2003-08-28
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REGULAR AUGUST TERM
HElD AUGUST 28, 2003
THE STATE OF TEXAS 9
COUN/Y OF CAlHOUN 9
BE IT REMEMBERED, that on this the 28'" day of August, A.D., 2003 there was begun and holden
at the Courthouse in the Oty of Port lavaca, said County and State, at 10:00 A.M. A Regular
Term of the Commissioners' Court, within said County and State, and there were present on this
date the following members of the Court, to-wit;
Michael J. PFeifer
Roger C. Galvan
Michael J. BaJajka
H. Aoyd
Kenneth W. Finster
Wendy Marvin
County Judge
Commissioner, Pet. 1
Commissioner, Pet. 2
Commissioner, Pet. 3
Commissioner, Pet. 4
Deputy County aerk
Thereupon the following Proceedings were had:
Commissioner Galvan gave the InvocatiOll and Commissioner Finster led the Pledge of Allegiance.
MEMORIAL MEDICAL CENTER - MONTHLY FINANCIAL REPORT
Saad Makhail presented the Memorial Medical Center monthly financial report
Buzz Currier talked about the hospital's first loss of the year actually the first loss in several years
due to the shutdown of several days during Hurricane aaudette. They are taking steps to cut
expenses alid make up for the loss. There have been three surveys clone this year by Texas
Deparbnent of Health, these surveys are done every three years, During the month of November
they will be doing a Semi-Annual Community Needs Assessment, the assessments will be
conducted throughout the County. The Board will follow with a Strategic Planning Retreat In
which the Board will Invite Commissioners' Court to partidpate in the Retreat; It will be a one-day'
session friday December s'" 2003.
MEMORIAL MEDICAL CENTER
YEAR-TO-DATE SUMMARY
JULY 31, 2003
@
OPERATING REVENUE
LESS:
OPERATING EXPENSES
10,955,275
(10,332,437)
622,839
CHANGE IN INVESTMENT:
Accounts Receivable_
(Incr) Deer
Accounts Payable-
Iner (Deer)
Prepaid Expense-
(Iner) Deer
Inventory
(Iner) Deer
(173,039)
1,914
(41,683)
(982)
TOTAL INVESTMENT CHANGE
(INCR) DECR
(213,790)
409,049
PLUS:
Depreciation
Contribution to the County
885,134
o
1,294,184
PLUS:
. County Subsidies Hospitai
28,341
T olal Cash-
Iner (Decr)
1,322,525
, : . ~ -: ~~-.
LESS:
Equipment Pu'rchases
(617,376)
.NET CASH-INCR (DECR)
705,149
~ ..
905
CALHOUN COUNTY TEXAS 2
COUNTY TREASURER'S REPORT MONTH OF: JULY1QOJ
BE.GINNING ENDING
FUND FUND 8AUNCE RECEfPTS [)lSBURSEMENTS FUND BA.U.NCe
MEMORIAL MEDICAL CENTER:
OPERATING S1.J68,740.16 S1,481.279.97 $1,601,011.52 SI.149,008.61
MEMORIAL 17,079.J9 21.76 0.00 [1.101.15
RESTRICTED DONATION 13,5.<16,04 17.26 0.00 ]3,563.'0
INOrGENT HEAL1HCARE 1,53UO 212,904.12 117,&&6.74 96,552.3&
TOTALS S I ,400,900.49 SI,694,223.21 SI,118,898.16 SI,376,225.oI4
BANK RECONCILIATION LESS~ CERT.
FUND OF DEPOSIT PLUS; CHEClCS BA.NK
FUND 8AUNcr OTHER ITEMS OUTSTANDING BA.LANCE
MEMORIAL MEDICAL CENTER:
OPERATING 1.149,008.61 ,0.00 nl.93US 1,570,940.46
MEMORIAl. 17,lOl.lS 17,lOl.lS
RES11UCI"ED DONATION 1J,56J.30 13,56].JO
INDIGENT HEAlTIlCARE 96,552.33 86.19 96,638..57
TOTALS Sl.316.12S..4~ s:o.oo S322.018.04 SI.698.,2<13.48
e
MEMORIAL MEDICAL CENTER
PORT LAVACA, TEXAS
PHYSICIAN'S ANALYSIS REPORT
JULY 31,2003
YTD YTD YTD
REVENUE CONTRACTUAL WRITE-OFF NET REVENUE
NAME MONTH YTD AMOUNT AMOUNT GENERATED PERCENT
e APOSTOL, CF. 116,554.13 820,238.39 315,644,34 49,214.30 455,379.75 S6%
APOSTOL, MELBClO 3,014,66 13,921.52 798.33 835.29 12,287,90 88%
W1LLIAM,G.A. 84,409,84 490,550.20 81,470.10 29,433.01 379,647,09 77%
UN, M.S. 115,546.52 921,994.29 260,684.08 55,319.66 605,990.55 66%
SMITH, J.K. 141,758,85 861,215.44 152,123.59 51,672.93 657,418.92 76%
0.00 0.00 0.00 . 0,00 0.00 0%
MCFARLAND, T,R. 137,334.39 1,068,205.31 208,893.13 64,OQ.2.32 795,219.86 74%
GRIFFIN, JEANNlNE 14,853.45 103,331.52 7,887.27 6,199.89 89,244.36 86%
BlJNNEI.L, D.P. 196,208.09 1,862,025.87 818,061.93 1Il,721.55 932,242.39 50"10
0.00 0,00 0.00 0.00 0.00 0"10
ARROYO-DlAZ, R. 209,178.22 1,810,465.58 589,508.87 108,627,93 1,112,328.77 61%
GILL, J. 81,764.79 734,878.63 180,950.52 44,092.72 509,835.39 69%
WlLLIAMS, WES 132,504,19 553,644,03 118,067.46 33,218.64 402,357.93 73%
CUMMlNS,M. 81,027.J8 440,517.78 J07,JOl.08 26,431.07 306,985.63 70%
.UPLEY, M. 11,278.53 105,733.25 16,123.02 6,344.00 83,266.24 79%
LEE, J 35,351.45 420,502.13 93,517.24 25,230.13 301,754.77 72%
LE, NHI 44,324.55 1,162,209.93 314,544,60 69,732.60 m,932.74 67%
CARAWAN, S. 9,937.75 943,087,76 229,494.62 56,585.27 657,007,88 70"10
STEINBERG, R. 6,202.26 65,597.69 J3,963.90 3,935,86 47,697.93 73%
RAMOS LABORATORY 33,960.42 66,508.50 45.24 3,990.51 62,472.75 94%
VJSITING PHYSICIANS 258,997.86 1,596,188.77 370,875,97 95,771.33 1,129,541.47 71%
ER PHYSICIANS 584,541.33 3,450,268.32 565,683.16 207,016,10 2,677,569.06 78%
NO LOCAL PHYSICIAN 1,3I1.J4 4,691.58 837.49 281.49 3,572.60 76%
0TIffiR 363,364.67 2,993,132.19 844,398.99 194,189.70- . 1,954,443.50 65%
e TOTAL 2,663,424.27 20,488,908.68 5,290,674.93 1,144,036.29..: 13,954,197.46 68%
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lIOORIrt. MEDICIl.CEHTER
BAUlNCE gm 08/19/03 07:59 RM ')
~ OF: 07/31/03
THIS YBlR UlST YBlR LAST MOtiTH
07131/03 07131/02 06/30/03 e
1JRRENT l\SSET5
:llSH
cmlATING RJlID 1,2\9,008.61 1,239,707.\1 1,369,054.48
IK'REST CASH IlCClJUNT 5,090.00 5,000.00 5,000.00
\lrn't CllSII 625. 00 625. 00 625. 00
'"' m PROCEEDS ,00 .00 .00
IHlIllSPITIIL PORTION .00 .00 .00
RE!rrRICIED OCWSlTlCli 13,618.75 13,167.92 13,5'l'l,05
IHl m SINKING FtJID/INTEREST 36.21 36.21 36.21
TlIlll. CRSH..................... 1, 268, 288. 57 . 1,258,536. 54 1,Ja.9, 314. 74
lCClJJ(JS REtEIVl\lllf
PATIENT 0Cl:lUIIS IlE!:EIVRBLE 4,361,606.51 ,,385,510.22 4, 565, 638. 19
IUOOI:E FDR BAD DEBT (2,122, $1. 08) (2, 268, 816. 00) (2,234,819.061
PlA1Il s:mll.1Y tuNICS IlE!:EIWlBl ,08 .00 ,00
"ISC AlIlltITS REtEIVllBlE 2,5,527.23 218,234.24 252,621.73
THIRD PARTY RECEIVRBLE 63, 718. 08 335,5'38. 00 63,718.00
T1F 6llAIIT .00 4,620.74 .00
TlIlll. 0Cl:lUIIS RECEIVABLE...... 2,548,290. 74 2,b75,117.20 2,647,150.92 ;t':'.'
17:.
IN'1EHTD1UE5
RlUlIlllJj'(-Fllll 4, B86. 69 6,805.61 10,5'34.10
l.AIlllRATIlRY 50, 23], 09 53,338.51 58, ,79. 66
camlll. SlJlPL y 123, 912. 31 112,301.96 115, SJiI. 49 e
!maY 15-\,6-\3.5'3 135,42'3.83 15-\,6-\3.59
DIETllRY 9,847.61 10,118.38 9,847.61
IIlINTEIm:E 4,128.7'3 \,961.71 4,128.79
PlIlRIR:Y 144,211.73 142, 269. 76 144,211.73
TlIlll. INVEllTORY................ 491,967.81 46S, 225. 76 497,439.97
:>REPAID EXml5ES .,
Plmlm INSlllI!1N!:E 63, 003. 11 ,3, 718. 30 89,295.78
PREPAID EXml5ES \6,724.38 55, 375.16 37,363.14
illTFl PREPRID'ElrosES......... 109,727.49 99, 093. 46 '126,.658. 92
illTFl aJRIIENT ASSETS........... 4,410,174.61 4,4'l{, 972. 96 4,65'3,564.:;:;
lJUlERTY, RJINT, & El!JIPl'BIT
UlND 32, 142. 60 32,142.60 32, 142. 60 .
BUILDINGS 8,835, 058. PiI 8;807,164.87 8,835,058.87
Fl XED 8lllPIElIT 2, \13, 4B2. 03 2,408,710.36 2, 413, 4B2. 03
IlAJOR KlVABlE EOOIP!!8IT 9, 858,1140. ,3 8;476,447.69 9,818,065.15
IElfJIlIrt. MEDICI1l. PUlZA 7,2~846.3S 7,232, 709.21 7,245,046.35
IiEPORIRBLE BtJlD ISStilRla aJST 78,557.00 77,073.00 . 70,557.00
llWSllU:TICIi IN PROOll:;S .00 .00 ,00
lSS: ACClIlUIIElIlEPRECIATlON (15, 00J, 1140. 61) (14,652, 100.6-\) (15,678, J.\lI. 1ll)
TOTIL P!ltPEllTY, NWT, & EIlIJIP 12, 642, 486. 67 12,382,147.09 12,736,003.60 e
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IIDUIWL IIEllICAt coon
DEP1\ltllOTA!. J;IlCOIl( STAtrIlIn 1lll/13l1l3 1l9:24 All
f'Olt lItE 71lO<<l1lS EllDlll: 07/M3
SH~lE ! ow T H VE H T 0 DATE
ACTlMl 0lm:T 1 VmAIlCE y.Villt ACTUAl. BlIDGET 1 VAAIAKC( %\lAI(
ImId. Slm.V
nulJE
IJP1\TIm ro'Eltll 30.S70.10 60.61)9.33 (30.039.m ('I9.sa) 393.13'1.74 0!14.<t39.65 (21.354.91) (s.m
IlUTl'llTIm RtVIJ( 21.1"'.85 lMIl9.S1 7.081.34 Sll.lS 9S.07S.1lO 96,<\90.17 <1.ill.971 (1.<16) e
TUTA!. ~. 51.760.95 74.718.S4 (22. 95T.m <30. n> 4SS.213.54 S10.noJ.42 (22,766.88) (4.<\5)
lFEllSES
SAUmS 2.763.92 2.836.00 12.08 2.54 19.325.91) 19.391.00 65.10 .33
OTIU EII'fJlSl] 14.163.09 4O.116.<tl 25.953.32 64.69 181.451.05 280.1S2.87 91,325.82 32.5:2
TUTA!. EmlStS 16.927.01 -l2.95:2.<tl U.025.~ 60.59 208.182.95 >00,113.87 91.391).92 30.'14
!lET WIl/(!.DSS H.sn.94 31.766.43 3.061.51 9.65 211.430.59 210.800.55 6S.624.04 32.5'5
1!I1Rlltlt'1 flIlO IV lllERllP'I
mm:
IftTIm ro'Eltll 10!0.104.z7 200M:;. 69 (60.4S(I.I2) (30.14> 1.509.226.31 1.m.1S7..f1 131.068.90 9.98
IlUTl'llTImI!'lEll 91.175.21 124.153.85 (2T.518.56) (22.10) S40.519.30 ..1IS3.155.39 (12.630.03) (1.48)
TllTA!. RmU:. 231.340.14 325.399.54 (1lS.059.'10) (21.(16) 2.349.14S.13 2~.312.86 124.432.87 5.59
ll'9S6
SllUmS 7.843.39 10.010.00 2.166.~ 21.64 52.102.62 68.449.00 16.346.38 23.1l8
1'1ClJt~rn: 7.1167.00 9.Z1Z.33 10345.33 H~ 48.702.89 64.486.31 15.783.42 24.47
~ 32.m.75 48.m.75 16.319.00 33.51 ;:;S. 064.55 340.161.25 (11.303.30) (5.07>
Will. EJPmtS 48.0S1.14 67.920.08 19,53(I.9<l 29.19 4S8,1I1tl.06 473.6%.56 14.126.50 3.12
1lDl/(UlSS 189.251.00 2S7..f79.<l6 (68.228.<16) (26.49) 1.8'l0.87S.61 1. m.616.3O 139.259.31 7.95
:If' Ilf1lSIllll 11DllI'I'
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DIPflTIm RrI9U .00 .00 .00 .00 .00 .00 .00 .00
IlIITPllllElll'R!:I'ElI .00 .00 .00 .00 .00 .00 .00 .00
TUTIIl. REVElIllE. .00 .00 .00 .00 .00 .00 .01) .00 e
lFmES
SRU<<II:S .00 .00 .00 .00 .00 .00 .00 .00
OTIU uru:x.> .00 .00 .00 .00 .00 .00 .00 .00
TUTlL ElFUSES .00 .00 .00 .00 .00 .00 .00 .00
IlET W!l/(UlSS .00 .00 .00 .00 .00 .00 .00 .00
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IlDIOI:IllL III]ICJlL cOIm
D!:PriImlElIrlil.:OO:lIllESTATDlElIT 08/13103 01=24 All
f~ l1iE 7 /lOlllllS mm 07/311\l3 ,
e SO~L[ ftOnH VE ~ ~ T 0 D ~ TE
ACTlI& O(l)ro- IVAAIllWCE ~I'AA ACTUIll Bl<<ET I \'AWl(C[ %\IAi:
EJl[RGl)(Y kllO!l
RB'ElIIl!:
IJI"llTlml:E\'EllU 26.276.31 2MS6.78 1.119.61 S.28 201.M7.ol6 170.672.20 31.17:;.26 18.U
IlI/Th\TlmREl'Ell 119.~3.15 m,246.17 62,316.9lI 4:i.4<' 1,lZ!.053.43 938.566.73 183,466.70 19.54
TOTlt REVOlE. 225.839.54 162.202.95 63.6..~.S9 39.23 1,3~,9'OO.S9 1,109,258.93 2lM<!l.% 11.3S
rntt.B
SALAmS 60.386.7:i 46,S2:i.(1Q (13.861.7S) m.m 307,7"'J<S.62 318,176.00 (49.530.62) <15.:16)
mFrSSIOllJlL FIE 71J.'I2l.33 19,<133.33 1.012.00 1.27 28.117.21 550,033.31 17.716.10 3.111
ILlS< J ROTJlL 2.6a1.SO 1.7"',,(1.00 (~1.:ii)) ('l5.6SJ 14.<163.90 12.250.00 (2.Z13.!/(l) (18.07)
onn EXPIlsts 1l.~.80 7.307.92 (4.120.83) (55.93) 73,641.20 :;r,OOO.44 (22.640.76) (44.39)
lUTaI. EXPE&S 152.818.3-8 m~76.25 (17.822.13) <13.19) 194.178.93 937.4:;9.7S (S6,719.18) (6.OS)
IlO can/(LOSS 7Z,9<tl.16 21.126.70 <;,814.% 1&8.81 ~. 721.96 171,719.18 157,922.78 91.92
Ii I'lI\'SIWIS
tEVElIJ[
lllP1lTlm2l:l'EllU 13,900.48 12.lllre.13 1.812.l:i 14.99 91.522.98 82.667.21 8,855.n 10.71
GUTPllnm ID'ElI 148,m.<llJ 1l'I,219.30 ~,sn.iM 66.n 71W,778.1S 610.1'l5.30 19.632.85 16.32
luTll.~. 162.696.88 101.Jll7.41 61.31l'1.39 60.51 801.301.13 692,812.51 108,4SS.62 15.05
EllERaY IDItJll samcr
IEValIE
lllP1lTlm Ra9ll .00 .00 .00 .00 .W .00 .00 .00
IlUIl'ATlm ID'ElI .00 .W .00 .00 .00 .00 .00 .00
-=~. .00 .00 .00 .00 .00 .00 .00 .00
SlUmS .00 .00 .00 .00 .00 .00 .00 .00
WSl: J RaTA!. 417.96 .00 (417.96) .00 1.559.66 .00 (1.559.66) .0Il
8llO DPElIS<S .00 .00 .00 .00 .00 .00 .00 .00
em SlBSIPY .00 .00 .00 .00 .00 .00 .00 .00
CIllJltlY smmv .00 .00 .00 .00. (.29) .00 .29 .00
TOTlIl DPElIS<S 417.96 .00 (417.96) .00 1.559.37 .00 (M59.37) .00
IlO WlI/(LOSS (417.96) .00 (417.16) .00 <1.559.37) .00 (1.559.37> .00
UIlOI:JllU2'l t PIl~
Ir'IOU:
IIIPilTlm IDElIU . 8lJ.905.08 87,328.02 (6,362.?'l) (1.28) 692.057.14 SP7 ,21!l.96 _ 95.446.78 15.98
8l!lPAnm ID'ElI 234,080.83' 2jb,7S5.<lS 17,325.3S 1.19 1.624.015.61 '1.482.327.82 1dJ..lif/.19 9.56
TOTM. ~. 315.045. ?l 3ll4.OS3.SO 10.962. oll 3.60 2.316.m.3S 2,019.538.18 '237 .1?<1.S7 1l.<<I
fJl'lJ!StS
su.ms 46.061.19 dJ..381.oo (4.680.19) <U.30) 301.S6<l.3ll 282.989.00 <24.815.30) (8.19>
l!ASl: t ~Ill ~.696.1l5 3,278.67 (l.41S.1Jll ({l.25) 11.161.15 22.9Sl.69 (8,ZU.06) m.m
onn IlI'OSrs Ga.161.69 if/.6a1.0lJ (21,160.69> (+I.'l5) 4<lS.446.0lJ 332.702.00 02.7+1:00) (21.86)
TUirL EXPllSl:S 119.S19.73 92.UO.67 (27.259.~) <29.54' 7+1.'l12.05 638.641.69 (105.830.30) (16.57)
IlO canl (lDSS 195.520.18 ZU.m.83 (10.296.05) <1.69) 1.572.261.30 1,~.897.01 131.36'(.21 9.11
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D<fAATIDTAl. IllCOllE STAmm (081131113 (J'):2~ All e
F~ TIlE 7 JlOKlRS D!llIK ({7/311f13
SInLE K 0 n K YE AR T 0 o ~ TE
ACTlliU. IllMT I VAUAJtCE r. WcR ACTIIIV.. BlJtlGET I I'AAIAACE % 'IAA
.000 8AlO:
:'IOOE
JIf'1\TIOO IlEVEllll 14.852.16 13.436.8~ 1,41~..32 lO.~ 8'5.591).71 9l.89iJ.68 (6.2'11.91) (4.1l5)
IllTI"llTlDT RtVEJl 12,721.1? 4.~0. 76 8.11'Q.43 180.n 41,43$. 7~ 30,98~.52 10.4"A.22 33.74
lOT Al. 1itV!lli:. Z7,S73.35 17.967.60 ?60:;.7'5 53.~ 127,02'1.45 122.m.20 47154..~ :\.38.
msts
ll'ml:S 6.83:!.9(I :\.m.(I(, (2.!157,9(I) <76.:m 21,417.10 27,l?J.OO (2,212.10) (8.45)
lOTIII. mmrs 6,832.?1l 3,m.oo G!,1S1.?O) <76.m 2?,-tt7.10 27.125.00 (2,292.10) (8.45)
IIET WI/(lOSS 2tl,740.4S 14.092.60 6,647.85 47.17 97 ,612.3S ~,7'""o.2tl 1,862.1~ 1.14
'CllF1\lIOlIAlIlEllIrIllE
DiE
lP1\TIOO REVEJlI .00 .00 .00 .00 .00 .00 .00 .00
IIll'1lnIlT mu .00 .00 .00 .00 .00 .00 .00 .00
TlITIt. ~. .00 .00 .00 .00 .00 .J)!) .00 .00
J'lJ(S[S
1t1lmS~ rn: .00 .Oll .00 .Oll .00 .Oll .Oll .00
mn 0PEJlS(S .Oll .00 .00 .00 .Oll .00 .00 .00
lllTllL txrEl!SES .00 .00 .00 .00 .00 .00 .Oll .00
IIET CAIIlt<tOSS .00 .00 .00 .00 .Oll .00 .Oll .00 e
m 'lTM
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IITP1lUt.-1 mu .00 .00 .00 .Oll .00 .Oll .00 .00
milt. 1t'lEIlE. .00 .00 .00 .Oll .Oll .00 .00 .00
:tasrS
i4llllR1IS .00 .00 .00 .00 .00 .00 .0Il .00
I71lEl EIPDSES .00 .00 .00 .00 .00 .00 .00 .00
mill. mas!:S .00 .00 .00 .00 .00 .1)(1 .00 .00
llET WI/(lOSS .Oll .00 .00 .00 .00 .00 .00 .00
ImOC{tRD~ (Em
:DIE
JPflnaT I:EI'OO 8,<tL8.6O 18,m .~ (1O,~.S&) (SSSIl U4.6ll2.60 129,644.72 (1~,%2.12) CU.54)
IIll'1lllIllT RG'Ell 42,768.67 47,%2.85 (5.1~.18) (10.82) . >48.149.17 :128.004.1)9 2O.1ilS.01l 6.14
lllTIll REVEJIll!:. 51.187.27 66.m.31 (15.m.O.\) (2:\'.51) ~2.831.n ilS7.6'l8.S1 5.182.% 1.13
:FEISES "'.--"
lPEI&S 4.582.:ro 1,625.42 (2,m.ns) (181.92) 20.541.57 u,m.?4 (9,163.63> (1lO.53)
TOTIlI. EXPfJ!SES 4,582.50 1.625.42 (2.m.ns) (181.92) 20.541.57 u.m.~ (9.163.63) (1lO.2) "
Ill]' GAIJ(/(U]SS 46.6O'l. n 65,Z94.8'l (18.6911.12) (28.62) 442.290.2lJ 446,270.87 (3,?1l1l.67J (.ll?)
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IlEllOIaAL IlEDICAI. Ctxm
DEPilImlOTAL llillllE ST!TDIElfl 00/13103 (19:24 All -)
F~ THE 7 IlOOHS mIll; 07131103
e SINGLE Non H VEH T 0 I) ~ IE
I\OUlll B!DG[T II'AtlllMCE % Yi\I: ACTIJAl 8(J1)~IT I. \\1RI111((( % VAA
WIOl.~
I!:VOOE
Il&'I1TlIlT R[VOU 101'946.26 12, nS.82 (1,821.:.6) <14.32) 126,"%.01 ~.370.14 39,125.87 44.78
OUTP1lTlIlT [([V[)l 127.1'93.55 ?<I,ill.72 n,879 .&3 3:;.99 894,6:;9.9:> 64:;.616.30 251,.043..6.5 39.00
TOTIll.~. 138.939.81 10.\.889.54 >2,050.27 2'-98 1,Q21,IS5.96 730.986.44 2901'169.52 39.69
EIPOS<S
SAUmS 52..164.84 39,688.00 (l3,076.S4) (3<.94) 341,526.91 271,419.00 00,107.91> (25.&3)
PI:OffiSIOllAL FEr 3.235.00 2.400.00 (835.00) (34.m 17.620.00 16,800.00 (820.00) (4.88)
01la IlPaSrS 11,~.97 12,702.66 1,343.69 10.~ 82.069.61 1l8.428.62 6.3S9.Cl 7.U
TOTIl OPOsrS 67,~.81 54,790.66 U2,S68.1S) (22.93> 4<11.216.52 376,647.62 (64,568.90) <l7 .14)
--
IIET WIt(lllSS 71,581.00 52,098.88 19.482.12 37.39 579,939.44 354,338.82 225,6llO.62 63.66
llUClfAI1 lIED ICM:
tEVElU:
~TIm'Rf:'IOll 6,924.97 3.824.73 3.100.24 81.05 42.32Il.~ ,: 26.156.13 16,164.44 61.79
0UTP1lTIm' In'Ell 2ll.926.81 22,6S7 .35 Ct,73O.54) <7. OJ) 241).397.61 154.947.01 llS,ol5Il.60 55.14
TOTIK. REVEl!U!:. 27,m.78 26,482.08 1.569.70 5.17 282.718.18 181.103.14 101,615.0'1 56.10
EXFIJlS<S
OTllEi IlPaSrS 1,3<lZ.s7 11,l47.Sl 9,804.93 87.95 52.567.20 78.032.50 25.40S.30 32.63
TOTAL 0PflSI:s 1,34Z.~ U,l47.Sl 9,804.93 87.95 52,567.20 78,lE2.5ll 25.40S.30 32.63
IlET WIt(UlSS 20,509.21 10,334.58 11,174.63 72.87 230,150.98 103,070.64 127.000.34 f;
lZ3.~
~~ 6.8..~.79 5,983.43 IlSl.36 14.22 37,~.54 41),918.87 (3,268.33) (7.'18)
OlllPRTIm' ttVElI 36,083.51 41),620.10 (4,SU.S9l m.16) W,S17.26 m,789.12 11,72ll.14 4.22
TOTAL RG'DlIE. '12,918.30 46,603.53 (3,~.23) <7.90) 327.l67.811 318,707,99 8,459.81 2.65
EIPDSCS
LEaSE t ttlTa .00 .00 .00 .00 .00 .00 .00 .00
OTllEJ: EIroSEs 2,790.90 3,316.67 ~.n 15.85 18,172.67 23..216.69 5,0+1.02 21.72
rOTIll EXPDs<:s z.. 790.90 3,316.67 52S.n 15.8:; 18,172.67 23,216.69 5,044.02 21.72
IlETM/(lllSS 40,127.40 43,286.86 (3,159046) <7.29) 308,m.13 29$,49l.30 13,S03.83 4.56
cr SGlI
RmJiIll:
IlI'llTIm' RlIDW 33.2~.'12 zg,77ll.38 Q,470.Q4 15.53 . 22<1,663.42 196.752.24 21,911.18 14.18
OllTl'tTIOO it\'El( 147,457.11 118,562.18 28,894.93 24.37 1,127.9<5.11. 8lG,812.2O 317.132.8:; 39.11
TOTIL ~. l81),6?7.53 147,332.56 33,364. ?7 22.64 1,3$2.608.53 1,007,$64.$1) 345,044.03 34.24
EIrOSO;
lIAS!: t WITIL 13.93:;.62 13,93:;.$1) (.12) .1)1) 97.549.34 97,$48.50 (.84) .00
ona lJIUs!:5 6,$34.93 7,711.33 1,m.'Il 10.25 &4,118.011 53,979.31 (1'),138.7'd) (18.78)
TOTAl 0l'IlS!:S ZQ,47G.55 21,640.83 1,176.28 5.013 161,667.013 m,527.81 (lo.l39.62) (6.69)
II[T WIt(lDSS 16I),2U.9S 125,685.73 ;4,5<11.25 27.48 1,190.94:1.10 8$6,030.69 334.904.<11 39.1'
e
,
r (' f
.
kr~ 913
IlEIlOUAl Il!]ICAl. CEKm
DEPAA'TlOTAl ncOllE S'IAIDIOO (811311)3 09:24 All e
rot THE I ftOllT1lS ElIDI!Il: fJ7t3111l3
SUIaE ft 0 n" VE A R T 0 DATE
ACT\W. O{I)G(T I \/MIAlKr ~ IIAA ACTIll1l BUOGET I VARIAKCE % VAR
IlllltlGAAPll'l
:vEJII!:
~TIOO R!:'iElU .00 19.71 (1'.m WJ<1.(I()) 110.51) 134.73 (24.23) <11.91))
IUiP1lTIOO Itl:I'[)( 5.m.21 ~,26S.n 6iJ9.SS 11.56 4?,9fJ7.02 36,(131.28 11,8r.i..74. 32..9S
TOTAl ~. 5.818.21 5.m.43 58U4 11.15 48,011 .52 36,166.01 U,SSl.~l 32.16
lPaSES
mn crasrs 1.863.'IS 1~8'S1..~ <12.:;(}) (.61> 1,625.15 12.9Sl1.7S 3,m.60 25.12
TaTlL EXPOOES 1.863.'IS 1,851.25 (12.:;()) (.m 1,625.15 12.9~S~7'j 3,m.6JJ ZJ..7Z
!lET Wl!t(LOSS ~,0:1.4.S2 3.401.18 m.34 16.7'1 38,312.01 23,20'7.26 15,185.11 65.43
:r
~
lIlPllTlIlT RE\UIl 11.504.14 5.901.83 5.5%.31 74.n 12.917.81 41),401.97 5M15.92 129.18
IUTPllTlIlT RG'Ell 123.728.70 . 116.313.61 7.>35.01 6.3ll \>1l\l.920.Zl m.m.19 113.938.01 14.31
TllTIlL~. 13S.232.84 122.301.44 12,131.'lO IDS! 1,002z838.1l'J ,-S30.31l4.16 166.42.93 19.91)
lPOSES
me EIP9Sl:S 3ll.l12.90 32.891.61 z.m.n 8.'l4 213.854.29 23ll.2<1l.69 16,387.40 7.11
TUTlIl. OPEJS[S 31).112.90 32.891.61 2.778.71 8.44 213.854.29 230.241.69 16.387.40 7.11
!lET CAIllJ(lQSS lOS.119.94 89.409.77 15.W.17 17.57 788.983.00 6G6.H2.~ 182,8't1.33 31).16
1lt.)1=.u\ e
EVEr
..,:,
DP1l. ~f; IB9U 22.83S.00 43,419.79 (2(l,S84.79) (~.o!l)) 198.178.75 m,935.33 (911,1S6.5S) <33.20)
ilUTl"AlIOO Itl:I'[)( 16.m.OIl 'lS.139.71 1.4lSS.21 1.39 4?4.m.0Il sn,%l.S9 (42.966.89) (8.29)
TOTIIl RE'lOOE. ",633.00 119.159.S<! (19.526.so) (16.38) 613.173. 'IS 814,8'T1.22 (141,723.41) <11.39)
XPDSES
hlli-ESSI\lIlAI. m: 31,064.27 30.296.12 <761.35) (2.11) 243.567.82 l;54,m.44 10,510.62 4.13
l!ASl' 1 ROOAl. 47.44 35.92 <13.52) m.63) 338.31 251.44 (86.93) (34SIl
tTm: EJPDISl:S 4,419.84 3.784.16 (635.62) U6.m 24.045.25 26,489 .12 2,4'13.87 9.22
TaTlt. masts 41,m.S:; 40,117.00 u.416.m a.:i3l 261,9:il.44 280,819.00 12,861.56 4.58
lET Wll/(l!lSS SB.,tm.45 79.00.5(1 (21),943.0:;) <26.49) 4Q'S.m.31 s;4,m.22 (12'd,855.91) (24.m
1IAl.'ISlS oor
:EDE
cmrtITlIlT I:tVEll 311,114.00 341,122.55 (31),008.55) (8.m 2.m,rn.SS ::".2,332,0311.13 (1,598.29) (.06)
TOTAl. cmllE. 311.U4.OO 341,122.55 (lll.OO8.SS) <8.79) 2.331,m.SS . 2rJ32,838.13 . (1.590.29) (.06)
JP9Sl:S
SllI1ImS 2S,802.~ 2~,025.oa (4,m.~) <19.88) 1'18,216.77 164,295.00 (13,m.771 -J8.4?)
GTm: DrEltStS 54.031.69 5(I,012.'lS (4,018.:14) (8.D3) 387.769.50 34'},031.25 (31,930,31> (10.1l4) .
TOTIt. orasrs 8<:!.S33.61 7~.o3? 7'5 (8,195.86) (U.88) S6S,9U.33 514,134.25 (51,852.08) (10.08)
MET CflIl(/(lDSS 228.280.39 267,0e4.1lll (3S,Illl4.m (H.~) 1,765,253.~ 1,818,703.88 (53,4S0.36) (2.13>
.. e
15
if .. ~.';,
, ,\ f..
L.. 914
~ \
f:~ 915
IIl1IO!atll /OlCAl. CIJllD: lee:
\
DmlR1lIrnAl mIllE SlAlDOT 081131113 (19=24 All e
r~ llIE 7 Iloms OlDM 0713l11l3
SIKGLE K 0 n H VEH T 0 o ATE \
ACTlUIl. IlIJlG(T I 'lAtlAIK( X 'IAR ACTlUIl. BllOGET I 'lARIAH(( % VAl:
lllIE IU.TH (AI:f
f:VOllE
IJPATlOO ~EIUlI .00 .(10 .00 .(1() .00 .00 .00 .00
OUlPATlOO I<!:VElI 64.096.95 SSr3l:tO.52 (24,M .51) m.41) 519.3(19.87 M.m.62 (84.592.75) (14.0(.)
TOTAllil:'lOllE. 64.m.95 SS,:w6.52 (24.Z(l7.m m.41) 519.309.87 &03.m.62 (84.592.75) <14.00)
lPEJ(S[S
SlllJ\lCIES 24.368.60 25.m.00 854.40 3.38 187.022.61 172.494.00 (14.528.61) (8.42)
wst 1 RDlTAl 81).19 80.00 (.19> (.23) 602.48 560.00 (42.48) <7.Sll)
0l1D 0PDlStS 9,629.93 U,74~.83 2,.11~.90 18.(11 88.186.47 1l1.94S.1l1 (6.2<lO.66) (7 . 61l
TOTAl EXPEIS!:S 34,07a.n TI,(l48.83 2.970.11 8.(11 m.m.56 Z54.m.81 (2(1,811.75) (8.16)
IlET tAIl(/(LOSS 30.020.23 51.257.69 (21.m.~) ('l1.43) 243.<498.31 34S.m.1l1 (105,404.51)) GO.21)
IllSf'IIE
9EllllE
OUTNHID:1' ~ .00 .00 .00 .00 .00 " .00 .00 .00
TlITIL RG'OOE. .no .00 .00 .00 .00 .00 .00 .00
:xrmES
S(OtI[S .00 .00 .00 .00 .00 .00 .00 .00
riOl (l,SIlJIW.. Fn: .00 .00 .00 .(1() .00 .00 .00 .00
0TlIEi 0fEll5(S .00 .00 .00 .00 .00 .00 .00 .00 e
TllTIIl ElPmES .00 .00 .00 .00 .J)I) .00 .00 .00
W' .tJl/<UlSS .00 .00 .00 .00 .00 .00 .00 .00
?nIlAl'I IU.JH [ARt
tmlIlE
IIITPATIOO ~ .00 .00 .00 .00 .00 .00 .00 .00
TIlTAI. mtJIlE. .00 .00 .00 .00 .00 .00 .00 .00
EJPaSe
stLAR1ES .00 .00 .00 .00 .00 .00 .00 .00
ana uPaSf> .00 .00 .00 .00 .00 .00 .00 .00
TIlTIL EXPaSES .00 .00 .00 .00 .00 .00 .00 .00
IlET Cl\III/(LOSS .00 .00 .00 .00 .00 .00 .(1() .0(1
IElI m:lI J
~
OllTl'ATIOO RE'IEl! .00 .00 .00 .00 .00 .00 .00 .1)0
TlITIL W'OlJE. .00 .00 .00 .00 ;00 .00 .Oll .00
IlFEl!Sl:S
SlllAmS .00 .00 .00 .00 .00 ,- .00 .00 .00
r>:lRl",LlIllAlFn: .00 .00 .00 .00 .00 , , .00 .00
.00
lITHO EXFDlst:S .00 .00 .00 .00 .w .00 .00 .00
TOTAl ElI'!JS[S .00 .00 .00 .00 .Oll .00 .00 .00
--
IlET WJ(I(LOSS .00 .00 .00 .00 .00 .00 .Oll .00
e
17
. '.'.--:
. .
916
: "
IIEllOWL IOICJI!. COOE!:
DEPIIKnlm~ MOllE STAIDIOO OSl1Y03 1ff=24 All
-
FOR THE 7 IlOlOHS OOnG 07l31m \
)
e S I U L E K 0 Xl H YEA! T 0 D A TC
ACTIlIIL 0lDGa I \fWIlj(([ % 'IAA IICllW. IIUllbET I VAAIA.\CE % VAA
(JlfJ!IC~ D€P8!DrnV
iE'IDIIIE
IllITPIl TIDlT k[VEJf .()() .00 .00 .00 .00 .W .00 .00
7OT~ RrnllJ!:. .(1(1 .00 .IJI.< .00 .00 .0(1 .00 .00
ElPDlSES
SIlUlIal:S .00 .00 .00 .00 .00 .00 .00 .00
Pl:Of!SSIOIlAl FIT .00 .W .00 .00 .00 .00 .00 .00
one ElPDlSES .00 .00 .00 .00 .(10 .00 .00 .00
TOT~ ElJ>ElS!:S .00 .W .00 .00 .00 .00 .00 .00
IlfT Wl!/(LOSS .00 .00 .00 .00 .00 .00 .00 .00
DIUAI:'i
I(VEJlIE
IIP1lTIOO tEI'ElU .00 .00 .00 .00 .00 .00 .00 .00
OUTPllTIDlT IDU .00 .00 .00 .00 .00 .00 .00 .00
TlJTlll REVIJU:. .0Il .0Il .00 .00 .00 .00 .00 .00
llPflCS<S
~ 1.2.048.84 11,<I9\I.0Il (841.84) <1.39) 86,037.18 78,634.00 (M03.18l (M1)
I'illftSSIllI!lll m: 1,-162.50 1.42S.00 162.:;0 10.00 11,537.50 11,375.00 (162.50) (1.42)
ona 0PEIlSES 19,009.a3 16,sa7.OS (2,422.15) (1~.61l) 118,1'1ll.~ us,na.76 (2,939.W (2.53)
TlJTlll 0PllSl:S 32,ll21.17 29 .711.OS (3,109.49) UO.ol6) 216,<193.20 205,987.76 (lMOS.44) (S.1\litc
\11:.
IlET WIl/(LOSS <32.ll21.l7) (29,711.68) (3,1il9.m (10.46) (216,493.21)) (205,187.76) (10.505.44) (5.10)
.~~
SAUiaIS 24,034.35 2'),(IS7.00 (3,m.35) <U.83) 161l,m.S3 137,162.00 (23,809.53) <17.35)
l!ASr 1 RWAL 2,+10.00 2,291.67 (148.<11) (6.47)' 16,562.24 16,Q41.69 (520.55) (3.24)
0llU 0PEIlSES ~,561.28 4,387.50 (173.78> G.96) 29,625.06 3(J,247.5O 622.44 2.OS
mil EXlUSf:s 31,035;71 26,736.17 (4,299.54) (16.05) 207,1:iS.83 183,451.H (23,707.64) (12.9()
~1'tlICiIIIf
llPflCS<S
Gna 0PEIlSES 40.15 .00 (43.15) .00 . 6,022.45 -.-.00 (6,622.45) .00
TlJTlllOPllSl:S 40.15 .00 (43.15) .00 6,022.45 .00 (6,622.45) .00
5AIIr1IIWlCE .
0PllSl:S ."
A
SQlAmS 13,639.7a 10,110.00 . (3,529.78) <34.91) 86,234.;;3 . 69.135.00 (17,1)99,53) (24.73)
OlIn 0PEIlSES l,316..l3 1,:G6.33 <31.811) (2.93) 10,64(1.87 9,309.31 (1,271.56) (13,5'/)
TOT~ EXPOsl:s 15,035.91 11.466.33 (3,569.58) m.13) %,875.010 7IhS1l4.31 m,m.09) (23.<10)
FUtiIT oral! TIlll(S
EII'OSI:S
u:.m: 1 RWAL 3,<405.00 58.33 (3,346.67) (5737.47) 7,054.31 'lOS.31 (6,646.0Il) (1627.68)
E:UrnIUTY 13,OSS.19 18,9-(7.33 5,892.14 31.09 127,417.51 132,631.31 5,213.80 3.93
UAm 1 SDIEJ: 405811.26 6,315.75 1,735.(1 27.'17 27.212.52 +1,210.25 16,9'!7.73 3ll.40
~ 92<(.81 ~,736.92 ',812.11 80.'17 23,010.89 33,158.44 10,147.55 3ll.611
STIn 0PllSl:S 9.2:;1).a9 6,916.67 (2,334.22) <33.74) (i,728.76 48,{(6.69 2,687.93 S.55
.lll orosrs 3l,216.1S 30,975.00 5.758.85 . 15.:i7 231).423.9<J 25S,82S,OO 2fI,4Q1.01 10.97
l"~ :
vr- 917
IlEllOIUAL IIJ)ICAl coon:
~Al MOllE STATDDT OOI1Y03 (11:24 All e
FllC 111: 7 IlOIT1lS I1lDM 0713l1U3
SUGLE K 0 IT II VE AR T 0 o A IE
ACTUAL DtDGrT I YMWCE ZYAA ACTUAL OOOGET I WIUAJ(([ % VAl:
tllUIlDS
XPmES
SlU.AAIE 5 .00 l,547.(I(j 1,547..00 100.00 .00 10.S7S.00 10.m~(l(l 100.00
OTHER rnos<:S m.38 416.67 ZS9.29 &2.22 1,163.74 2.881.69 1,697.~ :;S.92
TOTAL roasrs m.38 1.963.67 1,8(16.29 11.n 1.183.74 13.456.69 12,.272..95 91.20
~TATI1ll!
XPmES
SAUmS 1.169.59 1.m.00 (32.59) (2.~) 8,263.86 7.774.00 (489.86) (6.30)
onn UI'!JIS[S 264.59 m.67 29M8 S2.SS 10814.17 3.888.69 2.014.52 51.80
TOTrt. ElIU5ES 1.-434.18 1.694.67 26ll.49 15.37 10.13S.03 U.662.69 1.524.6.s 13.07
O1l:.t.W:l'IlG
IPDS<S
SlllMIIS 21.ll91.23 18.540.00 (2.552.31 <13.76) 144.566.41 126.792.00 <17.774.41> (14.01)
IJTIU llI'U:X.S 5~943..45 6.691.67 748.22 U.18 43.nO.47 .- ol6.441.69 2.671.22 5.r.;
TOTrt. EXPOSES 27 .035.68 ZS,231.67 (1,804.01) (7.14) 188.336.88 i13.m.69 (15.103.19) (8.71)
lIIIllrit'/
lI'mG
QIIlm( samES 8.43'1.90 8.158.33 (281~) a.(5) 62.&53.91 51,108.31 (5.S4S.6ll) (9.m
8nn LtPEllS(S .00 .00 .00 .00 .00 .00 .00 .ooe
TOTAl 0PDStS 8.43'1.90 8.158.33 (281.m (3.<5) 62~.91 51.100.31 (S.S4S.6lll (9.71) .
mL.
lP9SES
5lIl.AmS s.m.94 6.36S..00 ~.06 12.99 38.8'12.15 '13.526.00 4.633.85 10.64
IJTIU t.<PO><S 619.43 717 .:a 1S.0lI 2.:a 3.711.28 4.957.57 1.246.2'1 25.13
TOTrt. ElPDSl:S 6.m.37 7.082.51 1l4S.14 U.93 42.603.43 48.483.57 5.830.14 12.12
~~
lJ'OlS(S
SllLfImS 6.017.61 4.33Z.00 (1.765.61) ('*l.7'S) 30.053.32 29,620.00 ( 433.32) (1.4&)
ann 0I'0I5ES 618.31 ~.84 2.53 .41) 5.371.SS 4.~<5.88 (1,~.711) (26.51)
TOTAl E:XPUSl), 6.115.92 4.952.84 n.163.IJ8) (3S.s9) 3S..c24.90 33.~S.88 (1.559.1)2) (4.60)
lllUfL dmIDIs(~ P\JlIll(!
;xpmn
SlIUlmS 2.887 .1lS 2,895.00 87.1:) 3.01 19.042.57 19.il<:2.00 1:;9.43 3.83
0'Tlfl UP9Sf:s 230.60 1.155.42 924.82 80;04 5.671.30 8.007.94 2.336.64 2'1.17 .
TOT" ElPDSl:S 3.038.<5 4.(1:;(}.42 1.011.97 24.91l 24.713.87 Z7.809.9~ 3.Il?<\.07: U.B
[AUfOlil COUlaY OOIblJ!T
~ -
SUlRII:S 4.121.16 .00 (4.121.76) .00 21.134.64 .00 <27 .134.64) .00
0'Tlfl 0PlJISES (98.14) .00 98.74 .00 (103.61) .00 103.61 .00
C9OO'I OFfSET <3.846.64) .00 3.846.64 .00 (26.916.11) .00 26,916.99 .00
TllTALElPOSl:S 184.38 .00 (184.38) .00 U4.04 .00 (114.04) ,ooe
19
f:
'"
"j,: J)
" ~ ~.,'
,
, .
,
,.
918
K8lO2IJll JOICIll COOD:
~Ill IlKlIlIE 5TATDlOO 08/l31Q3 (19:24 All )
FIJC TIlE 7 IlOO1iS OODIG O7IJltO:\
- nUlE <<0 n H YEU T 0 OATE-
ACTUAL BtDGlJ' I VllWlKE % WlR OCnw. BUDCET I VAAIAJ((E % VAt
l<USIJI[SS mCE
ElPElS<:S
Sl1lJlmS 17.3?i.71 22.387.00 5.011.29 ZZ.>S 122,901.41 1~3,O97.00 30,19S.S1 19.72
lBlS<: 1 2EXT AI. 311.7'1 2(~I.(1(j (l11.m (:;'.89> 1.035.53 1,400.00 344.47 26.03
CotUITIllIf EXPIJI 1,973.44 2.000.00 26.50 1.3.2 16,9<13.24 14,(l(10.00 (2.943.24) (21.02)
onn EIPfJlS<:S 9.300.06 10.293..3iI. 993.27 9.64 61.(131)63 . 71,713.31 10,681.68 14.89
TlITIL ElIDS!:S 211,961.00 34,880.33 5,919.33 16.97 201,911.89 24(1, 210.31 38,m.42 15.1'4
(lIftllOOLl ITllllS
!lFl:lIS<:S
5aLAmS 8.159.00 8.m.OO 219.00 2.lil 5/'076.25 51.213.00 21/i.i'S .n
Gnu 0P0stS 1.355.06 1,133.33 (222.m U9.lil) 10.103.51 7.833.31 (2.270.26) (ZS.9S)
rorlL EXPaS!:S 9.514.60 MU.33 C3.33l (.03) 1i1.17'1.82 65.126.31 (2.053.51) <3.15)
MTA nocESSIJI;
rnr.su
S4lUmS 2.160.80 Z~6S(t.(l(I (116.86) (4040) 18.214.01 18,124.00 (90.01) (.41)
IllIU ElPflS!:S 10,918.34 11,<!S.41 ~.07 4.43 81,816.56 1'Ml?2.117 (2.1lO3.09l (2.50)
TOTllI. ElPEISES 13,6SS.2(I 14.015.41 390.21 2.71 100,110.51 '13.1l16.81 (2,lI93.70) (2.13)
asm llOflOO:Smll1Oll
lJPEJS<:S
SlUmS 8.681.78 8,Il1O.oo (611.m (8.38) 58.2:14.72 54. m.oo (3.439.72) (1i.21)
Gnu 0PEllSrS ~.91 8.783.08 1.816.11 88.9'1 10.260.80 61,481.50 51,214.76 83.3\)
.r:::5 9.64S.7S 16;193.08 7.144.33 (!.54 68.481.52 lU.25Q.50 41.m.04 41.09
0PEllSrS
SlUmS .00 .00 .00 .00 .00 .00 .00 .00
Gnu ElPOS<:S .00 .00 .00 .00 .00 .00 .00 .00
TOT IL ElPEISES .00 .00 .00 .00 .00 .00 .00 .00
DlrUTIlll! CIlmlll
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Gnu 0PEllSrS .00 .00 .00 .00 .00 ....00 .00 .00
roUt. EXPaS!:S .00 .0Il .00 .00 .00 .00, . '.00 .00
MAITIlIf "0
ElPOS<:S
SllUll1Il:S 4.431.26 4.137.00 (2'14.26) (7.m 27,427.83 ZS,297..00 869.11 3.01
IJl\D: EII'lJtS[S 1.069.17 1.484.16 <114.99 Zl.96 10,353.05 10,279.12 '. m.m (.m .
TlIT!lI. ElP!lS<:S 5.500.43 5,621.16 1..'>(\.73 2.14 n.m.sa 38,576.12 1'IS.24 2.06
AC(OUIllIJfC
ElfEJS(S
SlUmS 5.119.08 5.022.00 502.12 8.94 3I>.329.SS 38,442.00 21'112.1S 5.4l>
onn o:rocsu:s 3.170.09 4,007.91 m.82 2ll.911 26.134.39 27.88S.n 1,750.98 6.21
TOTtL D:I'!lSES 8.289.17 9.629.91 1.34ll.14 13.92 62,464.24 6O,327.n 3,863.13 5.82
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DEPMTIIOOlll IJClI1l!: SUmuT OOll3/O3 01'24 I'll e
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S IK C L ( KaNT" VE A R T a D A T( \
J\( TUilL DIIlCl:T I VAAIAlKC Z VAA ACTUilL OODGEr I VitRIAACC % VAl;
mIilImAiIOIl
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il\lAmS 20.647.2:i 23,"fflS.OO 3.137:r.; 13.19 138.157.61 162.Wl.OO 24,~,,33 1~.1l6
.rASE 1 RElITrL 80.19 250.00 169.81 61.92 6lJ2.4lI 1.1'",,0.00 1.141.:i2 65..57
mn moors 12.868.36 29.191.61 16.323.31 :;S.91 123.981.21 203.811.69 19.890.42 39.18
TOTIII. muses 33.59'5.80 53.226.61 19.630.81 36.98 262.1<U.42 W1.2Bl.69 lOS.54Q.21 2S.~
lSIIlESS 1)[V!llH'!lOO
lI'9SE:S
WJlmS 3.m.7S 3.917.00 (<0).78) (1.04) 27.074.12 U.791.OO (283.12) (1.1lS)
me tJ1EllSES 3<0).84 B14.99 474.15 SS.17 2.6S2.7S 5.594.93 2.912.1B 52.1lS
TOTIIl OPOISCS 4.298.62 4.731.99 ffi'.37 9.15 21.7'S6.S7 32.385.93 2.629.06 S.U
ISPITIl. l8EI:l\l
lPD&S
IORlOltiIS (1IllI' III 26.n25.28 l905B3.33 (6..0141.9'5) (32.89) lBM42.70 ,13M93.31 (<!S.1lS9.39) (32.Bl)
IIIlCIl!'l.O'II IllS 2.3SS.~ 6.2"A.00 3.864.52 61.83 34.392.66 ~. 7Sll.00 9.m.34 21.<;
mF llfilIUI'/ I 9.1'17.67 10.000.00 202.:13 2.!l2 55.703.20 70.000.00 14.2%.811 20.42
l!ASE 1 RElITM. M17.zl 2zB(l4.17 286.91 10.23 18.630.50 19.629.19 m.69 S.1lS
IIlllEl uru:><.> U.9'S1.6B 12.916.67 964." 7.47 59.3SG.89 9O.of16.69 31.835.8(1 34.32
TOTIl. mastS 52.rn .31 51.S54.17 (1.123.14> (2.m 350.219.9'5 360.rn .19 10~9 .24 2.95
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StU. . 3.<l3.U 4.153.00 699.89 iUS 22.9'19.39 2S.391.00 5.447.61 19.1B
me Ul'9S(S 3.1114.53 5.000.83 2.066.30 fl.66 22z.lll9 .29 . 3S.441l.U 13.131.:i2 37.OS
TlJlRl OPOISCS 6.467M 9.233.83 2.766.19 21.9'S 45.2SS.6B 63.837.$1 18.579.13 29.1Q
1lRtllASIllG
lPEIS[S
SlUmS . 8.510.67 4.391.00 (4.U3.m moSS) 38.873.03 3(l.66S.00 (8.8llS.03l (29.28)
me UI'tA>iS 1.112.2~ 1.s2:i.41 643..17 3S.23 6.536.4Il 12.m.gr 6.191.47 ~.64
TOTIL EJPmES 9.692.91 6.222.41 <3.(7(J.S/)) (:;5.77> 45.409. ~ 42. m.gr (2.613.56) (6.J.Q)
IIIJl1lJrt
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orasc:s 9.21 .Cll (9.21) .J)!) 29.42 .00 (i?;42) .00
. TOT!Il. 0Ftl&S 9.21 .00 <1.21) .00 29.42 .00 <21.42) .00
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S4ll.MlIS (ls.8m .00 15.80 .00 2<lS. IS' . .00 (2<lS.7S) .00
E1PD&S 15.80 .00 (15.80) .00 (2~.7S) .00 2<18.7'5 .00.
T07ri EXPEJSrS .00 .(1(1 .00 .00 .00 .(() .00 .00
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e SIn L r "0 n H YE A ~ T 0 o A TE
ACTUlll r.ww I~r % 'IAA ACT\Itll BUDbET I I'ARIAHCE % VAl1
!OOWlIl!]ICA1. fUZJ\
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iaTAlS 10,216.51 .00 10,216.51 .00 TJ,ots.51 .00 13,615.51 .00
TlITAl IBUUE. 10,210.51 .00 10,210.51 .00 TJ,ots.51 .00 13.615.57 .00
o:rEJS[S
SAlARlIS.... .... 2;,887.99 .00 (2;,SS7.99> .00 21,57S.9J' .00 (21,57a.95) .00
000 EIro!S!:5.. 16,556.50 .00 <16,506.50) .00 95,682.a1 .00 (95,682.a1) .00
roTAl. EXIUSl:S 19 ,<<4.S4 .00 m,444.54) .00 UI,261.74 .00 (UM61. ]4) .00
I&:T Wl/(UlSS (9,228.05) .00 (9,228.03') .00 ('13,646.11) .00 (43,646.17> .00
SlllllOTAl ~I 1,310,192.61 1,382.006.44 mAI3.s:;) (5.23) 10,954,334.48 9,m,45O.06 1.620.a79.42 17.36
071D OI'aAlIl!I; EIF!lSl:s
tEI'ElIlE O!N:TlllltS
lII3lIClll:( com A (698,297..l9) (700,617.J)Q) 2r!19.61 .3! . (.,177.823.59) (4,j91,:J'14.oo) (10586,509.39) (28.m
lCItmOlllTl: A <180,Q41..31J <1'l9,4S9.00) (J1,182.1'1) (2lJ.86) <1,287,ZS1.41) (l,ll22,ro.OO) (26S,1!lI.41) (25.94)
IllIlIQ:IT com A (12,919.68) .00 (12,919.68) .00 (112,5l'G.ol4) .00 (112,530.44) .00
ClIllmV (At( (6S.63S.96) (81,a77.00) 1>,241.04 19.85 (342,os;.28) (509.936.00) 217,zro.72 58.SO
8At oaT Elro!Sl: (188.951.90) (151,426.00) (29,525.90) (18.52) (1,244.036.29) (1,091)'274.00) (153,762.21> (14.10)
InnDlllll:Tlll<<S ClU.l!4.16) (218.656.00) 3<,521.84 14.87 (1,521,537.32) (1,495,522.00) 113,784.68 U.62
TlITAlI:E\'El!OC U,!32,5ao.~) (1,!1I)'03S.oo) G!2,S4S.4J) (1.72) (1O,485.a54.m (a,9Sll.959.00) (1,526,a75.13) (17.04)
EllPLm lOEFITS
27.740.0:> 25,055.00 (2,OS:;.1IS) (10.71) 1012,901.81 111,543.00 28.44l..19 16.59
~rr~ 83.316.S? 16.438.00 (6.m.S?) (a.m 5019.592.58 522;,74(1.00 (26,852.58) (5.13)
IISWllIcr 945.13 1.<J19.oo 73.87 7.24 6.ass.79 6.971.00 112.21 1.60
Dmill. IllSlbICr 4S4.10 2,l23.00 1.668.30 78.58 10,m.50 14,521.00 (2,444.5(1) (lo.m
La: 1Wl DIS 2,~.64 Z,lli.M m.&4) <1.49) H,on... 14,521.00 U71.66) (1.18)
Pll'/i:lIll nEAmG (1,423.10) .00 1,423.10 .00 <218.60) .00 218.60 .00
TOUt DlPlIl\'U ro,m.71 106,758.00 (6,0.71J (0.02) 730,812.74 730,0%.00 (710.14) (.09)
TOTAl. me 01' 1,44:;,768.U 1.410,7'13.00 (2l!.915.l1l (2.0-0 U,210,6'I6.81 9,689,4:;:;.00 (1,527,591.81) (15.m
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1lEllIl:1liE PllSS-TH 29,m.OO !!,m.!! (!,514.!!) (10.72) l'O1,861.7~ m,m.31 134,534.43 51.6S
CAFrlWA SllUS 7,7S9.94 6.....61 1.095.21 16.39 5O,m.22 46,660.69 a,444.53 la.13
mmsT lXlIllE 1.922.25 1,250.00 072.25 53.78 28,872.14 8,7Sll.oo 2U,122.14 229.96
1lrW:ST nclllE 19.10 .00 19.70 .00 210.41 .00 270.47 .00
mmsT ncOllE .00 .00 .00 .00 .00 .00 . .00 .00
IlIS(IllIliIDIas II( m.J'l) 1,160.67 <245.m (21.05) 426,+6..9 Sol66..9 418,277.00 5121.74
roTAL OTlERRE 4O,m.1\> 42,410.67 (2;,U!4.4B) (4.m a78,585.26 2;96,910..9 581,668.57 195.90
llU OI'aAmG (95,193.m a,230.13 (105,423.44) (12S6.04) 01O,272.a1 (58,6a5.25) 074,~.12 USO.16
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DlJ'M'!1Il:xT1lL mllllE SUTOIEllT 0S/13/03 1)9:24 All e
fOI: THE 7 I\IlIl11lS EJrollC 07/WO,
S I Kb L [ K 0 n K VEH T 0 D A T [ \
1l(11IAL IltDGET I VAI:IAll([ % 'I11R ACTUAL bWCrr I 'il\IUAllCE % VAl:
it!~TIllC ElJ'O(S[
<m:CIAlIllHll~ .00 .00 .00 .0Il .00 .00 .0Il .00
~TIIlll-am: >0.212.07 .00 (>0.212.07) .00 2>~.6U. 9> .00 '(2)~.6U.93) .00
O'ttl:IIlTIOHll 10.119.~~ .00 (10.m.oM) .00 7M06.57 .00 (7 M06.57> .00
m:roATIIlll-MJ 47 .6S6.19 129.51S.S0 8l,8S8.71 6>.20 ,1~.2llS.6S 9ll6.608.S0 592.322.82 6S.:>3
mtIIATItlIH'1ll: :I7.<<l.18 .00 m .442.18) .00 262.095.26 .00 (262.095.26) .00
DKm1llITIOtl Tn .00 .Ol) .00 .00 .00 .00 .I)f) .00
TOTAl. I!lllHl'EI: 12S.S'/Il.<UI 129.SlS.Sll ,,94S.02 ,.04 88S.1>4.~~ 9Q6.61lS.SlJ 21.47~.J)6 2.>0
TnTIW.. ~m (22Q.76>.m (121,2!lS.m (99.<rn.~) (82.02) (268.061.57) (965,291. "IS) 696.430.18 72.14
:lIUll1'/ SlIlSIDY .00 .00 .00 .00 28.>41.13 .00 29.:541.13. .00
lIEf ~/(LOSS (220.76>.19) (121.m.:I7) <99.m.>tt) (1l2.n2) (240.521).0\4) (965.2:91.75) 72~. 771.,1 IS.OS
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922
MEMORIAL MEDICAL CENTER
ACCOUNTS PAYABLE
BOARD OF TRUSTEES APPROVAL LIST FOR AUGUST 2003
e DATE APPROVED ACCOUNTS PATIENT
BY COUNTY AUDITOR PAYABLE REFUNDS
7/3/03 (weekly) $ 334,903,70
7/10/03 (weekly) $ 132,397.66 $ 334,30
7/17/03 (weekly) $ 192,836.19 $ 1,424.27
..
7/21/03 (weekly) $ 1,081.48
7/24/03 (weekly) $ 83,828.44
7130/03 (monthly) $ 118,813.71
TOTAL $ 863,861,18 $ 1,758,57
MONTHLY PAYABLE FOR AUGUST 2003 $ 138,941.54
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Referral
2002
$ 213,142;63
2002 YTD
2003 2003 YTD
$ 200,787) 1
$ .65,635.96 $ 308,243.48
$ 90,271.32 $ 715,407.53
Charity
$ 48,338,57
$ 736,023.78
Indigen t
$ 52,078.71
$ 533,168.58
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~~'(':f~
AUTHORIZE LOAN FROM THE GE~ERAL FUND TO THE CAPITAL PROJECT FUND -
LIGHnlOUSE
Byron Cumberland with Testengeer, lnc. presented the court with a report on the Ughthouse
Project. The project Is 60% complete and should be finished in the next 60 days. The project is
fully funded by TxDOT Grant plus 20% matching funds that was raised from Individuals and
groups locally so there Is no county money invoived In this project. The payments are on
reimbursement basis from TxDOT and we have to pay the Invoices and then submit them to
TxDOT to get the money. They are asking the county to give a short-tenn loan In the amount of
$176,005.17 to the project to pay Rexco's invoice and when the county gets reimbursed the
money will go back Into the general fund.
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A Motion was by made Commissioner Anster and was seconded by Commissioner Galvan to
make a loan from the general fund to the Capital Project Ughthouse Fund In the amount of
$176,005.17 to be repaid from the TxDOT Ughthouse Grant. Commissioners' Galvan, Balajka,
Aoyd, Anster and Judge Pfeifer all voted in favor.
MATAGORDA ISLAND LIGHrHOUSE
PROJECT STP %000 (64%) TE
. REXCO CONSTRUCTION CONTRACT
Original Contract Price $1,001,150.10 e
Change Order
-0-
Current Contract Price $1,001,150.10
Total Invoiced to Date $ 539,211.54
Total Paid to Date $ 188,034.16
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924
CLOSING OF THE COUNTY LAW LIBRARY
Shannon Sayler talked with the court regarding the County Law Ubrary that Is located In the
District Cerks office at Memorial Medicai Center. The law library Is not being used at this time, it
was developed for prisoners and they are being housed out of county at this time. Shannon
spoke with attorneys in the area and they are not using the library at this time and would be all
right with the dosure. The cost to have the law library at this time Is around $600.00 a monl:l1.
Once all offices get back together In one location the law library CXluld go online and the cost
would be around $75.00 a month.
A Motion was made by Commissioner Finster and seconded by Commissioner Floyd to dose the
law library until such a time It should be reinstated. Commissioners' Galvan, Balajka, Floyd,
Finster and Judge Pfeifer all voted In favor.
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DISCUSS INCLUDING THE DISTRICT ATrORNEY IN THE COUNTY SALARY PLAN
Mer discussion Judge Pfeifer asked that this issue be tabled and brought back to Court at a later
date.
~~~=~~UNTY JUDGE TO SIGN CONTRACT AND CHANGE NOnCE FOR TFJ(4f1;:
DEPARTMENT OF HEALTH
A Motion was made by Commissioner Floyd and seconded by Judge Pfeifer to authorize Judge
Pfeifer to sign the applications for the Texas Department of Health Title V/PHC Contract and the
MOl FF5 services for the fund year 2004. Commissioners' Galvan, Balajka, Floyd, Finster and
Judge Pfeifer all voted in favor.
CONTRACT'FOR PUBLIC HEALTH SERVICES
Contract bsued by: TEXAS DEPARTMENT OF HEALTH
(RECEIVING AGENCY)' 1100 WEST 49111 STREET
AUSTIN, TEXAS 78756-3199
TDH DOCUMENT NO. 7460019239 2004
CC
Legal Authority to Contract:
Chapters 12 and 121. Health and Safet)' Code.
Venue: The provisions of this Contract ~hall be interpreted in accordance wilh Tcxa.> law. Venue for any 'COurt disputes shall be in Travis County,
Texas. .
PERFORMING AGENCY NAME: CAlROUN COUNTY HEALTH DEPARTMENT
MAILING ADDRESS: 117 W ASH ST PORT LA V ACA TX 77979-2912
STREET ADDRESS: 117 W ASH ST PORT LA V ACA TX 77979-2912
NAME OF AUTHORIZED
CONTRACfING ENTITY: CALHOUN COUNTY
(J(~ frOQl f'ERroRM!NG A.GENCY)
PAYEE DATA (Ifnollhe same as PERFORMING AGENCY or AUTHORlZl!D CONTRACfING ENTITY; mw' be DO file wilh!he T.... S....
Comp<rollds om.,.,):
NAME: CALHOUN COUNTY TREASURER
. ADDREsS, COURTIlOUSE ANNEX PORT LA V ACA TX 77979-4210
(City, Slate. Zip)
Slate ofT.... Veodor Identification No, (14 dipls)
17460019239004 .
PAYEE AGENCY Fls<oJ
Year EndJ.u& Monthl Deccml:lcr
PAYEE BUSINESS INFORMATION FOR STATISTICAL REPOIn'lNGr Pi.... checic the _gorieslhat apply 10 yoOf l>IuiJ=s.
,
Small Business. A corporation, sole propric:tonhip, or other legal entity formed for the purpose of making a profit which is
iodejlClldontly owned and operaled and has fewer lhllIllOO ClIijlloYee.l or has less lhllIl $1.000.000 ilannu<l gross receip"-
Historically Underutilized Business (HUB) . A COrporation. sole proprietorship, or joint venture fOIInc11 for the purpose of making: a
profit in which at least 51 % of all c1assca of the sharea of .stock or other equitable sec;witiea arc owned by one or more pcnons who have
beeo hi$torically undcruti.Ii.zcd (.socially disadvantaged) because of their idenWication a.s members of certain groups: Black: Amcz.ican.
Hispanic American. Asian Pacific American. Native American. and WODlCO. The HUB must be certJfied by Gezwal Servicea
ColI1D1ission or another entity. .
For Profit Organization
SUMMARY OF CONTRACT DOCUMENTATION;
COVER PAGE I . Receiving and Performing Agency Data
COVER PAGE 2 - DeOlils of A'laciuneJll(s)
COVER PAGE 3 - Authorized Signatures
GENERAL PROVISIONS -1112001
A 11' ACHMENT(S)
EXHlBITS, IF APPUCABLE
" .
925
DETAILS OF ATTACHMENTS
Aul
Amd
No.
TDH Program IDI
TDH Purchase Order
Number
Term
Financial Assistance
Begin End
Source of
Funds*
Amount
Direct
Assistance
Total Amount
(TDH Share)
ACFHlFEE
01 0000001074 09101103 08/31104 State 93.994
TDH Document No.7460019239 2004 Totals
5,098.00
0.00
$ 5,098.00
$ 0.00
$ 5,098.
'Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
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Cover Page 2
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926
_
_BY:
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EXECUTED IN DUPLICATE ORIGINALS ON THE DAlES SHOWN,
CALHOUN COUNTY
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY NAME:
RECEIVING AGENCY NAME:
CALHOUN COUNTY HEALTH DEPARTMENT TEXAS DEPARTMENT OF HEALTH
By:
J0<J1M I ~ IIJ.
(Signature of person thonze si contracts)
r~wt; ~jv.
(Name and Title)
Date:
~ ~ A~ -f/5
RECOMMENDED:
~~~
(PERFORMING AGENCY Director, if different
from person authorized to sign contract)
By:
(Signature of person authorized to sign contracts)
Bob Burnette, Director
Procurement and Contractin2 Services Division
(Name and Title)
Date:
B),,, I"""
,
TDH Document No: 74600192392004
Cover Page 3
..: t '( ~
927
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DOCUMENT NO, 7460019239-2004
ATIACHMENTNO, 01
PURCHASE ORDER NO, 0000001074
PERFORMING AGENCY: CALHOUN COUNTY HEALTH DEPARTMENT
RECENING AGENCY PROGRAM: ASSOCIATE COMMISSIONER FOR FAMILY
HEALTH
TERM: September 01, 2003 THRU: August 31, 2004
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY shall provide or assure the provision of prenatal, preventive, and
primary child health, genetics, dysplasia, and dental services (for children and adolescents) for
Title V eligible clients. PERFORMING AGENCY shall provide services approved in the
PERFORMING AGENCY'S application or shall have an established referral relationship with a
qualified provider of each approved service, which it does not provide.
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PERFORMING AGENCY shall comply with all applicable federal and state laws, rules,
. regulations, standards and guidelines in effect on the beginning date of this contract Attachment
unless amended. The following documents are incorporated by reference and made a part of this
contract Attachment. These include:
· RECENING AGENCY Title V FY 04 Renewal Application;
. PERFORMING AGENCY FY 04 Renewal Application and any revisions;
. RECENING AGENCY Title V FY 03 Continuation Request for Proposal (RFP);
. PERFORMING AGENCY FY 03 Continuation Application;md any revisions;
. RECENING AGENCY Family & Community Health Services Grants FY 02
Competitive Request for Proposal (RFP);
. PERFORMING AGENCY FY 02 Competitive Application and any revisions;
. Title V Policy and Procedures Manual, revised for FY 04;
. Fees for Clinical Health Services, 25 T AC ~ 1.91 (Local Health Departments ~mly); and,
. RECENING AGENCY'S Client Services Standards for Public Health and Community
Clinics, revised June 1997,
Within thirty (30) days of receipt of an amended standard(s) or guideline(s), PERFORMING
AGENCY shall infonn RECENING AGENCY Program, in writing, if it shall not continue
perfonnance under this Attachment in compliance with the amended standard(s) or guideline(s).
RECENING AGENCY may terminate the Attachment immediately or within a reasonable
period of time as determined by RECENING AGENCY.
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RECEIVING AGENCY'S Public Health Regional Director or designee, as coordinator of
regional services, will' assist RECEIVING AGENCY staff in providing direction to
A IT ACHMENT - Page 1
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PERFORMING AGENCY. RECEIVING AGENCY personnel may, from time to time, provide
technical assistance and training to PERFORMING AGENCY. PERFORMING AGENCY shall
cooperate with RECEIVING AGENCY staff to attain the goals of unified community health
assessment, policy development, coordinated services, and quality assurance and to prevent
unnecessary duplication of services,
PERFORMANCE MEASlJRES
The following performance measure(s) will be used to assess, in part, the PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Attachment,
without waiving the enforceability of any of the other terms of the contract.
At least 25% of the total amount of this Attachment shall be for services provided to Title V
eligible individuals ages one (1) through twenty-one (21) by PERFORMING AGENCY.
PERFORMING AGENCY shall provide services to clients who receive services in the following
county(ies)/area: Calhoun,
SECTION II, SPECIAL PROVISIONS:
General Provisions, Terms and Conditions of Payment Article, is revised to include:
PERFORMING AGENCY'S contract amount under this Attachment is a ceiling against
which it may bill, on a fee-for-service basis, for the provision of allowable services to
Title V eligible clients. Only allowable services provided to Title V eligible clients may
be billed against this ceiling, The current schedule of allowable services and rates, as well
as Title V eligibility requirements, may be modified at the sole discretion of
RECEIVING AGENCY with thirty (30) days written notice to PERFORMING
AGENCY. The notice will provide PERFORMING AGENCY with an opportunity to
terminate this Attachment should the modification include a reduction in rates.
PERFORMING AGENCY shall have thirty (30) days frdm receipt of this notice to
exercise the option for termination, If the PERFORMING AGENCY does not exercise
the option during the thirty (30) day time period, PERFORMING AGENCY shall be
deemed to have waived the option. A Request for "AdVance or Reimbursement", Form
270 (TDH Form GC-lO), is due no later than ninety (90) days after the end of the
Attachment term,. This report shall be marked "Final",
BILLING REQUIREMENTS
PERFORMING AGENCY shall bill RECEIVING AGENCY on a monthly basis for
allowable services provided to Title V eligible clients. Bills for all allowable services
shall be submitted as aggregate activity reports with a TDH Monthly Reimbursement
Request and shall not refer to or identify individual clients. PERFORMING AGENCY
shall bill within thirty (30) days after the end of the month which services were provided
or within sixty (60) days in cases of potentially Medicaid eligible individuals who are
ATI ACHMENT - Page 2
~_.
~-- 929
RECEIVING AGENCY no later than thirty (30) days after the end of each quarter, and the
fourth quarter report to RECEIVING AGENCY sixty (60) days after the end of PERFORMING
AGENCY'S contract term in a format specified by RECEIVING AGENCY.
PERFORMING AGENCY shall submit an Annual Budget and Expenditures Report in a format
specified by to the RECEIVING AGENCY by January 31, 2005.
A IT ACHMENT - Page 3
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General Provisions, Program Income Article, is revised to include:
All revenues directly generated by a Contract Attachment(s) supported activity or eamed
olllyas a result of the Attachment(s) during the term of the Attachment(s) are considered
program income. PERFORMING AGENCY shall identify and report all program
income annually,
Prugram Income may be retained by PERFORMING AGENCY so long as it is used to
provide services specified in the scope of work detailed in this Attachment. This shall be
demonstrated only by submission of acceptable billing vouchers for services provided to
Tide V eligible clients which exceeds PERFORMING AGENCY'S Attachment amount
by the total program income amount.
General Provisions, Reports Article, is revised to include:
PERFORMING AGENCY shall submit:
. Title V MCH Monthly Aggregate Activity Report, in conjunction with each
monthly billing request. Each report shall detail the total unduplicated number of
clients seen for the first time within a service category type during the contract
period by age, and race/ethnicity, and the number of service visits provided during
the preceding month. Billing requests will not be processed for payment by
RECEIVING AGENCY unless accompanied by a complete corresponding client
acti vity report;
. An annual summary of all such data the month following the end of the
Attachment term; and,
. Other reports as deemed necessary by RECEIVING, AGENCY upon reasonable
notice to PERFORMING AGENCY
In addition to the site visits authorized by the Inspections Article of the General Provisions,
PERFORMING AGENCY shall allow RECEIVING AGENCY to conduct on-site quality
assurance reviews as deemed necessary by RECEIVING AGENCY, Unsatisfactory review
findings may result in implementation of General Provisions, Sanctions Article.
PERFORMING AGENCY certifies that neither the PERFORMING AGENCY nor any
individual who has a direct or indirect ownership or controlling interest of 5% or more of the
PERFOR:vIING AGENCY nor any PERFORMING AGENCY officer, director, agent or
managing employee (e.g. general manager, business manager, administrator, director, or like
individu:d who exercises operational or managerial control over PERFORMING AGENCY or
who directly or indirectly conducts the day-to-day business of the PERFORMING AGENCY), is
an entity or individual who:
. lL,s been convicted of any offense under .42 U.S.Co g 1320a-7(b)(I)-(3);
e AITACHMENT-Page4
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. Has had a civil monetary penalty assessed under 42 U,S.c. ~ 1320a and/or 42 U.S.c. ~
IJ20a-8; or
. Has been excluded from participation in a program under 42 U.S.c. ~ 1395 et seq.; or_
under a State health care program,
If the foregoing statement is not true, PERFORMING AGENCY shall submit a
disclosudownership form to RECEIVING AGENCY PERFORMING AGENCY shall
immedialdy notify the RECEIVING AGENCY in writing, in the event that the foregoing
statement changes during the term of this Attachment. A false statement regarding
PERFOl;MING AGENCY'S status will be treated as a material misrepresentation.
PHARMACY
If PERFr:RMING AGENCY is dispensing and/or providing prescribed medications, e.g., birth
control "iils, antibiotics, etc., on site, it shall have, at a minimum, a Class D pharmacy license as
provided by the Texas Pharmacy Act, Occupations Code, Chapter 560, or shall dispense and/or
provide such medications in compliance with other pharmacy statutes with prior approval from
RECEIVING AGENCY
SECI10N m. BUDGET:
PERFO. .MING AGENCY shall adhere to the current schedule of allowable services and rates as
referenc:d in SECI10N II, SPECIAL PROVISIONS, as amended and approved by the
RECEIY LNG AGENCY
Total payments will not exceed $5,098.00,
AIT ACHMENT - Page 5
" 932
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Department of Health and Human Services
Health Care FmanciDg Adminislra'ion
e
Form Approved _
OMB 0938-OO86/HCFA_lSI3 ~
INSTRUCTIONS FOR COMPLETING DISCLOSURE OF
OWNERSHIP AND CONTROL iNTEREST STATEMENT (HCFA-IS13)
Completion and submission of this form is a condition of participation, certification, or recertification under any
of the programs established by titles V, xvrn, XIX, and XX, or as a condition of approval or renewal of a
conttactor agreement between the disclosing entity and the secretary of appropriate state ageIIg' under any of the
above titled programs, a full and accurate disclosure of ownership and financial interest is required. Failure to
submit requested infonnation may result in a refusal by the Secretary or appropriate State agency to enter into
an agreement or contract with any such institution or in termination of existing agreements.
SPECIAL INSTRUCTIONS FOR TITLE XX PROVIDERS
All Title XX providers must complete Pan II(a) and (b) of this form. Only those Title XX providers
rendering medical, remedial, or health-related homemaker services must complete Parts II and m. Title
V providers must comolete Parts II and m.
GENERAL INSTRUCTIONS
For definitions, procedures and requirements, refer to the
appropriate Regulations:
'ev
e XVIII
ide XIX
Tide XX
42CFR 5Ia.l44
42CFR 420.200-206
42CFR 455.100-106
45CFR 228.72-73
Please answer all questions as of the current date, If the
yes block for any item is checked, list requested
additional infonnation under Remarks on Page 2,
referencing the item, If additional space is needed use an
attached sheet.
Return the original to the State agency; retain a copy for
your files.
This fonn is to be completed annually, Any substantial
delay in completing the fonn should be reported to the
State survey agency.
DETAILED INSTRUCTION
These instructions arc designed to clarify certain
questions on the fonn, Instructions are listed in question
order for easy referencc. No instructions have been
given for questions considered self-explanatory.
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IT IS ESSENTIAL THAT ALL APPUCABLE
QUESTIONS BE ANSWERED ACCURATELY AND
THAT ALL INFORMATION BE CURRENT.
Item I (a) Under identifying infonnation specify in what
capacity the entity is doing business as (DBA), example,
name of trade or corporation.
Item I (b) For Re~ional Office Use Only. If the yes
box is checked for Item vn the Regional Office will enter
the 5-digit nwnber assigned by HCFA to chain
organizations.
Item II Self-explanatory.
Item ill List the names of all individuals and
organizations having direct or indirect ownership
int~ests, or controlling interest separately or in
combination. amounting to an owncrship interest of 5 %
or more in the disclosing entity,
Direct ownership interest is defined as the possession of
stock, equity in capital or any interest in the profits of the
disclosing cntity. A disclosing entity is defined as a
Medicare provider or supplier, or other entity that
furnishes services or arranges for furnishing services
under Medicaid or the Matcrnal and Child Health
~= 933
Department of Health and HUOWI Services
Health Care Financing Administration
program, or health related services under the social
service program.
Indirect ownership interest is defined as ownership
interest in an entity that has direct or indirect ownership
interest in the disclosing entity. The amount of indirect
ownership in the disclosing entity that is held by any
other entity is detennined by multiplying the percentage
of ownersh;p interest at each ieveL An indirect
ownership interest must be reported if it equates to an
ownership interest of 5% or more in the disclosing entity.
Example: If A owns 10% of the stock in a corporation
that owns 80 % of the stock of the disclosing entity, A's
interest equates to an 8 % indirect ownership and must be
reported.
Controiling interest is defined as the operational direction
or management of a disclosing entity which may be
maintained by any or ail of the foilowing devices: the
abUity or authority, expressed or reserved, to amend or
change the corporate identity (I.e. joint venrure
agreement, unincorporated business status) of the
disclosing entity; the ability or authority to nominate or
name members of the Board of Directors or Trustees of
the disclosing entity; the abilitY or authority, expressed or
reserved, to amend or change the by-laws, constitution,
or other operating or management direction of the
disclosing entity: the right to control any or ail of the
assets or other property of the disclosing entity upon the
sale or dissolution of that entity; the ability or authority,
expressed or reserved, to 'control the sale of any or all of
the assets, to encumber such assets by way of mortgage
or other indebtedness, to dissolve the cntity, or to arrange
for the sale or transfer of the disclosing entity to new
ownership or control.
Items IV -VII Changes in Provider Status
Change in provider status is defined as any change in
management control. Examples of such changes would
include: a change in Medical or Nursing Director, a new
Administrator, contracting the operation of the facility to
a management corporation, a change in the composition
of the owning partnership which under applicable Scate
law is not considered a change in ownership, or the hiring
or disrrtissing of any employees with 5 % or more
financial interest in the faciiity or in an owning
corporation, or any change of ownership.
Items IV-VII If the yes box is checked, list additional
infonnation requested under Remarks. Clearly identify
which item is being continued.
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Form Approvech
OMB 0938-OO86/HCFA_lSl:f
Item IV (a and b) If there has been a change in
ownership within the last year or if you anticipate a
change, indicate the date in the appropriate space.
Item V If the answer is yes,. list name -Of the
management finn and employer identification number
(EIN), or the name of the leasing organization. A
management company is defined as an)' organization that
operates and manages a business on behalf of the Owner
of that business, with the owner retaining ultimate iegal
responsibility for operation of the facility.
Item VI If the answer is yes, identify which has changed
(Administrator, Medical Director, or Director of
Nursing) and the date the change was made. Be sure to
include name of the new Administrator, Director of
Nursing or Medical Director, as appropriate.
Item VII A chain affiliate is any free-standing hea_1th
care facility that is either owned, controlled, or opera
under lease or contract by an organization consisting ,
two or more free-standing health care facilities organized
within or across State lines which is under the ownership,
or through any other device, control and direction of a
common party. Chain affiliates include such facilities
whether public, private, charitable or proprietary, They
also include subsidiary organizations and holding
corporations. Provider-based facilities, such as hospital-
based home heaith agencies, are not considered to be
chain affiliates.
Item VIII If yes, list the actual number of beds in the
facility now and the previous nwnber.
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DeparcmcDr. or Hca1cb. and Huaun Services
Hca1tb Care F"1113.Dclog Administration
Fonn Approved
OMS No. 0938oOO861HCPA_ISI3 _
DISCLOSURE OF OWNERSIDP AND CONTROL INTEREST STATEMENT
1. IDENTIJ."YJNG INFORMATION
(aj
Name of Entity
. Provider No.
Vendor No.
Phone
DBA
Street Address
Cily
COUnty
SEale
Zip
o be co leted b HCFA Re ional Office Chain Affiliate No.
n. Answer the following questions by marking .Yes- or -No.. If any of the questions are answered .Yes.. list names and addresses of
individuals or co rations under Remarks on Pa c 2. Identi each item number to be continued.
(a) Arc there any individuals or organizations having a direct or indirect ownership or control interest of 5 % or more in the
instibJtion., organization, or agency that have been convicted 'of a criminal offense related to the involvement of such persons.
or or . 'onsinan of the co establishedb llt1esXVIII,XIX,orXX7 Yes No
(b) Are there any directors, officers, agentS. or managing employees of the imtitution. agency or organization who have ever been
convicted of a criminal offense related to lbeir involvement in such programs established by TItle xvm. XIX, or XX? '
Yes No
(c) Are there any individuals currently employed by !he instilUlion, agency, or organization in a managerial. accounting, auditing.
or similar capacity who were employed by lhc institution's, organiZation's. or agency's fLSCal intenncdiary or carrier within
the reviow 12 months? Itle XVIII roviders onl . Yes No
m.
(aj
List names, addresses for individuals. or the EN for organizations having direct or indirect ownership or a c:ontcolling interest
in !he emily. (See instructions for definition of'ownership and controlling interest.) Ust any additional names and addresses
under Remarks on Page 2. If more than one individual is reported and any of these persons are related to each other, this
must be rted under Remacb on Pa e 2.
NAME
ADDRESS
EIN
(bj Type of Entily:
_ Sole Proprietorship
Other s i
_Partnership
_ Unincorporated Associations
_ Corporation
,
(c) If the disclosing entity is a corporation, list names, addresses of the Directors, and EINS for corporations under Remarks on
Pa e 2. .
Mark appropriate answer for each of the following questions:
(d) Are any owners of the disclosing entity also owners of MedicareIMedicaid facilities? (Example. sole proprietor, partnership
or members of Board of Directors. Yes No If es, list names, addresses of individuals and rovider numbers.
NAME
ADDRESS
PROVIDER NUMBER
(,,'~{ > \' t
" ,-. . .~ .' .
\t 935
Ocputmcnt of HcaldL and Hum1.ft Serviees
Health Cue F'~ Administndon
e'
. Form ApproVed
OMB No. 0938-<Xl861HCFA_lS13
IV,
(a)
Has there been a change in ownership or control within the last year?"
Yes No If. ive date.
(b) Do you.anticipate any change of ownership or control within the year?
Yes No If es. when?
(e) Do you anticipate fLIing for bankruptcy within the year?
Yes No If es. when?
V. Is this fadlity operated by a management company, or leased in whole or part by another organization? Yes No
If es, ive date of chan e in 0 ration..
VI. Has there been a chan e in Administrator, Directoro( Nursin or Medical Director within the last ear? Yes No
vn,
(a) .
Is this facility chain affiliated'? If yes. list name, address of Corporation. and EIN.
Name
Address
EIN
(b)
If the answer to question vn (a) is No, was lhe facility ever affiliated with a chain? If Yes. list name, address of Corporation.
and BIN,
Name
Address
BIN
VIlI.
Have you increased your bed capacity by 10% or more or by 10 beds, whichever is greater, within the last 2 years:
If es. ive ear of chan e: Current bed ace: Prior bed s ace:
Yes
No
Whoeve- knowingly and willfully makes or causes to be made a false statement or representation of this statement. may be prosecuted
under applicable federal or state laws. In addition, knowingly and willfully Cailing to Cully and atttU'B.te1y disclose the inCormation
requested may result in denial of a request to participate or whe-e the entity already participates:~ a termination of its agreement or
contract with the state a en or thes , as a ro riate.
Name of Authorized Representative (Typed)
Title
Signature
Date
R=arla,
2
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TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRA VIS
TDH Document No, 74600192392004
Contract Change Norice No. Ql
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing
with CALHOUN COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now
desire [0 amend such COntract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT NO. 02 AC FAMILY HEALTH. FAMIL Y PLANNING
All terms and conditions not hereb amended remain in full force and effect
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CALHOUN COUNTY
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY,
RECEIVING AGENCY:
CALHOUN COUNTY HEALTH DEPARTMENT
TEXAS DEPARTMENT OF HEAL TH
By ~,,-~.. _ -;~
(Signature of person authorized to sign)
Michael J. Pfeifer, Calhoun County Judge
(Name and Title)
Bob Burnette, Director
Procurement and Contractin2: Services Division
(Name and Title)
Date:
28 August 2003
B-/~-,.;2Drh"i
Dare:
RECOMMEN~ C
By ~ l5-...rl-:_~
(PERFORMING AGENCY Director, if different -
from person authorized to sign COntracr
CC PCSD - Rev. 2/03
Cover Page 1
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DETAILS OF ATTACHMENTS
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Attl TDH Program ill/ Term Financial Assistance Direct Total Amount
Amd TDH Purchase Order Assistance (TDH Share)
No. Number Begin End Source of Amount
Funds.
01 ACFHlFEE 09/01/03 08131/04 State 93.994 5,098.00 0.00 5.098.00
00000o 1074
02 ACFHlFEE-FP 09/01/03 08/31/04 State 26,598.00 0.00 26,5')8.00
TD H Document No.7 4600 19239 2004 Totals $ 31,696.00 $ 0.00 $ 31,696.00
Chan.e No. 0 I
*F~eral funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applica.ble. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT A 1T ACHMENT FOR DETAILS.
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DOCUMENT NO. 7460019239-2004
ATTACHMENT NO. 02
PERFORMlNG AGENCY: CALHOUN COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: ASSOCIATE COMMISSIONER FOR FAMILY
HEALTH
TERM: September 01, 2003 THR U: August 31, 2004
SECTION L SCOPE OF WORK:
PERFORMlNG AGENCY shall provide or assure the provision of family planning services for
Title V eligible clients. PERFORMlNG AGENCY shall provide services approved in the
PERFORMlNG AGENCY'S application or shall have an established referral relationship with a
qualified provider of each approved service, which it does not provide.
PERFORMlNG AGENCY shall comply with all applicable federal and state laws, rules,
regulations, standards and guidelines in effect on the beginning date of this contract Attachment
unless amended. The following documents are incorporated by reference and made a pan of this
contract Attachment. These include:
. RECEIVlNG AGENCY Title V FY 04 Renewal Application;
. PERFORMlNG AGENCY FY 04 Renewal Application and any revisions;
. RECEIVING AGENCY Title V FY 03 Continuation Request for Proposal (RFP);
. PERFORMlNG AGENCY FY 03 Continuation Application and any revisions;
. RECEIVING AGENCY Family & Community Health Services Grants FY 02
Competitive Request for Proposals (RFP);
. PERFORMING AGENCY FY 02 Competitive Application and any revisions;
· Title V Policy and Procedures Manual, revised for FY 04;
. RECEIVlNG AGENCY Family Planning Standards and Ruies, 25 T AC Chapter 56;
. Sterilization, 42 CFR Pan 50, Subpart B;
. Fees for Clinical Health Services, 25 T AC ~ 1.91 (Local Health Departments only); and,
. RECEIVING AGENCY'S Client Services Standards for Public Health and Community
Clinics, revised June 1997.
Within thirty (30) days of receipt of an amended standard(s) or guideline(s), PERFORMING
AGENCY shall inform RECEIVING AGENCY Program, in writing, if it shall not continue
performance under this Attachment in compliance with the amended standard(s) or guideline(s).
RECEIVING AGENCY may terminate the Attachment immediately or within a reasonable
period of time as determined by RECEIVING AGENCY,
RECEIVING AGENCY'S Public Health Regional Director or designee, as coordinator of
regional services, will assist RECEIVING AGENCY staff in providing direction to
PERFORMlNG AGENCY. RECEIVlNG AGENCY personnel may, from time to time, provide
technical assistance and training to PERFORMING AGENCY, PERFORMlNG AGENCY shall
A IT ACHMENT - Page 1
I-;t
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cooperate with RECEIVING AGENCY staff to attain the goals of unified community health
assessment, policy development, coordinated services, and quality assurance and to prevent
unnecessary duplication of services.
PERFORMANCE MEASURES
The following performance measure(s) will be used to assess, in part, the PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Aitachment,
without waiving the enforceability of any of the other terms of the contract.
At least 25% of the total amount of this Attachment shall be for services provided to Title V
eligible individuals through twenty-one (21) years of age by PERFORMING AGENCY.
PERFORMING AGENCY shall provide services to clients who receive services in the following
county(ies)/area: Calhoun.
SECTION II. SPECIAL PROVISIONS:
General Provisions, Terms and Conditions of Payment Article, is revised to include:
PERFORMING AGENCY'S contract amount under this Attachment is a ceiling against ..
which it may bill, on a fee-for-service basis, for the provision of allowable family ..
planning services to Title V eligible clients, Only allowable services provided to Title V
eligible clients may be billed against this ceiling. The current schedule of allowable
services and rates, as well as Title V eligibility requirements, may be modified at the sole
discretion of RECEIVING AGENCY with thirty (30) days written notice to
PERFORMING AGENCY. The notice will provide PERFORMING AGENCY with an
opportunity to terminate this Attachment should the modification include a reduction in
rates, PERFORMING AGENCY shall have thirty (30) days from receipt of this notice to
exercise the option for termination, If the PERFORMING AGENCY does not exercise
the option during the thirty (30) day time period, PERFORMING AGENCY shall be
deemed to have wai ved the option,
BILLING REQUIREMENTS
PERFORMING AGENCY shall bill RECEIVING AGENCY for allowable services
,
provided to Title V eligible clients. Requests for payment shall be submitted to the
Health and Human Services Commission's claims administrator in a manner compatible
with the Compass 21 billing system by the 120th day after the date on which services
were provided or the date of any third party insurance Explanation of Benefits form.
Appeals must be submitted within 180 days of rejection, and all requests for payment
shall be submitted within 90 days of the end of the Attachment term. Claims shall be
submitted using an approved claim format which follows the RECEIVING AGENCY
Family Planning Division billing specifications which may be obtained from ..
RECEIVING AGENCY Family Planning Division, _
ATTACHMENT - Page 2
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BILLING ACTIVITY
RECEIVING AGENCY shall distribute funds in a way that will maximize the delivery of
authorized services to eligible clients. RECEIVING AGENCY will monitor
PERFORMING AGENCY'S billing activity. If utilization is below that projected in
PERFORMING AGENCY'S cOntract ceiling amount, shown in SECTION III. BUDGET, _
PERFORMING AGENCY'S ceiling may be subject to a decrease for the remainder of the
contract Attachment period. PERFORMING AGENCY may be subject to contract
ceiling amount decreases if PERFORMING AGENCY'S billing activity is less than
projected,
RECEIVING AGENCY may pay for additional services as specified in this Attachment
if provided by PERFORMING AGENCY during the term of this Attachment (but not
otherwise paid during the term of this Attachment) if is in the best interest of the State
and the RECEIVING AGENCY Program to do so, and funds are available. If
PERFORMING AGENCY exceeds the ceiling amount of the Attachment,
PERFORMING AGENCY shall continue to bill RECEIVING AGENCY for the services
provided, RECEIVING AGENCY may pay for these additional services if funds become
available at a later date.
ELIGIBILITY
All individuals considered for possible Title V eligibility must be screened for potenti'al
Medicaid and/or CHIP eligibility using a TDH or Title V Program approved screening
tool as updated in the spring of each year when the federal poverty level is revised.
CO-PAY
PERFORMING AGENCY may, assess a co-pay from clients provided services by
RECEIVING AGENCY under this Attachment. A co-payment assessment may not
exceed 25% of the amount RECEIVING AGENCY pays PERFORMING AGENCY for
the provision of a given service. A co-pay shall not be assessed from such clients if their
family income is at or below 100% of the most recently defined federal poverty level. A
. client shall not be denied services due to inability to pay. Local Health Departn1ents shall
comply with RECEIVING AGENCY fee collection policies detailed in 25 TAC S L9L
General Provisions, Program Income Article, is revised to include:
All revenues directly generated by a Contract Attachment(s) supported activity or earned
only as a result of the Attachment(s) during the term of the Attachment(s) are considered
program Income. PERFORMING AGENCY shall identify and report all program
income annually.
Program Income may be retained by PERFORMING AGENCY so long as it is used to
provide services specified in the scope of work detailed in this Attachment. This shall be
demonstrated only by submission of acceptable family planning claims for services
A TT ACHMENT - Page J
~=-941
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provided to Title V eligible clients which exceeds PERFORMING AGENCY'S
Attachment amount by the total program income amount.
General Provisions, Reports Article, is revised to include:
PERFORMING AGENCY shall submit:
. Other reports as deemed necessary by RECEIVING AGENCY upon reasonable
notice to PERFORMING AGENCY.
In addition to the site visits authorized by the' Inspections Article of the General Provisions,
PERFORMING AGENCY shall allow RECEIVING AGENCY to conduct on-site quality
assurance reviews as deemed necessary by RECEIVING AGENCY. Unsatisfactory review
findings may result in implementation of General Provisions, Sanctions Article.
PERFORMING AGENCY certifies that neither the PERFORMING AGENCY nor any
individual who has a direct or indirect ownership or controlling interest of 5% or more of the
PERFORMING AGENCY nor any PERFORMING AGENCY officer, director, agent or
managing employee (e.g. general manager, business manager, administrator, director, or like
individual who exercises operational or managerial control over PERFORMING AGENCY or
who directly or indirectly conducts the day-to-day business of the PERFORMING AGENCY), is _
an entity or individual who: ,.
. Has been convicted of any offense under 42 U.S,C, S 1320a-7(b)(I)-(3);
. Has had a civil monetary penalty assessed under 42 U.S,c. S 1320a and/or 42 US.c. S
1320a-8; or
. Has been excluded from participation in a program under 42 U.S,c. S 1395 et seq,; or
under a State health care program,
If the foregoing statement is not true, PERFORMING AGENCY shall submit a
disclosure/ownership form to RECEIVING AGENCY. PERFORMING AGENCY shall
immediately notify the RECEIVING AGENCY in writing, in the event that the .foregoing
statement changes during the term of this Attachment. A false statement regarding
PERFORMING AGENCY'S status will be treated as a material misrepresentation.
PHARMACY
If PERFORMING AGENCY is dispensing and/or providing prescribed medications, e.g., birth
control pills, antibiotics, etc., on site, it shall have, at a minimum, a Class D pharmacy license as
provided by the Texas Pharmacy Act, Occupations Code, Chapter 560, or shall dispense and/or
provide such medications in compliance with other pharmacy statutes with prior approval from
RECEIVING AGENCY.
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STERILlZA TION
ATTACHMENT - Page 4
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PERFORMING AGENCY shall comply with all federal regulations applying to sterilization
procedures. '.
Prior to receiying a s.terilization, a client shall sign a copy of the U.S. Department of Health and
Human Services (DHHs) sterilization consent form. The original of this form, with all required ._
signatures (including the physician's), shall be. kept in the client's medical reCords.
SECTION ITl. BUDGET:
PERFORMING AGENCY shall adhere to the current schedule of allowable services and rates as
referenced in SECI'ION IT. SPECIAL PROVISIONS, as amended and approved by the
RECEIVING AGENCY, . .
Total payments will not exceed $26.598.~O.
ATTACHMENT:" Page 5
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TEXAS DEPARTMENT OF HEALTH. REGION 8 SHELLFISH PROGRAM LEASE
After Discussion the Court felt the County could use the office space at the Agriculture Building
Instead of leasing out to other agendes. Judge Pfeifer offered to talk with Texas Department of _
Health, Region 8 Shellfish Division and let them know of the change. ..
A Motion was made by Commissioner Balajka and seconded by Judge Pfeifer to talk with Texas
Department of Health, Regional 8 Shellfish Division regarding the office lease. Commissioners'
Galvan, Balajka, Royd, Rnster and Judge PfeIfer all voted In favor.
EMPLOYEES' HEALTH INSURANCE BENEF1ITS AND DEPENDENT COVERAGE
A Motion was made by Commissioner Aoyd and seconded by Judge Pfeifer that as of January 1,
2004 employee health Insurance premiums will be $44.00 a month for employee only coverage
and $126.00 for the employee with dependent coverage. Commissioners' Galvan, Balajka, Aoyd,
Rnster and Judge Pfeifer all voted In favor.
As of October 1, 2003 all new employees will no longer be eligible for dependent coverage.
Commissioner Floyd voiced his concern that It's too big of a hit for new employees coming in and
people will be seeking employment elsewhere, Sheriff Browning agreed that he too will have a
hard time attracting new employees.
A Motion was made by Judge Pfeifer and seconded by Commissioner Galvan that as of October 1,
2003 all new employees will no longer be eligible for dependent coverage. Commissioners'
Galvan, BaIaJka, Finster and Judge Pfeifer all voted In favor and Commissioner Floyd was
opposed.
TAX RATE: TAKE RECORD VOTE AND SCHEDULE PUBUC HEARING FOR SEPTEMBER
11.2003
Judge Pfeifer proposed a tax break for operations of .4667 and debt services of .0543 for a total _
of .5210 and scheduled a publIc hearing for September 11, 2003 and was seconded by ..
Commissioner Floyd. Commissioners' Galvan, Balajka, Royd, Finster and Judge Pfeifer all voted
In favor.
PURCHASE OF COMPUTER AND SOFTWARE FOR J.P. #1
Passed
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ENTERINmAmMI'DA~wn:aSPAWII&YWJq, I"ft --CO~RTHm~/NEW3AJL_
A MotIon was by IIIllde by CoIrm-... Floyd and seconded by Judgli PfeIfer to enblr lnIDa
CIllI<baCt with SpiIW MaxweD Ctl. c........... FICI)'lI wDI be authorized tD $/gn the amtracttbal:
wDI pRlVIde construc:tIon 1IIBIIIIgeIlleI~ nlIalIng to Il!IIIedIatIon, pocIIh'"on 8IlllI9I"
IeIllCIdeI/ngfreplatement of the ...cbtIIiy QiuItIiouSe and CDIlStIud;Ion of the new JaB.
0InnJIsslanen;' GaIvao. BaIilIka, At1A finster and Judge PfeIrer aD voted ~ .favor.
.. ......., '-..,
AGREEMENT BETWEEN CALHOUN COUNTY
AND CONSTRUCTION MANAGER
AGREEMENT made this 28th day of August, 2003.
BETWEEN:
Calhoun County , Texas
211 South Ann Street
Port Lavaca, Texas 71979
Attn: CommiSljioner H. Aoyd
Phone: (361) 893-5346
Fax: (361) 893-5309
Hereinafter referred to as "OWNER',
and the CONSTRUCTION MANAGER:
SpawMaxwe/J Company
4321 DirectolS Row, Suite 100
Houston, Texas 71092
Hereinafter referred to as 'CONSTRUCTION MANAGER',
for the following PROJECT:
Construction management services related to the new 144-bed Calhoun County
Jail and the existing Calhoun County Courthouse iocated at 211 South Ann
Street In Port Lavaca, Texas, The courthouse building, which was constructed
in 1959, Is a 3-story, wllh basement, concrete frame structure containing
approximately 36,100 gross square feet (GSF).
The OWNER is represented herein for all purposes of this AGREEMENT by Commissioner H,
Floyd, or such other representative as may be authorized by Calhoun County Commissioners
Court,
The OWNER and CONSTRUCTION MANAGER agree to the following terms and conditions as
set forth below, .
ARTICLE 1
CONSTRUCTION MANAGER'S RESPONSIBIUTIES
1.1 BASIC SERVICES
1.1.1 The CONSTRUCTION MANAGER will serve as the OWNER'S professional consultant
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In those phases of the PROJECT to which this AGREEMENT applies, and will consult
and advise the OWNER during the performance of the CONSTRUCTION MANAGER'S
services. The CONSTRUCTION MANAGER shall provide sufficient organization,
personnel and management to perform the requirements of this AGREEMENT In an
expeditious and economical manner consistent wnh the Interest of the OWNER.
1.1.2 The CONSTRUCTION MANAGER'S Basic Services related to the existing Courthouse
Facility shall be referred to as the "Courthouse - Phase I" project and shall consist of the
following scope:
1 .1.2.1 Facility Assessment
> The CONSTRUCTION MANAGER shall conduct a physical condition
assessment of the existing Calhoun County Courthouse facility. The purpose of
this assessment is to identify the building elements that must be added,
upgraded, replaced, abated, or remediated In order to bring the existing facility
into current code compliance and extend the functional usefulness of the
building.
> The condition assessment will address architectural, structural, mechanical,
electrical, plumbing and environmental concerns readily observed through an
on-site Investigation.
> The CONSTRUCTION MANAGER shall prepare a written report summarizing
the facility assessment review, conclusions and recommendations.
> The facility assessment report shall include estimated construction costs for the
building elements requiring new Installations, upgrades, replacement,
abatement, or remediation.
> Prior to performing the facility assessment, the CONSTRUCTION MANAGER
shall review existing documents provided by the OWNER. The documents to
be reviewed may Include: original construction documents (if any); previous
facility/condition assessments; and the latest environmental reports.
> The CONSTRUCTION MANAGER shall assemble, coordinate and manage a
team of professional subconsultants to perform an on-site visual investigation of
the existing major building systems and components for the purposes of
determining the existing condition of such systems. The systems to be
reviewed include: accessibility issues and concems; code and life safety
compliance; condition of interior materials and finishes; existence of special
architectural features; vertical circulation; interior lighting; doors and windows;
exterior materials condition, building envelope integrity and efficiency; roof
condition and drainage; parking availability; site lighting; site drainage issues;
structural components; mechanical systems; electrical systems; plumbing
systems; Investigate the potential existence of asbestos containing materials
(ACM); investigate the potential existence of lead-contalnlng paint (LCP); and
visually Inspect accessible areas to confirm the extent and magnitude of
previously Identified water or mold damaged building materials.
1.1.2.2 Architectural Scace Prooram for Existino Courthouse
> The CONSTRUCTION MANAGER shall provide a written architectural program
with the current and future space needs clearly defined for the departments and
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functions within existing courthouse facility, The program document shall factor
departmental growth rates and increasing service demands to determine the
needs for a 30 year plan. The program document will not address departments
and/or functions currentiy extemal to the eXisting courthouse facility (Le. County
Auditor, County Treasurer, Probation, Justices of the Peace, etc.).
> The CONSTRUCTION MANAGER shall retain, manage and coordinate the
services of an architectural subconsultant with the qualifications and experience
necessary to prepare a program document for the existing courthouse facility.
> The program document shall include estimated construction cast impacts
related to recommended upgrades and/or renovations to meet the new
functional and/or space needs wnhin the eXisting facility.
1.1.2.3 Cost Estimate for Demolition of Existina Courthouse and Construction of a New Facilltv
> The CONSTRUCTION MANAGER shall prepare a preliminary cost estimate for
the demolition of the existing Calhoun County Courthouse. The demolition cost
estimate shall address anticipated costs related to the abatement of previously
identified hazardous materials (Le. ACM, LCP, mold, etc.) existing within the
courthouse facility.
>> The CONSTRUCTION MANAGER shall prepare a preliminary cost estimate for
the construction of a new courthouse facility based on the program areas
reported In the existing feasibility study entitled .Courthouse Needs Assessment
Study for Calhoun County, Texas., dated July 2002, prepared by The Facility
Group. The preliminary construction cost estimate will be conceptual in nature
and based on square-foot unit costs for a similar type of facility,
> The CONSTRUCTION MANAGER shall retain, manage and coordinate the
services of a professional environmental consultant to prepare a Phase I
Environmental Assessment Study (EAS). Impacts to the demolition cost
estimate, if any, will be developed by the CONSTRUCTION MANAGER based
on the findings of the EAS.
1.1.3 The CONSTRUCTION MANAGER'S Basic Services related to the new County Jail
Facility shall be referred to as the .Courthouse and Jail Interface. project and shall
consist of the following scope:
1.1.3.1 Desion Phase
> Attend design phase projact meetings as required in Port Lavaca, Texas (not-
to-exceed a total of three).
}> Prepare one (1) detailed construction cost estimate report based on Design
Development phase documents.
> With the OWNER'S input and assistance, develop and maintain a detailed
project budget.
> With the OWNER'S input and assistance, develop and maintain a detailed
project schedule.
1.1.3.2 Procurement Phase
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> Attend Pre-Bid conference In Port Lavaes, Texas.
> Assist OWNER with the review of contractor bids and qualifications.
> Update project budget.
> Update project schedule.
1 .1 .3.3 Construction Phase
> Attend Pre-Construction conference in Port Lavaes, Texas.
> . Attend monthly construction progress meetings at the project site in Port
Lavaca, Texas (not to exceed a total of thirteen).
> Perform monthly project site reviews (QA) and prepare report of findings (not-to-
exceed a total of thirteen).
> Update project budget.
> Update project schedule.
> Assist OWNER with final review of facility and prepare punchlist documenting
noted deficiencies.
1.1.4 The CONSTRUCTION MANAGER agrees to retain subconsunants approved by the
OWNER. All subconsullants shall have licenses, certifications, or other qualifications
required to perform the services under this AGREEMENT and shall be experienced and
qualified to perform such services.
1.1.5
The CONSTRUCTION MANAGER'S employees and associated subconsultants to be
employed in the performance of the PROJECT shall be acceptable to and approved by
the OWNER, and once approved by OWNER shall not be changed except with the
OWNER'S prior written acknowledgment and concurrence.
1.2 ADDITIONAL SERVICES
1.2.1 Additional Services shall be provided If authorized or confirmed in writing by the
OWNER, and shall be paid for by the OWNER as provided in this AGREEMENT, in
addition to the campensation for Basic Services. Additional Services authorized by the
OWNER shall form an attachment to this AGREEMENT, and all applicable articles of
this AGREEMENT shall apply to the Additional Services authorization. If the
CONSTRUCTION MANAGER identnies a need for Additional Services, a proposal for
these services shall be submitted for the OWNER'S consideration.
1 .2.2 The following services are not included In Basic Services unless so identified in Article
12:
1.2.2.1 Providing services required due to significant changes in the PROJECT scope including,
but not limited to, changes in size, quality, complexity or the OWNER'S schedule.
1.2.2.2 Providing services associated with comprehensive engineering reviews of specific
structural, mechanical, electrical, or plumbing elements that may be perceived to be
potential or suspected problem areas.
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1.2.2.3 Providing non-destructive forensic testing or analysis of structural elements.
1.2.2.4 Providing services during the PROJECT one year Warranty Period.
1.2.2.5 Providing services in regard to the replacement of work damaged by fire or other cause
during the performance of the Basic Services.
1.2.2.6 Providing services made necessary by the termination or default of the OWNER'S
consultants, contractors or subcontractors.
1.2.2.7 Providing services relative to future facilities, systems and/or equipment.
1.2.2.8 Providing any other services not otherwise included in this AGREEMENT or not
customarily furnished in accordance with generally accepted, regional construction
management practice Including, but not limited to the following items: special
subconsultant services (archaeological, historical preservation, traffic, etc.); services in
connection with legal proceedings; etc..
ARTICLE 2
OWNER'S RESPONSIBILITIES
2.1 The OWNER shall provide complete information regarding the requirements for the
PROJECT.
2.2 The OWNER shall provide all required information, services and approvals in a timely
manner in order to avoid unreasonable delay in the orderly progress of the
CONSTRUCTION MANAGER'S services. The CONSTRUCTION MANAGER shall be
entitled to rely upon their accuracy and completeness.
2.3 The OWNER acknowledges that the CONSTRUCTION MANAGER does not in any
manner assume responsibility for the design of the PROJECT.
2.4 The OWNER shall employ a General Contractor under separate agreement. The
OWNER acknowledges that the CONSTRUCTION MANAGER does not In any manner
assume responsibility for the construction of the PROJECT.
2.5
The OWNER shall assist the CONSTRUCTION MANAGER in gaining entry to public
and private property as may be required by the CONSTRUCTION MANAGER in the
performance of their services under this AGREEMENT.
2.6 The services, information and reports required by this Article shall be fumished at the
OWNER'S expense and the CONSTRUCTION MANAGER shall be entitled to rely upon
their accuracy and completeness.
ARTICLE 3
PROJECT DURATION AND SCHEDULE
3.1 The total duration of the PROJECT for the purpose of this AGREEMENT will be ~
calendar days from the date of this AGREEMENT.
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3.2 The PROJECT schedule for the purposes of this AGREEMENT will be as follows:
COURTHOUSE - PHASE I
> Facilitv Assessment
Duration - 63 calendar days (9 weeks)
Start Date - 8/28/03
> Arch. Prooram for Existino Courthouse
Duration - 35 calendar days (5 weeks)
Start Date - TBD
> Cost Estimate for Demo of Existina Courthouse & Construction of New Facilitv
Duration - 63 calendar days (9 weeks)
Start Date - 8/28/03
COURTHOUSE AND JAIL INTERFACE
> Deslon Phase
Duration -77 calendar days (11 weeks)
Start Date - 8/28/03
> Procurement Phase
Duration - 63 calendar days (9 weeks)
Start Date - TBD
> Construction Phase
Duration - 393 calendar days (56 weeks)
Start Oale - TBO
3.3 The PROJECT duration and/or schedule may be extended by mutual agreement in
accordance with Article 12.
ARTICLE 4
PAYMENTS TO THE CONSTRUCTION MANAGER
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4.1 PAYMENTS ON ACCOUNT OF BASIC SERVICES
4.1.1 Payments for Basic Services shall be made monthly upon' presentation of the
CONSTRUCTION MANAGER'S invoice, on the basis set forth in Article 11.
4.1.2 If terminated, the CONSTRUCTION MANAGER will be paid for all Basic Services in
accordance with Article 13.
4.2 PAYMENTS ON ACCOUNT OF ADDITIONAL SERVICES
4.2.1
Payments for Additional Services shall be made monthly upon presentation of the
CONSTRUCTION MANAGER'S Invoice, on the basis set forth in Article 11.
4.2.2 If terminated, the CONSTRUCTION MANAGER will be paid for all Additional Services in
accordance with Article 13.
4.3 REIMBURSABLE EXPENSES
4.3.1 Reimbursable expenses are in addition to compensation for Basic and Additional
Services and include expenses incurred by the CONSTRUCTION MANAGER and the
CONSTRUCTION MANAGER'S employees and consultants In connection with the
PROJECT.
4.3.2 Reimbursable expenses shall include, but are not limited to, meals, lodging,
transportation, permits, courier, equipment rentals, printing and reproduction costs.
4.3.3 Fees and expenses for professional subconsu/tants, as specifically authorized by the
OWNER, shall be Invoiced as a reimbursable expense.
4.3.4 Payments for Reimbursable Expenses shall be made monthly upon presentation of the
CONSTRUCTION MANAGER'S Invoice, on the basis set forth In Article 11.
4.3.5 If terminated, the CONSTRUCTION MANAGER will be paid for all Reimbursable
Expenses in accordance with Article 13.
4.4
ADDITIONAL PROVISIONS
4.3.1
Payments are due and payable thirty (30) calendar days from the date the
CONSTRUCTION MANAGER'S invoice is approved by the OWNER. Amounts unpaid
after the date on which payment is due shall bear interest at the legai rate prevailing
from time to time at the principal place of business for the CONSTRUCTION
MANAGER.
ARTICLE 5
CONSTRUCTION MANAGER'S ACCOUNTING RECORDS
5.1 The CONSTRUCTION MANAGER agrees to maintain appropriate accounting records
of costs, expenses,. and payrolls of employees working on the PROJECT for a period of
three (3) years aftei final payment for completed services and all pending matters
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conceming this AGREEMENT have been closed. The CONSTRUCTION MANAGER
further agrees that the OWNER shall have access during normal business hours to any
books, documents, papers and records of the CONSTRUCTION MANAGER which are
direcliy pertinent to the services to be performed under this AGREEMENT for the
purposes of making audits and examinations.
ARTICLE 6
OWNERSHIP AND USE OF DOCUMENTS
6.1 All documents, Including but not limited to plans, drawings, studies, reports, notes, logs,
data, or calculations, prepared or fumished by the CONSTRUCTION MANAGER or its
subconsultants pursuant to this AGREEMENT are instruments of service with respect to
the PROJECT and shall remain the property of the CONSTRUCTION MANAGER.
Proprietary concepts, systems, ideas utilized or developed during performance of the
services shall remain the sole property of the CONSTRUCTION MANAGER.
6.2 The OWNER may make and retain copies for information and reference in connection
with the use and occupancy of the PROJECT by the OWNER and others; however,
such documents are not intended or represented to be suitable for reuse by the
OWNER or others on any other PROJECT or for any other purpose(s). If the OWNER
reuses such items without the CONSTRUCTION MANAGER'S specific written
verification or adaptation, such reuse will be at the risk of the OWNER, without liability to
the CONSTRUCTION MANAGER.
6.3 All PROJECT files shall be maintained in general accordance with the
CONSTRUCTION MANAGER'S document retention policies and practices.
ARTICLE 7
INSURANCE REQUIREMENTS
7.1 CONSTRUCTION MANAGER'S LIABILITY INSURANCE
7.1.1 The CONSTRUCTION MANAGER shall carry insurance in the types and amounts
indicated below for the duration of the AGREEMENT:
7.1.2 Workers' Compensation and Employers' Liability Insurance coverage with limns
consistent with statutory benefits outlined in the Texas Workers' Compensation Act
(Title 5, Subtitle A, Texas Labor Code) and minimum policy limns for Employers Liability
Insurance of $100,000 bodily injury each accident, $500,000 bodily injury by disease
policy limit and $100,000 bodily injury by disease each employee.
7.1.3 Commercial General Uabllity Insurance with a minimum combined bodily injury and
property damage per occurrence limit of $750,000 for coverage's A & B.
7.1.4 Business Automobile Liability Insurance for all owned, non-owned, and hired vehicles
with a minimum combined single limit of $500,000 per occurrence for bodily injury and
property damage.
7.1.5 The OWNER and the CONSTRUCTION MANAGER shall wl;live subrogation against the
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other party on all general liability and property coverage.
7.1.6 The CONSTRUCTION MANAGER shall forward cerlificate(s) of insurance to the
OWNER before the AGREEMENT is executed, as verification of coverage required in
Paragraphs 7.1.1 through 7.1.3 above.
7.1.7 All endorsements naming the OWNER as additional Insured, waivers, and notices of
cancellation endorsements as well as the certificate(s) of insurance shall indicate:
Calhoun County c/o Commissioner H. Floyd.
7.1.8
The CONSTRUCTION MANAGER shall not cause any insurance to be canceled nor
permit any insurance to lapse during the term of the AGREEMENT or as required in the
AGREEMENT.
7.2 OWNER'S LIABILITY INSURANCE
7.2.1 The OWNER shall be responsible for purchasing and maintalning the OWNER'S usual
liability insurance. Optionally, the OWNER may purchase and maintain other insurance
for self-protection against claims which may arise from operations under this
AGREEMENT.
7.3 PROPERTY INSURANCE
7.3.1 Unless otherwise provided, the OWNER shall purchase and maintain, in a company or
companies lawfully authorized to do business in the jurisdiction In which the PROJECT
is located, property insurance for the entire work at the site on a replacement cost basis
without voluntary deductibles. Such property insurance shall be maintained until final
payment has been made or until no person or entity other'than the OWNER has an
insurable interest In the property to be covered, whichever is eartier.
7.3.2
Property insurance shall be on an "all-risk" policy form and shall insure against the perils
of fire and extended coverage and physical loss or damage Including, without
duplication of coverage, theft, vandalism, malicious mischief, collapse, falsework,
temporary buildings and debris removal including demolition occasioned by
enforcement of any applicable legal requirements, and shall cover reasonable
compensation for the CONSTRUCTION MANAGER'S services and expenses required
as a result of such insured loss.
ARTICLE 8
MISCELLANEOUS PROVISIONS
8.1 This AGREEMENT is performabie in Calhoun County, Texas and venue for any
litigation over any aspects of this AGREEMENT shall be in the appropriate courts of
Calhoun County, Texas.
8.2 If any word, phrase, clause, sentence or provision of this instrument, or the application
of same to any person or set of circumstances is for any reason held to be
unconstitutional, invalid or unenforceable, that finding shall only effect such word
phrase, clause, sentence or provision, and such finding shall not effect the. remaining
portions of this instrument; this being the intent of the parties in entering into this
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instrument; and all provisions of this instrument are declared to be severable for this
purpose.
8.3
NOTICES
8.3.1
Any and all notices under this AGREEMENT shall be in writing and shall be delivered to
the party entitled to receive the same by hand or U.S. Certified Mall, return receipt
requested, addressed as follows (or as amended in wrning In the future):
Mailed and/or Hand Delivered Notices to OWNER:
Calhoun County Precinct 3
24627 State Highway 172
Port LaVaca, Texas 77979
Attn.: Commissioner H. Floyd
Mailed and/or Hand Delivered Notices to CONSTRUCTION MANAGER:
SpawMaxwell Company
4321 Directors Row, Suite 100
Houston, Texas 77092
Attn.: Steve Mechler
8.3.2 Mailed notice shall be effective three (3) days after such notice is mailed by Certified
Mail with return receipt requested, properly addressed as set forth above. Hand
delivered notice shall be effective when received and acknowledged by signed receipt.
8.4
INDEMNIFICATION
8.4.1
The OWNER and CONSTRUCTION MANAGER hereby expressly agree to defend,
indemnity, and hold harmless the other, their agents, and employees, from and against
all claims, demands, casts, causes of action and liability, including reasonable attorney's
fees for the defense of such clams and demands, to the extent such claims, demands,
costs, causes of action and liability are caused by their negligent acts, errors, or
omissions.
8.4.2 In the event such claims, demands, costs, causes of action and liability are caused by
joint or concurrent negligence of the OWNER and CONSTRUCTION MANAGER, they
shall be borne by each party in proportion to Its own negligence under comparative fault
principles.
8.5 WARRANTY
8.5.1 The CONSTRUCTION MANAGER will perform the services in a manner consistent with
that level of care and skill ordinarily exercised by members of the profession currently
practicing under similar conditions in the same locale. The CONSTRUCTION
MANAGER makes no warranties or guarantees, express or implied, relating to the
CONSTRUCTION MANAGER'S services.
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8.6
8.6.1
8.7
8.7.1
8.8
8.8.1
9.1
LIMITATION OF LIABILITY
The OWNER and CONSTRUCTION MANAGER have evaluated the risks and rewards
associated wnh this PROJECT, Including the CONSTRUCTION MANAGER'S fee
relative to the risks assumed, and agree to allocate certain of the risks so, to the fullest
extent permitted by law, the total aggregate liability of the CONSTRUCTION MANAGER
for any and all Injuries, damages, claims, losses or expenses (Including attomey and
expert fees) arising out of the CONSTRUCTION MANAGER'S services regardless of
cause(s) or theory of liability, including negligence, Indemnity, or other recovery is
limited to the CONSTRUCTION MANAGER'S total fee under this AGREEMENT.
This limitation shall not apply to the extent the damage is paid under the
CONSTRUCTION MANAGER'S CGL policy.
CONSEQUENTIAL DAMAGES
Neither party shall be liable to the other for loss of profits or revenue; loss of use or
opportunity; loss of goodwill; cost of substitute facilities, goods, or services; cost of
capital; or for any special, consequential, indirect, punitive, or exemplary damages.
SAFETY
The CONSTRUCTION MANAGER will be responsible for supervision and site safety
measures for its own employees, but shall not be responsible for the supervision or
health and safety precautions for any other parties, Including the OWNER, the
OWNER'S contractors, subcontractors, or other parties present at the site.
ARTICLE 9
SUCCESSORS AND ASSIGNS
The OWNER and the CONSTRUCTION MANAGER bind themselves, their partners,
successors, assigns and legal representatives to the other party to this AGREEMENT
with respect to all covenants of this AGREEMENT. Neither the OWNER nor the
CONSTRUCTION MANAGER shall assign, sublet or transfer any Interest in this
AGREEMENT without the prior written consent of the other party.
ARTICLE 10
EXTENT OF AGREEMENT
10.1 This AGREEMENT represents the entire and integrated agreement between the
OWNER and the CONSTRUCTION MANAGER and supersedes all prior negotiations,
representations or agreements, either written or oral. This AGREEMENT may be
amended only by written instrument signed by both the OWNER and CONSTRUCTION
MANAGER.
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ARTICLE 11
BASIS OF COMPENSATION
11.1
BASIC COMPENSATION
11.1.1 For Basic Services performed by the CONSTRUCTION MANAGER, as described in
Article 1, and any other services Included in Article 12 as a part of Basic Services, Basic
Compensation shall be calculated on an hourly basis in accordance with the fee
schedule shown on Attachment" A" which is incorporated herein, with agreed upon
not-to-exceed amounts as follows:
> Courthouse - Phase I - $100,218
> Courthouse and Jail Interface - $84,356
11.2 COMPENSATION FOR ADDITIONAL SERVICES
11.2.1 For Additional Services performed by the CONSTRUCTION MANAGER, as described
in Article 1 , and any other services included in Article 12 as a part of Additional
Services, Compensation shall be calculated on an hourly basis in accordance with the
fee schedule shown on Attachment "A" which is Incorporated herein.
11.3 REIMBURSABLE EXPENSES
11.3.1 Reimbursable Expenses as described in paragraph 4.3 shall be calculated at the actual
costs incurred times a muUiple of one and one tenth (1.10).
11.3.2 The agreed upon not-to-exceed amount for the CONSTRUCTION MANAGER'S
expenses related to Basic Services as detailed in subparagraph 4.3.2 is :
> Courthouse - Phase 1- $3,740
> Courthouse and Jail Interface - $4,620
11.3.3 The agreed upon not-to-exceed amount for the CONSTRUCTION MANAGER'S
subconsultant fees and expenses related to Basic Services as detailed in subparagraph
4.3.3 is:
> Courthouse - Phase 1- $88,770
> Courthouse and Jail Interface - $0
11.4 ADDIT10NAL PROVISIONS
11.4.1 The rates set forth in Attachment "A" shall be annually adjusted in accordance with
normal salary review practices of the CONSTRUCTION MANAGER.
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11.4.2 If the CONSTRUCTION MANAGER'S services, scope or schedule are changed
materially, through no fault of the CONSTRUCTION MANAGER, compensation shall be
equitable adjusted through negotiation.
ARTICLE 12
OTHER CONDITIONS OR SERVICES
12.1 CONTRACT EXTENSION & CHANGES
12.1.1 The terms and conditions of this AGREEMENT may be extended and/or changed upon
mutual agreement between the OWNER and CONSTRUCTION MANAGER.
12.1.2 The OWNER may request changes to the scope of services by altering or adding to the
services to be performed. If OWNER so requests, the CONSTRUCTION MANAGER
will provide the OWNER with a supplemental proposal setting forth an adiustment to the
services, fees and schedule for the requested change(s). Following the OWNER's
review, OWNER shall provide written acceptance. If OWNER directs, authorizes, or
permits the CONSTRUCTION MANAGER to perform any changed or additional work,
the services shall be considered to be in addition to the Basic Services and the
CONSTRUCTION MANAGER will be paid for this work in accordance with Paragraph
11.2 (Compensation for Additional Services).
12.1.3 If project conditions change materially from those observed at the site or described to
the CONSTRUCTION MANAGER at the time of the proposal, the CONSTRUCTION
MANAGER is entitled to a contract modification equitably adjusting its services and fee.
ARTICLE 13
TERMINATION OF AGREEMENT
13.1
It is the intent of this AGREEMENT that the CONSTRUCTION MANAGER will provide
the services enumerated in this AGREEMENT unless the PROJECT is canceled or
indefinitely postponed and the services of the CONSTRUCTION MANAGER are no
longer required.
13.2
This AGREEMENT may be terminated without cause by either party upon seven (7)
days written notice to the other. In such case, the CONSTRUCTION MANAGER shall
be paid costs incurred and fees earned to the date of termination plus reasonable costs
of closing the project in accordance with Article 11.
13.3 The right to terminate provided in this Article 13, and any other rights provided to the
OWNER and CONSTRUCTION MANAGER by this AGREEMENT, are in addition to all
other rights and remedies available at law or in equity, such rights and remedies being
cumuiative, and not exclusive.
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This AGREEMENT Is executed to be effective upon the date of the last party to sign.
OWNER:
CALHOUN COUNTY, TEXAS
By: +1~ ~D
Printed Name: H Floyd
Title: County Commissioner
Date:.3 - 0 ~ - e>3
. ~ c: ~ l. :
CONSTRUCTION MANAGER:
SPAWMAXWELL COMPANY
BY:~
Printed Name: Steve Mechler
Title: Vice President
[/- ;2-8 - tl ~
Date:
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ATTACHMENT "Au
SCHEDULE OF CURRENT BILLING RATES
Rates and ranges are subject to annual cost of living increases and merit evaluation. The rates
shown beiow are fully burdened to include the actual hourly rate of personnel and include all
direct and indirect saiary costs, overhead and profit.
Hourly Fees for SpawMaxwell Personnel
Principal - (S. Mechler) ............................................................................................. $ 158.00
Sr. Project Manager - (W. Cully).............................................................................. $ 138.00
Project Manager - (C. Old, M. Crippen)....................................................................... $ 128.00
Estimator / Scheduler - (J. Ritsema)......................................................................... $118.00
Superintendent - (TBD) .......................................................................................... $ 118.00
Project Coordinator - (c. Clay) .................................................................................. $ 68.00
Hourly Fees for Bailey Architects Personnel (Architectural Subconsultant)
Principal- (Ray Leiker, AlA) ....................................................................................... $ 150.00
,
Programming - (John Focke, FA/A) ............................................................................ $ 150.00
Project Architect - (Gerald Moorhaad, FA/A) ................................................................ $ 122.00
Project Manager - (Jame. Knight, A/A)....................................................................... $ 102.50
Intern Architect - (18D)............................................................................................. $ n.oo
Hourly Fees for Haynes Whaley Associates Personnel (Structural Engineer Subconsultant)
Principal.......................... ......... .............. ........... ............ ......... ....... ........ ......... ....... $ 175.00
Project Manager............... ,........ .............. ......... .......... .................... ......... ......... ..... $ 125.00
Assistant Project Manager .................................................................................... $ 110.00
Project Engineer - (D. Walton).................................................................................... $ 95.00
Project Drafting Coordinator ................................................................................... $ 95.00
Construction Administrator..... ........... ............. ........... ......... ......... .......... .......... ........ $ 90.00
Senior CAD Drafter ................................................................................................. $ 65.00
Staff Engineer ......................................................................................................... $ 75.00
A-l
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ATTACHMENT "Au
SCHEDULE OF CURRENT BILLING RATES
CAD Drafter - (S. Wallon)........................................................................................... $ 75.00
Clerical .................................................................................................................... $ 45.00
Hourly Fees for Burns Delatte & McCoy Personnel (MEP Engineer Subconsultant)
Principal - (Jim Ang.Ii.) ............................................................................................ $ 150.00
Senior Engineer - (Don Nye).................................................................................... $ 150.00
Senior Designer - (T. Rocha, Grog Rick.rt, J. Shad./bower)............................................ $ 145.00
Engineer - (TSO)..................................................................................................... $ 120.00
Designer - (G. Maliory) ............................................................................................... $ 85.00
Senior Construction Administrator - (M. Look)......................................................... $ 125.00
Drafter - (TSO) .......................................................................................................... $ 70.00
Clerical- (TSO) ......................................................................................................... $ 55.00
Hourly Fees for HBC Terracon Personnel (Environmental Subconsullant)
Expert Witness ...................................................................................................... $ 150.00
Principal, Officer......... .......... ................ ....... ...... ...... ..................... ......................... $ 145.00
Associate Principal, Consultant ............................................................................ $ 130.00
Senior Environmental Professional....................................................................... $ 110.00
Senior Project Manager - (G. 51.v.n.)..................................................................... $ 110.00
Project Manager - (K. M./on.y).................................................................................. $ 95.00
Environmental Professional II........................................................................... ...... $ 85.00
Environmental Professional I - (v. capps)................................................................. $ 75.00
Environmental Technician II - (A. Oorg.r).................................................................. $ 60.00
Environmental Technician I..................................................................................... $ 47.00
Draftsperson / CAD Operator.................................................................................. $ 55.00
Word Processor ...................................................................................................... $ 45.00
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NON-DIREcnONAI BaCON AT r.JU IIftJlN COUNTY AIRPORT
A MotIon was made by CommIssIoner BaIajka and secon(Ied by CommIssIoner Galvan to authorize
Judge PfeIfer to sign Memorandum of Understanding belv..een theFedenIJ Avfatfon Admlnlstratlon
and Calhoun County In regards to the Non-OIredlonaI Beaaln InstaIfed at the Calhoun County
AIrpoIt Commlssloners' Galvan, ~ka, F!Qyd, FInsler and Judge PfeIfer an voted In favor.
MANUAL
OPERATIONS AND MAINTENANCE
FOR
PKV
(F ACILI1Y IDENTIFIER)
NDB
(FACILI1Y TYPE)
AT
Calhoun County Airport
Port Lavaca, Texas
(LOCATION)
.~.;.. 961
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CONTENTS
PART
TITLE
PAGE
I. Operational Requirements
II. Maintenance Requirements
4
m. Aircrnft Accident/Incident Procedures
7
N. Nonfederal Facility Data
17
Attachment 1. Facility Equipment Perionnance and
Adjustment Data
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MEMORANDUM OF UNDERSTANDING
BETWEEN THE
FEDERAL AVIATION ADMINISTRATION
AND
(Owner/Sponsor)
The owner/sponsor, CounlY of Calhoun. Texas. having installed the
(Owner/Sponsor)
PKV
(Identifier)
NDB
(Facility Type)
at Calhoun CounlY Airoort
(Location/Airport)
hereby accepts the enclosed Operations and Maintenance Manual as approved by the Federal Aviation
Administration (FAA). The undersigned agree to operate and maintain the above facility in accordance
with all FAA requirements, standards and criteria governing such facility, including those requirements
contained in the enclosed Operations and Maintenance Manual (OMM). . The FAA reserves the right to
change/amend the OMM to reflect changes in FAA operatiDg policies and procedures. The
changes/amendments shall be effective after a IO-<lay notification to the sponsor.'
At any time that the undersigned or persons named in the Operations and Maintenance Manual are no
longer performing the functions indicated, the FAA shall be notified within 10 working days.
The undersigned understands that noncompliance with the above requirements will be grounds for
NOTAMing the facility out-of-service and/or cancellation of FAA approved instrument flight rules
procedures.
With regard to any liability which may arise from the use and/or operation of this facility, each party
expressly agree that it shall be fully and exclusively liable for the negligence of its own agents, servants,
and/or employees in accordance with applicable law and that neither party looks to the other to save or
hold it hannless for the consequences of any negligence on the part of one of its own agents, servants,
and/or employees.
Signature:~~ l Date: August 28, 2003
(Owner or Desi d pre entative)
Galhoun County Judge Michael J. Pfeifer
Signature:~A^" If R../'7-k
Representative!
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PARTI
OPERATIONAL REQUIREMENTS
1. LicensinlZ. The following requirements must be met in order to operate a facility in the National
Airspace System. Failure to comply with these requirements will result in withdrawal of approval for
instrument flight rules use of the facility.
a. Facility TransmittinlZ Eauinment. The FCC license is to be conspicuously posted at the facility.
The normal period of the license is five years, after which time it mnst be renewed. Renewal
applications must be made at least 180 days prior to expiration. Copies of the application and the new
license, when received, must be provided to the FAA sector office. FCC forms may be obtained from the
FCC office. Each application must contain a statement indicating the FAA office has been notified and
the date of notification.
b. Maintenance Technician. The equipment shall be operated and maintenance performed only by
persons approved by the FAA.
1. A IZeneral class radio teleohone onerator license satisfies the FCC requirement. A copy of
this license must be provided to the FAA sector office.
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2. FAA annroval will be I!IlIIlted following the successful completion of both of the following:
. (a) FAA or F AA-annroved manufacturer's school or satisfactory completion of a
concept examination to be administered by a representative of theF AA. It is to be understood that the
satisfactory completion of the concept exam precludes the necessity of resident training.
(b) A nerformance examination to be given by a representative of the FAA.
3. A letter of technical verification will be provided by the FAA stating that these
requirements have been met.
2. Notice to Airmen. A Notice to Airmen (NOTAM) contains the establishment, condition, or change in
any aeronautical facility, service, procedure or hazard, the timely knowledge of which is essential to
personnel concerned with flight operations. Deviation from nonna! operation or failure of this facility is
to be promptly and accurately publicized by a NOTAM. The sponsor and the technician responsible for
the equipment maintenance shall be notified immediately of reports concerning irregular operation of this
facility by pilots or other persons detecting the irregularity. The sponsor or the authorized representative
shall ensure that a NOTAM has been filed through the associated flight service station (FSS). The
sponsor or the authorized representative shall also ensure notification of the applicable AF office by
telephone during normal office hours asIisted'in Part IV, Non-Federal Facility Data, to report any such
failure or deviation exceeding or expected to exceed 24 hours.
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3. MoDitorin!!.
a. It is FAA oolicy that a remote monitorin!! system be orovided for all electronics facilities used in
support of instrument flight procedures. Continuous monitoring requires that a responsible observer
check tbe remote status indicator at least once each half hour. Suitable monitoring equipment shall be
provided at an appropriate location to enable detection of any of the following conditions.
(I) A malfunction of failure of the transmitter equipment
(2) A malfunction or failure oftbe monitor equipment itself.
b. Navi!!ational facilities are classified in accordance'witb tbe manner in which tbey are monitored.
No change of monitoring status oftbe navigational aids shall be effected witbout prior FAA approval.
The monitoring categories are as listed below:
(1) Cate!!orv 1 - Internal monitoring witb a status indicator insta11ed at a manned control
point Facilities can be used for instrument flight procedures witbout limitation. In tbe absence of a
manned control point, tbe facility reverts temporarily to category 3.
(2) Cate"orv 2 - Internal monitoring with an inoperative status indicator at a control point,
but pilot reports indicate that the facility is operating normally. This is a temporary condition and is not
considered in procedures development These facilities are' taken out of service by iSSuing a NOTAM
when two pilot reports indicate facility malfunction. '
(3) Cate"orv 3 - Internal monitoring only. A status indicator not installed at control point or
if a non-fail-safe condition exists. Facilities may be used in accordance witb tbe following limitations:
(a) Alternate minima shall not be authorized iftbe facility provides a final approach
course guidance, is required for procedure entry, is used to define tbe final approach fix, or is used to
provide missed approach guidance.
(b) When the facility is used to desilmate a step-down fix, a1te1llllttl minim. shall be no
lower than tbe circling minima required withouttbe step-down fix.
I Do"le" airways or routes shall not be predicated on tbese facilities.
(d) Navi!!ational fixes developed from crossing radials of category 3 facilities shall not
be used to break a minimum en route altitude to a higher minimum en route altitude.
(4) Cate"orv 4 - This category is applicable only to nondirectional beacons. Internal monitor
not insta1Ied, but a remote status indicator provided at control point. . Failure of tbe status indicator will
render tbe facility and tbe approach procedure unusable during the outage. Facilities may be used in
accordance witb tbe following limitations:
(a) Alternate minima may be authorized when tbe remote status indicator is located in an
2
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FAA traffic facility and then only during periods that the control point is attended.
(b) If the control ooint is other than an FAA facility, a writtec agreement shall exist
whereby an air traffic facility and then only during periods that the control point is attended.
c. To issue a NOTAM for an unmonitored facility, the Oollowing conditions must be met:
(I) The facility is eauiDoed with a properly operating automatic shutdown feature.
(2) No reDOrts of abnormal facilitv oneration are received.
(3) Failure of the remote status indicator.
NOTE: If all of these conditions are not met, a NOTAM to place the facility out of service
shall be issued.
4. Shutdown for Routine Maintenance. Maintenance should be performed only when the following
conditions exist:
a. Interruntion should be confined to visual flight rules (VFR) conditions, daylight hours, and
periods of light traffic when possible.
b. The interruntion of service shall be coordinated with the appropriate air traffic control (A TC)
facility (FSS, airport traffic control tower (ATe1), etc.). Notificatioc should be made so that the notice
of shutdown or interruption will be published in advance of the proposed interruption. Facilities shall
not be shut down without Air Traffic (A1) approval.
c. A NOT AM shall be in effect announcing the scheduled interruption and the facility will not be
shutdown until that specified time has arrived. The advance notification of the interruption will state a
specific period of time for the interruption to occur.
d. The facility identification signal shall be disabled while maintenance is being performed.
5. Pilot Reoorts. The sponsor shall remove the facility from service immediately upon receipt of two
successive pilot reports (pIREPS) of malfunctioning. The facility will remain out of service until the
proper operation can be confirmed by the facility technician and/or flight inspection aircraft if necessary.
6. Reouired SunDOrt Items.
a. The SDonsor shall Drovide FAA-approved test equipment needed for maintenance of the facility.
Test equipment used to measure key performance parameters shall be calibrated at least annually. All
test equipment calibration shall be accomplished with standards traceable to the National Institute of
Standards and Technology.
b, There shall be a stock of scare Darts sufficient to make possible prompt replacement of
components which fail or deteriorate in service.
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7. EmerlZencies.
a. Militarv. In case of a national defense alert, the facility shall be shut down in the shortest
possible time after the alert is received from the air traffic facility and shall remain off the air until
official notice is received that the alert is over.
b. Aircraft Accident. Part ill of this mannal provides guidance in case of an aircraft accident.
8. Adiustment of Eauioment throulZh Remote Maintenance Monitorin" 1RMMl. Any non-Federal
facility having RMM uplink adjustment capability shall have an associated printer which documents all
maintenance activities. This printer shall make a record for the review of visiting FAA personnel of all
logons and eqnipment adjustment which may be initiated from a remote terminal. Printouts will be
maintained a minimum of 2 years before being discarded.
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PART n. MAINTENANCE REOUIREMENTS
9. General.
a. The facility shall be maintained in accordance with the applicable subparts of FAR Part 171 and
manufacturer's instruction books, maintenance technical handbooks, and/or other FAA-approved
requirements. FAA standards and tolerances will be used. If they do not exist, then the manufacturer's
handbook will be used.
N01E: The maintenance schedules and requirements contained in these publications are to be
considered the minimum level of maintenance in accordance with FAR Part 171 and this document
b. The FAA shall be resnonsible for providing FAA forms and appropriate FAA publications
required for maintenance of the facility. These forms will be made available by the FAA office having
inspection responsibility at no charge.
c. If a verified maintenance technician is not assigned or if the maintenance schedules as set forth
in FAA-approved maintenance procedures are not adhered to, the equipment shallbe removed from
service unless the sponsor or his/her designated represesntative has coordinated the exact circumstances
with the FAA.
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d. Facilitv reference data file (facility requirements performance and adjustment data forms, called
Record of Meter Readings and Adjustments, Form FAA 198, in FAR Part I7I)shall be completed by the
owner or the owner's representative at the time of the facility commissioning. One copy must be kept in
the permanent records of the facility and one copy must be sent to the appropriate FAA office. The
sponsor or the sponsor's representative must revise the data after any major repair, modernization, or
returning to reflect an accurate record of facility operation and adjustment. In the event the data is
revised, the owner or the owner's representative must notify the appropriate FAA office of such revisions
and forward copies of the revisions to the appropriate FAA office. within 10 days.
e. Facility Maintenance LolZ. FAA Form 6030-1.
(1) This lodcalled Facility Maintenance LOI'_ Form FAA 406c. in Far Part 171 is a
permanent record of all of the activities required to maintain the facility. Log entries shall be clear,
complete, concise, and recorded in universal time code (UTC). The entries must include all malfunctions
encountered in maintainin the facility, including information on the kind of work and adjustments made,
equipment failures, causes (if determined) and corrective action taken. In addition, the entries must
include statements describing periodic maintenance activities required to maintain the facility, facility
verification statements, and NOT AM infonnation. The original white pages of the maintenanCe logs
sball be retained at the facility for a period of 3 years. A copy of the log pages shall be sent to the
appropriate AF. office for review within 10 working days after the next facility visit after the end of the
month/quarter/semiannually as appropriate.
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(2) Amonll tbe most imoortant entries in tbe facility maintenance log are tbose indicating tbe
verification status of a system, subsystem or equipment. For tbe purpose oftbis OMM, tbe word
"certification" used in FAA directives shall be synonymous witb "verification". Verification statements
shall be entered in tbe facility maintenance log (FAA Form 6030- I) in accordance witb appropriate FAA
directives and orders. A verification statement shall be made before returning a system, subsystem, Or
equipment to service after tbe system has been out-of-service due to hardware or software failure and
whenever maintenance work tbat has been performed may have affected verification parameters.
f. Technical Performance Record. FAA Form 6000 Series (called Radio Equipment Operation
Record, Form FAA 418, in FAR Part 171), contains a record of system parameters recorded during each
scheduled visit to tbe facility. The sponsor or tbe sponsor's representative shall keep tbe original page of
tbe technical performance record at tbe facility and send a copy to tbe appropriate FAA office for review
witbin 10 working days after tbe next facility visit after tbe end oftbe quarter.
g. Imorovements in maintenance orocedures or equipment modifications shall be funded and
incorporated by tbe sponsor following approval by tbe FAA. An addendum to tbe OMM, approved by
tbe FAA, shall be completed if necessary.
h. The soonsor shall submit any proposed modifications to tbe facility to tbe FAA for approval and
shall not permit any modifications to be performed witbout specific FAA approval.
i. Neitber tbe eouioment nor antennl\ will be rep1aced or relocated witbout prior FAA approval. No
construction is to be planned in tbe vicinity that may alter or affect tbe facility witbout first coordinating
witb tbe FAA. Status monitor receivers shall not be removed or relocated witbout FAA approval.
j. Velletation. snow deotb. and otber potential obstructions to If''uracy of tbe facility operations
shall be controlled witb applicable FAA handbooks.
10. Phvsical Security. The facility shall be kept locked at all times. Normal protection shall be provided
to ensure that unautborized personnel do not have access to tbe equipment.
II. Flillht Insoections. Flight inspections will be performed as stipulated in FAA Handbook OA P
8200.1, United States Standard Flight Inspection Manual. The sponsor shall provide ground to air
communications on 135.85 or 135.95 MHz for flight inspection when required. The maintenance
technician shall participate in this inspection if required by tbe FAA. Those activities requiring flight
inspection are outlined in tbe FAA maintenance technical handbooks and orders.
12. Ground Insoections.
a. FAA llI'ound insoections will be accomplished on a periodic basis. Prior notification of ground
inspections will be given to tbe facility technician after coordination witb tbe sponsor. Failure to meet
tbe technical standards for equipment maintenance may be grounds for cancellation of tbe facility's
instrument approach procedures.
b. The FAA mav conduct a follow-uo insoection when a facility may have been a factor in an
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aircraft accident/incident. (See Part m.)
13. Safety. Occupational Safety and Health Administration requirementsshonld be followed to ensure
personnel safety. Vegetation shall be controlled to allow access to the facility.
14. NAPRS DATA. (To be provided.)
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PART ill
AIRCRAFT ACCIDENTIINCIDENT PROCEDURES
15. GENERAL. This part has been provided to help expedite the certification/verification of facilities in
the event of an aircraft accident and to help ensure that all required actions are accomplished. It contains
the following:
a General information checklist.
b. F acilitv evaluation checklist (completed for each facility evaluated by the certifYing/verifying
technician).
NOTE: The non-Federal technician completes original checklists. The original accident
checklists shall be retained in owner/sponsor office with a copy to the regional AF division, AnN:
AF Aircraft Accident Representative (AF AAR), through the appropriate FAA office.
Technician who completed the facility evaluation checklist:
(Signature)
(Date)
The non-Federal technician who completed the general information checklist
the facility evaluation checklist for completeness and accuracy:
and reviewed
(Signature)
(Date)
16. INFORMATION AND INSTRUCTIONS.
a There are a series of steDs to be performed following an aircraft accident . These steps need to be
performed ina very precise manner so that a true and accurate status of a facility is documented. The
latest edition ofF AA Order 8020.!I, Aircraft Accident Incident Notification, Investigation, and
Reporting, is the controlling directive and will take precedence Over other instructions where there are
conflicts. In general, the steps to be performed are outlined below and will be performed in the following
sequence.
(I) Initial determination of facility status.
(2) Notification of AF/AT offacility status.
(3) Technical evaluation of facility.
(4) Documentation of the condition of the facility.
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(5) Notification to the AFAAR of "as-found" condition.
(6) Flight check if applicable.
b. When a facility has been identified as possibly being used by an aircraft involved in an accident,
a technician will be notified by one of several different people such as systems engineer at the air route
traffic control center (ARTCC), AT supervisor, or sector manager. If notification comes from anyone
other than sector management, then the non-Federal technician should contact sector management for
instructions. Generally, the sector manager will be the AF AAR and will provide the guidance to the non-
Federal technicians as to who will do what and when.
17. lNITIAL DETERMINATION OF FACILTIY STATUS. This is important because it provides both
AT and AF with information that is needed to make other decisions vital to public safety. Unless
instructed to the contrary, a non-Federal technician should not do this step alone. Another person should
accompany the non-Federal technician to ensure that there is no question in the future as to what took
place at the facility. The non-Federal technician making the initial determination of the facility status
must have current certification/verification authority on the facility. The person accompanying the
technician should be an FAA technician but, if necessal)', can be someone else in order to save time. Log
entries need to be made indicating the purpose of the visit and the results of the initial determination.
The type of information to be obtained during an initial determination visit to a facility are only those ...
items that can visually be learned to ascertain whether a facility was or was not operating normally .
immediately preceding or at the time of the accident No adjustments or control functions are to be
performed; only that information which can be learned by looking at equipment indicators, meters, etc.,
sball be used.
Note: Complete paragraphs 2a( I) through 2a( 5) of the facility evaluation checklist.
18. NOTIFICATION TO AT/AF OF FACILITY STATUS. The information obtained on the facility
status must be given to Ibe AF AAR as soon as possible. A log entIy stating who was given this
information must be made at Ibe facility.
NOTE: Complete paragraphs 2a(6) and 2b of the facility evaluation checklist.
19. TECHNICAL EVALUATION OF FACTT ,TIY. When a non-Federal technician has been notified by
the AF AAR of AF field office manager that a complete technical evaluation of a facility is to take place,
two people will be involved in the evaluation process. One person will be the non-Federal technician
responsible for performing Ibe evaluation and is required to possess current certification/verification
authority on Ibe facility involved. The olber person (FAA technician) will act as an observer and will
normally possess current certification/verification authority. The requirement for an observer can only
be waived by Ibe AF AAR and if no waiver has been granted, Ibe technical evaluation is NOT to take
place. If Ibe observer requirement has been waived, Iben the person doing the evaluation shall not be the
last person who certified/verified Ibe facility.
NOTE: Complete paragraphs 3 and 4 of the facility evaluation checklist.
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20. DOCUMENTATION OF TIIE CONDmON OF TIIE FACILITY. This step is just as important as
any other and needs to be done with attention to detail. This includes entries in technical performance
records, facility maintenance logs, RMM screens, and ground check folIDS. The statements shown in the
facility evaluation checklist have been established to provide a standard description that can be unifonnly
interpreted by everybody concerned with the accident. It is extremely important that all entries are
accurate and complete.
21. NOTIFICATION TO THE AFAAR OF "AS-FOUND" CONDmON. This step needs to be
completed as soon as possible so that decisions can be made regarding further actions, such as whether or
not to call for a flight check.
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GENERAL INFORMA nON CHECKLIST
NOTE: The non-Federal technician completes original which is retained in owner/sponsor office
and provides a copy to the regional AF division,
A TIN: AF AAR, through tbe sector office.
I. Non-Federal /AT
by AT and name of AT person).
(Name of first ,:,on-Federal person contacted
If not notified by AT, indicate who made tbe initial notification on tbe above line.
Time notified.
(All times in UTC.)
2. The non-Federal person in paragraph I shall contact tbe sector manager and his/her owner/sponsor
and otbers as required by tbese instructions.
Time completed.
3. The sector manager or acting sector manager functioning as tbe AF AAR will determine with AT's
help which facilities may have been or were used by tbe aircraft, also the aircraft number and type and
location of crash, time of crash, and type of flight plan.
Facilities Identified bv AF AAR:
Location ID
Facility
Location ID
Facility
Aircraft
Type: _
Aircraft
ID:
OatelTime of
Accident:
Location of crash if known:
Aircraft on: _IFR _ VFR _No flight plan
11
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974
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FACILITY EVALUATION CHECKLIST
NOTE: Complete a separate checkIist for each facility listed in the
checklist.
. general information
Certif'ying/verifying non-Federal technician completes originaI which is retained in owner/sponsor office
and provides a copy to regional AF division, A TIN: AF AM, through the sector office.
1. If the facility is remotelv monitored. contact AT or the facility responsible for monitoring and ask if
there were any monitoring alanns or pilot reported problems.
a. Remote monitor alanns prior to accident? Yes_ No_ N/A
b. Pilot reoorted facility malfunction of
non-Federal eqnipment prior to accident? Yes_ No
Unknown
NOTE: Either AT control or RMM position or
systems engineer at ARTCC's may provide this
information.
2. The AF AAR normallv will direct the owner/soonsor to designate his non-Federal technician and FAA
observer to complete an initial determination of facility status. This may be done by the AF AAR if the
owner/sponsor/technician cannot be contacted.
a. Initial determination of facility status. If the facility has no remote monitoring or RMM, it will
be necessmy to get two pilot reports to confirm proper Operation or go to the facility. If you go to the
facility, enter required data in the facility log upon arrival at the facility. An observer will norrna1ly be
required; however, under certain conditions, the observer requirement may be waived by the AF AAR.
(1) Observer requirement waived by the
AFAAR? Yes_No
(2) If yes, record name of technician last certifying/verifying the facility or eqnipment:
Facility
Technician
(3) Log the following in the facility log; check off when completed:
(a) Arrival time at facility:
(b ) Weather conditions at facility:
1 Initial determination of facility
operational status. Determine and log:
12
< \",'
~' ~'\ t ~
975
. "
(d) Main or standby (#1 or #2) in
service, commercial, or standby power in operation,
monitor alarms, transfers, etc.
(e) AT facility/AFAAR notified of
initial determination:
Abnormal or
Normal Out of Service
b. Initial determination of facility:
(Facility/time verification completed)
3. If instructed bv tbe AF AAR tbe certifying/verifying non-Federal technician shall proceed with tbe
technical evaluation and measurement of tbe facility performance and make appropriate entries in tbe
facility logs and technical performance records. The technical performance of facilities, systems, or
equipment shall be determined by checking all certification/verification parameters required by tbe
applicable technical maintenance orders. The certification or verification parameters are listed in tbe
appendix oftbe maintenance directive for tbe facility being evaluated. Arrange for an observer witb
AF AAR or supeivisor and measure all required parameters or observe at the RMM positions as
applicable.
a. Observer requirement waived by the AF AAR? Yes_ No
If yes, record below tbe name of the technician(s) who last certified/verified the facility/facilities:
Facility .
Technician
NOTE: NO EQUIPMENT ADJUSTMENTS ARE TO BE MADE UNTIL TIiE "AS-FOUND"
READINGS ARE RECORDED AND/OR AFTER THE FLIGIIT CHECK (IF REQUIRED) IS
ACCOMPUSHED.
Check Off
b. If a transfer has occurred since tbe
last facility visit, take the following action:
(I) If a facilitY is remotelv monitored.
contact the monitoring point and ask if tbere have
been any short duration alanus or facility transfers
indicated.
13
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(2) If no transfers or intermittent alarms
have occurred within a period beginning I hour prior
and ending 30 minutes after the accident, take the
necessary action to certif)4verify only equipment
found in operation upon arrival. If there is any
question about whether the standby equipment was in
operation at the time of the accident, certifylverify
it also. When in doubt, certifylverify.
(3) If unable to determine if there were any
transfers of alarms within the times specified in
subparagraph (2) above or if there has been a transfer within
the timeframe described in subparagraph (2) above, proceed to
certifylverify the equipment (main and standby).
c.' If the facility is not ocerational upon
arrival, proceed as follows:
(I) Note the status of the monitor and transfer
unit if such a unit is installed. Record the facility
status in the log. (Verify monitor indications at the
remote monitoring facility if practical.)
(2) Dial or Dush the reset button: do not make
any adjustments.
(3) If the facility returns to normal. make
required meter readings and log entries, then notify the .
control point and the AF AAR.
(4) If the facility fails to restore to normal
after resetting it, notify the AF AAR (sector manager)
immediately for further instructions.
d. Facilities with Dublished 1ZI'0und-check procedures
shall have the ground-check performed.
14
,,:,,1'
977
I
. , '
4. Anycertificationlverification carameter out of tolerance? Yes_ No
a. If no. oroceed to checklist oaramoh S.
b. Ifves. list the facility and thenarne of the verification parameter:
Facilitv
Verification Parameter
c. Take aooronriate action to remove the
facility from service and advise the AF AAR of
the out-of-tolerance condition. Measure and
record all key performance parameters.
d. Was any key oerformance oarameter (listed
in the maintenance bandbook) determined to be
"not germane" to the evaluation and thus not
measured? Yes No
NOTE: This must be coordinated with the AF AAR
If yes, were details of the omission logged
in the facility log? Yes No
S. Is a flil!ht check reauired?
Yes_No
NOTE: Coordinate with AF AAR for this determination.
6. Soecific Documentation of Data and Adiustments.
a. Meter readinl!S shall be recorded accurately on the appropriate FAA Form 6000 series, Technical
Performance Record(s), or on FAA Form 6030-1, Facility Maintenance Log(s). For RMM facilities, all
required certification or verification screens shall be taken and a hard copy retained if remotely certified
or verified. Each screen must be certified of verified. If the equipment involved is operational, a set of
as-found readings or screens shall be recorded prior to any preventive or corrective maintenance.
Normally, no such maintenance will be accomplished at a facility subject to flight check until after the
flight check crew has determined the as-found condition of the facility. However, if weather or other
circumstances cause the flight check to be unduly delayed and there is an urgent need to restore a failed
facility to normal operation prior to flight inspection in order to make it available to other users, the
15
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decision to do so shall rest jointly with the regional AT, Flight Standards (FS), and AF division
managers.
(1) This decision should be based upon the recommendations of the responsible AF sector
manager and the AT facility manager. If a facility subject to flight check is restored to operation
preceding the start of the flight check, a set of as-left readings or screens shall be recorded and so
identified following any maintenance action(s). A statement that the system, subsystem, equipment, or
facility is not certifiedlverified for user use shall be entered following the as-left statement on the facility
maintenance log.
(2) If the sYStem. subsystem. eouicment or facility cannot be restored or is considered
unreliable (in the judgment of the non-Federal technician), the certi:ficationlverification will be removed.
(3) A statement shall be entered inunediatelv below each set of readinl!S or each screen
identifying whether they are "as found" or "as left" following. . . (specify exactly what preventative or
corrective action Was taken). If no adjustments or other maintenance were accomplished, a single
statement will suffice, followed by a certification or verification statement if the entries were made on
facility maintenance log. The statement to be used on the technical performance record is shown below:
FAA FORM 6000 SERIES AND RMM SCREENS
"I certify/verify that the above is a true record of the
meter readings
(Enter facility location identifier and facility type)
(Enter "as found" or "as left" or "as found and'left" or "screens" at
the date and time indicated.)
Check Off
TECHNICIAN:
(Signature)
YES
(Title)
OBSERVER: YES
(Signatufe )
b. Facility maintenance lOll: entries shall describe conditions as found in clear, concise language. A
typical enlly covering an instrument landing system (ILS) glide slope post-accident evaluation visit
wherein no out-of-toleranceconditions were found might be as follows:
"081030 - The operation of the ILS glide slope on runway was checked at 0930 this date and found
to be normal. Certification/verification performance parameters or screens were within established
standards and tolerances and certified."
16
979
. , ,
For RMM facilities, all facility maintenance log certificationlverification entries shall be entered in the
appropriate prime log.
c. Each loe: entrv covenne: checks made as a result of an aircraft accident shall be certified/verified.
The statements to be used for fucility log entries are shown below.:
FAA Fonn 6030,( ) Lee:
"1 certify/verify that this is a true and complete statement of my fmdings with regard to the
for the date
(identity facility/equipment)
and time indicated."
NOTE: "CertifY/verify" refers to the statement in paragraph 6c above, not facility
certification/verification.
"The following corrective action(s) were accomplished (if applicable):"
"The following key perfonnance parameters were not gennane to this evaluation and are omitted (if
applicable)."
"The is
(system, subsystem, equipment, or facility)
"
(certified/verified, out-of-service, unreliable, and certification/
verification is removed in accordance with Order 6000.15).
Check Off
TECHNICIAN:
( signature)
YES
(title)
OBSERVER:
(signature)
YES
WAIVED
(title)
Ground Check Perfonned:
YES
17
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NOT APPUCABLE
d. In the event that a facility flight inspection is to be performed as a result of an accident, nou-
Federal personnel shall record on the FAA Form 6000 series screens and the FAA Form 6030-1 as
indicated above:
(1) Conditions "as found" before the flight check.
(2) Concise descriotion of all adjustments or other maintenance performed subsequent to the
accident and the reason therefore.
(3) Concise descriotion of all adjustments made during the flight inspection.
(4) Conditions "as left" following the flight inspection.
18
981
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PART IV
NONFEDERAL FACILITY DATA
1. Facilitv.
a. Type NDB
b. Identifier PKV
c. FacilityName PKVNDB
d. Airport Name Calhoun County Airoort
e. Dire<:tiollS to Facility. On the airoort
e
f. Facility Elevation (MSL) 26'
g. Antenna Elevation (AGL)-21.
h. Latitude 38 39"01 . N
i. Longitude 96 ... '" . W
J. Frequency 515 kHz
k. FCC Licensed Power 25W Modulation Class
1. License Number W RLB25l 0
m. License Expiration Date 11312006
e
19
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982
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2. Eauioment.
a. Transmitter Manufacturer Southern Avionics
b. Transmitter Model SS250B
c. Internal Monitor/Shutdown YES --X- NO
d. External Monitor/Status
YES ~ NO
e. Receiver Manufacturer Southern Avionics
f. Receiver Model MR-7
g. Antenna TypeIModel SAC Mast "Too Hat"
h. StacdbyPower (Type) No
20
981
Jl' l \ ,
e
3. Contacts.
a. Sponsor City of Wharton, Texas
b. Spocsor's Representative:
1. NameITitle Hon. Arlene MarshaIVCounty Judge
2. Telephone Work/Home (36J)553-4600/
3. Address: 210 S Ann STE 217 Port Lavaca Texas 77979
<:. Verified Maintenance Technician:
1. Name Charles W. Brown
2. Telephone Work/Home 936 856 1943L
3. Address 12394 Squirrel Tree Road Conroe Tx, 77304
4. FCC License Number PG-9-13140
d. Person in charge of monitoring location:
e
1. Name Sheriff's Dept.
2. Telephone (361)553-4646
3. Location Address
210 S Ann Port LavacaTexas 77979
4. Monitoring Hours Administrative hours
e. F edera1 Aviation Administration:
1. Associated ARTCCITelephone Houston ARTCC /281-230-5310
f. Submit required forms to appropriate Airway Facilities Office:
I. Name Gulf Coast SYStems Manll2en\ent Office/281-876-5600
2. Address Gulf Coast SMO
222 Pennbri2ht Ste. 250
Drawer 25
Houston. TX 77090
Blank PalZe
e
21
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984
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FACILITY EQUIPMENT PERFORMANCE
AND
ADWSTMENT DATA
COVER SHEET
Orig. ( )
Rev. ( )
Location
Date
Sheet No.
Date Revised
Reason for Revision
COnstruction and adjnstment of the station have been carefully checked and are in acoordance with
installation and adjnstment specifications and/or instructions. The record of meter indications and dial
settings contained herein verifies the satisfactory condition of the facility.
(FAA Representative)
(Title)
Attachment 1
22
.llJ
985
~'.-~_..r---==,~~-C;:;O"'''-'-' .__'~_.~_~_._..
Tl:YAC OOUNTY AND ~Kl'Rlcr RETIREMENT ST::tI.:1I4 2004 PlAN INFORMAnON
DOCUM1!N1'
A MotIon was made by CommissIoner Floyd and seconded by Commls5loner Galvan to a
Judge PreIfer III sign Texas County and DIstrIcI: RelIriment Sy$m 2004 Plan Information
Document, CommIssIoners' GaJvan, IIaIaJIca. Floyd, finster and Judge PreIfer all voted In
~!9?~
~~ __=M
No PI~n Change Notice and
Rat~ Acknowledgment
. Varlable-Rate Plan
e
Please submit this form if your county or district is not making plan revisions for 2 04. Keep
in mind that even If your county or district elects no benefit changes, your required employer
contribution rate may change for 2004. An order or resolution must be submitted t TCDRS
if your county or dlsfrict is authorizing any new option, right or benefit. Please con act
TCDRS if you have questions.
Calhoun County
Employer Name
.128
Employer Number
My county or district chooses to make nll plan changes for 2004. I understand that ur
employee deposit and employer conbibutlori lales will be:
Employee Deposit Rate:
Employer Contrib\ ltion Rate:
7.00%
9.12%
e
Only the chair of the governing board or the official TCDRS correspondent may s gn this
form. . .
Michael J. Pfeifer
Name of Authorized Signee
Calhoun County Judge
TItle
~~~
Autho . Slg ature
August 28, 2004
Date
e
TCDRS' PO Box 2034 AustIn, TX 78768' 8ON2.l-1182 Dr ('12) J28.8889' fall 1'12) 328-8887' www.lcdrs.DIlI
~-lf'P .
986
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REPLACE OLD JOB DESCRIPTION FOR THE COURT COORDIN_AT()R/~OURT
REPORTER/OFFICE MANAGER POSI110N IN THE COUNTY m!!!!-!!:l,!J!!!
A Motion was made by Judge Pfeifer and seconded by Commissioner Floyd to replace the old job
description for the Court Coordinator/Court Reporter/Office Manager position in the County
Court-at-Law Office with the new job description, which has been approved by Katharine Ray of
Ray Associates, Inc., changing the EEOC Category from Office Oarical to Administrative,
changing the FLSA Status from Non-exempt to Exempt, but wIth no changes In Pay Group.
Commissioners' Galvan, Balajka, Royd, Finster and Judge Pfeifer all voted In favor.
REPLACE ADMINSTRATIVE COORDINATOR/HUMAN RESOURCES COORDINATOR
WITH OFFICE MANAGER - COUNlY JUDGE
A Motion was made by Judge Pfeifer and seconded by Commissioner Floyd to replace the old job
description from Administrative Coordinator/Human Resources Coordinator with the new job
description of Office Manager in County Judges Office, which will take effect on September 1,
2003. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
DISTRICT CLERK - EXTENSIN SERVICE - JP PCT 3 - MONTHLY REPORTS
The District Oerk, Extension Service and JP pct 3 presented their monthly reports for August
2003 and after reading and verifying same, a Motion was made by Commissioner BaJajka and
seconded by Commissioner Galvan that said reports be accepted as presented. Commissioners'
Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
ACCOUNTS ALLOWED - HOSPITAL
Oaims totaling $1,467,393.31 for Hospital Operations were presented by the County Treasurer
and after reading arid verifying same, a Motion was made by Commissioner Floyd and seconded
by Judge Pfeifer that said claims be approved for payment. Commissioners' Galvan, Balajka,
Floyd, Finster and Judge Pfeifer all voted In favor. .
ACCOUNTS ALLOWED - INDIGENT HEALTHCARE
Oaims totaling $78,246.99 for Hospital Indigent Healthcare were presented by the County
Treasurer and alter reading and verifying same, a Motion was made by Commissioner Floyd and
seronded by Commissioner Galvan that said claims be approved for payment. Commissioners'
Galvan, Balajka, Floyd, FInster and Judge Pfeifer all voted In favor.
987
~ . CALHOUN COUNTY, TIlWl Iq p~~ (~()r+ +-
. l.Inposlod BUdSOl1lwactloas - BXPIlND.AIlJIJS'BIIlNI FOR 8/28103 \ l F<tl{'~)
BUD303 . BUDGIlJ' ADJUSnIBNTS FOil 8/28103
~\.
~..
'-'""". Puod I!ft'ccti..
Code Ilalo Fund TItIt 'l'nuJaction Dcaaiptlon Depl TId. C3LTItIt -. noa- 'Ii
1000 8I28l2OO3 GENERALFUND IlNB lIllM TRANSFER UBRA1lY 1II1U111lS-MAIN UBIlA1lY 1.000.00
1000 8/28/2003 GENERALFUND . IlNB lIllM TRANSF1lll UBRA1lY 1TI1UI1Bll-POINTCOMFOIlT . 1.000.00
L1BRA1lY ~ii
tOOO 8/28/2003 OI!NIlIlI.LFUND REQUIRED BY PAYROlL 1A1LOPBRAlTONS OVERTIMB '556.00
1000 8I28f2003 0I!NIlIlI.L FUND IlNB lIllM TRANSFER 1AIL OPBRA1lONS OI!NIlIlI.LOFPICB SUPPlJES 197.00 f~1
1000 8/2812003 GENERALFUND IlNB lIllM TRANSFER 1AIL OPBRAlTONS PIUSON1lIl L01lCJINGCUT 16,229.0.0
Ol' COUNTY '1"
1000 8I28l2OO3 0I!NIlIlI.L FUND IlNB lIllM TRANSFER 1AILOP1lRA1TONS PIUSON1lIlMBDICAL 3,295.00
SBIlVICIlS gf. i
1000 8I28f2003 0I!NIlIlI.L FUND REQUIRED BY PAYROlL COUNIYTAX COUllCfOIl M1!ALALWWANCIl 31.00
tooo 8/2812003 OI!NIlIlI.LFUND REQUIRED BY PAYROlL COUNIYTAX COUllCfOR. O1lNl!IlALOFPICB SUPPlJES 31.00 i16g
1000 8I28f2003 0I!NIlIlI.L FUND UNB lIllM lRANSFEIl COMMlSSlONBRS COURT LBOALN011CI!S 500.00
1000 8I28l2OO3 0I!NIlIlI.L FUND I POII:II674 fIRST COMML'lS1ONER8 COURT LBOAL SB1lV1CF3 1.000.00 5'''~
SOI1IlIWBSTCOMPANY ~l :0
1000 8I28l2OO3 OI!NIlIlI.LFUND IlNB lIllM TRANSFER COMM1S8JONBRS COURT LBOALSB1lV1CF3 430.00 :0 I
1000 8I28l2OO3 OIlNERALFUND UNB lIllM TRANSFER COMML'lS1ONER8 COURT M1SCIlI.UNBoUS 430.00
tOOO 8I28f2003 OIlNERALFUND POII:11674 FIRST COMMISSIONBRS COURT SAC. RIlPOR1S t.ooo.oo Ill!
S01T1HWllSTCOMPANY II
1000 8/2812003 OIlNERALFUND UNB ITEM TRANSFER COMM1SSIONBRS COURT l11UlilBS-EMERG APPROVED
COMMUNICATION
N1lIWORK
1000 8I28f2003 OIlNERALFUND REQUIRED BY PAYROlL COUNIYCUlRK lBIPORA1lY ~ ~~
1000 8I28f2003 GENERALFUND REQUIRED BY PAYROIL COUNTY CUlRK OVllRl1MB AUG 21J{::i003
1000 8/28/2003 0IlNERAL FUND UNB lIllM TRANSFER AMBUlANCIl . SB1lV1CF3 Ii
OPBRATIONS-S1!ADRIFT
1000 8I28f2003 GENERALFUND UNB lIllM TRANSFER IlM1lIlGENCY MEDICAL GIlNIDw. OFPICB PLIES 500.00 ~f
SB1lV1CF3
1000 8/28/2003 0IlNERAL FUND UNB lIllM lRANSFEIl IlM1lIlGENCY MEDICAL supPlJI!SIOP1lRATIN 500.00
SBIlV1CF3 EXPENSES
1000 8/28/2003 0I!NIlIlI.L FUND PO#284n DIS1R\CT COURT INDIGENT 1II!ALrn CARE CARll 01' INDIGENTS 1,soo.00 ~l
APPlDATIY
1000 8/28/2003 0I!NIlIlI.L FUND IlNB lIllM TRANSFEIl COUNTYCOURT-AT-LAW ADULT 250.00 lil'l
ASSIONBD-ATTORNIlY I'BES f~
1000 8I28l2OO3 GENERAL FUND UNB lIllM TRANSFEIl COUNTYCOURT-AT-LAW ADULT ASSI<JNBD.OnIEI 22.00
UTlGAlTON I!XPBNSES l
1000 8/28/2003 GENERAL FUND IlNB ITEM TRANSFEIl COUNTY COURT-AT-LA W LilOAL SBIlVJCES.COURT 272.00
APPOINT1!D
.~ 1000 8/28/2003 GENERAL FUND . L1NB ITEM TRANSFER DlSlRICf COURT ADULT 5,921.00
(X) ASSIONED-ATTORNIlY I'BES
eX) 1000 8/2812003 WFUND L1NB ITEM TRANSFEIl DISTRICT COURT e ADULT' 1,402.00 e
ASSIONBD-1lMlST1GAlTON
llXPENSIi
Ddli:II27JOS05:4CkIe:rM
.' '. . CALIlOUN COtlNTY, TEXAS
. Unpostod Budpt_-IlllPIlND.ADIUS1ldI!NTS FOR 8/21103
~) BIJD303 - BUOOBT ADJUSTMI!NTS FOR 8/21103
"'?
Plmd -.
Codo Dato Plmd TId. Thmsecd... DesctIptlon DeptTltle OLTIIIe "'- ~
1000 8/28/2003 0IlNIlRAL FUND REQUJRBD BY PAYROlL ROADAND WORXMllNS !l4O.00
B~#4 COMPI!NSA11ON
1000 8I28l2OO3 OIlNIlRALFUND REQUJRBDBYPAYROlL ROADAND I'BDIlRAlISTA11I 15.00
BRIIXlB-PRIlCINCT #4 UNEMPLOYMENT
1000 8I28l2OO3 0IlNIlRAL FUND POII33008 FOR GRAPPLB ROAD AND ROAD A BRIDGB SUPPLIES 6,468.00
...~y BRIIXlB-PRIlCINCT #4
1000 8/2812003 OIlNIlRALFUND LINB rrEM 1llANSFBIl ROAD AND ROAD 4 BRDXIB SUPPLIBB 7,810.00
JiRmc:m.I'tulcJ #4
1000 8I28l2OO3 0IlNIlRAL FUND LINB rrEM 1llANSFBIl ROAD AND GARIIAGB COlLPOC PARKS 1,000.00
B~14
1000 8I28l2OO3 OIlNIlRALFUND POII33008 FORGRAPPLB ROAD AND MACHlNBRY AND . 6,468.00
ASSIlMIlLY BRIIXlB-PRIlCINCT #4 EQUIPMI!NT
tooo 8I28l2OO3 OIlNIlRALFUND IU!QUIRIlD BY PAYROlL BMI!RlJBIICY PBDI!RAlJSTA11I ....00
MANAOIlMBNT UNEMPLOYMENT
1000 8I28l2OO3 OIlNIlRALFUND REQUJRBD BY PAYROlL _1JIlNCY GIlNIlIl4LOFPICB SUPPLIES ....00
MANAOIlMBNT
1000 8I28l2OO3 OIlNIlRALFUND LINB rrEM 1llANSFBIl FIRB SBRVICllS 111.00
PROl1lCI1ON-SIlIllFT
1000 8I28l2OO3 OIlNIlRALFUND LlNBrrEM 1llANSFBIl HKlIIWAY PATROL COMPITI1lR MA1N11INANCB 50.00
1000 8I28l2OO3 OIlNIlRALFUND LINB rrEM 1llANSFBIl HKlIIWAY PATROL POST.AOB 50.00
1000 8I28l2OO3 <l1!NIlIIALFUND IU!QUIRIlD BY PAYROLL SIIIlIUPP 0VBil1lYB 11,1195.00
1000 8/2812003 OIlNIlRALFUND REQUJRBDBYPAYROlL SIIIlIUPP ADDnIOIIAL 129.00
PA Y-RIlGULAR RA11I
1000 8/2812003 <l1!NIlIIALFUND LINB l1EM 1llANSFBIl SHIlRIFF OASOllNBIOIlIPIESEllGR.. '64.00
1000 8I28l2OO3 OIlNIlRALFUND LINB rrEM 1llANSFBIl SIIIlIUPP COPIBRRBN1'ALS U8.OO
1000 8I28l2OO3 OIlNIlRALFUND LINB rrEM 1llANSFBIl SIIIlIUPP MISCl!U.ANEOUS 130.00
1000 8/2812003 OIlNIlRALFUND LINB l1EM 1llANSFBIl SHIlRIFF TBLBPHONIlSBRVICBS 49.5.00
Total 0IlNIlRAL FUND 54,05$.00 $4,05$.00
1000
2610 8/2812003 AIRPORT FUND LINB l1EM TRANSFER NO DEPARTMENT MACHlNBRY 52.00
PARTSISUPPI.ItlS
2610 8/28/2003 AIRPORT FUND LINB rrEM 1llANSFBIl NODEP~TMENT 0111BR SUPPLIES 52.00
Tolal AIRPORT FUND APPROVED 52.00 52.00
2610
~ Report T01l1 AUG 28 2003
<..t:) 54,107.00 54,107.00
~ e =e=
DIIIrlIlnJ0:5~II'"
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BUDGET AMENDMENT REQUEST
1000-18G-51610
1000-180-53020
1000-160-64910
1000-11lO-6486O
a
OVERTIME
GENERAL OFFICE SUPPUES
PRISONER MEDICAL SERVICES
PRISONER LODGING OUT OF COUNTY
DEPARTMENT TAL
1000-760-51610
1000-78G-51620
1000-760-53540
1000-760-51310
1000-760-63920
1000-760-66192
q()
~. ~.,
556 REQUIRED BY PAYROll
197 UNE ITEM TRANsFER
3,295
16,229)
(12,181)
11,095 REQUIRED BY PAYROll
129 REQUIRED BY PAYROll
84 UNE ITEM TRANSFER
286
130
495
12,181
o
APPROVED
AUG 2 8 3lO3
991
BUDGET AMENDMENT REQUEST
~
ACCOUNT NAME
DEPARTMENT NAME
UBRARY
1000-140-66618 UTIL1T1ES-POINT COMFORT LIBRARY
1000-140-66610 UTIUT1ES-MAlN LIBRARY
COUNTYTAX COllECTOR
l000-2()().l;17DO MEAL AllOWANCE
1000-200-53020 GENERAL OFFICE SUPPUES
COMMISSIONERS COURT
lllDO-Zl0.83920 MISCEllANEOUS
1000-2311-83350 LEGAL SERVICES
COUNTY ctERK
1000-250-51810 OVERTIME
1000-250-51540 TEMPORARY
AMBULANCE OPERATlON5-SEADRIFT
lD00-340-65740 SERVICES
FIRE PR07CCTlON-SEADRIFT
SERVICES
EMERGENCY MEDICAL SERVICES
GENERAL OFFICE SuPPLIES
SUPPLIESIOPERATlNG EXPENSE
COUNTY COURT-AT-LAW
ADULT ASSIGNED-ATTORNEY FEES
ADULT ASSIGNED-OTHER LITIGATION EXPENS
LEGAL SERVlCES-COURT APPOINTED
DISTRlGT COURT
ADULT ASSIGNED-ATTORNEY FEES
ADULT ASSIGNED-lNVESTlGATION EXPENSE
ADULT ASSIGNEO-EXPERT WITNESS EXPENSE
LEGAL SERVICES-COURT APPOINTED
EMERGENCY MANAGEMENT
llJOO.630-51950 FEDERALlSTATE UNEMFLOYMENT
llJOO.63 GENERAL OFFICE SUPPLIES
53cQ9 ROAD & BRiDGE PCT#2
1~, MISCEUANEOUS
lllOll-55O-53S10 ROAD & BRiDGE SUPPLIES
ROAD & BRIDGE PCT#3
l00lJ.660..661S2 TELEPHONE SERVICES
llJOO.$O.&S10 ROAD & BRIDGE SUPPLIES
Total for GENERAL RIND
1,000 LINE ITEMTRANSFER
(1,000)
31 REQUIREOBYPAYROU.
(31)
430 LINE ITEM TRANSFER
(430)
97 REQUIRED BY PAYROU.
(97)
171 LINE ITEM TRANSFER
'~40
lDOO-'!45-53020
10Q0.345..53980
(171) LINE ITEM TRANSFER
500 LINE ITEM TRANSFER
(500)
1000-410-60050
l000-410.000s3
1000-410-63380
250 LINE ITEM TRANSFER
22
(272)
1000-430-60050
l000-430-600S1
10lJ0.430.60052
llJOO.43O.6338O
S,S21 LINE ITEM TRANSFER
1,402
1,5560(8,879)
48 LINE ITEM TRANSFER
(48)
1,000 LINE ITEM TRANSFER
(l,ooo)
1,000 LINE ITEM TRANSFER
(1,000)
o
APPROVED
AUG 2 8 2003
e
op
992
3
~BODGE~ AMENDMENT REQUBST~
To:
Calhoun County Com~issioners' Court
From:
precinct 3
(O~f~tment making this request)
Date:
Auqust 18,. '2003
I request an amendment to the ?nn~
. (year)
4IIfollowing line items in my department:
AIIIendment
~~-~===~~!_~- ---~===~~!_~~!_-- ---~=~!_---
budget for the
~'~n-lififin7/
-~~n_j;~,qn
Reason
-------------------
Tlt.i1 it.i"R-Rmprg_
Communication Net.
I.9gal Nstisgs
o;nn nn
(500.001
- ~
Net change in total ~udget
tor this department is:
Other remarks/justification:
e
AUG 2 8 2003
$
=--==-.De::----=
I understand that my budget cannot be amended as requested until
Commissioners' Court approval is obtaine~'11 \~ . _
Signature of otficial/department head: ~ ~
Date of Commissioners' Court approval:
Date posted to General Ledger account(s):
e
r f.'~
9g3
if
~BUJ)Gft ltIIB1WDN'1'UQUB8T~
To: Calhoun County Commissioners' Court
Prom: ('^~J.MurN^;,) (I ~
(Department making this request)
r "d..d--03
e
Date:
I request
following line
an amendment to the ~I!lO~,
(year)
items in my department:
budget for the
GL AccOunt #
-------------
Jl.mendment
Account Rame AmouiI.t Reason
~=~-c:~~ ~'SC-~~
G,
~ ~(.,.6l.5O
c2.~()- (It":l., ')'\0
(
IIUIIII...II==aaa_a
Ret change in total budget
for this department is I
Other remarks/justification:
$' -0"--
I understand that my budget cannot be amended as requested until
Commissioners' Court approval is obtained.
Signature of official/department head.
Date of Commissioners' Court approval:
Date posted to General Ledger account(s):
e
, ~,{)
994
IIBUDGB'1' .~ UUUBST~
5
To: Calhoun County Commissioners' Court
From: j)" "
(Department ing this request)
Date:
'i? -- d5 -0.",\
e
I request
following line
an amendment to the ~o3
(year)
items in my department:
budget for the
GL Account #
-------------
Account Name
------------------
Amezldment
Amount
-------------
Reason
I 50u
J
-------------------
p () #-2.'& l/11
~;~~-
(lp'(ID ~.A)~
tf~o - (.,:\WO
31 QO -(,(j~l/O
<1/:\ O\:J).
,
...
Net Ch"Jlg~ in total budget
for this department is.
e Other remarks/justification:
$
-'0-
a..........aa
I understand that my budget cannot be amended as requested until
Commissioners' Court approval is obtained.
Signature of official/department head:
Date of COmmissioners' Court approval:
Date posted to General Ledger account(s):
e
;W!'
995
88126/2Il113 17: 14 361--983--4493 Il
e-26-~3 11 "7"" FRD~ OIU'LU" w. .....-.,_.tllir.ME. MARIt-E
'.I;P
,t "
PAGE 82
MJDQUAMl!~..aUHT
_1lCUI'lm'
1lC)URNSAllON
~
<<1/1Y ~ l.IASIi
~r~
APPROVED
AUG 2 8 ID03
Lo
e
e
e
996
BUDGET AMENDMENT REQUEST
7
.
APPROVED
AUG 2 8 2003
e
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,/"p
997
. .'p
]
BUDGET AMENDMENT REQUEST
1Q()()..570-61540
10Q0.S70-61910
1000-570-61930
11JOO.570-6194O
llJOO..57O..51950
1Q()()..57~
llJOO..57O..63510
NET CHAN E IN TOTAL BUDGET
AMENDMENT
AMOUNT
5,000 REQUIRED BY PAYROLL
383
472
940
15
1,000 UNE ITEM TRANSFER
APPROVED
AUG 2 8 2003
e
e
998
e
IIBlJDGBT 2lM'lnmMlPlft RBQUBSTII
To: Calhoun counT{ Commissioners' Court
From: .] [\ V ~k- 1'\-- <f
v
(Department making this request)
Date:
Z'", ~-D3
I request an amendment to the ~O ~
year)
following line items in my department:
q
budget for the
GL Account #
-------------
2lm"n=ent
---~~~~~_!~--- ---~~----
51o-12l4co
'51o~~Sl9
~~~.
~<lts.~
11!\lf/(.)? )
Ret change in total buc1get
for this department is.
e Other remarkS/justification:
e
$ --:-18
a............
lleaSOD
1 AUG ,,~ j
I understand that my budget cannot be amended as requested until
Commissioners' Court approval is obtained. .
Signature of official/department head:
Date of COmmissioners' Court approval:
Date posted to General Ledger account(s):
\;~nt
999
88/19/2803 18:16
3615262243
IlPS REFUGIO
PAGE ell
HIT MilD! p-m
D8-II-03 10:30111 Pr.
il 0
IDVDlIn ~ .llIQtlBS'l'~
nam :
Calhoun ecun~y commissioners' eourt
~UI() CA_ J.tW~ PA;~L
(DePl:lrtment lI\akinq th IS request)
alJ.9lp":ti
e
To :
Date I
en:. Maount ,
...............----
to the Zoo.3
(yearl
my department.:
:AllI81I4ment
AC:C01D1t 1Came AlIloun t.
--_.--------~----~ ._-------~--~
l2\l.eS9st :or .the
I req\1est an smendmen1i
,I "I""
followinq line items in
Reason
-~-----~-----------
1tJ>... "0410
771>-- (Ptf7t!D
~~~.~
~.<.""..,
.",. '. .... .
. '.
- $51)
+$SD
'I"! pd, 1I\l.fl~
~~
~"..", ,~.
.'j
,,.
Net ohange :1.1\ total l:IU!lqot. .
for this 4epartmentibll:. " .
., 'I
Other ~Bmark&l,ustittoation;
t,U..,. di"..
e .- 0-
==..---...-==
:',~':'W",~
I understand tha~ my bUdget cannot be 1:11I\8n
Commissioners' court approval is o~talneeS.
S1qnature of orricial/depa~en~ heaeS;
o.ate or comm1ssionen..r, Court app;rOV81:
requested until
Da~e pos~ed to Gen_ral ~qer account(s):
" ,
e
npp
1000
e
e
e
BUQGET AMENDMENT REQUEST
t (
APPROVED
AUG 2 8 2003
~" ~<
, :;
100l
"
.. (lOr
.
ACCOUNTS ALLOWED - COUNTY
Oalms totaling $1,134,611.89 were presented by the County Treasurer and after reading and ..
verifying same, a Motion was made by Commissioner Floyd and seconded by Judge pfeifer that .
said dalms be approved for payment Commissioners' Galvan, Balajka, Floyd, Finster and Judge
pfeifer all voted In favor. '
GENERAL DISCUSSION - CHANGE OF DATE OF SPECIAL MEETING
Judge pfeifer reminded everyone that the special meeting scheduled for Tuesday, September 16,
2003 has been rescheduled for Thursday, September 18, 2003.
GENERAL DISCUSSION - EMPLOYEE HEALTH INSURANCE BENEFITS AND DEPENDENT
COVERAGE
In reference to the insurance plan Lucy Dio stated she was opposed to the change In family
coverage for new employees, she feels like no one is going to want to come to work here without
this benefit. She doesn't have a problem wnh the new premiums for current employees. Carrie
Sanchez also stated she was opposed to the change In family coverage for new employees, she
said she would not be able to work here if she had to pay the full premium for family coverage.
GENERAL DISCUC:CYON - MAGNOI T4 BEACH ROADS
Commissioner Galvan stated that the roads at Magnolia Beach would cost about half a million
dollars, FEMA will pay 75% and Commissioner Galvan will apply for a grant where the county will
not have to pay anything.
GENERAL DISCUSSION - MEMORIAL MEDICAL PLAZA
Commissioner Galvan stated that he would be meeting with Ty Zeller to get contracts set up for ..
next week on Memorial Medical Plaza. .
The Court was adjourned at approximately 12:10 pm
e
1 O~ 1.