2021-05-26 Meeting MinutesCOMMISSIONERS COURT — 5/19/2021 (Re -Scheduled to 05/26/2021)
Richard H. Meyer
County judge
David Hall, Commissioner, Precinct i
Vern ]Lyssy, Commissioner, Precinct 2
Joel ]Behrens, Commissioner, Precinct 3 - ABSENT
Gary Reese, Commissioner, Precinct 4
Catherine Sullivan, Deputy Clerk
REGULAR TERM 2021 § MAY 19, 2021 (Rescheduled)
BE IT REMEMBERED THAT ON MAY 19, 2021, (Re -Scheduled to 05/26/2021) THERE WAS
BEGUN AND HOLDEN A REGULAR MEETING OF COMMISSIONERS' COURT.
1. Call meeting to order
Meeting called to order at 10:00 a.m. by Judge Richard Meyer
2. Invocation
Commissioner David Hall
3. Pledges of Allegiance
US Flag — Commissioner Gary Reese
Texas Flag — Commissioner Vern Lyssy
4. General Discussion of Public Matters and Public Participation
5. Approve the minutes of the May 5, 2021 meeting
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
Page 1 of 5
COMMISSIONERS COURT-5/19/2021 (Re -Scheduled to 05/26/2021)
6. Consider and take necessary action on FEMA-4586 DR -TX Grant Terms and Conditions
and Designation of Subrecipient Agent and authorize the County Judge to sign. (RM)
Motion made to NOT approve.
RESULT: APPROVED [UNANIMOUS]
MOVER: Bern Lyssy, Commissioner Pct 2
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Reese
7. Consider and take necessary action to approve the preliminary plat of the Hurta
Subdivision 5.00-acre tract in Port Alto, Texas. (JB)
Preliminary plat presented by Henry Danysh.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pct 2
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Reese
8. Consider and take necessary action to approve the final plat of the Hurta Subdivision
5.00-acre tract in Port Alto, Texas. (JB)
Final plat presented by Henry Danysh.
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: Vern Lyssy, Commissioner Pct 2
AYES: Judge Meyer, Commissioner Hall, Lyssy, Reese
9. Consider and take necessary action to appoint Liz Zarate to the Calhoun County Parks
Board. (JB)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
Page 2 of 5
COMMISSIONERS COURT-5/19/2021 (Re -Scheduled to 05/26/2021)
10. Consider and take necessary action to authorize the County Judge to submit a
commitment letter to the Texas General Land Office, which states that $80,392 in
County GOMESA funding will be used as the match for a proposed CEPRA project at
Swan Point. (GR)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
11. Public Hearing on a Petition to Vacate Lots 1 and 2 in Block 2 of Bayview Estates Section
II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract No. 19,
Calhoun County, Texas as recorded in volume Z, Page 475 of the Calhoun County Plat
Records. (GR)
Opened — 10:08 a.m.
Henry Danysh presented the petition.
Closed —10:09 a.m.
12. Consider and take necessary action on a Petition to Vacate Lots 1 and 2 in Block 2 of
Bayview Estates Section II, Port O'Connor, Texas situated in the Santiago Gonzales
Survey, Abstract No. 19, Calhoun County, Texas as recorded in volume Z, Page 475 of
the Calhoun County Plat Records. (GR)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
13. Consider and take necessary action to approve the Preliminary Plat of the
KUYRKENDALL SUBDIVISION (a replat of Lots 1 and 2 in Block 2 of Bayview Estates
Section II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract No.
19, Calhoun County, Texas as recorded in volume Z, Page 475 of the Calhoun County
Plat Records. (GR)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
Page 3 of 5
COMMISSIONERS COURT-5/19/2021 (Re -Scheduled to 05/26/2021)
14. Consider and take necessary action on VFIS insurance proceeds in the amount of
$1,948.22for repairs to a Port O'Connor VFD brush truck from April 11, 2021. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
15. Consider and take necessary action on a request by the Calhoun County EMS Director to
transfer a 2000 Chevy 350OHD Chassis, inventory number 542-0042 from CCEMS to the
Magnolia Beach VFD as indicated on the attached Departmental Inventory Transfer
Request form. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
16. Consider and take necessary action on any necessary budget adjustments. (RM)
Pass
17. Approval of bills and payroll. (RM)
MMC — 05/19/2021
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
County — 05/ 19/ 2021
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Vern Lyssy, Commissioner Pct 2
AYES: Judge Meyer, Commissioner Hall, Lyssy, Reese
Page 4 of 5
COMMISSIONERS COURT-5/19/2021 (Re -Scheduled to 05/26/2021)
18. Accept reports from the following County Offices:
I. County Clerk —April 2021
ii. District Clerk — April 2021
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Reese
Adjourned: 10:15 a.m.
Page 5 of 5
✓ All Agenda Items Properly Numbered
tContracts Completed and Signed
All 1295's Flagged for Acceptance
(number of 1295's )
All Documents for Clerk Signature Flagged
On thisZ-0ikday Of 2021 a complete and accurate packet
for 161 kof 2021 Commissioners Court Regular Session
Day Month
was delivered from the Calhoun County Judge's office to the Calhoun County
Clerk's Office.
&Qj
Calhoun County Judge/Assistant
CO MMISS I O NE RSCO URTCH EC KLI ST/FORMS
AGENDA
N011( 1 01 IUII 1 IING )/19/1021
AT C
GfILEO K� O'CLO
MAY 14 2021
NNA G{;QOivi/�P7 Richard H. Meyer
CO N C K" CALNUUPJ UNTY, TEXAS
6Y:
DEPUW County judge
David Hall, Commissioner, Precinct 1
Vern Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Cary Reese, Commissioner, Precinct 4
NOTICE OF MEETING
The Commissioners' Court of Calhoun County, Texas will meet on Wednesday,
May 19, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at
211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas.
AGENDA
The subject matter of such meeting is as follows:
1. Call meeting to order.
2. Invocation.
3. Pledges of Allegiance.
4. General Discussion of Public Matters and Public Participation.
5. Approve the minutes of the May 5, 2021 meeting.
6. Consider and take necessary action on FEMA-4586 DR -TX Grant Terms and Conditions
and Designation of Subrecipient Agent and authorize the County Judge to sign. (RM)
7. Consider and take necessary action to approve the preliminary plat of the Hurta
Subdivision 5.00-acre tract in Port Alto, Texas. (JB)
8. Consider and take necessary action to approve the final plat of the Hurta Subdivision
5.00-acre tract in Port Alto, Texas. (JB)
9. Consider and take necessary action to appoint Liz Zarate to the Calhoun County Parks
Board. (JB)
10. Consider and take necessary action to authorize the County Judge to submit a
commitment letter to the Texas General Land Office, which states that $80,392 in
County GOMESA funding will be used as the match for a proposed CEPRA project at
Swan Point. (GR)
Page 1 of 2
I NOIIf 101 MII IIIV(i
— /Ir)/2U27.
11. Public Hearing on a Petition to Vacate Lots 1 and 2 in Block 2 of Bayview Estates Section
II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract No. 19,
Calhoun County, Texas as recorded in volume Z, Page 475 of the Calhoun County Plat
Records. (GR)
12. Consider and take necessary action on a Petition to Vacate Lots 1 and 2 in Block 2 of
Bayview Estates Section II, Port O'Connor, Texas situated in the Santiago Gonzales
Survey, Abstract No. 19, Calhoun County, Texas as recorded in volume Z, Page 475 of
the Calhoun County Plat Records. (GR)
13. Consider and take necessary action to approve the Preliminary Plat of the
KUYRKENDALL SUBDIVISION (a replat of Lots 1 and 2 in Block 2 of Bayview Estates
Section II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract No.
19, Calhoun County, Texas as recorded in volume Z, Page 475 of the Calhoun County
Plat Records. (GR)
14. Consider and take necessary action on VFIS insurance proceeds in the amount of
$1,948.22for repairs to a Port O'Connor VFD brush truck from April 11, 2021. (RM)
15. Consider and take necessary action on a request by the Calhoun County EMS Director to
transfer a 2000 Chevy 3500HD Chassis, inventory number 542-0042 from CCEMS to the
Magnolia Beach VFD as indicated on the attached Departmental Inventory Transfer
Request form. (RM)
16. Consider and take necessary action on any necessary budget adjustments. (RM)
17. Approval of bills and payroll. (RM)
18. Accept reports from the following County Offices:
I. County Clerk — April 2021
ii. District Clerk — April 2021
Richard Meyer, County
Calhoun County, Texas
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 continuouslyfor
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 2 of 2
QCLOC PL
AT —q d
MAY 14 2021 Richard ]H . Meyer
COUNTY CL HK CAL211 COUNTY, TEXAS County judge
BY: n
' DEPUP!
4kD,ivid Fall, Commissioner, Precinct 1
Vern Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Gary Reese, Commissioner, Precinct 4
NOTICE OF PUBLIC HEARING
The Commissioners' Court of Calhoun County, Texas will meet on Wednesday,
May 19, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse,
211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas.
NOTICE IS HEREBY GIVEN that Calhoun County Commissioners' Court will
hold a public hearing in the Commissioners' Courtroom, 211 S. Ann Street, Suite 104, in
Port Lavaca, Texas, at 10:00 a.m. on May 19, 2021 on a Petition to Vacate Lots 1 and 2 in
Block 2 of Bayview Estates Section II, Port O'Connor, Texas situated in the Santiago
Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in volume Z, Page
475 of the Calhoun County Plat Records.
The public shall have the right to be present and participate in such hearing.
Richard Meyer, Countyi
Calhoun County, Texas
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 1 of 1
#5
Richard � ] . Meyer
County judge
]David Hall, Commissioner, Precinct 1
Vern ]Lyssy, Commissioner, Precinct B
Joel ]Behrens, Commissioner, Precinct 3
Gary Reese, Commissioner, Precinct 4
The Commissioners' Counrt of Calhoun County, Texas met on Wednesday,
May 5, 2021, at 10.00 a.m. in the Commissioners'Courtroom in the County Courthouse at
211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas.
Attached are the true and correct minutes of the above referenced meeting.
Richard Meyer, Cou(nj;j Judge
Calhoun County, Texas
Anna Goodman, County Clerk
Deputy Clerk
Page 1 of 1
COMMISSIONERS COURT—5/5/2021
Richard H. Meyer
County judge
David Hall, Commissioner, Precinct 1
Vern ]Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Gary Reese, Commissioner, Precinct 4
Anna Goodman, County Clerk
Catherine Sullivan, Deputy Clerk
REGULAR TERM 2021 § MAY 05, 2021
BE IT REMEMBERED THAT ON MAY O5, 2021, THERE WAS BEGUN AND HOLDEN A REGULAR
MEETING OF COMMISSIONERS' COURT.
1. Call meeting to order
Meeting called to order at 10:00 a.m. by Judge Richard Meyer.
2. Invocation
Commissioner David Hall
3. Pledges of Allegiance
US Flag — Commissioner Gary Reese
Texas Flag — Commissioner Vern Lyssy
4. General Discussion of Public Matters and Public Participation.
Karen Lyssy— Family and Community Health spoke on upcoming Summer
Classes available.
Pastor Ruben Castillo of Bayside Community Church announced
05/06/2021 will be National Day of Prayer and there will be a prayer cited
at 12:00 p.m. at the Court House lawn on that day.
Page 1 of 5
,I COMMISSIONERS COURT—5/5/2021
5. Approve the minutes of the April 21, 2021 and April 28, 2021 meetings.
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
6. Consider and take necessary action regarding the bids that were received Thursday,
April 15, 2021 for the Magnolia Beach Fire Station Project for Calhoun County, Texas —
Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020
CDBG-DR Contract Work Order No. C-1. Updated guidance from the Texas General
Land Office has resulted in the need to cancel the bids completely. The unopened bids
will be returned to the bidders. A new bid opportunity will be posted at a future date.
(DH)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
7. Consider and take necessary action to approve the Final Replat of Lot 10 and Lot 23,
Block 4 in Bayview Estates, Section 1 in Port O'Connor, Calhoun County, Texas. (GR)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
Joel Behrens, Commissioner Pct 3
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
8. Consider and take necessary action to accept an anonymous donation to the Sheriffs
Office to be deposited into the Motivation account. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES: .
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 2 of 5
COMMISSIONERS COURT — 5/5/2021
9. Consider and take necessary action on an insurance proceeds check from TAC in the
amount of $27,382 for repair of the Sheriffs Office elevator. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
10. Consider and take necessary action on an insurance proceeds check from TAC in the
amount of $100,000 for damages incurred during the Winter Storm the week of
February 15, 2021. (RM)
RESULT:
APPROVED[UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
11. Consider and take necessary action to declare the attached list of items from the
Building Maintenance Department as Surplus/Salvage. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 3 of 5
•1 COMMISSIONERS COURT—5/5/2021
12. Accept Cash Count Reports for the following County Offices:
a. Commissioner, Precinct 2
b. County Clerk
c. District Attorney
d. District Clerk
e. Elections
f. EMS
g. Extension Office for Fairground Facility Rentals
h. Floodplain Administration
1. Justice of the Peace, Precinct 3
j. Library
k. Museum
I. Sheriff
m. Sheriff— Adult Detention Center
n. Sheriff— Narcotics Buy Money Fund
o. Tax Assessor -Collector
p. Treasurer
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Joel Behrens, Commissioner Pct 3
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
13. Accept Audit Reports for the following County Offices:
a. Justice of the Peace, Precinct 5
b. Treasurer
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 4 of 5
COMMISSIONERS COURT—5/5/2021
14. Accept a report from the following County Office:
i. County Auditor — March 2021
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
15. Consider and take necessary action on any necessary budget adjustments. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Gary Reese, Commissioner Pct 4
SECONDER:
Joel Behrens, Commissioner Pct 3
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
16. Approval of bills and payroll. (RM)
County
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
MMC
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
ADJOURNED: 10:17 A.M.
Page 5 of 5
#6
Mae Belle Cassel
From: cindy mueller <cindy.mueller@calhouncotx.org>
Sent: Tuesday, May 11, 2021 3:40 PM
To: Mae Belle Cassel
Cc: ladonna thigpen; Joel Behrens; david.hall@calhouncotx.org; Gary Reese; Richard Meyer;
vern lyssy
Subject: Agenda Item Request
Attachments: Binder CCrt Agenda 2021.05.19.pdf
Please place the following item on the agenda for 5/19/2021:
• Consider and take necessary action on FEMA-4586 DR -TX Grant Terms and Conditions and Designation of
Subrecipient Agent and authorize County Judge to sign.
Cindy Mueller
County Auditor
Calhoun County
202 S. Ann, Suite B
Port Lavaca, TX 77979
V: 361.553.4610
F: 361.553.4614
Cindy.mueller@calhouncotx.org
Calhoun County Texas
1
FEMA-4586-TX
Texas Severe Winter Storms
Category Title Project
B Emergency Protective Measures
Cost Department Type
1,571.14
Plumbing supplies; fuel pump supplies
295.41
Excessive natural gas bill due to generator use
62.97
Faucet
28.47
Heat lamp bulbs, extension cords
385.07
Plumbing supplies; salt for bridges
309.69
Excessive water bills due to leaks
350.00 Propane for EMS communications tower
RBI
Materials
RB1
Utilities
JP3
Materials
RB2
Materials
RB4
Materials
Various Utilities
Commissioners
Court Utilities
$ 452.83 Fuel for ambulances (per annual bid) EMS Materials
Insurance
$ 2,500.00 TAC Property damage claim deductible Various locations deductible
$ 5,955.58
Minumum total cost threhold $ 3,300.00
Federal cost share 75%
Cost recovery estimate minimum threshold $ 2,475.00
Cost recovery estimate all costs eligible $ 4,466.69
County Auditor Comments
1) Potential cost recovery is relatively
insignificant.
2) My office does not have available staff hours
to manage this grant.
3) The county has yet to receive the final cost
reimbursement for Hurricane Harvey Coloma
Road Project. Although close out documents
were submitted a year ago, TDEM required
additional justification of costs in mid -March.
Project Cost Summary DR-4586; Cat B Expense Log 5/11 /2021
GRANT TERMS AND CONDITIONS
FEMA-4586-TX
This Agreement (consisting of these terms and conditions and all exhibits) is made and entered
into by and between the Texas Division of Emergency Management (TDEM), an agency of the
State of Texas, hereinafter referred to as " TDEM," and the award recipient,
Calhoun County , hereinafter referred to as the "Subrecipient." Furthermore, TDEM and the
Subrecipient are collectively hereinafter referred to as the "Parties." All subawards made under
this agreement are subject to the same terms and conditions below.
Subrecipient may not assign or transfer any interest in this award without the express, prior
written consent of TDEM and/or DHS/FEMA or other awarding agency.
a. The term Recipient and pass -through entity have the same meaning as "Grantee," as used in
governing statutes, regulations, and DHS/FEMA guidance.
b. A Recipient is also a "non-federal entity" for administration purposes.
c. A Subrecipient is also known as a "Subgrantee" as used in governing statutes regulations
and DHS/ FEMA guidance.
d. A Subrecipient is also a "non-federal entity" for administration purposes.
e. The "Grant" referred to in this agreement is an awardto the Subrecipient passed through from
TDEM to the Subrecipient.
f. Certifying Official will be the Mayor, Judge, or Executive Director authorized to execute these
grant terms and conditions, and to submit changes of Subrecipient Agents.
g. Projects and any subsequent versions for those projects accepted by the Subrecipient and
subsequently obligated or deobligated by DHS/FEMA are considered subawards to this grant
agreement.
h. TDEM uses contractors to administer subawards, both in communication with Subgrantees and
the awarding agency. A Subgrantee's point of contact for all awards will be the regional
Recovery or Mitigation Coordinator followed by the regional contractor. Subgrantees should
update their primary points of contact with every new award in addition to each time a contact
may change.
A. Standard of Performance. Subrecipient shall perform all activities as approved by TDEM.
Any change to a project shall receive prior written approval by TDEM and, if required, by
FEMA or other awarding agency. Subrecipient shall perform all activities in accordance with
all terms, provisions and requirements set forth in this Grant, including but not limited to the
following Exhibits:
1. Assurances — Non -Construction Programs, hereinafter referred to as "Exhibit A"
2. Assurances — Construction Programs, hereinafter referred to as "Exhibit B"
3. Certifications for Grant Agreements, hereinafter referred to as "Exhibit C"
4. State of Texas Assurances, hereinafter referred to as "Exhibit D"
5. Environmental Review Certification, hereinafter referred to as "Exhibit E"
6. Additional Grant Conditions, hereinafter referred to as "Exhibit F"
7. Additional Grant Certifications, hereinafter referred to as "Exhibit G"
8. Request for Information and Documentation referred to as "Exhibit H"
Page 1 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
B. Failure to Perform. In the event Subrecipient fails to implement and complete the project(s)
approved and awarded, or comply with any provision of this Grant, Subrecipient shall be liable
to TDEM for an amount not to exceed the award amount of this Grant and may be barred from
applying for or receiving additional DHS/FEMA grant program funds
or any other grant program funds administered by TDEM until repayment to TDEM is made
and any other compliance or audit finding is satisfactorily resolved, in addition to any other
remedy specified in this Grant. Failure to timely implement and complete projects may reduce
future funding in additional DHS/FEMA and/or other grant programs administered by TDEM.
C. Funding Obligation. TDEM shall not be liable to Subrecipient for any costs incurred by
Subrecipient that are not allowable costs.
1. Notwithstanding any other provision of this Grant, the total of all payments and other
obligations incurred by TDEM under this Grant shall not exceed the total cumulative award
amounts listed on the Subawards (projects and subsequent versions).
2. Subrecipient shall contribute the match funds listed on the subaward.
Subrecipient shall refund to TDEM any sum of these Grant funds that has been determined
by TDEM or DHS/FEMA to be an overpayment to Subrecipient or that TDEM determines has
not been spent by Subrecipient in accordance with this Grant. No refund payment(s) shall be
made from local, state or federal Grant funds unless repayment with Grant funds is specifically
permitted by statute or regulation. Subrecipient shall make such refund to TDEM within thirty
(30) calendar days after TDEM requests such refund. If the subrecipient is unable to refund
the amount due at the time of request, they may request offset funds from other open projects
under the same award or request a payment plan. If a subrecipient does not provide the
amount requested within 30 calendar days, TDEM will first offset the amount with any available
funds within the same award and may pursue other remedies to receive payment in full.
D. Performance Period, The Performance Period for this Grant is listed on the subaward letter
for each Protect. All Drolects shall he cmmnlafad within fha -;-A Aran -11
performance period, Subrecipient shall have expended all Grant funds and submitted
reimbursement requests, invoices and any supporting documentation to TDEM within
60 days of the end of the performance period. TDEM shall not be obligated to reimburse
expenses incurred after the performance period or submitted after the deadline.
Uniform Administrative Reaumraments, Cost Principals and Audit R aumrements. Except
as specifically modified by law or this Grant, Subrecipient shall administer this Grant through
compliance with the most recent version of all applicable laws and regulations, including but
not limited to DHS program legislation, Federal awarding agency regulations, and the terms
and conditions of this Grant. A non-exclusive list is provided below [not all may apply in every
project]:
• Public Law 93-288, as amended (Stafford Act)
• 44 CFR, Emergency Management and Assistance
• Disaster Mitigation Act of 2000
• OMB Regulations 2 CFR, Grant and Agreements
• Executive Order 11988, Floodplain Management
• Executive Order 11990, Protection of Wetlands
• Executive Order 12372, Intergovernmental Review of Programs and Activities
Executive Order 12549, Debarment and Suspension
• Executive Order 12612, Federalism
Page 2 of 20
TDEM - December 2020
GRANT TERMS AND CONDITIONS
• Executive Order 12699, Seismic Design
• Executive Order 12898, Environmental Justice
• Coastal Barrier Resources Act, Public Law 97-348
• Single Audit Act, Public Law 98-502
• Sandy Recovery Improvement Act publications
• Disaster Recovery Reform Act of 201816 U.S.C. § 470, National Historic Preservation Act
• 16 U.S.C. § 1531, Endangered Species Act References
• FEMA program publications, guidance and policies
F. State Requirements for Grants. Subrecipient shall comply with all other federal, state, and
local laws and regulations applicable to this Grant including but not limited to the laws and
the regulations promulgated in Texas Government Code, Chapter 783, Uniform Grant and
Contract Management, (UGMS) at:_
http•//www window state tx us/procurement/catrad/ugms odf
and the program State Administrative Plan, available at:
https:Hg rants.tdem.texas.gov
Subrecipient shall, in addition to the assurances and certifications, comply and require each
of its subcontractors employed in the completion of the project to comply with all applicable
statutes, regulations, executive orders, OMB circulars, terms and conditions of this Grant and
the approved application.
Grant funds may not be awarded to or expended by any entity which performs political polling.
This prohibition does not apply to a poll conducted by an academic institution as part of the
institution's academic mission that is not conducted for the benefit of a particular candidate or
party.
Grant funds may not be expended by a unit of local government unless the following
limitations and reporting requirements are satisfied:
1. Texas General Appropriations Act, Art. IX, Parts 2 and 3, except there is no
requirement for increased salaries for local government employees;
2. Texas Government Code Sections 556.004, 556.005, and 556.006, which prohibits
using any money or vehicle to support the candidacy of any person for office,
influencing positively or negatively the payment, loan, or gift to a person or political
organization for a political purpose, and using Grant funds to influence the passage or
defeat of legislation including not assisting with the funding of a lobbyist, or using Grant
funds to pay dues to an organization with a registered lobbyist;
3. Texas Government Code Sections 2113.012 and 2113.101, which prohibits using
Grant funds to compensate any employee who uses alcoholic beverages on active
duty and Subrecipient may not use Grant funds to purchase an alcoholic beverage
and may not pay or reimburse any travel expense for an alcoholic beverage;
4. Texas General Appropriations Act, Art. IX, Section 6.13, which requires Subrecipient
to make every effort to attain key performance target levels associated with this Grant,
including performance milestones, milestone time frames, and related performance
reporting requirements; and
5. General Appropriations Act, Art. IX, Sections 7.01 and 7.02, and Texas Government
Code §2102.0091, which requires that this Grant may only be expended if
Subrecipient timely completes and files its reports.
:- •T1al! -I- •Il •�
1. Use of Funds. DHS/FEMA Grant funds may only be used for the purposes set forth in this
Page 3 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
Grant, and shall be consistent with the statutory authority for this Grant. Grant funds may
not be used for matching funds for other Federal grants/cooperative agreements, lobbying,
or intervention in Federal regulatory or adjudicatory proceedings. In addition,
Page 4 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
Federal funds may not be used to sue the Federal government or any other government
entity.
2. Federal Employee Prohibition Federal employees are prohibited directly benefiting from
any funds under this Grant.
3. Points of Contacts. Within 10 calendar days of any change, Subrecipient shall notify TDEM
of any change in designated of Subrecipient Agents as submitted during the execution of
this agreement, and any subsequent changes submitted by Subrecipient. In the event a
Subrecipient hires a consultant to assist them with managing its Public Assistance grants,
they must be listed on the Designated Subrecipient Agent Form. TDEM will direct all
correspondence to the Subrecipient but will cc: the consultant on all email exchanges. The
Subrecipient will be responsible for sharing written communications with the consultant.
The Subrecipient will remain the primary point of contact and must be included in all
decision -making activities.
4. DUNS Number. Subrecipient confirms its Data Universal Numbering Systems (DUNS)
Number is accurate and is registered on Sams.gov. The DUNS Number is the nine digit
number established and assigned by Dun and Bradstreet, Inc., at 866/705-5711 or
htti)://fedciov.dnb.com/webform
5. Central Contractor Registration and Universal Identifier Requirements. Subrecipient
maintains that it has registered on the System for Award Management (SAM) at
www.sam.ciov or other federally established site for contractor registration, and entered
TDEM-required information. Subrecipient shall keep current, and then review and update
the information at least annually. Subrecipient shall keep information current in the SAM
database until the later of when it submits this Grant's final financial report or receives final
Grant award payment. Subrecipient agrees that it shall not make any subaward agreement
or contract related to this Grant without first obtaining the vendor/subawardee's mandatory
DUNS number. See Section §200.32 of OMB 2 C.F.R.
6. Reporting Total Compensation of Subrecipient Executives. 2 C.F.R. §200.331; see FEMA
Information Bulletin 350.
a. Applicability and what to report: Subrecipient shall report whether Subrecipient
received $25 million or more in Federal procurement contracts or financial assistance
subject to the Transparency Act per 2 C.F.R. §200.331. Subrecipient shall report
whether 80% or more of Subrecipient's annual gross revenues were from Federal
procurement contracts or Federal financial assistance. If Subrecipient answers "yes"
to both questions, Subrecipient shall report, along with Subrecipient's DUNS number,
the names and total compensation (see 17 C.F.R. §229.402(c)(2)) for each of
Subrecipient's five most highly compensated executives for the preceding completed
fiscal year.
b. Where and when to report: Subrecipient shall report executive total compensation at
www.sam.gov or other federally established replacement site. By signing this Grant,
Subrecipient certifies that, if required, Subrecipient's jurisdiction has already
registered, entered the required information, and shall keep information in the SAM
database current, and update the information at least annually for each year until the
later of when the jurisdiction submits its final financial report or receives final payment.
Subrecipient agrees that it shall not make any subaward agreement or contract without
first obtaining the subawardee's mandatory DUNS number.
7. Debarment and Suspension. Subrecipient shall comply with Executive Order 12549 and
12689, which provide protection against waste, fraud, and abuse by debarring or
Page 5 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
suspending those persons deemed irresponsible in their dealings with the Federal
government.
8. Direct Deposit. A completed direct deposit form from Subrecipient shall be provided to
TDEM, prior to receiving any payments under the provisions of this grant. The direct
deposit form is currently available at grants.tdem.texas.gov under Resources/Public
Assistance.
9. Property Management and Inventory. Subrecipient shall maintain property/inventory
records which, at minimum, shall include a description of the property, a serial number or
other identification number, the source of property, who holds title, the acquisition date,
the cost of the property, the percentage of Federal participation in the cost of the property,
the location, use and condition of the property, and any ultimate disposition data including
the date of disposal and sale price of the property Subrecipient shall develop and
implement a control system to prevent loss, damage or theft of property and Subrecipient
shall investigate and document any loss, damage or theft of property funded under this
Grant.
10. Site Visits. DHS/FEMA and/or TDEM, through its authorized representatives, have the
right at all reasonable times to make site visits to review project accomplishments and
management control systems and to provide such technical assistance as may be
required. If any site visit is made by DHS/FEMA on the premises of Subrecipient or a
contractor under this Grant, Subrecipient shall provide and shall require its contractors to
provide all reasonable facilities and assistance for the safety and convenience of the
government representatives in the performance of their duties. All site visits and
evaluations shall be performed in such a manner that will not unduly delay the work.
H. Procurement and Gontractina.
1. Procurements. Subrecipient shall comply with all applicable federal, state, and local laws
and requirements, including but not limited to proper competitive solicitation processes
where required, for any procurement which utilizes federal funds awarded under this Grant
in accordance with 2 C.F.R. 200. 318-326 and Appendix II to Part 200 (A-C) and (E-J)
2. Contract Provisions. All contracts executed using funds awarded under this Grant shall
contain the contract provisions listed under 2 C.F.R. 200.326 and Appendix II (A), Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments.
3. Procurement activities must follow the most restrictive of Federal, State and Local
procurement regulations:
a. Procurement by micro purchase
b. Procurement by small purchase
c. Procurement by sealed bid
d. Procurement by competitive proposal
e. Procurement by non-competitive proposal, solely when the award of a contract is
unfeasible under the other methods
The State must be contacted for approval to use a noncompetitive procurement method.
Failure to follow eligible procurement methods will result in ineligible costs. Other types of
agreements for services must have State approval prior to use or execution. A copy of the
local procurement policy must be provided to the State before initial payment.
Page 6 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
The cost plus a percentage of cost and percentage of construction cost methods of
contracting are ineligible.
MMIJ perform cost/price analysis for every procurement action in excess of the Simplified
Acquisition Threshold.
j1W negotiate profit as a separate element where required.
4. Evidence of non -debarment for vendors must be documented through,
http://www.sam.ciov/portal/public/SAM and
http://www.window.state.tx.us/procurement/prog/vendor performance/debarred/ and
submitted for review.
5. Comply with rules related to underutilized businesses (small and minority businesses,
women's enterprises and labor surplus firms) at 2 CFR 200.321
I. Monitoring. Subrecipient will be monitored periodically by federal, state or local entities, both
programmatically and financially, to ensure that project goals, objectives, performance
requirements, timelines, milestone completion, budget, and other program -related criteria are
met.
TDEM, or its authorized representative, reserves the right to perform periodic desk/office-
based and/or on -site monitoring of Subrecipient's compliance with this Grant and of the
adequacy and timeliness of Subrecipient's performance pursuant to this Grant. After each
monitoring visit, if the monitoring visit reveals deficiencies in Subrecipient's performance under
this Grant, a monitoring report will be provided to the Subrecipient and shall include
requirements for the timely correction of such deficiencies by Subrecipient. Failure by
Subrecipient to take action specified in the monitoring report may be cause for suspension or
termination of this Grant pursuant to the Suspension and/or Termination Section herein.
J. Audit.
1. Audit of Federal and State Funds. Subrecipient shall arrange for the performance of an
annual financial and compliance audit of funds received and performances rendered under
this Grant as required by the Single Audit Act (OMB 2 C.F.R. 200.501, formerly A- 133).
Subrecipient shall comply, as applicable, with Texas Government Code, Chapter 783, the
Uniform Grant Management Standards (UGMS), the State Uniform Administrative
Requirements for Grants and Cooperative Agreements.
2. Right to Audit. Subrecipient shall give the United States Department of Homeland Security
(DHS), Federal Emergency Management Agency (FEMA), the Comptroller General of the
United States, the Texas State Auditor, TDEM, or any of their duly authorized
representatives, access to and the right to conduct a financial or compliance audit of
Grant funds received and performances rendered under this Grant. Subrecipient
shall permit TDEM or its authorized representative to audit Subrecipient's records.
Subrecipient shall provide any documents, materials or information necessary to facilitate
such audit.
3. Subrecipient's Liability for Disallowed Costs. Subrecipient understands and agrees that it
shall be liable to TDEM for any costs disallowed pursuant to any financial or compliance
audit(s) of these funds. Subrecipient further understands and agrees that reimbursement
to TDEM of such disallowed costs shall be paid by Subrecipient
Page 7 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
from funds that were not provided or otherwise made available to Subrecipient pursuant
to this Grant or any other federal contract.
4. Subrecipient's Facilitation of Audit. Subrecipient shall take such action to facilitate the
performance of such audit(s) conducted pursuant to this Section as TDEM may require of
Subrecipient. Subrecipient shall ensure that this clause concerning the authority to audit
funds received indirectly by subcontractors through Subrecipient and the requirement to
cooperate is included in any subcontract it awards.
5. State Auditor's Clause. Subrecipient understands that acceptance of funds under this
Grant acts as acceptance of the authority of the State Auditor's Office to conduct an audit
or investigation in connection with those funds. Subrecipient further agrees to cooperate
fully with the State Auditor's Office in the conduct of the audit or investigation, including
providing all records requested. Subrecipient shall ensure that this clause concerning the
State Auditor's Office's authority to audit funds and the requirement to cooperate fully with
the State Auditor's Office is included in any subgrants or subcontracts it awards.
Additionally, the State Auditor's Office shall at any time have access to and the rights to
examine, audit, excerpt, and transcribe any pertinent books, documents, working papers,
and records of Subrecipient relating to this Grant.
K. Retention and Accessibility of Records.
1. Retention of Records. Subrecipient shall follow its own internal retention policy, or the
state's retention policy, whichever is stricter. At a minimum, the subrecipient shall maintain
fiscal records and supporting documentation for all expenditures of this Grant's funds
pursuant to the applicable OMB 2 C.F.R. Subpart D — Post Federal Award Requirements,
§200.333-337, and this Grant. Subrecipient shall retain these records and any supporting
documentation for a minimum of three (3) years from the later of the completion of this
project's public objective, submission of the final expenditure report, any litigation, dispute,
or audit. Records shall be retained for three (3) years after any real estate or equipment
final disposition. The DHS or TDEM may direct Subrecipient to retain documents or to
transfer certain records to DHS/FEMA custody when DHS/FEMA determines that the
records possess long term retention value.
2. Access to Records. Subrecipient shall give the United States Department of Homeland
Security, the Comptroller General of the United States, the Texas State Auditor, TDEM,
or any of its duly authorized representatives, access to and the right to examine all books,
accounts, records, reports, files, other papers, things or property belonging to or in use by
Subrecipient pertaining to this Grant including records concerning the past use of
DHS/FEMA funds. Such rights to access shall continue as long as the records are retained
by Subrecipient.
L. Changes. Amendments. Suspension or Term h nation
1. Modification. DHS/FEMA or TDEM may modify this Grant after an award has been made.
Once notification has been made in writing, any subsequent request for funds indicates
Subrecipient's acceptance of the changes to this Grant. Any alteration, addition, or
deletion to this Grant by Subrecipient is not valid.
2. Effect of Changes in Federal and State Laws. Any alterations, additions, or deletions to
this Grant that are required by changes in federal and state laws, regulations or policy are
automatically incorporated into this Grant without written amendment to this Grant and
shall become effective upon the date designated by such law or regulation. In the event
DHS/FEMA or TDEM determines that changes are necessary to this Grant after an
award has been made, including changes to the period of performance or terms and
conditions, Subrecipient shall be notified of the changes in writing. Once notification has
Page 8 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
been made, any subsequent request for funds will indicate Subrecipient's acceptance of
the changes to this Grant.
3. Suspension. In the event Subrecipient fails to comply with any term of this Grant, TDEM
may, upon written notification to Subrecipient, suspend this Grant, in whole or in part,
withhold payments to Subrecipient and prohibit Subrecipient from incurring additional
obligations of this Grant's funds.
4. Termination. TDEM shall have the right to terminate this Grant, in whole or in part, at any
time before the end of the Performance Period, if TDEM determines that Subrecipient has
failed to comply with any term of this Grant. TDEM shall provide written notice of the
termination and include:
a. The reason(s) for such termination;
b. The effective date of such termination; and
c. In the case of partial termination, the portion of this Grant to be terminated.
d. Appeal may be made to the Deputy Chief of the Texas Division of Emergency
Management - Recovery & Mitigation.
M. Enforcement. If Subrecipient materially fails to comply with any term of this Grant, whether
stated in a federal or state statute or regulation, an assurance, in a state plan or application,
a notice of award, or elsewhere, TDEM or DHS/FEMA may take one or more of the following
actions, as appropriate in the circumstances:
1. Increased monitoring of projects and require additional financial and performance
reports
2. Require all payments as reimbursements rather than advance payments
3. Temporarily withhold payments pending correction of the deficiency
4. Disallow or deny use of funds and matching credit for all or part of the cost of the
activity or action not in compliance;
5. Request DHS/FEMA to wholly or partially de -obligate funding for a project
6. Temporarily withhold cash payments pending correction of the deficiency by
subrecipient or more severe enforcement action by TDEM or DHS/FEMA;
7. Withhold further awards for the grant program
8. Take other remedies that may be legally available
In taking an enforcement action, TDEM will provide Subrecipient an opportunity for a hearing,
appeal, or other administrative proceeding to which Subrecipient is entitled under any statute
or regulation applicable to the action involved.
The costs of Subrecipient resulting from obligations incurred by Subrecipient during a
suspension or after termination of this Grant are not allowable unless TDEM or DHS/FEMA
expressly authorizes them in the notice of suspension or termination or subsequently.
Other Subrecipient costs during suspension or after termination which are necessary and
not reasonably avoidable are allowable if:
• The costs result from obligations which were properly incurred by Subrecipient before the
effective date of suspension or termination, are not in anticipation of it, and in the case of
a termination, are non -cancellable; and
• The costs would be allowable if this Grant were not suspended or expired normally at the
end of the funding period in which the termination takes effects.
The enforcement remedies identified in this section, including suspension and termination, do
not preclude Subrecipient from being subject to "Debarment and Suspension" under E.O.
Page 9 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
12549. 2 C.F.R., Appendix II to Part 200, (1).
N. Conflicts of Int r mot. The subrecipient will maintain written standards of conduct covering
conflicts of interest and governing the actions of its employees engaged in the selection,
award and administration of contracts and will establish safeguards to prohibit employees
from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest or personal gain.
O. Closina of this Grant. TDEM will close each subaward after receiving all required final
documentation from the Subrecipient. If the close out review and reconciliation indicates that
Subrecipient is owed additional funds, TDEM will send the final payment automatically to
Subrecipient. If Subrecipient did not use all the funds received, TDEM will recover the unused
funds.
At the completion and closure of all Subrecipient's projects (subawards), TDEM will request
the Subrecipient to Certify the completion of all projects (subawards) in accordance with the
grant terms and conditions to state there are no further claims under this subgrant.
The closeout of this Grant does not affect:
1. DHS/FEMA or TDEM's right to disallow costs and recover funds on the basis of a later
audit or other review;
2. Subrecipient's obligation to return any funds due as a result of later refunds, corrections,
or other transactions;
3. Records retention requirements, property management requirements, and audit
requirements, as set forth herein; and
4. Any other provisions of this Grant that impose continuing obligations on Subrecipient or
that govern the rights and limitations of the parties to this Grant after the expiration or
termination of this Grant.
P. Notices. All notices and other communications pertaining to this agreement shall be
delivered in electronic format and/or writing and shall be transmitted by fax, e-mail,
personal hand -delivery (and receipted for) or deposited in the United States Mail, as
certified mail, return receipt requested and postage prepaid, to the other party.
Page 10 of 20
TDEM — December 2020
EXHIBIT A
ASSURANCES - NON -CONSTRUCTION PROGRAMS See Standard Form 424B
As the duly authorized representative of Subrecipient, I certify that Subrecipient:
1. Has the legal authority to apply for Federal assistance and the institutional,
managerial and financial capability (Including funds sufficient to pay the non -
Federal share of project cost) to ensure proper planning, management and
completion of the project described in this Grant.
2. Will give the Department of Homeland Security, the Texas Division of
Emergency Management, the Comptroller General of the United States and,
if appropriate, the State, through any authorized representative, access to and
the right to examine all records, books, papers, or documents related to this
Grant and will establish a proper accounting system in accordance with
generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for
a purpose that constitutes or presents the appearance of personal or
organizational conflict of Interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after
receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C.
§§4728-4763) relating to prescribed standards for merit systems for programs
funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration (5 C.F.R.
900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These
include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 F.L.
88-352) which prohibits discrimination an the basis of race, color or national
origin; (b) Title IX of the Education Amendments of 1972, as amended (20
U.S.C. §§1681-1683, and 1685-1686 and 44 C.F.R. Part 19). which prohibits
discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of
1973, as amended (29 U.S.C. §794), which prohibits discrimination on the
basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42
U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e)
the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug abuse; (1) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and
527 of the Public Health Service Act of 1912 (42 U.S.C. §§290dd-3 and
290ee-3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.
§§3601 at seq.), as amended, relating to nondiscrimination in the sale, rental
or financing of housing; (i) any other nondiscrimination provisions in the
specific statute(s) under which agreement for Federal assistance is being
made; and O) the requirements of any other nondiscrimination statute(s) which
may apply to the application.
7. Will comply or has already complied with the requirements of Titles II and III
of the Uniform Relocation Assistance and Real Property Acquisition Policies
Act of 1970 F.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of Federal or
federally -assisted programs. These requirements apply to all Interests in real
property acquired for project purposes regardless of Federal participation in
purchases.
8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. §§1501-
1508 and 7324-7328) which limit the political activities of employees whose
principal employment activities are funded in whole or in part with Federal
funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40
U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18
U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40
U.S.C. §§327-333), regarding labor standards for federally -assisted
construction sub -agreements.
10. Will Comply, if applicable, with flood insurance purchase requirements of
Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234)
which requires recipients in a special flood hazard area to participate in the
Program and to purchase flood insurance if the total cost of insurable
construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant
to the following: (a) institution of environmental quality control measures under
the National Environmental Policy Act of 1969 (P.L. 91-190 as amended by
42 U.S.C. 4311 at seq. and Executive Order (EO) 11514) which establishes
national policy goals and procedures to protect and enhance the environment,
including protection against natural disasters. To comply with NEPA for DHS
grant -supported activities, DHS-FEMA requires the environmental aspects to
be reviewed and evaluated before final action on the application; (b)
notification of violating facilities pursuant to EO 11738;
(c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood
hazards in floodplains in accordance with EO 11988; (a) assurance of project
consistency with the approved State management program developed under
the Coastal Zone Management Act of 1972 (16 U.S.C.
§§1451 at sec.); (f) comply with the Clean Air Act of 1977, (42 U.S.C.
§§7401 etseq. and Executive Order 11738) providing forthe protection of and
enhancement of the quality of the nation's air resources to promote public
health and welfare and for restoring and maintaining the chemical, physical,
and biological integrity of the nation's waters; (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as
amended (P.L. 93-523); and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 at
seq.) related to protecting components or potential components of the national
wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the
National Historic Preservation Act of 1966, as amended (16 U.S.C.
§470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et
seq.).
14. Will comply with P.L. 93-348, 45 C.F.R. 46, and DHS Management Directive
026-044 (Directive) regarding the protection of human subjects involved in
research, development, and related activities supported by this Grant.
"Research" means a systematic investigation, including research,
development, testing, and evaluation designed to develop or contribute to
general knowledge. See Directive for additional provisions for including
humans in the womb, pregnant women, and neonates (Subpart B); prisoners
(Subpart C); and children (Subpart D). See also state and local law for
research using autopsy materials.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as
amended, 7 U.S.C. §§2131 at seq.) which requires the minimum standards of
care and treatment for vertebrate animals bred for commercial sale, used in
research, transported commercially, or exhibited to the public according to the
Guide for Care and Use of Laboratory Animals and Public Health Service
Policy and Government Principals Regarding the Care and Use of Animals.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C.
§§4801 at seq.), which prohibits the use of lead -based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in
accordance with the Single Audit Act Amendments of 1996 and OMB Circular
No. A-133 (now OMB 2 C.F.R. 200.500), "Audits of States, Local
Governments, and Non -Profit Organizations."
18. Will comply with all applicable requirements of all other Federal laws,
executive orders, regulations, grant guidance, and policies governing this
Grant.
Page 11 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
EXHIBIT B
ASSURANCES - CONSTRUCTION PROGRAMS See Standard Form 424D
As the duly authorized representative of Subrecipient, I certify that Subrecipient:
1. Has the legal authority to apply for Federal assistance, and the
institutional, managerial and financial capability (including funds
sufficient to pay the non -Federal share of project costs) to ensure proper
planning, management and completion of project described In this Grant.
2. Will give the Department of Homeland Security, the Texas Division of
Emergency Management, the Comptroller General of the United States
and, if appropriate, the State, the right to examine all records, books,
papers, or documents related to this Grant and will establish a proper
accounting system in accordance with generally accepted accounting
standards or agency directives.
3. Will not dispose of, modify the use of, or change the terms of the real
property title or other interest in the site and facilities without permission
and instructions from the awarding agency. Will record the Federal
awarding agency directives and will include a covenant in the title of real
property acquired in whole or in part with Federal assistance funds to
assure nondiscrimination during the useful life of this Grant.
4. Will comply with the requirements of the assistance awarding agency
with regard to the drafting, review and approval of construction plans and
specifications.
5. Will provide and maintain competent and adequate engineering
supervision at the construction site to ensure that the complete work
conforms with the approved plans and specifications and will furnish
progressive reports and such other information as may be required by
the awarding agency or State.
6. Will initiate and complete the work within the applicable time frame after
receipt of approval of the awarding agency.
7. Will establish safeguards to prohibit employees from using their positions
for a purpose that constitutes or presents the appearance of personal or
organizational conflict of interest or personal gain.
8. Will comply with the Intergovernmental Personnel Act of 1970 (42
U.S.C. §§4728-4763) relating to prescribed standards of merit systems
for programs funded under one of the 19 statutes or regulations specified
in Appendix A of OPM's Standards for a Merit System of Personnel
Administration (5 C.F.R. 900, Subpart F).
9. Will comply with the Lead -Based Paint Poisoning Prevention Act (42
U.S.C. §§4801 at seq.) which prohibits the use of lead -based paint in
construction or rehabilitation of residence structures.
10. WIII comply with all Federal statutes relating to nondiscrimination. These
include but are not limited to: (a) Title VI of the Civil Rights Act of 1964
(P.L. 88-352) which prohibits discrimination on the basis of race, color or
national origin; (b) Title IX of the Education Amendments of 1972, as
amended (20 U.S.C. §§1681 1683, and 1685-1686 and 44
C.F.R. Part 19), which prohibits discrimination on the basis of sex; (c)
Section 504 of the Rehabilitation Act of 1973, as amended (29) U.S.C.
§794), which prohibits discrimination on the basis of handicaps; (d) the
Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107),
which prohibits discrimination on the basis of age; (a) the Drug Abuse
Office and Treatment Act of 1972 (P.L. 92-255), as amended relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism; (g)
§§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.
§§290dd-3 and 290ee-3), as amended, relating to confidentiality of
alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights
Act of 1968 (42 U.S.C. §§3601 at sec.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statue(s) under which
agreement for Federal assistance is being made; and 0) the
requirements of any other nondiscrimination statue(s) which may apply
to the agreement.
11. Will comply or has already complied with the requirements of Titles ll and
III of the Uniform Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable
treatment of persons displaced or whose property is acquired as a result
of Federal and federally -assisted programs. These requirements apply
to all interests in real property acquired for project purposes regardless
of Federal participation In purchases.
12. Will comply with the provisions of the Hatch Act (5 U.S.C. §§1501-1508
and 7324-7328) which limit the political activities of employees whose
principal employment activities are funded in whole or in part with
Federal funds.
13. Will comply, as applicable, with the provisions of the Davis -Bacon Act
(40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and
18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act
(40 U.S.C. §§327- 333) regarding labor standards for federally- assisted
construction sub -agreements.
14. Will comply with flood insurance purchase requirements of Section
102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which
requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable
construction and acquisition is $10,000 or more.
15. Will comply with environmental standards which may be prescribed
pursuant to the following: (a) institution of environmental quality control
measures under the National Environmental Policy Act of 1969 (P.L. 91-
190) as amended by 42 U.S.C. 4311 at seq. and Executive Order (EO)
11514 which establishes national policy goals and procedures to protect
and enhance the environment, including protection against natural
disasters; (b) notification of violating facilities pursuant to EO 11738; (c)
protection of wetlands pursuant to EO 11990: (d) evaluation of flood
hazards in floodplains in accordance with EO 11988; (a) assurance of
project consistency with the approved State management program
developed under the Coastal Zone Management Act of 1972 (16 U.S.C.
§§1451 at seq.); (f) comply with the Clean Air Act of 1977, (42 U.S.C.
§§7401 at seq. and Executive Order 11738) providing for the protection
of and enhancement of the quality of the nation's air resources to
promote public health and welfare and for restoring and maintaining the
chemical, physical, and biological integrity of the nation's waters; (g)
protection of underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h)
protection of endangered species under the Endangered Species Act of
1973, as amended (P.L. 93-205).
16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.
§§1271 at seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
17. WIII assist the awarding agency in assuring compliance with Section 106
of the National Historic Preservation Act of 1966, as amended (16
U.S.C. §470), EO 11593 (identification and protection of historic
properties), and the Archaeological and Historic Preservation Act of 1974
(16 U.S.C. §§469a-1 at seq).
18. Will cause to be performed the required financial and compliance audits
in accordance with the Single Audit Act Amendments of 1996 and OMB
Circular No. A-133 (now OMB 2 C.F.R. 200.500), "Audits of States, Local
Governments, and Non -Profit Organizations."
19. Will comply with all applicable requirements of all other Federal laws,
executive orders, regulations, grant guidance and policies governing this
Grant.
Page 12 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
Exhibit C
Certifications for Grant Agreements
The undersigned, as the authorized official, certifies the following to the best of his/her knowledge and belief.
A. No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned to any person for influencing or
attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an
employee or a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the
making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,
or modification of any Federal contract, grant, loan, or cooperative agreement.
B. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee or a
Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete
and submit Standard Form-LLL Disclosure of Lobbying Activities, in accordance with its instructions.
C. The undersigned shall require that the language of this certification prohibiting lobbying be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that
all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into
this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
D. As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 C.F.R. Part 67, for prospective
participants in primary covered transactions, as defined at 28 C.F.R. Part 67, Section 67.510. (Federal Certification), the Subrecipient
certifies that it and its principals and vendors:
1. Are not debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a
State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency. Subrecipient
can access debarment information by going to www.sam.gov and the State Debarred Vendor List at
www.window.state.tx.us/i)rocurement/i)rog/vendor performance/debarred.
2 Have not within a three-year period preceding this Grant been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal,
State, or local) transaction or contract under a public transaction, violation of Federal or State antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen
property;
3 Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with
commission of any of the offenses enumerated in paragraph (13)(2) of this certification;
A Have not within a three-year period preceding this Grant had one or more public transactions (Federal, State, or local)
terminated for cause or default; or
5. Where Subrecipient is unable to certify to any of the statements in this certification, he or she shall attach an explanation to
this Grant. (Federal Certification).
E. Federal funds will be used to supplement existing funds, and will not replace (supplant) funds that have been appropriated for the
same purpose. Subrecipient may be required to supply documentation certifying that a reduction in non-federal resources occurred
for reasons other than the receipt or expected receipt of federal funds.
F. Subrecipient will comply with 2 C.F.R. Part 180, Subpart C as a condition of receiving grant funds and Subrecipient will require such
compliance in any subgrants or contract at the next tier.
G. Subrecipient will comply with the Drug -free Workplace Act, in Subpart B of 2 C.F.R. Part 3001.
H. Subrecipient is not delinquent on any Federal debt. Examples of relevant debt include delinquent payroll and other taxes, audit
disallowances, and benefit overpayments. See OMB Circular A-129 and form SF-424, item number 17 for additional information and
guidance.
I. Subrecipient will comply with all applicable requirements of all other federal laws, executive orders, regulations, program and
administrative requirements, policies and any other requirements governing this Grant.
J. Subrecipient understands that failure to comply with any of the above assurances may result in suspension, termination or
reduction of funds in this Grant.
Page 13 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
EXHIBIT D
State of Texas Assurances
As the duly authorized representative of Subrecipient, I certify that Subrecipient:
1. Shall comply with Texas Government Code, Chapter 573, by ensuring that no officer, employee, or member of the Subrecipient's governing
body or of the Subrecipient's contractor shall vote or confirm the employment of any person related within the second degree of affinity or
the third degree of consanguinity to any member of the governing body or to any other officer or employee authorized to employ or supervise
such person. This prohibition shall not prohibit the employment of a person who shall have been continuously employed for a period of two
years, or such other period stipulated by local law, prior to the election or appointment of the officer, employee, or governing body member
related to such person in the prohibited degree.
2. Shall insure that all information collected, assembled, or maintained by the Subrecipient relative to a project will be available to the public
during normal business hours in compliance with Texas Government Code, Chapter 552, unless otherwise expressly prohibited by law.
3. Shall comply with Texas Government Code, Chapter 551, which requires all regular, special, or called meetings of governmental bodies to
be open to the public, except as otherwise provided by law or specifically permitted in the Texas Constitution.
4. Shall comply with Section 231.006, Texas Family Code, which prohibits payments to a person who is in arrears on child support payments.
5. Shall not contract with or issue a license, certificate, or permit to the owner, operator, or administrator of a facility if the Subrecipient is a
health, human services, public safety, or law enforcement agency and the license, permit, or certificate has been revoked by another health
and human services agency or public safety or law enforcement agency.
6. Shall comply with all rules adopted by the Texas Commission on Law Enforcement pursuant to Chapter 1701, Texas Occupations Code, or
shall provide the grantor agency with a certification from the Texas Commission on Law Enforcement that the agency is in the process of
achieving compliance with such rules if the Subrecipient is a law enforcement agency regulated by Texas Occupations Code, Chapter 1701.
7. Shall follow all assurances. When incorporated into a grant award or contract, standard assurances contained in the application package
become terms or conditions for receipt of grant funds. Administering state agencies and subrecipients shall maintain an appropriate contract
administration system to ensure that all terms, conditions, and specifications are met. (See UGMS Section 36 for additional guidance on
contract provisions).
8. Shall comply with the Texas Family Code, Section 261.101, which requires reporting of all suspected cases of child abuse to local law
enforcement authorities and to the Texas Department of Child Protective and Regulatory Services. Subrecipient shall also ensure that all
program personnel are properly trained and aware of this requirement.
9. Shall comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of
1964 (P.L. 88-352), which prohibits discrimination on the basis of race, color, or national origin; (b) Title IX of the Education Amendments of
1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps and the Americans with
Disabilities Act of 1990 including Titles I, ll, and III of the Americans with Disability Act which prohibits recipients from discriminating on the
basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain
testing entities, 44 U.S.C. §§ 12101-12213; (d) the Age Discrimination Act of 1974, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (a) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and
Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; (g)
§§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290dd-3 and 290ee-3), as amended, relating to confidentiality of
alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 at seq.), as amended, relating to
nondiscrimination in the sale, rental, or financing of housing; (1) any other nondiscrimination provisions in the specific statute(s) under which
application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to this
Grant.
10. Shall comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c
and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327-333), regarding labor standards for federally
assisted construction subagreements.
11. Shall comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (P.L. 91-
646), which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally
assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation
in purchases.
12. Shall comply with the provisions of the Hatch Political Activity Act (5 U.S.C. §§7321-29), which limit the political activity of employees whose
principal employment activities are funded in whole or in part with Federal funds.
13. Shall comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act and the Intergovernmental
Personnel Act of 1970, as applicable.
Page 14 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
14. Shall insure that the facilities under its ownership, lease, or supervision which shall be utilized in the accomplishment of the project are not
listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the receipt
of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under
consideration for listing by the EPA (ED 11738).
15. Shall comply with the flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973, Public Law 93-
234. Section 102(a) requires the purchase of flood insurance in communities where such insurance is available as a condition for the receipt
of any Federal financial assistance for construction or acquisition proposed for use in any area that has been identified by the Secretary of
the Department of Housing and Urban Development as an area having special flood hazards.
16. Shall comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control
measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance
with EO 11988; (a) assurance of project consistency with the approved state management program developed under the Coastal Zone
Management Act of 1972 (16 U.S.C. §§1451 at seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clean Air Act of 1977, as amended (42 U.S.C. §§7401 at seq.); (g) protection of underground sources of drinking water under
the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of endangered species under the Endangered Species
Act of 1973, as amended (P.L. 93-205).
17. Shall comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 at seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
18. Shall assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16
U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974
(16 U.S.C. §§469a-1 at seq.).
19. Shall comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 at seq.) which requires the
minimum standards of care and treatment for vertebrate animals bred for commercial sale, used in research, transported commercially, or
exhibited to the public according to the Guide for Care and Use of Laboratory Animals and Public Health Service Policy and Government
Principals Regarding the Care and Use of Animals.
20. Shall comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 at seq.) which prohibits the use of lead -based paint in
construction or rehabilitation of residential structures.
21. Shall comply with the Pro -Children Act of 1994 (Public Law 103-277), which prohibits smoking within any portion of any indoor facility used
for the provision of services for children.
22. Shall comply with all federal tax laws and are solely responsible for filing all required state and federal taxforms.
23. Shall comply with all applicable requirements of all other federal and state laws, executive orders, regulations, and policies governing this
program.
24. And its principals are eligible to participate and have not been subjected to suspension, debarment, or similar ineligibility determined by any
federal, state, or local governmental entity and it is not listed on a state or federal government's terrorism watch list as described in Executive
Order 13224. Entities ineligible for federal procurement have Exclusions listed at hftps://www sam gov/portal/public/SAM/.
25. Shall adopt and implement applicable provisions of the model HIV/AIDS workplace guidelines of the Texas Department of Health as required
by the Texas Health and Safety Code, Ann., Sec. 85.001, at seq.
Page 15 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
EXHIBIT E
Environmental Review
As the duly authorized representative of Subrecipient, I certify that Subrecipient:
1. shall assess its federally funded projects for potential impact to environmental resources and historic properties
2. shall submit any required screening form(s) as soon as possible and shall comply with deadlines established by TDEM. Timelines
for the Environmental Planning and Historic Preservation (EHP) review process will vary based upon the complexity of the project
and the potential for environmental or historical impact.
3. shall include sufficient review time within its project management plan to comply with EHP requirements. Initiation of any activity prior
to completion of FEMA's EHP review will result in a non-compliance finding and TDEM will not authorize or release Grant funds for
non -compliant projects.
4. as soon as possible upon receiving this Grant, shall provide information to TDEM to assist with the legally -required EHP review and
to ensure compliance with applicable EHP laws and Executive Orders (EO) currently using the FEMA EHP Screening Form OMB
Number 1660-0115/FEMA Form 024-0-01 and submitting it, with all supporting documentation, to TDEM for review. These EHP
requirements include but are not limited to the National Environmental Policy Act, the National Historic Preservation Act, the
Endangered Species Act, EO 11988 — Floodplain Management, EO 11990 — Protection of Wetlands, and EO 12898—Environmental
Justice. Subrecipient shall comply with all Federal, State, and local EHP requirements and shall obtain applicable permits and
clearances.
5. shall not undertake any activity from the project that would result in ground disturbance, facility modification, or purchase and use of
sonar equipment without the prior approval of FEMA. These include but are not limited to communications towers, physical security
enhancements involving ground disturbance, new construction, and modifications to buildings.
6. shall comply with all mitigation or treatment measures required for the project as the result of FEMA's EHP review. Any changes to
an approved project description will require re-evaluation for compliance with EHP requirements before the project can proceed.
7. if ground disturbing activities occur during project implementation, Subrecipient shall ensure monitoring of ground disturbance and if
any potential archeological resources are discovered, Subrecipient shall immediately cease construction in that area and notify FEMA
and the appropriate State Historical Preservation Office.
Page 16 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
EXHIBIT F
Additional Grant Conditions
1. Additional damage requiring a new Public Assistance project to be written must be reported within 60 days
following the Project Scoping meeting with the State -Federal team (or FEMA process equivalent).
2. All work must be done prior to the approved project completion deadline assigned to each Project (POP).
For projects written at 100% complete, documentation must be submitted within 90 days of the Recovery
Scoping Meeting (or FEMA process equivalent) or within 90 days of the work completion date (both Hazard
Mitigation and Public Assistance), whichever is later, regardless of whether the project has been obligated.
Should additional time be required, a time extension request must be submitted which: a.) Identifies the
projects requiring an extension. b.) Explains the reason for an extension. c.) Indicates the percentage of work
that has been completed. d.) Provides an anticipated completion date. e) Provides detailed milestones
documenting expected progress. The reason for an extension must be based on extenuating circumstances
or unusual project requirements that are beyond the control of your jurisdiction/organization. Failure to
submit a time extension request 90 days prior to the end of the period of performance may result in
reduction or withdrawal of federal funds for approved work.
3. Any significant change to a project's approved Scope of Work must be reported and approved through TDEM
and FEMA before starting the project. Failure to do so will jeopardize grant funding. The Subrecipient shall
submit requests for cost overruns requiring additional obligations to TDEM, who will forward to FEMA for
review and approval prior to incurring costs. Approval of these requests is not guaranteed and is subject to
funding availability. Costs incurred prior to approval of any scope or budget/cost changes may be denied.
4. The Project Completion and Certification Report must be submitted to TDEM within 60 days of all approved
work being completed for each project. If any project requires the purchase of insurance as a condition of
receiving federal funds, a copy of the current policy must be attached to this report, or Duplication of Benefits
form certifying other funds were received to complete the project.
5. A cost overrun appeal on small ($128,900) Public Assistance projects must be reported to the Texas Division
of Emergency Management (TDEM) within 60 days of completing the last small project in order to be
considered for additional funding.
6. Appeals may be filed on any determination made by FEMA or TDEM. All appeals must be submitted to TDEM
within 60 days from receiving written notice of the action you wish to appeal. Should you wish to appeal a
determination contained in the project application, the 60 days will start the day the application is signed.
Appeals for Alternative Projects will be subject to the terms of the signed agreement for the Alternative
Project.
7. Public Assistance program projects will not receive funding until all of the requirements identified in the
comments section of the Project Worksheet are met.
8. You may request a payment of funds on projects by initiating a Request for Reimbursement (RFR) in TDEM's
Grant Management System (GMS) or an Advance of Funds Request (AFR), and including documentation
supporting your request. Small Public Assistance projects are paid upon obligation and will be initiated by
TDEM personnel. Payments for open projects must be requested at least quarterly if expenditures have been
made in that quarter.
9. Subrecipients will be required to submit quarterly progress reports (QPR) for open large projects and all
Hazard Mitigation Grant Program projects using TDEM's GMS. Your assigned Public Assistance and/or
Mitigation Coordinator will coordinate the due date for your specific reporting. Reports shall record all
Page 17 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
information in an accurate and timely manner for each quarter. Detailed information regarding each item of
information required is available on the form in GMS. Public Assistance program small projects are typically
exempt from quarterly reporting, however TDEM reserves the right to require QPRs on any smalls requiring
a POP extension. The first quarterly report will be due at the end of the first full quarter following the quarter
in which the project was obligated. No quarterlies are required for projects that Subrecipient has initiated a
closeout request and has provided a certificate of completion. Failure to submit required quarterly reports
for two or more quarters can result in withholding or deobligation of funding for Subrecipients until all reports
are submitted and up-to-date.
10.Subrecipients expending $750,000 or more in total Federal financial assistance in a fiscal year will be
required to provide an audit made in accordance with OMB Uniform Guidance; Cost Principles, Audit, and
Administrative Requirements for Federal Awards, Subpart F. A copy of the Single Audit must be submitted
to your cognizant State agency or TDEM within nine months of the end of the subrecipient's fiscal year.
Consult with your financial officer regarding this requirement. If not required to submit a single audit, a letter
must be sent to TDEM certifying to this.
11. Subrecipients will not make any award to any party which is debarred or suspended, or is otherwise excluded
from participation in the Federal assistance programs (EO 12549, Debarment and Suspension). Subrecipient
must maintain documentation validating review of debarment list of eligible contractors.
12.Subrecipients must keep record of equipment acquired by federal funds for the life cycle of the equipment.
A life cycle for most equipment will be three years, but could be longer. If the fair market value of a piece of
equipment is valued over $5,000, FEMA will have the right to a portion of proceeds if equipment is sold. If
the fair market value of a piece of equipment is less than $5,000, the property can either be retained, sold or
designated as surplus with no further obligation to FEMA.
13.TDEM will be using the FEMA Public Assistance Delivery Model to facilitate the writing of project worksheets
(Portal). Subrecipient will be responsible for establishing and maintaining an active account in the Portal and
to provide and upload timely, all information requested that is needed to write accurate project worksheets.
The Portal will provide the Subrecipient visibility of the entire project writing process.
14.TDEM requires the use of its Grant Management System (GMS) for Subrecipient grant management
functions. Subrecipient will access GMS to initiate Requests for Reimbursements (RFR), Advance of Funds
Requests (AFR), Time Extensions, Scope and Cost change requests, Quarterly Progress Reports, Project
Closeouts, Appeals, and other items deemed necessary by TDEM. Requested forms and processes may be
adjusted and changed to accommodate GMS processes and requirements. Subrecipient agrees to monitor
GMS as necessary to properly manage and complete awarded projects under this agreement.
16.2 CFR 200.210(a)(15), 2 CFR 200.331(a)(1)(xiii) and (a)(4) make reference to indirect cost rates. The
Subrecipient may use the negotiated Indirect Cost Rate approved by its cognizant agency, or may use the
10% de minimis rate of modified total direct costs (MTDC) (as per § 200.414) when receiving Management
Costs.
Page 18 of 20
TDEM — December 2020
GRANT TERMS AND CONDITIONS
EXHIBIT G
Match Certification
Additional Grant Certifications
Subrecipient certifies that it has the ability to meet or exceed the cost share required for all subawards (Projects)
and amendments (versions) under this Grant Agreement.
Duplication of Program Statement
Subrecipient certifies there has not been, nor will there be, a duplication of benefits for this project.
Match Certification
Federal Debt Disclosure
Subrecipient certifies that it is not delinquent on any Federal Debt.
For Hazard Mitigation Projects Only;
Maintenance. Agreement.
Applicant certifies that if there is a Maintenance Agreement needed for this facility copy of that agreement will be
provided to TDEM.
Environmental Justice Statement
Federal Executive Order 12898 compliance requirements — If there are any concentrations of low income or
minority populations in or near the HMGP project:
1. Applicant certifies that the HMGP project result will not result in a disproportionately high or adverse effect on
low income or minority populations.
OR
2. Applicant certifies that action will be taken to ensure achievement of environmental justice for low income and
minority populations related to this HMGP project.
Page 19 of 20
TDEM — December 2020
Formal Request for Information Policy
Timelines for providing complete and accurate information and documentation are crucial to the
success of the overall Grant Program and to the timely completion and closure of awarded projects.
TDEM has developed a framework to support this endeavor following a progressive series of
communications for the subrecipient, referred to as Request for Information (RFI). TDEM will work
with subrecipients throughout the Formal RFI process as communication is the key to success.
Scope: This policy will be applied to Public
Assistance and Hazard Mitigation projects
for management and closeout activities
after obligation. This policy will address non-
responsive and inadequate responses to
request for information. The timelines
outlined below represent a single 30-day
period, containing three milestones.
Generally, this 30-day RFI Timeline begins
after TDEM sufficiently documents
communication (minimum of two GMS
documented forms of outreach) with the
subrecipient that has been escalated up to
the Regional Unit Chief regarding the
requested documentation. However,
nothing limits the ability of TDEM to issue
either a First or Second Request.
-Outreach: Minimum 2 outreach attempts
documented in GMS.
-Day 1- First Formal Communication:
Regional Unit Chief to Authorized Agent
L
econd Formal Communication:
to Authorized Agent and Certifyinginal Action: Regional Unit Chief to
d Agent
IF-
RFI Timelines
First Formal Communication The TDEM Regional Unit Chief will issue a read -
receipt, high importance email to the
subrecipient's Authorized Agent(s) highlighting
previous requests and allowing thirty calendar
days to provide the requested information.
Second Formal Communication TDEM staff will issue a formal reminder through a
letter signed by the Unit Chief which is then
emailed to the subrecipient's Authorized Agent(s)
and Certifying Official informing them of the final
ten business days remaining to provide the
requested information. The Assistant Chief is to
be copied on the email for visibility.
Final Action
If the RFI is not sufficiently answered, the Unit
Chief will verbally contact the subrecipient's
Authorized Agent(s) informing them of TDEM's
intent to proceed with deobligation of funds or
other remedies deemed appropriate by TDEM.
Deobligation requires any previously paid funds
to be returned to TDEM within thirty calendar
days, per the State Administrative Plan.
GRANT TERMS AND CONDITIONS
Please initial by each Exhibit, acknowledging you have received them, understand them, and
agree to abide by them.
Assurances — Non -Construction Programs, hereinafter referred to as "Exhibit A"
Assurances — Construction Programs, hereinafter referred to as "Exhibit B"
Certifications for Grant Agreements, hereinafter referred to as "Exhibit C"
State of Texas Assurances, hereinafter referred to as "Exhibit W
Environmental Review Certification, hereinafter referred to as "Exhibit F
Additional Grant Conditions, hereinafter referred to as "Exhibit F
Additional Grant Certifications, hereinafter referred to as "Exhibit G"
Request for Information and Documentation referred to as "Exhibit H"
Please sign below to acknowledged acceptance of the grant and all exhibits in
this agreement, and to abide by all terms and conditions.
Signature of Certifying Official
Richard H, Meyer, County Judge
Printed Name and Title
TDEM — December 2020
Date
Page 20 of 20
Texas Division of Emergency Management
Designation of Subrecipient Agent
Primary Contacts
Subrecipient: Calhoun County
Disaster Number(s):4586 DR -TX
Grant Program: severe Winter storms
Primary Agent
Serves as the primary point of contact for projects.
Name: Richard H. Meyer
Office Number:361-553-4600
Position/Job Title: County Judge
Fax Number:361-553-4444
Organization/employer: Calhoun County
Cell Number' 361-920-0800
Email* richard.meyer@calhouncotx.org
The Primary Agent will have full GMS access
Secondary Agent
Serves as the secondary point of contact for projects.
Name: LaDonna Thigpen
Office Number: 361-553-4400
Position/Job Title: EMC
Fax Number: 361-553-4444
Organization/employer: Calhoun County
Cell Number:
Email* ladonna.thigpen@calhouncotx.org
The Secondary Agent will have full GMS access
Primary Finance Agent
Serves as the primary point of contact for financial matters.
Name: Cindy Mueller
Office Number:361-553-4610
Position/Job Title: County Auditor
Fax Number: 361-553-4614
Organization/employer: Calhoun County
Cell Number:
Email* cindy.mueller@calhouncotx.org
The Primary Finance Contact will have full GMS access
Certifying Official
Serves as the official representative of the organization.
Must possess the authority to obligate funds & enter into contracts for the organization.
Name: Richard H. Meyer
Office Number:361-553-4600
Position/Job Title: County Judge
Fax Number:361-553-4444
Organization/employer: Calhoun County
Cell Number:
Email* richard.meyer@calhouncotx.org
GMS Access (pick 1) Full 8 Read Only ❑ None ❑
The above Primary and Secondary Agents are hereby authorized to execute and file the application on behalf of this organization for the purpose of
obtaining certain state and federal financial assistance under the Robert T. Stafford Disaster Relief & Emergency Assistance Act (Public Law 93-288
as amended) or otherwise available. Primary Financial Agent and the Certifying Official are authorized to represent and act for this organization in
all financial operations pertaining to this grant with the State of Texas. The Primary Agent will have authority to add or remove users within the
Texas Division of Emergency Management (TDEM) Grant Management System (GMS) for all grants.
*Note: All email addresses must be unique to user
Richard H. Meyer
Signature of Certifying Official Print Name Date
(Must be a Mayor, Judge, or Executive Director with the authority
to obligate funds & enter into contracts for the organization)
September 2019
Texas Division of Emergency Management
Designation of Subrecipient Agent
Alternate Contacts (Optional)
Subrecipient: Calhoun County
Disaster Number(s):4586 DR -TX
Grant Program: severe winter storms
Alternate Contact
List any additional contact here
Name: Candice Villarreal
Office Number: 361-553-4610
Position/Job Title: 1st Assistant County Auditor
Fax Number:361-553-4614
Organization/employer: Calhoun County
Cell Number:
Email* candice.villarreal@calhouncotx.org
GMS Access (pick 1) Full 8 Read Only ❑ None ❑
If this contact replaces an existing contact, write their name below. Otherwise, leave blank or mark N/A
Alternate Contact
List any additional contact here
Name:
Office Number:
Position/Job Title:
Fax Number:
Organization/employer:
Cell Number:
Email*
GMS Access (pick 1) Full ❑ Read Only ❑ None ❑
If this contact replaces an existing contact, write their name below. Otherwise, leave blank or mark N/A
Alternate Contact
List any additional contact here
Name:
Office Number:
Position/Job Title:
Fax Number:
Organization/employer:
Cell Number:
Email*
GMS Access (pick 1) Full ❑ Read Only ❑ None ❑
If this contact replaces an existing contact, write their name below. Otherwise, leave blank or mark N/A
Alternate Contact
List any additional contact here
Name:
Office Number:
Position/Job Title:
Fax Number:
Organization/employer:
Cell Number:
Email*
GMS Access (pick 1) Full ❑ Read Only ❑ None ❑
If this contact replaces an existing contact, write their name below. Otherwise, leave blank or mark N/A
Additional Contacts are authorized to represent and act for this organization in all operations pertaining to this grant with the State of Texas.
*Note: All email addresses must be unique to user
Richard H.
Signature of Certifying Official Print Name Date
(Must be a Mayor, Judge, or Executive Director with the authority
to obligate funds & enter into contracts for the organization)
September 2019
Instructions:
• The Designation of Subrecipient Agent (DSA) form is divided into two pages, the Primary
Contacts page and the optional Alternate Contacts page. The second page is not
required if there are no additional contacts to list.
• In the header of the document, list the name of the subrecipient (the organization
applying for the grant), as well as the disaster numbers and grant program this DSA
applies to (the disaster number is 4 digits long and assigned by FEMA. For example,
Hurricane Harvey is 4332. The grant program is either PA for Public Assistance or HMGP
for Hazard Mitigation Grant Program.)
• Multiple disasters may be listed on one DSA as long as specific disaster numbers are
indicated.
• None of the positions on the primary contact page may be left blank. However, the
same person may hold multiple positions. Contacts may be left blank on the additional
contact page.
• If a third party consultant/contractor is listed on the DSA, the agency that they are
employed by should be listed in the Organization/Employer field.
• All contacts require a unique email address. Additionally, contacts on the DSA cannot
share the same email address.
• All contacts must have a phone number listed.
• Granting a contact full Grants Management System (GMS) access will allow them to
perform tasks such as submitting quarterly reports and requesting reimbursements,
time extensions and scope/cost modifications within the State of Texas Grant
Management System on behalf of the subrecipient. Granting a contact Read Only access
will allow a contact to view information in GMS, but they will not be able to edit any
existing information themselves.
• The Primary, Secondary, and Finance Agents will always be granted full GMS access for
all grants within the program selected.
• The subrecipient can request that GMS access be added or revoked from a contact at
anytime if the need arises.
• The Certifying Official must be an individual who possesses the authority to obligate
funds and enter into contracts on behalf of the subrecipient.
• Both pages, if applicable, of the DSA must be signed and dated by the certifying official.
• If a new DSA is submitted with a different person listed for a position on the primary
contact sheet, the old contact holding that position will be removed. If a new contact is
added on the additional contacts page, no old contacts will be removed unless they are
specified in the field provided.
Joel Behrens
Calhoun County Commissioner, Precinct 3
z4bz t Jtate Hwy. 172—Olivia, Port Lavaca, Texas 77979 —Office (361) 893-5346 —Fax (361) 893-5309
Email: joel Ne rensailcalhotmcotx org
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 Commissioner's Court Agenda for May 19, 2021.
• Please Consider and Take Necessary Action to approve the preliminary plat of the Hurta Subdivision
5.00 acre tract in Port Alto, TX.
Sincerely, q0ef/)/k
Joel Behrens
Commissioner Pct. 3
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Joel Behrens
Calhoun County Commissioner, Precinct 3
24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 — Fax (361) 893-5309
Email: joel.behrens(ocalhouncotx.or4
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 Commissioner's Court Agenda for May 19, 2021.
Please Consider and Take Necessary Action to approve the final plat of the Hurta Subdivision
5.00 acre tract in Port Alto, TX.
Sincerely,
Joel Behrens
Commissioner Pct. 3
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Joel Behrens
Calhoun County Commissioner, Precinct 3
24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 — Fax (361) 893-5309
Email: ioelbehrens0calhouncotx.om
9
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 Commissioner's Court Agenda for May 19, 2021.
• Please Consider and Take Necessary Action on appointing Liz Zarate to the Parks Board.
Sincerely, *COA
Joel Behrens
Commissioner Pct. 3
# 10
Gary D. Reese
County Commissioner
County of Calhoun
Precinct 4
May 13, 2021
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 May 19, 2021.
• Consider and take necessary action to authorize the County Judge to submit a
commitment letter to the Texas General Land Office, which states that $80,392 in
County GOMESA funding will be used as match for a proposed CEPRA project at
Swan Point.
Sincerely,
T\�
Gary D. Reese
GDR/at
.�_-.._...._._---------------
P.O. Box 177 — Seadrift, Texas 77983 — email: garv.reese(1a calhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602
#11
AT
`L _OCLOG c"LI air
MAY 14 2021 Richard H. Meyer
AaOD 1.County judge
MuNn DL ru
BY
DfPU'N
,avid Mall, Commissioner, Precinct 1
Vern Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Cary Reese, Commissioner, Precinct 4
NOTICE OF PUBLIC HEARING
The Commissioners' Court of Calhoun County, Texas will meet on Wednesday,
May 19, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse,
211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas.
NOTICE IS HEREBY GIVEN that Calhoun County Commissioners' Court will
hold a public hearing in the Commissioners' Courtroom, 211 S. Ann Street, Suite 104, in
Port Lavaca, Texas, at 10:00 a.m. on May 19, 2021 on a Petition to Vacate Lots 1 and 2 in
Block 2 of Bayview Estates Section 11, Port O'Connor, Texas situated in the Santiago
Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in volume Z, Page
475 of the Calhoun County Plat Records.
The public shall have the right to be present and participate in such hearing.
Richard Meyer, County
Calhoun County, Texas
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 1 of 1
Gary D. Reese
County Commissioner
County of Calhoun
Precinct 4
May 13, 2021
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 May 19, 2021.
• Public hearing on Petition to Vacate Lots 1 and 2 in Block 2 of Bayview Estates
Section II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract
No. 19, Calhoun County, Texas as recorded in Volume Z, Page 475 of the Calhoun
County Plat Records.
Sincerely,
1�
Gary D. Reese
GDR/at
__..----..-...---._...._._._.__..... ._.._.....__........_.__......__...__.............
�__...-- ---
P.O. Box 177 — Seadrift, Texas 77983 — email: gary.reese@calhouncomore — (361) 785-3141 — Fax (361) 785-5602
PETITION TO VACATE
LOTS 1 AND 2 IN BLOCK 2 OF BAYVIEW ESTATES SECTION II, PORT O'CONNOR,
TEXAS SITUATED IN THE SANTIAGO GONZALES SURVEY, ABSTRACT NO. 19,
CALHOUN COUNTY, TEXAS AS RECORDED IN VOLUME Z, PAGE 475 OF THE
CALHOUN COUNTY PLAT RECORDS.
STATE OF TEXAS
COUNTY OF CALHOUN
KNOW ALL MEN BY THESE PRESENTS:
That the undersigned, being the designated agent of the owner of the property described as
Lots 1 and 2 in Block 2 of Bayview Estates Section II, Port O'Connor, Texas situated in the
Santiago Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in Volume
Z, Page 475 of the Calhoun County Plat Records, do hereby petition the Calhoun County
Commissioners Court to vacate said Lots 1 and 2 in Block 2 of Bayview Estates Section II in
accordance with Sections 206 and 207 of the Subdivision Regulations and Recreational
Vehicle Park Regulations Adopted by Calhoun County Commissioners Court on November
29, 2004 and Amended on December 13, 2007.
Property owners: Derick Kuyrkendall and Judith Kuyrkendall
Located at 1978 West Monroe in Port O'Connor, Texas
The property is proposed to be replatted in accordance with a plat submitted to the Calhoun
County Commissioners Court.
The petition will be considered by the Calhoun County Commissioners Court on May 19,
2021 at 10:00 a.m.
APR 21 2021
®Y; 1'ytFnn„
lry
Designated Agent:
Hen A. Danysh, .P.L.S. 5088
G & Engineers, Inc.
TBPLS Firm No. 10022100
205 W. Live Oak
Port Lavaca, TX 77979
(361) 552-4509
DESIGNATION OF AGENT
G & W Engineers, Inc.
205 W. Live Oak
Port Lavaca, Texas 77979
(361)552-4509
PROJECT: Replat of LOTS 1 AND 2 IN BLOCK 2 OF BAYVIEW ESTATES SECTION II, Port
O'Connor, Texas
PROPERTY ADDRESS: 1978 W. MONROE AVENUE, Port O'Connor Texas
LEGAL DESCRIPTION: Lots 1 and 2 in Block 2 of Bayview Estates Section II, Port O'Connor. Texas
situated in the Santiago Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in
Volume Z, Page 475 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.
i tc1C n
Brick Kuyrekendall Date
Before me, the undersigned authority, on this day personally appeared Derick Kuyrekendall
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
,eh t c�a
Not ry Si ature
'. A i I County, Te
day of f 2t',G�`
EVELYN F HERRERA
Notary Public, State of Texas
My Camm. Exp.10-01-2023
ID No. 117539M
name
OWNER: Judith Kuyrkendall
�
J ith KuyrkendafI Date
�L
Before me, the undersigned authority, on this day personally appeared Judith Kuyrkendall 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 C day of
County, Te ��`� EVELYN F HERRErf�ted r typed name
b, Nota y Public, Sdte of Texas
My Comm. Exp.1D-01-2023
VK1 WO
D No.1175390-0
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.
Signature Date
#12
Gary D. Reese
County Commissioner
County of Calhoun
Precinct 4
May 13, 2021
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 May 19, 2021.
Consider and take necessary action to Vacate Lots 1 and 2 in Block 2 of Bayview
Estates Section II, Port O'Connor, Texas situated in the Santiago Gonzales Survey,
Abstract No. 19, Calhoun County, Texas as recorded in Volume Z, Page 475 of the
Calhoun County Plat Records.
Sincerely,
F 7�.
Gary D. Reese \
GDR/at
._.._..-----.------..�_—�
P.O. Box 177 — Seadrift, Texas 77983 — email: earv.reese(a.calhouncotx.org — (361) 785-3141 — Fax (361) 785-5602
PETITION TO VACATE
LOTS 1 AND 2 IN BLOCK 2 OF BAYVIEW ESTATES SECTION Il, PORT O'CONNOR,
TEXAS SITUATED IN THE SANTIAGO GONZALES SURVEY, ABSTRACT NO. 19,
CALHOUN COUNTY, TEXAS AS RECORDED IN VOLUME Z, PAGE 475 OF THE
CALHOUN COUNTY PLAT RECORDS.
STATE OF TEXAS
COUNTY OF CALHOUN
KNOW ALL MEN BY THESE PRESENTS:
That the undersigned, being the designated agent of the owner of the property described as
Lots 1 and 2 in Block 2 of Bayview Estates Section II, Port O'Connor, Texas situated in the
Santiago Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in Volume
Z, Page 475 of the Calhoun County Plat Records, do hereby petition the Calhoun County
Commissioners Court to vacate said Lots 1 and 2 in Block 2 of Bayview Estates Section II in
accordance with Sections 206 and 207 of the Subdivision Regulations and Recreational
Vehicle Park Regulations Adopted by Calhoun County Commissioners Court on November
29, 2004 and Amended on December 13, 2007.
Property owners: Derick Kuyrkendall and Judith Kuyrkendall
Located at 1978 West Monroe in Port O'Connor, Texas
The property is proposed to be replatted in accordance with a plat submitted to the Calhoun
County Commissioners Court.
The petition will be considered by the Calhoun County Commissioners Court on May 19,
2021 at 10:00 a.m.
At 3,T7 aID
.. ii
APR 2 12021
@Y,�k//
r� rY
Designated Agent:
lLil� j
Hen A. Danysh, .P.L.S. 5088
G &AN Engineers, Inc.
TBPLS Firm No. 10022100
205 W. Live Oak
Port Lavaca, TX 77979
(361) 552-4509
DESIGNATION OF AGENT
G & W Engineers, Inc.
205 W. Live Oak
Port Lavaca, Texas 77979
(361)552-4509
PROJECT: Replat of LOTS 1 AND 2 IN BLOCK 2 OF BAYVIEW ESTATES SECTION 11, Port
O'Connor; Texas
PROPERTY ADDRESS: 1978 W. MONROE AVENUE, Port O'Connor Texas
LEGAL DESCRIPTION: Lots 1 and 2 in Block 2 of Bayview Estates Section II, Port O'Connor, Texas
situated in the Santiago Gonzales Survey, Abstract No. 19, Calhoun County, Texas as recorded in
Volume Z, Page 475 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.
G Brick Kuyrekendall Date
Before me, the undersigned authority, on this day personally appeared Derick Kuyrekendall
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 day of /� 0�
Not ry Si at1 Print d typed name
�n Q / I County, Te K�PgIEVELYN F HERRERA
oPublic,Stateof Texas
My Comm. Exp. 10-01-2023
D No. 1175390-0
OWNER: Judith Kuyrkendall
J ith Kuyrkenda , Date
Before me, the undersigned authority, on this day personally appeared Judith Kuyrkendall 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 v day of
a nr. EVELYN F HERREMed r typed name
County, TeN WO
r Not
Public, State of Texas
y My Comm. Ew.10-01-2023
ID No, 1175390-0 .,
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.
Agent's Signature
#13
Gary D. Reese
County Commissioner
County of Calhoun
Precinct 4
May 13, 2021
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 May 19, 2021.
Consider and take necessary action to Approve the Preliminary Plat of the
KUYRXENDALL SUBDIVISION (a replat of Lots 1 and 2 in Block 2 of Bayview Estates
Section II, Port O'Connor, Texas situated in the Santiago Gonzales Survey, Abstract
No. 19, Calhoun County, Texas as recorded in Volume Z, Page 475 of the Calhoun
County Plat Records).
(Sincerely,
1 q),
Gary D. Reese
GDR/at
P.O. Box 177 — Seadrift, Texas 77983 — email: Rary.reeseAcalhouncomom — (361) 785-3141 — Fax (361) 785-5602
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#14
Mae Belle Cassel
From: candice villarreal <candice.villarreal@calhouncotx.org>
Sent: Monday, May 10, 2021 4:46 PM
To: Mae Belle Cassel; Richard H. Meyer; David Hall; vern lyssy;
joel.behrens@calhouncotx.org; Gary Reese
Cc: April Townsend
Subject: Agenda Item - VFIS Insurance Proceeds
Attachments: VFIS POC VFD 041121.pdf
MaeBelle,
Please place the following on the next open agenda.
• Consider and take necessary action on VFIS insurance proceeds in the amount of $1,948.22 for repairs to a Port
O'Connor VFD brush truck from April 11, 2021.
Thank you,
Candice Vidarreal
laAssistantAuditor
Calhoun County Auditors Office
202 S. Ann Street, Suite B
Port Lavaca, 7X 77979
Phone (361)5534612
Calhoun County Texas
#15
Mae Belle Cassel
From: Dustin Jenkins <Dustin.Jenkins@calhouncotx.org>
Sent: Wednesday, May 12, 2021 2:52 PM
To: Mae Belle Cassel
Cc: Richard Meyer; vern lyssy; Joel Behrens; Gary Reese; David Hall
Subject: Re: 2000 Chevy 350OHD Chassis Transfer
Attachments: Department Inventory Transfer Form-2000-Chevy-350OHD to MagBeach from
CCEMS_scanned.pdf
Mae Belle,
Please place the following item on the agenda for the next available Commissioners Court:
Consider and take necessary action on request by Calhoun County EMS Director to transfer a 2000 Chevy 350OHD
Chassis, inventory number 524-0042 from CCEMS to Magnolia Beach VFD as indicated on the Calhoun County, Texas
Departmental Inventory Transfer Request form.
Respectfully,
J. Dustin Jenkins, DMIN, MBA, MTh, LP
Director of EMS
Calhoun County, TX
From: "David Hall" <David.Hall@calhouncotx.org>
To: "Dustin Jenkins" <Dustin.Jenkins@calhouncotx.org>
Cc: "Richard Meyer"<richard.meyer@calhouncotx.org>, "vern lyssy"
<vern.lyssy@calhouncotx.org>, "Joel Behrens" <joel.behrens@calhouncotx.org>, "Gary Reese"
<gary.reese@calhouncotx.org>, "Mae Belle Cassel"<maebelle.cassel@calhouncotx.org>
Date: Thu, 29 Apr 2021 12:43:03 -0500
Subject: Re: 2000 Chevy 350OHD Chassis
I think Chief Mayne expressed interest in it for MBVFD
Sent from David's Phone
On Apr 29, 2021, at 12:41 PM, Dustin Jenkins<Dustin.Jenkins@calhouncotx.org>
wrote:
Dear Calhoun County Commissioners,
I know all of you are very busy, so I'll be brief. Recently, we remounted the Frazer Ambulance Box
received from Port O'Connor, which was mounted on a 2000 Chevy 350OHD chassis. Are any of you
interested in this chassis for your precinct or perhaps any of the volunteer fire departments in your
precincts?
Very Respectfully,
J. Dustin Jenkins, DMin, MBA, LP
Director of Emergency Medical Services
705 Henry Barber Way
Calhoun County, TX
dustin.jenkins@calhouncob(.org
(361)571-0014
Calhoun County Texas
Calhoun County Texas
J. Dustin Jenkins, DMin, MBA, LP
Director of Emergency Medical Services
705 Henry Barber Way
Calhoun County, TX
dustinjenkins@calhouncotx.org
(361) 571-0014
Calhoun County Texas
Calhoun County, Texas
DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM
Requested By: J. Dustin Jenkins
Inventory
Number Description Serial No. Transfer From/To Department
524-0042 2000 Chevy 3500HD Chassis 1 GBKC34JOYF495074 From 345/CCEMS to 640/Magnolia Beach VFD
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# 17
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---May 19, 2021
TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES
TOTAL PAYABLES,.PAYROLL AND ELECTRONIC BANK PAYMENTS $ 721,10131'�-
TOTAL TRANSFERS BETWI=EN FUNDS $ 371,700.11
TOTAL NURSING HOME UPL EXPENSES $ 377,815.19 ✓
TOTAL INTER -GOVERNMENT TRANSFERS $
GRAND TOTAL DISBURSEMENTS APPROVED May 19, 2021 $ 1,470,616.61
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---MaV 19,2021
PAYABLE$ AND PAYROLL
5/13/2021 Weekly Payahles
495,302.29
5/17/2021 McKesson-340B Prescription Expense
2,156.74
5/1712021 Ameriscurce Bergen-340B Prescription Expense
1,831.02
Prosperity Electronic Bank Payments
5/1 D/2021 Credit Card & Lease Fees
5,522.04
5120/2021 Sales Tax for April 2021
1,225.98
5/1612021 TCDRS April Retirement
214,3D4.35
5/11/2021 Cleargage-Patient Financing Service
ST40
5110-6114121 Pay Plus -Patient Claims Processing Fee
244.41
511412021 ExpertPay- child support
446.08
TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS
$ 721000.31,
TRANSFER BETWEEN FUNDS -NURSING HOMES
5/1312021 MMC Operating to Solera-cormction of NH insurance payment deposited
into MMC operating
927,50
5/1312021 MMC Operating to Broadmoor-correction of NH insurance payment
deposited into MMC Operating
24,836.24
5/1312021 MMC Operating to The Crescent -correction of NH insurance payment
deposited into MMC Operating
1,110.00
5/13/2021 MMC Operating to Golden Creek Healthcare-corection of NH insurance
payment deposited into MMC Operating
91,633,35
5/13/2021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment
deposited into MMC Operating
77,589.92
5/13/2021 MMC Operating to Tuscany Village -correction of NH insurance payment
deposited into MMC Operating
75,371.81
511312021 MMC Operating to Bethany Senior Living- correction of NH insurance
payment deposited into MMC Operating
100,531.29
TOTALTRANSFERSBETWEEN;FUNDS'
$ 311700.11
NURSING HOME UPL EXPENSES
5/1712021 Nursing Home UPL-Cantex Transfer
5/17/2021 Nursing Home UPL-Nexion Transfer
5/17/2021 Nursing Home UPL-HMG Transfer
5/17/2021 Nursing Home UPL-Tuscany Transfer
511712021 Nursing Home UPL-HSL Transfer
QIPP/INTEREST/RECOUP CHECKS TO MMC
5/17/2021 Ashford -Medicare recoup
5/17/2021 Broadmoor-Medicare recoup
5/17@021 Crescent -Medicare recoup
5/17/2021 Fort Bend -Medicare recoup
5/17/2021 Solera-Meicare recoup
5/1712021 Golden Creek -Medicare recoup
5/17/2021 Tuscany
TOTAL NURSING^HOME UPL EXPENSES
TOTAL INTER -GOVERNMENT TRANSFERS,
235,556.25
25,962.78
26,789,02
9,784.62
26,974.71
8,657.5E
12,157.30
5,978.62
5,978.52
6.978.52
5.978.62
8,019.85
$ 377,815.19
GRAND TOTAL DISBURSEMENTS APPROVED May 1,9, 2021 $ 1',470+515.61
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Invoice List
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Due Dates Through:
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Vendor#'
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Pay Code
A0401
ABBOTT NUTRITION✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DI
Pay
Gross
Discount
No -Pay
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613499258 ✓04/30/2021 03/17/2021 04/01/2021
6.27
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6.27 ✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
A0401 ABBOTT NUTRITIOt
6.27
0.00
0.00
6.27
Vendor#
Vendor Name
Class Class
Pay Code
10246
ACCENT ✓
Invoice# Comment Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
1307582210105112/2021 05/06/2021 05/06/2021
71.29
0.00
0.00
71.29
PATIENTREFUND
Vendor Totals: Number Name
Gross
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No -Pay
Net
10246 ACCENT
71.29
0.00
0.00
71.29
Vendor#
Vendor Name
Class
Pay Code
11283
ACE HARDWARE 15521 V/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
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Gross
Discount
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153014 w' 05/12/2021 04/02/2021 04/2712021
8.59
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153011 1 05/12/2021 04/02/2021 04/27/2021
27.98
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21,98
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1532571/ 05/12/2021 04/13/2021 05/08/2021
6.28
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16.99
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5Z98
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153565 v` 05/12/2021 04/23/2021 (1812021
28.99
0.00
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28.99
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28.99
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153619 f 05/12/2021 04/25/2021 05/20/2021
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22.58
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1.59
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153676 ✓F 05/12l2021 04/27/2021 05/22/2021
22.98
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140.46
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Vendor Totals: Number Name
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Discount
No -Pay
Net
11283 ACE HARDWARE l!
405.38
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0.00
405.38
Vendor#
Vendor Name
Class
Pay Code
A1680
AIRGAS USA, LLC - CENTRAL DIV M V_
Invoice# Com ent Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
9112366561 4/30/2021 04/15/2021 05/10/2021
307,59
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307.59
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9112416528 0y /30l2021 04/22/2021 06/17/2021
237.76
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Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
A1680 AIRGAS USA, LLC - v!'
545.35
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0,00
545,35
Vendor#
Vendor Name
Class
Pay Code
A1715
ALCO SALES & SERVICE CO
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Invoice# Comment Tran Di Inv Dt Due DI
Check Dt
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Gross
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224.00
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Vendor#
Vendor Name
Class
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10958
ALLYSON SWOPEJ
Invoice# Comment Tran DI Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
051121 05/12/2021 05/11/2021 05/11/2021
3.192.76
0.00 0.00
3,192.75 ✓
CONTRACT EMPLOYEE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10958 ALLYSON SWOPE
3.192.75
0.00
0.00
3,192.75
Vendor#
Vendor Name
Class
Pay Code
13912
APRIL KUBALA PHOTOGRAPHY V/
Invoice# Comment Tran Dt Inv DI Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
050321 05/11/2021 05/03/2021 05/03/2021
125,00
0.00 0.00
125.00 ✓/
NEWBORN SESSION MARKETING
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13912 APRIL KUBALA PHC
125.00
0.00
0.00
125.00
Ventlor#
Vendor Name
Class
Pay Code
A2271
ARTHREX, INC ✓
W
Invoice# Comment Tran Ot Inv Ot Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
912003200 W64/3012021 04/22/2021 06/12/2021
160.00
0.00 0.00
160.00
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912028922 „ 04/30/2021 04f27/2021 05/12/2021
6,125.32
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6,125.32
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
A2271 ARTHREX, INC
6,285.32
0.00
0.00
6,285.32
Vendor#
Vendor Name
Class
Pay Code
A2600
AUTO PARTS & MACHINE CO. i /
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Invoice# omment Tran Dt Inv Dt Due DI
Check DI
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Gross
Discount No -Pay
Net
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955559f 04/28/2021 04/26/2021 06/01/2021
302.49
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SUPPLIES
956220 ✓ 05/13/2021 05/04/2021 05/19/2021
104,68
0.00 0.00
104.68
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
A2600 AUTO PARTS & MA,
407.17
0.00
0.00
407.17
Vendor#
Vendor Name
Class
Pay Code
80435
BARD PERIPHERAL VASCULAR
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Invoice# Comment Tran Dt Inv DI Due Ot ,/
Check Dt
Pay
Gross
Discount No -Pay
Net
$2416486 „f04/30/2021 04/16/2021 05/11/2021
109,32
0.00 0.00
109.32,
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
80435 BARD PERIPHERAL
109.32
0.00
0.00
109,32
Vendor#
Vendor Name
Class
Pay Code
61150
BAXTER HEALTHCARE ✓
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Invoice# Go ment Tran DI Inv DI Due Dt
Check DI
Pay
Gross
Discount No -Pay
Net
70390487 04/30/2021 04/12/2021 05/07/2021
719,06
0.00 0.00
719.06
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2,367.50
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665.22
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665.22 ✓l
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
61150 BAXTER HEALTHC/
4,381,28
0.00
0.00
4.381.28
Vendor#
Vendor Name
Class
Pay Code
61320
BEEKLEY CORPORATION yr/
M
Invoice# Comment Tran Dt Inv Dt Due Ot
Check Di
Pay
Gross
Discount No -Pay
Net
INV1432740 4/30/2021 04/30/2021 05112/2021
936.95
0.00 0.00
936.95V/1
SUPPLIES
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Gross
Discount
No -Pay
Net
81320 BEEKLEY CORPOR
936.95
0.00
0.00
936,95
Vendor#
Vendor Name
Class
Pay Code
B1601
BOHLS BEARING & POWER TRANI M V`
Involce# gomment Tran Dt Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
267365 ✓ 05/12/2021 04/30/2021 04/30/2021
449.1E
0.00 0.00
449.18
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
B1601 BOHLS BEARING &
449.18
0.00
0.00
449.18
Vendor#
Vendor Name
class
Pay Code
B1650
BOSART LOCK & KEY INC /
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Invoice# Comment Tran Dt Inv Dt Due Ot
Check Dt
Pay
Gross
Discount No -Pay
Net
122025 f 04/30/2021 04/20/2021 05/30/2021
260.80
0.00 0.00
260.80
CYLINDERS/KNOBLOCKS/K EYS
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
B1650 BOSART LOOK & KI
260.80
0.00
0.00
260.80
Vendor#
Vendor Name
Class
Pay Code
11295
CALHOUN COUNTY INDIGENT AC( ✓
Involce# Comment Tran Dt Inv Dt Due Of
Check Dt
Pay
Gross
Discount No -Pay
Net
051221 05/12J2021 05/12/2021 06/12/2021
80.00
0.00 0.00
80.00
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TRANSFER
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
11295 CALHOUN COUNTY
80.00
0.00
0.00
80.00
Vendor#
Vendor Name
Class
Pay Code
C1325
CARDINAL HEALTH 414, INC.✓
W
Invoice# Comftpent Tran 01 Inv Ot Due DI
Check Dt
Pay
Gross
Discount No -Pay
Net
80025038B1.E4/30/2021 041M2021 05/05/2021
375.74
0.00 0.00
375.74
SUPPLIES
8002510467 /30,2021 04/17/2021 05/12/2021
363.17
0.00 0.00
363.17 r/
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
C1325 CARDINALHEALTH
738.91
0.00
0.00
738.91
Vendor#
Vendor Name
Cl ss
Pay Code
1.9028
CAVALLO ENERGY TEXAS LLC
Invoice# Comment Tran Dt Inv Dt Due Ot
Check Dt
Pay
Gross
Discount No -Pay
Net
2111200149t04/30/2021 04/21/2021 05/24/2021
7.66
0.00 0.00
7.66 %
ACCT 167662
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Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13028 CAVALLO ENERGY
7.66
0.00
0.00
7.66
Vendor#
Vendor Name
Class
Pay Code
01992
CDW GOVERNMENT, INC. /
M
Invoice# Comment Tran Or Inv Dt Due t 9
Check Dt
Pay
Gross
Discount No -Pay
Net
C113526 05/12/2021 04/21/2021 05/21/2021
1,156.67
0.00 0.00
1,156.67
SCANNER/OFFICE SOFTWARE
C125372 05/12/2021 04/22/2021 05/22/2021
1,941A0
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1,941A0 f
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Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
C1992 COW GOVERNMEN
3,098.07
0.00
0.00
3,098.07
Vendor#
Vendor Name
Class
Pay Code
1D105
CHRIS KOVAREK
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Invoice# ; Comment Tran Dt Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
49 Y/' 05f11/2021 05/04/2021 05/04/2021
200.00
0.00 0.00
200,00
SWING BED
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10105 CHRIS KOVAREK
200.00
0.00
0.00
200.00
Vendor#
Vendor Name
Class
Pay Code
10212
CLINICAL PATHOLOGY LABS ZICP
Invoice# Comment Tram Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
1765520210,05113/2021 04/30/2021 04/30/2021
13,048.94
0.00 0.00
13,048.94 ✓%
LAB SERVICES
Vendor Totals: Number Name
Gross
Discount
No -Pay
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10212 CLINICAL PATHOLC
13,048.94
0.00
0.00
13,048.94
Vendor#
Vendor Name
glass
Pay Code
01166
COASTAL OFFICE SOLUTONS
W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
OEOT1732010611312021 04/20/2021 04/30/2021
1,278.74
0.00
0.00
1,278.74
SUPPLIES
f
OEOT1724810511312021 04/28/2021 05/08/2021
77,26
0.00
0.00
77.26 ✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
C1166 COASTAL OFFICE:
1,356,00
0.00
0.00
1,356.00
Vendor#
Vendor Name
Class
Pay Code
C1970
CONMED CORPORATION �-
M
Invoice# omment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
525991 04/30/2021 04/12/2021 05/11/2021
787.95
0.00
0.00
%
787.95r!
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
C1970 CONMED CORPORA
787,95
0,00
0.00
787.95
Vendor#
Vendor Name
class
Pay Code
10646
COVIDIEN
Invoice# Comment Tran Dt Inv Dt Due DI
Check DI
Pay
Gross
Discount
No -Pay
Not
5863356395 �04/30/2021 04120/2021 04/30/2021
1,261.62
0100
0.00
1,261.62
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10646 COVIDIEN
1,261.62
0.00
0.00
1.261.82
Vendor#
Vendor Name
Class
Pay Code
10006
CUSTOM MEDICAL SPECIALTIES
,j"
Invoice# Cpmment Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net t
280545 of 04/22/2021 04/29Y2021 05/11/2021
765.09
0.00
0,00
765.09✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10006 CUSTOM MEDICAL
765.09
0.00
0.00
765.09
Vendor#
Vendor Name
Class
Pay Code
10368
DEWITT POTH & SON V/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
6422540 05/13/2021 04/28/2021 05/23/2021
94.14
0,00
0.00
94A4
SUPPLIES
6422630 ✓ 05/13/2021 04/28/2021 05/23/2021
581.43
0.00
0.00
581.43
SUPPLIES
642524005/13/2021 04/29/2021 05/24/2021
51.66
0100
0.00
51,66 rr�
SUPPLIES
f
6427690 V 05/13/2021 05f04/2021 05/29/2021
163.24
0.00
0,00
/
163.24
SUPPLIES
6429390 05/1312021 05/05/2021 05/30/2021
46.78
0.00
0100
r
46.76 yip
SUPPLIES
6433830 �/05113Y2021 05/07/2021 06/01/2021
163.52
0.00
0.00
f
163.52 ✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10368 DEWITT POTH & SC
1,100.75
0.00
0.00
1,100.75
Vendor#
Vendor Name
Class
Pay Code
11011
DIAMOND HEALTHCARE CORP V
Invoice# Com ent Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net /
IN20054589 /07/2021 05/01/2021 05126/2D21
19,166.67
0.00
0.00
19,166.67,
CPR
IN200545B8,05/0712021 05t0l/2021 05/26/2021
31,144,56
0.00
0.00
31.144-68 �..
BEV HEALTH
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
11011 DIAMOND HEALTH(
50,311.25
0.00
0.00
513,311.25
Vendor#
Vendor Name
Class
Pay Code
10789
DISCOVERY MEDICAL NETWORK
f
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
Net
D43021 04/30/2021 04/3012021 04/30/2021
254.910.59
0.00
D.00
254,910.59
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PRO FEES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10789 DISCOVERY MEDIC
254,910.59
0.00
0.00
254,010.59
Vendor#
Vendor Name
Class
Pay Code
10175
DSHS CENTRAL lAS MC2004
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
GENCN042605/1312021 05/04/2021 05/29/2021
1,211.60
0.00 0.00
1,211.60
LAB SERVICES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Nei
10175 DSHS CENTRAL LA
1,211.60
0.00
0.00
1,211.60
Vendor#
Vendor Name
Pay Code
D1785
DYNATRONICS CORPORATION
/Class
✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gress
Discount No -Pay
Net
IN2127209,/64/30/2021 04/30/2021 05/12/2021
270.79
0.00 0.00
270.79
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
D1785 DYNATRONICS COI
270.79
0.00
0.00
270.79
Vendor#
Vendor Name
Class
Pay Code
13872
ETHOS MEDICAL STAFFING v/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net !
25664 ✓ 04/30/2021 04/30/2021 05/30/2021
2,936.80
0.00 0.00
2,936.80 ✓
NURSE STAFFING
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13872 ETHOS MEDICAL 5
2,936.80
0.00
0"00
2,9$6.80
Vendor#
Vendor Name
Class
Pay Code
02510
EVIDENT ref
M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
T210416137&5/13/2021 04/16/2021 05/11/2021
11,947.94
0.00 0.00
11,947,94
BUSINESS SERVICES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
C2510 EVIDENT
11,947.94
0.00
0.00
11,947,94
Vendor#
Vendor Name 1
Class
Pay Code
F1100
FEDERAL EXPRESS CORP. ✓
w
Invoice# Co ment Tran Dt Inv Dt Due DI
Check Dt
Pay
Grass
Discount No -Pay
Net
735513406 5/12/2021 W2912021 06,24/2021
10.26
0.00 0.00
10.26 "
SHIPPING
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
F1100 FEDERAL EXPRESF
10.26
0.00
0.00
10.26
Vendor#
Vendor Name
Class
Pay Code
F1300
FIRESTONE OF PORT LAVACA W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
0072860 V 04/30/2021 03/15/2021 03/15/2021
711S
0.00 0.00
71.15 ✓!
OIL CHANGE
0072877 �"04/3012021 03/16/2021 03/15/2021
51.44
0.00 0.00
51.44
- OIL CHANGE
0073S12 i/05/102021 05/03/2021 05/03/2021
91.00
0.00 0.00
91.00 ✓'�
BATTERY
Vendor Totals: Number Name
Gross
Discount
No -Pay
Not
F1300 FIRESTONE OF POI
213.59
0.00
0.00
213.59
Ventlor#
Vendor Name
Class
Pay Code
10788
FIRETROL PROTECTION SYSTEM; v,"
Invoice# Ccpffient Tran Dt Inv Dt Due Dt
Check Dt
Pay
Grass
Discount No -Pay
Net
100714546 6,104/30/2021 04/21/2021 05/01/2021
782.50
0.00 0.00
782.501__,�
CHECK OUT DAMPERS IN L7D ARI
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10788 FIRETROL PROTEC
782.50
0.00
0.00
782,50
Vendor#
Vendor Name /`
Class
Pay Code
F1400
FISHER HEALTHCARE ✓
M
Invoice# Cc ment Tran Ot Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
7361031 �04/3012021 03/18/2021 04/12/2021
235.85
0.00 0.00
235.85 1'f
SUPPLIES
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8873378 1// 04/30/2021 04/02/2021 05/27/2021
149,59
0.00
0.00
149.59
SUPPLIES
✓
9404168 04/30l2021 04l07/2021. 05/27l2021
1,351.64
0.00
0.00
1,351,641/'
SUPPLIES
0334698 /04/30/2021 04/12/2021 05/27/2021
255.00
0.00
0.00
255.001/�
SUPPLIES
0793160 v/ 04/30/2021 04/14/2021 05/27/2021
28826
0100
0.00
288.26 V'
SUPPLIES
0793158 /0413012021 04/14/2021 05/27/2021
176.61
0.00
0100
176.61
SUPPLIES
0884679 ,J 0430/2021 04/15/2021 05/27/2021
9,63822
0.00
0.00
9,638.22 v'
SUPPLIES
0985032 1/04/30/2021 04/16/2021 05/11/2021
159.00
0.00
0,00
159,00
SUPPLIES
1056603 r% 04/30/2021 04/19/2021 05/27/2021
53.85
0.00
0.00
63.85
SUPPLIES
1056600 04/3012021 04/19/2021 05/27/2021
2,424.00
0.00
0.00
2,424.00.�;
SUPPLIES
1380249 y% 04/30/2021 04/22/2021 05/27/2021
387.70
0.00
0.00
387,70
SUPPLIES
J
1490468 ,/ 04/30/2021 04/23/2021 05/27/2021
251.02
0.00
0.00
251,02 ✓�
SUPPLIES
9769012 ,/ 041SM021 05/06/2021 05/27/2021
62.76
0.00
0.00
62.76
SUPPLIES
1056604 ,/05/13/2071 04/19/2021 05/14/2021
180.32
0.00
0.00
180.32
SUPPLIES
1056601 /05/13/2021 04/19/2021 05/14/2021
652.67
0.00
0.00
652.67
SUPPLIES
1380252 �65113/2021 04/22/2021 05/17/2021
159.00
0.00
0.00
/
159.00
SUPPLIES
1380251 /05113/2021 04/22l2021 05/27/2021
1,910.48
0.00
000
1.910.4E ✓/
SUPPLIES
1612297 „/05113/2021 04426/2021 05/21/2021
488.30
0.00
0.00
488.30 ✓��
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
F1400 FISHER HEALTHCA
18,624.27
0.00
0.00
18,824,27
Vendor#
Vendor Name
Class
Pay Code
12404
GE PRECISION HEALTHCARE, LLC �/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt Pay
Gross
Discount
No -Pay
Net
6001839110010412021 05/01/2021 05/31/2021
86.67
0.00
0.00
86.67
/ MAINT CONTRACT
6001839109,05104/2021 05/01/2021 05/31/2021
3,568.58
0100
0.00
3,588.58,//
MAINT CONTRACT
6001839037 /4/2021 05/01/2021 05/31/2021
680.00
0.00
0.00
680.00
MAINT CONTRACT
6001639317 0 04/2021 05/01/2021 05/31/2021
868-16
0.00
0.00
666.16 ✓
// MAINTCONTRACT
6001839156,Q5/04/2021 05/01/2021 OM112021
5,665.83
0.00
0.00
5,665.83v
MAINT CONTRACT
6001839038 105�04/2021 05/01/2021 05/31/2021
572.33
0100
0.00
572.33 "
MAINT CONTRACT
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
12404 GE PRECISION HE/
11,461.57
0,00
0,00
11.461.57
Vendor#
Vendor Name
Class
Pay Code
10901
GENESIS DIAGNOSTICS ul �
Invoice# Comment Tran Dt Inv Dt Due Ot
Check Dt Pay
Gross
Discount
No -Pay
Net
/
52045 ✓ 04/30/2021 04/22/2021 05/22/2021
224,89
0.00
0,00
224,89,✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10901 GENESIS DIAGNOS
224.89
0.00
0.00
224.89
Vendor#
Vendor Name
Class
Pay Code
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W1300
GRAINGER ✓
M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
9872072765a,t/30/2021 04/16/2021 05/11/2021
769.23
0.00 0.00
769,23 v/
SUPPLIES
9875602469r04/3012021 04/20/2021 05/15/2021
57.63
0.00 0.00
57.63 v
� SUPPLIES
9875128556,94/30/2021 04/20/2021 05/15/2021
196.08
0.00 0.00
196.08 ,%
SUPPLIES
9875128549,0 /4 30/2021 04/20/2021 05/15/2021
61.80
0.00 0.00
61.80 ✓�
SUPPLIES
9875B02451 gXI3012021 04/20/2021 05/15/2021
47.64
0.00 0.00
47.64 ✓:"
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
W1300 GRAINGER
1,132.38
0.00
0.00
1,132.38
Vendor#
Vendor Name i
Class
Pay Code
G0401
GULF COAST DELIVERY ✓
Invoice# Comment Trap Dt Inv Dt Due Dt
Check DI
Pay
Gross
Discount No -Pay
Net •
043021 04/30/2021 04/3012021 05/30/2021
25.00
0.00 0.00
25.00 tf
DELIVERY SERVICE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
G0401 GULF COAST DELI\
25.00
0.00
0.00
25.00
Vendor#
Vendor Name
Class
Pay Code
G1210
GULF COAST PAPER COMPANY
VM.
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
1829947 V' 04/22/2021 03/13/2021 04/12/2021
239.47
0.00 0.00
239.47
SUPPLEIS
/
2037615 ✓ 05/1312021 04/27/2021 05/27/2021
128.38
0.00 0.00
126.38
SUPPLIES
2037622 05/13/2021 04/27/2021 05/27/2021
685.21
0.00 0.00
685.21
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
G1210 GULF COAST PAPE
1,051,06
0.00
0.00
1,051.06
Vendor#
Vendor Name
Class
Pay Code
H0032
H +.H SYSTEM, INC. „i/
invoice# omment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
034311 V 04/30/2021 04/22/2021 0412PJ2021
58.95
0.00 0.00
58,95
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
H0032 H + H SYSTEM, INC
%95
0.00
0.00
58.95
Vendor#
Vendor Name
Class
Pay Code
11784
HALF LEAGUE STORAGE
Invoice# Comment Tran Dt Inv Ot Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
050121 05/07/2021 05/01/2021 05/01/2021
3W00
0.00 0.00
360.00
MAY - JUL UNIT 11/12/35
Vendor Totals: Number Name
Gross
Discount
No -Pay
Not
11784 HALF LEAGUE STO
360.00
0.00
0.00
360.00
Vendor#
Vendor Name
Class
Pay Code
10804
HEALTHCARE COOING 8 CONSUL u f
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
10841 ,% 04/30/2021 04/30/2021 05130/2021
11125.00
0.00 0.00
1,125.00 v'
PRO CLINIC AUDIT APRIL 2021
10891 04/30/2021 04/30/2021 05/30/2021
658.50
0.00 0.00
658.50
CODING SERVICES
Vendor Totals: Number Name
Grass
Discount
No -Pay
Net
10604 HEALTHCARE COD
1,783.50
0.00
0.00
1,783,50
Vendor#
Vendor Name
Class
Pay Code
11552
HEALTHCARE FINANCIAL SERVICI
Invoice# Comment Tran Dt Inv Dt Due Ot
Check Dt
Pay
Gross
Discount No -Pay
Net
100458720,i430/2021 04/27/2021 06/01/2021
4,610.52
0.00 0.00
4,610.52
PHONE STERILIZER GEM PREM
4N
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
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11552 HEALTHCARE FINA
4,610.52
0.00
0.00
4,610.52
Vendor#
Vendor Name
Cl a
Pay Code
13544
HEALTHSMART INTERNATIONAL
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
H851663 �/05/13/2021 03/23/2021 04/14/2021
270.61
0.00 0.00
270.61
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13544 HEALTHSMART INT
270.61
0.00
0.00
270.61
Vendor#
Vendor Name
Class
Pay Cade
12866
HOLT CAT ,,'
Invoice# Comment Tran Dt Inv Dt Due DI
Check DI
Pay
Gross
Discount No -Pay
Net
WIEC005864V4/30/2021 04/21/2021 05/21/2021
1,924.00
0.00 0.00
1,924.00
PREVENITIVE MAINTENANCE
WIECO0586660413012021 04/21/2021 05/21/2021
2,287,02
0.00 0.00
2,287.0214
PREVENITIVE MAINTENANCE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
12868 HOLT CAT
4,211.02
0.00
0.00
4,211.02
Vendor#
Vendor Name
Class
Pay Code
13924
(KISS
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
6749 vie 05/13/2021 05/03/2021 05/18/2021
1,995.00
0,00 0.00
1,996.00
TONO PEN XL MEDTONIC
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13924 (KISS
1,995.00
0.00
0.00
1,995.00
Vendor#
Vendor Name
Class
Pay Code
11108
ITERSOURCE CORPORATION
, /
Invoice# Comment Tran Ot Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
711339 ,05111/2021 05/01/2021 05/01/2021
250.00
0,00 0.00
250.00
SUPPORT SYSTEM
y
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
11108 ITERSOURCE CORI
250.00
0.00
0.00
250.00
Ventlor#
Vendor Name
Class
Pay Code
J0150
J & J HEALTH CARE SYSTEMS,
IN( f
Invoice# Comment Tran Dt Inv Dt Due DI
Check Dt
Pay
Gross
Discount No -Pay
Net
924644039, 64130/2021 04/06/2021 05/06/2021
97.11
0.00 0.00
97.11
SUPPLIES
�
924664105 ,04/30/2021 04/08/2021 05/08/2021
1,039.79
0.00 0.00
1,039.79
// SUPPLIES
924713671 VO4/30/2021 04/15/2021 05/15/2021
587.38
0.00 0.00
587-38 1/,/
SUPPLIES
924776325 1164/30/2021 04/26/2021 05/26/2021
200.46
0.00 0.00
200.48 t%
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
J0150 J & J HEALTH CARE
1,924.76
0.00
0.00
1,924.76
Vendor#
Vendor Name
Cass
Pay Code
11576
JOHNGSELF + PARTNERS, ING
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Not
003729 0511=021 05/04/2021 05/04/2021
17,400.00
0.00 0.00
17,400.00 ✓
INITIAL. RETAINER FOR CFO
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
11576 JOHNGSELF+PAR
17400.00
0.00
0.00
17,400.00
Vendor#
Vendor Name
Class
Pay Code
13920
//
KAYLIN EASLEY ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
050521 05/11/2021 05/06/2021 05/05/2021
9.43
0.00 0.00
9.43 �f
TRAVEL FOR LAB DRAWS
050521A 05/13/2021 05/05/2021 05/05/2021 L4jZI- GI5I2I-)
6,87
0.00 0.00
5.87
TRAVEL FOR LAB DRAWS
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13920 KAYLIN EASLEY
15.30
0.00
0.00
15.30
Vendor#
Vendor Name
Class
Pay Cade
file:///C:tUsers/mmckissack/cpsl/memmed.cpsinet.com/u86l5Oldata_5/imp_cw5reporL2909223723657388501.html
8114
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L0700
LABCORP OF AMERICA HOLDING: M ✓/
Invoice# Comment Tran Dt Inv
Dt Due
Dt Check Dt Pay
Gross
Discount
No -Pay
Nei
69260115 /05/1312021 05/01/2021
05/26/2021
945.00
0.00
0.00
945.00 ✓
PURCHASED SERVIES
Vendor Totals: Number
Name
Gross
Discount
No -Pay
Net
L0700 LABCORP
OF AMEF
945.00
0.00
0.00
946.00
Vendor#
Vendor Name
Class
Pay Code
10972
M G TRUST ✓J
Invoice# Comment Tran Dt Inv
Dt Due
Dt Check Dt Pay
Gross
Discount
No -Pay
Not
051021 05/12/2021 05/10/2021
05/10/2021
790.86
0.00
0,00
790.86
PAYROLL DED
Vendor Totals: Number
Name
Gross
Discount
No -Pay
Net
10972 M G TRUST
790.86
0.00
0.00
790.86
Vendor#
Vendor Name
Class
Pay Code
M2178
MCKESSON MEDICAL SURGICAL I i%
Invoice# Comment Tran Dt Inv
Dt Due
Dt Check Of Pay
Gross
Discount
No -Pay
Net
23071093 t/04130/2021 04/06/2021
04/21/2021
958.27
0.00
0.00
958.27 1'
/ SUPPLIES
23765077,/ 04/30/2021 0412PJ2021
05/07/2021
245,92
0,00
0.00
245.92
SUPPLIES
21887083 /05/12/2021 03/04/2021
03/19/2021
165.86
0.00
0.00
165.86
SUPPLIES
Vendor Totals: Number
Name
Gross
Discount
No -Pay
Net
M2178 MCKESSON MEDIC
1,370.05
0.00
0.00
1,370.05
Ventlor#
Vendor Name
/
Class
Pay Code
M2827
MEDIVATORS
✓
M
Invoice# Comment Tran Dt Inv
Of Due
Dt Check Of Pay
Gross
Discount
No -Pay
Net
90881420 04/30/2021 03/232021
05/11/2021
195.00
0.00
0.00
196.00 V _'
SUPPLIES
Vendor Totals: Number
Name
Gross
Discount
No -Pay
Net
M2827 MEDIVATORS
195,00
0.00
0.00
195.00
Vendor#
Vendor Name
Class
Pay Code
M2470
MEDLINE INDUSTRIES INC
„% M
Invoice# Comment Tran Dt Inv
Dt Due
Dt Check Dt Pay
Gross
Discount
No -Pay
Net
1702201413 10/22/2020 10/26/2019
06/012021
100.14
0.00
0.00
100.14
INTEREST
1948490251 4/30/2021 03/30/2021
04/24/2021
199.88
0.00
0.00
199,88
SUPPLIES
1Z
1946490253 /30/2021 03/30/2021
04124/2021
397.89
0.00
0.00
397.89
SUPPLIES
1946490255 �0A/30/P021 03/30/2021
04/24/2021
435.66
0.00
0.00
435.66 f
SUPPLIES
1946960154 e4/30/2021 04/02/2021
04/27/2021
243.96
0,00
0.00
243.96
/f�� SUPPLIES
�
1947505932,04/3012021 04/07/2021
05/02/2021
163.32
0.00
0.00
163.32
1 SUPPLIES
1948644626 04/30/2021 04/16/2021
05111/2021
19.61
0.00
0.00
/
19.51 v'
SUPPLIES
1948644525 Q4%30/2021 04/16/2021
05/11/2021
9.28
0.00
0.00
9.28
D w4tiStl SUPPLIES
1949584257 3012021 04/16/2021
05111/2021
31.95
0.00
0.00
/
31,95 ✓
SUPPLIES
�
1948891448,.04/30/2021 04/17/2021
05/1212021
617.76
0.00
0.00
817.76
SUPPLIES
194881450 04/302021 04/17/2021
05/12/2021
48.07
0.00
0.00
48.07 X
// SUPPLIES
1948891447 04/30/2021 04/17/2021
05/1 PJ2021
57.73
0.00
0.00
57.73
SUPPLIES
1948891452 gAI30/2021 04/17/2021
05/122021
411.17
0.00
0.00
411.17 �,.•'"
// SUPPLIES
1948891448 a9/302021 04/17/2021
05/12/2021
4,703.33
0.00
0.00
4.703.33
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SUPPLIES
1948891453 Q#//30/2021 04/17/2021
05/12/2021
6.68
0.00
0.00
6.68 %
/ SUPPLIES
1949013256414l30/2021 04/2012021
05/15/2021
103.02
0.00
0.00
103.02 ✓�
SUPPLIES
194901325W]3012021 04/20/2021
05/15/2021
15435
0.00
0.00
154.35 ✓�
SUPPLIES
1949237884, 4/30/2021 04/21/2021
05/16/2021
104,23
0.00
0.00
104.23
SUPPLIES
19492378764A/30/2021 04/2112021
05/16/2021
1,909.85
0.00
0.00
11909.85
// SUPPLIES
1949293361, 4/30/2021 04/21/2021
05/16/2021
452.21
0.00
0.00
452,21
SUPPLIES
jj.
1949237886t04/3012021 04/21/2021
05/16/2021
11.21
0.00
0.00
11.21 ✓�
SUPPLIES
1949237879 Q4'/30/2021 04/21/2021
06/16/2021
89.60
0.00
0.00
,r
89.60 ✓
SUPPLIES
1949237878,04%30/2021 04/21/2021
05/16/2021
346.69
0.00
0.00
346.69
// SUPPLIES
19492378800W/30/2021 04/21/2021
05/16/2021
28.36
0.00
0100
28.36 ✓f
SUPPLIES
,�
1949237875 t0'4/30/2021 04/21/2021
05/10/2021
3.68
0.00
0.00
3,68 v�
SUPPLIES
�
19492378811091/30/2021 04/21/2021
05/16/2021
110.56
0.00
0.00
110.56
� SUPPLIES
194923788264/30/2021 04/21/2021
05/1&2021
41.43
0.00
0,00
41.43 ✓
SUPPLIES
' 1949540202 QA/30/2021 04/23/2021
05/18/2021
9614
0.00
0.00
96,14 1/�
SUPPLIES
1949540203, 4/30/2021 04/23/2021
05/18/2021
75.94
0.00
0.00
75.94 ✓`
SUPPLIES
1949540204 44A0/2021 04/23/2021
05/18/2021
19.33
0,00
0.00
19.33 t%
SUPPLIES
1949534259 V6012021 04/23/2021
05/16/9021
51,47
0.00
0100
51.47 ✓
SUPPLIES
1944256269 r0 /13/2021 03/09/2021
04/03/2021
184,70
0.00
0.00
184.70
SUPPLIES
1944256266 08713/2021 03/09/2021
04/03/2021
77.61
0.00
0100
77.61
SUPPLIES
/
1944256268105/13/2021 03/09/2021
C4/03/2021
48.25
0.00
0.00
48.25 ✓�
SUPPLIES
1945807584 /13/2021 03/23/2021
C4/17/2021
233.64
0.00
0.00
233.64
SUPPLIES
�
1946407625,06,13/2021 03/27/2021
04/21/2021
171.06
0.00
0.00
171.06
SUPPLIES
1946407627,95/113/2021 03/27/2021
04/21/2021
171.06
0.00
0.00
171.06
SUPPLIES
1947319821,p!5 3/2021 04/06/2021
05/01/2021
25.38
0.00
0.00
25.38
SUPPLIES
1949237877 06 13/2021 04/21/2021
05/16/2021
11.B6
0.00
0.00
11.66 vZ
// SUPPLIES
194923788V1 /13/2021 04/21/2021
05/16/2021
858.65
0.00
0.00
858.65
// SUPPLIES
1949237885 W//13/2021 04/21/2021
05/16/2021
20.84
0,00
0,00
/
20.84 ✓
SUPPLIES
Vendor Totals: Number
Name Gross
Discount
No -Pay
Net
M2470 MEDLINE
INDUSTR 13,047.25
0.00
0.00
13,047.25
Vendor#
Vendor Name
Class
Pay Code
10963
MEMORIAL MEDICAL CLINIC
Invoice# Comment Tran Dt Inv
Dt Due Dt Check Dt Pay
Gross
Discount
No -Pay
Net
051021 05/12/2021 05/10/2021
05/10/2021
160.00
0.00
0.00
160.00 v�
file:/I/C:/Users/mmckissack/cpsilmemmed.opsinet.comlu88150/data_5/imp_cw5report2909223723657388501.html
10114
5113/2021
tmp_cw5report2909223723657388501.html
PAYROLL DIED
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10963 MEMORIAL MEDICF
160.00
0.00
0.00
160.00
Vendor#
Vendor Name
Class
Pay Code
10536
MORRIS & DICKSON CO, LLC ✓
Invoice# CPmment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
6863050 J O5/1112021 05/04/2091 05/14/2021
53.26
0.00 0.00
53.26
INVENTORY
6862305 ✓05111/2021 05/04/2021 05/14/2021
7.32
0.00 0.00
7.32
/ INVENTORY
6863286 �'OS/11/2021 06/04/2021 06/14/2021
19.22
0.00 0.00
19.22 ✓
INVENTORY
6863049 /05/1112021 05/04/2021 05/14/2021
5.47
0.00 0.00
5.47
INVENTORY
6863287 /65/11/2021 05/04/2021 05/14/2021
351.00
0.00 0.00
351.00 ✓
INVENTORY
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10536 MORRIS & DICKSOI
436.27
0.00
0.00
436.27
Ventlor#
Vendor Name
Class
Pay Code
M2659
MXR IMAGING, INC ✓
(VI
Invoice# Corn ant Tran Dt Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
8800744466:4/3012021 04/02/2021 05/02/2021
1,51a.67
0.00 0.00
1.518.67
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
M2659 MXR IMAGING, INC
1,518.67
0.00
0.00
1,618.67
Vendor#
Vendor Name
Class
Pay Code
01500
OLYMPUS AMERICA INC /�
M
Invoice# Co meet Tran Dt Inv Ot Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
30833510 04/3U/2021 04/23/2021 05/18/2021
226.95
0.00 0.00
226.95v,,
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
01500 OLYMPUS AMERICr
226.95
0.00
Vendor#
Vendor Name
Class
01416
ORTHO CLINICAL DIAGNOSTICS
✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
1851875204 0ai/13/2021 04/26/2021 05/26/2021
769.03
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
01416 ORTHO CLINICAL C
759.03
0.00
Vendor#
Vendor Name
Class
11069
PABLO GARZA
Invoice# Comment Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
051121 05/19J2021 05/11/2021 05/11/2021
2,535,00
CONTRACT EMPLOYEE
Vendortotals: Number Name
Gross
Discount
11069 PABLO GARZA
2,635,00
0.00
Vendor#
Vendar Nre
Class
11155
F. ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
8573 y! 05/05/2021 05/01/2021 05/31/2021
31084.00
REVENUE INTEGRITY PROGRAM
Vendor Totals: Number Name
Gross
Discount
11155 PARA
3,084.00
0.00
Vendor#
Vendor Name
Class
P2200
POWER HARDWARE �/
W
Invoice# Comment Tran Ot Inv Dt Due Dt
Check Ot
Pay
Gross
B61561 r/! 05/12/2021 04/12/2021 04/22/2021
6.79
SUPPLIES
A73228 ✓�05/12/2021 04/27/2021 05/07/2021
25.75
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
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5/tmplcw5report2909223723657388501.html
No -Pay Net
0.00 226.95
Pay Code
Discount No -Pay Net
0.00 0.00 759.03 y/
No -Pay Net
0.00 759.03
Pay Code
Discount No -Pay Net
0.00 0.00 2.535.00
No -Pay Net
0.00 2,535.00
Pay Code
Discount. No -Pay Net
0.00 0.00 3,084.00 ✓
No -Pay Net
0.00 3,084.00
Pay Code
Discount No -Pay Net
0.00 0.00 6.79
0.00 0.00 25.75
No -Pay Net
11114
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P2200 POWER HARDWAR
32.54
0.00
0.00
32.54
Vendor#
Vendor Name
Class
Pay Code
11932
PRESS GANEY ASSOCIATES, INC.
Invoice# Comment Tran Dt Inv 01 Due Dt
✓
Check Ot
Pay
Gross
Discount No -Pay
Net
11400047785eP4/30/2021 04/30/2021 05/30/2021
2,523.79
0.00 0.00
2.523.79 j
PT SURVEY
Vendor Totals: Number Name
Gross
Discount
No -Pal'
Net
11932 PRESS GANEY ASS
2,523.79
0.00
0.00
2,523.79
Vendor#
Vendor Name
Class
Pay Code
81001
SANOFI PASTEUR INC
W
Invoice# Co ment Tran Dt Inv DI Due Dt
Check Dt
Pay
Grass
Discount No -Pay
Net
91645347/30/2021 04/20/2021 06101/2021
2,252.17
0.00 0-00
2,252.17
INVENTORY
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S10ol SANOFI PASTEUR 1
2,252.17
0.00
0.00
2,252.17
Vendor#
Vendor Name
Class
Pay Code
S1405
SERVICE SUPPLY OF VICTORIA IN W ,%
Invoice# Comment Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
701096695 1,,d4/30/PO21 04/30/2021 05/30/2021
2.75
0.00 0.00
2.75 y%
FINANCE CHARGE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
81405 SERVICE SUPPLY (
2.75
0.00
0.00
2.75
Vendor#
Vendor Name
Class
Pay Code _
S1800
SHERWIN WILLIAMS
W
Invoice# Comment Tran Dt Inv Ot Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
61192 ," 05/12/2021 04/27/2021 05/1212021
212.35
0.00 0.00
212.3E �!
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S1800 SHERWIN WILLIAM!
212.35
0.00
0.00
212.35
Vendor#
Vendor Name
Class
Pay Code
10936
SIEMENS FINANCIAL SERVICES,/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
116042957 ,¢44/3012021 04/10/2021 05/16/2021
2,193.83
0.00 0.00
2,193.63
MAINT CONTRACT
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10936 SIEMENS FINANCIP
2,193.83
0.00
0.00
20W.83
Vendor#
Vendor Name
Class
Pay Code
10699
SIGN AD, LTD. ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
261511 -/ 05/1112021 05/01/2021 05/11/2021
400.00
0,00 0.00
400.00
AD
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
10699 SIGN AD, LTD.
400.00
0.00
0.00
400,0E
Vendor#
Vendor Name
Class
Pay Code
S2362
SMITH & NEPHEW /
Invoice# Comment Tran Ot Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
9422300001/04/30/2021 04/25/2021 04/22/2021
642.00
0.00 0.00
642.00 ✓
SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S2362 SMITH & NEPHEW
642.00
0.00
0.00
642.00
Vendor#
Vendor Name
Class
Pay Code
S3960
STERICYCLE. INC
Invoice# Com am Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
4010077826 /04/2021 (15/01/2021 05/31/2021
2.53.5.76
n.nn 0.0E
2,535.76
DISPOSAL SERVICES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S3960 STERICYCLE, INC
2,535.76
0.00
0.00
2,535.76
Vendor#
Vendor Name ,
Class
Pay Code
S3940
STERIS CORPORATION 4,f�
M
Invoice# Commenl Tran Ot Inv Dt Due DI
Check Dt
Pay
Gross
Discount No -Pay
Net
9356433 ✓0413012021 04/24/2021 05/19/2021
123.20
0.00 0.00
123.20
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5/13/20$1
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SUPPLIES
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S9940 STERIS CORPORAI
123.20
0.00
0.00
123.20
Vendor#
Vendor Name
Class
Pay Code
S2833
STRYKER ENDOSCOPY ✓ r
Invoice# Cc ant Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
10372199E 1330/2021 04/28/2021 05112/2021
1,603.12
0.00 0.00
1,503.12
SUPPLIES
v
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
S2833 STRYKER ENDOSC
1,503.12
0.00
0.00
1,503.12
Vendor#
Vendor Name
Class
Pay Code
13528
STRYKER FLEX FINANCIAL
Invoice# Comment Tran Dt Inv Dt Due DI
Check DI
Pay
Gross
Discount No -Pay
Net
207215 /04/3D/2021 04/13/2021 06/01/2021
1,294.26
0.00 0.D0
1,294.26V
FIFA MACHINE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Not
13828 STRYKER FLEX FIN
1.294.26
0.00
0.00
1.294.26
Vendor#
Vendor Name
Class
Pay Code
S2830
STRYKER SALES CORP �x
M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
9201182494r.e'4/30/2021 04/09/2021 05/11/2021
730.36
0.00 0.00
730.36,,,'
SUPPLIES
3367840 v04/30/2021 04/20/2021 05/20/2021
10,286.26
0.00 0.00
10,286,26 ✓
WIDE TRANSPORT STRETCHER
Vendor Totals: Number Name
Gross
Discount
No -Pay
.Net
82830 STRYKER SALES C
11,015,62
0.00
0.00
11,015,62
Vendar#
Vendor Name
Class
Pay Code
T2539
T•SYSTEM, INC ,/
W
Invoice# Comment Tran DI Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
44913 ✓ 04/30/2021 04/27/2021 05/27/2021
431.42
0.00 0.00
431.42
EXR
449BO 04/30/2021 04/30/2021 05/30/2021
5,699.00
0.00 0.00
5,699.00 yi -
TRACK I NG/HOSTING/STAT
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
T2539 T-SYSTEM, INC
6,130.42
0.00
0.00
6,130.42
Vendor#
Vendor Name
Class
Pay Code
T2204
TEXAS MUTUAL INSURANCE CO
W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
100267193304/20/2021 05/12/2021
11570.35
0.00 0.00
1.570.35
-'30/2021
FINAL AUDIT
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
T2204 TEXAS MUTUAL IN;
1.570.35
0.00
0.00
1,570.35
Vendor#
Vendor Name
Class
Pay Cade
T2250
THYSSENKRUPP ELEVATOR COR''.
M r,f
Invoice# Com,�ant Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
5001520061;/30/2021 04/22/2021 0422/2021
834.00
0.00 0.00
834.00v
OIL AND GREASE
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
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834.00
0.00
0.00
834.00
Vendor#
Vendor Name
Class
Pay Code
13616
TRIOSE, INC r,/F
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Ot
Pay
Gross
Discount No -Pay
Net
TR1085722 v65/1312021 05/03/2021 05/03/2021
400.38
0.00 0.00
400.36
SHIPPING
Vendor Totals: Number Name
Gross
Discount
No -Pay
Net
13616 TRIOSE, INC
400.36
0.00
0.00
400.36
Vendor#
Vendor Name /'
Class
Pay Code
U1054
UNIFIRST HOLDINGS v'
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Invoice# Comment Tran Dt Inv Dt Due Dt
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Gross
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61.78
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LAUNDRY
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Gross
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Nei
U1054 UNIFIRSTHOLDINC
1,791.92
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lass
Pay Code
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VICTORIA RADIOWORKS, LTD
Invoice# Comment Tram Dt Inv Dt Due Dt
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Pay
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560.00
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Vendor Name
Class
Pay Code
10793
WAGEWORKS, INC. ,/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount No -Pay
Net
051021 05/12/2021 05/10/2021 05/10/2021
3,762.98
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Gross
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10793 WAGEWORKS, INC,
3,762.98
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Vendor#
Vendor Name
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I1110
WERFEN USA LLC
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Dt
Pay
Gross
Discount
No -Pay
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9110935903,Q4/22/2021 01/29/2021 02/23/2021
800.30
0.00
0.00
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SUPPLIES
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9110972823 �0#30/2021 04/19/2021 05/14/2021
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Gross
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No -Pay
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11110 WERFEN USA _LC
2,413.59
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P -UQ-M cYj gc�l 1454 a l
Date/Time 05-17-2021/09:OOAM
Submitted By
Pay Date 04-30-2021
Employee Deposits $93,699,68
Employer Contributions $120,604.67
Group Term Life Premiums $0.00
Total $214,304.35
Comments
Payroll File April 2021 Retirement Upload.xlsx
QQ Confirmation: You Have Filed Successfully
Sales and Use Tax Period Ending 04/30/2021(2104)
TaxpayerlD,
Taxpayer Name:
Entered By::
Reference Number:
MEMORIAL MEDICAL CENTER
Email Address:
Date and Time of Filing:
Taxpayer Address:
05/13/2021, 12:50:47 PM
815 N VIRGINIA ST PORT LAVACA , TX
Telephone Number
77979-3025
IP Address:
PAYMENT SUMMARY
Electronic Check
Payment Reference Number.
Type of Bank Account:
State Amount: $928.77
Trace Number:
Accountholder Name:
Local Amount: $297.21
Bank Routing Number:
Amount to Pay: $1,225.98
Bank Account Number:
Electronic Check: $1,225.98
Payment Effective Date
CREDIT SUMMARY
Credits Taken
Are you taking credit to reduce taxes due on this return?
No
Licensed Customs Broker Exported Sales
Did you refund sales tax for this filing
period on items exported outside the United States
based on a Texas Licenced Customs No
Broker Export Certifications?
LOCATION SUMMARY
Loc#
Total Texas Taxable Sales Taxable Subject to State
Sales Purchases Tax (Rate .0625)
00004 14935 14935 0 14935
SubTotal 14935 14935 0 14935
Total Tax for Locations
State Tax Due Subject to Locat Tax Rate Local Tax Due
Local Tax
933.44 14935 0.02 298.7
933A4 14935 298.7
$1,232.14
Total Tax Due: $1,232.14
Timely Filing Discount: - $6.16
Balance Due: $1,225.98
Pending Payments: -$0.0D
Total Amount Due and Payable: $1,225.98
( State amount due is $928.77) ( Local amount due is $297.21 )
' 5/13/2021
lmp,_cw5repon3631345881402884866.html
05/13/2021
MEMORIAL MEDICAL CENTER
0
10:59
AP Open Invoice List
ap_open_invoice.template
Dates Through:
Vendor#
Vendor Name Class
Pay Code
11828
SOLERA WEST HOUSTON ✓
Invoice#
Comment Tran Dt Inv Dt Due DI Check Ot Pay
Gross
Discount No -Pay
Net
042921 04/30/2021 OM2912021 06/03/2021
927.50
0.00 0.00
927.50
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11828 SOLERA WEST HOI 927.50
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927.50
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Gross Discount
No -Pay
Net
927.50 0.00
0.00
927.50
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tmp_cw5reporl2672934070306958888. html
05/13/2021
MEMORIAL MEDICAL CENTER
0
10:58
AP Open Invoice List
ap open_invoice.template
Dates Through:
Ventlor#
Vendor 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
042021 04/30/2021 04/20/2021 06/03/2021
1,051.74
0.00
0.00
1,051.74 ✓
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042921E 04/30/2021 04/29/2021 06/03/2021
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11,180.00 ✓'
TRANSFER tl
11
042921C 04/30/2021 04/29/2021 06/03/2021
2,782.50
0.00
0.00
2,782.50 ✓
TRANSFERik
11
Vendor Totals: Number Name Gross
Discount
No -Pay
Net
11832 BROADMOOR AT C 24,536.24
0.00
0.00
24,536.24
Grand Totals:
Gross Discount
No -Pay
Net
24,536.24 0.00
0.00 -
24.536.24
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511312021
tmp_cw5report3188628653660524147.html
05/13/2021
MEMORIAL MEDICAL CENTER
0
11:00
AP Open Invoice List
Due Dates Through: 06/03/2027
ap_open_involce.template
Vendor#
Vendor Name Class
Pay Code
11824
THE CRESCENT
Invoice# Comment
Tran Dt Inv Dt Due Dt Check Dt Pay
Gross Discount No -Pay
Net
040921 04/30/2021 0409/2021 06/03/2021
1,110.00 0.00
0.00
1,110.00
TRANSFER h/41ASU.YK W_ 10M_j dep SIW jK�1 Mluc. 0p6yti-'{7�
Vendor Totals:
Number Name 7'_ Gross
Discount
No -Pay
Net
11824
THE CRESCENT 1,110.00
0.00
0.00
1,110.00
Ropo,: Summary
Grand Totals:
Gross Discount
No -Pay
Net
1,110.00 0.00
0.00
1,110.00
file:///C:/Users/mmckissack/cpsi/memmed.opsinet.comtu88150/data_51Imp_cw5report3188628653660524147.html - 1/1
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tmp_cw5report320124939631486025.html
05/13/2021
MEMORIAL MEDICAL CENTER
10:58
AP Open Invoice List
0
ap_open_invoice.template
Dates Through:
Vendors
Vendor Name Class
Pay Code
11836
GOLDENCREEK HEALTHCARE
Invoice#
Comment Tran Dt Inv Dt Due Dt Check Dt Pay
Grass
Discount
No -Pay
Net
041421
04/30/2021 04/14/2021 06/0�3(/�2�021
10,991.99
0.00
0,00
10,991.99
TRANSFER t* 1'r�q.lWKLL btn�t 0fd'{4 c1
I kiN MkU(.
O'eUA1�
042721E
04/30/2021 04/2712021 06/0312021
1,695.86
0.00
0.00
1.695.86
TRANSFER L1
11
042821
04/30/2021 04/27/2021 06/03/2021
39,600.81
0.00
0.00
39,600.81�
TRANSFER 1L
11
043021
04/30/2021 04/27/2021 06/03/2021
841.33
0.00
0.00
841.33
TRANSFER I1
)1
042921A
04/30/2021 04/27/2021 06/03/2021
1,351.73
0.00
0.00
1,361.73
TRANSFER 1 L
I r
043021A
04/30/2021 04/27/2021 06/03/2021
1,773.56
0.00
0.00
1,773.56
TRANSFER U
11
y/
042921
04/30/2021 04/27/2021 06/03/2021
10,076.59
0,00
0.00
10.076.59
TRANSFER Lk
It
050321A
05/12/2021 05f03/2021 06/03/2021
15,937.61
0.00
0.00
15,937.61
TRANSFER
050321E
05/12/2021 05/03/2021 06/03/2021
7,051.37
0.00
0.00
7,051.37 ✓-
TRANSFER
050321
05/12/2021 05/03/2021 06/03/2021
2,162.65
0.00
0.00
2.162.65 j
TRANSFER
✓
050421
05/12/2021 05/04/2021 06/03/2021
149.85
0.00
0.00
149.85
TRANSFER
Vendor Totals: Number Name Gross
Discount
No -Pay
Net
11836 GOLDENCREEK HE 91,633.35
0.00
0.00
91,633,35
Grand Totals:
Gross Discount
No -Pay
Not
91,633.35 0.00
0.00
91,633.35
4AY 13 2021
file:IIIC:/Users/mmckissacklopsitmemmed.cpsinet.com/u$8150/data_51tmp_cwSreport320124939631486025.html 1/1
r 5/13/2021
tmp_cw5report2476218463702801282.html
05/13/2021
MEMORIAL MEDICAL CENTER
0
10:59
AP Open Invoice List
ap_open_Invoice,template
Dales Through:
Vendor#
Vendor Name Class
Pay Code
12696
GULF POINTE PLAZA
Invoice#
Comment Tran Ot Inv Dt Due Dt Check Dt Pay
Gross
Discount
No -Pay
Net
041621
04/30/2021 04/16/2021 06/03/2021
0.00
0.00
1,564,89
1
TRANSFER NN- IMtSiWR1UR- fbpLk j,(f4Gj4
y1,�564.89
jltta �1lWLL-(/pGYl.,hvky
041921
04/30/2021 04/19/2021 06/03/2021
13,398.36
0.00
0.00
13,398.36 ✓f
TRANSFER It
1f
041521
04/30/2021 04/19/2021 06/03/2021
1,584.00
0.00
0.00
1,584.00r,/
TRANSFER t t
II
0422221
04/30/2021 04/19/2021 06/03/2021
1,057.00
0.00
0.00
1,057.00
TRANSFER (t
11
042121
04/30/2021 04/19/2021 06/03/2021
3,560.99
0.00
0.00
3.560.99 bl
TRANSFER t1
II
042021
04/30/2021 04/19/2021 06/03/2021
1�
12,879.57
0.00
0.00
12,879.57
TRANSFER
)I
042621
04/30/2021 04/28/2021 06/03/2021
1,584.00
0.00
0.00
1,584.00
TRANSFER 1t
It
043021C
04/30/2021 04/29/2021 06/03/2021
16.99
0.00
0.00
15.991-,
TRANSFER I t
If
043021
04/30/2021 04/29/2021 06/03/2021
5.33
0.00
0.00
5.33
TRANSFER Il
It
0429216
04/30/2021 04/29/2021 06/03/2021
278.88
0.00
0.00
278.88
TRANSFER It
bL
043021E
04/30/2021 04/29/2021 06/03/2021
250.66
0.00
0.00
250.66 ✓
(I.
TRANSFER
If
042921A
04/30/2021 04/29/2021 06/03/2021
610.46
0.00
0.00
610.46
TRANSFER U
1t
043021 A
04/30/2021 04/29/2021 06/0312021
200,70
0.00
0.00
200.70
TRANSFER t'
1)
042921C
04/30/2021 04/29/2021 05/03/2021
134.55
0.00
0.00
134.55,_Z
TRANSFER It
It
042921
04/30/2021 04/29/2021 0610612021
6,732.65
0.00
0.00
6,732.651l�'
SUPPt" It
11
043021 D
04/30/2021 04/30/2021 06/03/2021
1.660.00
0.00
0.00
i
1.680.00 1/
TRANSFER K
4
043021E
04/30/2021 04/30/2021 08/03/2021
33.63
0.00
0.00
33.63,,,/
TRANSFER It
11
050321
05/12/2021 05/03/2021 06/03/2021
9,869.02
0.00
0.00
9,869.02t/
TRANSFER
050421A
05/12/2021 05/04/2021 06/03/2021
15,213.24
0.00
0.00
15,213.24
TRANSFER
050421
OS/12/2021 05/04/2021 06/03/2021
6,936.00
0.00
0,00
6,936.00
TRANSFER
Vendor Totals: Number Name Gross
Discount
No -Pay
Net
12696 GULF POINTE PLA2 77,589.92
0.00
0.00
77.589.92
Grand Totals:
Gross Discount
No -Pay
Net
77,589.92 0.00
0.00
77,589.92
4AY
13 2021
A
L o
file://IC:/Userslmmckissacklcpsi/memmed.cpsinet,comlu88150fdata_51tmp_cw5report2476218463702801282.html 111
5/13120F1
Imp_cw5report5133606172815574441.htm1
05113/2021
MEMORIAL MEDICAL CENTER
0
AP Open Invoice List
10:59
ap_open_invoice.template
Dates Through:
Vendor#
Vendor Name
Class
Pay Code
13004
TUSCANY VILLAGE f
Invoice#
Comment Tran Dt Inv
Dt Due Dt Check Ot Pay
Gross
Discount
No -Pay
Net
041621
04/30/2021 04/16/2021
06/03/2021
1,232.00
0.00
0.00
1,232.0Q%
__1 1
TRANSFER NA IP15ltykKA_ Mpt,'�rtFOC, 44 k
tL
11'l1® 1kWU.. 0
042121
04/30/2021 04/19/2021
06/03/2021
247.00
.
0.00
247.00 ,f
TRANSFER 1
1i
042621A
04/30/2021 04/19/2021
06/03/2021
2,107.20
0.00
0.00
2,107.20
TRANSFER It
it
042221
04/30/2021 04/19/2021
06/03/2021
1,452.20
0.00
0.00
1,452.20 ✓
TRANSFER 1t
j1
042821B
04/30/2021 04/19/2021
06/03/2021
1,179.94
0.00
0.00
1,179.941,/'
TRANSFER It
1t
042321
04/30/2021 04/19/2021
06/03/2021
1,144.00
0.00
0.00
1,144.00"/
TRANSFER It
It
042221A
04/30/2021 04/19/2021
06/03/2021
10,536.00
0.00
0.00
10,536.00
TRANSFER"
It
042021
04/30/2021 04/19/2021
06/03/2021
6,777,16
0.00
0.00
6,777.10 1%!
TRANSFER It
at
041921
04/30/2021 04/19/2021
06/03/2021
4.657.41
0.00
0.00
4,657.41 ✓
TRANSFER 11
It
041921A
04/30/2021 04/19/2021
06103t2021
1,038.37
0.00
0.00
1,038W
TRANSFERII,
11
042621
04/30/2021 04/19/2021
06/03/2021
2,965.50
0.00
0.00
2,955.50
TRANSFER it
It
042121 B
04/30/2021 04/19/2021
06/03/2021
11071.63
0.00
0.00
1.071.63 v/
TRANSFER
0427213
04/30/2021 04/19/2021
06/03/2021
5,959.80
0.00
0.00
5,959.80
TRANSFER
043021
04/30/2021 04/19/2021
06/03/2021
1,820.00
0.00
0.00
1,820.00
TRANSFER
042121A
04/30/2021 04/19/2021
06/03/2021
5,011.85
0.00
0.00
5,011.85 ✓
TRANSFER
042621B
04/30/2021 04/19/2021
06/03/2021
4,710.64
0.00
0.00
4,710.64 v'
TRANSFER
042821C
04/30/2021 04/19/2021
06/03/2021
388,71
0.00
0.00
388.71y/'�
TRANSFER
042821 A
04/30/2021 04/19/2021
06/03/2021
321.18
0.00
0.00
321.181/'
TRANSFER
042921
04/30/2021 04/19/2021
06/03/2021
1,541.47
0.00
0.00
1,541.47 ✓r
TRANSFER
042821
04/30/2021 04/19/2021
06/03/2021
7.587.37
0.00
0.00
7,587.37 y j
TRANSFER
D50321
05/12/2021 05/03/2021
06/03/2021
5,304.88
0.00
0.00
5,304.88 v
TRANSFER
050421
05/12/2021 05/04I2021
06/03/2021
742.00
0100
0.00
742.00 "r
TRANSFER
050421A
05/12/2021 05/04/2021
06/03/2021
7,585.50
0.00
0.00
7,585.50
TRANSFER
Vendor Totals: Number
Name Cross
Discount
No -Pay
Net
TUSCANY
VILLAGE 75.371.81
0.00
0.00
75,371.81
Grand TotalsAv j
PP1�N�1
2, Gross
Oint
No-Pay
Net
75,371 B1
000
0.00
75,371.81
16.g3
file:///C:/Users/mmokissack/cpsi/memmed.cpsinet,com/uB8150/data_5/imp_cw5report5133606172815574441.html
111
5113/2021
tmp_cw5report7240454151005823611.html
05/13/2021
MEMORIAL MEDICAL CENTER
0
10:57
AP Open Invoice List
ap_open_Invoice.template
Dates Through:
Vendor#
Vendor Name Class
Pay Code
12792
BETHANY SENIOR LIVING
Invoice#
Comment Tran Of Inv Dt Due Dt Check Dt Pay
Gross
Discount
No -Pay
Net
042821
04/28/2021 04/29/2021 06/03/2021
657.21
0.00
0,00
657.21 tj
TRANSFER jJRjrtSu"W_ Vp+ dt170h1'1La
�J Y
In-h �WkL, Opdh bill-
042020
04/30/2021 04/20/2020 06/03/2021
3,674.71
0.00
0.00
3,674.71 y-
TRANSFER tt
11
041921
04/30/2021 04/19/2021 06/03/2021
7,935.60
0.00
0.00
7,935.601„i
TRANSFER U
II
042121
04/30/2021 04/21/2021 06/03/2021
521.00
0.00
0.00
521.00,/
TRANSFER cc
II
042221A
04/30/2021 04/22/2021 06/03/2021
1,222,52
0.00
0.00
1,222.52,,-
TRANSFER It
I
042321
04/30/2021 04/23/2021 06/03/2021
10,746.68
0.00
0.00
10,746.66t/•r
TRANSFER 6t
11
042621
04/30/2021 04/26/2021 06/03/2021
57,276.55
0.00
0.00
57,276.55
TRANSFER 11
It
042621A
04/30/2021 04/26/2021 06/03/2021
33.32
0.00
0.00
33.32
TRANSFER tr
E1
042721
04/30/2021 04/27/2021 06/03/2021
1.646.36
0.00
0.00
1,646.36
TRANSFER uL
11
0429218
04/30/2021 04/29/2021 06/03/2021
543.11
0.00
0.00
543.111j`
TRANSFER k
11
043021B
04/30/2021 04/30/2021 06/03/2021
3,567.71
0.00
0.00
3,567.71/
TRANSFER is
If
043021A
04/30/2021 04/30/2021 06/03/2021
7,599.53
0.00
0.00
7,599.53
TRANSFER 1•
I1
043021
04/30/2021 04/30/2021 06/03/2021
651.71
0.00
0.00
661.71
TRANSFER It
I1
050321A
05/12/2021 05/03/2021 06/03/2021
4,005.93
0.00
0.00
4,005.93
TRANSFER w
-
N
050321
05/12/2021 05/03/2021 06/03/2021
439.35
0.00
0.00
439.35
TRANSFER"
it
Vendor Totals: Number Name Gross
Discount
No -Pay
Net
12792 BETHANY SENIOR 1 100,531,29
0.00
0.00
100,531,29
Grand Totals:
Gross Discount
No -Pay
Net
100,531.29 0.00
0.00
100,531.29
:rgrip'ps w
Ble:///C:/Userstmmckissack/cpsi/memmed,cpsineCcom/u88150/data_5/tmp_cw5report7240454l51005823611.htmI 1N
0
Memorial Medical Center
Nursing Home UPL
Weekly Cantex Transfer
Prosperity Accounts
5/17/2021
Prevlau
Aumber BepnnN! / AW Pandin!
shalt
Beginning Amount
ra Be iranalened to Xveln!
Nunln Hame
Number Balance Tnntl[n0u[ XramleNn Bem(n
Ba an
Nome
Aifl(SrQil'-aB0!'G`I
120,23231 65,959.9] ID,D3.19
170,446.oea /
-M7,'8981T
Bank Oahnm
IIDA46A9.✓
L IO�IICfI,�`�
3 O
Votlmm
-
Y
Lave In 0olonee
L00.00
Wlthholdln8 for MCNeare Rvcaup- Hasp
Ira4LB0'Ir' 4AID
WBhholding for Medlore I ----- -ginic
PeAdln3 Amedgfaup CAPP Ck
Klass a�
APRILIN7LRLST
43.79r/
MAYINTEREET
JUNE INTEREST
Adjurt BalamalrlamN, Amt
4"re Bt,
Bmadmpot"' ,_,._
77,763.38 4/55,233.15 J43,00].63
-
$5,637.95
30,930.33
Bank Balance
I
65,637A6 y'
Volanm
Laveln Balanm
100.60
Pending AmeriEraup OIPP a
22A19.42 a/
Wiphalmn6f4r MedlMreRomuP HprP
10,924.52E
Wlthholdln8 Mr Medicare Bekeu}tank
APMLINTER65T
1,232.78
30.81
MAY INTEREST
JUNE INTEREST
Adjurt BEI.nWTnnafw Prat
30,93033y'
�
67,3B0.97 Bl49,287.11 V/ 42,86Lm e/�
60,955.93
36,883.55
f
Bank Balanm
60.955.93
Variance
Lavern8alanm
100.00
PeadlAgFmedgmuPU.Ipp Fk
17,97E41✓
Wltldtoldingfor Mediae Remuy HmP
4:14S.T4a/l
Wllhheldinl Mr Media!* R9mup- mni4
1,232.78
APRILINTEREST
22.45✓L
MATINTEREST
JUNEINTEREET
Adjust Balanae/rnnaferAmt
36AN.55
62,075.26✓ 40,000.80 Y 8,69B.16 T/
40,69152 /
12,719.64
Bank Balanm
40,692.52 a/
Variance
Leave In B.I.M.
20..0
Pending AmerlgruuPCIPPCk
22,894.63✓
Wllhholding for Medium Ramup Ham
4,7A574✓
/
Withholding kr Mediae Remo, tank
I'M178
APRILINTEXf5r
9.03 yi
MAYINTERE$T
10NEINTERPST
Mind Balance/tnnAer Amt
U.719.64 y/
$Olem;Tyifi011f1dt1 !
I1,04.70 89,690.04 ✓53,984.OB ✓
71,838.74 /
47,505.56
Bank Baian4e
✓
]4,838.)4VIM
Valance
-
a
Leave In Babnce
100.00
V / i t?.
MAY 1 7 2021
Pending Ara-agroup CiUsPCk
21,219.54 Y
r
WNhh.N1ngkr Mediae R[mup-Naip
4,745.74 ✓/
-
Withholding for Medkare par., cltnic
1,232.78
35.1E ✓ �r {dye
INTEAPANINTERMT
tiTaFr' ,
mNE
NlINTEMURFST
Adjust BMlYcaftnnderAmt
47,50536
23C�J 555 tip/
✓✓39"9fa:/5'— J
i ) ��. j �, G
TOTALTRAN9ilRS
;L
Nvte: pnlv6alannr elerfr$S,WO wIXb[wNkN<tl fa lka MNlaghome.
Appmued,
Nvtt 2: FVNvcmootFvabambalnn[ev/$JaOMotMM[dtperAN[v vpenvaevunt
JMvnAngllmJMonAyIl, ac,
5/17/20215/17/2021
FAWN wnUYTI*AO*Y Y1N UPI TIamfvramm0nl2B]ITMsANJ UPL TPmttrSummary 5371I. ax
T I f \
512021 IXf5
5/10/]0]1 WIREOUTCANTF]f NFAIINCARE [ENRR5111
S/13/]021 UHCOO MUNETI]3DMNSHMNTMPoOMN01129341
S/121
5/32/20N MHCCOMMUITHCAR NOUNAAPMT]4W03U19]OMO
S/12(2021 MOLTH HFMANVR=ILAIMCH00P24MMI13VM2
wil/2031 HEALTN HUMAN SYC NccLAIMPMTll46W341130013
5/13/IMI HEAOM
5/14/2021 HHCMAHUMAN SVt HCCWMlMT I]46M411330M2
5/14(3021 UHC COMMUNITY Pt HCCWMPMT]46093411910N0
5/14/ID2i LIKE HUMANA MUXITYPL HCLMMPMTHOESMU3910M0
511412M1 HEAUCH HCHAOISV HOOL MPMT39046141MN13M
5/34/iNl HFAITNHUMAN SVCHCCWMPMi]I46N341I30N2
111 E
3/IIOU cc ME
5(llA/20L1 MAEAGHUMAREANONET331AHMONTHM443 MRSHPIZ1
5/ll/2021 HUMANAINSCOHIXWMCAMCEK4RStil J9]p3
5112/2011 WIREOU]GWTf%NFpITNfAPE CENRR5111
5/12AD2] M todil-Iflinm ]lOAIMPAI MMMMO 1249M 91
5/12/lon MMtedNeal<M1me N[CIAIMPME]OBMl4ll 124384
5/13/IOg OapoJt
5/13POIl MpNp6EANOcamINRMN3PMN]MOOMIIM00NA 41
5/1312011 UMIeJHPPIOMCMNCCC MIMPW46M 3421143R9
5(13/2MI AAM OMUNEl NCCOLAIIPMTT46N)4ll RHD1
5/14/2021 MHC WMMMNUT PL HCCLAIMPMT74 WW411910NO
5/14/2022 UHCCA5 SOLD IY HHMLJU IMPMTM32a4ZM10M0
5/34/S011 NOVRAS SOIVNON HEYIAIMPMT 6>M33430M0139
A"uxY}Ikcv+cr�- "Oif"` f1R'^"'3 "d> R.ta • 0.
51111201E CRllfi
5/11/IMS WIREOIITCANIIX NWTH CAFF[FNRMIII
5/3l/2021 Oepmlt
Sd`efd atV2ci Naii`s01i 6�7,7''" 7_
5/10/2021 NOVQASSOLUNON HCCLAIMPMT67631042NM102
sillawl CA Ills
5/1MD11 UnitedHok Sore HCCLAIMPMT74603341112438A
5/32/323 WIREOMCRNIIXHO1LTH fAPECFX1FA5111
51331202E UnlledHeaRkme HIXWIMPMT 74SM34111243M
5/U/2021 oepNal
5/13/2021 MANAOFANONET3316 MINE PMMOMNMNM248142
5/ll/2021 UnitedHeafftam HMIAIMPMT 7OW34U 1243M
5/14/2N1A ergraup MC HCCLIIMPMT 3159]M)99 UIM3
5/39/ = UHC COMMUNITT PL IIMVIMPUT70MU1191000
5/14/2021 HUMLNAINSCOHMIAMPM739086283MN592760
TOTALS
ans en0ut Tr fu4n
3]2.03
29,691.99
36.251.99
FAN31 WaeHVTraMlen\Red Oownloed Wo,IAe.uV@2\M.,\NH B.M O-I-d 5-10,211M1ry 51421.a1n F.,3
MMCPORVGN
5/10/3093 UHCCUMMUNRYPI H[CIAIMPMT]460DI411910000
5/11/i021 IX]ll3
5/13/2021 WIPEOUTnSHfOPD NFpLTH CARE CEHRR LTD
5/13/2021 Amuilt - 46,2R1P - 46,265.26
5/13/3021 HOATHeuMAN SVC RECILAMT3T1746M511HU 39,2fi3.29 - 3L970fl
9/14/2021 U"CC 1HUMAN]VCNLCIAMPMT1T46W3ilglOS2 1,9M.Oi - ],9I6M
5/14/2021 UHE COMMUNIST PI HMWMPW7460M IlOHM0 - i1,1N.EO - 11,2M60
5/14/20I1 UH[COMMUNMPLH¢WMPMT]960M111910W0 - 1,391.P0 - 1,391J0
6SM957 Y 116.1]3.]5 % L61T3.75
MM[PORnON
gIPP/GmPO
TnnsleMut irenaferl" QUIP/tO I DIPP/CR 2 NPP/CmmP3 5OPF6 QIPP TI NHPORTION
11,79937
41,933.79 -
OPP/wmw
aupse gIPPn NH VOR11aN
61263.87
- 61263.87
274.74
- 2]4.]4
430m
UOM
9.9e541
9,94"1
19163.40
- 39.163A9
2,421M
- 3A23.86
2,793d0
- 3,793.10
1.433.21
- ],433.31
1PSM
- MAN
134.M
- 374,30
96.II3.16 -' 0.OBT.83 13.M].63
MMCpOPnoN
I To�3(5i ryy( Traniiern WpP/[ompl gIPP/Wmpi QIPP/camp3 8bpf! gIPPTI NHPOPl10N
9.65864 - -
Mo.M
1110.93
;b0m
138393
39.939AT
-
5.O6a.M
SA95.N
i.01Bm
I,BIB.M
-
S.I.H
15.323.13
5.0456,000.Po -
5,45B,M
36.M
232.0
6093 -
6 8.93
-
4,51L97 -
-
3.1M32 -
3.WI
3.1043E
-
4.913.i9 -
0.973,79
o.m.21
9;8A;ID V
IL06E.97
I
MMCPORTION
gIIP/famp9
TnTn x�
]ranxfplaB
IUPP([ompl OIPP/ComPT NPP(Cemp3 Blgfe NPPn
NN PBRnON
1;M5.13
- -
28.074.67
- -
-
-
18698.18 -
10,01.
/ /
dO.BW.BO
I. 69B.I6
1D,690.18
MMCPOAnON
NPP/4mp4
nne -VOI Tranaler-In QIPP/Camp] QIPP/UmP2 NPP/Clmp3 Bupie
yPPn NNPOMION
2.7026E - 1,7N.M
I16U.05
410.03 41QM
]RNB.99
-
-
-
4510.03
4,510.00
1gU4.14
- 10,134.14
-
1,090.N
- 1.590.M
•
10.6M.M
- 10,66OM
-
105499T
- IM49.97
4.424.71
- 4,624.78
-
22.55
32.55
0.598.N
53.4H.M �
- 09.404.00
3M.1526,
3.7 p .Po
2]VREG9
' 5/1712021 Treasury Center
Account Type
DDA
-
Data reported as of May 17, 2021 9
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balance
Number of Accounts: 15
$7,254,862,84
$7,517,230.45
$7,254,862.84
$7,474,934.49
'4551
CAL CO INDIGENT
S6,348.78
$6,348.70
$6,348,78
$14,827, 19
HEALTHCARE
'4454
MEMORIAL MEDICAL I
NH GOLDEN CREEK
$32.080.43
$32,080.43
$32,080.43
$32,080.43
HEALTHCARE
`4366
MEMORIAL MEDICAL
CENTER - CLINIC SERIES
$535.11
$535.11
$535.11
$635.11
2014
'4357
MEMORIAL MEDICAL
$4,099,181.36
$4,228,484.04
$4,099,181.36
$4.388,713.73
CENTER -OPERATING
'4373
MEMORIAL MEDICAL
CENTER - PRIVATE
$430.82
$430.82
$430.82
$430.82
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$170,446.09
$223.763.53
5170,446.09
$141,949,69
CENTER/NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
S65,637.86
$92.210.20
$65,637.86
S61,05L51
BROADMOOR
'4411
MEMORIAL MEDICAL
$60.955.93
$67.915.07
$60,955.93
S48,364.85
CENTER/NH CRESCENT
'4446
MEMORIAL MEDICAL
$40,692.62
$40.692.62
$40,692.62
$40,692.62
CENTER NH FORT BEND
'4438
MEMORIAL MEDICAL
CENTER /SOLERA AT
$74,838.74
$101,090.44
$74,838.74
$59,641.44
WEST HOUSTON
'2998
MMC-MONEY MARKET
$2,605,369.97
$2,605,369.97
$2,605,369.97
S2,605,369.97
FUND
'5506
MMC-NH BETHANY
$27,136.82
$27,138.82
$27.138.82
S12,367.46
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA-
$26.915.78
$26,915.78
$26,915.78
S24,61914
MEDICAREIMEDICAID
'5433
MMC-NH GULF POINTE
$112.65
$20,076.9B
$112.65
$112.65
PLAZA- PRIVATE PAY
'3407
MMC-NH TUSCANY
$44,177.88
$44,177.88
$44,177.88
$44,177.88
VILLAGE
' Indicates rc
Page generated on 05/17/2021 it 9
Copyright 2021 Prosperity Bank.
Y
hops:!/prosperity.olbanking.comlonllneMessanger 1!1
Memorial Medical Center
Nursing Home UPI.
Weekly Nexion Transfer
Prosperity Accounts
5/v/2021
Re.10.a
Atcount Beginning
Pending
Tod.,'a B,,Innln3 Amount to Be Transferred to Nursing
NursN Home Number Balance HLn an, Transfer -In
De osits
Balance Home
GnfdaACiegk 84,961.94 04,62R.g1 51,941.30
- -
32,090,43 / 26,962.79
Bank Balance
32,090,43 1/
Yarlanae
Us. In Balance
Withholding for Madf.e Raw., -Hoe,
MOD
4,245.74./
WithholdingforMadlure Retoup-ClrniO
1,232.79
APRIL INTEREST
39.13 ✓
-- ---
MAY INTEREST
LONE INTEREST
Note: only botonces vfover$Aow W276e tmneferred to the nursing home.
Note Z: Each O¢ rth=a base befentef$100thotMMCdepmfted to open na0aa,
Adlum A.W.ITramfier Amt 25h962..78 V
AM..d:
Raran AnBlin,CEO I If S/17/2021
>AY 17 2021
.4.' ..ai'aiie.>:e...
6:\NN Needy Tonefere\NN UK Tramfer5vmmary\LOZI\May\NH UN. Lumfcr Summery 5.10.2Lvlu
i•.o-u* i i .� i� '
GeIM'T" 5/13GK/2021henst6tRA0l
WIPE OOT NFXgN nFRlM AT 60WEnCMfK 9R.6Al
5/13/2032 Deposit
9/13/3021 RYS/iMNSi1MiBKCO2ItMt5o34815254M9119
MMCPORTION
QIPPltpmpoLl NH
rmmfgro I WPP/ComPt glpP/Comp3 WPP/Comp3 pple WPPTI I PORTION
31,35&30
59LM
31,350.30
59t.00
6i,63381 /31,941.90 J 31,94136
' 5/1712021
Treasury Center
Account Type
Search All
DDA
Data reported as of May 17, 2021 9
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balance
Number of Accounts: 15
$7,254,862.84
$7,517.230.45
S7,254,862.84
$7,474,934.49
*4551
CAL CO INDIGENT
S6,348.78
$6,348,78
$6.348.78
$14,827.19
HEALTHCARE
-4454
MEMORIAL MEDICAL I
$32,080,43
$32,080.43
$32,080.43
$32,080.43
NH GOLDEN CREEK
HEALTHCARE
-4365
MEMORIAL MEDICAL
$535,11
$536.11
$535.11
$535.11
CENTER - CLINIC SERIES
2014
'4357
MEMORIAL MEDICAL
$4,099,181.36
$4,228,484.04
$4,099,181.36
$4,388,713.73
CENTER - OPERATING
'4373
MEMORIAL MEDICAL
$430.82
$430,82
$430.82
S430.82
CENTER - PRIVATE
WAIVER CLEARING
*4381
MEMORIAL MEDICAL
$170,446.09
$223,763.53
$170,446.09
$141.949.69
CENTER/NH ASHFORD
*4403
MEMORIAL MEDICAL
CENTER/NH
$65,637.86
$92,210.20
$65,637.86
$61,051.51
BROADMOOR
*4411
MEMORIAL MEDICAL
$60,955.93
$67,915.07
$60,955.93
S48,364.85
CENTER/NH CRESCENT
`4446
MEMORIAL MEDICAL
$40,692.62
$40,692.62
$40,692.62
S40,692.62
CENTER/NH FORT BEND
*4438
MEMORIAL MEDICAL
CENTER SOLERA AT
$74.83B.74
$101.090.44
$74,838.74
$59,641A4
WEST HOUSTON
*2998
MMC -MONEY MARKET
S2,605,369.97
$2.605,369.97
$2,605,369,97
$2,605,369,97
FUND
'5506
MMC-NH BETHANY
$27,138.82
$27,138.62
$27,138.82
S12,367.46
SENIOR LIVING
`5441
MMC -NH GULF POINTE
PLAZA-
$26,915,78
$26.915.78
$26,915.78
S24,619.14
MEDICARE/MEDICAID
`5433
MMC -NH GULF POINTE
$112.65
$20,076.96
$112.65
$112.65
PLAZA - PRIVATE PAY
-3407
MMC-NH TUSCANY
$44,177.88
$44,177.88
$44,177.88
S44,177.88
VILLAGE
` indicates re
Paoe generated on 05/17/2021 at 9
Copyright 2021 Prosperity Bank.
F
https:/fprosperity.olbanking.com/onllneMessenger 1/1
Memorial Medical Center
Nursing Home UPL
Weekly HMG Transfer
Prosperity Accounts
5/17/2021
PaaWaus
Amount to Be
Acmugt h,innle,
Pending,
Transle.dto
Nwslne NGme
^ti• Balance T,.,fC, Gut Tnmtenln pI(Iii. ed
0! 09N
TOdn !Be Ineln Balance Nunb Nmm
GuIjVelrite Fya" nePik+ �_
10,110.65 1MA00.00 I0.W0.00
-
112.0 -
„1(
✓
B CkDuWoc,
WAS."
Leave in Balance
190.00
Prawaus
Account
NunlreNome ounce,
G'UI[ 'NnyY»@/iQWt�Nlld 'r
Rautlnb lnfeno d. /ee.GulhedMrk more,
N.C.OnIPbPlanFm oto.$5, MRiff Ue tmnrfeerod to the nunbR bone.
Note 3: E0rb...the, o bmebebn. ofS7W Uner MMCdeponted M ogn..I.
APRIL INTEREST 10.66 1/
MATINIFRM
TUNE MRREST
Adjust Balan[ejlnnsler Amt 0.00
Amaun11o0e
Ponce, Tans&rred to
Bank Balance
VOW.
Lou. in Balance
100A0
VAlhholdlN for Minlnrc Recoup Host,
Withholding Inr Medicare Recoup MCI
/
APRILINTEREST
36.]6 e/
MAYINTEREST
IUNEINTEREST
Adjust Relantt/12n#v4mt
26.18.E
TMALTIOLNSFERS
16.7004E
o ed:
mm� 4n,In, CFO 51171N131
W 17 A21
41"RefjolpFf
PUIN WeekryTmmfenV H VH.Tn norn,Summary\]@l\M1Nv\NN UPL nnnsfa Summery 5.17.71Ae
MMCPORTION
'S
QIPP/CoMM&
Trin518bOUt Ti_C_pNeo-ln gIPP(Campl QIPP/Comp2 QIPP/Comp3 Laps! QIPP TI
5AMI321 WIRE OUT HMG SEHIICES, LLC 10,000.00✓
5113/202I Telephme/WLra X/er ]0,0'0.00 -
5/13/2021 Transfer fmm DOA 5441 WIRE AMOUNT SENT BY - 10.000.00 -
5/10/2021 NORIDIAN I3A HCCIAIMPMi 6]58924N000ll1»40
S/12/2001 WIRSOUTHMGSEAVICESAW
5/13/2021 Tnnsferto0DA5433-WIREAMOUNTSENTBYM
5/13/2021 OBP410
S/13/2021 HEALTH HUMAN SIC HCCMIMPMT 1748W3111SO13 2
5/1412021 HEALTH HUMAN M RMWIAPMT I146W34113013 2
NH
PORTION
10,OW.W
20000.W 1000000 1000000
MC PORTION
QIPP/C4MP4& NH
Transfeo-out Tranaf Mn QIPP/COmpa QIPP/COmp2 QIPP/Comp3 Ups! QIPPN PORTION
- 61939.15 - 8,939.13
71,219.74 - -
30,000.00 -
12,993.12 - 22,993.11
12,560.14 - 12,560.14
2,296.64 - 2,296.64
81.219.74 3&789.02 36.739.02
101,L19.)1 451789.02 4&789.02
5117/2021
Treasury Center
Account Type
L
t
Search All
DDA
Data reported as of May 17, 20219
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balance
Number of Accounts: 15
$7,254,862.84
$7,517,230.45
$7,254,862.84
$7,474.934.49
'4551
CAL CO INDIGENT
$6,348.78
$6,348.78
$6,348.78
$14,827.19
HEALTHCARE
`4454
MEMORIAL MEDICAL (
NH GOLDEN CREEK
332,080,43
$32,080.43
$32.080.43
$32,080.43
HEALTHCARE
'4365
MEMORIAL MEDICAL
CENTER - CLINIC SERIES
$535.11
S535.11
S535.11
S535.11
2014
^4357
MEMORIAL MEDICAL
$4,099,181.36
$4.228.484.04
$4,099,181.36
$4,388,713.73
CENTER - OPERATING
'4373
MEMORIAL MEDICAL
CENTER -PRIVATE
S430.82
$430.82
$430.82
$430.82
WAIVER CLEARING
`4381
MEMORIAL MEDICAL
S170,446.09
$223,763,53
S170,446,09
$141,949.69
CENTER NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
$65,637.86
$92,210.20
$65,637.86
$61,051.51
6ROADMOOR
'4411
MEMORIAL MEDICAL
$60.955.93
$67,915.07
$60,955.93
$48.364.85
CENTER/NH CRESCENT
`4446
MEMORIAL MEDICAL
$40,692.62
$40,692.62
$40,692,62
$40,692.62
CENTER/NH FORT BEND
*4438
MEMORIAL MEDICAL
CENTER /SOLERA AT
$74.838,74
S101,090.44
$74,838.74
$59.641.44
WEST HOUSTON
'2998
MMC-MONEY MARKET
$2,605,369.97
$2.605,369.97
$2,605,369.97
$2,605.369.97
FUND
'5506
MMC-NH BETHANY
$27,138.82
$27,138.82
$27,138.82
$12,367.46
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA-
$26,915.78
$26,915.78
$26,915.78
$24,619.14
MEDICARE/MEDICAID
'5433
MMC -NH GULF POINTE
$112.65
S20,076.96
$112.66
$112.65
PLAZA - PRIVATE PAY
•3407
MMC-NH TUSCANY
$44,177.88
$44,177.88
$44,177.88
344.177,88
VILLAGE
Inoicales r5
Page generated on 05117,12021 at e
Copyright 2021 Prosperity Bank.
https://prosperity.olbanking,com/onllneMessenger 111
Memorial Medical Center
Nursing Home UPL
Weekly Tuscany Transfer
Prosperity Accounts
5/17/2021
PreHaua Amount to Ba
Astnunt BeRlnni, Pandln8 Tmnsfemed to
NUM, IIaMe NOm5e1 Bum. Tm.of—cut TransfaMn norleared 9e oslts Tada sU W. Balance Nursin Home
aulcdv8enkr(Mnaj=._,,,,. _,;' IDa474.19 77,100.79 17,9B4.67 - - - 4yv7.ae 9,784.41
&nkBalanse 44,1>Z99
Varimce
Lot.o Balmce 10000
Withhofdin, for Medl.. Rawry Nos, 519>.91r%
,Idlnafor Meditart Rem., rink 3.82213✓
PandN6Amatlgmop QlPPLk 26,273.41 ✓
N,te:Onrybaknm,(wer $&POOwi40attomleaed to fhe nwinBkame.
Npre is fodl paaunt h9s o bore bolpn[c of 3iw tkot MML dmotked eo opm attnunc
Adjust eabnufrransferAmt 91t0.61
A rowd:
Imon A[gR%cE4 7
SiDPWI
MAY 1 1 1021
3 j
l iiA
hofima'Y ,r - Transfer-0et
5/12/2021 WIRE OUT UNBAR ENTERPRISES, LLCC 77,100.78
5/19/2021 Oepasit -
MMC PORTION
QIPP/CumPA
Transfervin I QIPP/Cpmpl gIPP/[omp2 gIPPTI NH PORTION
17,800A7
17,806A7
5/17/2021 Treasury Center
Account Type j
v!
Search r All
DDA
Data reported as of May 17, 2021 9
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balance
Number of Accounts 15
$7,254,862.84
$7,517,230.45
$7,254,862.84
$7,474,934.49
'4551
CAL CO INDIGENT
$6,348.78
$6,348.78
$6,348.78
514,827.19
HEALTHCARE
`4454
MEMORIAL MEDICAL I
NH GOLDEN CREEK
$32,080A3
$32,080.43
$32,080,43
S32,080.43
HEALTHCARE
'4365
MEMORIAL MEDICAL
CENTER - CLINIC SERIES
$535.11
$535.11
$535.11
$535.11
2014
'4357
MEMORIAL MEDICAL
$4,099,181,36
$4,228,484,04
$4,009,181.36
$4,388,713.73
CENTER - OPERATING
373
MEMORIAL MEDICAL
CENTER - PRIVATE
$430.82
$430.82
$430.82
$430.82
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$170,446.09
S223,763.53
S170,446.09
$14l,949.69
CENTER/NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
S65,637.66
$92,210.20
$65,637,86
$61.051.51
BROADMOOR
'4411
MEMORIAL MEDICAL
$60,955.93
$67,915.07
$60,955.93
S48,364.85
CENTER/NH CRESCENT
'4446
MEMORIAL MEDICAL
$40,692.62
$40,692.62
$40,692.62
$40,692,62
CENTER/NH FORT BEND
'4438
MEMORIAL MEDICAL
CENTER SOLERA AT
$74.838.74
S101,090.44
$74,838.74
$59,641.44
WEST HOUSTON
'2998
MMC-MONEY MARKET
$2,605,369.97
$2,605.369.97
$2,605,369,97
$2,605,369.97
FUND
'5506
MMC-NH BETHANY
$27,138.82
$27,138.82
$27,138.82
S12,367,46
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA-
$26 915 78
$26,915.78
$26,915.78
S24,619.14
MEDICARE/MEDICAID
'5433
MMC -NH GULF POINTE
$112.65
$20,076.96
$112.65
$112.65
PLAZA - PRIVATE PAY
'3407
MMC-NH TUSCANY
$44.177.88
$44.177.88
$44,177.88
$44,177.88
VILLAGE
Pape generated on 0511712021 ai 9
Copyright 2021 Prosperity Bank.
1
https://prosperity.olbanking.comlonlinaMesseriger 1I1
Memorial Medical Center
Nursing Home UPL
Weekly HSLTransfer
Prosperity Accounts
5/17/2021
PMvl4w An4emke8e
AavunL Beginning P.raing Tr4W..d ra
Nvrshu Hvme ^•�• Balance ,Trust-0.1 /Tnndenln QeCl... ad Oe vuh Ted. [Ba innm Balance Nmaln Nome
294•716.01 244•SSL90,/ 26,974.71 - - $i,13B.83 26,97C71
Bank 8a6we 37.138.8E
Wriana
kGvnln Rhona 100.00
WBhdNB ter Medfnn Ne[P
WOM1h.ldingler Medlonftam.t.., ep QN[
APRILINTEREST 64.11 L/
MAYWTEREST
IUNEIMERQT
AdjwLRd.nn/TnnderArnE6974.71
Mae: koch —tat/arahatebotancben5M/emd nehenvaorketto roved:
Na1eY. FvcFacmuneFmvbuebdvncevf 5100MveMMCdepsifed tvopm vttaunC Iamn M{IIry CIO 5/17/1025
+4AY 1I7021•
F:VIN WeckryT—f—\NN UN Tnnder 1ummary\]021\F.LYWN UPL TnmterSummary£L7,EIvL[
5/30/2D21 Deposit
5/V/2D21 Deposit
5/11/2021 Deposit
5111IM21 Deposit
5/12/2021 WIRE OUT 6ETHANY SENIOR LIVING, LTD
5/14/2021 Deposit
5/14/M21 HOSPICE OF $0 TX VENDORS NF 9100003
MMCPORTION
QIPP/Comp4
Transfer -OW TramQIPP/COmpl QIPP/Comp2 QIPP/Comp3 &lapse DIPP iI NH PORTION
2,716.92 - 2,716.91
1,37L02 - 1,372.01
5,580.00 - 5,580.00
2,534A2 - 2,534,42
244,561.80 - - -
12,809.70
1,96L66
12,809.70
1,961.60
244,561.90 / 26,974.71 20,974.71
' 5717/2021 Treasury Center
Account Type I '
�I
Search All
DDA
Data reported as of May 17. 20219
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balance
Number of Accounts: 15
$7,254,862.84
$7,517,230.45
$7,254,862.84
$7,474,934.49
'4551
CAL CO INDIGENT
$6,348.78
$6,348.78
$6.34878
$14,827.19
HEALTHCARE
`4454
MEMORIAL MEDICAL I
NH GOLDEN CREEK
$32,080.43
$32.080.43
S32,080.43
$32,080A3
HEALTHCARE
'4365
MEMORIAL MEDICAL
CENTER- CLINIC SERIES
$535.11
$536.11
$53$.11
$535.11
2014
'4357
MEMORIAL MEDICAL
S4,099,181.36
$4,228,484.04
$4,099,181.36
$4,386,713.73
CENTER - OPERATING
'4373
MEMORIAL MEDICAL
CENTER - PRIVATE
$430.82
$430Z2
$430.82
5430.82
WAIVER CLEARING
`4381
MEMORIAL MEDICAL
5170,446.09
S223,763.53
S170,446.09
$141,949.69
CENTER INH ASHFORD
*4403
MEMORIAL MEDICAL
CENTER INH
$65,637.86
$92,210.20
$65,637.86
$61,051.51
BROADMOOR
'4411
MEMORIAL MEDICAL
$60,955.93
$67,915.07
S60,955.93
S48,364.85
CENTER INH CRESCENT
'4446
MEMORIAL MEDICAL
$40,692.62
$40,692.62
$40,692.62
$40,692.62
CENTER/NH FORT BEND
`4438
MEMORIAL MEDICAL
CENTER /SOLERA AT
$74,838.74
$101,090.44
$74,838.74
$59,641,44
WEST HOUSTON
•2998
MMC-MONEY MARKET
$2,605,369,97
$2,605.369.97
$2.605.369.97
$2,605,369.97
FUND
'5506
MMC-NH BETHANY
$27,138.82
S27,138.82
S27,138.82
$12,367.46
SENIOR LIVING
`5441
MMC -NH GULF POINTE
PLAZA-
S26,91578
S26,915.78
$26,915.78
$24,619.14
MEDICAREWEDICAID
'5433
MMC -NH GULF POINTE
$112.65
$20,076.96
$112.65
$112.65
PLAZA - PRIVATE PAY
'3407
MMC-NH TUSCANY
$44,177.88
$44.177.88
$44,17T88
$44,177,88
VILLAGE
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/`.MOUNT 7,424.80
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MAY 17 2021
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Date Requested:
AMOUNT 1232.78
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#18
CALHOUN COUNTY CLERK
MONTHLY REPORT RECAPITUATION
I`APRIL207,1
DISC -:. 6LCbBE:.
CARL
ORIMM
mNDAL
iu$uE
I I=M
AOMTE
TOTAL
DISTIOCTATTORNEYFFES 1D0044020
$ 234AI
IS 234.41
BEER LICENSE IM42010
$ 10.00
IS 10,00
COUNTY CLERK FEES 100044030
$ 385.45
$ 430.00
$ 12,828.50
$ 315.00
$ 13.959.85
APPEAL FROM IF COURTS IOW 44030
$ -
IS -
COUNTY COURT ATLAW 8IJURY FEE 10W44140
IS -
JURVFEE 100044140
$ -
$ 40.00
$ 40.00
ELECTRONIC FILL NG FEES FOR FIRINGS 100044058
$ -
$ -
$ -
$ -
IS -
JUMCSEDUCATION FEE 1000441W
$ -
$ -
$ -
$ 25.00
$ 25.00
JUDGE'S ORDEB/SIGNATURE 1W044100
$ 10.00
$ -
$ -
IS 66.00
$ 76.00
SOERIFFSFEES 100014190
$ 300.00
$ 36989
$ -
$ 150,00
$ 819,89
VISUAL RECORDER FEE 1OW44250
IS 61
$ 65,48
TIMEPAYMEATFEE- COUNTY "N£W2020" 100044332
IS 30.00
IS 30.00
COURT REFPORTER FEE LOGO"270
$ E000
$ -
IS
$ 75.00
$ 165.00
RESTITUTION DUE TO OTHERS 10OD49020
$ -
ATTORNEY FEES -COURT APPOINTED 100049030
$ -
$ -
APPELLATEFUNDITGQFEE 262044030
$ 35,00
$ 25.00
$ 6000
TEOINOLOGYFUND 265344030
$ 45.09
$ 45.09
COURTHOUSE SECURITY FEE 267044030
$ 35.00
$ 99.54
$ 543.00
$ 2500
5 70254
COURT I N171ATED GUARDIANSHIP FEE 267244030
$ 100.00
5 100.00
COURT RECORD PRESERVATION FUND 267344030
$ IOAO
$ -
$ 5000
$ 120.00
COURT REPORTER SERVICE FUND"NEW 2020" 2674 30
$ 28.16
$ 28.16
RECORDS ARCHIVE FEE 267544030
$ 5,190.00
$ 5,190.09
COUNTYSP£CRUncDURT *Nm2020" 267644030
$ 187.7$
$ 187,75
COUNTYJURYFUND "NEW2620" 267940030
$ 9.39
$ 9.39
DRUG& ALCOHOLCOURT PROGRAM 269844030 W5
$ 1.45
IS 1.45
JUVENILE CASE MANAGER FUND 269944033
$ -
$ -
FAMILYPROTECTIONFUND 270644030
$ 45.00
$ 45,00
JUVENILE CRIME& DELINQUENCY FUND 271544030
$0.00
$ -
PRE-TRIAL DIVERSION AGREEMENT 272944034
$ -
$ -
UW/UBARYFEE 273144G30
$ 210.00
$ 175.00
$ 385.00
RECORDS MANAGEMENT FEE -COUNTTC2ERKK 273EA43M
$ 4.71
$ 5,260.00
5 5,264.71
RECORDS MANGEMENT FEE - COUNTY 273944030
IS 30.00
$ 2TFA2
$ 2500
$ 332.12
FINES -COUNTY COURT 274045040
$ 5,263.81
5 5.263.81
BOND FORFEITURE 27404SOGO
IS
IS -
STATE POLICE OFFICER FEES - STATE(OPS)(20%) 702020740
$ 125.
$ 1.25
CONSOLIDATED COURT COSTS - COUNTY 7070-20610
$ 8154
$ 8,54
CONSOLIDATED COURT C095-STATE 7070-20740
$ 76.81
IS 76.81
CONSIXIDATEOCOURTCDSTS COUNTY ••NEW2020" 707210610
$ 141.85
IF 141.05
CONSOLIDATED COURT COSTS -STATE "NEW2010" 7072.20740
$ 11270..62
IF 1,276.62
JUDICIAL AND COURT PERSONNEL TRAINING STNW%) 7502-20740
S 35.00
$ -
$ 2500
$ 6000
DRUG& ALCOHOL COURT PROGRAM -COUNTY 7390-20610
S 0.29
$ 029
DRUG& ALCOHOL COURT PROGRAM STATE 739020740
$ 1,16
$ 1,16
STATE ELECTRONIC FILING FEE -CIVIL 7403-22887
IS 180.00
$ -
$ 15000
$ 33000
STATE ELECTRONIC FILING FEE CRIMINAL 7403-22990
$ 4.42
5 4.42
EMS TRAUMA -COUNTY IID I 7405-20610
$ 149,95
$ 149.95
EMS TRAUMA - STATE ISM) 7405-20740
$ 16.66
$ 16,66
CIVIL INDIGENT FEE - COUNTY 7480301510
$ 3,50
$ 2,50
$ 6.00
CIVIL INDIGENT FEE STATE 748030740
$ 65.50
$ 47.50
$ 114,00
JUDICIAL FUND COURT COSTS 7495-20740
$ 28.27
$ 28,21
JUDICIAL SALARY FUND - COUNTY (IO)H 750520610
$ 065
$ 0,65
JUDICIAL SALARY FUND - STATE (90%) 7503-20740
$ 5,88
$ 5,88
JUDICIAL SALARY FUND (CIVIL & PROBATE) -STATE 750580740.005
1 $ 25200
3 210.00
$ 462.00
TRAFFIC LOCAL (ADMINISTRATIVE FEES) 7538-228144359
$ 6,00
$ 6.00
COURT COST APPEALOF TRAFFIC REG HP APPEAL) 7538-22885
$ -
BIRTH - STATE 7855.20780
$ 12600
$ 126DD
INFORMAL MARRIAGES - STATE 7855-20782
$ 12M
$ 12.50
JUDICIALFEE 795520786
$ 240.00
$ -
5 200.0D
$ 440.00
FORMAL MARRIAGES - STATE 7855,20788
IS 540.00
$ 540,00
NONDISCLOSURE FEE STATE 785540790
S -
$ -
$
$ -
TCLEOSECOURT COST -COUNTY(10%) 795620610-
TCLOOSE COURT COST - STATE (90%) 785620740
$ -
$ -
JURYRETMBURSEMENTFEE COUNTY(10% 785780510
$ 0.47
$ OA7
JURY REIMBURSEMENT FEE -STATE (90%) 7857-20740
$ 4.21
$ 4.21
STATE TRAFFIC FINE-COUMYI396) 7860-20610
S 3.00
S 3.00
STATE TRAFFIC FINE - STATE (95%) 786020740
$ 57.00
$ 57,00
5TATETNAFFIC FINE - COON" 14%) 91112019 7860-20610
IT -
$ -
STATE TRAFFIC FINE - STATE(%%) 91112019 186620740
$ -
$ -
INDIGENT DEFENSE FEE - CRIMINAL - COUNTY (100D 786520610
$ 0,22
IS 022
INDIGENT DEFENSE FEE - CRIMINAL - STATE (90%) AMS-20740
$ 1195
$ 1.95
TIME PAYMENT - COUNTY FSOY) 7950-20610
IS (12.50)
$ (12,50)
TIME PAYMENT - STATE ISO%1 795020740
$ (1250)
$ (12.50)
BAIL JUMPING AND FAILURE TO APPEAR - COUNTY 1870-20610
$ -
BAILIUMPINGANDFAILURETOAPPEAR STATE 797020740
I -
DUEPORTIAVACAPD 9990.99991
$ 27.09
$ 27.09
OUESMDRIFTPD 9950A9992
$ -
$ -
DUE TOPOINT COMFORT RD 999099993
$ -
$ -
DUETOTEIUSPARKS&WILDLIFE 999099994
$ -
$ -
DUETOTERA9PARKS&WILDLIFEWATERMFETY 999099995
IS -
DUETOTABC 99WA9996
$ -
DUETOATTORNEYADUTEMS 993099997
$ -
DUE TOOPEMTING/NSFCHARGES/DUE TO OTHERS 7120-26759
$
$
$ 898 od
IS 2.000.00
$ 1,102.00
$ 1,98745 $ 8.835.00 $ 23.612.00 S 3,706,00 $ 38.140.45
TOTAL FUNDS COLLECTED $ 38,140.45 FOOD)
FUNDS HELD IN ESCROW:$ - AMOUNT DUE TO TREASURER(20R'S); $'zr:37A11,38:
TOTAL RECEIPTS: $'. '. t38,140AS: AMOUNT DUE TO OTHERS i ESS SF-S): $ 1,129.09
J.I3
5'1IQ021
CALHOUN COUNTY CLERK
BEGINNING BOOK BALANCE
3/ilpmi ;; $
95,629.74
FUND RECEIVED
$
7,940.00
—BALANCE OF CASH BONDS"
$ 77,440.00
DISBURSEMENTS
$
2,9M.00
ENDING BOOK BALANCE
4/90/10;1 f
100,819.74
"OTHER REGISTRY REMS^
$ 16,042.24
"IBC CASH BOND CHECKS"
$ 7,337.50
BANK RECONCILIATION REGISTRY OF COURT FUNDS
ENDING BANK BALANCE
4/30/2e21 $
110,064,54
—TOTAL REGISTRY FUNDS-
$ 100819.74
OUTSTANDING DEPOSITS"
OUTSTANDING CHECKS'-
$
9,719.80
RacantllW:
$ N75.001
rmi t-ATF%F1F nFFFIGITC HF In IUTR I MT-fnlnCOFRIN RftNM
'CIYS,
B4h HsuaB
'Bahlnca;,..,Purcixaw4
WNhErarnl
BaaOw
$731=1 "
Intilirld,
04130121
1040
112412018
$
5
$
10411
W412018
$ 10,283.59
$ 1.27
IS 10,284.66
10M2
124120/8
$ 1,275.87
$ 0.16
$ 1,276.03
10443
i/2512018
$ 1,275.87
$ 016
$ 1,276,03
10444
12512018
$ 9,635.02
$ 1.19
$ 9.636.21
10445
125/2018
$ 9,635.02
$ IA9
$ 9.636.21
10446
1252018
$ 9.635.02
$ 1.19
$ 9,636.21
10449
619/1955
$ 20,361.03
$ 20,351.03
104M
312/2018
$ 3,593.90
$ 3.59390
10455
31220 9
S$ 3,593.90
$ 3.593.90
10496
6262020
$ 5,915.66
$
is 5,915.66
TOTALS: $ 75d&1.88 $ 5.16 $ $ 76,200.04
511112021
-
Subrlll0e0by: Anna M Gaudreau, County Clerk Data
r
Relhard Meyer. Calhoun County Judge Date
UT REWRTSW0FJHLT UM!GlANe TRFAGURERREPORT92031043M,TRE SURM REPORTS A.,ea 2.12
9nw:l
MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS
5/3/2021
COURT NAME:
DISTRICT CLERK
MONTH OF REPORT:
APRIL
YEAR OF REPORT:
2021
ACCOUNT NUMBER
ACCOUNT NAME
DEBIT
CREDIT
1000-001-44190
SHERIFF'S SERVICE FEES
$4,816.44
1000-001-44140
JURY FEES
$80.00
1000-001-44045
RESTITUTION FEE
$0.00
1000-001-44020
DISTRICT ATTORNEY FEES
$0.00
1000-00149010
REBATES -PREVIOUS EXPENSE
$6.50
1000-001-49030
REBATES-ATTORNEY'S FEES
$1,255.42
1000-00144058
DISTRICT CLERK ELECTRONIC FILING FEES
$0.00
1000-001-44322
TIME PAYMENT REIMBURSEMENT FEES
$33.63
1000-001-43049
STATE REIMB- TITLE IV-D COURT COSTS
$0.00
DISTRICT CLERK FEES
CERTIFIED COPIES
$864.31
CRIMINAL COURT
$174.00
CIVIL COURT
$4,570.58
STENOGRAPHER
$330.00
CIV FEES DIFF
$0.00
1000-00144050
DISTRICT CLERK FEES
$5,938.89
1000-999-20771
FAMILY VIOLENCE FINE
$0.00
1000-999-10010
CASH - AVAILABLE
$12,130.88
2706-001-44055
FAMILY PROTECTION FEE
$45.00
2706-999-10010
CASH - AVAILABLE
$45.00
2740-00145055
FINES - DISTRICT COURT
$490.43
2740-999-10010
CASH - AVAILABLE
$490.43
2620-00144055
APPELLATE JUDICIAL SYSTEM
$110.00
2620-999-10010
CASH - AVAILABLE
$110.00
2670-00144055
COURTHOUSE SECURITY
$219.85
2670-999-10010
CASH - AVAILABLE
$219.85
2673-00144055
CRT RECS PRESERVATION FUND- CO
$386.39
2673-999-10010
CASH - AVAILABLE
$386.39
2739-00144055
RECORD MGMT/PRSV FUND - COUNTY
$207.85
2739-999-10010
CASH - AVAILABLE
$207.85
2737-00144055
RECORD MGMT/PRSV FUND -DIST CLRK
$387.26
2737-999-10010
CASH - AVAILABLE
$387.26
2731-00144055
LAW LIBRARY
$770.00
2731-999-10010
CASH - AVAILABLE
$770.00
2663-00144050
CO & DIST CRT TECHNOLOGY FUND
$17.42
2663-999-10010
CASH - AVAILABL
$17.42
7040-999-20740
BREATH ALCOHOL TESTING - STATE
$0.00
7040-999-10010
CASH - AVAILABLE
$0.00
2667-00144055
CO CHILD ABUSE PREVENTION FUND
$0.52
2667-999-10010
CASH - AVAILABLE
$0.52
7502-999-20740
JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE
$190.32
7502-999-10010
CASH-AVAILABE
$190.32
7383-999-20610
DNA TESTING FEE - County
$4.46
7383-999-20740
DNA TESTING FEE - STATE
$40.17
7383-999-10010
CASH - AVAILABLE
$44.63
7405-999-20610
EMS TRAUMA FUND - COUNTY
$9.09
7405-999-20740
EMS TRAUMA FUND - STATE
$81.77
7405-999-10010
CASH - AVAILABLE
$90.86
7070-999-20610
CONSOL. COURT COSTS - COUNTY
$29.77
7070-999-20740
CONSOL. COURT COSTS - STATE
$267.94
7070-999-10010
CASH - AVAILABLE
$297.71
7072-999-20610
STATE CONSOL. COURT COSTS- COUNTY
$43.11
7072-999-20740
STATE CONSOL. COURT COSTS- STATE
$388.00
7072-999-10010
CASH- AVAILABLE
$431.11
2698-001-44030-010
DRUG CRT PROG FEE - COUNTY (PROGRAM)
$71.90
2698-999-10010-010
CASH -AVAILABLE
$71.90
7390-999-20610-999
DRUG COURT PROG FEE - COUNTY (SVC FEE)
$14.38
7390-999-20740-999
DRUG COURT PROG FEE - STATE
$57.51
7390-999-10010-999
CASH -AVAILABLE
$71.89
7865-999-20610-999
CRIM - SUPP OF IND LEGAL SVCS - COUNTY
$0.47
7865-999-20740-999
CRIM - SUPP OF IND LEGAL SVCS - STATE
$4.19
7865-999-10010-999
CASH - AVAILABLE
$4.66
7950-999-20610
TIME PAYMENT - COUNTY
$23.54
7950-999-20740
TIME PAYMENT - STATE
$23.53
7950-999-10010
CASH - AVAILABLE
$47.07
7505-999-20610
JUDICIAL SUPPORT-CRIM - COUNTY
$2.09
7505-999-20740
JUDICIAL SUPPORT-CRIM - STATE
$11.85
7505-999-10010
CASH - AVAILABLE
$13.94
7505-999-20740-010
JUDICIAL SALARIES -CIVIL- STATE(42)
$1,622.84
7505-999-10010-010
CASH AVAILABLE
$1,622.84
2740-001-45050
BOND FORFEITURES
$0.00
2740-999-10010
CASH -AVAILABLE
$0.00
2729-001-44034
PRE-TRIAL DIVERSION FUND
$0.00
2729-999-10010
CASH - AVAILABLE
$0.00
7857-999-20610
JURY REIMBURSEMENT FUND- COUNTY
$0.93
7857-999-20740
JURY REIMBURSEMENT FUND- STATE
$8.40
7857-999-10010
CASH - AVAILABLE
$9.33
7860-999-20610
STATE TRAFFIC FINE- COUNTY
$0.00
7860-999-20740
STATE TRAFFIC FINE- STATE
$0.00
7860-999-10010
CASH - AVAILABLE
$0.00
7403-999-22888
DIST CRT - ELECTRONIC FILING FEE - CIVIL
$1,290.00
7403-999-22991
DIST CRT - ELECTRONIC FILING FEE - CRIMINAL
$21.52
CASH - AVAILABLE
$1,311.52
1000-001-44050
DISTRICT CLERK FEES
$93.22
1000-999-10010
CASH - AVAILABLE
$93.22
2739-001-44055
RECORD MGMT/PRSV FUND - COUNTY
$58.26
2739-999-10010
CASH - AVAILABLE
$58.26
2669-001-44050
COUNTY JURY FUND
$2.33
2669-999-10010
CASH - AVAILABLE
$2.33
2670-001-44055
COURTHOUSE SECURITY
$23.30
2670-999-10010
CASH - AVAILABLE
$23.30
2663-001-44050
CO & DIST CRT TECHNOLOGY FUND
$9.32
2663-999-10010
CASH -AVAILABLE
$9.32
2676-001-44050
COUNTY SPECIALTY COURT FUND
$58.26
2676-999-10010
CASH - AVAILABLE
$58.26
TOTAL:
7855-999-20784-010
DIST CRT - DIVORCE & FAMILY LAW - STATE
$277.75
7855-999-20657-010
DIST CRT - DIVORCE & FAMILY LAW - COUNTY
$7.25
7855-999-20792-010
DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - STATE
$525.00
7855-999-20658-010
DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY
$15.00
7855-999-20740-010
DIST CRT - OTHER CIVIL PROCEEDINGS - STATE
$1,449.05
7855-999-20610-010
DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY
$76.27
7855-999-20790-010
7855-999-10010-010
DUE TO STATE - NONDISCLOSURE FEE $0.00
CASH - AVAILABLE $2,350.32
Revised 01/31/20
TOTAL (Distrib Req to Oper Acct) $21,813.08 $21,568.39
DUE TO OTHERS (Distrib Req(s) attached)
ATTORNEY GENERAL (RESTITUTION) 0.00
OUT -OF -COUNTY SERVICE FEES 2,460.00
REFUND OF OVERPAYMENTS 93.00
DUE TO OTHERS 0.00
TOTAL DUE TO OTHERS $2,553.00
REPORT TOTAL -ALL FUNDS 24,121.39
PLUS AMT OF RETURNED CKS 0.00
LESS: TOTAL TREASURER'S RECEIPTS (24,121.39)
OVER / (SHORT) $0.00
DISTRICT COURT
APRIL
STATE COURT COSTS REPORT
2021
APRIL
SECTION I: REPORT FOR OFFENSES COMMITTED
COLLECTED
COUNTY
STATE
0111/20 - Present
_
43.11
388.00
01/01/04 - 12/31/19
m$2.97,46�
29.75
267.71
09/01/01 - 12/31/03
0.02
0.18
09/01/99 - 08131 /01
0.01
0.04
09/01/97 - 08/31/99
e,10
-
-
09/01/95-08/31/97
-
-
09/01/91-08/31/95
DNA TESTING FEES
44.63
4.46
40.17
EMS TRAUMA FUND
90.86
9.09
81.77
JUV. PROB. DIVERSION FEES
JURY REIMBURSEMENT FEE
$9.33
0.93
8.40
INDIGENT DEFENSE FUND
$4.66
0.47
$4.19
STATE TRAFFIC FEES
$0.00
-
$0.00
DRUG CRT PROG FEE
$143.79
$86.28
57.51
SECTION II: AS APPLICABLE
STATE POLICE OFFICER FEES
FAILURE TO APPEARIPAY FEES
-
-
JUD. FUND-CONST. CO. CRT.
.........:'.
JUD. FUND -STATUTORY CO. CRT.
_
MOTOR CARRIER WEIGHT VIOLATIONS
TIME PAYMENT FEE
$47.07
23.54
23.53
DRIVING RECORD FEE
JUDICIAL SUPPORT FEES
$13.94
2.09
11.85
ELECTRONIC FILING FEE - CR
$21.52
$21.52
TOTAL STATE COURT COSTS
$1,104.62
$ 199.75
$ 904.87
CIVIL FEES REPORT
APRIL
COLLECTED
COUNTY
STATE
BIRTH CERTIFICATE FEES
MARRIAGE LICENSE FEES
DECL. OF INFORMAL MARRIAGE
ELECTRONIC FILING FEE - CV
$1,290.00
$1,290.00
NONDISCLOSURE FEES
0
$0.00
$0.00
JUROR DONATIONS
JUSTICE CRT. INDIG FILLING FEES
STAT PROB CRT INDIG FILING FEES
STAT PROB CRT JUDIC FILING FEES
STAT CNTY CRT INDIG FILING FEES
STAT CNTY CRT JUDIC FILING FEES
STAT CNTY CRT -JUDICIAL SUPPORT
CONST CNTY CRT INDIG FILING FEES
CNST CNTY CRT JUDIC FILING FEES
DIST CRT DIV $ FAMILY LAW
29'':
$265.00
7.25
277.75
DIST CRT OTHER THAN DIV/FAM LAW
_
30'-':'
$540.00
15.00
525.00
DIST CRT OTHER CIVIL FILINGS
8�1
': $1,525.32
76.27
1,449.05
FAMILY PROTECTION FEE
................................
JUDICIAL SUPPORT FEE
41s
$1,622.84
$1,622.84
_
JUDICIAL B COURT PERSONNEL TRANING FEE
78
$190.32
-
$190.32
TOTAL CIVIL FEES REPORT
$ 5,453.48
$ 98.52
$ 5,354.96
TOTAL BOTH REPORTS
$ 6,558.10
$ 298.27
$ 6,259.83