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2021-11-3 CC Meeting MinutesAll Agenda Items Properly Numbered Contracts Completed and Signed 1_1295's Flagged for Acceptance (number of 1295's ) All Documents for Clerk Signature Flagged On t�h�is1 5�day of "/ L�t'i, � 2021 a complete and accurate packet for 3 uk of Y Lf U�(iy�,I,.P,t 2021 Commissioners Court Regular Session Day Month was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoun CountyJudge/Assistant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOTICE OF MEETING— 11/3/2021 Richair ll H. Meyer County judge David Ball, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Kaddie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, November 3, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting called to order at 9:59 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag -Commissioner Gary Reese Texas Flag -Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Consider and take necessary action to approve the Final Plat of the GRAHAM SUBDIVISION (a replat of Lots 3 and 4 in Block of the Tilke and Crocker First Addition to Alamo Beach). (DH) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 1 of 5 I NOTICE OF MEETING— 11/3/2021 6. Consider and take necessary action to approve the Preliminary Plat for the DESILOS RV PARK. (VL) Victor Fredricksen with VEF Engineering presented Preliminary Plat. Commissioner Vern Lyssy suggested a number of things to be added in order for final plat to be approved. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Consider and take necessary action to approve the Final Plat of the BURIES SUBDIVISION (a replat of lots 258, 259, 260, and 261 of Sunilandings, Phase 1). (JB) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese S. Public Hearing regarding a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of -Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). Regular meeting closed at 10:10a.m. Anne Marie Odefey spoke on behalf of the family that would like to seek abandonment on road. Regular meeting opened back at 10:11a.m. Consider and take necessary action to approve a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of - Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 2 of 5 NOTICE OF MEETING— 11/3/2021 10. Consider and take necessary action to accept a Release and Settlement Agreement in the amount of $3,832.55 for the loss of appliances at Port O'Connor Community Center on May 18, 2021 due to faulty work by Victoria Electric Cooperative, Inc. and authorize Commissioner Reese and two witnesses to sign the documentation. (GR) Commissioner Gary Reese explained the damages. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 11. Consider and take necessary action to approve the Final Plat of the PERSHALL SUBDIVISION (a replat of Lot 2 of the Hull and Zimmermann Subdivision). (GR) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 12. Consider and take necessary action to approve the Final Plat of the REDDING SUBDIVISION (a replat of part of Outlots 1 & 4 in Outblock 15 of the Port O'Connor Townsite). (GR) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 13. Consider and take necessary action to accept insurance proceeds from TAC in the amount of $10,900 ($13,400 - $2,500 deductible for damages from the power outages on August 7, 2021. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 14. Consider and take necessary action to authorize the EMS Director to sign a Mutual Aid Agreement with Allegiance Mobile Health (Matagorda County). (RM) Dustin Jenkins explained how the agreement would benefit both counties. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 3 of 5 NOTICE OF MEETING— 11/3/2021 15. Public Hearing regarding granting AEP an Easement and Right of Way for a new underground service to the new shop at the EMS Center on Henry Barber Way. Closed regular meeting at 10:20 Dustin Jenkins EMS Director explained the need for the service. Regular meeting opened at 10:22 16. Consider and take necessary action to authorize Judge Meyer to sign the Easement and Right of Way granting AEP an easement for a new underground service to the new shop at the EMS Center on Henry Barber Way. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 17. Consider and take necessary action to authorize the EMS Director to sign a Contribution - in -Aid -of -Construction Agreement for the underground service to the new shop at the EMS Center on Henry Barber Way. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 18. Consider and take necessary action to approve the attached Calhoun County Election Precincts that have been altered to achieve greater efficiency and not impacting the political boundaries. (RM) Mary Orta with Elections explained that combining precincts would only accommodate voters. This combining will not show an impact on Commissioners. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 19. Consider and take necessary action to allow Calhoun County Elections to consolidate fourteen (14) polling locations to eleven (11) locations to coincide with Election Precinct merges. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 4 of 5 NOTICE OF MEETING— 11/3/2021 20. Accept report from the following County Office: i. County Treasurer — August 2021, revised Rhonda Kokena verbally stated that there was a typo and the report was in fact not a revised copy. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 21. Consider and take necessary action on any necessary budget adjustments. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese 22. Approval of bills and payroll. (RM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Adjourned: 10:37 a.m. Page 5 of 5 j NOT ICE OF MEETIN(-, — 1]/312021 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Crary Reese, Commissioner, Precinct 4 NOTICE OF M]E]E7Cl[NG The Commissioners' Court of Calhoun County, "Texas will meet on Wednesday, November 3, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: aT_1 b'CLOCK M Call meeting to order. OCT 2 9 2021 Invocation. COU Sanwa.000DUnm rY LEAKff OU UNA S ay. 3 Pledges of Allegiance. I 4General Discussion of Public Matters and Public Participation. `�./Consider and take necessary action to approve the Final Plat of the GRAHAM SUBDIVISION (a replat of Lots 3 and 4 in Block of the Tilke and Crocker First Addition to /Alamo Beach). (DH) Consider and take necessary action to approve the Preliminary Plat for the DESILOS RV / PARK. (VL) S. Consider and take necessary action to approve the Final Plat of the BURES Gfo$�SUBDIVISION (a replat of lots 258, 259, 260, and 261 of Sunilandings, Phase 1). (JB) (9 Public Hearing regarding a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of -Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the GlOS application. (Ragusin, et al, applicants). A. 9. Consider and take necessary action to approve a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of - Page 1 of 3 NOTICE OF iVILLI- ING— J 1/3/2021 Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as Amore fully described in the application. (Ragusin, et al, applicants). (GR) 'io. Consider and take necessary action to accept a Release and Settlement Agreement in the amount of $3,832.55 for the loss of appliances at Port O'Connor Community Center on May 18, 2021 due to faulty work by Victoria Electric Cooperative, Inc. and authorize Commissioner Reese and two witnesses to sign the documentation. (GR) 11 Consider and take necessary action to approve the Final Plat of the PERSHALL SUBDIVISION (a replat of Lot 2 of the Hull and Zimmermann Subdivision). (GR) 12. Consider and take necessary action to approve the Final Plat of the REDDING SUBDIVISION (a replat of part of Outlots 1 & 4 in Outblock 15 of the Port O'Connor � Townsite). (GR) T3. Consider and take necessary action to accept insurance proceeds from TAC in the amount of $10,900 ($13,400 - $2,500 deductible for damages from the power outages on August 7, 2021. (RM) ' 4 Consider and take necessary action to authorize the EMS Director to sign a Mutual Aid c'o�greement with Allegiance Mobile Health (Matagorda County). (RM) 04? Public Hearin regarding g g g granting AEP an Easement and Right of Way for a new underground service to the new shop at the EMS Center on Henry Barber Way. Glos�e, V Consider and take necessary action to authorize Judge Meyer to sign the Easement and Right of Way granting AEP an easement for a new underground service to the new shop at the EMS Center on Henry Barber Way. (RM) iZ7. Consider and take necessary action to authorize the EMS Director to sign a Contribution - in -Aid -of -Construction Agreement for the underground service to the new shop at the EMS Center on Henry Barber Way. (RM) r8. Consider and take necessary action to approve the attached Calhoun County Election Precincts that have been altered to achieve greater efficiency and not impacting the ,political boundaries. (RM) 19. Consider and take necessary action to allow Calhoun County Elections to consolidate fourteen (14) polling locations to eleven (11) locations to coincide with Election Precinct merges. (RM) Accept report from the following County Office: i. County Treasurer — August 2021, fevised- 21. Consider and take necessary action on any necessary budget adjustments. (RM) Page 2 of 3 NOTICE OFF MEETING -- 11/3/20,21 422. Approval of bills and payroll. (RM) � r Richard Meyer, County J d e Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse,.211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours precedingthe scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.ore under "Commissioners' Court Agenda" for any official court postings. Page 3 of 3 ('ALI IOUN MUNT%TI%AS k '� NEW RESIMN t GLNIML INI OItANIIDN I Lta i I", IM orb Ty N, C 04 ME,Il 1 }I 11/ kklM ...... fil }-9I Y" u S I 1k 1 N 1ll lirt b IlUy 111 blS.. ............ .... Alllnlll 1 t r Ha J61 i c]0 MI ((5 i t p Y A of M1lld I( ..... (15161Y MIJI 1 UIIIII en al , tl tifanhP. .__.. t p 1 a.;m OIL" wl avll I arl znn: au r yt4 ry L( .. r r ro t ryy ISIXI z z 1 II. U M rl J 1 s L I I4 n T r y l P r la w } uco m of n ...... GIM1 C tS 51 If 151 kfy CII Co IYE rq Y Y ry '} i 1 "I �` PT t I i rt s x, .Af4�'A's i t YE r4 P i t S 9 9 ym�y a•, ,,)r a� tyfi �`� f t''n �Y�fl I ska) iu'�� rod` �RO .J 4 Part WVH4A rR, ilt 5 �i�,.. �1 8 4 8iY ��"'k §aq} Sd TM7,� ➢ � /tk4 1 y t("1� }20 4A e:"' d .✓ � � ')w 4 s 'a`F 2 ,"� ad T"� �r �'r �"Ixa£'. 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(DH) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 2 of 19 Mae Belle Cassel From: david.hall@calhouncotx.org (David Hall) <david.hall@calhouncotx.org> Sent: Thursday, October 28, 2021 9:35 AM To: MaeBelle.Cassel@calhouncotx.org Subject: FW: Graham Subdivision Attachments: 10149-001 FINAL PLAT.pdf From: hdanysh@gwengineers.com (Henry Danysh) [mailto:hdanysh@gwengineers.com] Sent: Thursday, October 28, 2021 9:29 AM To:'David Hall' <David.Hall@calhouncotx.org> Cc: gking@gwengineers.com Subject: Graham Subdivision CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recoenize the sender and know the content is safe. Commissioner Hall, Please place the following item on the agenda for November 3, 2021: 1) Consider and take necessary action to Approve the Final Plat of the GRAHAM SUBDIVISION (a replat of Lots 3 and 4 in Block 3 of the Tilke and Crocker First Addition to Alamo Beach) Thank you HENRY A. DANYSH Registered Professional Land Surveyor State of Texas No. 5088 G & W ENGINEERS, INC 205 W. Liveoak Street Port Lavaca, Texas 77979 Office: 361-552-4509 Cell: 361-920-4524 Calhoun County Texas 9 / p /S�aaOW/' e� oy ,i33ais/ / 3y0 LO.L1N 14� —// 9 / [rA is b r zo n z P _ z g� p Cy y � � M.SS.64925 `e $ a � t�•1 z 'p"J ay a y N O C^ O Y � 1 M;LO.WItS °¢ 3 x s x as '[[� f- zm ®i `� A4or 1L r0 z p �, < n w W cE x m z r iV w a W iU O y p p gg 9i.ic" e` a s 3 cRR` g o�;d C' tz R�€�WF R• e $ F£1R R 9"5 R w C7 d mdo 1Cr yg ss we9 �� Y C p O op�z I� a� Q z2 ps pgi £3 v egg@gg i o0{qu s= n s"pC'S K �P39F� 8� 2®gPH� a�"� •i l+ O to G q A 9 Li n � Ila It {a W. HE lipflmP.3 yLP CAq R� 5F 99 aa8 y O s 4 $59 LT f'1Z 4 S a ba 4y ap€ A a � G & W ENGINEERS, INC. �R a: e o m > m * • ENGINEERING • SURVEYING • PLANNING • 11 > n ~ O O O p 205 W. LIVE OAK STREET, PORT LAVACA, TEXAS 77979 T0PL5 FIRM N0: 10022100 FINAL PLAT (391) 552-4509: PORT LAVACA (979) 323-9100: BAY CM 'Y #6 NOTICE OF MEETING — 11/3/2021 6. Consider and take necessary action to approve the Preliminary Plat for the DESILOS RV PARK. (VL) Victor Fredricksen with VEF Engineering presented Preliminary Plat. Commissioner Vern Lyssy suggested a number of things to be added in order for final plat to be approved. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 3 of 19 Vern L Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 October 14, 2021 Honorable Richard Meyer. Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda Consider and take necessary action to approve the Preliminary Plat for Desilos RV Park. Vern Lyssy I FM 1090 N42°4902"E 184_45' D r?-- -r--- — ----- 0 X ,. I ONZ I1 Tz� I I nor I I IA D x Z ip� I O m II 1 Im yZO � 2 1 1 mm 0 m Kma -0 8 a z 2t) O 1 3- im Di 2 I 9 <m ]mJ I m I. a N Z III F0 N , I 1 m x0 I N N y III m I 1 III ps= m c0i mCy OS O m mm O I I m yip i 1 0 1 N mFr O N I I m I I C T I =< m m I I p m� m i 1 my i mN z y I © O AZ m m a 1 1 1 > 1I ® O I m 0 1 1 2 I m Q I IN ® a cz Ise18 m 0 wo>O o I I m Q III m nw'Sy A m �r 1 I 2 II y - HT 0A m © I m g n9 _ o�A I 1 11 I a y 342°5]'00"E 255.38' I; w O{ 3 m S z f s00 I�� a�;.3aR i Da �tiP� Me 'a« NOTICE OF MEETING — 11/3/2021 7. Consider and take necessary action to approve the Final Plat of the BURIES SUBDIVISION (a replat of lots 258, 259, 260, and 261 of Sunilandings, Phase 1). (JB) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 4 of 19 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 —Office (361) 893.5346 —Fax (361) 893-5309 Email: icel behrensno.calhouncotx.or2 9 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for November 3, 2021. • Please Consider and Take Necessary Action to approve the final plat of the Bures Subdivision (a replat of lots 2.58,259,260 and 261 of Sunilandings, Phase 1). Sincerely, Joel Behrens Commissioner Pct. 3 g Rip §a R€ R. a _��• � �m .il@l• ilip, P as �jqr z$ ♦ N i a z •'b p z o anem.a H g[ k� Z r44 r 10 a d at 55 1 ti I -----3AI80---NP8Vw---3LIHM---� -- €€ gg Aga No p 9G `••. a NNE �• `c'• � � 6 <� $ G & W fYOENGINEERS, INC. s I,.u.. *• p ' .. o R � � • ENGINEERING • SURVEYING • PLANNING • q N � > � Q i s g o vp ms w uve out sm°rr. raxr uwcA mus nw° a o mB ? ' FINAL PLAT Ml) M"W8: Pp IAVAGA0. (wg) 3 -TM. °AY MY x "� Mo NOTICE OF MEETING — 11/3/2021 8. Public Hearing regarding a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of -Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). Regular meeting closed at 10:10a.m. Anne Marie Odefey spoke on behalf of the family that would like to seek abandonment on road. Regular meeting opened back at 30:11a.m. Page 5 of 19 PUBLIC HEARING - 17./3/?.0)7. Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 (nary Reese, Commissioner, Precinct 4 all 081.I(i I11pre\I105411ffiell The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, November 3, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse, 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. NOTICE IS HEREBY GIVEN that Calhoun County Commissioners' Court will hold a Public Hearing in the Commissioners' Courtroom, 211 S. Ann Street, Suite 104, in Port Lavaca, Texas, at 10:00 a.m. regarding a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of - Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). Richard Meyer, County Judge Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda" for any official court postings. Page 1 of 1 WJ I NOTICE OF MEETING— 11/3/2021 9. Consider and take necessary action to approve a Petition to Vacate and Abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre -tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of - Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 6 of 19 Gary D. Reese County Commissioner County of Calhoun Precinct 4 October 25, 2021 Honorable Richard Meyer Calhoun County judge 211 S. Ann Port Lavaca, TX 77979 I zowaej DIP . Y V Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 3, 2021. Consider and take necessary action to vacate and abandon a portion of public road in Calhoun County, Texas, namely, a 0.413 acre tract of land situated in Calhoun County, Texas being a portion of Polk Avenue (a 60-foot Right -of - Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, as more fully described in the application. (Ragusin, et al, applicants). Sincerely, 1� Gaxy D. Reese GDR/at P.O. Box 177 -Seadrift. Texas 77993 -email: earv.reese r calhouncmx.ore - (361) 785-3141 - Fax (361) 785.5602 MN = N I VACATE AND ABANDON A PORTION OF PUBLIC ROAD m IN PORT O'CONNOR, CALHOUN COUNTY, TEXAS P A ofon was made by Commissioner and seconded by Commissioner o to Vacate and Abandon a portion of a public road in Port O'Connor, Calhoun County, Texas as shown on the following Order with exhibits attached. Commissioners. 444%. , N voted in favor of the motion. Q ORDER DECLARING CLOSURE OF A PORTION OF PUBLIC ROAD IN PORT O'CONNOR, CALHOUN COUNTY, TEXAS WHEREAS, on the P day of November, 2021, the Commissioner's Court of Calhoun County, Texas considered the request of William Anthony Ragusin, Jr. and wife, Dawn Michelle Ragusin; William A. Ragusin and wife, Margaret Ragusin; Jose F. Holland; and Bernal Business Solutions, Inc., Texas, being property owners in Precinct 4 of Calhoun County, Texas, to abandon and vacate the following portion of a public road in Port O'Connor, Calhoun County, Texas more fully hereinafter described and as shown on Exhibit "A" which is attached to this order and incorporated by reference. WHEREAS, Texas Transportation Code §251.051 vest in the Commissioner's Court the authority to abandon and vacate a portion of the road; and WHEREAS, the Commissioners have not previously classified the subject road as either a first class or second class road; and WHEREAS, the Commissioner's actions to abandon or vacate the road have not been enjoined or sought to be enjoined by any party; and WHEREAS, proper notice of the petition to abandon and vacate the road has been posted at the Courthouse door of Calhoun County, Texas and at other places in the vicinity of the affected route, being at the mail box station in Port O'Connor, Texas and on the property at the 1 portion of the road to be abandoned and vacated, for at least twenty (20) days before the date the application was made to the Court; and WHEREAS, the Commissioners have voted unanimously to abandon and vacate the portion of the road described on the attached Exhibit "A"; and WHEREAS, all requirements of Texas Transportation Code §251.051 and §251.052 have been complied with in declaring said road to be abandoned and vacated. .NO, W, THEREFORE, ON MOTION DULY MADE BY Commissioner Raw and SECONDED by Commissioner UUIX,411 , and upon said Motion having been approved by the Commissioner's Court in a properly posted public meeting; IT IS ORDERED AND DECREED, that Calhoun County does hereby CLOSE, ABANDON and VACATE that portion of road described on the attached Exhibit "A". IT IS FURTHER ORDERED AND DECREED that on the date this Order is signed, title to the portion of road closed by this Order is vested in William Anthony Ragusin, Jr. and wife, Dawn Michelle Ragusin; William A. Ragusin and wife, Margaret Ragusin; Jose F. Holland; and Bernal Business Solutions, Inc., the owners of the property that abuts the portion of the closed road, pursuant to Texas Transportation Code §251.058(b). IT IS FURTHER ORDERED AND DECREED that a copy of this Order is to be filed in the Official Records of Calhoun County, Texas and a duly filed copy of the Order shall serve as the official instrument of conveyance of the closed portion of the road, Port O'Connor, Calhoun County, Texas from CALHOUN COUNTY to the respective owners of the abutting property as set forth hereinabove, pursuant to Texas Transportation Code §251.058(b). SIGNED this 3`d day of November, 2021. 2 CALHO TY, TEXAS HO ORABLE RICHARD R, CALHOUN COUNTY JUDGE ATTESTED TO BY: ANNA GOODMAN CALHOUN COUNTY CLERK 0.413 ACRES THE STATE OF TEXAS) THE COUNTY OF CALHOUN) BEING a 0.413 acre tract of land situated In Calhoun County, Texas being a portion of Polk Avenue (a 60400t flight - of -Way) as shown on Day Subdivision No. 2 according to the established map or plat thereof recorded in Volume Z, Page 419 of the Plat Records, Calhoun County, Texas, old DAIS acre tract of land being more fully described by metes and bounds as follows: BEGINNING at a found 5/9" steel rebar along the southeast rlght-of--way ilne of said Polk Avenue marking the west corner of Lot 7, Block 236 of the aforesaid Day Subdivision No.2 for the south corner of the herein described tract; THENCE, North 2W35'12" West, over, Into, and across said Polk Avenue, a distance of 60.00 (60.00) feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." along the northwest right-of-way, line of Bald Polk Avenue marking the south corner of Lot 6, Block 237 of the aforesaid Day Subdivision No. 2 for the west corner of the herein described tract; THENCE, North 63'22'00" East (North 63'22'00" East), along the northwest rlght-of-way line of said Polk Avenue with the southeast line of Lots 1.6, Block 237 of the aforesaid Day Subdivision No. 2, a distance of 30D.00 (300.00) feet to a found 5/8" steel rebar along the northwest rlght-of-way line of old Polk Avenue marking the east corner of said Lot 1. Block 237 of the aforesaid Day SubdMh1on No. 2 for the north corner of the herein described tract; THENCE, South 26'35'12" East, over, Into, and across said Polk Avenue, a distance of 60.01) (60.00) feet to a found 5/8" steel rafter along the southeast right-of-way line of said Polk Avenue marking the north corner of Lot 12, Block 236 of the aforesaid Day Subdivision No. 2 for the east comer of the herein described tract; THENCE, South 63°22'00" West (Basis of Bearing), along the southeast right-of-way line of said Polk Avenue with the northwest line of Lots 7.12, Block 236 of the aforesaid Day Subdivision No. 2, a distance of 300.00 (30D.0D) feet to the POINT OF BEGINNING, CONTAINING within these metes and bounds a 0.413 acre tract of land, more or less. Basis of Bearings are based on Plat recorded In Volume 2, Page 419 of the Plat Records of Calhoun County, Texas, The foregoing legal description and accompanying survey plat were prepared from an actual survey made on the ground under my supervision In August, 2021 and are true and correct to the best of my knowledge and belief. 09/1112021 Urban Surveying, Inc. By: Michael K. Williams Registered Professional Land Surveyor Texas No. 6616 524624.00 EXHIBIT A 8$,g o.-� -066M, gg 5p o ¢5 hT°c i inCr ��L1 mT CUmD mQ� ZNO C o ">$ z ' ?m C(1'Nz 00 111 fj SC JC m2 Iin T N Im�� mN m m8 A il"°��y9V 5�pi�� - �+/,{M 00 O�M�zN So pg%�g 0zz o N N m o v Ci m FN�q sl O O� 5 0 YOR,t m osdf ^r o T Cm1 O a m Y. I F r Yb`tb$, 0 0 � 10 w 02 do sm D o ro $m6b� a�Pyem� $P0� x o rat^ a R :R 8 X rrvR� < v yW g ez s 4 �� ®e # Zo NOTICE OF MEETING— 11/3/2021 10. Consider and take necessary action to accept a Release and Settlement Agreement in the amount of $3,832.55 for the loss of appliances at Port O'Connor Community Center on May 18, 2021 due to faulty work by Victoria Electric Cooperative, Inc. and authorize Commissioner Reese and two witnesses to sign the documentation. (GR) Commissioner Gary Reese explained the damages. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 7 of 19 Gary D. Reese County Commissioner County of Calhoun Precinct 4 October 25, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 3, 2021. • Consider and take necessary action to accept Release and Settlement Agreement in the amount of $3,832.55 for loss of appliances at Port O'Connor Community Center on May 18, 2021 due to faulty work by Victoria Electric Cooperative, Inc. and authorize Commissioner Reese and two witnesses to sign documentation. Sincerely, Gary D.nese GDR/at P.O. Box 177 — Seadrift. Texas 77983 —email: cary.reese r calhouncmcore — (361) 785-3141 —Fax (361) 785-5602 THEJ4THE HARTFORD WESTERN GL OFFICE P.O. BOX 14265 LEXINGTON KY 40512 HARTFORD Port O'Connor Community Center Po Box 177 Seadrift TX 77983 US Re: Insured: VICTORIA ELECTRIC COOPERATIVE INC Claimant: Port O'Connor Community Center Date of Loss: May 18, 2021 Event Number: GL0019145617 Claim Number: Y2M LP 13250 Dear Port O'Connor Community Center: October 25, 2021 In accordance with your agreement to settle your claim, enclosed please find a Release and Settlement Agreement for the amount of $3832.55, representing full and final settlement. Kindly sign the agreement in the presence of two witnesses and a notary public and return the original to me. Once I receive your signed release, I will issue the settlement check to you. Should you have any questions, please contact me at (877) 625 - 2652 Ext. 2303896. Thank You, The Hartford —///6�z A410,125 Megan Moore Claim Representative Direct Number: (480) 629 - 9137 Toll Free Number: (877) 625 - 2652 Ext. 2303896 Fax: (866) 809 - 1955 Megan. Moore@thehartford.com Writing Company Name: Hartford Underwriters Insurance Company MT00074 HIGC-005302-Y2M LP 13250 Page 1 of 1 #11 NOTICE OF MEETING — 11/3/2021 11. Consider and take necessary action to approve the Final Plat of the PERSHALL SUBDIVISION (a replat of Lot 2 of the Hull and Zimmermann Subdivision). (GR) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 8 of 19 i , f �W3� UJ2 y `Yfi � ,Z O N = Cu •' C �` \ fir++ f'` " � 42 �i�in � H JI- rdn°cE \ 9YA, •.'0 R Y.f$9.$, fir^+ yz G I�y ZO •,48y "fi"o, \\ v4 � �q� ��Yy6+Y �O e+ ILI�..I�J�� 'd � 00 �� \ Py fn f Rg �O Ln \ �9�++ >'a RY C'C VITIl a o m m TTTr/��1 z y v? ¢ R u w A e a r5gg daps _ �y O 1--1 CC RAx Qg � P �2 �3 A F $2f a �pf a ®q 9 CUHI W O p. lit W g$3`y!a z. Pt= EE f o f e$d4d X z w n }"� n :q d5.. i R9 �54f ~ RR §Wk CBA dp .`w iX�5 RA �gp�'Sgp�fd�94�0. z94Yi m> S4 flg f. A C 4 s $4d 9f 9 Gn agR4 - I - �P 3� $2 Ai4: w�b6&d rf �N a oN E R Pi .41 12 m:e G& W ENGINEERS, INC. _ 8 i5 • ENGINEERING • SURVEYING • PLANNING • n s z ~ Z m 205 W. LIVE OAK STREET, PORT LAVACA, TEXAS 77979 m O O 9 3 • i9P15 FIRM NO.: 10022100 FINAL PLAT (361) 55R-A509: PORT LAVACA (979) 323-7100: 9AY — K Gary D. Reese County Commissioner County of Calhoun Precinct 4 October 28, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 3, 2021. 1) Consider and take necessary action to Approve the Final Plat of the PERSHALL SUBDIVISION (a replat of Lot 2 of the Hull and Zimmermann Subdivision). Si7rely, Gary Deese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: earv.reese r).calhouncom.ore — (361) 785-3141 — Fax (361) 785-5602 #12 NOTICE OF MEETING — 11/3/2021 12. Consider and take necessary action to approve the Final Plat of the REDDING SUBDIVISION (a replat of part of Outlots 1 & 4 in Outblock 15 of the Port O'Connor Townsite). (GR) Henry Danysh explained the reasoning for the replat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 9 of 19 Gary D. Reese County Commissioner County of Calhoun Precinct 4 October 28, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 3, 2021. • Consider and take necessary action to Approve the Final Plat of the REDDING SUBDIVISION (a replat of part of Outlots 1 & 4 in Outblock 15 of the Port O'Connor Townsite) Sincerely, Gary Deese GDR/at P.O. Box I77 — Seadrift. Texas 77983 —email: jzarv.rccsc a calhmmcaa.ore — (36l) 785-3141 —Fax (361) 785-5602 xve amo-ac (616) YJVAVI lend 60se-zss (ISE) „ .. 1H-ld IVNIJ m m r ooazaol �aN rvtlu s33da 616LL StlX31 'tlJtlAtll 1tlOd '133e15 Ntl0 iN M SOS • ONINNVId • ONLUMn5 • ONIN33NION3 • L 9 : Iti J 'BNI S2IHHIQI91SH At�8 0 o; y ry .� z;tl�gy 8 y p R de ia?� p$ 7 a a L@ x@ a p• z y z 0 o E�� LE E mY etl g@g@ y 6E@ LR zru cS 5® kR egg d `F� R'i �5> A oUTLOT z m ra. OUTBLOCK 16 OUTLOT 3 6 S2W29'00'E W S Z 80.00' 0.l 8t w c O lb a a $ E$ llia F a ;;p m q,; m <w 8G n� e_g ffia� a aq � Lo 528R8'00'E 8t0.00' $'s E 4" O n O F ''� S a g E- " F inPi ram— p N28R8'00'W Fy 510.00' » xl k " ram- O @e 0) E a Hi E an 8 00 00 n oz 3„d0,az.ers �x a s28'ze'00'E p�� 570.00• ED I € a cO ,00'OLS or,Nea 61AO�B®.BZN A #13 NOTICE OF MEETING — 11/3/2021 13. Consider and take necessary action to accept insurance proceeds from TAC in the amount of $10,900 ($13,400 - $2,500 deductible for damages from the power outages on August 7, 2021. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 10 of 19 Mae Belle Cassel From: candice.villarreal@calhouncotx.org (candice villarreal) <cand ice.vi Ila rreal@cal houncotx.org> Sent: Wednesday, October 27, 2021 3:16 PM To: maebelle.cassel@calhouncotx.org; Richard H. Meyer, David Hall; vern lyssy; joel.behrens@calhouncotx.org; Gary Reese Subject: Agenda Item - TAC Proceeds from 8/4/21 Power Outage Attachments: TAC Proceeds - CH 080721 Power Outage.pdf MaeBelle, Please add the following to the next Commissioners Court agenda. • Consider and take necessary action on insurance proceeds from TAC in the amount of $10,900 (13,400 — 2,500 deductible) for damages from the power outages on August 7, 2021. Thank you, Candice Viflarreal 1slAssistantAuditor Calhoun County Au&tors Office 202 S. Ann Street, Suite B Tort Lavaca, 4X 77979 Phone (361)5534612 Calhoun County Texas TEXAS ASSOCIATIA OF COUNTIES RISK MANAGEMENT POOL -CLAIMS 54,072 10/21/2021 PR20210675-1 I Calhoun County 202 S Ann St Ste''B Port Lavaca,,TX 77979-4204 $-2500.00 54072 TO REORDER CALL (705)327-9550 W148F001014M 05/21 #14 NOTICE OF MEETING — 11/3/2021 14. Consider and take necessary action to authorize the EMS Director to sign a Mutual Aid Agreement with Allegiance Mobile Health (Matagorda County). (RM) Dustin Jenkins explained how the agreement would benefit both counties. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 11 of 19 Mutual Aid Agreement This agreement is made and entered into by Calhoun County Emergency Medical -Service (CCEMS) and Allegiance Mobile Health this 2e day of October 2021. Definition of Mutual Aid: Assistance rendered by one EMS provider to another when the requesting EMS system's resources are overwhelmed and it is in the best interest of the patient. The undersigned parties desire to enter into a mutual aid agreement wherein the equipment, facilities, and trained personnel of each are available to the other on an as -requested basis as per the above definition. It is hereby agreed as follows: Scope of Agreement A. The parties agree that a request for mutual aid will be made only when an emergency occurs in the area within the jurisdiction of any party hereto and local resources may be inadequate to control and respond to that emergency. B. During the term of this agreement the parties agree to provide upon request of the other party such equipment, facilities, and trained personnel as may be requested, unless such an action would prevent or disrupt adequate service and/or protection of its own area of jurisdiction and responsibility. C. If there is a conflict between the operating procedures and professional standards of the providing party and the requesting party, the respective operating procedures of the providing party will control. Policies Each party hereto agrees: 1. To maintain the personnel and equipment sufficient to respond to emergency calls of the type and magnitude which are likely to occur in its area of responsibility, according to TDSHS license requirements. 2. To be responsible for its own cost and expenses. 3. To be responsible for the liability of its own employees and equipment. Term of Agreement The term of this agreement shall be indefinite with either party having the right to terminate this agreement upon thirty (30) days written notice to all parties. Compliance with Applicable Laws All parties shall observe and comply with all'FederaI, State, County, and City laws, rules, ordinances and regulations which in any manner affect the conduct of the services herein provided and performance of all obligations undertaken by this agreement. Legal Constructions In case anyone or more of the provisions contained in this agreement shall be held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision thereof and this agreement shall be construed as if such invalid, illegal or unenforceable provisions had never been contained herein. Amendments The agreement maybe amended by the mutual agreement of the parties hereto in writing, to be attached to and incorporated into this agreement. Entire Agreement This agreement supersedes any and all otheragreements, eitheroralor in writing between the parties hereto with respect to the subject matter hereof, and no other agree ment, statement, or promise relating to the subject matter of this agreement which is not contained herein shall be valid or binding. Calhoun County EMS Allegiance Mobile Health (Matagorda County) 705 Henry Barber Way PO Box 2775 Port Lavaca, TX 77979 Georgetown, TX 78627 Signature of Authorized Representative Signature of thorized Representative Date Signed Date Si ned #15 15. Public Hearing regarding granting AEP an Easement and Right of Way for a new underground service to the new shop at the EMS Center on Henry Barber Way. Closed regular meeting at 10:20 Dustin Jenkins EMS Director explained the need for the service. Regular meeting opened at 10:22 Page 12 of 19 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Cary Reese, Commissioner, Precinct 4 NOTICE OF PUBLIC HEARING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, Novennher 3, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse, 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. NOTICE IS HEREBY GIVEN that Calhoun County Commissioners' Court will hold a Public Hearing in the Commissioners' Courtroom, 211 S. Ann Street, Suite 104, in Port Lavaca, Texas, at 10:00 a.m. regarding granting AEP an Easement and Right of Way for a new underground service to the new shop at the EMS Center on Henry Barber Way. Richard Meyer, County Judge Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda' for any official court postings. Page 1 of 1 #16 16. Consider and take necessary action to authorize Judge Meyer to sign the Easement and Right of Way granting AEP an easement for a new underground service to the new shop at the EMS Center on Henry Barber Way. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 13 of 19 ROUNDLFS5 ENERGY" October 28, 2021 Richard Meyer Calhoun County Judge 211 S. Ann St RE: easement Dear Sir. Attached you will find a copy of the Easement and Right of Way for new addition for EMS Center on County Road 101 located in Port Lavaca, Texas. Please print out two single sided copies, sign in blue ink exactly the way the signature block appears on the easement. Please have your signature notarized on each easement and return the two originally signed easements to AEP. To, avoid any delays to your job please return two original signed and notarized easements as, soon as possible to: Mailing Address AEP Texas Attn: Sandra Luna 6024 Crosstown Expressway Corpus Christi, Texas 78417 If you have any questions or need additional information, please contact me. Sincerely, EPAE—�ARNOLDO SANDOV4 TECHNICIAN PRIN AESANDOVALI @AEP.COM f D:361.574,3301%AS A:8.470.3301 F„ 104 E CRESTWOOD, VICTORIA, TX 77901 -3317 CP 460 (OH/UG) Rev. (01/21) Town: PORT LAVACA Submitted by: aes EASEMENT AND RIGHT OF WAY TX212240 WR#80718496 COUNTY OF CALHOUN, ("Grantor"), for and in consideration of Ten & 00/100 Dollars ($10.00), and other good and valuable consideration to Grantor in hand paid by ALP TEXAS INC., a Delaware Corporation, whose address is P.O. Box 2121, Corpus Christi, Texas 78403 ("Grantee") the receipt and sufficiency of which is hereby acknowledged and confessed, has GRANTED, SOLD, and CONVEYED, and by these presents does GRANT, SELL, and CONVEY unto Grantee, its successors and assigns, a perpetual easement and right of way for electric distribution lines, consisting of poles made of wood, metal, or other materials, cross arms, static wires, guys, wire circuits, underground cables and conduits, communication circuits, metering equipment and all necessary or desirable appurtenances (including, but not limited to, transformers, meters, vaults, and service pedestals) over, under, across, and upon a portion of the following described land located. in CALHOUN County, Texas, to wit: Being a 5.00 acre tract of land situated in the Samuel Shupe Survey,Abstract 137, Calhoun County, Texas, also being a portion of the remainder of that certain 20.0 acre tract of land as conveyed from Dorothy J. Davis Administratrix of the Estate of Betty Maule Blardone to American G.I. Forum, Inc. according th instrucment recorded in Volume 7, Page 94 of the Official Records of said County. More specifically, the strip of land covered by this Easement and Right of Way shall be 5 feet in width, as described by GPS waypoints as depicted on Exhibit "A", attached hereto, made a part hereof and incorporated herein for all applicable purposes. Notwithstanding the foregoing, the actual as -built location of the electric line shall locate, define and establish the easement. (the "Easement Area") Together with the right of ingress and egress over, under, across and upon the Easement Area and Grantor's adjacent land for the purpose of constructing, operating, reconstructing on poles or burying and replacing underground cables and conduits (including necessary ditching and backfiling), enlarging, inspecting, patrolling, repairing, maintaining, upgrading and removing said lines, circuits, underground cables and conduits, poles, wires and appurtenances; the right to relocate along the same general direction of said lines, cables, and conduits; and the right to remove from the Easement Area all structures, obstructions, trees and parts thereof, using generally accepted vegetation management practices, (whether from the Easement Area or that could grow into the Easement Area) which may, in the reasonable judgment of Grantee, endanger or interfere with the safe and efficient operation and/or maintenance of said lines, cables, conduits or appurtenances or ingress and egress to, from or along the Easement Area. Grantor reserves the right to use the Easement Area subject to said Easement and Right of Way in any way that will not interfere with Grantee's exercise of the rights hereby granted. However, Grantor shall not construct or permit to be constructed any house or other above ground structure on or within the Easement Area containing Grantee's improvements without the express written consent of Grantee. TO HAVE AND TO HOLD the above described easement and rights unto the Grantee, its successors and assigns forever. Grantor binds itself, assigns, and legal representatives to warrant andforever defend all and singular the above described easement and rights unto the said Grantee, its successors and assigns, against every person whomsoever lawfully claiming or to claim the same or any part thereof. EXECUTED this 3AA,_ day of A U :M21 C./e / .2021. [Rest of this page intentionally left blank -Signature page follows] CALHOUN,C U TY By: chard, Meyer, Calhoun County udge ACKNOWLEDGMENT STATE OF TEXAS COUNTY OF CALHOUN TX212240 WR#80718496 This instrument was acknowledged before me on this A / _ day of nyu ten 'r-'t/ , 2021, by Richard Meyer, Calhoun County Judge. �)� &A44� NOTARY PUBLIC, State of TEXAS MAE BELLE CASSEL My Notary ID # 132012524 '"•'aa; '` (SO)s May 94, 2023 N Location: City: County: Exhibit "A" WR:80718496 Easement #: N/A Depiction of a 5' wide AEP Easement POINT OF REFERENCE NORTH EAST PROPERTY \ CORNER. LATITUDE 28.599917 LONGITUDE-96.646830 2 AA TT,&4 AL TD # 17 VlLL I mU - 11/3/LUZi 17. Consider and take necessary action to authorize the EMS Director to sign a Contribution - in -Aid -of -Construction Agreement for the underground service to the new shop at the EMS Center on Henry Barber Way. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 14 of 19 EICAN RICR BOUNDLESS ENERGY' October 28, 2021 Customer Address: Calhoun County EMS Dustin Jenkins 705 Henry Barber Way Port Lavaca, Texas 77979 Project: underground service to new shop WR # 80718496 Project Address: 705 Henry Barber Way Port Lavaca, Texas Mr. Jenkins: Enclosed please find a Contribution -in -Aid -of -Construction Agreement (CIAC) for the requested utility work at the location listed above. In order to move the project forward the CIAC agreement needs to be signed and returned. If you choose to proceed with the project, please sign the agreement and return to the mailing address or email shown below: Mailing Address AEP Texas Attn: Sandra Luna 6024 Crosstown Expressway Corpus Christi, Texas 78417 QCm Email mgfertschCo aep.com 01IS IS NOT AN-1-MV-0101E The invoice will be mailed to you with payment instructions. Invoice should arrive within one week. If you do not receive the invoice, please call me. Please do not delay in getting the invoice paid. The job will remain on hold until payment has been received and processed. It will then be moved to the scheduling and construction phase which may take up to 6 weeks or longer. Therefore, please return payment to the address provided on the invoice received in the mail as soon as possible to avoid delays in getting the job completed. If you have any questions or need additional information, please contact me. Sincerely, aFP ARNOLDO SANDOVAL I TECHNICIAN PRIN 7bMA5 AESANDOVALl@AEP COM I D:361,574.3301 I A:8.470.3301 104 E CRESTWOOD, VICTORIA, TX 77901-3317 AEP Texas Contribution-In-Aid-O£-Construction Agreement Dustin Jenkins For Electric Distribution Service Service: 705 COUNTY ROAD 101 PORT LAVACA, TX Contract #: DWMS00000530780 Work Request #: 80718496 - Date: 10/28/2021 You, Dustin Jenkins (Customer) have requested AEP Texas (Company) to install/construct certain electric distribution facilities (hereinafter referred to as "Facilities") as follows:underground conductors and devices. The cost for construction/installation of the requested Facilities will be in excess of what would normally be provided by Company at no additional cost to the Customer to initiate service. In accordance with the Company's approved Tariff, as filed with the Public Utilities Commission of Texas, the Customer agrees to pay Company a one-time, non-refundable, Contribution -In -Aid -Of -Construction (CIAC) in the amount of 750.13. The Customer understands that he/she receives no ownership or control of the Facilities by virtue of the payment of the CIAC. The Facilities installed by the Company will remain the property of the Company. The Company expressly retains the right to use said Facilities for any purpose which Company deems appropriate under good utility practices, including the distribution of electric service to other customers. Company agrees to provide single phase 120/240 underground service to new shop, and the Customer agrees to provide trench, conduit, up -front cost, easement and to be ready to take electric service on or before 12/10/2021. It is understood and agreed that the Company will not begin construction/installation of the Facilities until full payment of the CIAC has been received by the Company; therefore, Customer understands and agrees that he/she needs to make full payment of the CIAC in sufficient time to allow for the construction/installation to be completed by the In Service Date. The pricing of the CIAC quoted herein is based on the specifics of the Customer's request, including the Customer's stated In Service Date, and must be accepted by the Customer by executing and returning to the Company this Agreement by 1/26/2022 to remain valid. Should Customer alter the request for facilities, or request a delay in (or is otherwise unable to take service by) the stated In Service Date, the Company reserves the right to update the pricing and require an additional CIAC payment to reflect any increases in cost due to the alteration in requested facilities or the delay in taking service, or both. Nothing contained herein shall be construed as a waiver or relinquishment by Company of any right it has or may hereafter have to discontinue service for default in the payment of any bill owing or to become owing hereunder or for any reason or cause allowed by law. By signing and returning this Agreement, Customer understands and accepts the above described terms and conditions. Customer Company By Dustin Jenkins By Signature: Title: Date: Signature: Title: Date: #18 18. Consider and take necessary action to approve the attached Calhoun County Election Precincts that have been altered to achieve greater efficiency and not impacting the political boundaries. (RM) Mary Orta with Elections explained that combining precincts would only accommodate voters. This combining will not show an impact on Commissioners. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 15 of 19 CALHOUN COUNTY ELECTIONS DEPARTMENT 211 S. ANN ST, PORT LAVACA, TX 77979 • PH: 361-553-4440 • FAX: 361-553-4443 October 29, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann St. Port Lavaca, Texas 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for November 03, 2021. * Consider and take necessary action to approve the attached Calhoun County Election Precincts that have been altered to achieve greater efficiency and not impacting the political boundary's. Thank You,, MaryAnn Ortao Calhoun County Elections Administrator NOTICE OF CHANGE OF ELECTION PRECINCT Notice is hereby given that the Calhoun County election precincts have been altered or abolished. There is a justifiable combination of factors that would support this decision. These factors include: Redrawing election precincts to increase voter convenience; Consolidations of election precincts were practicable; and Resizing election precincts achieves greater efficiency. The current political boundaries of Calhoun County, shall remain in effect. The following changes will be implemented: Current county voting precincts 1, 2, & 3 will now bVRECINCT 1. Current county voting precincts 4 & 5 will now be PRECINCT 2. Current county voting precincts 6 will now be PRECINCT 3. Current county voting precincts 7, 8, 9 & 10 will now be PRECINCT 4. Current county voting precincts 11, 12 & 13 will now be PRECINCT 5. Current county voting precincts 14 & 15 will now be PRECINCT 6. Current county voting precincts 16, 17 & 18 will now be PRECINCT 7. Current county voting precincts 19 will now be PRECINCT 8. Current county voting precincts 20, 21, 22 & 23 will now be PRECINCT 9. Current county voting precincts 24 will now be PRECINCT 10. Current county voting precincts 25 will now be PRECINCT 11. This change will be effective on I , Z4Zz r.0 Signed this 3 ' day of Ns ✓4 Commissioner, Precinct 3 County Clerk, Calhoun County 2021. Commissioner, Precinct 2 Commissioner, Precinct 4 r County Judge, Calhoun County #19 19. Consider and take necessary action to allow Calhoun County Elections to consolidate fourteen (14) polling locations to eleven (11) locations to coincide with Election Precinct merges. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 16 of 19 CALHOUN COUNTY ELECTIONS DEPARTMENT 211 S. AKIN ST, PORT LAVACA, TX 77979 • PH: 361-553-4440 • FAX: 361-553-4443 October 29, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann St. Port Lavaca, Texas 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for November 03, 2021. * Consider and take necessary action to allow Calhoun County Elections to consolidate 14 polling locations to 11 locations to coincide with Precinct merges. Thank You,, C) ) Mary Ann Orta Calhoun County Elections Administrator 4ALHUUN CUUN fY 11 POLLING LOCATIONS (Revised October 29, 2021) PCT 1 PCT 7 Calhoun County Library Bauer Community Center 200 W. Mahan St. 2300 N. Hwy 35 Port Lavaca, TX 77979 Port Lavaca, TX 77979 PCT 2 PCT 8 Bauer Exhibit Building Olivia Fire Station 186 Henry Barber Way 61 County Road 318 Port Lavaca, TX 77979 Port Lavaca, Texas 77979 PCT 3 PCT 9 Magnolia Beach Vol. Fire Dept. Calhoun County EMS 873 Margie Tewmey Rd 705 Henry Barber Way Port Lavaca, TX 77979 Port Lavaca, TX 7797 PCT 4 PCT 10 Calhoun County Annex Seadrift City Hall 201 W. Austin St. 501 S. Main St. Port Lavaca, TX 77979 Seadrift, Texas 77983 PCT 5 PCT 11 Six Mile Volunteer Fire Dept. Port O'Connor Library 34 Royal Road 506 W. Main St. Port Lavaca, TX 77979 Port O'Connor, Texas 77983 PCT 6 Port Lavaca City Hall 202 N. Virginia St. Port Lavaca, Texas 77979 # 20 20. Accept report from the following County Office: i. County Treasurer — August 2021, revised Rhonda Kokena verbally stated that there was a typo and the report was in fact not a revised copy. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 17 of 19 TAXA1515534514 P.0011003 AIRPORTMAINTRNANCE S 29,296,381.85 S 69,640.78 2.09a,164.98 S 1.01,206,32 S 27,747,546.51 APPELLATE JUDICIAL SYSTEM 99600 l62.56 386.87 69.816.47 COASTAL PIIOTECDON FUND COUNTY AND DIST COURTTECH FUND 2.290,819.83 16729 1:0167.59 1,16339 COUNTY CHILD ABUSE PREVENTION FUND 7,71983 0, 171.19 2,305,66319 .42 7,819.76 819.76 COUNTY CHILD WELFARE BOARD FUND 694,09 6,694.09 CO JURY FUND 378.47 139.00 6.097.33 627.22 COURTHOUSE SECURITY 289,039.75 99.039.75 26.08 - 404.55 COURT INITIATED GUARDIANSHIP FUND 3,68329 - 292,725.04 DIST CLK RECORD PRESERVATION FUND 38.564.01 183.84 - 12,613A1 COURT REPORTERS SERVICE FUND 415.03 600.40 39.244.49 CO CLK RBCORDS ARCHIVE FUND TY COUNSPECIALTY COURT FUND 9,834.74 20.5229 6.659.27 43160 DONATIONS 3,237.65 104.890.43 18531 306,513.01 3,423.00 DRUOA7W7 COURT PROGRAM FUND -LOCAL 23.627.59 1.427,77 379.64 103,938.56 JUVENILE CASE MANAGER FUND 19.329.90 214.74 2s.842,32 FAMILY PROTEC77ON FUND JUVENILE ORLINOURNCY PREVENTION FUND 11.943.10 223.4E W.43 350.14 - 18.203.19 GRANTS JUSTICE COURT TECHNOLOGY 9.199.71 731.073.39 64.OD 76.767.82 85.519.63 18.203.19 0.253.71 JUSTICE COURT BUILDING SECURITY FUND 91,553.79 1,43115 - 722.321.57 92,987.04 2,987.04 LATERAL ROAD PRECINCT#1 6.530.46 4A57.68 82.92 92.92 - 6.633.33 LATERAL ROAD PRECINCT#2 1-47ERAL ROAD PRECINCT03 4.357.68 30.19 87 LATERAL ROAD PRECINCT04 4,357,66 30.19 4,387.87 JUROR DONATIONS -HUMANS SOCIETY 4,357.63 30.19 - 4.387.97 4,387.85 PRETRIAL SERVICES FUND 3,737.91 84.290A6 70.00 3.130.p0 707.91 LOCAL TRUANCY PREVENTIONWIVERSION FUND 11.058.52 79449 33.065.05 8770791 LAW LIBRARY LAW GNP OFFICERS STD, EDUC, p.EOSB) 212,991.1E 864.24 L607.87 1.149.15 76 214,440.83 POC COMMUNITY CENTER 29.196.90 16,30D.74 212.29 - 29.W9.19 29.409.19 RECORDS MANAGEMENT-DISTRICTCLERK 8.633.5D 4,189.00 3,226.17 07 RECORDS MANAGEMENT -COUNTY CLERK 209.059.67 323AS - 91156.63 RECORDS MONT R PRESERVATION 36345.19 61056.I4 13.261.25 201.954,56 ROAD A BRIDGE GENERAL 6MILE PIERJRpAT RAMP INSURJMAINT 45950.012,81 693.19 32,015.60 37,239.39 CAPITAL PRO! • BOGGY BAYOU NATURE PARK 33,439.24 251.43 - 1,631,028.45 CAPITAL PRO] AMEICAN RESCUE PLAN ACT OF202 202.683.80 2A10.707.36 - 35.029AS 235,694.67 10 CAPITAL PROI- CORO DR INFRASTRUCTURE 16.70736 2.067,666.30 CAPITAL PROI CHOCOLATE BAYOU BOAT RAMP 176,050.01 291,729.64 309,437.0p 309,437.01 CAPITAL PRGJ- ELECTION MACHINES 0.21 - CAPITAL PRGJ-RB INFRASTRUCTURE 9.71"1 - 0.21 CAPITAL PROI ENERGY TRZ 81 CAPITAL PR0I AIRPORT RUNWAY IMPROVfiMENTS 221,799.81 1.00D,000AD - 50,116.64 55,449.00 959,597.77 166350.85 CAPITAL PROI MAGNOLIA BEACH EROSION CONT 14.972130DA - 66,350.35 CAPTJALpRpJ E13 VENTCENTER i _ CAPITAL PROJ FIRE TRUCKS At SAFETY EQUIP 12l,927.09 5,927.09 _ - - 175,000.00 CAPITAL PRO] • GREEN LAKE PARK 6,449.68 125,92709 5.927.09 GPI1'AL PROJ WATE448,62 RNS PARK/BOAT RAMP - - CAPITAL PROJ FORT ALTO PUBLIC BRACW 20,7A2.36 - 7.160,74 CAPITAL PRO; HURRICANE HARVEY PEMA 1.242.35 - 20,242.36 L484.36 CAPITAL PROD IMPROVEMENTS pROJECTS 11.434.78 334.914.68 - S.414,78 CAPITAL PROJ HOSPITAL IMPROVEMENTS 2,944,WI.65 _ 346,369Jo CAPITAL FRO]-MMC LOANS ARREST PEES 3500000W no•ow•00 2,944,602.66 BAIL BOND FEES (HE 1940) 393.84 263.44 4.000,000.00 CONSOLIDATED COURT COSTS (NEW) 3004 705.00 - 65726 735.09 CONSOLIDATED COURT COSTS 2020 3001 . 2 •240•9 - 2.27031 DNATEiSTINOFUND DRUG COURT PROGRAM FUND -STATE 230.00 11.182.75 90.40 - - ILISZ75 Tan an P686 1 of COUNTY TREASURER'S REPORT MONTH OF. AUGUST202l DEDINNING ENDING F ND OPERATING FUNDS -BALANCE FORWARO FUNDMIS E 5 45.472,32A.185 RECEIPTS OJSEURSEMENJI FUND BALANCE ELECTION SERVICES CONTRACT 96.202.86 4.057.147.08 1 3.862.292.54 $ 43,667,578.72 ELECTRONIC FILING FEE FUND 000 5.247.01 1,713.45 16.161.64 $3.288.23 EMS TRAUMA FUND 126.57 IR633 1.713A5 FINES AND COURT COSTS HOLDING FUND 7,84731 47.31 )1L90 INDIGENT CIVIL LEGAL SERVICE 4.30 288.00 >31L9 047.31 JUDICIAL FUND(ST. COURT COSTS) JUDICIAL k COURT PERSONNEL TRAINING FUND 10.00 26436 _ 030 JUDICIAL SALARIES FUND 002 E.264.26 53 270.00 IUROR DONATION CRIME VICTIMS FUND 369.00 4000 2,278.75 008 55 JUVENILEPROBATION RESTITUTION 62.51 LIBRARY GIFT AND MEMORIAL 40,062.57 29200 _ US 9.808.14 245.35 226.04 40,362.57 19 9.927.45 REFUNDABLE DEPOSITS REFUNDABLEEEPUND 2.000.00 STATE ED FUND (27.00) 21695.27 _ 2�IN USTCIVIL CIVIL JUSTICE DATA REPOSITORY FUND 000 1.14 2.653.27 JURY REIMBURSEMENT PEE 162.98 1.14 SUBTOFECFUND 13.77 5,40831 DEFENSE SUPPTIME 5,422.08 PA ME,7INDIOENT TIME PAYMENTS 0.05 478.42 _TRAFFI81.03 APPEAR OX 737.49 476,47 EDPROLAW UNCLAIMED UNCLAIMEDEVENTIri PROPERTY 12.603.35 91.86 737,49 TRUANCY PREVENTION AND DIVERSION POND 105.10 40.76 12,685.21 BOOTC BOOT 14743 - 65.96 147,43 JUVENILE JUVENILE PROBATION PROBATAEPION 125.96 _ 147.43 TAXES IN ESCROW 3.902,70.19 4,05SUBTOTALS ,6I0.77 S 3.924058.27 6269 TOTAL OPERATING FUNDS 7 ,19 77 000 4 OTHER FUNDS D A FORPEIram PROPERTY FUND 13.78932 I410 SHERIFF NARCOTIC FOEPEITURB9 20.457.35 3.25 2,494.OD 13,291. I2 CERT OF OB-CRTxSEREFSERIBS2010 08-CRTIIOUSB 509.028.49 2.113.74 477,500.00 2L966.12 32,642.23 CERT OF IkS SERIES 2012 CAL. CO. FEES k FINES125 694,341.95 2,76S31 650,926.00 46,185.26 64 162.233.54120 7491 173 127.87 MEMORIAL MEDICAL CENTER OPWATINO MONEY MARKET 4,065.05452 3AOi.613.06 3,724,566A6 S 3,742,101A2 INDIGENT HEALTHCARE 1,108,17,4A9 5.020.93 5.255,344.11 5.235,053.86 S 1,108.404.74 PRIVATE WAIVER CLEARING FUND 431.30 10.77938 10.781.09 S.OI932 01932 CLINIC CONSTRUCTION SERIES 2014 331.71 006 0•07 " NHASPORD NH R 156,059.25 483.812.76 - 367.356.49 535.78 272,535.52 NH CRESCENT 97.494.00 68,142.63 39OA97.21 408.201.05 79.190.16 NH FORT BEND FORT 45,207.60 273,174.43 124,098.26 199.202.94 105.297.61 142.114.22 NHGOLDE NH GOLDEN CREEK 10807.45 479.746.01 381,273.60 64,008.23 203,919.96 NH DACA 152,582,16 0.00 223,113.45 329,490.40 46,20492 ASHFORSOLERA NH ASIIFORD DADA " 0.00 NH GROADMOOR DACA 0.0000 0.00 NH GULF POINT PAY 60,301.33 2W.146.93 170,79436 139.653.0.50 NH POINT PLAZA ME 39.736,03 200.004.82 112,72630 131,014.55 BETHANYSGULF SENIOR uvEDICARE/MEDICAID NH TUSCANY SENIOR WVINO NHTTO AL VILLAGE 123.411 AS 913.530.17 751.396.30 18S1565.66 TOTAL MEMORIAL MEDICAL CENTER FUNDS 134.773.79 509.875. 2 941.920.9 222.726.45 I3. 723911,736,94 1 06 71 DRAINAGE DISTRICTS NO.a NO.5 44,442.95 S 12.42 5 102.00 S 4435337 NO, 10-MAINTENANCE 134.301.93 201.73912 79.17 27.36 139.83 134.441,22 NO. 11-MAINTENANCE/OPERATING 126,588.21 1.271.21 99.50 36,700.96 201.666.68 NO. 11-PMSRVE 22541971 3 . 91,156.16 225.520.31 TOTAL DRAINAGE DISTRICT FUNDS 73376164 3 1 a 1 4 CALHOUN COUNTY WCID Rl OPBRA71NO ACCOUNT $ PAYROLLTAX 342,775.84 18.57 21,91 27.456,32 3 311,331.43 .00 8 S 594, TOTAL WCID FUNDS .91 27 CALHOUN COUNTY PORT AUTHORITY 49,228.37 95.50 MAINTENANCE AND OPERATING - S 49,323.87 CALHOUN COUNTY FROST BANK S 2 5.s 7025.97 7 1 9a 12 0017A 13 03 31.a1 TOTALMMC, DR. DIST., NAY, DIST. WCID k FROST I TOTAL ALL FUNDS S 31582,659.09 S 16,659,00950 $ 17,479,057.61 7 10 71.11 S 53,762,606.91 PRRC 2 of 3 COUNTY TREASURER'S REPORT MONTH OF: AUGUSTIN, EANKRECONCILrATION LESS: CENT. OFDEPI FUND FUND OUTSTNDODEP/ PLUS: CHECKS RANK 844ANCE OTHER ITEMS OUTSTANDING EALINCE S 46,117,283,66 OPERATING S 46,064,522.69 S 117.140,00 S 169.939.97 OTHER D A FORFRITEO PROPERTY FUND 13.291.12 SHERIFF NARCOTIC FORFEITURES 21.966.00 2L966.60 13.291.12 CERT OF OS•CRTHSE REP SERIFS 2010 32,642.23 _ 55'00 2ZODA0 CERT OFOR•CRTHOUSE I&S SERIES 2012 _ 32,64223 CAL CO FEES &FlNES 173,127.87 11,284.01 122.617.73 246,461.26 MEMORIAL MEDICAL CENTER OPERATING S 3.742.101.42 MONEY MARKET 1.100.404.74 - 547,672.97 4.289.774.39 PRIVATE WAIVER PRIVATE WAIVER CLEARING FUND LEA 5A1932 10.729.67 11,132,68 1,107,a444.74 CLINI3.33 SERIES 201a 431.36 535.78 _ 431.36 NHAS FONSTRUCTION NH 272,535.52 - 535.78 NH BROA M R 79,180.16 _ 272,53552 CRESCENT NHCRRT CRESCENT 142,114.22 79,180,16 NH FOLS REND 64,008.25 _ 142.114.22 NH SOL 20S.919.86 _ 64.008.25 DE NH GOLDEN CREEK 45.20492 - - 205,910.96 NH SOLBRA DACA MOD - 46,204.92 NH ASHFORD DACA - 0.00 NH BROADMOOR DACA 000 - 0100 NH GULF POINT PRIVATE PAY 139,650.00 0100 NH GULF POINTE PLAZA MEDICARE MEDICAID 131,613.50 139.653.50 NH BETHANY SENIOR LIVING 131.014.55 18272845 _ - 131.014.55 NO TUSCANY VILLAGE - 125.545.66 )RAINAGE DISTRICT: - 222,728AS NO.6 NO.1 44313.37 134.M132 134,441.22 12.00 44.365.37 NO. 10 MAINTENANCE 134A41.22 NO. II MAINTENANCEMPERATINp 9LI3866 -_ MOD 201,678.68 NO. If RESERVE225.520.31 91,158.46 - 225,520,31 :ALHOUN COUNTY WCO)p OPERATING ACCOUNT 315XIA3 PAYROLLTAX tA52,29 313331.43 :ALHOUN COUNTY PORT AUTHORITY - - 1,632.29 MAINTENANCEII)PERATING •"' 49,323,87 • 49,323.87 ALHOUN COUNTY FROSTBANK 2.025,L7 - - 2,02$.87 4 7 THE DEPOSITORY FOR CALHOUN COUNTY WCID 19 IM'ERNATIONAL BANK OF COMMERCE • PORTLAVACA THE DEPOSITORY FOR CALHOUN CO. NAVIGATION DISTRICT IS FIRST NATIONAL BANK -PORT LAVACA .... THE DEPOSITORY FOR CALHOUN COUNTY I ROST IS FROST BANK - AUSTIN. TEXAS THE DEPOWTORY FOR ALL OTHER COUNTY FUNDS IS PROSPSRITY BANK, PORT LAVACA Court costs and fees collected and reported may not be current ad up •daze duo to non -Compliance by other county offices, I hereby certify that the current balances are correct to all monies nth a been re ived by e O My Treasurer as of the date of this report RHO 8DA S. KOKBNA COUNTY TREASURER 1 � l Page 3 0173 #21 21. Consider and take necessary action on any necessary budget adjustments. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Page 18 of 19 O =_ � =O O =M Z =0 z =`Z =Z � =W = d =W = 0 i r r F- 4 mzz z z t l U' U' z z L i rn w rn rn w W z z w a W W z z e w IL 0 m w W U IL > �w (n rn M H �I ofH J F 0 r LL_ LL' c w m zZ O Q w a 0 w U z In Q c W c _ O _ _ _= Z �j s _z W uj =d u W t� y W C = V W a O O W =v 3 a = z 2 d `° z r Q =Z ' a _W m h z =z z lu W C m =z d =e m ul =J N > _M� Z O y� W =W F U z z W z a = C Z W W Z Z V ti M N O O O H O O O OOi m � O � i e rn H O O O �J N rn E N » w w a �YSY C H T y O O H H C aH 0 o O o r C r a • � 66 CF- z z t H z 0 m rn e z °� O lu 0 H Q a � w aao Z ai ha 0) z Z s5 LU F z J � m W W N z rL m N � C aim k§ ( @ z o _� ■ @ )� § §) § Q § ;u § U. §§ o § )z § B § Es -� § \ )L § § /LL� k §±2& B\)\ \k )d =z §� =z )§ )� )L )§ 0 § « k B B B �( 0 0 � / 0 v U) k § § ; ■ S B z )U § LU )L ° )Z § 0 \w % § 3 k /L z k=uj it §- § B B § ■ B 2 LL Lu z k N 7 2 2 \C4 )a =z ■� .z )§ )� )L )§ z 0 ■ z UA B z § % z 2 § 2 hNI —Sa it �§aasa §§ 2 §§aa! ■ NJ 2 §k )o =z §� =z )§ )� )L )2 z k q B b §wE(\ §§§�� Big _ NMI ■§2/ �aaaa2 §§ 2 §§aa; ■ 21 ( LU � ■ § 2 § CO 'o :z :z :§ .L �§ :■ :o :z :z :o :o :o �z :@ :0 :0 :■ :W :« :z :z :§ :L :§ Q1 0 0 2 2 eo = ao =_o O _= Z =r =Z =W =g =W =C s =0 0 =z Z It _O �0 _0 _p �d O Q7 F LLI Or o _no I z EA GO z z Q z z w rn rn m rn m 29 m U) W U) z W a w O Z m Q w a 0 w w zi U a Of 7 W coU) it m v rn r a � � �n m w J I0- Q 0 Z z z O U O 0 O a Z O U 0 K IL w Ix LL �oo 0 _alll ?N Ooo �y O f9 O 0 O O cl N N z I i9 IA _ Lid mix _= Z =W fR d3 to w =r � �I OI � 5W Uzi rc o � F O O W F I 0 O O Q ro O = CCC �z¢2 0 Z O =Z = U Lj =W er N ~ 0 0 zzW 2 z O =Z z ¢ a _ "mm �mm o =r 0 z _4 Z U z =_0 yg =Z 19 m = W =W O = =Q Z e p3 =z =r a z 5 EZ =W a w W Q =g 2 F N a W LU °W W 0 W ° so _ �66 Z 7 NW Q g N ? � � a W _J Q f W _Z J W 2 W � g r r a W G O � Z la , Z g a a � | � 1 411- 14 ,Z 0 LU @ 2 ■ � � k z § B 2 § % z § a ■ § u 2 z LLI 2 ■ 5 Klaa § §we § k |a §z !z (§ )lz )� (§ ) § ) § (I $ \z $ k� ( ■ !L § z §� § � (0 B k |LU @ 2 ■ .to 2 § 0 B � e ( z a t k k k� d\\ � § j ■ « z ¥ z k a k yp dp Hf fR (D (D = O a EA fA p » m co cl e M M tl! 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(RM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Lyssy, Behrens, Reese Adjourned: 10:37 a.m. Page 19 of 19 November 3, 2021 2021 APPROVAL LIST - 2021 BUDGET COMMISSIONERS COURT MEETING OF BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 11/03/21 FICA 21 $355,647.97 MEDICARE FWH P/R $ 56,371,04 NATIONWIDE RETIREMENT SOLUTIONS P/R P/R $ 13,391.00 OFFICE OF THE ATTORNEY $ 39,680.00 GENERAL - CHILD SUPPORT CALHOUN COUNTY P/R $ 4,516.15 CAHOUN COUNTY GENERAL FUND 3RD QRT DRUG CRT PROGRAM FEE P/R $ 1,S 16.I5 CALHOUN COUNTY JUVENILE CASE 3RD QRT F A/P A/P $ 3RD QRT STATE STATE STATE COMPTROLLER CRrnIINAL COST & $ 95.49 195.09 STATE COMPTROLLER 3RDQRTCP✓IIFEE ap $ 88.Sg 3RD DRUG COURT FEES STATE COMPTROLLER A/P $ 12,743.50 TEXAS ASSOC. OF COUNTIES RISK MGM3RD QRT LLECrR (CLAIMS) FILING SYS. 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UN O U N N C� 0 0 O O O O m 0 w O" O w O w 00 O0 XU XU XU XU C¢a¢7 W oof rFLa Fa'a O CJ N N N N N N b V b a L6 F Um U;D Uy u z W£ 3g F`O c7 QQ 6� Q� Qua a VU aU P U P a F �+ a a � $ a H O ❑ Z O x z a ; ( f � (\k\ ) } § \\(\ \ ) ) ) ° § ! ) ( ! § ) 0 0 0 Q [C 2 O as �qO V F 0 �WW6 O C � U a a a a F ,F� F 0 oz oz y 0 3� ai ) § \� \ § § , ) } \ \ ) 9 0 U a C7 N W F oy F > C7 A CU7 a U a n v q a F O H � C S \ \ \ \ \ \ \ \\ 2z )(\ & \ ; ` +>; m) °r$ 0 °®S 3@ a2s } )§/ \$@ U)/ U29 )2 U29 j\ } } } _ ) )(( `>< ® ` ! § (\k \� \w \, ` \\ $ ! \\ \\ \\\ \. \§ \\ �( /o \z ma ! wo ro mo mo wo ! % )) \ \ \ / )! 3< a o )) ))) ()0 )z F.)) )2§ )2 (2 §2\ §§ � | ) , ƒ 0 0 ) \ ) MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 03, 2021 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 711,981,28 ✓ TOTAL TRANSFERS BETWEEN FUNDS $ 27940823 ✓ TOTAL NURSING HOME UPL EXPENSES $ 1,09%803.29 TOTAL INTER -GOVERNMENT TRANSFERS- $ GRAND TOTAL' DISBURSEMENTS APPROVED November 03,, 202T $ 2 090,393.30: MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 03 2021 PAYABLES AND PAYROLL 10/2912021 Weekly Payab(es 692.724.60 10/29/2021 Texas HHSC-UC Application Stale Fee for Medicaid DSH and UC 10,000.00 11/1/2021 McKesson-3408 Prescription Expense 5,87T67 11/112020 Amerisource Bergen340B Prescription Expense 1,814.60 11/1/2021 Payroll Liabilities for supplemental payroll -Payroll Taxes 156.54 11/1/2021 Supplemental Payroll 811.25 Prosperity Electronic Bank Payments 10252021 Credit Card & Lease Fees 48.00 10/25-10129121 Pay Plus Patient Claims Processing Fee 548.62 TOTAL,P.AYABLES, PAYROLLpNb ELECTRONIC BANK PAYMENTS $ 711,961.28 TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 10/29/2021 MMC Operating to Solera-correction of NH Insurance payment deposited into 9,805.80 MMC Operating in error 10/2912021 MMC Operating to Crescent -correction of NH insurance payment deposited 6,930.00 Into MMC Operating in error 10/29/2021 MMC Operating to Golden Creek -correction of NH insurance payment 47,396.37 deposited into MMC Operating in error 10/29/2021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 19,860.94 deposited into MMC Operating 10/29/2021 MMC Operating to Tuscany Village -correction of NH insurance payment 33,600,52 deposited into MMC Operating 10/2912021 MMC Operating to Bethany -correction of NH insurance payment deposited 57,077.34 into MMC Operating in error MEDICARE ADVANCE PAYMENT RECOUP 11/1/2021 Broadmoor to MMC Operating -correction of Broadmoor medicare recoup 996.21 taken from MMC Operating 11/112021 Broadmoor to Bethany -correction of Broadmoor medical recoup taken from 9,626.30 Bethany 111112021 Broadmoar to Golden Creek -correction of Broadmoor medical recoup taken 2,120.23 from Golden Creek 11/1/2021 Crescent to MMC Operating -correction of Crescent medicare recoup taken 996,21 from MMC Operating 1111/2021 Crescent to Bethany -correction of Crecent medicare recoup taken from 8,626,30 Bethany 11/1/2021 Crescent to Golden Creek -correction of Crescent medicare recoup taken from 2,120.23 Golden Creek 11/1/2021 Solera to MMC Operating -correction of Solera medicare recoup taken from 996.21 MMC Operating 11/112021 Solera to Golden Creek -correction of Solera medicare recoup taken from 2,120.23 Golden Creek 11/112021 Solera to Bethany -correction of Solera medicare recoup taken from Bethany 9,626.30 11/1/2021 Golden Creek to MMC Operating -correction of Golden Creek recoup taken 996.21 from MMC Operating 11/1/2021 Golden Creek to Bethany-correctionof Golden Creek medicare recoup taken 9,626.30 from Bethany 11/112021 Tuscany to MMC Operating -correction of Tuscany medicare recoup taken 996.21 from MMC Operating 11/1/2021 Tuscany to Bethany -correction of Tuscany medicare recoup taken from Bethany 9,626.$0 11/112021 Tuscany to Golden Creek -correction of Tuscany medicare recoup taken from Golden Creek 2.120.23 TRANSFER OF FUNDS BETWEEN NURSING HOMES 11/112021 Gulf Pointe Plaza -PP -correction of MMC insurance payment deposited into 7,491.64 Gulf Pointe Plaza -PP in error 11/1/2021 Gulf Pointe Plaza -PP -correction of MMC Clinic insurance payment deposited 78T36 into Gulf Pointe Plaza -PP in error 11/1/2021 Gulf Pointe Plaza -PP -correction of Broadmoor insurance payment deposited 5,803.39 Into Gulf Pointe Plaza -PP in error 11/1/2021 Gulf Pointe Plaza -PP -correction of Crescent insurance payment deposited 11,642.00 into Gulf Pointe Plaza -PP in error 11/1/2021 Gulf Pointe Plaza -PP -correction of Solera insurance payment deposited into 13,530.00 Gulf Pointe Plaza -PP in error 11/1/2021 Gulf Pointe Plaza -PP -correction of Tuscany insurance payment deposited into 4,390.00 Gulf Pointe Plaza -PP in error TOTAL TRANSFERS, BETWEEN FUNDS' NURSING HOME UPL EXPENSES 11/1/2021 Nursing Home UPL-Cantex Transfer 498,199.42 11/1/2021 Nursing Home UPL-Nexion Transfer 36,253.11 11/1/2021 Nursing Home UPL-HMG Transfer 165,395A4 11H/2021 Nursing Home UPL-Tuscany Transfer 162,540.71 11/1/2021 Nursing Home UPL-HSL Transfer 86,763.77 QIPP CHECKS TO MMC 11/1/2021 Ashford 34,595.75 11/1/2021 Broadmoor 14,320.60 11/1/2021 Crescent 11,501.00 11/1/2021 Fort Bend 13,956.55 11/1/2021 Solera 13,660,05 11/1/2021 Golden Creek 28,712.65 11/1/2021 Gulf Pointe 12,710.64 11/1/2021 Tuscany 20,293.70 TOTAL NURSING HOME UPL EXPENSES TOTAL INTER -GOVERNMENT TRANSFERS $ 279,608:73 $ 1,098;803.29 GRAND TOTAL: DISBURSEMENTS APPROVED November 03; 2024 $ 2 090,393:30 Page I of 15 10/28/2021 MEMORIAL MEDICAL CENTER 11:34 AP Open invoice List 0 Due Dates Through: 11/10/2021 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 10995 ABILITYNETWORK(SHIFTHDUND) ,./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 21M0150318✓"10/28/20 10/06/20 11/05/20 616.28 0.00 SHIFTHOUNO 0.00 616.28 ✓� Vender Totals Number Name Gross Discount No -Pay Net 10995 ABILITY NETWORK (SHIFTHOUND) 616.28 0.00 0.00 Vendor# Vendor Name Class Pay Code 616.28 R1200 ADTCOMMERCIAL,-I Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 14212918'h/10/21/20 10/04/20 11/04/20 49.18 0.00 FIRE MONITORING 0.00 49.18 V.. Vendor Totals Number Name Gross R1200 ADT COMMERCIAL Discount No -Pay Net 49,18 Vendor# Vendor Name 0.00 0.00 49.18 Class Pay Code 10958 ALLYSON SWOPE Invoice# Commenl� Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 102721 10/27/20. 10/2712010/27/20 21668.50 0.00 0.00 CONTRACT EMPLOYEE 2,668.50 Vendor Totals Number Name Gross 10968 ALLYSON SWOPE Discount No -Pay Net 2,668,50 Vendor# Vendor Name 0.00 0.00 2,669.50 Class Pay Code A2218 AQUA BEVERAGE COMPANY �: M Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 164712 L l 10/2212009/30/2011/04/20. 52.00 0.00 0.00 SUPPLIES 52.00 Vendor Totals Number Name Gross Discount No -Pay Net A2218 AQUA BEVERAGE COMPANY 52.00 0.00 Vendor# Vendor Name 0.00 52.00 Class Pay Code A0400 AUREUS RADIOLOGY LLC ,% Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net '2,WS&i" 10/1812010/11/2011/10/20. 2.760.00 235beH ! 0.00 0.00 2.760.00 TRAVEL STAFFING .% 2341659 `/ 10/18/20 10/11/20 11/10/20 2,378.50 0.00 AGENCY STAFFING LAB 0.00 2,378.60 2341295✓ 10/18/201011112011/10/20 2.144.00 0.00 TRAVEL STAFFING 0.00 2,144.00 Vendor Totals Number Name Gross Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 7.282.50 0.00 0.00 Vendor# Vendor Name 7,282.50 - Class Pay Code 81150 BAXTER HEALTHCARE �,i' W Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net '83089385 10/27/20 08/19/20 owl a/2o. 187.18 11 gtly a j SUPPLIES 0.00 0.00 187.18 Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 187.18 0.00 0.00 Vendor# Vendor Name 187.1E Class Pay Code M2485 BAYER HEALTHCARE Z M file:///C:/Users/eheiman/cpsi/Mennned.cpsinet.corn/u9g547/data 5/tmp cw5report7390... 10/28/2021 Page 2 of 15 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 6009533169,// 10/21120. 10/13/20 11/04/20 890.40 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay M2485 BAVER HEALTHCARE 890.40 0.00 0.00 Vendor# Vendor Name Class Pay Code B1286 BECKMAN COULTER CAPITAL ,i' Vv Invoice# Comment Tran Dt Inv Ot Due Dt Check D, Pay Gross Discount No -Pay 109350626 t/ 1011 PJ20. 10/11/2011/10/20 45.97 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay B1266 BECKMAN COULTER CAPITAL 45.97 0.00 0.00 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC „i M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 109354199,✓^ 10/18/20. 10/12/2011/06/20. 301.33 0.00 0.00 SUPPLIES 109356282 1/10118/2010/12120 11/06/20 43.56 0.00 0.00 SUPPLIES 109358899✓ 10/18120103/2011/07/20 1,093.10 0.00 0.00 lug3tr298i SUPPLIES 67mam 10/1s/20.10115/20 11/09/20 1,288.4.9 0.00 0.00 1093�6141 LEASE 6718447-75- 10/25/20. 10/13/2011107/20. 52.54 0.00 0.00 10131,%d SUPPLIES 47866898 10/25/20 10/15/20 11100/20 269.02 0.00 0.00 SUPPLIES S447898✓ 10/27/20. 10/13/2011/07120 5,016.58 0.00 0.00 LEASE Vendor Totals Number Name Gross Discount No -Pay B1220 BECKMAN COULTER INC 8,064.58 0100 0.00 Vendor# Vendor Name Class Pay Code 12600 BIOFIRE DIAGNOSTICS LLC Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount No -Pay 1280142536 ^ 10/27/20 10/22/2011/04120 13,950.00 0,00 0.00 V SUPPLIES Vendor Totals Number Name Gross Discount No -Pay 12600 BIOFIRE DIAGNOSTICS LLC 13,950.00 0.00 0.00 Vendor# Vendor Name Class Pay Code B1655 BOSTON SCIENTIFIC CORPORATION v ^ M Involce# Comment Tran or Inv Dt Due Dt Check D, Pay Gross Discount No -Pay 980786932 ✓ 10111/20. 09122/2011/01/20 374.00 0.00 0.00 SUPPLIES ^ 981000640 ✓ 10/19/20 10/04/20 10/19/20 384.00 0.00 0.00 SUPPLIES 980397422 +.`� 10/27/20 10127/20 10/27/20 374.00 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay B1855 BOSTON SCIENTIFIC CORPORATION 1,132.00 0.00 0.00 Vendor#Ventlor Name Class Pay Code 14120 CALHOUN COUNTY EMS v ' Net 890.40 4^ Net 890A0 Net 45.97 ✓ Net 45.97 Net 301.33 43.66 v' 1,093.10 1,288.45 +r' 52.54 269.02 5,016.58 Net 8,064,5E Net 13,950.00 Net 13,950.00 Net 374.00 �. 384.00 374.00 0^ Net 1,132.00 file:///C:/Users/Cheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp ew5report7390... 10/28/2021 Page 1 of 15 Invoice# Comment Tran Ot Inv Dt Due Dt Check D" Pay Gross 21-10-0003 10/15/20 10/14/20 11/05/20 3,080.00 PATIENT TRANSPORTS Vendor Totals Number Name Grass 14120 CALHOUN COUNTY EMS 3,080.00 Vendor# Vendor Name Class Pay Cade C1992" CDW GOVERNMENT, INC. <<'' M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross L813857 _/' 10/18/20. 10/06/20 11/05/20. 110.49 SUPPLIES Vendor Totals Number Name Gross C1992 CDW GOVERNMENT, INC. 110.49 Vendor# Vendor Name Class Pay Code 13264 CERVEY, LLC ✓- Invoice# Comment Tran or Inv Dt Due Dt Check D" Pay Gross 12769 10/19/20. 10/15/20 11/09/20 1,699.00 MONTHLY LICENSING FEE Vendor Totals Number Name Gross 13264 CERVEY, LLC 1,699.00 Vendor# Vendor Name Class Pay Code C1730 CITY OF PORT LAVACA �,/ W Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross 101221 10120/2010/1 PJ2011/05/20 25.68 WATER ACCT 12-1315.00 1012E 10/20/2010/1212011/05/20 64.13 WATER ACCOUNT 12-1260.02 101221C 10120/20 10112120 11105/20 60,93 WATER ACCT 12-6505-01 101221A 10/20/2010/12/2011/05120 5,442.38 WATER ACCT 12-1320-00 Vendor Totals Number Name Gross 01730 CITY OF PORT LAVACA 5,593,12 Vendor# Vendor Name Class Pay Code Cl 166 COASTAL OFFICE SOLUTONS ,1 ' W Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Grass OE-OT-18567-1 q./ 10/27/20 10/01/20 10111120. 162.72 SUPPLIES Vendor Total: Number Name Gross C1166 COASTAL OFFICE SOLUTONS 162.72 Vendor# Vendor Name Class Pay Code 14080 CORROHEALTH, INC. vZ Invoice# Comment Tran Dt Inv Dt Due Dt Check D" Pay Gross 84 10/11/20 lo/05/2011/04/20 2,578.30 CODING SERVICES 46958 �' 10/2W2007/06/2011104/20 2,183.00 CODING SERVICES Vendor Totals Number Name Gross 14080 CORROHEALTH, INC. 4,761.30 Vendor# Vendor Name Class Pay Code 11107 COURTNETHURLKILL✓` Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0.00 0.00 3,080.00 Discount No -Pay, Net 0.00 0.00 3,080.00 Discount No -Pay Net 0.00 0.00 - 110,49 Discount No -Pay Net 0.00 0.00 110,49 Discount No -Pay Net 0.00 0.00 11699.00 Discount No -Pay Net 0.00 0.00 1.699.00 Discount No -Pay Net 0.00 0.00 25.68 y: ` 0.00 0.00 84.13 0.00 0.00 60.93 0.00 0.00 5,442,38 v Discount No -Pay Net 0.00 0.00 5,593.12 Discount No -Pay Net 0.00 0.00 162.72 Discount No -Pay Not 0.00 0.00 162.72 Discount No -Pay Net 0.00 0.00 2,578.30 0.00 0.00 2,183.00 Discount No -Pay Net 6.00 0.00 4,761.30 Discount No -Pay Net file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp cw5report7390... 10/28/2021 Page 4 of 15 102021 10/26/2010/20/2010/27/20. 888.00 0.00 0.00 888.00 DEA LICENSE RENEWAL G-1 Vendor Totals Number Name Gross Discount No -Pay Net 11107 COURTNETHURLKILL 888.00 0.00 0.00 888,00 Vendor# Vendor Name Class Pay Code 10646 COVIDIEN ,../ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5864557956 ✓ 10/25/20 10/14/2011/04/20. 3,764.85 0.00 0.00 3,784.85 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10648 COVIDIEN 3,784,85 0.00 0.00 3,784.85 Vendor# Vendor Name Class Pay Code 10368 DEWITTPOTH$SON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6581890 10/11/20. 10111 /2011/05/20. 419.36 0.00 0.00 419.36 tj SUPPLIES 6581870 ✓ 10115/2010/0412011/04120. 37.39 0.00 0.00 37.39 Vim. SUPPLIES 6588791tj 10/15/20. 10/11/2011/05/20 35.58 0.00 0.00 35.58 SUPPLIES 6593780 z 10/15/20 10/12/20 11/06/20 16.23 0.00 0.00 16.23 SUPPLIES 4j 6592770 .,!� 10/15/20. 10/12/2011106/20 175.00 0.00 0.00 175.00 ✓- SUPPLIES 6592750 10/15120. 10/12/2011/06/20 237.09 0.00 0.00 237.09 .SUPPLIES 6593900./ 10/15120 10113/20 11/07120, 200.11 0.00 0.00 200.11 ✓' SUPPLIES 6593740 10/15/20 10113120 11/07/20 309.92 0.00 0.00 309.92 SUPPLIES 6592811 W+' 10119/2010/15/2011/09/20 86.65 0.00 0.00 86.65 SUPPLIES 4,r' 6597y'1680 � 10119120 10/15/20 11/09/20 886.16 0.00 0.00 886.16 SUPPLIES 6597800 v% 10/19/20 10/15/20 11/09/20. 49.43 0.00 0.00 49.43 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH 8 SON 2,452.92 0.00 0.00 2,452.92 Vendor# Vendor Name Class Pay Code 11960 DILONTECHNOLO(3IES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 00036531 10/26/2010/13/2011/08/20 100.00 0.00 0,00 100.00 SUPPLIES 00036496 ✓ 10/28/2010104/2011/01/20. 300.00 0.00 0.00 300.00 SUPPLIES Vendor TotalsNumber Name Gross Discount No -Pay Net 11960 DILON TECHNOLOGIES 400.00 0.00 0.00 400.00 Vendor# Vendor Name Class Pay Code 10789 DISCOVERY MEDICAL NETWORK INC y% Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMC101521 10/22/20. 10/15/2011104/20 71,432.42 0.00 0.00 71,432,42 V• file:///C:/Users/eheiman/cpsi/menuned.ei)sinet.com/u98547/data 5/tm13 cw5report7390... 10/28/2021 Page 5 of 15 PROFEES OC.i- 1-IS,Ztrzl Vendor Totals Number Name Gross 10789 DISCOVERY MEDICAL NETWORK INC 71,432.42 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 40682 10127/20. 10/31/2011/01120 40,062.50 ED PHYSICIAN SERVICES [IeVvLk Vendor Totals Number Name Gross 11284 EMERGENCY STAFFING SOLUTIONS 40,062.50 Vendor# Vendor Name Class Pay Code 10042 ERBE USA INC SURGICAL SYSTEMS �, ,' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 709276 .,� 10/25/20 10/18/20 11/04/20 139.50 SUPPLIES Vendor Totals Number Name Gross 10042 ERBE USA INC SURGICAL SYSTEMS 139.50 Vendor# Vendor Name Class Pay Code 13872 ETHOS MEDICAL STAFFING ,,,`' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 28463 10/22/2010101/2011/04/20 4,988.30 TRAVEL NURSE STAFFING ICI 28606 10/22/20 I0/08120 i wmo 3,944.30 TRAVEL. NURSE STAFFING ICI Vendor TotalsNumber Name Gross 13872 ETHOS MEDICAL STAFFING 8,932.60 Vendor# Vendor Name Class Pay Code S0501 EVOQUA WATER TECHNOLOGIES LLC - Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 905104491 ✓ 10/18/20 10/12/20 11/06/20 710.98 CARTRIDGE Vendor Totals Number Name - Gross S0501 EVOQUA WATER TECHNOLOGIES LLC 710.98 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP.yi l W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 7-532-37983 V 10/21/20. 10/14/20 11/0t1/20 90.62 FREIGHT Vendor Totals Number Name Gross F1100 FEDERAL EXPRESS CORP. 90.62 Vendor# Vendor Name Class Pay Code 14092 FIRST CONNECT CENTER LLC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 2934 �z 10/1212010108/2011/07/20, 4,500.00 MEd SURG STAFFING Vendor Totals Number Name Gross 14092 FIRST CONNECT CENTER LLC 4,500.00 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE ,i M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross 7256209 �Z 10/1,9/2010/15/2011/09/20 255.88 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Net 71,432A2 Net 40,062.50 a = Discount No -Pay Net 0.00 0.00 40,062.50 Discount No -Pay Net 0.00 0.00 139.50 Discount No -Pay Net 0.00 0.00 139.50 Discount No -Pay Net 0.00 OAO 4,988.30 ,�- 0.00 0.00 3,944.30 ,r v Discount No -Pay Net 0.00 0.00 8,932.60 Discount No -Pay Net 0.00 0.00 710.98 Discount No -Pay Not 0.00 0.00 710.98 Discount No -Pay Net 0.00 0.00 90.62 t j ` Discount No -Pay Net 0.00 0.00 90.62 Discount No -Pay Net 0.00 0.00 4,500.00 Discount No -Pay Net 0.00 0.00 4.500.00 Discount No -Pay Not 0.00 0.00 255.88 file:///C:/Users/eheiman/cpsi/memmed.cpsinet,com/u98547/data 5/tmp cw5report7390... 10/28/2021 Page 6 of 15 SUPPLIES 8109930' 10119/2010/08/2011/02/20 30.11 0.00 0.00 30,11 SUPPLIES 8277865 ,� 10/19/2010/1112011/05/20 71.32 0.00 0.00 71.32 �.-%- SUPPLIES 8109931 �%� 10/19/2010/15/2011/09/20. 120.59 0.00 0.00 120.59 SUPPLIESX 8639223 b% 10/26/20 10/13/20 11/07/20 114.40 0.00 0.00 114.40. v" SUPPLIES 9367511 v' 10/26120 10/14120 11108/20 1,1366.90 0.00 0.00 1,066.90 v' SUPPLIES 1003095 10127120. 09/02/20 11/01/20 1,082,96 0.00 0.00 1,082.96 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 2,742,16 0.00 0.00 2,742.16 Vendor# Vendor Name Class Pay Code 12944 FRASIER HEALTHCARE CONSULTING,/' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 191n ,„ 10/21/2010/18/2011/04/20.. 12,279.48 0.00 0.00 12,279.48 u.•' COLLECTIONS Vendor Totals Number Name Gross Discount No -Pay Net 12044 FRASIER HEALTHCARE CONSULTING, 12,279.48 0.00 0,00 12,279.48 Vendor# Vendor Name Class Pay Code 11984 GUERBET, LLC . Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 18561304 y 10/05/20 10/04/20 11/04/20 350.00 0.00 0.00 350.00 v- SUPPLIES 18563976 .,' 10/25/20 10/13/20 11/04/20 700.00 0.00 0.00 700.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11984 GUERBET, LLC 11050.00 0.00 0.00 11050,00 Vendor# Vendor Name Class Pay Code H0416 HOLOGIC INC rj , Invoicelt Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9887228 e% 10/21/2010/1312011/04/20 708.75 0.00 0.00 708.75 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 708.75 0.00 0.00 708.75 Vendor# Vendor Name Class Pay Code 12932 INTRADO 1%I Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay Net INVO02383688 ✓' 10/21/20. 09130/2011/04/20 683.85 0.00 0.00 682.85 ✓ HOUSE CALLS Vendor Totals Number Name Gross Discount No -Pay Net 12932 INTRADO 683.85 0.00 0.00 683.85 Vendor# Vendor Name Class Pay Code 11285 ITA RESOURCES INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMC102021 r,/' 10/25/20 10/18/20 11/07/20 26,660.00 0.00 0.00 26,660.00 RESPIRATORY ` Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/Users/eheimaii/cpsi/memmed.cpsinet.com/u98547/data 5/tmp cw5report7390... 10/28/2021 Page 7 of 15 11285 ITA RESOURCES INC 26,660.00 0.00 0.00 26,660.00 Vender# Vendor Name Class Pay Code L0700 LABCORP OF AMERICA HOLDINGS J., M Invoice# Comment Tran Dt Inv Dt Due Dt 70308060A^'`! Check D Pay Gross Discount No -Pay Net 10/27/20 09/2512010/20120 36.43 0.00 0.00 38.43 LAB SERVICES Vendor Totals Number Name v-' Grass Discount No -Pay Net L0700 LA13CORP OF AMERICA HOLDINGS 38.43 0.00 0.00 Vendor# Vendor Name Class Pay Code 38.43 M1511 MARKETLAS,INC ✓ w Invoice# Comment Tran Dt Inv Dt Due Dt Check D'Pay Gross Discount No -Pay Net IN01496908 ✓' 10125/20 10/13/20 11/04/20 96.66 0.00 SUPPLIES 0.00 96.66 Vendor Totals Number Name Gross Discount No -Pay Net M1511 MARKETLAB, INC 96.66 0.00 0.00 Ventlor# Vendor Name Class Pay Code 96.66 11612 MASA GLOBAL BUILDING Invoice# comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 1106313 10121/2010/21/2011/04/20. 1,655.00 0.00 0.00 INSURANCE 105.00 Vendor Totals Number Name Gross Discount No -Pay Net 11612 MASA GLOBAL BUILDING 11655.00 0.00 0.00 1,655.00 Vendor# Vendor Name class Pay Cods M2827 MEDIVATORS ,.� M Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount No -Pay Net 91042452 ,% 10111/20 09/08/20 11/01/20 202.80 0.00 0.00 SUPPLIES 202.804;/ 91091114 ✓` 10/21/20 10/19/20 11/04/20 202.80 0.00 SUPPLIES 0.00 202.80 w/ Vendor Totals Number Name Gross M2827 MEDIVATORS Discount No -Pay Net Vendor# Vendor Name 405,60 0.00 0.00 405.60 Class Pay Code M2470 MEDLINE INDUSTRIES INC M v Invoice# Comment Tran Ut Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 1968143335 vim' 10/11120 09/29/20 11/01/2D 117.87 0.00 0.00 SUP LIES 117.87 1968143330 10/11/2009/29/2011/01/20. 1,333.01 0.00 SUPPLIES 0.00 1,333,D7 e,r%- 1968869041 .f 10/1 t/20. 10/05/2010/30/20 1,759.95 0.00 SUPPLIES 0.00 1,759.95 1968869056 / 10/11/20 10/11/20 11/06/20 121.98 0.00 SUPPLIES 0.00 121.98 ✓' 1957468788 ,r` 10/12/2007/03/2011/01/20 131.61 0,00 0.00 SUPPLIES 131.61 ate` 1969028376 ✓/ 10/12/20 10106120 10131/20 3,729.50 0,00 S SUPPLIES 0.00 $,729.50 1969617661 ✓ 10/12/2010109/20 11/03/20 233.96 0.00 SUPPLIES 0.00 u 1969802293.% 10/12/20 10112/20 11/06/20 369.83 0.00 SUPPLIES 0.00 389.83 1969802294 `,, 10/12/20 10112/20 11/06120 72.32 0.00 0.00 72.32 tile:///C:/Users/0hciman/cPsi/memmed.cpsinet.com/u98547/data 5/tmp cw5report7390... 10/29/2021 Page 8 of 15 SUPPLIES 1969802289 i . 101121201011PJ2011/06/20 SUPPLIES 1969802287 10/12/20 10/12/20 11/06/20 SUPPLIES 1969802298y` 10/12/2010/12/2011/06120 SUPPLIES 1970365728 ✓ / 10/12/20. 10/15/20 11/09120. SUPPLIES 1970365729 1l� 10112120. 10/15/2011/09/20. SUPPLIES 1965636474 �/ 10/15/20. 09/09/2011/04120 SUPPLIES 1967241549 yj 10/15/20 09/22/20 11/04/20 SUPPLIES 1967215380 ✓ 10/15/20 09/22/20 11/04/20 SUPPLIES 1969843423 .i 10/15/2010/1212011/06/20 SUPPLIES 1970139153, % 10/15/20 10/13/20 11107/20. SUPPLIES 1970189915 i/ 10/15/20 10/14/20 11/08/20 SUPPLIES 1970189913 1/ 10/15120. 10/14/20 11/08/20. SUPPLIES 1969028372 // v 10/15/20, 10/75/20 11/09l20 SUPPLIES 1969843419 10/18120, 10/12/2011/06/20 SUPPLIES 1970537730�/ 10/1812010/1512011/09/20 SUPPLIES 19705377311% 10/18/2010115/2011/09120. SUPPLIES 1969957483 V/ 10/2512010/13/20 11107/20 SUPPLIES 1969958813 � 10/25/20. 10/13/20 11/07/20 SUPPLIES 1969957497 „r` 10/25/20. 10/13/2011107120 SUPPLIES 1969957492 ii ' 10/25/20 10/13/20 11/07/20. SUPPLIES 197013153 10/25/20 10/13/20 11/07/20 SUPPLIES 1969957489 ,/ 10/25/20 10/13/20 11/07/20 SUPPLIES 1969957496 1/ 10/25/20 10/13/20 11/07/20 SUPPLIES 1969957494 � / 10/25/20 10/13/2011/07/20 SUPPLIES 1969957485 V1 10/25/20 10/13/20 11/07/20 SUPPLIES 367.18 0.00 0.00 53.87 0.00 0.00 226.31 0.00 0.00 40.56 0.00 4.75 0.00 1,102.47 0.00 2,851.47 0.00 3,028.24 0.00 816.01 0.00 11251,11 0.00 89.60 0.00 2,302.04 0100 1,471.72 0.00 5,000.00 0.00 255.69 0.00 75.38 0.00 51.38 0.00 272.02 0.00 78.19 0.00 54.90 0.00 1,251.11 0.00 66.38 0.00 44.58 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,536.20 0.00 0.00 5.38 0.00 0.00 367.18 v 53.87 M,,- 226.31 ,, 40.56 v' 4.75 1,102.47 y' 2,851.47 3.028.24 V^'' 816.01 1,251.11 89.60 2,302.04 1,471.72 5,000.00� 255.69 75.38 ✓ 51.38 a/ 272.02 � 78.19 j 54.90 ✓ 44.58 r i 1,536.20 ✓ 5.38 file:///C:/Users/eheimall/cpsi/niemmed.cpsinet.com/u98547/data 5/tlnp cw5report7390... 10/28/2021 Page 9 of 15 1969057490 ✓ 10/25/20. 10/13/20 11/07/20. SUPPLIES 69.70 0.00 0100 69.70 1969958812 ✓ 10/25/20 10/13/2011/07/20 SUPPLIES 203.86 0.00 0.00 203.86 1969958807 ✓ 10/25/20. 10/13/2011107/20 2,244, ,244.63 0.00 0.00 2,244.63 pF'` ,A969957476✓ 10/26120 10/13/20 11/07120 SUPPLIES 52.82 0.00 0100 52.82 1969957487,,.1 10/25/2010/13/20 11/07/20 SUPPLIES 4.60 0.00 0.00 4.60 1969957478 / 10/25/20 10/13/20 11/07/20 ' SUPPLIES 54.52 0.00 0.00 54.52 1969958814 � - 10/25/2010/13/2011/07/20 SUPPLIES 22.78 0.00 0.00 22.78 1969957481 t/' 10/2-9/20. 10/13/20 11/07/20 SUPPLIES 96.76 0.00 0.00 96.76 v' 1970536515,// 10/25/20 10/15/20 11109120 SUPPLIES 92.93 0.00 0.00 92.93 1961145259./- 10/27/2008/04/2011/01/20 SUPPLIES 48.08 0.00 0.00 48.08 v' 1962209299 ,j- 10/27/20. 08/12/201 owo SU/I PLIES 146.tB 0.00 0.00 146.18 1963301175 r/ 10/27120, 08/20/2011/Ot/20. - SUPPLIES 69,96 0.00 0.00 69.96 19636622215 , / 10/27/20 08/24/20 11/04/20 SUPPLIES 54.89 0.00 0.00 54.89 1965723080 _/ 10127/20. 0911012011104/20 SUPPLIES 1,923.17 0.00 0.00 1.923,17 vi 1969987285 ✓ 10/27120. 10/13/2011/07120 289.14 0.00 0.00 289.14 19699987287 ✓ 10/27/20 10/13/20 11/07/20 SUPPLIES 207.61 0.00 0.00 207,61 Vendor Totals Number Name �. M2470 MEDLINE INDUSTRIES INC Gross Discount 0.0 Not Vendor# Vendor Name 35,748.20 0.00 0.000 35,748,20 10825 Class Pay Code MEMORIAL MEDICAL CLINIC ,% ICP Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross 102121 10/26120. 10/21/20 10/21/20 Discount No -Pay Net PAYROLL DEDUCT$ 190.00 0.00 0.00 190.00 - Vendor TotaN Number Name v- 10825 MEMORIAL MEDICAL CLINIC Gross Discount No -Pay Net Vendor# Vendor Name 190.00 0.00 0.00 190.00 Class Pay Cade 10536 MORRIS & DICKSON CO, LLC ✓ Invoice# Comment Tran Dt I Inv Dt Due Dt Check D Pay Gross CM81700 ✓10/27/20 1D/14/20 10/24/20 Discount No -Pay Net 1 CREDIT -285.88 0.00 0.00 -285.88 7434712 ✓ 10/27/20 10/14/20 10/24/20 INVENTORY 12029 0.00 0.00 120:29 ✓� CM81454 J 10/27/20 10/14/20 10124120. CREDIT MEMO -30.66 0.00 0.00 -30.66 2394 ,.% 10/27/20 10114/20 10/24120 y -5.00 0.00 0.00 •5.00 ✓' file:///C:/Users/eheitnan/oDsi/nletntned.CDsinet.COm/U98547/data Slttnn cw5rennrt7390 i(l/�R/71171 Page 10 of 15 CREDIT 7484711 ✓ 10/27/2010/14/2010/24/20. INVENTORY 23.16 0.00 0.00 23.16 a, CM81453 �e 10/27/2010114/2010/24/20 CREDIT I Not hkWk(,�r GVLWA� •40.98 O.OD 0.00 •40.98 7452684 �/ 10/27120 10/19/20 10/29/20 4,464.43 INVENTORY 0.000.00 4,464.43 745266510/27/20. 10/19/20 10/29/20 INVENTORY 1,954.11 0.00 0,00 1,954.17 7452686 .%` 10/27/20 10/19/20 10/29120 489.32 0.00 0.00 489.32 , 7449557 ,,� 10/27/2010/19/2010/29/20 INVENTORY 4,741.69 0.00 0.00 4,741.89 7449558 -�'- 10/27/2010/19/2010/29/20 INVENTORY 21.36 0.00 0.00 21:38 7455600 V.' 10/27120 10/20/20 10/30/20 4.75 INVENTORY 0.00 0.00 4.75 l 7457483 / 10127/2010/20/2010/30/20 185.43 INVENTORY 0.00 0.00 185.43 7457484 10/27/2010/20/2010/30/20 33.15 0.00 0.00 33.15 CM83076 ,/`� 10/27/20 10/2212011/01/20 CREDIT •34.74 0.00 0.00 -34,74 v 7467956 �/ 10/27120 10/24/20 11/03/20 33.06 INVENTORY 0.00 0.00 33.06' 7467955 r 10/2712010/24/2011103120 v 987.44 0.00 ' INVENTORY 0.00 987.44 t„! 7467954 10/27/20 10/24/20 11103120, 195.72 INVENTORY 0.00 0.00 195.72 Vendor Totals Number Name 10536 MORRIS & DICKSON CO, LLC Gross Discount No -Pay Net Vender# Vendor Name 12,856.87 0,00 0.00 12,856,87 Class Pay Code 14164 MOUSER ELECTRONICS, INC. Invoice# Comment Tran 6[r Inv Dt Due Dt Check D Pay Gross 64264752 10/25/20 10/20/20 11 /04/20. Discount No -Pay Net SUPPLIES 38.70 0.00 0.00 38,70 Vendor Totals Number Name 14164 MOUSER ELECTRONICS, INC. Gross Discount No -Pay Net Ventlor# Vendor Name 38.70 0.00 0.00 36.70 Class Pay Code 13548 NACOGDOCHES TRANSCRIPTION Ihvoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross ✓7518 Discount No -Pay 10/26/20 1012WO 11/04/20 721.14 0.00 Net CODING SERVICES 0.00 721.14 Vendor Totals Number Name 13548 NACOGDOCHES TRANSCRIPTION Gross Discount No -Pay Net Vendor# Vendor Name 721.14 0.00 0.00 721 14 Class Pay Code 12388 NATIONAL FARM LIFE INSURANCE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 3538286 Discount No -Pay 10/21/20 10/21 /20 11 /0412Q Net INSURANCE 31505.88 0.00 0.00 3,505.88 ir- Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/Users/eheiman/cl)si/memmed.cnsinet-com/u98547/data MITID ew5reuort7390... 10/28/2021 Page 11 of 15 12388 NATIONAL FARM LIFE INSURANCE Vendor# Vendor Name 31505.88 0.00 0.00 31505.88 Pay Code 13024 NEXION HEALTH AT NAVASOTA INC 'Class Invoice# Comment Tran Dt Inv Dt� Due Dt Check D Pay Gross TELEMED 1002 10/28120 10/01 /20 10/31120. Discount No -Pay Net TELEMED REIMBURSMENT 11000.00 0.00 0.00 11000.00 Vendor Totals Number Name 13624 NEXION HEALTH AT NAVASOTA INC Gross Discount N0 Net Vendor# Vendor Name 11000A0 0.00 0.00 11000.00 10868 NOVABIOMEDICAL // Class Pay Cade Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass 90919655 ✓ 10/21/2010/15/2011/04/20 Discount No -Pay Net 120.QD SUPPLIES 0.00 0.00 120.00 Vendor Totals Number Name Gross 10868 NOVA BIOMEDICAL Discount No -Pay Net 120.00 Vendor# Vendor Name 0.00 0.00 1,.n 000 11256 NOVITAS SOLUTIONS -PART A Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 102721 10/27/20 10l27/20 10/27/20 Discount No -Pay Net MEDICARE INTERIM REIMBUF 339,928,00 {Mv usovul:rMa 0.00 wq 0. vdM19bWyM._1- 339,928.00 ovk Vendor Total; Number Name IV uu4 ) 11256 Gross NOVITAS SOLUTIONS • PART A Discount No -Pay Net Vendcrlr Vendor Name 339,928.00 0.00 0,00 339,828.00 Class Pay Code 11069 PABLO GARZA �' Invoice# Comment Tran Dt Inv Dt Due Dt Check DL Pay Gross 102721 10/27/2010/27/2D 10/27/2a, Discount NO -Pay Net CONTRACT EMPLOYEE 2,632.50 0.00 0.00 2,692.50 Vendor Totals Number Name Gross 11069 PABLO GARZA Discount No -Pay Net Ventlor# Vendor Name 2,632.50 0.00 0.00 2,632.50 Class Pay Code z 13988 PAYCHEX, ADVANCE FBO a,, Invoice# Comment Tran Dt Inv Dt Due Dt Check Or Pay Gross 007080 10/22/2010(20/2011/04/20 Discount No -Pay Net TRAVEL NURSE STAFFING 3,675.00 0.00 0.00 3,675.00 4 Vendor Totals Number Name 13988 PAYCHEX, ADVANCE FBO Gross Discount Pay Net Vendor# Vendor Name 3,675.00 0.00 0.0 0.00 3,875.00 12708 POO ELECTRIC, LLC -, Class Pay Cede Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 3416 of 10/21/2010/13/2011/04/20 No -Pay Net POWER UP CHILLER 900,U0 0.00 0.00 900,00 Vendor Totals Number Name 12708 POC ELECTRIC, LLC Gross Discount No -Pay Not Vendor# Vendor Name 900.00 0.00 0.00 900.00 Class Pay Code P2100 PORT LAVACA WAVE �, W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 093021 10/27/20. 09/30/20 10/25/20 Discount No -Pay Net 250.00 WAVE ONLINE 0.00 O.OD 250.00 Vendor Totals Number Name Gross P2100 PORT LAVACA WAVE Discount No -Pay Net 250.00 Vendor# Vendor Name 0.00 0.00 250.00 Class Pay Coda file:///C:/Users/eheiman/cl)si/memmed.cDsinet.com/Lt98547/data 5/tmn cw5renort7390... 10/28/2021 Page 12 of 15 12460 PRO ENERGY PARTNERS LP ✓,- Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2109.0600 ✓ '- 10/25/20 10/13/20 11/04/20 3.094.71 0.00 0.00 3,094.71 NATURAL GAS Vendor Totals Number Name Gross Discount No -Pay Net 12480 PRO ENERGY PARTNERS LP 3,094.71 0.00 0.00 3,094.71 Vendor# Vendor Name Class Pay Code 11080 RADSOURCE / Invoice# Comment Tran or Inv Dt Due Dt Check tT Pay Gross Discount No -Pay Net SC62863 10119/2010/16/2011/10120. 1,625.00 0.00 0.00 1,625.00 MAINT CONTRACT Vendor Totals Number Name Gross Discount No -Pay t.' Net 11080 RADSOURCE 1,625.00 0.00 0.00 1,625.00 Vendork Vendor Name Class Pay Code 11764 ROBERT RODRIQUEZ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gress Discount No -Pay Net 102621 10126/20. 10/26/2010126120 64.71 0.00 0.00 64.71 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11764 ROBERT ROORIQUEZ 64.71 0.00 0.00 64.71 Vendor# Vendor Name Class Pay Coda $0900 SAWS CLUB DIRECT - w v Invoice# Comment Tran Dt Inv Dt Dua Dt Check D Pay Gross Discount No -Pay Net 009215 10/26/20 09/20120 11/08/20 104.62 0.00 0.00 104.62 SUPPLIES �,. 00475 10/26120. 0912112011/08/20 169.90 0.00 0.00 169.90�� " SUPPLIES 001181 10/26/20 09/24/20 11108/20. 43.74 0.00 0.00 43.74 SUPPLIES �.•' 005270 10/26/20 09/2612011108120 47.90 0.00 0.00 47.90 SUPPLIES -'' 005724 10/26/2009/29/2011108120. 78.48 0.00 0.00 78.48 SUPPLIES 006687 10/26/2010/04/2011/08/20 138.84 0.00 0.00 138.84 SUPPLIES 006707 10/26/20 10/07/20 11/08/20 75.76 0.00 0.00 75.76 SUPPLIES 002162 10/26/20 10/10120 11108/20 108.78 0.00 0.00 108.78 SUPPLIES ,,. 005401A 10/26/2010/1112011/08/20. 100.37 0.00 0.00 100.37 SUPPLIES 007085 10/26/20 10/13/20 11/08/20 85.28 0.00 0.00 85.28 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Not 50900 SAM'SCLUBDIRECT 953.67 0.00 0.00 953.67 Ventlor#Vendor Name Class Pay Code 13172 SERACARE LIFE SCIENCES, INC w% Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 90168090 / 10/27/2009/02/2011/03/20 189.52 0.00 0100 supplies 189.52 N' Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/Users/cheiman/cnsi/memned.ct)sinet.com/u9R547/data 5/tmn cw5re.nnrt73Q0 tp/?R/7n?1 Page 13 of 15 13172 SERACARE LIFE SCIENCES, INC Vendor# Vendor Name 189.52 0.00 10936 SIEMENS FINANCIAL SERVICES Class Pay Cade Invoice# Comment Tran Dt Inv Dt .Due Dt Check D Pay Gross 118122788 �� 10/26/2010/16/2011/09/20. Discount MAINT CONTRACT 2,193.83 O.Oq Vendor Totals Number Name Gross 10936 SIEMENS FINANCIAL SERVICES Discount Vendor# Vendor Name 2,193.83 0.00 10699 SIGN AD, LTD. 4j Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Grass Discount 287118 10/27/20. 10/16/2010/26/20 ��BILLBOARD 400.00 0.00 Vendor Totals Number Name 10699 SIGN AD, LTD. Gross biscoun[ Vendor# Vendor Name 400.00 0.00 11296 SOUTH TEXAS BLOOD & TISSUE CEN ,lass Pay Cade Invoice# Comment Tran Dt Inv Di' Due Dt Check D Pay Grose i 107017948 ✓ 10/25/2010/15/20 I i/09/20 Discount 13,976.00 BLOOD 0.00 CM5609 „/ 10/25/20. 10/15/20 11/09/20 -3,081.00 CREDIT 0.00 Vendor Totals Number Name Gross 11296 SOUTH TEXAS BLOOD & TISSUE CEN Discount 10,895.00 VentloNt Vendor Name 0.00 $2345 SOUTHEAST TEXAS HEALTH SYS Class Pay Code Invoice# INComment Tran Dt Inv Dt Due Dt Check D Pay Gross 26582 ✓� 10/07/20. 10/05/2011/04/20. Discount CREDENTIALING 125.00 0.00 Vendor Totals Number Name S2345 SOUTHEASTTEXAS HEALTH SYS Gross Discount Ventlor# Vendor Name 125.00 0.00 C1010 SPARKLIGHT .! Class Pay Code W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 1016278 - 10/26120 10116120 11/04/20 ACCOUNT 128686862 100.65 0.00 101621A 10126/201011612011104/20. ACCOUNT 118134105 101.70 0.00 101621 10/26/20 10/16/20 11/04/20 �3%-LU2,2�&oo ACCOUNT logsa76z7 moo 041521 10127120. 04/15/20 10/31/20 1,675.13 INTERNET 0.00 0.00 189.52 No -Pay Net 0.00 2,193.83 No -Pay Net 0.00 2,193.83 No -Pay Net 0.00 400.00 No -Pay Net 0.00 400A0 No -Pay 0.00 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 0.00 0.00 0,00 101621D 10/2712010/16/2o 10/16120 INTERNET 1,685.67 0.00 0.00 Vendor Totals Number Name C7010 SPARKLIGHT Gross Discount No -Pay Ventlor# Vendor Name 51813.15 0.00 0.00 14100 STAFFING FIRST Class Pay Code Invoice#Comment Tran Dt Inv Of Due Dt Check D Pay Gross Discount 211018 10/22/20 10/18h20 11 /04/20 No -Pay TRAVEL NURSE STAFFING 4,626.00 0,00 0.00 Net 13,976,00 v; -3,081.00 _, Net 10,895.o0 Net 125.00 Net 125.o0 Net 100.65 , , c 101.70 4 j 2,25gt00 zgti d.w 1,675.13 , 1.685.67t,/ Net 51813.15 Net 4,625.00 4r file:///C:/Users/eheunan/cpsi/memined.cpsinet,eom/u98547/data 5/t1nD cw5renor1:7390... 10/28/2021 Page 14 of 15 Vendor Totals Number Name Gross Discount No -Pay Net 14100 STAFFING FIRST 4,625.00 0.00 0.00 4,625.00 Vendor# Vendor Name Class Pay Code 10735 STRYKER SUSTAINABILITY 5% Invoice# _Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4265071 / 10/11/20 09/09/20 11/01/20 6,976.18 0.00 0.00 6,97618 Vendor Totals Number Name Gross Discount -No-Pay Net 10735 STRYKER SUSTAINABILITY 6,976.18 0.00 0.00 6,976.18 Vendor# Vendor Name Class Pay Code T1450 TEXAS ASSOCIATION OF COUNTIES „�'r W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 100921 10/21/20 10/09/20 11/04/20 4,319.03 0.00 0.00 4,319.03 3RD ORT UNEMPLOYMENT t f: Vendor Totals Number Name Gross Discount No -Pay Net T1450 TEXAS ASSOCIATION OF COUNTIES 4,319.03 0.00 0.00 4,319.03 Vendor# Vendor Name Class Pay Code 10758 TEXAS SELECT STAFFING, LLC 1i Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0018340510791N ,f� 10122/20 10/21/20 11104/20 9,180.00 0.00 0.00 9,180.00 TRAVEL NURSE MEDSURG/IC L!` Vendor Totals Number Name Gross Discount No -Pay Net 10768 TEXAS SELECT STAFFING, LLC 9,180.00 0.00 0.00 9,180.00 Vendor# Vendor Name Class Pay Code 11908 TMS SOUTH 1./- Invoice4 Comment Tran Dt Inv Dt Due DI Check 0 Pay Gross Discount No -Pay Net INV26202 , ,- 10/21120. 09/10/2011/04/20 239.53 0.00 0.00 239.53 - SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11908 TMS SOUTH 239.53 0.00 0.00 239.53 Vendor# Vendor Name Class Pay Code T3334 TRINITY PHYSICS CONSULTING LLC - W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 03-5228 10/19/20 10111120 11/10/20 3,150.00 0.00 0.00 3,15o.00 V%% EVAL SERVICES Vendor Totals Number Name Gross Discount No -Pay Net T3334 TRINITY PHYSICS CONSULTING LLC 3,150.00 0.00 0.00 31150.00 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 8400379131. 10/1512010/141/2011108(20 197.10 0.00 0.00 197.10,,,- LAUNDRY 8400379163,j" 10/15(2010/14/2011/08/20 132.89 0.00 0.00 132.89 LAUNDRY f i 8400379144 ✓ 10118/20 10/14/20 11/08/20 79.43 0.00 0.00 79.43 LAUNDRY 8400379130 �' 10/18/2010/1412011/08/20. 137.13 0.00 0.00 137.134j� LAUNDRY 8400379133 10118/2010/14/2011/08/20. 199.32 0.00 0.00 LAUNDRY 8400379128 ✓'` 10/18120 10/14120 11/08/20 3875 0.00 0.00 38.75 file:///C:/Users/eheiman/ci)si/memmed.cosinet.com/u98547/data 5/tmn cw5renort7390_. I0/2R/9091 Page 15 of 15 LAUNDRY 8400379150 ✓ 10/18/2010/14/2011/08120. 1,440.97 0.00 0.00 1,440.97 LAUNDRYV 8400378812 1/10/28/20.10111/2011/05/20 88AS 0.00 0.00 88.33 LAUNDRY I 1400378835 10/28/2010,11/2011105/20 2,586.81 0.00 0.00 2,586.81 CA UNDRY V 8400378811 10/28/20 10/11/20 11/05/20 45.15 0.00 0.00 45.15 LAUNDRY Vendor Totals Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 4,945.88 0.00 0.00 4,945.88 Vendor# Vendor Name Class Pay Code 13808 VITA PERSONA LLC Z Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net VP20212490 / 10/2512010114/2011/04/20. 687.91 0.00 0.00 687.91 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 13808 VITA PERSONA LLC 687.91 0.00 0.00 687.91 Vendor# Vendor Name Class Pay Code I1110 WERFEN USA LLC Invoice# Co mr�tant Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9111053824 / 10/27/2010115/2011/09120. 1,571.67 0.00 0.00 , 1,571.67 / CONTRACT ✓ Vendor Total[ Number Name Gross Discount No -Pay Net 11110 WERFEN USA LLC 1,571.67 0.00 0.00 1,571.67 Report Summary Grand Totals: Gross Discount No -Pay Net 692,675.62 0.00 0.00 692,675.62 IDO 10 tow hovl j t4o•cl% 4Gyn Prt�()'i-i9D tlM1�I OCT 2 G 2021 M 11 LoOtA.&kk -�aa�oo'7 +�a5`i•vo �b�at7a�.r�o file:///C:/Users/eheiman/eDsihnemmed.cosinet.com/u98547/data 5/tmn cw5rennrt7390_. 10/�.8/2021 Page 1 of'] 10/2912021 MEMORIAL MEDICAL CENTER 12:41 AP Open Invoice List 0 Dales Through: ap open invoice.template Vendors Vendor Name Class Pay Code 14168 TEXAS HHSC Invoices Comment Tran Dt Inv DI Due Dt Check D- Pay Gross Discount No -Pay 102821 10/29/20 10129/20 10/29/20 10.000,00 0,00 0.00 LIC APPLICATION -NV fV� &i -Ai A D6fl- rd K& Vendor Totals Number Name Gross Discount No -Pay 14168 TEXAS HHSC 10,000.00 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 10,000.00 0.00 0.00 Net j 10,000.00 Net 10.000.00 Net 10.000.00 file:///C:JUsers/eheimanlepsiimemmed.cpsinet.com/u98547a/data_5/tmp_cw5report214,.. 10/29/2021 TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800.572.8683) F-1"ENTER9-DIGITTAXPAYER IDENTIFICATION NUMBER" a"ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BYTHE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" El "ENTER 2-DIGITTAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec ❑"ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #### ENTER: 0 $ 156.54 1 $ 119.24 $ 27.88 $ 9.42 CHECK $ CALLED IN BY: CALLED IN DATE: CALLED IN TIME: # # JAAP-Payroll FileslPayroll Taxes12021W21 R1 MMC TAX DEPOSIT WORKSHEET 10.21.21 R3.xls 1012912021 Run Date: 10/29/21 MEMORIAL MEDICAL CENTER Pace 3 Tine: 10:4.3 Payroll Register ( Oi-Weedy 1 p2REG Pay Period 10IOS121 - 10; L;21 Run; 3 Final Summary '-- Pay Code Summary PayCd Description ` ................................. P ------------------------------------`._ D e d u c t i o n s Era I OT I SH1i3E IH01 CE j Gross I Code Amount ------------- ---------------------------------------.----- 20.00 N N N N '•------•...... Grand Totals: 20.00------- f Gross: Checks Count:- FT PT 1 Other Female I Male '------------------------ --------------- 96L54 ME ADVAHC CAFE H CAFE-3 CAFE-C CAFE-H CAFF-P CL3NiC DO ADV DID-LF FEDTAX FIRSTC FORT D GRANT HOSP-T LEGAL METVIS MMCSHR PHI RELAY SCRUBS STONDF STUDER SUNIND DUMlIS TSA-2 TSA-R UV7i HOS A/P.2 AWARDS CAFE-1 CAFE-4 CAFE-D CAFE -I CANCER 0 III DENTAL FAT 9.42 PICA-M FLEX S FUTA GRP-IN 1D TFT WRA MISC NATFML p3F*" REPAY SIGNOR SIONE SUNACC SUNLIF SURCSG TSA-C 07.31 TOME S u m m a r y ------------* ----------------- 03 BOOTS CAFE-2 CAFE-F CAFE_F CAFE-L CHILD CREDUN DEP-LF EATCSH 13.94 FICA-0 59.62 FIX FE GIFT B GTL LEAF MIS yTSCI OTHER PR FIR SAKS Si-T.( STONe2 SUNILL SUNSTD TSA-1 TSA-P mirm.. 961.54 ➢eductions: I50.29 %et: 911X 1 Credit ver.x 2eroNet Ten Total: i 1 ---------- --_.............. ............... MSKESSON STATEMENT uamomr. escs MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBIT AP Statement for information only 915 N VIRGINIA STREET PORT LAVACA TX 77979 )stag Date As of: 10/29/2021 Page: 002 To emlre Proper cash to Your eeeouM, detach and return this Made with your remittance DC: 9115 A. of: 10/29/2021 Pogo: 002 Mall to: Camp: 6000 Territory. AMT DUE REMITTED VIA ACH DEBIT Cuatomx 632536 Statement for Information only Data: 10/30/2021 Cum: 632536 PLEASE CHECK ANY Dale: 10/30/2021 ITEMS NOT PAID (,) Cash Amount P Amount P Reealvable Desmdpthm Discount (im ee) F rat) F Number W column legend: P = Pam Due Item, F = Future Due Item, blank = Current Due Item 'OTAL National Acd 632535 MEMORIAL MEDICAL CENTER Subtotals: 5,997.65 USD 'uture Due: 0.00 N Paid By 11/0212021, hall Due: 0.00 Pay This Amount: 5,677.67 USD AM Payment 2.451.97 If Pald After 1110212021, 18/0712017 Poy this Amount: 5,997.65 USD 5U•11 ' n%:*l I1<ilV tl 1 2021 For AR Inquiries please contact 800-867-0333 Due It I On Time: USD 5,877.67 Olse lost If paid late: 119.96 Due It Paid I.M. USD 5,997.65 MSKESSON STATEMENT As of: 10/29/2021 Page: 001 To ansu s propar creditto your account, detach and return this umeooy: es.s stub with your remIttanee DC: 8116 As of: 10/29/2021 Page: 001 HEB PHCY 0434/MEN MM MS AMT DUE REMITT® VIA ACH OMIT Territory: 400 Mall to: Comp: 8000 MEMOPIAL MEDICAL CENTER Statement for information only EM ITTE DEBIT At T DUE REMITTED VICKY KALISE( Customer. 190813 Intonation only 815 N VIROINIA ST Dale: 10/30/2021 PORT LAVACA TX ]79]9 Cast: 190813 PLEASE CHECK ANY Data: 10/30/2021 ITEMS NOT PAID (r) pipn Nallonal Acsouni 5?6 9 Due pecelve610�&' Cash Amount P Amount P Hecalvable )ale Date — Number Reference Description Discount (gross) F last) F Number :umomer Number 190813 HEa PHCY 0434/MEM MED PHS 0/27/2021 11/02/2021 7302498897 2017037938 1151nvoice 0.60 29.77 29.17 ✓ 7302498897 0/29/2021 11/02/2021 7303010666 2017038086 1151nvoire 0.02 0.90 0.94-� 7303010556 B W column legend: P = Past Due Item, F = Rdure Due Item, blank = Current Due Item ----__'._— 'OTAL• .Customer Number 190813 H® PHCV 0439/MEM Mm PHS sumwal4: 30.73 USD 'inure Due: 0.00 Due It Paid On Time: If Paid By 1110212021, USD 30.11 'eat Duo: 0.00 Pay This Amount 30.11 USD Disd lost If geld late: AM Payment 9,079.18 1f Paid After 71/02/2021, pus 11 Paid Lem; 0.62 0/25/2021 Pay this Amount: 30.73 USD USD 30.73 tITF TE1J CIN igpj 0 1 2021 Cr"� ArZ.X(' . CAL..GT% O'""'i,'GLr,G\S For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As of: 10129/2021 Peg.: 001 TO ensure proper credit to your BOeaunl, detach and Mum this c Pmv e000 dub w16 your remittance WALMART 1098/MBA MED MEMORIAL MEDICAL CENTER VICKY KALISEC 815 N VIRGIAVAC IA PORE LAVACA TX 77979 PHS AMT DUE REMITTED VIA ACH DESK Staement for Information only DC: 8115 Territory: 400 Curtomer. 258342 Dale: 10MO12021 As of: 1012912021 Pogo; 001 Mall to: Camp: 8000 AMT DUE REv11TTED VIA ACH DEBIT Statement for information Only Cum: 256342 PLEASE CHECK ANY Data: IOMO/2021 ITEAS NOT PAID (r) Nlling Due Doe _Date _- Pec.lvablr.tlona Account 9JA5fi6 Number Reference Description Cash Discount Amount P F_ Amount P (not) F Re4elvebla Number D9alomer Number 256342 WALMART 1098/MFM MED PHS _ -(9rose) 0/23/2021 11/02/2021 7301999975 1022210926 1151nvoice 1.88 94.07 92.19✓ 7301999975 0/25/2021 11/02/2021 7301944869 17733503 115Invoice 0.01 0.33 0.32 ✓ 7301944869 0/25/2021 11/02/2021 7301944890 17754934 1151nvolc. 5.38 268.84 283.46 ' 7301944690 0/26/2021 11/02/2021 7301944891 17778965 116lnvolce 5.38 268.98 283.6W 7301944891 0/26/2021 11/02/2021 7301944893 17800158 1151nvoice D.48 424.39 415.90✓ 7301944893 0/25/2021 11/02/2021 7301944895 17800158 1151nvo1ce 0.02 0.96 0.94✓. 7301944995 0/26/2021 11/02/2021 0/26/2021 11/02/2021 7301944897 7302254323 17822179 17881034 1151nvolce 1161nvoice 0.01 0.01 0.63 0.31 0.62 r 0.30'� 7301944B97 7302264323 0/26/2021 11/02/2021 7302423347 1025211148 1151nvOic. 23,60 t,t79.90 1,156.30V 7302423347 0/27/2021 11/02/2021 0/27/2021 11/02/2021 7302622908 7302522999 18000788 18000788 1151nvoice 1151nv.ice 0.70 7.86 34.99 393.19 34.29 ✓" 366.33 "� 7302522998 7302622999 0/27/2021 11/02/2021 7302526000 18007467 1lslnvoice 0.01 0.26 0.27 7302526000 0/27/2021 11/02/2021 7302668572 1026210750 1951nvoice 6.58 328.96 322.38 7302668572 0/27/2021 11/02/2021 7302668573 1026210905 1151nvolce 0.04 1.90 1.86 7302668573 0/20/2021 11/02/2021 7302778659 18065889 1151nv01ce 16.98 848.78 831.80 7302778659 0/28/2021 11/02/2021 7302936110 1027210824 1151nvolce 3.92 196.02 192.10 ✓ 7302936110 0/29/2021 11/02/2021 7303050510 16092525 11 slnvoice 5.38 269.14 263.76 / 7303050510 0/29/2021 11/02/2021 7303050511 18092525 1151nvolce 0.03 1.27 1.24 / 7303050511 0/29/2021 11/02/2021 7303060512 18136107 1151.vdce 0.01 0.03 0.62 7303050612 0/29/2021 11/02/2021 7303197345 1028210815 1951nvoice 0.18 8.79 8.61 7303197345 For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT Comcwr aocs WALMARr 1098/MEM MED PHS AMT DUE RBAITTED VIA ACH D®IT M@ ORIAL MEDICAL CMTER Slalement for Information only VICKY KALISER 815 N VIRGINIA ST PORT I.AVACA TX 77970 As of: 10/29/2021 DC: 8115 Territory: 400 Customer. 256342 Date: IW30/2021 IF column legend: P = Peal Due Item, Aa kuWWec{ b%IM36 blank = Current Due Item OTAL: Customer Number 256342 WALMARr 1098IMEM Mm PHS Subtotals uture Due: 0.00 6 Pam By 1110212021, Iset Due: 0.00 Pay This Amount: .0 Payment %Q79.18 If Peld After 1110212021, 012512021 Pay this Amount: $:^l Y.nBGu L"3 4,322.36 USD Page: 001 To ensure proper credit to your account, detach and Mum this stub wbh your rembtalmo As of: 10/29/2021 Page: 001 Mall to: Cane: 6000 AMT DUE REMITT® VIA ACH DEBIT Slalemeni for information only cum: 256342 PLEASE CHECK ANY Date: 10/30/2021 ITWS NOT PAID (II) i Due If Pold On Time: USD 4.235.89 �- 4.235.99 USD Dim Joel If paid late: 86.47 Due If Peld late: 4,322.36 USO USD 4.322.36 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: 10/29/202/ Page: aof To Downs Proper cretlH t0 your a44oeM, detach and Mum Into eoso stub with your rem„tance DC: 8115 As of: 10/29/2021 Pegs: 001 H® PHY FC 490/MEM MC MS pMT DUE RFSv11TTEp VIA ACH DEBIT Territory: 400 Malt to: Comp: 8000 AL CENTFF7 Statement for Information only AMT DUE REMITTED VIA ACH DEBIT VICKYMEMO SB(MED VICKY KALISIX Customer: 404450 Statement for information only 815 N VIRGINIA ST POITC IAVACA T% 77979 Date: 10/30/2021 Coat: 464450 PIS SE CHECK ANY Date: 10/30/2021 ITEMS NOT PAID (+) filling Do. N no.Naabjlational Account�qf aa6 DYAQr Amount P Amount P Number le )ale Reference DewHPrbn Dleoamt Disc (gross) F (oat) F Number Iugomer Number 464450 HEB MY PC 400IMEM MC PHIS 0/26/2021 11/02/2021 73022407134 SSx693135 115lnvoice 9.23 461.63 452.40 v' 7302240784 0/26/2021 11/02/2021 7302240785 55x693244 1151nv0ice 0.24 11.84 11.8D✓ 7302240785 0/26/2021 11/02/2021 7302240787 55093246 1151nvcice 0.25 12.38 12.13 ✓ 7302240787 0/28/2021 11/02/2021 7302753604 55XB98119 115lnvafce 0.08 3.85 3.77 ✓ 7302753684 0/29/2021 11/02/2021 7303013579 55x702619 1151nvoice 12.49 624.64 612.15 ✓ 7303013579 0/29/2021 11/02/2021 7303013580 55002733 1tslnvofce 5.32 266.14 260.82 '/ 7303013580 T column legentl: P = Peel Due Item, F e Future Due Item, blank = Consort Due Item 'DTAU Customor Number 464460 HIES P14Y FC 490/META MC MS abductors: 1,380.48 LED -More Dug: 0.00 Due It Paid On Time: If Pent By 1110212021, LED 1.352.67 ✓ rued Due: 0.00 Pay This Amount: 1,352.87 USD Dix load It paid late: AMPayment 9,079.18 If Paid Alter 11/02/2021, Due If Paid late: 27.61 0/26/2021 Pay this Amount: 1.380.48 LED USD 1,380.48 :1Ys .ONV[lI <i!Y NOV U 1 2021 For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As of: 10/29/2021 Page: ODi To ensure proper eras„ to your axount, detach arM Mum this CumrelY. torn stub with your reentrance DC: 8115 As of: 1012OJ2021 Page: 001 CVS PHCV 7475/MEM MC PliS pMT DUE REMITTED VIA ACH DEBIT Territory: 400VIC Mail to: Comp: 8000 MEMORIAL MEDICAL CENTER Statement for Inimmelien only AMT DUE REMITTED VIA ACH DEBIT Customer: 835938 KALISIX Statement for information only 15 815 N VIROINIA ST PORE LAVACA TX 77979 Dale: 10/30/2021 Cult: 835438 PLEASE CHECK ANY Date: 1013012021 ITEMS NOT PAID (v) Riling Due Rxelvable4sho al Account e rate Cosh Amount P Amount P Racebahis Pala Number Relermce Description Dlxxnl (gross) F (me) F Number 1uatOmer Number 835438 CVS PHCY 7475/MEM MC PHS 0/28/2021 11/02/2021 7302961193 1419163 1181nvolce 5.28 264.08 258.80,,,� 7302951193 O IF column legend: P = poet Due Item, F = Future Due Item, Wank = Current Due Item —,____ _. 'OTAL Cuatamer Number 835438 CVS PHCY 7475/M81A MC PHS SuWWals: 264.08 USD 'vtum Do. 0XIO Due If Paid On TMe: It Paid By 1110212021, USD 258.80 -..' %at Due: 0.00 Pay This Amount: 268.80 USD Of. Icet If pale late: suet Payment 9,079.18 II paid After 11/02/2021, Due If Pall Leto: 5.28 0/26/2021 pay this Amount: 264.08 USD USD 264.08 aN NOV u i 2021 For AR Inquiries please contact 800-867-0333 M STATEMENT Statement Number: 61860782 AmerlsourceBergen' Date: 10-29.2021 AMERISOURCEBERGEN DRUG CORP WALGREENS #12494 340B 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER 100135284 / 037028186 SUGAR LAND T% 77478.6101 1302 N VIRGINIA ST PORT LAVACA T% 77979.2509 Sal -Fri Due In 7 days DEA: RA0289276 866451-9655 AMERISOURCEBERGEN P.O. Box 905223 CHARLOTTE NC 282903223 Not Yet Due: Current: 0,00 1,814,60 Past Due: 0.00 Total Due: 1,814.60 Account Balance: 1.814.60 M{ UWYIIL MUtIVILy Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount W-25-2021 11.05.2021 30716NI35 163293 Invoice 3.20 0.00 3.20-' 10-25-2021 11-05.2021 3071666136 163294 Invoice 6.57 0.00 6.57J- 10-25.2021 11-05-2021 3071694286 163342 Invoiw 135.48 0.00 135.48,1 10-264021 11-05-2021 3071818407 163362 Invoice 1,605.22 0.00 1,605,22r 10.27-2021 11-05-2021 3071960133 163360 Invoice 1.01 0.00 1.01 l 10.27-2021 11.05.2021 3071960134 10361 Invoice 0.09 0.00 009v,' 10.28-2021 11-05.2021 3072100740 1633N Invoice 40.38 0.00 4098,1 10-28.2021 11-05-2021 W72100741 163370 Invoice 0.09 0.00 0.09,1- 10-29.2021 11-05-2021 3072239920 163381 Invoice 22.56 0.00 22.56 Current 1-15 Days 16-30 Days 31.60 Days 6190 Days 91.120 Days Over 120 Days I 1,614.60 0.00 0.00 0.60 0.00 0.00 0.00 Reminders / Thank You for Your Payment Date Amount ' Due Date pl^�` 1 /� Amount 10-29-2021 (251.64) 11-05-2021 ��///�/ f'� - VVV 1,814.60 Total Due: 11814:80 lYsJs:^I:3:1 CeJV ;1 1 2021 MEMORIAL MEDICAL CENTER pM(Vim PROSPERITY BANK 1 66 1.. ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT --- October 25, 2021-Octobe31, 2021 5I r 1 S 4. Dale Bank Description MM[Notes Amount I Uu 10/29/2021 PAY PLUS ACHTRANS 452579291101000694595925 - 3rd Party Payer Fee $ 10/29/2021 AMERISOURCE BERG PAYMENTS 0100007769 2100002 - 3408 Drug Program Expense $ 251.G4 10129/2021 MEMORIAL MEDICAL PAYROLL 746003411113122650 -Payroll $ 33620992'7V 10/28/2021 PAY PLUS ACHTRANS 452579291101000693582634 - 3rd Party Payor Fee $ GCS 10/27/2021 PAY PLUS ACHTRANS 4S2579291 101000G92815803 3rd Party Payor Fee $ aSwE a�' 16�4:3b t 41'-lIU - 10/26/2021 PAY PLUS ACHTRANS 452579291101000691907615 -3rd Party Paver Fee $ ,.� .! ' 5-" 10/26/2021 MCKESSON DRUG AUTO ACH ACH04780601910000121 34080rug Program Expense $ 9,079.18%' 10/25/2021 TRANSFIRST LLC VMC SETTLE 41399801332385 611 - Credit Card Processing Fee $ -.48.00 8 .. ,., 10/25/2021 PAY PLUS ACHTRANS 452579291 101000690928526 - 3rd Party Payer Fee $ ° q8,°74 10/22/2021 WIRE OUT CBNA INCOMING SETTLEMENT ACCOUNT CitiBank Corporate Card Payment 381.00vb{ 1; �: i4S•- Ih .� 346,518.36 .. ;; 1 6 6 November 1, 2021 Anthony Richardson, CFO 1 Memorial Medical Center :-"d I - PROSPERITY BANK Y if Al 1 a. ?a 1 596 ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT -- ESTIMATED ACHS Date Description MMC Notes Amount 5 e I:. , 6 U•r1� .- November 1, 2021 Anthony Richardson, CFO Memorial Medical Center IN Nov 11 1 2f,21 Ph e l of I�;y .'x� '3 7'x 10/2812021 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List i 1:57 ap_open_invoice.template Dates Through. 11/11/2021 Vendor# Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Df Due Ot Check D Pay Gross Discount No -Pay Nei 101521 10/27/20 10115120 11/11120 9,505.80 0.00 0.00 9,505.80 -' TRANSFER tdH jR1,;'f u '1 dA17U6;-1zd Vendor Totals Number Name Gross Discount No -Pay Net 11828 SOLERA WEST HOUSTON 9,505.80 0.00 C.00 9,505.80 Report Summery Grand Totals: Gross Discount No -Pay Net 9,505.80 0.00 0.00 9.505.80 11i'LP1,311w w+1 OCT2.9 2021 C51yYia lAI+ Y,,Y�p file:///C:/Usersleheimanlcpsilmemmed. cpsinet.com/u98547/data_5/tmp_cw5report5O85... 10/28/2021 Page 1 of 1 11/01/2021 10:43 Vendorh Vendor Name 11824 THE CRESCENT MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 1111112021 Class Pay Code 0 ap_open_invoice.template Invoice8 Comment Tran or Inv Dt Due Dt Check D Pay Gross Discount No -Pay 101821 10/2T2010118/20 11/11120 6,9$0.00 0.00 0.00 TRANSFER N1V IVlr3,/VilkLL Vi AA (,(A, )Ug6k ih� WkW}— Un Vendor Tota4 Number Name JJ,, Grass Discount No- ay 11824 THE CRESCENT 6.930.00 0.00 0.00 Grand Totals: Gross 8,930.00 Rid Lit, i 2 9 2021 Net 6.930.00 Net 6,930A0 Report Summary Discount No -Pay Net 0oo 0.00 6,930.00 fil e:l//C: /Usersleheiman/cpsilmemmed.cpsinet.com/u98547/data_5/tmp_cw5report54541... 11 / 1 /2021 Page 1 of 1 MEMORIAL MEDICAL CENTER 10/28/2021 0 AP Open Invoice List 11:54 ap_open_invpice.template Dates Through: 11/11/2021 Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101321 10/27/20 10/13/20 11/11/20 9,225.66 0.00 0.00 9,225.66 TRANSFER WlftWKU ptJMfC cl 04E A IA+' MWtL ijpCh-'�/ 101321A 10/27/20 10/13/20 11/11/20 34,730.36 0.00 01 0.00 34,700.35 TRANSFER 1t 11 101421 10127/20. 10/14/20 11/11/20 572.52 0.00 0.00 572.52 TRANSFER t1 it ✓� 101521 10/27/20. 10/1512011/11/20 1,907.87 0.00 0.00 1,907.87 TRANSFER tt It 101921A 10127120 10/19/20 11/11/20 374.36 0.00 0.00 374.36 TRANSFER 11 k 101921 10/27120. 10M9/2011/11/20. 53.38 0.00 U0 53.38 it V` TRANSFER H 102021 it0/27/20. 10/20/20 11/11/20 532.23 0.00 0.00 532.23 TRANSFER It It �- Vendor Total: Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 47,396.37 0.00 0.00 47,396.37 Report Summary Grand Totals: Gross Discount No -Pay Net 47,396.37 0.00 0.00 47,396.$7 (4N OCT 2 9 2021 CO WATA! tsroa file:///C:/Users/eheiman/cosi/memmed.CDsinet.com/u98547/data 5/tmn cw5renort577R.__ 10/29/209.1 Page 1 of 1 MEMORIAL MEDICAL CENTER 10/28/2021 0 AP Open Invoice List 11:55 ap_open_Invoice.template Dates Through: 11/11/2021 Vendor#Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 101321 10127/20. 10/13/2011/11/20 427.89 0.00 0.00 427.89 TRANSFER N q 141khb H.0 V)JA-1 cltpot; AA K Mk,(_- Ik 101421 10/27/20 10/14/20 11/11/20 4,080.00 0.000.00 4,080.00 TRANSFER i1 101521 10/27/20 10/15/20 11/11/20 4.080.00 0.00 0.00 4,080.00 TRANSFER I It 101921A 10/27/20. 10/19/20 11/11/20 655.88 0.00 0.00 655.88 TRANSFER `t n 101921 10127/20. 10/19/2011111/20. 1,699.77 0.00 0.00 1,699.77 TRANSFER 102021 10/27/20 10/20/20 11111120. 5,887.57 0.00 0.00 9,88T57 TRANFER t• ,i 102021A 10127/2010/2012011/11120. 3,029.83 0.00 0.00 3,029.83 TRANSFER t' � Vendor Total: Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 19,860.94 0.00 0.00 19,860.94 Report Summary Grand Totals: Gross Discount No -Pay Net 19,860.94 0.00 0.00 19,860.94 tLPt'.aif9tlI*�l"5 i3PI OCT 2.9 2021 file:///C:/Users/elieinian/cnsi/memmed.cosinet.com/u98547/data 5/tmn cw5renort3302... 10/29/2021 Page 1 of 1 10/28/2021 MEMORIAL MEDICAL CENTER 11:58 AP Open Invoice List 0 ap_open_invoice.lemplate Dates Through: 1ill i/2021 Vendor# Vendor Name / Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101321 101111217/2010/13/2011/11/20 8,341.00 0.00 0.00 8,341.00 Y� TRANSFER n-1{'ISVIA{1 (L fblv_� rLg0Ci-6Zr1, jk}o 11y11111.(_. t�tp_j, / , 101321A 10127120 10/13/20 11/11120 1,092.54 0.00 0 1,092.64 TRANSFER (( 1� 101421B 10/27120 10/14120 11/11/20 4,518.54 0.00 0.00 4.519.54 TRANSFER lk it 101421A 10/27/20. 10/1412011/11/20 9,219.00 0.00 0.00 9,219.00 TRANSFER tt 1( 101421 10/27/20 10/14120 11/11/20 1,870.20 0.00 0.00 1,870.20 i TRANSFER 11 It�r 101521 10/27/20 10/15/20 11/11/20 1,416.60 0.00 030 1,416.60 TRANSFER 1` I( 101821A 10127/20 10118120 11111120 17.62 0.00 IT10 17.62 TRANSFER (� rt 101821 10/27/2010/1812011111120 5,707.00 0.00 C L) 5.707.00 TRANSFER 1, 1, 102021 10/27/20 10/20/20 11/11/20 1.418.02 0.00 1,418.02 TRANSFER m Vendor Total: Number Name Gross Discount F"1,2y Net 13004 TUSCANY VILLAGE 33,600.52 0.00 0.F( 33,600.52 Report Summary Grand Totals: Gross Discount No -Pay Net 33.600.62 0.00 0.00 38,600.52 OCT 2 9 2021 C file:///C:lUsers/eheiman/cpsi/memmed.opsinet.com/u98547/data_5/tmp_cw5 report9O5O... 10/28/2021 Page 1 of 1 MEMORIAL MEDICAL CENTER 10/28/2021 0 AP Open Invoice List 11:53 ap_open_invoice.template Dates Through: 11/11/2021 Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING `/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101321 10127/20 10/13/20 11/11/20 1,994.63 0.00 0.00 1,994.63 TRANSFER NN tVgtjvr,h(7 (K-yj p.{-. 101321A 10/27/20 10/13/20 11/11/20 32,936.74 0.00 '0.00 32,938.74 TRANSFER rc 101421 10127/20. 10/14/2011/11120 1,298.50 0.00 0.00 1,298.50 �11 TRANSFER 101821 10127/20. 10/18/2011/11/20 20,196.00 0.00 0.00 20,196,00 TRANSFER Ic h 102021 10/27/20 10/20/20 11/11120 649A7 0.00 0.00 649.47 TRANSFER (' � Vendor Totals Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 57,077.34 0.00 0.00 57,077.34 Report Summary Grand Totals: Gross Discount No -Pay Net 57,077.34 0,00 0.00 57,077.34 !1F'e`!,iUVM "r UL T 2 9 2021 Cd*T TlW A isF WOPi c^omq,', j.BXjS file:///C:/Users/eheiman/ct)si/menimed.ct)sinct.com/u98547/data 5/tmD cw5renort8671... 10/28/2021 Request for Transfer of Funds Imn[me 4: Date Requested ID/2R/2 , vayer Requested It, AuRl"In hotol Requ:IlnaemeII Requestols phone number DIS4immCaunty 'non, la: uli+ie ee la+nn rp :21�➢'2LSL�9 Qf5ljnl X4:�, E REO may M. a aft IreenEE E mp A u gmpne Y 6M neNM.[p(4 ly 9(plwtweyj)_ (a.SBDRevaupl Victor,N/A N/A "Wit.[R 4$5.12 EF14116294 CVMBON024P69 440] pPOABMDOPAI (PEf P5111f N/A N/A 10/13/2.1 Efi 2.42590 EM1111429 CVMPIXa02b9B9 111.84 IIPOAOMOOP R[RffR510E N/A N/A IM 54/201. fR }SBB.39 ffi6120189 NOM1PWOp]EPFA 122.24 BROADM00RAt CPEER5111f N/A H A IOf,5 2021 [li I", MUMS! CVOAPKXU2(8b9 495 BROADh100PAiCPEEMIOE N/A H/A 10/1512wt [IT 5 "M. EFI6121017 CVCARM026869 M10 BROADMOORAI CBEER5I0f N/A N/A IBf19/2021 "I 5 4,@2.24 EFT6125433 CVOARM026069 11169 ORGA...AATC.f"5ND N/A N/A 1012012021 M 5 I.COSAS 111.111,83 fVDAROWD215R69 i]fi5 RPOAOMOORAt CRFER5111f 12/A N/A 1011112021 EFI 5 1.650,01 Ef16129511 CVOAROtl l.MI 116.33 BROADMOOP A f MUSIC C N/A N/A I0/22/20a It $ 41308.90 ER6131212 CVDARDNf126BG9 MbR BR..D ..RoTlhEll$hX To. 20.931.52 ah to be Blled alit he Mema:lal Meditel Center. IntDMeente SO — .1,ofhan CClevenlc Date of of n,: 13 m21 To Fa Eamiq: Alin"— i4Fadnry: mm ICI Anm:ni: 99421 �/-- �I N'OV 0 11 2021 Request for Transfer of Funds framleu Dale RequMlPd PaYcr RwueTted by: IAIUM WNUDN- DUSHF55 OFFICE MANAUH RepueslNs entail iDn!dn nLee Nl_^Y11'!HL'kn•P Repueslw's Phone number 364551115. hMaRnr Cau., cFlhnu. NOTE, HPIhanY S,TA, U., EON 15�en(c!peFnm9y jyaC 9twn PNIenF LLm! Dtln olXrvl[e TvoaW Pavmenl p+.me"L nETEI yr vaRPda0.vFrtlSC MMr11 w(rfa[u R IRFO R�UJRFO aE RI [F nYXum e 5 Im Mu to vow V[oum 1CyAFCt MDPL CPf IN5111( 4UR LLIMi H/A N/A W/13/1U21 fFl [Li 4110995 CVUAXLVUDEW49 1150 AUVAXCCEMT 1UNIP k CNFI RSID( AU %IIIAXY N/A A IP/I ME11E1 LiC FFI 6123R1 CV11A111pDp2 9 Jtl3 )0 THAT W:PMi T0NC. N¢NPUMMDfl[Cfl [[NSICI AU%III ANY N/A N/A 1U/19/EN21 !fl 6LIUR5512 LVIIApINKKIEW69 tl,65.56 ADVANCL EMT NIf CP IEY.SIDIAU%III ANY NIA H/A IDQDRIIH fFl [41 fi1E ]924 dUA IIppUEW69 IPL21 AUl AHlr 111DPF " OUTHEAIF UMUpE Cq(I NSNF AUXIII ANY ill..E N/A A 10/E 3/IOlI F41 [114129G/1 CVDAAWg12 W49 i094 I AUVANCADML 1Nf AW1 0M0RF CRT I N510[-AU%IlIM4Y N/A N/A_ IU/E 2/21121 FR (1141)M 32 ryNAPPMg2 W69 111,51 MVANCL I'MI TOTN 9Gi63D ITT pled Pulh MemoXaI MHII.. CPAlee Dale !0 !0 14E1 AppwTEdV[d hY• C PatvrRcr Ople of lransle [: I1 3 EPEI flam PatlllM 11HITOADMOOR T. Fa[iliry: oelnany AmaunU 9.6E6.3U nyy !INN 11 1 2O_I G:11;r`_•F01 t'.v ei f�','1'iY1G Request for Transfer of Funds uannarP. odte Pequeeted carer R<Rpestea br: eamm llwPe, Pt9,ItstpiS tnRi (M1•NIY„'LIIru4^JIW1LI�tom _ fle9ue[Mli Pllpne remhel 933d72 B<I) UIetG[t pr COuety Mem n+I Metie+l Cen hmltr Lddenl:,e•ek [YUA111Rp M69 Palknt Nome Q<Lel Rervle RE MEP pF Twe & emenlp<mmnt fF �uM.l C slm Rumbe< �M3I_ A. tuy,_1<iJ1 pAp( ptea lU/iP/]U]I F11412101, $I3.Ile.9x1 [gGlx]p]] (VpARWW)4969 $ ).111.9] pueblluWen 4eek lrnm lLe p,mNnno, ([eeke lP/21/2p]l [FlL129pM $ 11-31 [1f6129N< CYOANM'btLMLP $ l.11 Uuelo GM,len Cmrk 4,Nn ILe Rlpupn,Op, Leekr TPT9L $12,Itaixl $ LIxU,]) To be filled m !by Me:mdal Medial Center: wk Pe[< a px EP)1 PpP:pe'ed b% C Ie�enlA, wtepFuantler: u3zpn immfaGllK - C6 T FaclMY MM(— L10[x F1 Y�i7v BN gmoum: �—x,l ax�— Request for Transfer of Funds Nan[le, n ..W.11 110 0)/28ROn hYe[ Requene06Y AVXNNNA SIXANOS Req ueflo/s email Reque[lo(a plrgna number plal,la e, conmy Fe[Illry AtlukeaM FOR tFIYYfA4fr SLpr TOInnl3rr5gan9 mn,xs nnaam � ..cPe^^_, tlenl Name ftMjjl_R PoY olYrvlm nne of pavmnnt payment Xum [ AV SLL N04LL1 xfw(El•1 IPY411pa{(qp{ nsss} bhnnon N/A N/A 10/IM"It L11 925.12 F81611G298 (VOAflO ,)I9552 d4.03 Illf (P[S[NI N/A N/A IN/23/2021 (Fi 293590 FFC6II9429 CVOAROCCO19552 III. Ial CXfSI.I N/A N/A 10/10/2021 (11 2$68.39 EEiN 1201Rq 1VVA0WNt9552 "1.11 It, CRFSENi N/A X/a IN15/2021 61 14389 EFT4V1fl 51 <VOApORNl9Sb G85 _ III, IKKNI N/A N/A IWIS/2011 FTI 5 41"GIM MG122812 CVVAROVXl19551 11010 IIIE(RESINI N/A N/A 1.119/2021 EI2 5 e.011.1< EFIG125431 111OARWC019SS1 19169 I111 IGISElp N/A X/A 10/20/2021 CR S 1005.45 9...171H (VFMROCOIL9551 4IN1 IIIf CRESCN1 N/A N/A 10/21/2021 En 5 2.65(LOI M6.19511 (VOAppXN11959 ur, 11 114CRFS1N1 N/A N/A IOIZ212021 M 5 4.388,96 E"61312R [VOAROW019551 M..NICCRCSINI iOiAL 10.93 L51 99621 aobe Nl,d oulh Me,mrla1 Me81[al Cenler. Pole Re[n a I0 eR AppmredbV en vun er Dale allmnsle f. O 1011 iNm id[IIiIY: 111—tt To iatlllry: Gam"al[ A=unC 9961.1 a'33:9:J?>ti aF:!Z•i'fi'P. Request for Transfer of Funds ommne, d: Dale Requested Poyla Requested by: I.L. WIDOW ODSINFSS GIIIII MANADFX nequo:.a email _ _ Nequealge,,h number i6L551 U0IX1 DI[1rllL or [aumy Crlhonn luffity Delhany Irmo, Irvin, werpsymintarnwuOmMt P4aN P'DMta FOB alweryJd OJm Il�A��nJlm llarA[ wm �_SP9_L__Sm0 Polll nl Name 8� E�{IIjUJ eofYrvle RE o Pa YweOl Pd vmin[ CFe R A vwmg0l [Re NumEPI Oalm Nu d{1149df8ded'Inrx Iyne.In.PILupQtll. INiQLS26WUA1 Nol N/A N/A 10/I3/2021 F11 LI16118091 [VOAflCW01Ti5] 1158 TNLLULSENTMIXIl1ARVADVANCUMl N/A N/A i0jiffJ2021 Ell FF10113]21 MA801KK119S51 let AR IRI IRD-UN IA11X111ARY ADVANCL PMT N/A We 10/19/2021 cf. P1I.135517 CVUARGMNIYSSI 8,61566 TIIF CROWN TAUXILIARY ADVANCL PMT NjA N/A 10120/2021 1. El 10127DID CVUANW0019151 10731 TNIIRISINI' AUXIINRIADVANCE PMr WA N/p 10/212011 EFT I116129G]1 CVDAMI 1%57 ]096 11ILCNFSENT' AUXILIARYA.V NLI PMI II/A N/A 1022202E FFT 1I16131437 1V.R.DCO9517 VI) l 11111 I.KSINL-AU FILIALLY AUVANII PMC lOiPt 9,GI630 Ta be Nlktl Oul Memorial Medhal Cenlll: OaIe RPMrv! APPmwtl 4 oa. onmmt!= m Faster Ta FaMG AnmUM: 1 202 CClwen nr 1 net ue OIIAanV .676.iO i'ejv Ii 12021 L3'ss'[!r1:fd:alt Request for Transfer of Funds banO.0 Xne Pexuemd PiY![ Regamtea b'Y: M•quatl esemR XequeaYaispbone numbs $/1�Ih+L`:urExln.INalnuom 90]3>i.tltl1E OletJdorC my Memurral MCJi[al Cenlu I.alit, 6oIJen LeeM CVOnx.Msl .Wnn.aa.ap.r"'eneo.r.wrrvmeuee>..v[a+laemeolaeeryna J.lm [ eve [tiSElpl!lvunlpy.!,!.. q�. In n[prvllar_,flurn MkMXanb qE u Yaleal5ervke RE 419r41 21 N a nt Txae of Paame E x r±LJ✓m!"—L fM1e[k a Qlm Ag19X0ei/SG'fgt4E IUWLllnfxneell. 19YW EHP!,11 EI! 102201 E1201 .In Er1620 CRsJ ]9E fula 6oldcn Crc6 te Cresml 1011112011 CM11902E S 1E311 [RLI2902.e (.flb.gs52 _ m G.Ik. cl-A lmn lhe Gesen! TOTFL S 2.l]0.2]I $ 2.!N1.23 io be fllktlom bYMemxrial MetllW Ceneen uae uL�u7IDR'o ] vppmeeaeY: eaere,rre[ . armnner u92an Elam q[mh: -'Y n[W'Ur io Eatillry: 11 Mwunk. .IL Ei leil ED 0 I 2Q2I Request for Transfer of Funds o-MSa. m. Oall R11-10 Paver Pegvesletl by: PIgYO mall flly Ye51oY50flOM nYmbtt Oln.in vrcounh Fxlllh AORIANNA STMNOS Balbnl Nana u uNFpJ d[lWYrvl[e RFO uve el garment EOfPJLnt<_ va.m."+ Y Q{LbfAIW bN+ +>w.a. NT p[OItA_a{(yYnl N/A N/A 10/13/2021 925.1E EF161161% IVI+ARODUU SOIEM WISI NM N/A 10IA/1.11 UT Ill 2.50I0 FEI41189E9 (VUAPWOOIPIN M 7. _ HOUSTON SCUM WEST NOUSM N/A N/A 10/10/20E1 LEE 2569 39 FFiIMES, (WAROY0018110 El", IIE 2.+ SOLEM Wl 51110USION N/A N/A 10/15/2021 LEE 1tl389 EP16121851 SOL(MWISEIIOUSTON N/A N/A IS IOpS/2021 EFTWE $ E,]44W EF761218E7 MAROM181I0 CW1A80 0 ED 130.E0 5O1feAWI5l I1l1USTON N/A N/A 111/19/2021 $ FF1612 OD1017O [VUAOWWItlI]0 191.81 WESi 110U51011 N/A IU/20/2021 LEE (II ImE , 5 LW595 .3 F1f41})IB3 CVISAR00WIR110 9]85 1011. W(t1110N51011 WA WA IU/11/E021 [ft S El iL 129511 Y 11513 SOLEM SOLEM WISI WA N/p H/A 10/22/E021 fFl MagEs1 5 n,I88.96 Ei 161]¢VE C.EO CVOABpp01tl120 M"O >Oe.tltl HOU51ON tOl[RA WEST NOUSION TOLL 20.93E.5E 99G E1 i[he f4etl ou[ MemaXI Metlinl4nlen E6 hr c evrm;m I.E.9I I +e nlmmle[: ulx0ll T)isoteu iso Fatlli,l9: M Cim( ARAYnI: 991i 11 t:'k;1'y<ti i if Siy 'a _�1J Request for Transfer of Funds .0, Revu6l0 nave, Rpues,ed by; na lwyyv, ReAueslpis.mall ppr... .M.'',. 'do,t •,0 phone -mb.ron numbs, umaueau DNVIRor Uunry Men:oR.I Mumoa Ceme, Btlliry UOWen Ouea IwWmmavO palknl Mame OeleeEue ke mmim Oaleafpaen" Tvvenfprvme PAWER pavmene be4J kl. WMba LFYflY AlbbyL N ID/t012021 FRW2... $It,ll)9)I MIT2O11 CVMPWODW I]0 $ 43", I:ue to Gallen CmeY b—, {ak a WOR 11 IW2111021 EFT61t'1DM 5 II311 EFIU29029 CVO.,=QO1U1/U 5 t!1 Due lOGnitlenC—yf,nm 9ok Wid Ilouilm� TOTAL $I;ItO.]] 5 2,33023 ie be 011vE pulE Menwtlal MCCI[al Centel: _ ale Aemive: 10t t0t1 Ppp:ovvO EY 2�lave^I,e, mkmla�Re�. u310n fro WI": Amvunl: &y n.UJ H 1 2u2 Request for Transfer of Funds tlenalel A: ram Requested m/)a(zpn pa" MVDICARL BII.IN It, IA I LIN GUN DUN -BUS IN ESSOFXEE MANAGER Aequeel,lT small IE; IIU9L'�I'y! ly3u pRjn"i RequeflgYf pnone nYmbee 141i51951p mndn mcwmr r.Imann .61MY Reronnr Sen�o,Lm�X W. and BOB _1nLxC�zrs'LNs11 I�.x�rsa<SnyA Anlwmo PXbnneMN.dm y IX( paWUIReOl a rvne olpavmem Paemenl funPtL, 4LFVnds r1. PE UTAFJ MQJ RF UIREp 0 e EET n _Ne[YNumher Slim NUSL_ IIYAVAet(o_o_nl ele 5OILvewetl11w11o11AIIMILIA0.Y AIIVAM[[ N/A X/A 10/Il/20)1 [fl EfI MIBd95 [VpAAONIUIXIID ll 18 UMI SNey Wnsl llauslm AIIXIIIARYMVANEE N/A N/A IA/IR/)0)1 ITT [II LI)3))1 [VUARCBM1191]0 383 ]A I�MI salsa wru Immlan A.IAIWllAUVm¢[ N/A N/A IW191)0)1 EFT LF101)5A) (VUARWWIAPO 8,57S64 fMT Snlem WIU NN.0 n A11A111AXYAUVAN(E IPA N/A W120/2023 f11 _ EFt 6121920 11DIUMM USIID 10]2. PMT SWIW,Illlnutlnll- AUXIILARYAWM2(E 11/A N/A IWlilan If] III W29611 LVUAMMA IID I096 PMT 5,4_Wef1110 U_ AUXAUMtV Af1VAX[L X/A N/A _ IU(22/2021 (II 11f 613Li32 LVUA PUWp181]0 ]IJ.SI I'ASI TOTAL 9.62610 to he filled wlh Mem0,191 MlPlyl Ceram: le AeyN raze tun PPPmved br C(evengel Bale ollnntle,: 11 3 SUSI Fmmfatllity: _ ]efxlllry: Uultvnv Pmnuni: 9.G14 ]U Request for Transfer of Funds uaode, p: mmxequesled paver uq�mea bw nnnlnxxn saNnxas Requeeroia emtll Requefrols pxgne number plane orce�ory pM1nq [[IIYSaerNmmr ynhr paNenLXeme N �gfpJ OMALEAM rvke IIIEp1 W Tvm oL PevmeM e[ E PjyPdp[ [D1m Xum r Le^OJ1'lYS%[4tll Lq X x/A 1013120E1 LET 955,90 ECT6116)96[ O 1951p <00l GOGG'CNELX EN/AGA EGA x/A 10/13/3011 LET Sq]5.90 LlL4I18A]9 cvINut CVOA,,EOGJ 9510 N/A N/A lolIM15/2021 LEE S.SOE.39 IS 2.iA Ul14 GOIDD. MlL 40 N/A 10/M/Spit LEE 11161E01NA LE 14111E 51 lvIGGNLg19540 4E5 GOLDEN CXELX GD,cAIIE N/A N/A N/A IW1912021 LET 146.. 1$TWSX11 MAROLUp195A0 [YOAFG0QDI9sE0 10 GOLDEN CN[EK N/A N/A LET 5 4.0A6.74 $ Lf16,21M [YDAX0C00195f0 19IG9 VG GOLDEN INDEX N/A N/n WoflOt1 10/E11MI LET Imms 5 1.O]S.AS Lfa61SSSX3 NOAXCGWIRSAO 2613 GULDEN N/A N/A 10/SIROn LET S CI'I61S9s11 CLOAPfNW195A0 IS413 MEP CGEO, H/A N/A 10/dS/toil Fil ..M.9L 5 0,3A9.96 LC16131272 NOAPEOW195A0 IDe.XX GOLOEx GD1nIN CNffN TOTAL 349]LSS 99fit1 To be0lkdaul Memvtltl Centel: .7 O Re[e ve IO FN AP,wYetl IN: C [ erenEea pale of lranefe[: Il 3 tptl EfgmEa[illry: 4Mden <[erN io Fxility: MMI.I NI[ ATOY AC 9 L ` RN \j4 U 1 i021 s)?:1, Request for Transfer of Funds Il.vliler P. Odle A.,bb,led IIMEB/EOII Payer MCUICAK {equd.b. by IA IIIM GOPI)DN DV]INESSOIEICEM.AGEN Nequea.'I email _n_.I pt., nn_Y.Ii,. ru'emu fle queel0(a tfie, � umbel AL LSSILSW Oleldalal Cou.H EN. — Wide, eeth..ny xmm hvine .1�1DLLrylon�?Eytam e,ma l„In�.mmua. �- flEWO{I9A�Ell E LLVID Ob, OMealYrvlre I. MPavmene r01®S6E. C�'I �SIM 110 RF EQO NIDI Dal a,Pa al{pl f 1.d LEE _ Oldrellubb., Im u _bee 19i40P i1La^I GOINCNCINENG flIIIAN 06VnIl1AN1 H/A N/A W/li/1021 Ffl Ell 411H9Y] CVUANO0,IV19540 ILSA AIIVANELPMI G0101N1N11N8, Af11M1,gV%IIIAIIV N/A N/A 10/IA/f11E1 D. LIi 41Ei 2E1 N11/,N00L919 ]<0 lAl lP AOVAIICF PMI GOIOCNCNLEC &PEIIMLpVN111AN1 N/A N/A _ IW19/]021 F11 EFl G1x55q rypANCCOp19Sg0 8,4I5fi4 ANVANCE VMI GOLDEN CREEK W IDEAL AUMNANY N/A N/A IO/20/IDL III EF11121926 (WAflW0019540 101.11 ADVANCEPMI GONIfN CNEEM A NEIIMI, AULEDANY 11/A N/A _1oluo021 ELI Ol GL19G71 CVMNWEN95V0 DI-16 ADVANCE I'MI GOLDEN 11119 M NEINII- AUMLIANY NIA N/A 101221202E LII LFl G.Id31 NI MPIgOD II]AO 3)251 ADVANCE PMI IDTAL 9,4K.10 TO be filled ddtbv MenN,OI MCJiDOCenlel: DOefle[e a 10 H3021 APPInYed bY: CLlpven{el e alllamlel: IIl71DE1 imm{atiMY nMJen CIeN PamDy: oelnaAr A mounl: 9.GE63O 4)ly rov !) ' 2,U21 Request for Transfer of Funds IIBn51t/p: Oale Requeetetl Patel Requeped or: Ileyu:rAes email set Do' Plmne number District or County ,.0II, 10/28/202E AORIANNA STRAWS «Irve[ree $ mlpnrll ivi 1 'a line/! n p[ItnrNAvam ]_ Pilknl Name U pF_Of N/A N/A N/A N/A N/p N/A H/A N/A oa3e ol5ervke EO N/A N/A N/A II/A N/A N/A 11/A ILA 10/I1/I021 10/I )/3031 10/INEOlI 10/L/20I1 IO/EM111rt 10/1912021 10/EO11031 __10/11/x 021 10/E2/2021 Tvm M�P{{ggU_ EFI [fT EFI Ef3 EFT ER EFT EFI o>rme„E, SMxn pn 925.1E 141590 2.5fip.39 143.fl'9 $2,74005 5 4.02]J4 5 Ip0545 5 2.650Y1 5 4,49894 Nu fRfi116]96 EET6EADl I'MU01.4 EFT6121851 ER0121017 ERpRN31 CmE21M EF3MEII1 ER4131272 Im NOAgoO]ply9p5 NOARWLWI9E5 INOARCCU00]9p5 NOAR000WE995 NOApOW09)9p5 NOAAO]p0019p5 _ NOARCW00]9p5 NIIAROOMg19.1 NpAp00p0p1'3tl5 ka=b=Ea-14 DE N$(AryY VIl1AYE NS(ANY II AG1 Ti VIIIACC IOSEANYVIIIA A NS(ANY (it NS[ANY VIUAE, NSCANY VIIIAfiE lU5[AHY VIl1AGF ]US(.., VItIAGF N Ma1Ju9undr a/ F Mi[Aull 4q 0] II I An 11114 (. tl5 1311fi 19L1A 9IN5 lEli 13 EONS. ROYAL 30,9ILSl 996.21 to011etl oath Memorial Metll[al Canlec ArtReceW O1 2tl APPmuldvetlbY:y (fluvnnY.'v ]lakolvmner u]mxl _ Fmm....Ac m:uury ]o FatlnlK mmc mm Amount 996 E1 ,;)"I ij i 2021 Request for Transfer of Funds ..miler n' Met lt.,-ebed lo/ pon Poye! MIulcr.t nequoted by tATUMGORDON BUSINESS BfflCC MANAGER Pequena—.11 rge...... 1L93 —'f1u: Nequesbls Rbone ,umber ]G b Ss wso4 06lneler County olhuu, Adliry brabany Senior 6v:., Advl.eaMEO6 ri.,It ��l9mrnXlndxtla,Rcn Pallent Name Ueb elbrvke ivee e(M A�Y12 � 'n—e"l GWM ne�(df^_34i fIe14111stEnHL+. RE U (pJ RFG OMe el Pevmenl gynm u 3 t2CGYgy N N4$} IlI3d11Y VIl UGf-AU FIl1APY AGVAN Cf N/A H/A 10/11/30E1 Ifi [It 6116e95 (VOAPV]pM]985 11511 PMI USCAN11I11AIA AUIIIInNYA.110E N/A N/A 10/Itl/t031 111 E1i61}JIII [V OAPIM Mill 383.39 PAIL IUSCANI VIIIAG1 MIURIA111 M.111f N/A N/A 10/19/2021 I11 EfTGIPVHi (VlMX00000/9X5 B.W566 PMI I IIJCANYVIIIA6f AUMIAyl ANVANCE N/A NM 10/30/}0ll NT IFT6fEl9}6 CVIMXLtlCW1985 IIN.}t PMJ IUSCAWVVIl1A6l AUXI111.1AUVANCE 11/A 11/A 10/21/1011 fll (!1 AI}'34)I CVIIAmMOIXI}9R5 )0.96 PMI f I1SCANY VUTAGJ AUXIIIAXYAUVANCE WA JWA 10/}]/]0}1 111 IR 4131A 3} CV NAN W]II]UBS )1]51 PMJ TGTAL To be filled Wl byM rnorlal Medical Mer: W Io P.IV : APPmved by. r Oale al lnnslec 11 J l@I fmm fadllly: lur[nnyP Td Padllly: Xel Aeny Ameunl: 9,6141U ary ?JV 0 1 2021 Request for Transfer of Funds rra�skrR. we Requested 10/16/2OZI rvOaNNgN]9as P.K. Novdv Re ... A'dhY [hind llopper agave mNemeu �,2uv _�ronu,Fmn __ a<qu.,mrepnooe oomber 9o3112sp12 pm,inormmrn uel eeoJ�.aaem.. eealiq Luleen LeeF [n�nnstClse nl—,.,edru� E3vd��13<.,.,o 0 Pa ent W7jG UI Fp oeleu F W EYR1.1 O xyx Mlamv hvmerrt kp ImN CVUpgW11L4%yX5 CVOAPOgaq)9X5 A.2baeal,Rd_Fg� IJVt II=gFtL. 1q.YH�4+,gVbt 5 Z,11]92 $ ).JI IluCb Ewltlenl'reN lruin iu„eny Villyle Ou¢(p401d¢n (ie¢A bnm lustan VJIApa•. 10))o/39Z1 10/ZWall fFILli111Yr It IWWA $IZ.II].93 $ 11.311 FF(LIZ]h]2 EFIWT.Z4 lOTAI $(Z, 130.331 Ta be Ulkdoulby W.NI Wdlral Cemm� oa¢XRe a miR ron A,.-d b6 CtleyniLe, pamonnn,ler: u 3 zun Fromh[tl4 : [nry io Nalil, 4WawI�L bfl! llT \ l Y�'l1L UO n ° M21 U. "J L MMC --- ---- , ) ;) N I J, V ! : 1 : 11/1/21 L--j 2021 Li fvui Wendof U i-. L, AMOUNT 7491.54 F;E Echo Payments owed from GPP F k-.-Caitlin Clevenger �kl�- Pol�at 4'�ku - -- i' MMC U1 Yl1 (.r / Uri >qurs;cai 111/21 I i I� zr N0V 0 2021 � E wdt,, .------- - ---- iln/ti4��: , I' Echo payments owed from GPP ii 1' �I is Caitlin Clevenger �kl� PotnAt.4leZi-" Bvnadnwvv 11/1/21 U r -. .ifi•..r 20191 I i ,r- �Pd'6t1, 5,803.39 17 i ,N 2 1 Echo payment owed from Gulf Pointe Private Pay Account I — Caitlin Clevenger -Nor- Fbik-k plk7i�- S T ldmc- U4- 11/1/21 R4 Ie, fr/ ER, n �✓U�cvau 11/1/21 GL"F Poiv(IIL PIA7, iE NOV it i 2021 4,390.00 Echo payment owed from Gulf Pointe Private Pay Account C, Caitlin Clevenger n ��F ® WCCW®CM=MM c a, . -i ^ram tTr n n ��r_rs>mr•r_r_�r_r_t_r_�t• f""ll t r m T n-ii' n r-ii®�� u�-trn __'�r ^*, r x��t n<m. ®rs+mr_�r_r_r_r_r_r_��r•� �mtmrssni®r•r_r_r_r_r_r_r_r_r_�r_ Memorial Medical Center Nursing Nome UPI Weekly Cantex Transfer Prosperity ACCOunts i1/1/2021 n.ww TN.v[ x.n.m1 ..nmm�9 r.Nm. B.umm1 ulmmtrob n.mnme wnunln. xm x.m. x.mw Be..,[. mnrr.ow rwlry.m m a __, ,,_ ;y,. wbd<d6G tC6,61Raa nl.}ov sN 11,IW.sI Se6s9L60 Bm4 B.bnu Vanan[e }}1,10936 telneM enmp. IW.W am.mavnealpv rvpm Mnm sl 1a,59s.}5 - OCr INRREST I6:3✓ NOymn'"T OtCINTEREST / eawnlenunnn.- lusvr vp / 5�,. Brn�Wm.awt _ 169.5]1.16✓169.115.16 Y/III.i950} 6/ 111.1950, 114,]}e35 Bm4 emm1. 1.1.115 or te.m lne.kn! I.. 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JASOm / cAQ. 1]1f ]M J S.ele.3 L,I1Pm 3I,IMJq MMIPORnox arorcanPl l�r� TnnrO 11 4wlcmyt are/cmw+ arP/curo3 61Jp. aron xxrann;x I19 2, S,IIJS9 $.1019 IWISS ll," bAg15f 1.99390 S.PIS.W x9ges6wr,% - ll6.l]I l9 113.111. 6MS,R - fiN3It i.SilN - I,SIIF LEAIIO % . sww� - 692 102%11 10,1%93 / 10 96'1 10.11.41 lan ✓ 31❑ 1916fWI 16)Ylll 16IY111 ISE,WIM e»,e10.N 11/1/2021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Accounl TypeIf Am1 Group h4y Gmups 'DA Data repo 1 o as of Nov 1 2021 10 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8,304.655.72 $8.366.589.88 $8,304,555.72 $8,277,355.65 '4651 CAL CO INDIGENT $5,441,71 $5,441.71 $5,441,71 $5,440.86 HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $75.699.68 $76,013,12 S75,699.68 S47.354.32 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $535.92 S536.92 S535.92 S535.85 2014 '4357 MEMORIAL MEDICAL S5.978.481,43 S6.012.740.12 $5,978,481A3 $5,965,009.97 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE S431.46 $431.46 S431,46 S431 41 WAIVER CLEARING '4381 MEMORIAL MEDICAL S221,309.58 S227,482.18 S221,309.58 S205,684.60 CENTER t NH ASHFORD '4403 MEMORIAL MEDICAL CENTER INH $141,895.02 S142,314.21 S141,895.02 $125,466.71 BROADMOOR '4411 MEMORIAL MEDICAL S63,514,03 563.514.03 S63,514.03 S59 162.33 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S34.220.00 $34.277.66 $34.220.00 S33A48.26 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER ISOLERA AT S163.981.81 $171,361.81 $163.981.81 S146.292.00 WEST HOUSTON '2998 MMC-MONEY MARKET S1,108,867.88 S1.108.867.88 S1.108.867.88 S1.108,632A9 FUND 'S606 MMC-NHBETHANY S06.889.16 $86,889.16 586,889.16 $76,299.29 SENIOR LIVING '5441 M1MC -NH GULF POINTE PLAZA- $36,006.45 S36,006.45 S36,006 45 S34.138 15 MEDICARElMEDICAID '5433 MMC -NH GULF POINTE 5191,60a 44 S205.037,02 $191.60,4A4 S251;356 72 PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY 5195,677.15 S195.67715 S195.677.15 $198,102.69 VILLAGE https:/Iprosperity.olbanking.com/onlineMessenger 1f1 Memorial Medical Center Nursing Home UPL Weekly Ne9ion Transfer Prosperity Accounts 11/1/2021 PRNou! 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J l9.h l?tl 10/]1(]0ll»» MNSlWS901C05)Nn 5656M5316769179 1W27002IH ITMMtUTMNHCCWMPM]OW9)IIWWIN U?50 1111. 1 W16hW[ ItYt(IMNMIPJI B[COSi11A1 M]fiMJSSM69»9 }.M56s ' 1.3.566 1W13/IO]I nWIMWMI WO 5.T SA6MS510]691]9 6)» W IM1(2W 1 CI4n. nCNIMIM11500]5%J 9Ju'm1mus5 L93] W 1.932 W 1921, 346N.M }s,IK.N Is.»!;s I0.i1i 55 46 11/1/2021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Account Type Add Groun h1y Groups Search F All ❑DA Data reported as of Nov 1, 2021 10 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 58,304,555.72 $8,366.589.86 $8,304,655.72 58,277,355.65 '4551 CAL CO INDIGENT $5,441.71 55,441.71 $5.441.71 55,440.66 HEALTHCARE '4454 MEMORIAL MEDICAL I NH GOLDEN CREEK $75,699,68 576,013.12 575,699.68 547.354.32 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES 5535.92 $535.92 $535.92 S535,65 2014 '4357 MEMORIAL MEDICAL 55,978481A3 $6,012,740.12 $6.976481 A3 $5.985,009.97 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE S431 A6 $431.46 5431.46 5431.41 WAIVER CLEARING 'd381 MEMORIAL MEDICAL $221,309.58 5227,482.18 S221,309.53 5205,684.60 CENTER INH ASHFORD •4403 MEMORIAL MEDICAL CENTERINH $141,895.02 $142,314,21 5141,895.02 $125,466,71 BROADMOOR '4411 MEMORIAL MEDICAL $63,514.03 563,514.03 S63.514.03 559, 162.33 CENTER INH CRESCENT '4446 MEMORIAL MEDICAL $34,220.00 $34,277.66 $34220.00 $33,448.26 CENTER I NH FORT BEND '4436 ME MEDICAL CENTER ERI SOSOLERA AT 5163.981.81 5171.361.81 5163 981.81 5146,292 00 WEST HOUSTON 2998 MMC -MONEY MARKET 51, 108.867.86 S1.108,867,88 S1.108.867.88 51.108,$32.49 FUND '5506 MMC-NH BETHANY SENIOR LIVING $86,889.16 386,889A6 $86.889.16 576,299.29 '5441 MMC -NH GULF POINTE PLAZA- $3fi.006.45 $36,006,45 536,00645 53413615 MEDICAREIMEDICAID 'S433 MMC -NH GULF POINTE $191.604 44 $205.037.02 5191.604,44 S251.356.72 PLAZA - PRIVATE PAY -3407 MMC-NH TUSCANY VILLAGE 5195,677A5 6195,67715 5195,677.15 5198,102.59 htlps:gprosperity.elbankinq.com/onlineMessenger Ili Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Acmun[5 I111/E021 Sao'— Maounl aglnnNE NunM Ilona � Btlm[e aub"-. aWw+AN9wplpi:: .:,. aTJmn PIe9low A[[o Nunn H MY[A6n NWer GnlYbolan[n W prN5S.0.V wdlbeOanSJwnJN(benwu^YM1ame. 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ECHO NCCWMPW 14601341144MO251]N UP2512011 HAS ECHO HCCWMPMT 74603411 146W0}51164 101231l021 NNE ECHOHCMIMPMT2A6 311144ONDIS11N 19/25/1011 HNBECIIOHCCUIMPMT54600IAII440001511Y 10/75/1021 NNE fCHOHCMIMPMT146W341144W00151164 10125/1021 PUB ECIIOHCCLAIMPMT146003411YOOW1S1164 IW25tl021 INS 1CHO HCCLAIMPMT 146003411440000251264 10I25/IDI1 HIRE ECHO HCCLAIMPMT 746MI41144000251764 10R512021 AETNA N0S HCCIAIMPMT 1921091190 311002097023 10/31/1011 Add"IL) AMPunt - 10/29/2031 HNI3HHUAIAN5VCHCMIAIPMT334600N1150112 1012VIO21 WIRE OUT HMO SERVICES. PLC IP/29/3021 Oepo41 1000/1021 MUNDIAN 13A HCMIMPMT 17599242000014SI915 1012112021 HEALTH HUMAN SVC HCLIAIM9MT 174NO34111013 2 101261202E WE$TD[FIC CONIR HCCIAIMPMT I2129913062IN0 10136/2021 NORIDIAN LEA IICCWMPMT 67539242003463612 1011511W1 WP54D[RC COSTS HCMIMPMT 2222HUNS, 21W0 TO/EI20A NORMAN 13A HCCWMPMI 07589241MISO5055 MMC PMOON Tland,T-C. T In gIPo/COmp1 OFFP/COmpl CHNICHO 3 gIPPLOW NI antler. p Pu gmPn PORTION .9u bi 69,366 N 32.130.6. 12,7IO.N ly)ION 25991 M592 SO.Soll 85 35,22913 ea'I'l 5 _ 19,]6B p6 N.6321] , 40,66514 11742 - I1712 ?.A. 11 2.404 111 17642 11641 21.160.71 13,26011 1568 IS66 112.61 - 11161 To OF I.Sl u]4 1214 2151 - 21.52 7841 - 1e41 - 235E - 2351 5.512,48 - 5.511 Cp I1410 31 11.410 32 135 91 13S 64 9B6. S9 OF6.to 33 21 3 2E LEE i1 - 1.40417 ISO" - 15 66 I,I20 N 2,120 N 6,3W 00 - 6.30000 453,202.30 9B.99S.0! lylW.N 12 )ION Y10641 MMC PORTION g3PP/COmp16 ryH TIIOtlelAV3 TI.AdH-F11 gIPP/COmOI gIPI/[OmP2 OIPP/6TREE F.P. Olppll I PORTION 6.11 6.1E L363,01 S,YLOI 41226183 3IDol3 TOM IF }p15.03 243}99 },A1299 212 21 - 21712 9,675.96 5.615.96 3.353.50 - 3.151,50 134256153 / 13,1%63 UB,151Y'/15.906.45� - 35906 5 591353.99 92,503.50 1L]N.N RRON ILLSON1116 I I/112021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number I Name Groups Accounl Type Aud Group Poly Groups [ODA Data reported 7c of Nov 12021 10 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8.304,555.72 $8,366.589.66 $8,304,555.72 $8,277,355.65 '4551 CAL CO INDIGENT S5A41 71 $5.441.71 55,441.71 $5,440,86 HEALTHCARE -a454 MEMORIAL MEDICAL / NH GOLDEN CREEK $75,699.68 576.013.12 375.699.68 547,354.32 HEALTHCARE '4385 MEMORIAL MEDICAL CENTER -CLINIC SERIES 5535,92 $535.92 5535.92 5535 85 2014 '4357 MEMORIAL MEDICAL 55,978A81.43 56,012,740.12 $5.97848143 55.985.00997 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE 5431 46 5431.46 S431.45 S4.31 41 WAIVER CLEARING '4381 MEMORIAL MEDICAL $221.309.58 5227.482.18 $221.309.58 5205,684.60 CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL CENTER 1 NH1..5,46E.7' S141,895.02 5142,314.21 5141,895.02 $ BROAOMOOR '4411 MEMORIAL MEDICAL CENTER I NH CRESCENT $63.514.03 563.514"03 S63514.03 559,162.33 "444 MEMORIAL MEDICAL CENTER I NH FORT BEND $34.220.00 $34,277.66 534,220.00 533.448.2E '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $163,981.81 $171,361,81 $163 961.81 $146,292,00 WEST HOUSTON '2998 MMC-MONEY MARKET FUND 51.108.867.88 51, 108.867.88 $1,108.867.88 51, 108,632.49 'S506 MMC -NH BETHANY SENIOR LIVING 586,889.16 $86,889 16 586,889.16 57629929 '5441 MMC -NH GULF POINTE PLAZA- MEDICAREIMEDICAID 536,006.45 $36.00646 S56006.45 53473815 'S433 MMC-NH GULF POINTE PLAZA - PRIVATE PAY 5191,6044.1 5205.03702 5191.604,44 $251,35E 72 '34l)7 MMC -NH TUSCANY VILLAGE 5195,677 15 $195,677.15 5195,677 75 S 198.102 69 httpsll/prosperity.olbanking,comlonlineMessenger h 1I1 Memorial Medical [enter Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 11/1/2021 vurlw. gmnnun e< Kenun$ aellnNnL ImdlnB hm]lerted In NYn N _ &Y94 nml[nON Tnml<rin C4iUeareG ttB TW [O. Inn Wuiu NYNn Nmre }1,6)099 315)091 195.$))ds 185,4)).1$ fi3.S.p.)1 W n$OiUn[n 195.6)l.$$ V<n.n[e xaee: onN minn[nn/over55,aoowraee]mntl<xw]n MenuninBnume. xafee mm oaewLAoa o Baeeemn[eo/SFOJmN MMc aGm,twmWm a -mum + :r �' r r ' Bu-) Inane MRl4n[r yp3,W / \mEMA dB TO SEManll S4,d1.iq✓/ MLOIGRE REIgTMFNi TORETHNiY 9,61614'✓/ ddRFeLB\Y4O14LNLRFFN },130 ]]✓ MFdt'dRF RFPAYMENG\YNLNI TO MMeONIC q96}I✓/ atliYn Mh ITmih[NnrE. -']1,^` / • r MlM1orryN O 10/31/2021 Added to Account 10/29/2021 CK 1069 10/29/2021 CK 1070 10/29/2021 Molina HC oft% HCCIAIMPMT PNIZ757178944200 10/28/2021 WIRE OUT LINDAR ENTERPRISES, LLC 10/2812021 Deposit 10/28/2021 Deposit 10/28/2021 Molina HE of TR HCC1.AIMPM1" PNIZ757179944200 10/27/2021 NOVITM SOLUTION HCOUMMPMT 676ZOI 4201)W 144 10/26/2021 Molina HC of TK RCCIAIMPMT IN 127571799442W MMC PORTION QIPPIComP4 ToenPfefOut Tmn$fer4n QIPP/Qmpt QIPP/Cui QIPP/ComP3 &bpse QIPPM 13.34 8.249.80� 1,281.)0 `- ,094.62 12.039.44 NH PORTION 11.34 7,094.62 19,037.53 19.037.53 40.669.74 40.668.74 • 317.84 317.84 - 121.352.46 121,352.46 ,7.034.6E i >094 fit 23,5]0.94 ,ii95.51).ti ✓ 195,577.15 111112021 Quick View Select Quick View Accounts Account Number / Name Account Type v Soarch All RDA Account Number Current Balance Number of Accounts: 15 58,304,555,72 '4551 CAL CO INDIGENT 55,441.71 HEALTHCARE '4a 4 MEMORIAL MEDICAL / NH GOLDEN CREEK 575,699 68 HEALTHCARE '436y MEMORIAL MEDICAL CENTER -CLINIC SERIES $53592 2014 '4357 MEMORIAL MEDICAL 55,978,481.43 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER • PRIVATE 5431,40 WAIVER CLEARING '4381 MEMORIAL MEDICAL 5221,309.58 CENTER I14H ASHFORD •4a93 MEMORIAL MEDICAL CENTER/NH 5141,895.02 BROADMOOR '4411 MEMORIAL MEDICAL $63,514.03 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $34,220.00 CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT 5763.981.81 WEST HOUSTON 22H MMC-MONEY MARKET $1,108,867,88 FUND 'S506 MMC -NH BETHANY 586.889.16 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- 536,006 S MEDICAREIMEDICAID 'S433 MMC-NH GULF POINTE 5191,604.44 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY 5195,677.15 VILLAGE https://prosperity, olban king, com/onli n8Messenger Treasury Center Select Group Groups AdU Group kty Groups Data repunen : s of tin, 11 2o, I to Available Balance Collected Balance Prior Day Balance $8,366.589.08 58,304,555.72 $8,277.355.65 $5.441,71 55,441.71 $5440.66 $76,013.12 575.699.68 547.35432 5535.92 S535.92 $535,85 $6.012.740.12 55,978.481 43 55,985.009 97 5431,46 5431,46 S431.41 5227.482.18 $221,309.58 5205,684.60 S142,314.21 5141,895.02 $125,466.71 $63.514,03 $63,514,03 559,162.33 $34.277.66 S34.220.00 533.448.26 S 171.361.81 5163,981.81 5146,292,00 $1,108,867.88 $1.108,867,88 $1,108,832A9 586,889.16 586,88916 576.299.29 $36,006.45 $36.006.45 $34, 138.15 5205.037 02 5191.604.44 $251,356.72 5195,677.15 $195.67715 $198.102.69 r V1 Memorial Medical Center Nursing Home UPL Weekly HSL7ransfer Prosperity Accounts 11/1/2021 vrmnem venein, Rmounl laa A[[eall B[tl-I' m1".n. rnmrmvale NUNn Nemlr NumErf RYu[v LmbnWl V+Mer.ln <b ma b [ enl r 1vG Ba Imin &hn[s x n Nome :-,Wl.1 laASP.N }6],s,2, R. )... e.m wi.n[. easeela U.1 . m[e.on[. m.. lyaR M.Nps LSr nil v/ NRUIxTER / NRM QEcov:AFir •adlml![bn[v pnrt ✓/ Nell:Mh'Ov:mar afaM SS.f%w.11pe lrvnl/NrMly NeeWl:np M1ane. ((L`�/ Mmor2G' , Nol!): fvU e[fWn!Avr vlercallonnv/$ICOIM1VIMM[ee/umMmeymv[fvunf Mllwrry Rid,r a44]vu V1� f:1NN waeW rnn,lm\MI Veltnm![,SummrryUW I\xwemM\NNUn lnn,lm5ummrry 11131.•lu 3013INO21 Added 14 Aaount 10/29/2021 Gepasit 10/29/2021 HOSPICE OF SOUTH PaymenU NF 113122650048170 10/28/2021 WIRE OUT BETHANY SENIOR LIVING, LTO 10/29/2021 Depelil 10/20/2021 Deposit UV26/1021 0epmo l0/2]/2G21 D40511 10/25/2021 O4p411t 10/25/2021 O.01R 10/25/2021 NOVITAS SOLUTION NCCL9MPMT 67648142000D128 MMCPORTION 41PP/Comp] Tmnikr-0u4 T nslenl L.-Pi 4IPP/C0m02 OIPP/[omp3 BUpi! QIPP TI NM PORTION 25.39 25.39 9,991,03 - 9,991.03 573AS 573.A5 26),431.24 19,946.11 19,9<fi.li ]]9100 7p91.00 4.199,37 4.199.37 4.225.63 4,225.63 410.44.35 4,044.35 • 28.O61 00 28,0611M • 7.931.32 ],931.93 26]•43).24 6169.16 86.089.16 111112021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Account Type AtlU Group My Groups Search All [DDA Data reported as of Nov i. -'021 10 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8.304,555.72 $8,366,589,88 $8.304,565.72 $8,277,355.65 '4551 CAL CO INDIGENT S5,441.71 S5,441 71 S5,44171 S5A40.86 HEALTHCARE '4454 MEMORIAL MEDICAL/ NH GOLDEN CREEK $75,699.68 $76,013.12 S75,699.68 $47,354,32 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $535.92 $535.92 $53592 S535.85 2014 '4 57 MEMORIAL MEDICAL $5.978,481.43 $6.012,740.12 $5,978.481 43 $5.985,009,97 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE S431.46 $43146 S431 46 $431,41 WAIVER CLEARING Jag MEMORIAL MEDICAL $221,309.58 S227,482.18 S221,309.58 S205.684.60 CENTER! NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH S141,895.02 S142,314.21 S141.895.02 S125.466.71 BROADMOOR '4411 MEMORIAL MEDICAL $65,514.03 $63.514,03 S63,514.03 S59,162.33 CENTER / NH CRESCENT '4446 MEMORIAL MEDICAL $34.220,00 $34.277.66 $34.220.00 $31448.26 CENTER/NH FORT BEND V43B MEMORIAL MEDICAL CENTER I SOLERA AT $163,981,81 $171.361.81 $163.981.81 $146.292.00 WEST HOUSTON '2998 MMC-MONEY MARKET S1,108,867,88 $1.106.867,88 51.10B,867.88 S1.108.632.49 FUND '5506 MMC-NH BETHANY S66,889, 16 S86,889, 16 S86.8119.16 575.299.29 SENIOR LIVING •5441 MMC NH GULF POINTS PLAZA. $36.006.45 $36.006.45 S36.006 45 S34.138 15 MEDIC AR EMI ED I CHID '5433 MMC -NH GULF POINTE $191.604.44 S205,037.02 $191 604,44 $251,356,72 PLAZA • PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE S195,677.1.5 $195,677.15 S195,67715 $198 102.69 httpsx/prosperity.olbanking,eomlonlineMessenger 1!' RiAIL N',E IC -Ai_ i'HF.( lc Rc:OilI:S- MMC ii5h-iw�.�.arsled: 11/1/21 A rOR A.CrCI. USE N[.)' 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M [JSXSD Il l]fi3E "1112 1]63: - SFsm% Ip.6MW Ll6tif tip6a3 µy1% ;y3N m,m ex m lalm seRSS 1155 ]] Sb3ID 3.3111, ]Id)] rlfT eaa;GE eax pl µ1.132m I11S31Y MO. IANS f.lµµ ILSmm ✓ sI M9M mrL3.tl sl].W.}3 Symm 31.YI.64 53.tYN nJµ3S WALK gg 7 n� 3/31/2021 Added to AmoYnt 3/31/2021 WIRE OUT UNBAR ENTERPRISES, LUC 3/31/2021 ANTHEM INC&PAYMENT E62132824111000023415 4JV2021 NOV0AS SOLUTION HCCIAIMPMT 676201420Wp115 41212021 NOVI7AS SOLUTION NCCIAIMPMT 676201420000141 MMC PORTION gIPP/Cemp4 TransferOut ransfer•In lQIPP1Cnm0 gIPP/[omp2 piPP/[amp3 814pse gIPP TI NN PORTION 53.17 53.17 121,723.20 - 24,70BA0 15,878.80 2.652.65 6,177.15 20,293.70 4,42430 37,892AS - 37,892,46 4,838.92 - 4.838.92 121,723.20 67,493.25 15,878.80 2,652.65 6.177.15 20,293.70 s ' 47.199.45