OF THIS COMMISSIONERS COURT that where necessary, any materials required for the completion of this project shall be solicited by a standard that is known to be suitable for use in road construction and repair projects, that the County will comply with HUB Program Requirements, as applicable, and the County will require such testing as may be deemed appropriate to determine that such materials meet any applicable standards, either by specification or by direct inquiry with the provider or vendor of such materials. The County Authorized Representative is hereby expressly authorized to certify to such. Read and Adopted this « day of 2020, by a J`^ ayes and _ 7 nays. I-,-) �9,e-,— , oC iniiiissioner, Precinct 3 Commiss oner, Precinct A TEST: County Cler vote of Resolution and Order of Commissioners Court Approving TxDOT Grant Agreement Page 3 #7 Sec. 26.04 Texas Property Tax Code Page 286 (2019 Edition) 2) "Voter -approval tax rate" means a rate expressed in dollars per $100 of taxable value calculated according to the following applicable formula: (A) for a special taxing unit: VOTER —APPROVAL TAX RATE _ (NO -NEW -REVENUE MAINTENANCE AND OPERATIONS RATE x 1.08) + CURRENT DEBT RATE or Page 287 ASSESSMENT Sec. 26.04 (B) for a taxing unit other than a special taxing unit: VOTER -APPROVAL TAX RATE _ (NO -NEW -REVENUE MAINTENANCE AND OPERATIONS RATE x 1.035) + (CURRENT DEBT RATE + UNUSED INCREMENT RATE) (c-1) [Effective January 1, 2020] Notwithstanding any other provision of this section, the governing body of a taxing unit other than a special taxing unit may direct the designated officer or employee to calculate the voter -approval tax rate of the taxing unit in the manner provided for a special taxing unit if any part of the taxing unit is located in an area declared a disaster area during the current tax year by the governor or by the president of the United States. The designated officer or employee shall continue calculating the voter -approval tax rate in the manner provided by this subsection until the earlier of: (1) the second tax year in which the total taxable value of property taxable by the taxing unit as shown on the appraisal roll for the taxing unit submitted by the assessor for the taxing unit to the governing body exceeds the total taxable value of property taxable by the taxing unit on January 1 of the tax year in which the disaster occurred; or (2) the third tax year after the tax year in which the disaster occurred. Motion: "I move that the Commissioners' Court of Calhoun County, Texas, direct that the Chief Appraiser of the Calhoun County Appraisal District or his/her designee calculate the voter -approval tax rate for the County of Calhoun for the 2020 tax year, in the same manner as provided for a special taxing unit as authorized by the Texas Property Tax Code Sec. 26.04 (c-1) and 26.04 (c)(2)(A) due to Calhoun County being declared a disaster area by the governor of the state of Texas. VOTER APPROVAL TAX RATE _ (NO NEW REVENUE MAINTENANCE AND OPERATIONS RATE x 1.08) plus the CURRENT DEBT RATE" David E. Hall Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for August 19th, 2020. • Consider and take necessary action on amending and Updating Bauer Exhibit Exempt list Sincerel Davi . Hall DEH/apt LIST OF EXEMPT ENTITIES (As of February 18, 2019) For the use of the Calhoun County Fairgrounds and Agricultural Facilities ($200 Kitchen deposit, no rent) 1. The Calhoun County Commissioner's Court 2. All Calhoun County Departments for department meetings or events 3. Port Lavaca Police and Fire Departments 4. Guadalupe Blanco River Authority(GBRA) S. Volunteer Filing Department in Calhoun County 6. Calhoun County Fair Association 7. Calhoun County Independent School District 8. Texas Department of Public Safety 9. Texas Parks and Wildlife Department 10. Texas General Land Office 11. Farmers Home Administration 12. U.S. Post Office 13. Future Farmers of America (FFA) 14. Calhoun County Boy Scouts of America 15. Calhoun County Girl Scouts of America 16. Boys and Girls Cub Scouts 17. 4-H meetings and activities 18. Calhoun County Extension Service 19. Calhoun County Drainage District 20. Farm Service Agency (USDA) - 6 meetings a year 21. Natural Resources Conservation Service & SWCD (USDA) - 6 meetings a year 22. Shellfish Sanitation Department, Texas Dept. of State Health Services - 6 meetings per year 23. Angel Food Ministries 24. Calhoun County Farm Bureau 25. Calhoun County Parks Board ($200 Kitchen & $25 Key deposits required but no rent) 1. Calhoun County Quilt Guild 2. Port Lavaca Garden Club 3. Beta Sigma Phi Sorority 4. Old -Timers Association S. Republican Party 6. Democratic Party 7. League of United Latin American Citizens ( LULAC) 8. GI Forum 9. Humane Society 10. YMCA 11. Calhoun County Chamber of Commerce 12. American Cancer Society 13. United Way 14. Cattlemen's Association 15. Citizens Advisory Committee (CAPA) 16. American Legion 17. Baseball All-stars e 18. ' Calhoun County Area Go Texan 19. Master Naturalist 20. Master Gardeners #9 08-12-'20 09:33 FROM- CALHOUN CO SHERIFF 361-553-4668 T-864 P0001/0002 F-455 CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553-4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: DONATIONS DATE: August 19, 2020 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR August 19, 2020 • Consider and take necessary action to accept a donation to the Calhoun County Sheriff's Office from Joyce or John Rhyne in the amount of $25,00. This is to be deposited into our motivation account 2697-679. Sincerely, / f /obbiVtckery Calhoun County Sheriff 08-12-'20 09:33 FROM- CALHOUN CO SHERIFF 361-553-4668 T-864 P0002/0002 F-455 1 #10 Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 13, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 19, 2020. • Consider and take necessary action to authorize Commissioner Reese to enter into and sign Service Agreement with Legacy Disposal & Sanitation for portable sanitation stations at Bill Sanders Memorial Park at Swan Point. Sincerely, n)U,&jv� Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: aarv.reese0calhouncomorg — (361) 785-3141 — Fax (361) 785-5602 PO Box 527 Yoakum, Texas 77995 Phone: (361) 293-8044 Service Agreement - Terms of Service Billing Information: Name on Account: Calhoun Co. Pct. 4 • :n Seadrift. TX • . Service Location: County County PCT # Bill Sanders Memorial Park 1681 Swan Point Rd eadrift, Texas 77983 one: 361 — 7 R 5— 31 41 home/office/cell Email: anri1 1-nwncanrl@r..q 1 hnnnc,nt-x org Service: Quantity Portable Toilet (3 ) (serviced 2 x wk) Handicap PT (1 ) (serviced 2 x wk) Address: 1681 Swan Point Rd, Seadrift, TX 1681 Swan Point Rd, Seadrift, TX Price Per Unit: $160.00 / cycle $200.00 / cycle Services Rendered: Contractor agrees to furnish the solid and liquid waste collection recycling and/or disposal services and equipment specified and customer agrees to make payments as provided for herein and abide by the terms and conditions of this agreement. Pricing - All equipment and services are billed at an agreed upon rate for twenty-eight (28) days of service, subject to applicable taxes. Minimum four weeks rental rate assessed on all portable restrooms. Legacy Disposal & Sanitation does not prorate for unused days, unless approved by Legacy Disposal & Sanitation. Billing - { billed on 28 day cycle } - { 1 week = 7 days } The contractor may adjust the rate hereunder annually to reflect the percentage increase in the U.S, city average Consumer. Price Index for All Urban Consumers (CPI-U) published by the U.S. Department of Labor. The contractor may also adjust the rates hereunder in any amount in excess of such percentage increase with the Customer's approval upon thirty (30) day notice from the Contractor prior to the effective date of the adjustment. Rate acceptance shall be evidenced by the practices and actions of the parties. Changes: Changes in the rates, the type of service and amounts of equipment, and the frequency of service may be agreed to rally or in writing byt the parties without affecting the validity of this agreement, Consent to oral changes shall be evidenced by the practices and actions of the parties. This agreement shall continue in effect far the term provided herein and shall apply to changes in service location(s) or additional service locations of the Customer within the area in which the Contractor provides collection service. Terms: Customer agrees that Contractor shall have exclusive Right to provide portable sanitation services to collect, recycle and/or dispose of waste materials pursuant to this agreement for an initial Term of ( 1 ) year from the effective date of service, and shall continue indefinitely thereafter, renewing in one-year increments, unless terminated by either party via certified mail ( Ninety Days) to the anniversary date. Payment Terms - All past due amounts under this agreement shall bear late fees. Legacy Disposal & Sanitation also requires a form of payment be provided up front prior to the delivery of services and card placed on file, unless otherwise approved by Legacy Disposal & Sanitation. . Credit Card Processing - Customer declares that all credit information be submitted is true, accurate and appears in the name as stated. Authorization is hereby given to Legacy Disposal & Sanitation to use the credit card information provided for the amounts due to Legacy Disposal &Sanitation on a monthly basis as charges accrue. . Default - If customer fails to make any payment or perform any obligation under this Agreement or becomes in any way the subject of a bankruptcy proceeding, Legacy Disposal & Sanitation shall be under no obligation to furnish additional equipment or services to Customer until the default is cured and Legacy Disposal & Sanitation may, without penalty, legal process or notice of any kind, immediately retake possession of all of its equipment from Customer, regardless of location. . Risk of Loss or Damage- Customer agrees to return all equipment under this agreement to Legacy Disposal & Sanitation in the same condition as delivered, subject only to normal wear and tear. Customer shall bear the risk of loss and damage to the equipment. Customer is responsible for equipment until time of pick up, regardless of call -off date. This includes damaged, lost or stolen units. Damage which is not ordinary "wear and tear" includes but is not limited to: damage resulting from tip -over, exceeding capacities; improper use; abuse; graffiti; items other than sewage waste in tanks including rags, oil, cement, beer cans and bottles etc. Damage to pumps due to trash, rags, oil, cement, beer cons, and bottles may be charged back to the renter and/or rental of said equipment may be terminated. . Unit Delivery, Service, Location and Retrieval - Accessibility to unit(s) must be within 25 foot of a safe road surface to allow Legacy Disposal & Sanitation to perform service operations. Customer is responsible for providing any and all lock codes/combinations needed to access location for delivery and service. If codes/combinations cannot be provided, customer or pre -arranged authorized individual must be present at time of delivery/service to make location accessible to Legacy Disposal & Sanitation. Legacy Disposal & Sanitation is not responsible for Customer's failure to designate unit placement at delivery. If unit is set in an undesired area because Customer failed to designate placement area and Legacy Disposal & Sanitation is asked to return, Legacy Disposal & Sanitation reserves the right to charge a fee ranging from $25-$75 depending on the service location. Relocation of the unit will be performed at Legacy Disposal & Sanitation's earliest convenience. • Limitation of Liability - Legacy Disposal & Sanitation shall not be liable for damage to pavements or other driving surfaces resulting from the weight of vehicles servicing equipment location designated by Customer, nor for any damages incurred while executing Customer's directions. In no event shall Legacy Disposal & Sanitation, its members, managers, employees, agents, attorneys, insurers, affiliates, successors, or assigns be liable for: i) any claim, loss, damage or expense of any kind (including strict liability in tort) arising out of or related to the ownership, selection, possession, lease, operation, control, use, maintenance, delivery or return of the equipment; ii) incidental, indirect, special or consequential damages (including the loss of profits or production), whether suffered by the Customer or any third party, no matter the cause; or, iii) any amount excess of the amount Legacy Disposal & Sanitation receives from a Customer as payment under this Agreement. . Indemnity - Customer agrees to defend, indemnify and hold Legacy Disposal A Sanitation harmless from and against any and all claims, actions, suits, costs, expenses (including attorney's fees), damages and liabilities for injury or death to persons or loss or damage to property, arising out of or related to the equipment or services furnished under this Agreement, including costs expenses, and attorneys fees incurred by Legacy Disposal & Sanitation in an action, claim, or suit to enforce or prosecute Customer's obligations under this provision or Agreement. By signing below, Customer agrees to adhere to both pages of above agreement and all provisions included in this agreement in its entirety. Customer Signature: Date: CERTIFICATE OF INTERESTED PARTIES FORM 1295 toll Complete Nos. t - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2020-656437 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Legacy Disposal & Sanitation Yoakum, TX United States Date Filed: 08/12/2020 2 Name of governmental entity or state agency that Is a party to the contract for which the forms being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or Identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Open Portable Sanitation, Solid Waste Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling .Intermediary Calhoun County Various, TX United States X 5 Check only If there is NO Interested Party. ❑ 6 UNSWORN DECLARATION ,�/J My name is 9., lu �G��JJ . WkF4 and my dale of birth is My address is (street) (city) (state) (ZIP code) twuntry) 1 declare under penalty of perjury mat the foregoing is true and correct. Executed In 40t.r r County, State of l' U , on the 3 day of d6"�- , 20 Z . (month) (Year) Sign�of uthorizedhorized agent ng business entity (Declarant) Forms Drovided by Texas Fthies Cnmmissinn www mhire etAta tv ue Vareinn Vt i RaAaaf7d CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1 - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2020-656437 Legacy Disposal & Sanitation Yoakum, TX United States Date Filed: 08/12/2020 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 09/23/2020 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Open Portable Sanitation, Solid Waste Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Calhoun County Various, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is and my date of birth is My address is 1 , (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct, Executed in County, State of , on the _day of , 20_ (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas ttnics commission www.ethics.state.tx.us Version V1.1.3a6aaf7d #li Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 12, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 19, 2020. • Consider and take necessary action to Vacate Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, recorded in Slide No. 598B of the Calhoun County Plat Records. Sincerely, 1) 2ese Gary A GDR/at _v._..__._.._....__-�....._ ......... _..__.. _. _..._.__.._....._._.... _....... ...............____..__� — ___-- P.O. Box 177 — Seadrift, Texas 77983 -- email: ¢arv.reese(la calhouncotx:ora — (361) 785-3141 — Fax (361) 785-5602 DESIGNATION OF AGENT G & W Engineers, Inc. 205 W. Live Oak Port Lavaca, Texas 77979 (361) 552-4509 ph PROJECT: Replat of Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, Texas PROPERTY ADDRESS: Rabbit Drive, Port O'Connor, Texas LEGAL DESCRIPTION: Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, recorded in Slide No. 598 "B" of the Calhoun County Plat Records This form designates G & W Engineers. Inc. as my/our duly designated agent, to act on my/our behalf in matters concerning Calhoun County's review process for platting and variance(s) for the property described above. OWNER: BRUCE YANTA Bruce Yanta Date Before me, the undersigned authority, on this day personally appeared BruCiL ycLr. known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that that such person executed the same for the purpose and considerations therein stated. Sworn to and Subscribed before me this I I _ day of _j_U_V14_ , _ab -U-j Via-K Aatm Notary Signature _ _ _ _, r'n or typed name nG County, Texas a ^UA VAN T 'HAM Notary 10 N1 Z308210 !v� My Commission Expires' June 26, 2023 I, the undersigned Agent, understand and accept by authority and responsibility to act as the legally authorized Agent on behalf of the Owner(s) of the property described above, in matters concerning this property. e: �7j i� gent' Signature � /r� z Date #12 Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 12, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 19, 2020. • Consider and take necessary action to approve the Preliminary Plat of Marlin Azul Villa's Subdivision, a replat of Lot 13 of the Re -Plat of Outlot 1 in Outblock 12 of Port O'Connor, recorded in Slide No. 598B of the Calhoun County Plat Records. GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: gary reesc( calhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 mAlb A" '001L-Fzc (6L6) tl.ml IHod cross—zss (ISE) 1Vld',ILIVNIVIM3 Id 'm o a01zz001'ON wei! sldel_od v 6LGLL SVXk VOVAtl 1N'0d MaS NVo 3 n 'M soz i o F y 6 • ON NNtlld • ONK3 N(15 • ONR133NION3 • 'J' g bL'r'Jy arc: p.Q�: p: 9 . Xs a Is k p € yy IM pi �€ �� gb F5Ab gE b��55 gb 3gg g@@ qy y3 tbtgg ui pg ,+p, p@gp$p9 W O � C � O p w Rill n� e ��11 O UZ i6i y5SiS� kn4� I Ile �w xq S€' 3g�n 1� zE O bgg E ¢u. �.� H 33G @� E�b�q�� 16 b g S n Y`s a l4 =a m>� aaza W w o F S HI NF Omr� m z 2 S F+i l O z OO s 0 F F F a F O S .ma S REKAT OF OUTLOT d IN OUTBL CK 12 ma s; U1 .i SYB'-----E 3J5.00' A',.____________JiVR______________ ______�asm_____________l A_______us� ___________ F O ______ m y 69'Nd y5'gy i 3 NI O �59 FOOT WIDE ACCESS RABBIT 0 ROAD &'SUTILITY EASEMENT , - 9$1 y tl ryryyy �WJ \ � - I co �•, _____, L_______ L_______s�.______� ._______«________ ________sue _____ •.00,ezeaN z zo1sno s I1,0111no #13 Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 12, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 19, 2020. • Consider and take necessary action to Vacate Tract 6 and a part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. Sincerely, Gary D.yReese\, GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: earv.reesc(la calhouncomore — (361) 785-3141 — Fax (361) 785-5602 i.l l�di • G & W Engineers, Inc. 206 W. Live Oak PortLavaoe,Texas 77079 (361) 552.4509 ph PROJECT: Replat: of Tract 6 and a part of Tract 7 out of -146 acres described in File ft., 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas PROPERTY ADDRESS: Easy Street and Carrie. Street In Part O'Connor, Texas LEGAL DE$CRIFMON: Tract 6 and a part.of Tract 7 out of 146 acres described in file No. 2019- 01808 of the Calhoun County Official Records, Peat O'Connor, Texas This form designates G & W Engineers, Inc. as my/our duly designated agent, to act on myfour behalf in matters concerning Calhoun County's review process for platting and varian*s) for theproperty described sbove. s o, -K 1, LPACft—dmd TV �nt Date Before me, the undersigned authority, on this day personally appeared r kite pti� known to me to be the person.whose name issubscribed to'the foregoing instrument:and actcnawledged to merthat that such person executed #* $ame for the purpose and considerations thsralrtstated: i V� / - day of Printed or typed name G8ro♦130424 MMyCpnmhs'on Exp" November 3, 2023 f, the undersigned Agent, understand and accept by authority and responsibility to act as ft Iegafly authorized Agent on behalf of the Owner(s) of the property described above, in matters concerning this property. kc<Z2 ..._ Agent's. ignature #14 Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 12, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 19, 2020. • Consider and take necessary action to approve the Preliminary Plat of Saltwater Haven Subdivision, a replat of Tract 6 and a part of Tract 7 out of 146 acres described in File No. 2019-01808 of the Calhoun County Official Records, Port O'Connor, Texas. Sincerely, 1 kJfL\ GaryD. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: earv.reesencalhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 A13 AVS OML-UT (Us) VOMLNU '6091-ZgG G90 00' NU : 0. 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L ---------- a .00 Lgz ------------- IKM Mfg of— - — - — - — I - — - — - — - — - — ---- I----------- II no).vs A000a # 15 MAL Calhoun County Public Library www,ccbbrary.arg 200 W, Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.S525218 Report March 2020 The following materials have been donated to the Calhoun County Public Library System during the month of March 2020 Books Donor 19 Unknown 2 Vernon Barnett 121 Cheryl Teseny 1 Charles Willoughby 231 Moore Family 3 Lillie Garza Paperbacks Donor 21 Unknown 1 Vernon Barnett 11 Cheryl Teseny 1 Charles Willoughby DVD Donor 9 Unknown 4 Bo Warren B Elda Luera Others Donor 1 VHS Unknown 315 Magazines (Cheryl Teseny) 1 Magazine (Amy Day) 2 Bags of suckers (Jerry Wayne Russel) 3 Cups (Smile Experts) S Dental Floss (Smile Experts) S Pens (Smile Experts) g Koozies (Smile Experts) $1000 City of Point Comfort n Calhoun County Public Library ww .ccrbrary.org 200 W. Mahan i Port Lavaca, TX 77979 Ph:361.552.7323 Fax:361.552.5218 Report June 2020 The following materials have been donated to the Calhoun County Public Library System during the month of June 2020 Books Donor 165 Unknown 7 Charles Willoughby 28 Gary McKeithen 34 Ruth Boyd Robertson 18 Betty Jordan Paperbacks Donor 33 Unknown 1 Kaleigh McCauley 13 Charles Willoughby 3 Gary McKeithen 6 Ruth Boyd Robertson DVD Donor 31 Unknown 4 Norma Leslie Othere Donor 7 VHS Unknown 1 Audio Book Unknown $1,000 Wal-Mart $295 Friends of the Calhoun County Library $2.05 Seadrift Library Donation Bucket $223.35 Port O'Connor Library Donation Bucket Am, Calhoun County Public Library Ww ,cdlhrary org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report July 2020 The following materials have been donated to the Calhoun County Public Library System during the month of July 2020 Books Donor 32 Unknown 28 Chris Scroggs Paperbacks Donor 4 Unknown 11 Brenda Carter DVD Donor 11 Unknown 25 Chris Scroggs Others Donor 25 VHS Chris Scroggs 1 Audio Book Chris Scroggs 1 Memory Board Game Unknown $87.99 TISD $2.40 Seadrift Library Donation Bucket $37.04 Port O'Connor Donation Bucket Calhoun County Public Library . "Iibrary,org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report March 2020 I would like the following to be declared Surplus/Salvage 248 Books 17 Paperbacks 10 DVD 1 VHS IAL Calhoun County Public Library www ccHbrary.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552,7323 Fax: 361.552.5218 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Calhoun County Library Date: March 2020 Calhoun County Public Library www ccll6rary.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report June 2020 I would like the following to be declared Surplus/Salvage 180 Books 32 Paperbacks 10 DVD 6 Audio Books 7 VHS Calhoun County Public Library www.ccgbrary.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.S218 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Calhoun County Library Date: JUNE 2020 Inventory Description Serial No. Reason for Number Surplus/Salvage Declaration Philips Monitor#14 bz000601426372 Obsolete HP LaserJet VNB3L73092 Obsolete Printer Philips Monitor BZ000603422074 Obsolete #15 Acer Monitor ETLE10DO9200 Obsolete #49 HP Monitor 3CQ0194CM1 Obsolete #42 Sams Club Popocorn SC-35858 Obsolete Machine HP Color LaserJet CNHCC76W30W Obsolete 2600n Dell Optiplex 780#31PC H07FVL1 Obsolete Kelley HP ProDesk'600 GS SFF #29 PC MXL5241TRP Obsolete Marsha HP Elite Desk 600 G2 SFF MXL5502878 Obsolete #42 Public PC HP Pavilion #32 3CR01901MK Obsolete PC Cynthia Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Calhoun County Library Date: JUNE 2020 Inventory Number Description Serial No. Reason for Surplus/Salvage Declaration Computer #39 Hp Elite Desk 800G2 SFF MXL6440SVY Obsolete Laptop #17 Toshiba Satellite 6D207808Q Obsolete MdL Calhoun County Public Library w cd7brafy.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report July 2020 I would like the following to be declared Surplus/Salvage 17 Books 7 Paperbacks 13 DVD 25 VHS 1 Audio Book 1 Memory Board Game #17 r Calhoun County Public Library www.cclibrary.org. 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report March 2020 I would like the following items to be declared waste 49 Books 9 Paperbacks 316 Magazines MAL Midgm Calhoun County Public Library *w cclibrary,org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552,5218 Report June 2020 I would like the following items to be declared waste 42 Books 6 Paperbacks 9AL Calhoun County Public Library Ww cclibrary.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 Report July 2020 I would like the following Items to be declared waste 43 Books 8 Paperbacks #18 #19 08-13-20;10:50 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 1/ 4 FAX COVER SHEET August 13, 2020 FROM: JUSTICE COURT PCT. 4, CALHOUN COUNTY 103 W. Dallas Street. P.O. Box 520 Seadrift, Texas 77983 PHONE: 361-78S-7082 FAX: 361-785-2179 T0: County Judge Office Ref: Money Distribution Report FAX: 361-553-4444 NOTE: The July 2020 report is attached. Please give me a call if you have any questions. PAGES TO FOLLOW: 4 INCLUDING THIS COVER PAGE Thank you, judge'WesCe1 J. Hunt 08-13-20;10:50 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 2/ 4 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/3/2020 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: JULY YEAR OF REPORT: 2020 ACCOUNT NUMBER ACCOUNTNAME AMOUNT OR 1000-001-45014 FINES 11816.92 OR 1000-001-44190 SHERIFFS FEES 154.00 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 10.00 CHILD SAFETY 0.00 TRAFFIC 15.75 ADMINISTRATIVE FEES 10.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0,00 OR 1000-001-44364 TOTAL ADMINISTRATIVE FEES 35,75 OR 1000.001-44010 CONSTABLE FEES -SERVICE 0.00 OR 100D.001-44064 JP FILING FEES 150.00 OR 1000-001.44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001.49110 OVERPAYMENTS (LESS THAN $10) 0.00 OR 10OD-001-44322 TIME PAYMENT REIMBURSEMENT FEE 0.00 OR 1000-ODl-44145 SCHOOL CROSSINGICHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 OR 1000-999-20744 DUE TO STATE-SEATBELT FINES 102.46 OR f 000-999.20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 OR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 OR 1000.999.20770 DUE TO JP COLLECTIONS ATTORNEY 358.50 TOTAL FINES, ADMIN. FEES & DUE TO STATE $2,617.62 OR 2670-001.44064 COURTHOUSE SECURITY FUND $93.40 OR 2720-001.44064 JUSTICE COURT SECURITY FUND $5.00 CR 2719-001-44004 JUSTICE COURT TECHNOLOGY FUND $84.00 OR 2699.001-44064 JUVENILE CASE MANAGER FUND $10.00 OR 2730.001-44064 LOCAL TRUANCY PREVENTION & DIVERSION FUND $80.00 OR 2669-001-44064 COUNTYJURYVUND $1.60 STATEARRESTFEES OPS FEES 1.00 P&W FEES 0.00 TABC FEES 0.00 OR 7020-999-20740 TOTAL STATE ARREST FEES 1.00 OR 707MBS-20610 CCC-GENERAL FUND 20.00 CR 7070.999-20740 CCC-STATE 180.00 DR 7070-999-10010 200.00 OR 7072-999.20610 STATE CCC- GENERAL FUND 99.20 OR 7072-999.20740 STATE CCC- STATE 892.80 OR 7072-999-10010 992.00 OR 7860-999.2D610 STF/SUBC-GENERAL FUND 1.50 OR 7860-999-20740 STF/SUBC-STATE 28.50 OR 7860-999-10010 30.00 OR 7660-999.20610 STF- EST 9/1/19- GENERAL FUND 8.50 OR 7860-999.20740 STF- EST 9/1 /19- STATE 203.98 DR 71160-999-10010 212.48 OR 7950-999.20610 TP-GENERAL FUND 50.00 OR 7950-999.20740 TP-STATE 50.00 DR 7950-999A0010 100.00 Page 1 of 2 08-13-20;10:50 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 3/ 4 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/3/2020 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: JULY YEAR OF REPORT: 2020 OR 7480-999.20610 CIVIL INDIGENT LEGAL-GEN. FUND 1.80 OR 74BU99.20740 CIVIL INDIGENT LEGAL -STATE 34.20 OR 7480-999.10010 36.00 OR 7865-999.20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 1.00 CR 7805-999.20740 GRIM-SUPP OF IND LEG SVCS-STATE 9.00 OR 7865-999.10010 10,00 OR 7970-999.20610 TUFTA-GENERAL FUND 40.00 OR 7970.999.20740 TUFTA-STATE 80.00 DR 7970-999-10010 120.00 OR 7305.999-Z0010 JPAY - GENERAL FUND 3.09 OR 7505-099.20740 JPAY - STATE 27.00 OR 7505-999-10010 30.00 OR 7857-999.20610 JURY REIMB. FUND- GEN. FUND 2.00 OR 7857-999.20740 JURY REIMB. FUND- STATE 18.00 OR 7857-999.10010 20.00 OR 7856-999.20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.04 OR 7856.999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.36 DR 7866-999-10010 0.40 OR 7502-999.20740 JUDICRT PERSONNEL TRAINING FUND -STATE 30.00 DR 7502-999-10010 30.00 7998-999-20701 JUVENILE CASE MANAGER FUND 5.00 CR 7998.998.20740 TRUANCY PREVIDIV FUND - STATE 5.00 DR 7998-999-10010 10.00 OR 7403-999.22889 ELECTRONIC FILING FEE 60.00 DR 7403-999.10010 60.00 TOTAL (Distrib Req to Oper Acct) $4,743.50 DUE TO OTHERS (Di$(ribRggA((chd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0100 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 0.00 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $0.00 TOTAL COLLECTED -ALL FUNDS $4,743.50 LESS: TOTAL TREASUER'S RECEIPTS $4,743.50 REVISED 01/29/20 OVERI(SHORT) $0.00 Page 2 of 2 08-13-20;10:50 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 4/ 4 CALHOUN COUNTY 201 West Austin DISTRIBUTION REQUEST DR# 480 A 44047 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Wfttey Hunt Address: Title: Justice or the Peace, Pct. 4 City: State. Zip: Phone: ACCOUNT NUMBER DESCRIPTION AMOUNT 7544-999-20759.999 JP4 Monthly ColleCtions • Distribution $4,743.50 JULY 2020 V# 967 -roTAL11 4,743.50 Signature of # 20 0 Cl) 4- §§;; /mom 0 Z < 0 g §) § z § b° ) < (§§§§I o ;66G6 to it m §222§ 2 §��ee§ q § § k� k ■@«@e® } 000 0 § 0 0 000 § B W L \� § ■ ) \ § q % 7 � § k 2 k � k M= ■ kk z| 0= op $§§ �]k\§§mB■ ,_�,:: „ ■ )§333§E3 ,=000>=o :\\§//§z :e§ � 3000@000 }\\\\\\\§�■ L.: »; z 0 $ z 3 m 0 1 m � ■ z 0 z � � 0 0 � z 0 0 \ k m m y o�o�o D z o�r. Imp r A m j O " fz/1 c.) fNn D� m m M N V1 U) O O O zzz n n v 0 oa o m m O O T N O di ffl O O V N J v€ M: a: 3€ M: Z: 0 EP O O zzzz 0 c z y z: 0: N: c 0 a m m m C v F I #21 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---- August 19, 2020 INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES Cardiovascular Associates of Victoria HEB Pharmacy (Medimpact) Pharmacy Reimbursement MMCenter (In -patient $0.00/ Out -patient $1,571.05/ ER $749.44) Memorial Medical Clinic Port Lavaca Clinic Associates Singleton Associates, PA SUBTOTAL Memorial Medical Center (Indigent Healthcare Payroll and Expenses) Co -pays adjustments for July 2020 Reimbursement from Medicaid by:CT 46.73 123.48 2,320.49 956.81 103.63 15.23 3,566.37 4,166.67 Subtotal 7,733.04 (70.00) 0.00 'U. UUUU8192020 'i CALHOUN COUNTY, TEXAS _..I DATE: VENDOR # 852 CC Indigent Health Care ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES UANTITY UNIT PRICE TOTAL PRICE 1000-800-98722-999 Transfer to a bills for Indi ent Health Care 7 663.04 approved b Commissioners .Court on.08119/2020 1000-001-46010 diil 31, 202'0 interest ( 2.29) (0 7,660.75 COUNTY AUDITO& APPROV ONLY4, THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD ITION AND REQUEST THE COUNTY TREASURER TO PAY THE AH 0 LIGATION. BY: 8/19/2020 c^.f 0 CA � � -L O � V DEPA TMENT HEAD DATE RUN DATE: 08/06/20 MEMORIAL MEDICAL CRIME PAGE 122 TIME: 15,39 RECEIPTS PROM 07/01/20 TO 07/31/20 RCHREP GA RECEIPT PAY - CASH RECEIPT OISC COLL GL CASH NUMBER DATE MR4EER TYPE PAYER AMOUNT !+MOUNT NUMBER CAKE DATE IMT CODE ACCOUNT 50240.000 07/15/20 557999 CA 10.00 10,00 00/00/00 CAS 2 50240.000 07/10/20 557489 CA 10.00 10,00 00/00/00 JRC 2 50240,000 07/10/20 557531 CA 10.00 10.00 00/00/00 JRC 2 50240,000 07/29/20 559133 CA 10.00 10.00 00/00100 JRC 2 50240,000 07/16/20 558112 CA 10.00 10.00 00/00/00 ?LB 2 50240,000 07/17/20 558219 CA 10.00 10.00 00/00/00 PLB 2 50240,000 07/21/20 558357 CA 10,00 10,00 00/00/00 PLB 2 "TOTAL" 50240.000 CO M, INDIGENT COPAYS 70.00 I ':,PROSPERITY BANW Statement Date Account No THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13406 7/31/2020 Page 1 of 2 STATEMENT SUMMARY Public Fund Contractual Ckg w Int Account N�� 07/01/2020 Beginning Balance $5,548.22 3 Deposits/Other Credits + $7,487.46 6 Checks/Other Debits - $7,548.72 07/31/2020 Ending Balance 31 Days in Statement Period $5,486.96 Total Enclosures 8 07/03/2020 Deposit 07/15/2020 Deposit 07/31/2020 Accr Earning Pymt Added to Account Check Number Date Amount Check Number Date Amount 12377 07-20. $131.41 12379 07.03 $143.19 12378 07.03 $4,166.67 12380 07-03 $1,753.00 DALY ENDING BALANCE Date Balance Date Balance 07-01 $5,548.22 07.14 $5,536.08 07.03 $6,890.53 07-15 $5,616.08 07.13 $6,756.08 07-20 $5,484.67 Amount $7,405.17 1,Aaf P �4Y $80.00 $2.29 Check Number Date Amount 12381 07.14 $1,220.00 12382 07-13 $134.45 Below is an itemization of the Earnings paid this period. " Interest Paid This Period $2.29 Annual Percentage Yield Earned Interest Paid YTD $17.94 Days in Earnings Period Earnings Balance Date Balance 07-31 $5,486.96 0.45 % 31 $6,006.14 MEMBER FDIC NYSE Symbot'PB" euokl ©IHS Source Totals Report Issued 08/04/20 Calhoun Indigent Health Care Batch Dates 08/01/2020 through 08/01/2020 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed 01 Physician Services 418.70 02 Prescription Drugs 123.48 08 Rural Health Clinics 1,224.00 14 Mmc - Hospital Outpatient 4,855.02 15 Mmc - Er Bills 2,342.00 Expenditures Reim6/Adjustments Grand Total 9,023.22 -60.02 8,963.20 EXPENSES COPAYS TOTAL APPROVED ON AUG 1 1 202 BY CALHOUN COUNTY AUDITOR Amount Paid 61.96 123.48 1,060.44 1,571.05 749.44 3,626.39 -60.02 3,566.37 4,166.67 7,733.04 <70.00> 7,663.04 ©iHS Source Totals Report Issued 08/04/20 Calhoun Indigent Health Care Batch Dates 02/01/2020 through 08/01/2020 For Source Group Indigent Health Care For Vendor., All Vendors Source Description Amount Billed 01 physician Services 16,027.73 01-2 Physician Services -Anesthesia 3,120.00 02 Prescription Drugs 1,219.92 08 Rural Health Clinics 7,087.00 13 Mmc - Inpatient Hospital 47,647.45 14 Mmc - Hospital Outpatient 65,017.04 15 Mmc - Er Bills 7163.00 Expenditures 147,854.34 Reimb/Adjustments-572.20 Grand Total 147,282.14 EXPENSES COPAYS TOTALS Amount Paid 2,465.17 885.03 1,219.92 6,101.27 22,870.77 21,012.60 2,292.16 57,419.12 -572.20 56,846.92 29,166.67 86,013.69 <860.00> V85,153.59 ME�1\4C)OR.IAL MET3ICAL 1ft CENTER 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552.6713 Date: 8/6/2020 Invoice # 346 For: Jul-20 Bill To: Calhoun County Funds to cover Indigent program operating expenses. $ 4,166.67 UJI- Jason An in CEO Total $ 4,166.67 APPROVI p ON ALiG f ' 20 By CALHOUN COUNT/ AU DITOR January February March April May June July August September October November December Calhoun Count t Care Patient Caseload 2020 ` Approved Denied Removed Active Pending 0 2 1 17 2 0 1 2 15 2 0 0 1 15 1 1 0 6 10 2 1 2 0 11 1 0 0 0 11 0 0 0 0 11 1 YTD Monthly Avg 0 1 1 13 1 December 2019 Active 18 Number of Charity patients 183 Number of Charity patients below 100%FPL 105 Calhoun County Pharmacy Assistance Patient Caseload 2019 Approved Refills Removed Active Value January 0 2 0 114 $1,498.00 February 3 6 0 110 $12,514.00 March 3 3 1 112 $10,108.00 April 1 6 0 111 $26,370.00 May 1 3 0 112 $9,424.00 June 2 6 0 114 $38,390.00 July 1 5 0 115 $28,973.00 August September October November December YTD PATIENT SAVINGS Monthly Avg 2 4 0 113 $18,182.43 0 December 2019 Active 112 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---August 19,202 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL_PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 651,135.96 ' Gx TOTAL, TRANSFERS BETWEEN LFUNDS $ 83,.891.66, 'TOTAL NURSING HOME UPL EXPENSES $ 619,261.35 TOTAL INTER,GOVERNMENT TRANSFERS $ 3,0%6.37 [GRAND TOTAL DISBURSEMENT$ APPROVED August 18, 2020 _ $ 1257,385.3.3', MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---Auqust 19,202 PAYABLES AND PAYROLL 8/13/2020 Weekly Payables 227,832.80 8/1312020 Patient Refunds 2,670,29 8/13/2020 Citibank Credit Card -see attached 2,417.90 8/1712020 McKesson-340B Prescription Expense 3.359.14 8/1712020 Amerisource Bergen-340B Prescription Expense 396.55 8/21/2020 Payroll Liabilities -Payroll Taxes 100,239.78 8/21/2020 Payroll 307,759.29 Prosperity Electronic Bank Payments 8/10/2020 Credit Card & Lease Fees 5,135.22 8/20/2020 Sales Tax for July 2020 1,182.64 8110-8/14/2020 Pay Pius -Patient Claims Processing Fee 143.34 TOTAL POAPLE%, PAYROLL ANDiELECTRONIC BANK PAYMENTS $ 661;136v95' TRANSFER BETWEEN FUNDS -NURSING HOMES 8/13/2020 MMC Operating to Broadmoor-correction of NH insurance payment deposited into MMC Operating 5,280.00 8/13/2020 MMC Operating to Golden Creek Healthcare -correction of NH insurance payment deposited into MMC Operating 4,281.07 8/13/2020 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment deposited into MMC Operating 32,882.08 8/13/2020 MMC Operating to Tuscany Village -correction of NH insurance payment deposited into MMC Operating 41,448.51 TOTAL IRkNSF'ERS'BEIIEENFUNDS $ 63i&91i.66i' NURSING HOME UPL EXPENSES 8117/2020 Nursing Home UPL-Cantex Transfer 207,846.86 8/1712020 Nursing Home UPL-Nexion Transfer 52,555.77 8/17/2020 Nursing Home UPL-Tuscany Transfer 40,628.34 8/17/2020 Nursing Home UPL-HSL Transfer 217,757.34 QIPP/INTEREST/RECOUP CHECKS TO MMC 8/17/2020 Ashford 295.06 8/17/2020 Crescent 20.08 8/17/2020 Fort Bend 83,82 8/17/2020 Solera 74.08 TOTAL NURSING HOME UPL EXPENSES $ 61,0 161r35 INTER -GOVERNMENT TRANSFERS 8/18/2020 IGT DY3 to be paid September 04, 2020 3,096.37 (TOTAL:INTER-OOVERNMt�NT'IAANSFERS $ 3,0$6.37 GRAND+TOTALiDISBURSEMENTS.APPROVED:August 19, 2020' e/13l2g2�1 = ;r< 1 a, +� [ tl tmp_ew5mport2371263034716784470.htmI . �II/1} MEMORIAL MEDICAL CENTER 08/T3/202Yi`�! 0 AP Open Invoice List ?lti/z Due Dates Through: 08/26/2020 ap open_invoice.tamplate Vendor# Vendor Name Class Pay Code 11283 ACE HARDWARE 15521 t,/ Invoice# Comment Tran Dt Inv DI Due Dt Check Dt Pay Gross Discount No -Pay Net 145909 ✓ 07l31/2020 07/02/2020 07/27/2020 15.87 0.00 0.00 15.87 SUPPLIES 146013 ✓ 07/31/2020 07/06/2020 07/31/2020 28.99 0.00 0.00 28.99 ✓ SUPPLIES 146074 ✓ 07/31/2020 07/08/2020 08/02/2020 35,98 0.00 0.00 35.98 ✓ SUPPLIES 146116 07/31/2020 07/09/2020 08/03/2020 4.74 0.00 0.00 4.74+�- I SUPPLIES 146295 07131/2020 07/16/2020 08/10/2020 119.99 0.00 0.00 119,99 SUPPLIES 146327 ✓ 07/31/2020 07/17/2020 08/11/2020 44.93 0.00 0.00 44.93 SUPPLIES BSO301 07/31/2020 07/27/2020 08/21/2020 �( 9gI 0.00 0.00 / 9.6% 1 -1 f1;:4 tLrL/ / SUPPLIES �IJNiIy UQh(IOY $� '�-''1��WQ� 146623 ✓� 07/31/2020 07/29/2020 08/23/2020 42.95 0.00 0.00 / 42.961 / SUPPLIES 146645 ✓ 07/31/2020 07/30/2020 08/24/2020 59.97 0.00 0.00 59.97 ✓/ SUPPLIES Vendor Totals: Number Name / Grass Discount No -Pay Net 11283 ACE HARDWARE 1f 363704 353. `I3 0.00 0.00 353.y3 36.64 Vendor# Vendor Name Class Pay Code R1200 ADT COMMERCIAL „/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 453576/ 08/11/2020 08/01/2020 OB/26/2020 47.29 0.00 0.00 47.29 FIRE MONITORING Vendor Totals: Number Name Gross Discount No -Pay Net R1200 ADT COMMERCIAL 47.29 0.00 0.00 47.29 Vendor# Vendor Name Class Pay Code A2218 AQUA BEVERAGE COMPANY M Invoice# Comment Tran Dt Inv Ot Due Ot Check Dt Pay Gross Discount No -Pay Net 984660 ✓ 08/12/2020 07/09/2020 08/03/2020 34.48 0.00 0.00 34.48 WATER ✓ Vendor Totals: Number Name Gross Discount No -Pay Net A2218 AQUA BEVERAGE C 34.48 0.00 0.00 34.48 Vendor# Vendor Name Class Pay Cade 12800 AUTHORITYRX ✓ Invoice# /Comment Tran Ot Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 1041 ,/ 08/12/2020 08/11/2020 08/11/2020 4,950.00 0.00 0.00 4,950.00 ANNUAL 340E AUDIT PT 1 Vendor Totals: Number Name Gross Discount No -Pay Net 12B00 AUTHORITYRX 4.950,00 0.00 0.00 4,950.00 Vendor# Vendor Name Class Pay Code B7150 BAXTER HEALTHCARE J W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 67635366 ✓07/31/2020 07/23/2020 08/17/2020 537.95 0.00 0.00 537.95 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Nei B1150 BAXTER HEALTHCF 537.95 0.00 0.00 537.95 Vendor# Vendor Name Class Pay Code M2485 BAYER HEALTHCARE �,/ M Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 6008782535.07/31/2020 07/24/P020 08/07/2020 1,727.70 0.00 0.00 1,727.70,✓ SUPPLIES 6008788897 X133112020 07/28/2020 08/07/2020 11151.80 0.00 0.00 11151.80 1,-,' File:l/lCaUsers/mmckiaseck/cpsilmemmed.cpsinet.cam/u88150a/data 5ltmp_cw5report2371263034716784470.himl 1111 8/13/2020 ,. imp_ew5repart2371263034716784470.html SUPPLIES 600678682"7/31/2020 07/28/2020 08/07/2020 1,439.75 0.00 0.00 1,439.75 v� SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCAf 4,319.25 0.00 0.00 4,319.25 Vendor# Vendor Name Class Pay Code �,' B1220 BECKMAN COULTER INC �%� M Invoice# Cc ment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net 108518726✓78/1112020 07/14/2020 08/08/2020 49.68 0100 0.00 49.68 SUPPLIES 10852338a8/11/2020 07/15/2020 08/09/2020 1,288.45 0.00 0.00 1,288.45 SUPPLIES 108528394 ✓08/11/2020 07/20/2020 08/14/2020 1,156.96 0.00 0.00 1,156,96 ✓ SUPPLIES 108537364 ve8/11/2020 07/23/2020 08/1712020 44.38 0.00 0.00 44.38 ✓� SUPPLIES 5427,922 ✓08/11/2020 07/30/2020 08/24/2020 3,507.27 0,00 0.00 3.607.27 w,F' SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 81220 BECKMAN COULTE 6,046.74 0.00 0.00 6,046.74 Vendor# Vendor Name Class Pay Code 10599 f BKD, LLP ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 8K01256218417/31/2020 07/29/2020 08/23/2020 15,735.70 0.00 0.00 15,735.70 FINAL AUDIT 2019 BK012562026731/2020 07/29/2020 OB/23/2020 1,248.00 0.00 0.00 1,248.00 REVIEW ADJ 12/31/18 MED COST I Vendor Totals: Number Name Gross Discount No -Pay Net 10599 BKD, LLP 16,983.70 0.00 0.00 16,983.70 Vendor# Vendor Name Class Pay Code 11224 CABLES AND SENSORS y' Invoice# .Comment Tran Dt Inv Dt Due Dt Chock Dt Pay Gross Discount No -Pay Net 95847 v1 07/29/2020 07/20/2020 08/2O/2020 442.00 0.00 0.00 442.00 ✓ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 11224 CABLES AND SENS 442.00 0.00 0.00 442.O0 Vendor# Vendor Name Class ; Pay Code 11295 CALHOUN COUNTY INDIGENT AC( V Invoice# Comment Tran Dt Inv Dt Due Or Check Dt Pay Gross Discount No -Pay Net 080620 08/11/2020 08/06/2020 O8/06/2020 70.00 0.00 0.00 70.00 TRANSFER Vendor Totals: Number Name Gross Discount No -Pay Net 11295 CALHOUN COUNTY 70.00 0.00 0.00 70.00 Ventlor# Vendor Name class Pay Code C1325 CARDINAL HEALTH 414, INC. ✓ W Invoice# Cc ment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 80022806Z7/31/2020 07/31/2020 08/22/2020 361.10 0.00 0.00 361.10 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net C1325 CARDINAL HEALTH 361.10 0.00 0.00 361.10 Vendor# Vendor Name /Class Pay Code C1600 CITIZENS MEDICAL CENTER .' W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 063020 O8111/2020 06/30/2020 06/30/2020 33.41 0.00 0.00 33.41✓,/ PHARMCY CLIENTS Vendor Totals: Number Name Gross Discount No -Pay Net C1600 CITIZENS MEDICAL 33.41 0.00 0.00 33.41 Ventlor# Vendor Name - Class Pay Code C1970 CONMED CORPORATION M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 308483 ✓ 07/31/2020 07/27/2020 07/28/2020 787,95 0.00 0100 787.95 file:///C:/Users/mmel issacWcpai/memmed.cpsinet.comlu88150a/data_5/tmp pw5report2371263034716784470.html 2111 8/13/2020 tmp_cw5mport2371263034716784470.html SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net C1970 CONMEO CORPOR, 787.95 0.00 0.00 78T95 Vendor# Vendor Name Class Pay Code C1443 CYGNUS MEDICAL LLC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 315622 07/31/2020 07/27/2020 08/26/2020 450.00 0.00 0.00 450.00 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net C1443 CYGNUS MEDICAL 450.00 0.00 0.00 450.00 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON �j Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net 6139670 /07/3112020 07/27/2020 08/21/2020 226.91 0.00 0.00 228.91 ✓ SUPPLIES 6141970 v/07/31/2020 07/28/2020 08/22/2020 35.00 0.00 0.00 35.00 SUPPLIES 6141890 t/ 07/31/2020 07/28/2020 08/22/2020 45.77 0.00 0.00 45.77 SUPPLIES 6143910 0,✓07/31/2020 07/30/2020 08/24/2020 414.00 0.00 0.00 414.00 ✓! SUPPLIES 6144820 t/07/31/2020 07/31/2020 08/25/2020 561.40 0.00 0.00 561.40 SUPPLIES 6144950 V07131/2020 07/31/2020 08/25/2020 47,98 0.00 0.00 47.98 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SC 1,333.06 0.00 0.00 1,333.06 Vendor# Vendor Name Class Pay Cade 11011 DIAMOND HEALTHCARE CORP ✓ Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net IN20053950.97/31/2020 07/31/2020 08/25/2020 19,166,67 0.00 0.00 19,166.67 ✓� CPR IN20053949�&W31/2020 07/31/2020 08/25/2020 31,144.58 0.00 0.00 31,144.58 v% BEV HEALTH Vendor Totals: Number Name Gross Discount No -Pay Net 11011 DIAMOND HEALTH( 50,311.25 0.00 0.00 50,311.26 Vendor# Vendor Name Class Pay Code 11960 DILON TECHNOLOGIES ✓` Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net 34086 ✓ 07/31/2020 07/29/2020 08/07/2020 400.00 0.00 0.00 400.00 ✓ / SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 11960 DILON TECHNOLOC 400.00 0.00 0.00 400.00 Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 17875 ✓ 07/31/2020 07/31/2020 08/25/2020 105.00 0.00 0.00 105.00 PEST CONTROL 17963 07/31/2020 07/31/2020 08/26/2020 505.00 0.00 0.00 505.00 •' PEST CONTROL ✓ 17873 ✓ 07/31/2020 07/31/2020 08/25/2020 160.00 0.00 0.00 160.00 J PEST CONTROL v' 17962 ,/ 07/31/2020 07/31/2020 08/25/2020 260.00 0.00 0.00 260.00 �- PEST CONTROL Vendor Totals: Number Name Gross Discount No -Pay Net 11291 DOWELL PEST COP 1,030.00 0.00 0.00 1.030.00 Vendor# Vendor Name Class Pay Cade 12040 DRIESSEN WATER INC. ✓� Invoice# Cpmment Tran Dt Inv Dt Due Dt Check Dt Pay Grass Discount No -Pay Net 14302703®.7:C7/31/2020 07/31/2020 0812PJ2020 422.50 0.00 0.00 422,50 SUPPLIES fiie:///C.,/Users/mmckissack/cpsi/memmed.cpsinat.com/u88l50atdata_5/tmp_pwSreport2371263034716784470.html 3111 8/13/2020 ,. tmp_cw5report2371263034716784470.html Vendor Totals: Number Name Gross Discount No -Pay Net 12040 DRIESSEN WATER 422.50 0.00 0.00 422.50 Vendor# Vendor Name Clash Pay Code 11284 EMERGENCY STAFFING SOLUTIO ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 39428 D7131/2020 07/31/2020 08/15/2020 - 4,560.00 0.00 0.00 4,560.00 / COVER DR. BUNNELL VACATION 39447 ✓ 08/11/2020 08H5/2020 08/25/2020 40,062.50 0.00 0.00 40,062.50 PROFEES (1-I5f' ) Vendor Totals: Number Name Gross Discount No -Pay Nat 11284 EMERGENCY STAF 44,622.50 0.00 0.00 44,622.50 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE v'/ M Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 3767874 ✓08/11/2020 07/21/2020 08/16/2020 2,094.56 0.00 0.00 2,094.56 SUPPLIES 3851034,% 08/12/2020 07/22I2020 08/16/2020 93.60 0.00 0.00 93.60 SUPPLIES ✓% 3945595 /08/12/2020 07/23/2020 08/17/2020 1,019.27 0.00 0.00 1,019.27 SUPPLIES 4037725 /68/12/2020 07/24/2020 08/1812020 807.83 0.00 0.00 807.83 v.! 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lmp_ow5report2371263034716784470.htm1 080420E ,i 08/11/2020 08/04/2020 08/04/2020 200.00 0.00 0.00 200.00 REHAB LAWN 080420A Z6/11/2020 08/04/2020 08/04/2020 520.00 0.00 0.00 520.00 HOSPITAL LAWN 080420 (18/11/2020 08/04/2020 08/04/2020 380.00 0.00 0.00 380.00 CLINIC LAWN Vendor Totals: Number Name Gross Discount No -Pay Net 12544 PATRICKOCHOA 1,100.00 0.00 0.00 1,100.00 Vendor# Vendor Name Class Pay Code P2100 PORT LAVACA WAVE '" W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 073120 08/11/2020 07/31/2020 08/25/2020 1,020.00 0.00 0.00 1,020.00 L,, AD Vendor Totals: Number Name Gross Discount No -Pay Net P2100 PORT LAVACA WA\ 1,020.00 0.00 0.00 1,020.00 Vendor# Vendor Name Class Pay Code P2200 POWER HARDWARE ,� W Invoice# Comment Tram Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net B55852 / 07/31/2020 06/25/2020 07/05/2020 30.98 0.00 0.00 30.98 13 5 P 301 SUPPLIES 61 (P S'(00-s Vendor Totals: Number Name Gross Discount No -Pay Net P2200 POWER HARDWAR 3)148 4,511 0.00 0.00 35A Vendor# Vendor Name Class Pay Code P1725 PREMIER SLEEP DISORDERS CEI M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 96 07/31/2020 07/31/2020 08/15/2020 2,850.00 0.00 0.00 2,850.00 SLEEPSTUDIES Vendor Totals: Number Name Gross Discount No -Pay Net P1725 PREMIER SLEEP DI 2,860.00 0.00 0.00 2,850.00 Vendor# Vendor Name Class Pay Code 13272 RAPID AIR Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net / 8531 �/' 0-1/31/20PO 07/07/2020 07/17/2020 110.00 0.00 0.00 110.00 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 13272 RAPID AIR 110.00 0.00 0.00 110.00 Vendor# Vendor Name Class Pay Code 11764 ROBERT RODRIQUEZ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -.Pay Net 081020 08/11/2020 08/10/2020 08/10/2020 20.00 0.00 0.00 20,00 REIMBURSE FEE FOOD PERMIT Vendor Totals: Number Name Gross Discount No -Pay Net 11764 ROBERT RODRIQU 20.00 0.00 0.00 20.00 Vendor# Vendor Name Class Pay Cade 10625 SARA RUBIO Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 080620 08/11/2020 08/06/2020 08/06/2020 26.00 0A0 0.00 25.00 REIMBURSE REGISTRATION FEE Vendor Totals: Number Name Gross Discount No -Pay Net 10625 SARA RUBIO 25.00 0.00 0.00 25.00 Vendor# Vendor Name j Class Pay Code 10699 SIGN AD, LTD. ✓ Invoice# Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net /Comment 252843 ✓ 08/1 V2020 08/01/2020 08/11/2020 400.00 OAD 0.00 400.00 _ AD L "_ 252837 /08/11/2020 08/01/2020 08/11/2020 790.00 0.00 0.00 790.00 AD v Vendor Totals: Number Name Gross Discount No -Pay Net 10699 SIGN AD, LTD. 1,190.00 0.00 0.00 1,190m Vendor# Vendor Name Class Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE C file:///C:iUsers/mmckissack/cpsi/memmed.cpsinet.comfu88l 50a/data_5/tmp_cw5report2371263034716784470.html 9111 8A3/2020 tmp_cw5report2371263034716784470.html Invoice# Co ment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net CM2628 O8/1112020 07/31/2020 08/25/2020 -2,844.00 0.00 0.00 -2,844.00 CREDIT ��. 107007883 ✓08/11/2020 07/31/2020 08/25/2020 10,059.00 0.00 0.00 10,059.00 ✓ BLOOD Vendor Totals: Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLO 7,215.00 0.00 0.00 7.215.00 Vendor# Vendor Name Class Pay Code 53040 STERIS CORPORATION y� M Invoice# Comment Tran Dt Inv Dt Due Dt Check. Dt Pay Gross Discount No -Pay Net 8868595 ✓0713112020 07/27/2020 08/21/2020 25.63 0.00 0.00 25.63 y ` SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 53940 STERIS CORPORAL 25.63 0.00 0.00 26.63 Vendor# Vendor Name Class Pay Code T2539 T-SYSTEM, INC w Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 37277 ,j 07/31/2020 07/27/2020 08/26/2020 431.42 0.00 0.00 431.42 ERX LICENSE Vendor Totals: Number Name Gross Discount No -Pay Net T2539 T-SYSTEM, INC 431.42 0.00 0.00 431.42 Vendor# Vendor Name Class Pay Code U1054 UNIFIRST HOLDINGS ,jam w Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 8400338020 07131/2020 07/27/2020 08/21/2020 48.25 0.00 0.00 48.25 y% LAUNDRY 8400338019 7/31/2020 07/27/2020 OB/2112020 47.15 0.00 0.00 47.15 ✓ LAUNDRY 8400338044,,,97/31/2020 07/27/2020 O8/2112020 1,294.74 0.00 0.00 1,294.74 LAUNDRY 8400338398,07/31/2020 07/30/2020 08/24/2020 175.67 0.00 0.00 175.67 LAUNDRY 8400338423 07/31/2020 07/30/2020 08/24/2020 1,286.24 0.00 0.00 1,286.24 LAUNDRY ✓/' 8400338397,g761/2020 07/30/2020 08/24/2020 131.55 0.00 0,00 131.55,,- LAUNDRY 8400338415.01/31/2020 07/30/2020 08/24/2020 81.67 0.00 0.00 81.67 LAUNDRY 840033/3395 V6112020 07/30/2020 OBY24/2020 26.10 0.00 0.00 26.10 . LAUNDRY 8400338399 VAII/2020 07/30/2020 OBY24/2020 164.64 0.00 0.00 164.64 LAUNDRY 8400338400 07/31/2020 07/30/2020 08/24/2020 175.83 0,00 0.00 175.83i/� LAUNDRY 8400338440 07/31/2020 07/30/2020 08/24/2020 96.67 0.00 0.00 96.67 LAUNDRY Vendor Totals: Number Name Gross Discount No -Pay Net U1054 UNIFIRST HOLDINC 3,528.51 0.00 0.00 3,528,51 Vendor# Vendor Name Class Pay Code U1200 UNITED AD LABEL CO INC „! M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net r 469374568 .67/31/2020 07/23/2020 08/17/2020 92.28 0.00 0.00 92.28 ✓ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net U1200 UNITED AD LABEL 1 92.28 0.00 - 0.00 92.28 Vendor# Vendor Name Class Pay Code V1080 VICTORIA COMMUNICATION SVCf M Invoice# Comment Tran DI Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 6275 u,' 07/31/2020 07/24/2020 08/24/2020 53.50 0.00 0,00 50.50 SERVICE KIT/INSTALL PTT SIDE B Vendor Totals: Number Name Gross Discount No -Pay Net file:///C:/Users/mmeidasack/cpsi/memmed.cpsinst.com/u88l50a/data_5/tmp_cw5report2371263034716784470.htmi 10111 8/43/2020 tmp_cw5report2371263034716784470.html V1080 VICTORIA COMMUP 53.50 0.00 0.00 53.50 Vendor# Vendor Name Class, Pay Code 10768 VICTORIA MEDICAL FOUNDATION ✓ Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 163 " 07/31/2020 07/22/2020 07/22/2020 725.00 0.00 0.00 725.00 ANNUAL MEMBERSHIP DUES v' Vendor Totals: Number Name Gross Discount No -Pay Net 10768 VICTORIA MEDICAL 725.00 0.00 0.00 725.00 Vendor# Vendor Name Class Pay Code W1005 WALMART COMMUNITY W Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net TRO2422 07/31/2020 06/17/2020 08/11/2020 59.85 0.00 0.00 59.85 SUPPLIES TH02146,/07/31/2020 06/18/2020 08/11/2020 5.60 0.00 0.00 5.60 ✓ SUPPLIES TR07719 07/31/2020 06/23/2020 08/11/2020 56.80 0.00 0.00 56.80 SUPPLIES TR05237 07/31/2020 06/30/2020 08/11/2020 1.60 0.00 0.00 1.60 SUPPLIES TRO8407 07/31/2020 07/13/2020 08/11/2020 94.56 0.00 0.00 94.56 ✓% SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net W1005 WALMARTCOMMUI 218.41 0.00 0.00 218.41 Vendor# Vendor Name Class Pay Code 11400 WEST COAST MEDICAL RESOURC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net INVO59755 07/31/2020 07/28/2020 08/07/2020 20.00 0.00 0.00 20.00 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 11400 WEST COAST MEDI 20.00 0.00 0.00 20.00 R: [l Ofl SU 111,11'1) Grand Totals: Gross Discount No -Pay Net 227,832A4 0.00 0.00 227,832.44 APPROM ON AUG 13 2020 COUNTYAUD1TOg CAL$OUN couNTy, TEXAS file:/OC:/Users/mmckissacklcpsi/memmed.cpsinet.com/u8815Oaldata 51tmp_cw5report2371263034716784470.html 111111 LrtJYA,ATEi009/4-3/20' TIME: 09:06 Aw PpATTIIENT cdR@%-' 1;[7PAY$E2NA'M8L'��I°�T ------------ ----------------------------- ARID=0001 TOTAL ------------- ............................ TOTAL APPROVED ON AUG 13 2020 COUNTY AUDITOR CAMOUN COUNTY, TEW MEMORIAL MEDICAL CENTER PAGE 1 EDIT LIST FOR PATIENT REFUNDS ARID=0001 APCDEDIT PAY PAT DATE AMOUNT CODS TYPE DESCRIPTION GL NUN 031020 30.00 ✓ 3 081020 30.00 ✓ 3 081020 57.20 ✓ 3 081020 34.15 ✓ 2 081020 ISO. Do ✓; 3 081020 25.00 ✓ 2 091020 081020 25.00 ✓ 3 15.00� 2 091020 373.80 ✓ 3 081020 100.00✓ 2 081020 165.00 ✓ 3 081020 25.00 2 081020 30.00 ✓ 3 081020 49.32 ,/ 1 081020 35.52 ✓ 1 081020 198.00 5 081020 198.00 i 5 081020 43.62 2 081020 49.80 ✓ 2 081020 198.00 ✓ 2 081020 55.00 ✓ 2 081020 25,00 ✓ 2 081020 198.00 ✓ 2 081020 15.00✓ 2 081020 110.00 ,� 2 081020 198.00 2 081020 120.00 ✓ 2 081020 66.78 001020 ,�12 50.10 ,✓ 2 2670.29 2670.29 ✓ atle 0556709800364699700000000000600031 Account Number [toa/29�/2020 Nin Salem AdolmumAmountDae EnferAmobntPak •••• •••• 11 $0.00 $0.00 JASON W ANGLIN CALHOUN COUNTY 202 9 ARM STREET SUITE A PORT LAVACA TX 77979-4204 Citibank P.O. Box 78026 PHOENIX, AI 8$0624025 ------------------------------------------- CITIBANK CORPORATE CARD Previous Salancb Pa nls sad z".. New chews New Helena, CmdRUne $0.00 $325.6D $2,743.50 42, 417.90 $20,000.00 For customer service call or write 1-600.2484553 Citibank P.O. Box 8125 Sioux Falls, BD 67117 Send payments to: Citibank P.O. Box 78025 PHOENIX, AZ 85062.8025 Statement Date 08/03/2020 Payment Date 08/22/2020 AwounlNumber Cash Advance UmlP Available Credit Una Available Cash Une^ •••• •••• • $0.00 $20 000.00 $0.00 Safe Pow Oa la bate Reference Number Type ofAcffW Amount "'•••"'••••••`•"'•""•"••"•••••..........•^"^^^'•'•"'NOTICE MEMO ITEMS) LISTED BELOW.••••••'"••^••"•••.'•'.'•'«.«••+••••.•••..•^•..•..*+••••+•••.+ 07/14/2020 07/15/2020 55432860196200419333694 AMEN METE OS MV5TU18R1 ANZN.COM/BILL NA $104.00 +/ 113-0706423-77402 v; 07/17/2020 07/20/2020 75454910199017480338928 SCREENFLEX PORTABLE PA 847-7262900 IL v$1,557.00 ` 07/22/2020 07/22/2020 55432860204200331233436 AND, CREDENTIALING 800-621-8335 IL 07/21/2020 07/23/2020 05436840204300190042309 BTS THYSSENERUFP 770-799-0400 GA 1/144.00 68. so i 6390003665 07/22/2020 07/23/2020 55429SO0204852958324869 PAYPAL NAREC 8663061961 MI // /y400. 00 V` 95832486 07/24/2020 07/27/2020 55429500206713588839486 VITALITY MEDICAL INC 18017334449 UT 5225.60 CR 07/213/2020 07/28/2020 55432860210200795714465 ABTA CARIMIALING 800-621-0335 IL , 07/28/2020 07/29/2020 55429500210852276035603 PAYPAL NAREC 8663061962 MI �41/26.00 CR 07/30/2020 07/30/2020 55432860212200291504099 AMA CREDENTIALING 800-621-8335 IL v$1D0.00 $44.00 ••••••••••••••-—'--------TOTAL AMOUNT OF MEMO ITEM(S): $2,417,20 ACCOUNTSUI, y Purchases Interest CURRENT PERIOD Previous Balance Payments Credits and Advanaa Channe NawBal... Purchases $0.00 $0,00 Aduanas 00.00 $0.00 TOTALS $0,00 $0.00 DAYS IN BILUNGPERIOD: 031 pumnaaac $0.00 cash A4vanaae Payment Due: Amount Over Credil Umll: $0.00 $0.00 Balance Sub)acl To Interest Charges > $0.00 FOOD& Rate > .0000% .00DD% Amount Pest Due: �I� APPRO • •440.00 ANNUAL PERCENTAGE RATE > 0.00% 0.00% MINIMUM AMOUNT DUE: ON 80.00 Cash Advance limit Is a potion of your Total Ciedil Urte ••Available Cash Una 1s a pardon ofyourAvallable Credit tino AU ii 13 2020 Page t of 2 COUNTY AUDI•POR CAIROUN COUNTY, TEXAS MEMORIAL MEDICAL CENTER PURCHASE' ORDER Bill To: 815 N. VIRGINIA ST PORT LAV P,CA, TX 77979 PHONE: (361) 552-6713 FAX: (361) 552-0312 Vendor Name: Vendor Address: Vendor Phone #: Vendor Fax #: Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (36611) 5552^2-0312 Date: P.O. # Account # Initiated Date Required Expense# Department Deliver To roam n yru 1 Line Na Qty. Catalog Number Descri [ion p Unit Cast Unit Maas. Extended Cost 2 I & wt -e- ,/v Y&, 4 5 t C�tJC 'nip �- UI�r a t4bD-00 6 is U t - Li it. g ;• 0 V I a(p.v 10 W f qq Est. Freight a v _ " _ . .. . NOTES: 8 — MM Est. Total Cost c- TOT -AL GOST p 1A21 in�twtan poi 0�• bl�l Sc..vfmfloc-- metl lt. PAY. CA)vto 1'fi 155�. pll vikaV V&,u aa�•�o� - �—• Q�luyltt flzriuc. if H1� Uitut, hrft1tta � Contact: Date: Quoted By: 13uyw.. Dept Director Dir. Niusing E.T& Adm.bir. 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ON EE 'o ` ( W �)\ |!s, \ k�(j§ / , §k 2 k \( § UInvoice Number: 3041169056 P.O. Number: 157609 1 of 1 AmensourceBergene INVOICE Invoice Date: 08/1012020 Order Date: 0810812020 SKIP Date: 08/0912020 SELLER BUYER AMERISOURCEBERGEN DRUG CORPORATION WALGREENS #12494 340B 012494 1300 MORRIS DRIVE MEMORIAL MEDICAL CENTER 100136284l037028188 • CHESTERBROOK PA 19087 1302 N VIRGINIA ST ' PORT LAVACA TX 77979-2509 142.16 08121/2020 STATE LIC: 26453 DEA: FW1512296 AMERISOURCEBERGEN DRUG CORP MEMORIAL MEDICAL CENTER Monday -Friday due in 7 days 12727 W. AIRPORT BLVD. 815 N VIRGINIA STREET SUGAR LAND TX 77478.6101 PORT LAVACA TX 77979 AMERIBOURCEBERGEN PO BOX 906223 ' STATE LIC: 9084977 CHARLOTTE NC 28290-5223 DEAD RA0289278 CD 1 EA BUPRENORPHINE 10MGGMR PAT 4 RPH 3 AD 10177802 4265BO493AO unit EM,nded 142.16 142.16 669400 _ For Med Guide, search NDC at htV/Idailymed.nlm.nih.gov/dallymadt 1 Total Number of Places for this lavolce Product Sumst RuGwes RX Cost OTC Cost Baled CUP % 0.00 142.16 0.00 0.00 0.00 DI866 C.Moolbd54bs1anoes R%Ph81rn808N108H GM Genial Merchandise AMM PAm PPIiw Chwpa(lWttin PutWdapl Codes 2. 2N, 3, SN, A,b I OT Over Ne Counter Me Medical supplies HB HeeBha Beduty LC Listed Chemlcah On - Legend OOncsuded Pow bAgo Pow RPir.d Pdw i8u mx Xm- I ...Iem Total Amount: 142.16 TaNIC.000 ala dlaldhutoL pre membw efN pr8M Wpoles product alms o puwhaxtl Ne protlucrtlironty Mom the menu0nureq exlusive dindbulprol Bic manNlanurer. or repecMeperlhel pans iBRllale 202055dbplpr. IOOG:dM[W31a1JIpH3 1mdm TypalFe gtlerT lw: 290a M1dp8091915M of 9l Terms of sale and Gaims on nexlpa9e next U^L. z :} it >> ,. APPROVED ON AUG 17 2020 COUNIYAUDITOR CALROON COUN9'Y, .rEXAB zInvoice Number: 3041169055 P.O. Number: 157808 1 of 2 AmerisourceBergen° INVOICE Invoice Date: 08/1012020 Order Date: 08108/2020 Ship Dale: 08I09/220 SELLER BUYER AMERISOURCEBERGEN DRUG CORPORATION WALGREENS 012494 340E 012494 1300 MORRIS DRIVE MEMORIAL MEDICAL CENTER 1001352841037026186 CHESTERBROOK PA 10087 1302 N VIRGINIA ST ' PORT LAVACA TX 77979-2509 254.39 08/21/2020 STATE LIC: 26453 DEA: PW1512296 AMERISOURCEBERGEN DRUG CORP MEMORIAL MEDICAL CENTER Monday- Fddaydue in 7 days 12727 W. AIRPORT BLVD. 815 N VIRGINIA STREET SUGAR LAND TX 77478-6101 PORT LAVACA TX 77979 — AMERISOURCEBERGEN PO Box 905223 STATE LIC: 0064977 CHARLOTTE NC 28290-5223 DEA: RA0289276 1 EA ALBUTEROL SULFATE HFA 90 MCG INH 353M TEV RX AO 10211325 00093-3174-31 11.59 11.69 845412 1 EA ALBUTEROL SULFATE HFA 80 MCG INH 8.5 GM TEV RX AO 10211826 0009M17441I 0.00 0.00 845412 Shod Supply Item 1 EA FAMOTIDINE 40 MO TAB 100 TEV RX A IN08510 00172.5729E0 075162 Shen Supply Item Antidpaled Delivery Dale 0910M020 3 EA FARXIOA 10 MG TAB 30 AST RX AO 10146856 00310.6210-30 0,31 093 3WS48 1 EA HYDROCORTISONE BUTYRATE 0.1%CRM 45 GM 9-L RX AO 10163549 686020.27046 40.66 40.56 519987 3 EA JANUVIA 100 MG TAB 30 MSD RX AO 100515M 000064277-31 0.31 0.93 798160 1 FA OZEMPIC 0.25MG46 MG PFP 1.51ML NNP RX AO IOIMS67 001694132-12 105.14 165,14 716546 1 EA PULMICORT FLX 180 MCG INH 120 AST RX AO 10063823 00186-0916-12 001 0.01 844973 2 FA TAMSULOSIN 0.4 MG CAP 100 ZYO RX AO 10006715 083320-132-01 3.47 6.04 059238 11 Invoice Number: 3041169055 P.O. Number.157608 2 of 2 AmensourceBergenx INVOICE Invoice Date: 08/1012020 Order Date: 08/08/2020 Ship Date: 0810912020 Number pum, Amount i EA VALACYCLOVIRiGMTAB90 MYL RX AO 10010052 00378427647 2a29 28.29 087833 13 Total Number of places for this invoice EWAG1 Sum m 139aliku RX Cost OTC cost awall 0.00 254.39 0.00 0.00 0.00 C1d66 ConWlled 6ubstendes RA FMmleaeuHtOls GM General Membandise A uMed gpCon✓, nlnee etr" puts04sas1 Codas 2.2Nonll54.5 OT Owrlhe Counter MS Medial Supplies CO-L090nd pd[e 8Sex. bid 1k.prw Is aRogninM. PoR HB HeeMBaeaNy lG Mated Chemke4 "a PdR ZSuRrMPAO TTmallollem Total Amount: 254.39 hilwho1esaladlllrlbN4f. ore memberaflhe aMlielea❑uuM1 whalesela dislnbulOr, pu¢hased Mb producldVaayfromtha111anuladurer,ex4uslyetilidbOoro/themanu/aNurar. orrepeobagerlhefpmchea0d Iha pmdud dirogq hnmthemanabaurer A¢[ 100IM84 WALGflEEN81112191]IOp TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" FTIF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" E_T6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #### ENTER: _ ###I— u 941 # 0 �' 20 '* 09 0 $ 100,239.78 1 $ 50,613.34 $ 12,091.20 $ 37,535.24 CHECK S CALLED IN BY: CALLED IN DATE: CALLED IN TIME: FAAP-Payroll Files\Payroll Tsxes12020*17 MMC TAX DEPOSIT WORKSHEET 08.17.20 RI -xis 811712020 Run Date: 08/17/20 MEMORIAL MEDICAL CENTER Page 114 Time: 11:26 Payroll Register ! Ei-weekly P2REG Pay Period OV31/20 - 09113/20 Rua: 1 Final Sumnar/ '-- P a y C c d e S u m m a r y-----------------------------------------•-- ➢ e d u c t i 0 n s 5 u n m a r y ------...... PayCd Description Hrs IOTISHINEIHOICBI Gross I Code ATount ........................... ........ .....------------------------------------------ ............ .-- ........ .............. --------' 1 REGULAR PAY-SI 9492.75 N N 11 188922.20 A/R 1055.53 A/R2 105,00 A/R3 1 REGULAR PAY-S1 2009.25 N N N N 85767.34 ADVAIIC AWARDS BOOTS I REGULAR PAY-S1 317.50 Y N N 6712,94 CAFE H CAFE-1 CAFE-2 2 REGULAR PAY-S2 2S14.00 N tl N 57121.74 CAFE-3 CAFE-4 CAFE-5 2 REGULAR PAY-S2 9.25 N N N N 2V A6 CAPE-C WE-D 1798.46ZFR-F 2 REGULAR PAY-52 170.50 Y 11 N 5362.55 CAFE-E 20551.21-CAFE-I CAFE-L 3 REGULAR PAY-S3 1510.75 11 11 N 39625.01 CAPE-P CANCER CHILD i REGULAR PAY-S3 14B.25 Y N 11 6049.94 CLINIC 35.00 COMSIN 438.97 CR£DUN C CALL PAY 2370.75 11 1 N 11 4741.50 DD ADV DENTAL DEP-LF E EXTRA WAGES 11 1 tl 11 N 2368.75 DIS-LF EAT E.ATCSH F MISRAL LFAVE 22,00 11 1 N N 348.42 FEDTAX 37335.24 FICA-M 6045.60 FICA-0 25306.67 K £%TENDED -ILLNESS -BANK 24.00 N N N N 271.20 FIRSTC FLEX S 4763.43 FLX FE K EXTENDED -ILLNESS -RANK 402.15 N 1 N N 945E.85 FORT 0 FUTA GIFT S 83.10 P PAID -TIME -OFF 554.48 N 11 11 N 11o57.48 GRANT GRP-IN GTL P PAID -TIME -OFF 1071.27 tl 1 it N 27951.16 HOSP-I ID TFT LEAF X CALL PAY 2 160.00 11 1 11 N 32OAO LEGAL 358.16 NASA 927.50 PILALS 262.82 Z CALL PAY 3 HAD N 1 11 11 288.00 MTSC MISC/ 1511SMA o PAID TIME OFF - PROBATION 92,00 11 ': N N 1532.40 NATFNL 2111.2E OYNER PHI PNI•*. PR FIN RELAY REPAY SANS SCRUBS SIGNON ST-17 STONDF 640.86 STONE ST01122 STUOEN SUNACC 963.25SUNILL 1323.28•S@ILIF 1248.48 SUNSTD 1700.85'4UNVIS 1269.61SURC4G 165.00 TSA-1 TSA-2 TSA-C TSA-P TSA-8 31510.35iTUTIOtI CNIPOP, 1489.34.VM/HOS -1.00 •-••••--•-•-••------- Grand Totals: 2096E.50------- 1 Gross: 450147.2E Deductions: 142397.99 Net: 307759.29 i Checks Co,.mt:- FT 204 PT 7 Other 42 Female 226 Male 25 Credit OverAmt 6 ZeroNet Term Total: 251 1 `------------------ '---------- '----------------------------------------------------------------------- --------'------------- �. Pal da+e: 09.21-4v :o m r h m n n a o �d1p b ry N vpi N m W� m n C al C tii N N OO eF O1 O M rtl N m m pj yj {] m 1ll n�O�n.N-.emu rv+, iOno`° p eV .Nin N e m lre m n a W N N a w W W W ai N W 4L LL LL LL LL LL LL u, n n N L' C C C C C C C F W W O Ti•N a E. 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Reference Number: 224201OD541 Date and Time of Filing: 08/11/2020 03:36:46 PM Taxpayer ID: 17460034113 Taxpayer Name: MEMORIAL MEDICAL CENTER Taxpayer Address; 81S N VIRGINIA ST PORT LAVACA , TX 77979 - 3025 Entered by: Sarah L Henderson Email Address: shendeMan@mmcportievaca.com Telephone Number: (361) 552-0342 IP Address: 24.116.195.218 taking credit to reduce taxes due on this return? Taking Licensed Customs Broker Exported Sales Did you refund sales tax for this filing period on Items exported outside the united States based an a Texas Licensed Refund Satea Customs Broker Export Certification] Tax? Lac Total Texas Taxable Taxable Subject to State Tax state Tax Subject to Local Tax Local Tax a Sales Sales Purchases (Rate.0625) Due Local Tax Rate Due 00004 14,407 14,407 0 14,407 900.44 14,407 .02000 288.14 Total Tax Due 1,188.58 Total Tax Due: = 1,188.58 Tlmely Filing Discount: - 5.94 Balance Due: c 1,182.64 Pending Payments: - 0.00 Total Amount Due and Payable: c 1,182.64 (State amount due is 895.94) (Local amount due Is 286.70) Payment Summary State Amount: 89S.94 Local Amount: 286.70 Amount to Pay: 51, 182.64 Electronic Check: $1,182.64 Payment Reference Number: 22420100539 Trace Numbert 37745265 Type of Bank Account: CHECKING Accountholder Nama: PROSPERITY BANK Bank Routing Number: 113122655 Bank Account Number: ••^""••"4357 Payment Effective Datei 08/20/2020 Print Remmto Menu Flle for Anther Taxpa er texas.eoy i Texas Records and Information Locator (TRAILI State Link Policy i.. Texas Homeland Security i Texas Veterans Portal Glenn Hagar, Texas Comptroller • Home . contact us PrivaCv and Security Palen Accessibility Pohcv I k P i Public Information Act Comoae: with Texans htips://myepa.cpa.state.tx.us/salestaxweb/GotoSuccess.do 8/ 11 /2020 8/1 &2020 tmp_cw5report6662570649575757218.html a 1 lit, V 08/13/2020 AP( 10:11 '1U1�3 t ,� MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: 0 ap_open_invoice.template Vendot_rlyt:r.,q;t. ,vtlOtY 1'L09�itolendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PAF Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay, Net 081020 08/10/2020 08/10/2020 08/27/2020 5,280.00 0.00 0.00 5.280.00 TRANSFER hJF jhS WA(L VqK i dtro,$j-1C1 jK}j ak(_ o7C,h-+'>� Vendor Totals: Number Name Gross Discount "'Co -pay Net 11832 BROADMOOR AT C 5,280.00 0.00 0.00 5,280.00 t7 tpol t t ummnr;, Grand Totals: Gross Discount No -Pay 5,280.00 0.00 0.00 APPROVED ON AUG 13 2020 COUNW AUDITOR CAMOUN COUNTY, TMM Net 5,280,00 file:/f/C:/Users(mmckissack/cpailmemmed.cpsinet.comlu88150aldata_5ftmp_cw5repon6662570649575757218.html ilt 811312020 ' tmp_cw5report6787635815728899413.html 08/13/2020 MEMORIAL MEDICAL CENTER 10:09 r�i96 �d ?(Ir.f1 AP Open Invoice List 0 ap_open_Inveice.template Dates Through. VebdA�#•?43;3 �f'e0i5aE+_90.t{9 Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net 073120 07/31/2020 07/31/2020 08/27/2020 3,278.39 0.00 0.00 3,278.39✓ TRANSFER NN 111Sutr0ue pylKk dept]Siird irt-h PAkL. Dpjri,+W\ 073120A 07/3112020 07/31/2020 08/27/2020 1,002.68 0.00 0.00 1,002.68 ✓ TRANSFER NN iY4SuYwYu,L- fyYx..� dcposr kCA " I&Ili&L (JVt "_6 Vendor Totals: Number Name Gross Discount Pay Net 11836 GOLDENCREEK HE 4,281.07 0.00 0.00 4,281.07 N,ypert Summary Grand Totals: Gross Discount No -Pay Net 4,281.07 0.00 0.00 4,281.07 AUG 13 2020 COUNTY AUDITOR CALEOUN COUNTY, TEXAS rile;//IC:lUsers/mmckissack/cpsl/memmed.cpsinet.00mlu88150a/data_5/tmp_cw5report6787635815728899413.html 1/1 8/13/2020 tmp_cw5report7815353498921225308.html 08/13/2020 _ MEMORIAL MEDICAL CENTER 0 ,o:,, AP Open Invoice List ap_open_invoice.template Dates Through: VeSddf#crdr'd1 �L'r�eala; l,,: ixdr!lta,,, Vendor Name Class Pay Code 12696 - GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay 080420 08/10/2020 08/04/2020 08/27/2020 27,602.08 0.00 0.00 TRANSFER 20� p� � �`T"� 0�,280L.00 080520 08/10/2020 OB//06 2020 08/27/20� 0.00 0.00 TRANSFER lfW-1 yt$UlM�1(A- �N�.�' C�fgB ryL��L �-rp hAV(_ oiler Vendor Totals: Number Name Gross Discount No -Pay 12696 GULF POINTE PLA2 32,882.08 0.00 0.00 NepoIt.Sunmlwv Grand Totals: Gross Discount 32.882.08 0.00 APPROVED ON AUG 13 2020 COUNTYAUDPPOR CALHOUN COUNTY, TAX" Net 27,602.08 5.280.00 % Net 32,882.08 No -Pay Net 0.00 32,882.08 lilea//C:IUsers/mmckissock/opsilmemmed.cpsinet.com/u8B150a/data_51tmp_cw5report7815353498921225308.html ill 8/13/2020 tmp_cw5repart8427239608965795642.html 1- � _1•e i 2 08/13/2020 " '�""' MEMORIAL MEDICAL CENTER t 10:1Q{�j� ; �h�llil AP Open Invoice List Dates Through: 0 ap_open_involce.template "W"I Vendor Name Class Pay Code iaooa _`ar:g1,U `1;11r/i trrr TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay 073120 07/31/2020 07/31/2020 08/27/2020 N�uI� 23,730.01 0.00 0.00 TRANSFER�I jNkkWPjL f V "+ALP6 vital, jK+ MW_ l.r/tjA `��(/ 080320 08/10/2020 08/03/2020 08/2712020 2 506 91 00f,,, �. 0.00 TRANSFER NH jYiSWMLp�M11 dcplsi+L�l (K Mom- i)r)6"-X 060420 08/10/2020 08/04/202101''�t08/27/2020 ff _'rr 15,211.59 ��ry ��0 00 U 0.00 TRANSFER N W � : L. µ1'� jql) (kj I0-u � "I""" Vendor Totals: Number Name Gross Discount o-Pay 13004 TUSCANYVILLAGE 41,448.51 0.00 0.00 Grand Totals: AUG 13 2020 COUNTY AUDITOR CMMOUN COUNTY, TEXAS Net 23,730.01 2,506.91 15,211.59,, Net 41,448.51 i2u0ri :'.ULIiO�;'Irp Gross Discount No -Pay Net 41,448.51 0.00 0.00 41,448.51 file:11/C:lUsershnmckisseck/cpsilmemmed.cpsinet.comlu88150a/data_5/tmp_cw5report8427239608965795642.html 1/1 Memorial Medical Center Nursing Home UPL Weekly Cantex Transfer Prosperity Accounts 8/17/2020 Prarbus Rwunt er91rmm9 A. nan Name Numbee 0a6nse TaamlW. tan i UandaP.ln 9su 53.476,33 53,314.90 .i 111,829.16, Rou[Inalnbrmonanbr AlhraMaofdens: A4hfar1Neaah Cafe Cenler Md Co 2P Marvan Chase Bona 36.393.47 36,2S4.37 ✓12,965.33 J 17,937.N 17,803.97 IS,730.51 22,5.1433 ✓ 22p29AI /1.759.62 / 1 0%219,fi1 82,984.0E s/ 62.fn5PB ,%� Rashns, Onfannobant A, Crnce,11 5,jPq of PPU suvUm / Coal" Nwlm ColeCennrt Ilr t 6 1P M.'an can's Bank Nole: R+ly6alonm o(ortr $S.PA,nilde panlJNlr01d Mrnunmghm:e Note 2:900 erwml has o bve bonnae ofSwl worMMC deannled taopen-sounr. i \NN WnkN nanehra\NII UPI T,ander Summary\2W01Au t al\!M UPI render Summary eJ2la do Tgdayt AmovnttoeeTmnalme4w N ask.. HYMt Up o11Y 11L990.79 .% 131,53430 Bank Balanse 114990.79 ✓ V.1 ann tei9e to balance utew Opp 1,2,3,4 Ssupw 2%.w ✓ 1u191nteren 61.43 Asaug nletlat Saptemberinte na Munn B91Ai Rwntler Amt 111,534.30 y� 13.101.43 j 12.%5.33 Bank Babnn 13,104.43 ✓ wnsnn wavtln6at se 1M.00 CUPP 1".1 & tap!! Radial41PP A to MMC 191ymterest 39.10 f A."Isstlaetl S l"And OlOtlntt Adjust Ba1anse7rmmler And 131965.33 ✓� 15AB4.53 15,710.43 tank Babnse Vananee tearalnealanse 4pP1,2A,461aPK I00A0 WAS Pmdint Glpp AwMMC wlYlnler.R Mal AYBURIniNl11 September lntew4t Adjust Balmse/rmntler Amt /" 15,I10A3 h./ S,074,7A 5,675.80 Bank Babnse S,074.74 Varnpee Ilan In balance 100.00 CUPP 2.2.3.4& lapse 838E ✓ PendIn801PP Au MMC 3u191maeaN 15.Q AuNn saftnst 5aptembeth atast Adjust 9abnat/rmnsfer Amt / 5,05.W V/ 62,1a9.64 61,961A0 Bmk Bllmse 6211618.1 t/ Van.M. leave In Galante IwaD CUPP L1A,44Laos. 7aoe ✓, APPROVED ON PM01a1801PP A to MMC )a„Inta.etl I1.56 v1 AUG 17 2020 Aa4VRtntl«st Saphanbeellnarast COUNTYAUDITOR Adjust BalnNa/Twmla, Amt 611961.00 /CAMOUN COUNTY, TMM TOTIOTMNSPEAf 107.546.86 APPrOvltl: a !U lawn Anna Cho i 1 8117/2020 F \f111 WxSle IunJngwnS oo«Mfiiev]abxauR0i11\ioryn\ryneinl On«nm>a eda3a Mm R.I41o..x. 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J 1{{.H9.%` 11A.W Sim MAO %.IS b9iT IISS%% MMCPoRNON w11/MmpJ feM[M[nlri III /m1" (VI w11/(amli w11/4m19 6ICA. wNT NN IORTON U6.W I16W 1,934 91 2193893 IO,W6]D . J,Iw.W i;W.W - 1,550.W - 535030 ]6,iH31 ✓12.96S.0 yJ IL962.0 MMC90RnON wlllwmPJ r[nr]_ In.oul 11[111,14 wPP/C ll OIWMA I 41N/Cnn0 NIMw wpPN NNPgNOX i91N - 391H i,J59S9 1lulse I,ULSI - LN3;1 1W1w - 16.19 IUO Ads 2oAR 9.w U,]H 69 - IL31869 U.Nl;2 1'f15.79041 ! ILW 415 6A0 L00 M.q IS.l10.M MMCIAMMAN wN/w pJ Tn1T�}ji S3�Li innrlNn w4/6nP1 wN/Gmp2 w11/Cmpl Uqu wNT XN bFNON 6w966 16,1015 - 1.247.18 - IIO.m MR IS,W law It. 43.1 I'm - 1A0112 �S.)f9.42 UAtlL S6A2 IS.W 2BL0 II.W NlE 5;12A0 MMCpgVON wPP RJOfltlyyl ][[nUrt.ln VIIP/Cvn91 M!/CnvpJ 41N/CmN a=1JpM w9P 91 NN 90RT4N a,Iq;B - A189.19 - 1,.91 I6,IN.96 5,922912.99 9,9i199 S,ISOLi 991 is 9y165 Hl.l] 9,97J H 10.t 9Rq so 93,011 1J.W 21.f4 9.00 ]Aq 111 iJp5.16 - 16 1,E95.16 IO,M) 10.95L64 . d,lll.1/ - J,111.19 Y.1NL9 ✓ 6]:0%.q - 17 f2W ILW LAB 9D0 IJAp 6LKLW -i4uLIB %9,]19.90 in" "IS IHB] W." 411134 "I'SA.n 8/1712020 Quick View Select Quick View Accounts Account Number 1 Name Account Type Siialchilr All Treasury Center Select Group Grou s Acd Group DDA Data reported as a1 Aug 17, 2020 8 Account Number Current Balance Available Balance Collected Balance Prior Day Balance ' '4381 MEMORIAL MEDICAL $111.990,79 5163,856.61 $111,990.79 $58,33795 CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL S13.104.43 $54.783.27 $13,104.43 57,554.03 CENTER I NH - BROADMOOR '4411 MEMORIAL MEDICAL $15.86. 53 $32,033 53 515,864.53 $4 469A9 CENTER/NH CRESCENT - *4446 MEMORIAL MEDICAL 55,874.74 $26.190.43 55.874.74 52.362.30 CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL S62.169.64 $8$756.14 562,169.64 543.612.36 CENTER I SOLERA AT WEST HOUSTON - hltps:ilprosperity.olbanking.com/onlinaMessonger ' indlr.3les , pan0 I)ef10f:110n UII 06�1 %!� 92e 11 ? I 1/1 Memorial Medical Center Nursing Home UPL Weekly NeAlon Transfer Prosperity Accounts 8/17/2020 Accents Routine mlarmatgn foe Golden Cnek Nalon Health at Guerra Creek WeNt Forgo Bank, NA. Prevl.., 8glnning Balance hans`ee �Tonshn0 BJ,330,82 83.973.13. 52,SSB7l Nate: Only habaces o/over $SWO will be Iran[rermd to the nureing battle, Nate 2. Each ac.unt has a base balance of $20 chat MMC dspaNhd to open account Pending TodaTs Usual, Amount to Be Tumlerred to Nursing 0ebo111te gala.. No.. • 52,693.34 % 52,555.77 Bankeelaa[e 52.693.3J 1/ Wrlanro - Lane. In solstice SWAG Pending OIPP h. MMC OIPP 5,2,■ 3 OIPPe Is LAPSE % July lot anrt 33.67 ✓ AM.Stlakwect September 044,411 Adjust BaUnteyTransleMnn 52.555.77 ✓ AvAnavoll, Jason Anglin,C60 O')IIVII/2020 nLr�Y/ APPROVED ON AUG 17 2020 COUNigAUDrrolt CALHOUN COUNTY, TEEAH f:%NH Weekly TramlacgNN GPl Transfer Summary\R0uy Aagakt\NN OPL Thmler Summary 6,I7-20.0br MARC PORTION w"ARRR Ol xN Si.f,,4 I an/Cemol Nry/C—la 011/Cbnpl .p. g,AU PORTION s/lulolu um w u,vl.a R/Il/IOIO WIRE ORMEXR1ONNC(IH AT GO G]4Mill00W ll) IPH'1'((]543K13'lllblY011i'MM40111 41l/1010 WIRE 011]NFYb11NGt1H1i G010lN CRlSk 19.L061 042/20200epREt SId6f.iB . 31,]63J3 {1.3]1.1f SLSR.]] 3;533.1> L199.99 1.139.m 811712020 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups And Group Account Type _ 5enrch Ail - 7A Data reported as of Aug 17. 2020 8 Account Number Current Balance Available Balance Collected Balance Prior Day Balance 'Ja54 MEMORIAL MEDICAL t SS2.693.34 $53.830 3a S52.693.34 S52.693.34 t NH GOLDEN CREEK HEALTHCARE - nnps'aprosperity.olbanking.COm/onlinOMesseng er mdmalcu rc Pnry genommn mi o811?2020 at 9 1/1 Memorial Medical [enter Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 8/17/2020 RlYIW. MWpmmaa M[Wnt 9eaNMn( pMdhIn[IlMprp NIVW Mm! u.nW. aaW[v ilinlmWt rTnmfervM [Yffklretl Ce ut ura 1 rM I.M. ([Iwn XunN NdXe 1p.1i3 W M.6}XFt 1J6X.'li 2,]]I13 LiG:1e Dan\BaYnn }.!}U} Xvrnnler Ylflan[e lnrl In BlYnl! IW.M 0113,41. W'.1 wa pfndin(NH d u,MMf J*lnnml lea MpllmE!/Inlertal MyY11Wwn(nanalf[pml },IN.)1 ✓r pMwf LmwntlYN 4ccw , Nsu[nYM Mnllnf N...". lu Nunl Nwnt NumCa1 w.93 !}ranfln-0ul Tnminin fif tllmd Pt r fpe 4'nree HuN N!M Sf,Wl91 S},pS.tS 1.091 e5 1,}}4 31 Ban.on n ,nncltl Ya/1.... [nn o40 Nae:Onlvuvlvn esv/en/SS0.tlw,4MNenr/errctllo l/vnuninplromn Nate]: FvNw[vunrlle[ vEv[e Evlan[evl S} W,M1tt MM1lCpew[rtrdry opm auumi. Ionan Btlm[e IPLW wwkg Yaef rypF.4Npli IWYrntmat }fA6 ./ WfYMIMImt MWlmMflrNMt / Hqun ulM[.rtMf}u11mt LWlts ✓ Tmuruwsssxs Fpp—M' I.wn Mallgao 0/17/}0}a APPROVED ON AUG 17 2020 COUNTYAUDTTOR CAMOUN COUNTY, T=" eVlxwttlMu.nxernxnunnnner summanW}OJufuvµx uttnamrnpumm.rypaa}o.[M 8/15/1030 C6tt515 0/14/2020 HUMANA �NSCO HCCINMPMT62498185WMS1SS30 THU-I' W I29MSISTRI60-139126347A MMCMICTION CRPP/Camp16. NH TH"'IAut TUNI&I-I I WPP/Campl QIM/Camp2 WPv/Cemvl UNA Own PORTION 29.62841 2.168. 2.169.74 29,6L.11 2.151.13 S.161.14 IMMC PORTION QIPP2CAmPCfl NH 7N4/e1-0ut T ePT I QIPP/QUPPI OIPP/CA'P3 TI I PORTION � 1/121NIM WHO OUT HMG SERWCES, UC 57,625A5 8/14/1020 HEALTH HUMAN SVC IICCIAIMPMT 174600311130132 TRN4•OSR6i221922027W 1146000l 1.09195 I.W BS S7,815A5 2.0"M 1.09465 67.503.16 3126359 17049 6/172020 Quick View Select Quick View Accounts Account Number / Name Account Type Saamh Jdl DDA Treasury Center Select Group Grob s Add Group Data rebutted as of 441 MIMIC -NH GULF POWTE PLAZA - $1.224.31 St.224.31 $1.224,31 $12946 MEDICARE/MEDICAID 'S4:13 MIMIC -NH GULF POINTE 52,273A2 512644 75 52273A2 5104 66 PLAZA- PRIVATE PAY httPs://prosperity,olbanking.comlonlineMossenger nJ¢.ees PagC yeneraleC bn d8!' T262n n1 P 111 Memorial Medial Center Nursing Nome UPC WaNy TYYeny Tamfer Frenferlxy Attouna 811713030 I,.,Mn. Mnwwl,aY uu.n Mll,.ws / .uxa Yawxfu au uu In... =:osal L MA.ls wuu .o.Ufl. .THl}s ,pfxaY M,u).0 es bunt. .nnvo. t,J sm..fmnt. :mm Nmf aYMM Pose rwwnelrrsw MMebnb.Ylll IA.4M. 1WrF,mw >Jl m4 fryuMxFlxxt YM.t 4xwlf,wM MI .nfL.Y Zx 9wr.vaw. Hfw.ff.a0-1..,,..p.m 1. w n.mnr... su. tful sau. 11v.H.1 iq—of tl M,en nuuxpv nai.n«min, Mm.Yi{Il..ao Ik-I APFWVED ON AUG t l�ti8i courM AUM01t comet, )tetiF CALHo B)10/2020 NOVOAS SOLUTION Mtt1AIMPMT 878201420000I23TRN't•E BIW2020 WIRE OUT LINEAR ENTERPRISES, U.0 8/12/2020 Deposit 3/13/2020 NOVITAS SOLUTION HCCUOMPMT 676201420000101 TRN'1•E 8/14/2020 Enhanced Analysis Ch 8/14/2020 BS IRMN ADMINIST HCCLAIMPMT In 111000024297TI111-I' L MMC PORTION pIPP/C MP4 Tmns(e7Out Ten er•In IOJPP/U.pl QIPP/Camel QIPP/Cnmp3 &lapse pIPPN NH PORTION 8,730.80 - 8.730.110 M,704.88 - 17,22S.60 17,225.60 - 756.94 - 7561% 40.00 13.955.00 - 13.955.00 54,744.88 40,668.39 ✓ 40,66834 an 7.2020 Quick View Select Qulck view Accounts Account Number! Name Account Type. Treasury Center Select Group Groups ACa Group •3407 MMC-NH TUSCANY $40.73221 566.266.60 S40.732.21 S26.817.21 VILLAGE indirates It Pa70 generaan , 08' H 7W2e w g hnos:rlprosperny. olbanking.cormenlmeMessenger M Memorial Medical Censer Nursing Home UPL Weekly HSLTransfer ProSperisYAccounss 9/17/2020 v.niw. "curn.e. Menw1 p.Mlq 3nm4mtll. PA. / XUMn NM• _N.04e • in • OM ml.nln �. Cl.wtl De Ot Tel. ta• fiMn Nl.rc• Nun Nvm• 33,a31.02 12.73E.1, 117.75].x SI3• 317.757.34 .Asuann 27..16331 tlmve lelveln 6.Nntt IW.W N)e1.)M03 1JYIM.ntt 450 •uryYlMemt xa•n4.umm� Xljw3 WlnnRnml..Lnt Et).1533e Xp.: dYybY:uMn efOWr55.bbi„iI1W rlonlf[/Ill to fAewn.n9Apne. NeMi; FxM1M[vw[hvmbmebvlwnvf510)thvrMMClepeublroepena[[avnt. X .M IOw Prylip(FO !/1]R010 APPROVED ON AUG 17 2020 COUNTYAUDUOR CAIXOUN COUNTY,T[MU r Vmw..lM i..numvnf an o.nu«suinm,nVOtauurvnlryX un u.n,h.suam.rcsn.]a.y. MMC PORTION gIPP/Campo Transfer -Out Transfer -In 101pp/co-pi gIPP/Cpmp2 gIPP/Comp3 8lapse QIPPTI NH PORTION 960.90 - 860.90 0,147.16 8,147.16 32,732.22 8/10/2020 Deposit 8/10/2020 Deposit 8/12/2020 WIRE OUT BETHANY SENIOR LIVING, LTD 8/13/2020 Deposit 650.50 - 650.50 8/13/2020 NOVITA650LUTIONHCCIAIMPMT676081620000101Ti 3,548.75 - 3,S48.7S 8/14/2020 NOVITASSOLUTIONHCCf IMPMT676e81420000196Ts - 204.550.03 - 204.550.03 32.732.21 /217,757.34 �/ 217.767.34 8/172020 Quick View Select Quick View Accounts Account Number i Nome Account Type Treasury Center I Select Group Groups Aatl Graup IDDA Data reported as at Aug 17, 2020 8 '6606 MMC -NH BETHANY 5217.662.24 5226,1 77.06 5217,862.24 513.312.21 SENIOR LIVING nuns.uprofipenry.olbankmg.convonlineM1lessenger ' nd¢ales rc Pale generated on 0807'2020 at 8 r 1l1 MEMORIAL MEDICAL CENTER CHECK REQUEST P Memorial Medical Center Operating B_17-20 Date Requested: A Y E E APPROVED ON AUG 17 2020 COUNWAUDMR CALHOUN COUNw ". FOR ACCT. USE ONLY UI m prest Cash [�A/P Check nMail Check to Vendor LJ Return Check to Dept AMOUNT 295.06 G/L NUMBER: 21000012 LXFLAIVAI"lON: � OIPP Yr 1 Adjustment payment, period 3.— 1oyZI ttJ-QUE.STFD BY: Caitlin Clevenger AU T HOWZ"EC BY: p A MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating — Date Requested: 8-17-20 FOR ACCT. USE ONLY Y APPROVED ON I-�ImprestCash k AUG 17 2020 []A/P Check Mail Check to Vendor E COUNTYAUDITOR 11 Return Check Lo DepL CALHOUNCOUNPy, TEXA-- AMOUNT 20.08 G/L NUMSER: 22000010 r.XFLANATION: QIPP Yr 1 Adjustment payment, period 3. R[_QUE5i E(i BY: Caitlin Clevenger AUTHORI'ED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST P Memorial Medical center Operating Date Requested: 8.17-20 A AMOVW Y ON ti AUG 17 2020 E COUNTY AUffiTOR CALHOUN COUNTY, TEXAS FOR ACCT. USE ONLY FlImprest Cash E]A%P Check Mail Check to Vendor Return Check to Dept AMOUNT 83.82 G/L PIUMBER: 21000008 EXPLANATION: OIPP Yr 1 Adjustment payment, period 3. -- r-OY• - T;ehC RLQUFiStLDBY: Caitlin Clevenger AUTFtURIZED BY: P A y E E MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 8-17-20 FOR ACCT. USE ONLY Dmprest Cash F]A/P Check E]Mnil Check to Vendor Return Ch(-.d, to Dent AMOUNT 74.08 G/L NUMBER: 21000011 t - XPLANATION: QIPP Yr 1 Adjustment payment, period 3. — '001 evvv RLIQUES 'LD BY. Caitlin Clevenger Akj-F]J(,)Ft]ZFE,) BY: ------------- August 19, 2020 2020 APPROVAL LIST - 2020:BUDGET COMMISSIONERS COURT MEETING OF BALANCE. BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE FICA MEDICARE FWH ARMSTRONG, VAUGHAN & ASSOCIATES P.C. CITIBANK FRONTIER COMMUNICATIONS PAYROLL FOR 8/21/20 08/19/20 13 $8$,509.83 P/R $ 550.44 P/R $ 128.74 P/R $ 616.29 A/P $ 51,900.00 A/P $ 19,772.87 A/P $ 2,452.62 TOTAL VENDOR DISBURSEMENTS: $ 163,930.79 P/R. S 306,089.33 TOTAL PAYROLL AMOUNT: S 306,089.33 CALHOUN COUNTY INDGENT HEALTH CARE A/P S 7,660.75 CALHOUN COUNTY OPERATING CLOSE CD - TRANSFER FOR HIGHER INTEREST RATE A/P S 5,000,000A0 TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS• $ 5.007.660.75 TOTAL AMOUNTFOR APPROVAL: $ 5,477,680.87 e y y n n m ° z � 3 y o = O y � n 0 r 'O v y y o � y H O A A P P P P P P P P P P P N O O O O O O O O O O O O O O O p m b n gn 20 xa CC77 yyxyn sync n n x cc tt CnC xn n n n n y� < n . r- � O tC^ cS � rC- m ,av n n n �nEn gn gn En �n Fn En y0y y0y 0 y0y 0 �,yy y0 �,yy y0 ,yb0 �,yy0 yy,�0 �yq y0 yy,�0 �o �yf0 0� qm r r r r r r r r r r r m m m ^pP a a. a a 0 n A A > A A O O 0 b N N N P P P P P P w W P P P W y w .O w A A Aa A A A A A A A A w I L d N w O w P P P P P P U U U U N n r caio tio� c3 °oa mm; wa mg> W,g a m cg v� a CV)73 n v m M i t y '9 9 i 'tl.� a '0 �-1 .�. 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