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2021-11-17 Meeting MinutesI ME We I I(�l � All Agenda Items Properly Numbered _ Contracts Completed and Signed �G All 1295's Flagged for Acceptance " ,-(number of 1295's I ) ra All Documents for Clerk Signature Flagged On this rLi6day of 2021 a complete and accurate packet for rg)of 71141WIh4/ 2021 Commissioners Court Regular Session Day Month was delivered from the Calhoun County ]udge's office to the Calhoun County Clerk's Office. Calhoun County7udge/Assistant not si g rid �y Amw I am as of COMMISSIONERSCOURTCHECKLI ST/FORMS AGENDA I UI vIII, liwl I Il.,O11 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 MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, November 17, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Inn Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: Y' Call meeting to order. Z. Invocation. ledges of Allegiance. `General Discussion of Public Matters and Public Participation Approve the minutes of the November 3, 2021 meeting. y'9%FlL ATo_ CLOO CKED M NOV 12 2021 ANNARGOO@AAN GOUN�I7y//ff,�,�LEjRR,KJ� 1,110 dCOUNTY,TE%AS SY. K I,,LIl,�, Consider and take necessary action to approve a 63-month lease contract between the Calhoun County Human Resource Office and Great American Financial Service for a Kyocera Copier, model number 6635cidn and authorize the Human Resource Coordinator to sign. (RHM) Consider and take necessary action to approve the purchase of a 2,000-gallon Distributor Truck for R & B Precincts 1 and 2. (VL) Consider and take necessary action to approve the Specifications, Project Manual and Plans for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas and to authorize Urban Engineering to advertise for bids. A pre -bid meeting shall be held at 10:00 a.m., Thursday, December 2, 2021at the Boggy Bayou Nature Park, Port O'Connor, Texas. Bids will be due before 2:00:00 p.m. on Tuesday, December 21, 2021. (GR) Page 1 of 2 I Nk)i[(I Cii N11II Il /T'()? I t Consider and take necessary action to authorize Urban Engineering to release any addenda to the bidding documents approved by Commissioner Gary Reese that is related to the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas. (GR) 410'Consider and take necessary action to rescind a Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas due to First National Bank selling this parcel of property. (GR) 31/. Consider and take necessary action to sign a new Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas and authorize Judge Meyer to sign all documentation. (GR) 42#16onsider and take necessary action to authorize the installation of an emergency key holder for fire and law enforcement agencies at the Calhoun County Library. (RHM) 13. Consider and take necessary action to approve the transfer of two (2) leather chairs �fr m the County Court at Law to Human Resources. (RHM) �14. Consider and take necessary action to declare a HP Colored Laser 3525dn Jet Printer, serial number CNCCBCQ21Z as Waste. (RHM) i5. Accept reports from the following County Office: (- � unty Clerk — October 2021 / 0� Justice of the Peace, Precinct 3 — September 2021, amended 16. Consider and take necessary action on any necessary budget adjustments. (RHM) 17. Approval of bills and payroll. (RHM) j Richard H. Meyer, Cour 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.calhcurcotx.org under "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 NOTICE OF MEETING — 11/17/2021 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Kaddie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, November 17, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Smite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Gary Reese Texas Flag -Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Approve the minutes of the November 3, 2021 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 1 of 4 NOTICE OF MEETING—11/17/2021 6. Consider and take necessary action to approve a 63-month lease contract between the Calhoun County Human Resource Office and Great American Financial Service for a Kyocera Copier, model number 6635cidn and authorize the Human Resource Coordinator to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to approve the purchase of a 2,000-gallon Distributor Truck for R & B Precincts 1 and 2. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the Specifications, Project Manual and Plans for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas and to authorize Urban Engineering to advertise for bids. A pre -bid meeting shall be held at 10:00 a.m., Thursday, December 2, 2021at the Boggy Bayou Nature Park, Port O'Connor, Texas. Bids will be due before 2:00:00 p.m. on Tuesday, December 21, 2021. (GR) Matt Glaze with Urban Surveying explained the use for the plans. Commissioner Gary Reese adds: Under article 8 #E, all protest and disputes will be held in court by Calhoun County, Texas. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to authorize Urban Engineering to release any addenda to the bidding documents approved by Commissioner Gary Reese that is related to the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NOTICE OF MEETING — 11/17/2021 10. Consider and take necessary action to rescind a Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas due to First National Bank selling this parcel of property. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to sign a new Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas and authorize Judge Meyer to sign all documentation. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to authorize the installation of an emergency key holder for fire and law enforcement agencies at the Calhoun County Library. (RHM) Naomi Cruz explained the reason for the box, and that the Fire Chief recommended having one. Commissioners agreed to pass on this item. 13. Consider and take necessary action to approve the transfer of two (2) leather chairs from the County Court at Law to Human Resources. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action to declare a HP Colored Laser 3525dn Jet Printer, serial number CNCCBCQ21Z as Waste. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 4 NOTICE OF MEETING — 11/17/2021 15. Accept reports from the following County Offices: L County Clerk — October 2021 ii. Justice of the Peace, Precinct 3 — September 2021, amended RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES. Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 16. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 17. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Image/Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned: 10:24 a.m. Page 4 of 4 #5 NOTICE OF MEETING — 11/17/2021 Richard H. Meyer County judge David ]F1aH, Commissioner, Precinct h Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 (nary Reese, Commissioner, Precinct 4 Kaddie Smith, Deputy Clerk NOTICE OF MEETING The Com missioners' Court of Calhoun County, Texas will meet on Wednesday, November 17, 2021 at 110:00 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. 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Gary Reese Texas Flag -Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A Page 1 of 14 NOTICE OF MEETING— 11/17/2021 5. Approve the minutes of the November 3, 2021 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 14 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, November 3, 2024 at 10:00 a.m. in the Commissioners'Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. r Richard Meyer, Countydge Calhoun County, Texas Anna Goodman, County Clerk Page 1 of 1 NOTICE OF MEETING — 11/3/2021 Richard H. Meyer Coiin>ty judge David Hall, 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. f-Ch4�1pill 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 3 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 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 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. 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 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 #6 NOTICE OF MEETING — 11/17/2021 6. Consider and take necessary action to approve a 63-month lease contract between the Calhoun County Human Resource Office and Great American Financial Service for a Kyocera Copier, model number 6635cidn and authorize the Human Resource Coordinator to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 14 Mae Belle Cassel From: clarri.atkinson@calhouncotx.org (Clarri Atkinson) <clarri.atkinson@calhouncotx.org> Sent: Monday, November 8, 2021 11:49 AM To: maebelle.cassel@calhouncotx.org; richard.meyer@calhouncotx.org; David Hall; vern lyssy;joel.behrens@calhouncotx.org; gary.reese@calhouncotx.org Subject: Agenda Item Request Attachments: doc11973720211108113703.pdf MaeBelle, Please place the following item on the agenda for November 17, 2021: Consider and take necessary action to approve a 63-month lease contract between the Calhoun County Human Resource Office and Great American Financial Service for a Kyocera Copier, model number 6635cidn and authorize Human Resource Coordinator to sign. Thank you kindly, Clarri Atkinson Calhoun County Chief Deputy Treasurer — Human Resources Coordinator 202 S. Ann, Suite A Port Lavaca, TX 77979 P: 361.553.4618 F: 361.553.4614 Clarri.atkinson@calhouncotx.org Confidentiality Notice: Privileged/confidential information maybe contained in this message and maybe subject to legal privilege. Access to this e-mail by anyone other than the intended is unauthorized. If you are not the intended recipient (or responsible for delivery of the message to such person), you may not use, copy, distribute or deliver this message (or any part of its contents) or take any action in reliance on it. In such case, you should delete this message, and notify us immediately. If you have received this e-mail in error, please notify us immediately by e-mail or telephone and delete this e-mail and all attachments from any computer. Calhoun County Texas COST PER IMAGE AGREEMENT !M-1GreatAmerica %FINANCIAL SERVICES GREATAMERICA FINANCIAL SERVICES CORPORATION 625 FIRST STREET SE, CEDAR RAPIDS IA 52401 PO BOX 609. CEDAR RAPIDS IA 52406-OM AGREEMENT NO.: 1714600 'CUSTOMER• •• FULLLEGALNAME Calhoun County OP �snsn •n.,n ADDRESS: ",-A I',-Yi 1mR rvn �avaw ,n r•ar a-rc,v Dewitt Poth & Son Yoakum, TX EQUIPMENT• • PAYMENT TERMS NOT FINANCED TYPE, MAKE, MODEL NUMBER, SERIAL NUMBER, UNDER THIS AND INCLUDED ACCESSORIES AGREEMENT BEGINNING METER READING SEEATrACHED MONTHLY IMAGE ALLOWANCE SCHEDULE EXCESS PER IMAGE CHARGE PLUS TAX B&W COLOR B&W COLOR B&W COLOR Kyocera 6635cidn ❑ 0 0 0 0 .0125 .07 TOTAL CONSOLIDATED MONTHLY IMAGE ALLOWANCE AND EXCESS PER IMAGE CHARGES IP CONSOLIDATED EOUIPMENTLOCATION: Calhoun County Human Resources METER FREQUENCY: Monthly TERM IN MONTHS: 63 MONTHLY SASE PAYMENT AMOUNT': $79.00 (*PLUS TAX) PURCHASE OPTION•: Fair Market Value RELATED TO THIS AGREEMENT SHALL BE GOVERNED BY THE LAWS OF THE ST LINN COUNTY, IOWA. YOU HEREBY CONSENT TO PERSONAL JURISDICTION AND RIGHTTO A JURY TRIAL BY SIGNING THIS THISTWO-PAGEI GreatAmerica Financial Services Corporation RECEIVED AND READ THEADDITIONAL TERMS AND CONDITIONSAPPEARING ON I WE EXECUTE THIS AGREEMENT AND PAY FORTHE EQUIPMENT. )R STATE COURT IN PARTY WANES ANY OWMER SIGNATURE -- PRINT NAME B TITLE DATE CERTIFICATE OF DELIVERY AND ACCEPTANCE The Customer hereby ceRi3as that all the Equipment 1) has been rmWed, installed, and Inspected; and 21 Is fully operational and unconditionally ampted. SIGNATURE X NAME AND TITLE: DATE: ZG03AM(TL)_0320 10/25/21 PAGE 1 OF 2 230 onnTnnNAL.TERMS AND.CONDITIC AGREEMEt7C Yea Wan us m lax Pay you VanMr f<me puipment area sohrare referenced hersM, txdd'u0 Wulpmenf marked as ml4aacad w low this Agreaoent ('[yapmenrl and the amends Yow Vendor Imaeded An the invoice to us Ia the Equgaent of rased hard ialgn, training, adofor Implementation Warta. and you weandttlonaty agree to pay w Am mmmrrb payable under the ems of We agrmtmnt rAgmomanr) each period by tie due date. This Agreement Wa begin an M d3w ha Equipment b delivered to you a any later date he dmiplsta. We may Charge Yw a ankles Wgmalim toe of S76.00. B any amount payable 0 us is past der, true Will pay a I&chage equd In, if the gmekraften (10) cents for cash doom Mat" w twenlysa dollara(S2&00}; a 2) Me highest LAIcharge, If W. NET AGREEMENT. THIS AGREEMENT M NOWCANCELABLE FOR THE ENME AGREEMENT TERM. YOU UNDERSTAND WE ARE PAYING FOR THE EQUIPMENT BASED ON YOUR UNCONDITIONAL ACCEPTANCE OF R AND YOUR PROMISE TO PAY US UNDER THE TERMS OF THIS AGREEMENT, WTTHOUT SET -OFFS FOR ANY REASON, EVEN IF THE EQUIPMENT DOES NOT WORK ON IS OAMAGEO. EVEN M IT IS NOT YOUR FAULT. IMAGE CHARGES AND OVERAGES. You We abided to male he Alta number dlmpes shovm undo Image Aganance MrTota Canaaaasd ImpaAlkwarn, N appike") each paled dung the term d this Agreemed, Hyou make erne ban he awwd snaps Many period, far VOil pay us an Admtmd amount Whin M the numhad the, exomaImages maledudng such period mulfipled by AM appkale Excess Pa Image design, Rd by us arime Vendor. pd'mrdpMc rode aanyP� Ye men Alva pal essnit Ste Base teeymmnlgmowt YW a4w s Amddo GAMS moWa wSh the dada maamWtires el army bwMass day m designated M us a the Vendor. provided maws may atmaM Ere mmbodimoges vaetl IT such meter rea''wIR are no reserved wdhln fivedaya etW being mgwcbd. We Will adjust the eaMmmd charge tamove, am8a upon Mupt of actual Alma reeditgs. You agree Mat he Use Paymerd Amid and he Excess Pa image Charges may be pmpaSanetoly increased at any Item if VadNs %firmed vamp page cwwrpe b poneeded. After the and she Post year of this Agreement and not MeMan once each SUCCOW"bnew wth period theretlto, Me Baca Payment Mauer and he Exces Po Image Chagas land, awtefec/m. Me Bane Payment Amount ad Excess Per mage0amps War my subsequent apeem rule between you and As Mairwapurae Me arms; here%} may be increased by a madmmm d 10%of the then a rang payment &charge. bmpes made anegwpowlmend As not financed under thisApmermel WN mincluded In daaMn ngyaaimlge and average charges. EQUIPMENT USE You VA keep he EOMMI htgcod WMdng wda, use ft for business painam only, not modtyor move it from As legal isvelim Wtlrouloa Wnsent and bsvae risked It norvmmplianme with appGciew laws. Yen Ogres Mat you win net tam he Egdpmenteutdsa gee and Aare athird party pay (apo&afunds to pay)Me Weun6due hereweler. You must msowa Cry dispute you may here mxerulr0 McEqupmml%ih he m endocWmrmVendw. YAM will can* with ANlews, or&mnces, mpladms, requirements ad miss raabp W if* Mad cooperation ofthe Equipment. VENDOR SERVICES.PaymaM under tux Agreement may Weds Amanda you aweyour Vedwunder asepwate a engeame(tar maintenance, WYIM sppea, en:), Which anomb may be bwcad M user yoaVendaa behalf he your mawanlence. You will boksdaytoyour Vada for pamrmAr a under my Much arrargamm ato address my aspules adsh y flummdo. SOFTWAREIDATA Except es provided M this POMRWh, mfma ces to"Egwpmear loclude my sottwWe lelel mN13mvo of fmtaled m Me EquiP L We do All own the Sodeae and cannot bamia any idaast in Rmyou. Wave adna arm ble same wb are a he ON DOM dYm 0 Me, lican a under any HOWN pmamnt You are W*msp=!W he pmmcArp amdramovM9 any confdoga dateimages a oadon the Emelpmnlidamihnature, for any meson. NO WARRANTY. WE MAKE NO WARRANTIES, E%PRESS OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE YOU HAVE ACCEPTED THE EQUIPMENT •ASaB". YOU CHOSE THE EQUIPMENr;THE VENDOR AND PNYIALLSERVICE PROVIDER(S)WED ON YOUR JUDGMENT. YOU MAY CONTACT YOUR VENDOR FOR A STATEMENT OF THE WARRANTIES. M ANY.THAT THE MANUFACTURER OR VENDOR W PROVIDING. WE ASSIGN TO YOU ANY WARRANTIES GIVEN TO US. ASSINMENT.Ym may not sal. Mate, asubimethe Wilmot a Able ApeernemwimmtMewddan consent We may soil At assign Oils Agreement aaa fipms in And Equipment. in whole ado part to a mid party OWnotce eyat. You agree Arm Ifwa do ea, the="awill AM Am dolt but Wig not besl"10 AnyCGym, debme, orsepd Wortateagahatmamy" aka. LOSS OR DNWGE You are responsible, tar arty damage to a loss of Me Equipment. No such as or damage win relieve you from your payment obligmans beteuda. We as notrespomRge for. and you wR Mdlum* us soared, any ddmAwares or dammed, Including aomeyfees. Mary way raring to Me Equpmentadata slaed An N In no went W11"be Seine for mywnequaltna abehead dar eges. INSURANCE You ape to maeddn commercial gm" earthy krsael,aceplabla In m. You dso as" 0:1) keep Able Equipment ICY award! spend less at Ad and 21 "We aoa of lewace, sabfamay to As no Whir than 30 days iM MrQ he mnmemmlent of this Agreement and Mereafar upon ax wmbn moues the premium which mey be high%than Ada ties Agreement ame Alan Oils AVISM, plod our hooked residua, Ix 1110 TAMS, We over ha Eguipnant.You WM pay whir der, Ow firmly bymmbursip Us. all Alms and lass relmoe to Me Equipment And M Agreement Sawa we ex due uph lout bePayibwWarta lure, wMtadoemechampa END OF TERM. At Me end rime IWm dare AW OMW (a Wry resod arm) (Me'End Dad), hb Agmemad will raewmanh to mom union a)we meuivewmta, notice from yes, at woa3Ddays print to the End Of, of You Import to On As Equipment ad b) you "redm Me Equipment to the location designated bye, d YM WPM N a Purchme Option s ImI cad AM and YOU se rats MwM 0 the Ed One, you may purchase Me Equipment Man us AS IS- Am Me PumAeue Optam price. it the redamd Equipment bmtImmediately, avetaMa fame by enotlmrwthmi nmddrepal,you wig TelMust wfor so moarcous.You cannot ear of ftAgreement amYm Me, Warman Oft to AaEd Dowihadour causal, Here consent an may drape you, in addition he ohm aMmAsored, err Andy lamination too Met DEFAULTIREMEM,if a payment bewms10+days past der, a9yw omerrke bramob thkABTcemar, yes xa be addset,Met are may Tatum the EgWpmal to w%Your WPM and pay m:1) all paid der events ad 2) at mm wining paAnenb for tiro moxpked term, plus o%booked w1dua, amWnled at 3%par sanum; end an may disable ampoadene he 4herfletd and We are ohm Ingo Mom" watable to us. You agree to pay AN Coss ad axpanms (hube ft mmme" atanayhome) we I=In my dspta with ym leleod to this Agreweent.You car" topay w 1,6% bmrot permamh mar potdm amamb. UCO. You egme that This Apreem nt Is (aria abab be breed m) a'Fimabe tsmd mina ame is deleted in Argue 2A of Me UnYam Commodal Code ('UWJ You Agree to Imp to Tights and famdes pavldd wdasecdons 5D7.5YLdArtidr2Aof 00UM APPLICABLF TO GOVERNMENTAL You hereby mpesea and wamm w w Met m of the date of the Ap eamnh (a) N hetkltlud Who wended Area Agreement had hD power and ashmltyto exeads tin Agrorcentm Pan behalf; (b) All mrydled procedure naessay to man he AW Wenl a boa add Meeting oblea ion panel you here been fdMwed; Ia the Equipment all be Worsted ad mnhdad by you and win be used to msauia goeamment purposes err Am mho mom of tiro AIPeanerd; N rent m paymnas due Ord pay" for the tward A" year ae aAhin Me tuned boded and ems mU am wobble, o mdaoled, end umeumbemd axvmdegm: Eel arm Word to om all amens MBWB undo me lama of IN Almomm rtwhen due, if Pods ere lagrgy metals to do so; M ypapMigAdpm h ream miwnb und%the Agreement w r AMb a paymme is due call09 Ag Alm Agreement ement You OM dinithmM Agraamml Ym pea that this p least thirty (3D) days Pia w ice aim of Arm Sold paid for Which Pods were Alt eppoplaed, you Chip Executve Officer la Legal CosweO 4WM to w a state a a My competed pagCca sub&,Wm ao3ency of MeMae, iowtddt you War bwwd 0) ends have Mban aplmpdaadiorthe appHmps Damf paid be mrvaoomoodeton did nd resuARam ant Act a WON to am by mu; and Itlt ywtbave exhausted an Ids legally walab fix Me paAcentdWvxants do Mew the smi ally. K, ad to the a"haL stew In paclutm you ban entering Into he Apeamed K Me Agreement mmAMes a nKa-Yw luMMO a Payment ZCa03AM(R)_0320 1012=1 PAGE 2 OF 2 230 NON -APPROPRIATION ADDENDUM This is an addendum ("Addendum") to and part of that certain agreement between GreatAmerica Financial Services Corporation ("we", "us",, "our") and Calhoun, County of ("Governmental Entity", "you", "your"), which agreement is identified in our records as agreement number 1714600 ("Agreement"). All capitalized terms used in this Addendum which are not defined herein shall have the meanings given to such terms in the Agreement. APPLICABLE TO GOVERNMENTAL ENTITIES ONLY You hereby represent and warrant to us that as of the date of the Agreement: (a) the individual who executed the Agreement had full power and authority to execute the Agreement on your behalf; (b) all required procedures necessary to make the Agreement a legal and binding obligation against you have been followed; (c) the Equipment will be operated and controlled by you and will be used for essential government purposes for the entire term of the Agreement; (d) that all payments due and payable for the current fiscal year are within the current budget and are within an available, unexhausted, and unencumbered appropriation; (a) you intend to pay all amounts payable under the terms of the Agreement when due, if funds are legally available to do so; (f) your obligations to remit amounts under the Agreement constitute a current expense and not a debt under applicable state law; (g) no provision of the Agreement constitutes a pledge of your tax or general revenues; and (h) you will comply with any applicable information reporting requirements of the tax code, which may include 8038-G or 8038-GC Information Returns. If funds are not appropriated to pay amounts due under the Agreement for any future fiscal period, you shall have the right to return the Equipment and terminate the Agreement on the last day of the fiscal period for which funds were available, without penalty or additional expense to you (other than the expense of returning the Equipment to the location designated by us), provided that at least thirty (30) days prior to the start of the fiscal period for which funds were not appropriated, your Chief Executive Officer (or Legal Counsel) delivers to us a certificate (or opinion) certifying that (a) you are a state or a fully constituted political subdivision or agency of the state in which you are located; (b) funds have not been appropriated for the applicable fiscal period to pay amounts due under the Agreement; (c) such non -appropriation did not result from any act or failure to act by you; and (d) you have exhausted all funds legally available for the payment of amounts due under the Agreement. You agree that this paragraph shall only apply if, and to the extent that, state law precludes you from entering into the Agreement if the Agreement constitutes a multi -year unconditional payment obligation. If and to the extent that the items financed under the Agreement is/are software, the above -referenced certificate shall also include certification that the software is no longer being used by you as of the termination date. The undersigned, as a representative of the Governmental Entity, agrees that this Addendum is made a part of the Agreement. ZG07NAMC_0320 Amendment F MMGreatAmerica ��►FINANCIAL SERVICES This Amendment amends that certain agreement by and between GreatAmerica Financial Services Corporation ("Owner') and Calhoun. County of ("Customer') which agreement is identified in the Owher's internal books and records as Agreement No. 1714600 (the "Agreement"). All capitalized terms used in this Amendment, which are not otherwise defined herein, shall have the meanings given to such terms in the Agreement'. Owner and Customer have mutually agreed that the following modifications be made to the Agreement. The Section entitled INSURANCE Is hereby deleted In its entirety and replaced with the following: "You Agree: (a) to keep the Equipment fully insured against loss at its replacement cost; and (b) to maintain comprehensive public liability insurance." Except as specifically modified by this Amendment, all other terms and conditions of the Agreement remain in full force and effect. If, and to the extent there is a conflict between the terms of this Amendment and the terms of the Agreement, the terms of this Amendment shall control. A facsimile copy of this Amendment bearing authorized signatures may be treated as an original. This Amendment is not binding until accepted by Owner. GreatAmerica Financial Services Corporation Calhoun, County of Owner Customer By: <`p.By: X Signature & Title Date Accepted: 0W7ad031ne_F1107 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. i - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2021-818322 Date Piled: 10/2912021 Date Acknowledged: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. GreatAmerica Financial Services Corporation Cedar Rapids, IA United States 2 Name of governmental entity or state agency that is a party to the contract for which the form Is being filed. County of Calhoun 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 1714600 Copier Lease 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is Dylan YOuel and my date of birth is My address is , (street) idly) (state) (ZIP Code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Linn County, State of Iowa , on the 29 day of October , 2o2i_. J�j*''✓ (month) (year) Signature of authorized agent of contracting business entity (Dedarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc NOTICE OF MEETING— 11/17/2021 7. Consider and take necessary action to approve the purchase of a 2,000-gallon Distributor Truck for R & B Precincts 1 and 2. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 14 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 November 9, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary action to approve the purchase of a 2000 gallon Distributor Truck for Precinct 1 and Precinct 2. Since6e, Vern Lyssy VL/lj //n►,a{/Ij�-,„I. CONTRACT PRICING WORKSHEET 7f��4�4/ Y� For MOTOR VEHICLES Only Contract HT06-20 No.: Date i 10/26/2021 Prepared: i This Worksheet is prepared by Contractor and given to End User. If a PO is issued, both documents MUST be faxed to H-GAC @ 713-993-4548. Therefore please type or print legibly. auymg lCalhoun County Pct.2 Agency: Contractor: jHouston Freightliner Contact i ern L ss Fenno: °VY Y Prepared i By: Adam Neuse Phone: i361-552-9656 Phone: M3.580.8148 Fax: 1361-553-6664 Fax: i713-955-6282 Email: 6ern.1 sS ca1houncotx.OY Email: ;adam.neuse@strhouston.com Product DS Code: Description: iM2-1060 Conventional Cab, SBFA, SRA (PRL-20M) A ±Protluet I(eim Base Ui it Price Per'Cgntractof/s'H-G,AC`Contract: 63147 B, iPublishcS :Options - Itemize below:r Attach additional shect(s).if„tiecey ary' Inciude;Qption Code in description if applicable, (Now,publishe4 Options are optioas whi16h4ere sob mitled and priced in Coal reetor's�bid. Description Cost Description ! Cost 86.7 250 HP 660 LB FT TQ ENGINE 2408 LH/RH Electric Windows I 164 3500 RDS AUTOMAAjJ&JjRA1JJWlON 33 0 Sm x ills ! 149 b 1 74 igh Bac 159 12,000 LB FLAT L ON RS-21-230 21,AMEAMEW 21,000 LB AI to 359 189" Wheelbase'nNEW 218 Battery Disconnec H o Slier . S,ii RH Outboard Under Cep td onzontal Aftertreatment wuh k 617 Front Tow Hooks 56 Air Cab Mounts 91 Emyre 2000 Gallon Asphalt Distributor { 138527 LED Marker Lights ; 26 Subtotal From Additional Sheet(s): L� Dual West Coast Mirrors w/LH-RH Remote 215 IF SubtotalB: i 152857 C„UnpubYistied 4. Options Itomlzo beiow f`attaclt ii(ldttioaal aheot(s) if necessary, (Motet Unpublished options are items wfitoll were not sulimitied-and priced is Contraglor's bid.) Description Cost Description Cost MXL 17T Meritor Extended Lube Main Drivelinc 173 '0 ' Subtotal From Additional Sheat(a): Subtotal C: _ 193� Check: Total cost of Unpublished Options (C) cannot exceed 25%of the total of the Base Unit` For this transaction the percentage is: Oo/ Price plus Published Options (A+B). D;�YotalCoaf$gfpfeAhy:AppilcableTrailetn/otherAlloWaacas/Discounts(o+B+C), . '• Quantity Ordered: 1 X Subtotal ofA+B+C: 216177 = SubtotalD:! 216177 E.H:-GAG,Order Proceeaing;Qharge (Amount Par Current Pplloy) Subtotal E: ? 1000 &'Trade,ius / $ppeigl Diseonpt5 l Other A'ilowanc'ee / F,ceight / Instflllaiion /Miscellaneous Charges Description Cost Description I Cost Standard Freightliner Destination Charge 2700 Discount j -1700 Subtotal F: € 1000 G. Total Purcliasei�ric21817711 1)el►vety Datesi NOTICE OF MEETING— 11/17/2021 8. Consider and take necessary action to approve the Specifications, Project Manual and Plans for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas and to authorize Urban Engineering to advertise for bids. A pre -bid meeting shall be held at 10:00 a.m., Thursday, December 2, 2021at the Boggy Bayou Nature Park, Port O'Connor, Texas. Bids will be due before 2:00:00 p.m. on Tuesday, December 21, 2021. (GR) Matt Glaze with Urban Surveying explained the use for the plans. Commissioner Gary Reese adds: Under article 8 #E, all protest and disputes will be held in court by Calhoun County, Texas. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 14 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 9, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 17, 2021. Consider and take necessary action to approve the Specifications, Project Manual and Plans for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21- 060-013-C673 Port O'Connor, Texas and to authorize Urban Engineering to advertise forbids. A pre -bid meeting shall be held at 10:00 AM, Thursday, December 2, 2021 at the Boggy Bayou Nature Park, Port O'Connor, Texas. Bids will be due before 2:00:00 pm, Tuesday, December 21, 2021. erely, 5� -)O Gary D. Reese GDR/at P.O. Box 177 - Seadrift. Texas 77983 - email: earv.recscfakalhouncoN.ore - (361) 785-3141 - Fax (361) 785-5602 NOTICE OF MEETING— 11/17/2021 9. Consider and take necessary action to authorize Urban Engineering to release any addenda to the bidding documents approved by Commissioner Gary Reese that is related to the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013- C673 Port O'Connor, Texas. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 14 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 9, 2021 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 FlygF&TV00 4_ Y1L 01 Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 17, 2021. • Consider and take necessary action to authorize Urban Engineering to release any addenda to the bidding documents approved by Commissioner Gary Reese that is related to the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21- 060-013-C673 Port O'Connor, Texas. (GR). Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift. Texas 77983 — email: aarv.reese n calhouacmx,.ora -- (361) 785.3141 — Fax (361) 785-5602 # io NOTICE OF MEETING — 11/17/2021 10. Consider and take necessary action to rescind a Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas due to First National Bank selling this parcel of property. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 14 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 9, 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 17, 2021. • Consider and take necessary action to rescind Lease Agreement with First National Bank for location site for an Emergency Medical Service Heli Pad in Seadrift, Texas due to First National Bank selling this parcel of property. Sincerely, Gary D. Reese CDR/at P.O. Box 177 —Seadrift. Texas 77983 —email: earv.reese a calhouncotx.ore — (361) 785-3141 —Fax (361) 785-5602 #11 NOTICE OF MEETING — 11/17/2021 11. Consider and take necessary action to sign a new Lease Agreement with First National Bank for a location site for an Emergency Medical Service HeliPad in Seadrift, Texas and authorize Judge Meyer to sign all documentation. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 14 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 9, 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 17, 2021. • Consider and take necessary action to sign new Lease Agreement with First National Bank for location site for an Emergency Medical Service Heli Pad in Seadrift, Texas and authorize Judge Meyer to sign all documentation. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift. Texas 77983 —email: earv.reese r calhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 Exhibit "A" TRACTIL 0,748 ACRES THE STATE OF TEXAS) THE COUNTY OF CALHOUN) BEING two tracts of land situated In the lose Felix de la Fuumes Survey, Abstract no. 13, Calhoun county, Texas out of the Seadrift Townsite according to the established map or plat thereof as recorded In Volume 2, Page 4 of the Plat Records, Calhoun County, Texas being comprised of the remainder of a called 0.80 acre tract of land described by deed dated April 14, 1971 conveyed from W.H. Bauer, Jr., at at to the Seaport Bank of Seadrift as recorded In Volume 265, Page 413 of the Deed Records, Calhoun county, Texas and a portion of the remainder of a tailed 2.864 acre tract of land described by Warranty Deed dated July 25, 198B conveyed from W.H. Bauer, Jr., et at to the Seaport Bank of Seadrift as recorded In Volume 21, Page 659 of the Official Records, Calhoun County, Texas, sold 0.88E acre tract being more particularly described by metes and bounds as follows: BEGINNING at a found 5/8" steel rebar with yellow plastic car, stamped "URBAN SURVEYING, INC." along the northeast line of Railroad Avenue (a 60400t Right of -Way), being the southwest line of sold 2.864acre tract, and being the west corner of a called 0.29 acre tract of land described by Instrument to W.H. Bauer, Jr. et at as recorded In Volume 298, Page 710 of the Deed Records, Calhoun County, Texas for the south corner of the herein described tract; THENCE, North 34°12'05" West (North 33°33'00" West), along the northeast right-of-way Ilne of said Railroad Avenue, with the southwest line of said 2,864 acre tract, a distance of 162.73 feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." along the northeast right-of-way line of said Railroad Avenue and being the southwest line of said 2.864 acre tract for the west corner of the herein described tract; THENCE, North 55'47'55" East, departing the northeast right-of-way line of said Railroad Avenue, over and across said 2.864 acre tract and the aforesaid 0.80 acre tract, a distance of 200.15 feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC" along the northeast line of said 0.80 acre tract and being along the southwest line of the remainder of Lot 8, Block 211of the aforesaid Seadrift Townsite for the north corner of the herein described tract; THENCE, South 34°31'09" East, along the northeast line of said 0,80 acre tract and said 2.864 acre tract, a distance of 127.03 feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC" along the northeast line of said 2.864 acre tract and being along the southwest line of the remainder of Lot 3, Block 211 of sald Seadrift Townsite for a point of curvature to the left for the herein described tract; THENCE, along the northeast line of said 2.864 acre tract, with a curve turning to the left having a radius of 1382.40 feet, an arc length of 35.70 feet, and a delta angle of 0128'47", with a chord bearing of South 34°39'SG" East, and a chord length of 35.70 feet to a found 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC" along the northeast line of said 2.864 acre tract and being along the southwest Ilse of the remainder of tat 2, Block 211 of said Seadrift Townsite for the east corner of the herein described tract; THENCE, South 55* 47'S5" West (South 56*27005" West), over and across sand 2.864 acre tract, a distance of 200.19 feet to the POINT OF BEGINNING, CONTAINING within these metes and bounds a0.748 acre tract of land, more or less. Basis of bearing Is based on the Texas Stair: Plane Coordinate System (HAD 83), South Central Zone (4204). This survey was adjusted using a combined scale factor of 1.00001170537413 (GEOIDI2A). The foregoing legal description and accompanying survey plat were prepared from an actual survey made on the ground under my supervision in January, 2021 and are true and correct to the best of my knowledge and belief, O}Ft 10/0512021 +--•^••na•—• -• 1' YIBH_ACL g. III] ... Al1! Urban Surveying, Inc. ("o Eet6 By: Michael K. Williams �.\-#o�r�StO�lg Registered Prefessional Land Surveyor '�A.iwt..,to Texas No.6616 (/ SUR 523893.02. Tract Exhibit IIB11 ---� - pINSION SURVEY n01°I - 35e' o 0 BEING TWO TRACTS OF LAND SITUATES IN THE JOSS FELIX BE Id FUEHIES SURVEY, eUSTMCi NO, IB, _\SITEi es _� UN COUNTY. TEXAS OUT OF THE SUADRIPT TON'NSITE ACCORD1140 TO DID ESTiWLISIIEU MVLP On CALHOUN FLAT THEREOF AS RECORDED IN VOLUME 2. PAGE J OF THE PLAT RECORDS. CALHOUN COUNTY, TEXAS [IV DECO _[ _ VEINS COMPRISED OF THE DEMANDER OF A CALLEO S.CU ACNE TRACT OF LAHD OCSC10BED DATED APPiL U, 1911 DOGVE.YEO FROM W.H. HAVER, JR., ET AL TO IRE SEAPORT DARK OF BEACH[" AS RECORDED IN VOLUME 165. PACE iIJ OF THE DEED RECORDS. CALHOUN LOUNt1', TEXAS AND THE REMAINOCR OF A CALLED 2.061 ACRE TIIACT OF LAND DESCRIBED BY WARRANTY SEEN DATED JULY 25. BRA CONVEYED FROM FILL BAUER. in.. ET AL TO THE SEAPORT BANK OF SEADRIFT AS RECORDED IN VOLUME 21. PAGE 6590E THE OFFICIAL RECORDS, CALHOUN COUNTY. TEXAS. - VICINITY MAP Imm 1L ro; salon m c0i11I0 nawol 1 Llnu.l r ollniv v: nvnvY V1Lu ilT; ml m°ID LVD0.s. 1101 1.10111, fLN.S r Uq 1 '1L I r' I .IL C 0 LI P Lf _ ] ILLHS OF BVA' G 1 .1. BF 11L 1. SMIL lN.. f(Nllri. IL 11W. I.. 011 .11 W CIW^ l! = 5 ] y4. ^ f01 : (` E T 1 5 5 . C r i ILNSIIO UY IE ovo a sur rcma ar 0000ur0;n°] (41DI11]Aj ,a rw. Lor 1 r 5 DY96'20' E L01 > STATE HIGHWAY N0. 785 Lot U411r-OI'.y yb. n n oursorv. u¢ L1 __ 1 2 ;rn sn�xl rv.c n mm� A ' nnr.+x+or.' wuu a]a un:N Y lI 9 I to Lot �m ,lpp `6. — ry X�.-„xL•°'wt t^ for oLlrr Lar Lm TRACT I " rz Lm CK ly'�Fv A yAs• 0.808 AcreryoG' `5 LF�, LT—C i° 'r f1TS d\FaS C M1� : N y�PLCI'YZI_rLot a'n f:uq OCI( PGINT O- j' ;Sn by OTI LOT I LOT I'M " ST. LOUIS AVENUE (60' Rlcsr-Or-TYAr) LOT LOT LOT LOT RR 10 W -< BLOCK 17 o o"I U� OF Lm LUI J 2 1 RACT �D9 40 Lf'1�e °� \ . Or IOt I LOT I LOT 1 THE ABOVE FLAT WAS PREPARED FROM AN ACTUAL SURVEY MADE ON THE GROUND UNDER MY SUPERVISION IN OCTOBER 2021 AND IS TRUE AND CORRECTTOILE BEST OF MY KNOWLEDGE AND DELIEF. ACCORDING TO THE FLOOD INSURANCE RATE MAP IFIRA1) FOR THE CRY OF SEADRIFT. CALHOUN COUNTY. TEXAS, COMAIUNRY PANEL 14UMBER-18057C 0090E, MAP REVISED OCT. 16, 2.041, THE SUDJECT PROPERTY IS LOCATED IN ZONE X(SHAOW) WHICH IS A SPECIAL FLOOD HAZARD AREA.AREAS OF 0.2% ANNUAL CHANCE FLOOD: AREAS OF Ill. ANNUAL CHANCE FLOOD WITH AVERAGE DEPTHS OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS OF LESS THAN I SQUARE MILE: AND AREAS PROTECTED BY LEVEES FROM I! ANNUAL CHANCE FLOOD. ID- rF�A''TPSIGNED:10!05203t.......°..d,... WILW.YSURBAN GVRVEYING.INC.DY� MICHAEL K. WILLIAMS """""""'18REGISTGREU PROFESDIONAL LAND SURVEYOR,..yTEXAS No. 6516 RN4' 'CRT I LOT I LOi I LOT I LOI ST. LOUIS AVENUE (Bo' P`AU_OF_1141) OT ItLOr LOT it OT H I , ID LEGEND imNL'.m.e.rvL.: LO A;ti;i'BIfkL 0.[WILII.II V'A'V? errs p: nron'n� r cmD nm0000rx B'..P m<L 0 0 100 200 GRAPHIC SCALC IN FEET Is u S' Lund Sumeo, r AotlM Imag'n0 I.mu n:uv INII)rr.uNlO+glmomr GlO. rFYAS r .vu, wwnm.w, rtrna pmlxermN nuv lalmw DRAIY'NBY.' EULiL_ JOBNO.: 123093.02 / Lease Basic Information Date: /�NCiynA/C.}/ 14 2021 Landlord: First National Bank, a Texas corporation Landlord's Address: Tenant: First National Bank Port Lavaca, TX 77979 Calhoun County, a unit of Texas government Tenant's Address: Calhoun County, Texas c/o Gary Reese, Commissioner Precinct #4 of Calhoun County P.O. Box 177 Seadrift, TX 77983 Premises: BEING two tracts of land situated in the Jose Felix de la Fuentes Survey, Abstract No. 13, Calhoun County Texas out of the Seadrift Townsite according to the established map or plat thereof as recorded in Volume 2, Page 4 of the Plat Records, Calhoun County, Texas being comprised of the remainder of a called 0.80 acre tract of land described by deed dated April 14, 1971 conveyed from W.H. Bauer, Jr., et al to the Seaport Bank of Seadrift as recorded in Volume 265, Page 413 of the Deed Records, Calhoun County Texas and a portion of the remainder of a called 2.864 acre tract of land described by Warranty Deed dated July 25, 1988 conveyed from W.H. Bauer, Jr., et al to the Seaport Bank of Seadrift as recorded in Volume 21, Page 659 of the Official Records, Calhoun County, Texas said 0.888 acre tract being more particularly described by metes and bounds on Exhibit "A" and depicted on Exhibit "B" attached hereto and incorporated for all purposes. Term (months): 5 years (60 months) Commencement Date: November 2021 Termination Date: December 31, 2026. Base Rent (monthly): $0.00 Renewal Option: This lease may be renewed by Tenant for addition 3-year terms upon Commissioners' Court approval. This clause expressly grants extension of this lease between Tenant and Landlord for multiple 3-year terms. Tenant's Pro Rata Share: Zero percent (00/9) Security Deposit: $0.00 Permitted Use: Construction and use of the premises as an emergency medical helicopter landing pad. Tenant's Insurance: Statutory amounts as required by law. Tenant shall provide Landlord proof of said insurance coverage when requested by Landlord. Landlord's Insurance: N/A Tenant's Rebuilding Obligations: If the Premises are damaged by fire or other elements, Tenant will be responsible for repairing or rebuilding the following leasehold improvements: The emergency medical helicopter landing pad. A. Definitions A.1. "Agent" means agents, contractors, employees, licensees, and, to the extent under the control of the principal, invitees. A.2. "Essential Services" means utility connections reasonably necessary for occupancy of the Premises for the Permitted Use. A.3. "Injury" means (1) harm to or impairment or loss of property or its use, (2) harm to or death of a person, or (3) "personal and advertising injury" as defined in the form of liability insurance Tenant is required to maintain. A.4. "Lienholder" means the holder of a deed of trust covering the Premises. A.S. "Rent" means Base Rent plus any other amounts of money payable by Tenant to Landlord. Clauses and Covenants B. Tenant's Obligations BL Tenant agrees to - B.I.a. Lease the Premises for the entire Term beginning on the Commencement Date and ending on the Termination Date. Tenant shall maintain the premises in neat manner consistent with the permitted use of the property as an emergency medical helipad. B.1.b. Accept the Premises in their present condition "AS IS," the Premises being currently suitable for the Permitted Use. B.I.c. Obey (a) all laws relating to Tenant's use, maintenance of the condition, and occupancy of the Premises and Tenant's use of any common areas and (b) any requirements imposed by utility companies serving or insurance companies covering the Premises. B.Ld. Pay monthly, in advance, without demand, on the first day of the month, the Base Rent to Landlord at Landlord's Address. B.I.e. Pay a late charge of 5 percent of any Rent not received by Landlord by the tenth day after it is due. Alf Obtain and pay for all utility services used by Tenant and not provided by Landlord. B.I.g. Pay Tenant's Pro Rata Share of any utility services provided by Landlord. B.l.h. Allow Landlord to enter the Premises to perform Landlord's obligations, inspect the Premises, and show the Premises to prospective purchasers or tenants. B.11 Repair, replace, and maintain any part of the Premises that Landlord is not obligated to repair, replace, or maintain, normal wear excepted. B.1 j. Submit in writing to Landlord any request for repairs, replacement, and maintenance that are the obligations of Landlord. B.l.k Allow Landlord to file a financing statement perfecting the security interest created by this lease. B.1.1. Vacate the Premises on the last day of the Term. B.I.m. INDEMNIFY, DEFEND, AND HOLD LANDLORD AND LIENHOLDER, AND THEIR RESPECTIVE AGENTS, HARMLESS FROM ANY INJURY (AND ANY RESULTING OR RELATED CLAIM, ACTION, LOSS, LIABILITY, OR REASONABLE EXPENSE, INCLUDING ATTORNEY'S FEES AND OTHER FEES AND COURT AND OTHER COSTS) OCCURRING IN ANY PORTION OF THE PREMISES IF CAUSED IN WHOLE OR IN PART BY THE ACTS OR OMISSIONS OF TENANT OR ITS AGENTS, INCLUDING IN WHOLE OR IN PART BY THE NEGLIGENT ACTS OR OMISSIONS OF TENANT OR ITS AGENTS. THE INDEMNITY CONTAINED IN THIS PARAGRAPH (i) IS INDEPENDENT OF TENANT'S INSURANCE, (ii) WILL NOT BE LIMITED BY COMPARATIVE NEGLIGENCE STATUTES OR DAMAGES PAID UNDER THE WORKERS' COMPENSATION ACT OR SIMILAR EMPLOYEE BENEFIT ACTS, (ii) WILL SURVIVE THE END OF THE TERM, AND (iv) WILL APPLY EVEN IF AN INJURY IS CAUSED IN PART BY THE ORDINARY NEGLIGENCE OR STRICT LIABILITY OF LANDLORD BUT WILL NOT APPLY TO THE EXTENT AN INJURY IS CAUSED IN WHOLE OR IN PART BY THE GROSS NEGLIGENCE OR WILLFUL MISCONDUCT OF LANDLORD, LIENHOLDER, OR THEIR RESPECTIVE AGENTS. B2. Tenant agrees not to - B.2.a. Use the Premises for any purpose other than the Permitted Use. B.Z& Create a nuisance. B.2.c. Permit any waste. B.2.d. Use the Premises in any way that would increase insurance premiums or void insurance on the Premises. B.2.e. Change Landlord's lock system. B.2.f. Alter the Premises. B.2.g. Allow alien to be placed on the Premises. B.2.h. Assign this lease or sublease any portion of the Premises without Landlord's written consent. C. Landlord's Obligations C.1. Landlord agrees to - C La. Lease to Tenant the Premises for the entire Term beginning on the Commencement Date and ending on the Termination Date. Cl.b. Obey all laws relating to Landlord's operation of the Premises. Cl.c. Provide the Essential Services. C.Ld. Repair, replace, and maintain the (a) roof, (b) foundation, and (c) structural soundness of the exterior walls, excluding windows and doors. C I. e. Return the Security Deposit to Tenant, less itemized deductions, if any, on or before the N/A day after the date Tenant surrenders the Premises. C.2. Landlord agrees not to - C.Interfere with Tenant's possession of the Premises as long as Tenant is not in default. C2.b. Unreasonably withhold consent to a proposed assignment or sublease. D. General Provisions Landlord and Tenant agree to the following: D.1. Alterations. Any physical additions or improvements to the Premises made by Tenant will become the property of Landlord. Landlord may require that Tenant, at the end of the Tenn and at Tenant's expense, remove any physical additions and improvements, repair any alterations, and restore the Premises to the condition existing at the Commencement Date, normal wear excepted. D.2. Abatement. Tenant's covenant to pay Rent and Landlord's covenants are independent. Except as otherwise provided, Tenant may not abate Rent for any reason. D.3. Insurance. Tenant must and Landlord may maintain the respective insurance coverages described hereinabove. D.4. Release of Claims/Subrogation. LANDLORD AND TENANT RELEASE EACH OTHER AND LIENHOLDER, AND THEIR RESPECTIVE AGENTS, FROM ALL CLAIMS OR LIABILITIES FOR DAMAGE TO THE PREMISES, DAMAGE TO OR LOSS OF PERSONAL PROPERTY WITHIN THE PREMISES, AND LOSS OF BUSINESS OR REVENUES THAT ARE INSURED BY THE RELEASING PARTY'S PROPERTY INSURANCE OR THAT WOULD HAVE BEEN INSURED BY THE REQUIRED INSURANCE IF THE PARTY FAILS TO MAINTAIN THE PROPERTY COVERAGES REQUIRED BY THIS LEASE. THE PARTY INCURRING THE DAMAGE OR LOSS WILL BE RESPONSIBLE FOR ANY DEDUCTIBLE OR SELF -INSURED RETENTION UNDER ITS PROPERTY INSURANCE. LANDLORD AND TENANT WILL NOTIFY THE ISSUING PROPERTY INSURANCE COMPANIES OF THE RELEASE SET FORTH IN THIS PARAGRAPH AND WILL HAVE THE PROPERTY INSURANCE POLICIES ENDORSED, IF NECESSARY, TO PREVENT INVALIDATION OF COVERAGE. THIS RELEASE WILL NOT APPLY IF IT INVALIDATES THE PROPERTY INSURANCE COVERAGE OF THE RELEASING PARTY. THE RELEASE IN THIS PARAGRAPH WILL APPLY EVEN IF THE DAMAGE OR LOSS IS CAUSED IN WHOLE OR IN PART BY THE ORDINARY NEGLIGENCE OR STRICT LIABILITY OF THE RELEASED PARTY OR ITS AGENTS BUT WILL NOT APPLY TO THE EXTENT THE DAMAGE OR LOSS IS CAUSED IN WHOLE OR IN PART BY THE GROSS NEGLIGENCE OR WILLFUL MISCONDUCT OF THE RELEASED PARTY OR ITS AGENTS. D.5. Casualty/Total or Partial Destruction D.5.a. If the Premises are damaged by casualty and can be restored within ninety days, Landlord will, at its expense, restore the roof, foundation, and structural soundness of the exterior walls of the Premises and any leasehold improvements within the Premises that are not within Tenant's Rebuilding Obligations to substantially the same condition that existed before the casualty and Tenant will, at its expense, be responsible for replacing any of its damaged furniture, fixtures, and personal property and performing Tenant's Rebuilding Obligations. If Landlord fails to complete the portion of the restoration for which Landlord is responsible within ninety days from the date of written notification by Tenant to Landlord of the casualty, Tenant may terminate this lease by written notice to Landlord before Landlord completes Landlord's restoration obligations. D.5.b. If Landlord cannot complete the portion of the restoration for which Landlord is responsible within ninety days, Landlord has an option to restore the Premises. If Landlord chooses not to restore, this lease will terminate. If Landlord chooses to restore, Landlord will notify Tenant in writing of the estimated time to restore and give Tenant an option to terminate this lease by notifying Landlord in writing within ten days from receipt of Landlord's estimate. If Tenant does not notify Landlord timely of Tenant's election to terminate this lease, the lease will continue and Landlord will restore the Premises as provided in D.5.a. above. D.S.c. To the extent the Premises are untenantable after the casualty, the Rent will be adjusted as may be fair and reasonable. D.6. Condemnation/Substantial or Partial Taking D.6.a. If the Premises cannot be used for the purposes contemplated by this lease because of condemnation or purchase in lieu of condemnation, this lease will terminate. D.6. b. If there is a condemnation or purchase in lieu of condemnation and this lease is not terminated, Landlord will, at Landlord's expense, restore the Premises, and the Rent payable during the unexpired portion of the Term will be adjusted as may be fair and reasonable. D.6 c. Tenant will have no claim to the condemnation award or proceeds in lieu of condemnation. D.7. Uniform Commercial Code. Tenant grants Landlord a security interest in Tenant's personal property now or subsequently located on the Premises. This lease is a security agreement under the Uniform Commercial Code. Landlord may file financing statements or continuation statements to perfect or continue the perfection of the security interest. DA Default by Landlord/Events. Defaults by Landlord are failing to comply with any provision of this lease within thirty days after written notice and failing to provide Essential Services to Tenant within ten days after written notice. D.9. Default by Landlord/Tenant's Remedies. Tenant's remedies for Landlord's default are to sue for damages and, if Landlord does not provide an Essential Service for thirty days after default, terminate this lease. D.10. Default by Tenant/Events. Defaults by Tenant are (a) failing to pay Rent timely, (b) abandoning the Premises or vacating a substantial portion of the Premises, and (c) failing to comply within ten days after written notice with any provision of this lease other than the defaults set forth in (a) and (b). D.11. Default by Tenant/Landlord's Remedies. Landlord's remedies for Tenant's default are to (a) enter and take possession of the Premises and sue for Rent as it accrues; (b) enter and take possession of the Premises, after which Landlord may relet the Premises on behalf of Tenant and receive the Rent directly by reason of the reletting, and Tenant agrees to reimburse Landlord for any expenditures made in order to relet; (c) enter the Premises and perform Tenant's obligations; and (d) terminate this lease by written notice and sue for damages. Landlord may enter and take possession of the Premises by self-help, by picking or changing locks if necessary, and may lock out Tenant or any other person who may be occupying the Premises, until the default is cured, without being liable for damages. D.12. Default/Waiver. All waivers must be in writing and signed by the waiving party. Landlord's failure to enforce any provisions of this Lease or its acceptance of late installments of Rent will not be a waiver and will not estop Landlord from enforcing that provision or any other provision of this Lease in the future. D.13. Mitigation. Landlord has mitigated the loss of rent if Landlord, within thirty days after Tenant's loss of possession, (a) places a "For Lease" sign at the Premises, (b) places the Premises on Landlord's inventory of properties for lease, (c) makes Landlord's inventory available to area brokers on a monthly basis, (d) advertises the Premises for lease in a suitable trade journal in the county in which the Premises are located, and (e) shows the Premises to prospective tenants who request to see it. D.14. Security Deposit. If Tenant defaults, Landlord may use the Security Deposit to pay arrears of Rent, to repair any damage or injury, or to pay any expense or liability incurred by Landlord as a result of the default. D.15. Holdover. If Tenant does not vacate the Premises following termination of this lease, Tenant will become a tenant at will and must vacate the Premises on receipt of notice from Landlord. No holding over by Tenant, whether with or without the consent of Landlord, will extend the Term. D.16. Alternative Dispute Resolution. Landlord and Tenant agree to mediate in good faith before filing a suit for damages. D.17. Attorney's Fees. If either party retains an attorney to enforce this lease, the party prevailing in litigation is entitled to recover reasonable attorney's fees and other fees and court and other costs. D.18. Venue. Exclusive venue is in the county in which the Premises are located. D.19. Entire Agreement. This lease, its exhibits, addenda and riders, are the entire agreement of the parties concerning the lease of the Premises by Landlord to Tenant. There are no representations, warranties, agreements, or promises pertaining to the Premises or the lease of the Premises by Landlord to Tenant, and Tenant is not relying on any statements or representations of any agent of Landlord, that are not in this lease and any exhibits, addenda, and riders. D.20. Amendment of Lease. This lease may be amended only by an instrument in writing signed by Landlord and Tenant. D.21. Limitation of Warranties. THERE ARE NO IMPLIED WARRANTIES OF MERCHANTABILITY, OF FITNESS FOR A PARTICULAR PURPOSE, OR OF ANY OTHER KIND ARISING OUT OF THIS LEASE, AND THERE ARE NO WARRANTIES THAT EXTEND BEYOND THOSE EXPRESSLY STATED IN THIS LEASE. D.22. Notices. Any notice required or permitted under this lease must be in writing. Any notice required by this lease will be deemed to be given (whether received or not) the earlier of receipt or three business days after being deposited with the United States Postal Service, postage prepaid, certified mail, return receipt requested, and addressed to the intended recipient at the address shown in this lease. Notice may also be given by regular mail, personal delivery, courier delivery, or e-mail and will be effective when received. Any address for notice may be changed by written notice given as provided herein. D.23. Abandoned Property. Landlord may retain, destroy, or dispose of any property left on the Premises at the end of the Term. D.24. Early Termination. Landlord may terminate this Lease before the hereinabove- stated termination date of December 31, 2026 with three months' prior written notice to Tenant at P.O. Box 177, Seadrift, Texas 77983 that Landlord wishes to terminate this Lease agreement. Executed in Duplicate originals this the day of tr-:. i- i t��a r z�021. First National Bank, a Texas corporation, William Bauer, Chairman Calhoun County, a unit of Texas government c Ri lard H. Meyer, Coun dge STATE OF TEXAS COUNTY OF CALHOUN This hereinabove instrument was acknowledged before me, the undersigned authority on �7,2 William Bauer, Chairman of First National Bank in the capabilities stated. STATE OF TEXAS COUNTY OF CALHOUN This hereinabove instrument was acknowledged before me, the undersigned authority on !tnPh/ 1 :7. 2C62Jby Richard H. Meyer, County Judge for Calhoun County, Texas in the capabilities stated, pee r• MAEBELLECAM MY&tWlD#132012524 E*m May 14, 2D23 T Ri hard H. Meyer, Calhoun County Judge #12 NOTICE OF MEETING— 11/17/2021 12. Consider and take necessary action to authorize the installation of an emergency key holder for fire and law enforcement agencies at the Calhoun County Library. (RHM) Naomi Cruz explained the reason for the box, and that the Fire Chief recommended having one. Commissioners agreed to pass on this item. Page 9 of 14 Mae Belle Cassel From: ncruz@cclibrary.org (Noemi Cruz) <ncruz@cclibrary.org> Sent: Wednesday, November 10, 2021 11:20 AM To: MaeBelle.Cassel@calhouncotx.org Subject: Agenda Item CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hello MaeBelle, Please add to the next Commissioners' Court Approval to install an emergency key holder for fire and law enforcement agencies at the Calhoun County Library. -Thanks Noemi Cruz, Library Director Calhoun County Public Library 200 W. Mahan Port Lavaca, TX 77979 Phone 361.552.7250. ext. 6 Fax 361.552.4926 Email ncruz@cclibrary.or¢ Web www.cclibrary.ore "A library outranks any other one thing a community can do to benefit its people. It is a never failing spring in the desert." Andrew Carnegie Calhoun County Texas N M .+ S m n 2 y c � O � m itn m y (D m .r t t c o °- 0 m x w m_ w m 3 aCL N N 3, m c y O 'a y N y 0 0 7 .d+ N � 3 � (D e � 7�C•' � 17 � � /J (mCL N m ^" °CL 3 %I fD '+ m 0 Q (o M�' 3 y 0 m � N CD � 3 o G t t i O yrt 0 Q 3 A y d m m 3 9; 8 c m 3 m 3 � a ui 3 h �� h O N /^� G t� C7 O m ( 'O A B 25: M 0 � CO m M •O 0 0 .� 0 m 7 n A j K N m (m <_. O CL a O O -ti m co -n O c cr y y m 0 C G mlD m Q .p O X C O O 3 C (D 0 7 to 0) n x :3CL C N C 00 •+ tC 0 m 0 X ID r (D 0) f-• O CO)f V C c D s- 0 (D y. m o cA 0. m O 7 N ° m y N a I� m = _ Q m IJ A x O CL O m S A C #13 NOTICE OF MEETING — 11/17/2021 13. Consider and take necessary action to approve the transfer of two (2) leather chairs from the County Court at Law to Human Resources. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 14 Mae Belle Cassel From: clarri.atkinson@calhouncotx.org (Clarri Atkinson) <clarri.atkinson@calhouncotx.org> Sent: Friday, November 5, 2021 7:57 AM To: maebelle.cassel@calhouncotx.org Subject: Agenda Item Request - Department Inventory Transfer Request Attachments: doc11960420211105075531.pdf Please place the following item on the agenda for November 17, 2021: Consider and take necessary action to approve and transfer the 2 Leather chairs from County Court at Law to Human Resources. Clarri Atkinson Calhoun County Chief Deputy Treasurer — Human Resources Coordinator 202 S. Ann, Suite A Port Lavaca, TX 77979 P: 361.553.4618 F: 361.553.4614 Clarri.atkinson@calhouncotx.org Confidentiality Notice: Privileged/confidential information maybe contained in this message and maybe subject to legal privilege. Access to this e-mail by anyone other than the intended is unauthorized. If you are not the intended recipient (or responsible for delivery of the message to such person), you may not use, copy, distribute or deliver this message (or any part of its contents) or take any action in reliance on it. In such case, you should delete this message, and notify us immediately. If you have received this e-mail in error, please notify us immediately by e-mail or telephone and delete this e-mail and all attachments from any computer. Calhoun County Texas Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: #14 NOTICE OF MEETING — 11/17/2021 14. Consider and take necessary action to declare a HP Colored Laser 3525dn Jet Printer, serial number CNCCBCQ21Z as Waste. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 11 of 14 Mae Belle Cassel From: rhonda.kokena@calhouncotx.org (rhonda kokena) <rhonda.kokena@calhouncotx.org> Sent: Tuesday, November 9, 2021 2:03 PM To: maebelle.cassel@calhouncotx.org Subject: AGENDA ITEM Attachments: TREASURER WASTE DECLARATION.pdf Please put the following item on the next agenda: Consider and take necessary action to declare a HP Colored Laser 3525dn Jet printer, serial number CNCCBCQ21 Z as Waste. See attached Waste Declaration Request Form Thank you. RholulcvS. Ko-1c,Pna/ C,AL-toL,�rl coLkrlTY TrzEASl/cT�-'i R CnLkouvu Couvt� Awwex tl 202 S. Avw�, St., Suite A -POVt LPVtaCR, TeXCIS 777j7j 367-553-46i9 0�6CE 36Y-553-l16i4 � GIX Calhoun County Texas 1 Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: Requested By: Q- 11E 1YV (j= Inventory Number Description Serial No. Reason for Waste Declaration rt`al(l .)• acl #15 NOTICE OF MEETING — 11/17/2021 15. Accept reports from the following County Offices: I. County Clerk — October 2021 ii. Justice of the Peace, Precinct 3 — September 2021, amended RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 14 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION OCfOBER2021 OFFICIAL PUBLIC DISC %CODE COAL CRIMINAL RECORDS PROBATE TOTAL DISTRICTATTORNEY FEES 1000+ 020 $ 356.09 $ 356.09 BEER LICENSE 100042010 $ 1DDO $ 10.00 COUNTY CLERK FEES 1000-0 030 $ 725.80 $ 681.61 $ 12,940.65 $ 420.00 $ 14,768.06 APPEAL FROM JP COURTS 100041030 $ - $ - COUNTY COURT ATLAW #1 JURY FEE 100044140 $ JURY FEE 1000-0 140 $ - $ - $ - ELECTRONICFILINGFEESFORE-FILINGS 1000-44058 $ - $ - $ - $ - $ - JUDGE'S EDUCATION FEE 1000d 160 $ - $ - $ - $ 30.00 $ 30.00 JUDGE'S ORDER/SIGNATURE 1000-0 160 $ 14.00 $ - $ - $ 68.00 $ 82.00 SHERIFF'S FEES 1000-0 190 $ - $ 400.09 $ - $ 175.00 $ 575.09 VISUAL RECORDER FEE 1000d4150 $ 86.32 $ 86.32 TIMEPAYMENTFEE- COUNTY ""NEW2020" 1000-0 332 $ 143.77 $ 143.77 COURTREFPORTER FEE 1000-0 270 $ 90.00 $ - $ - $ 90.00 $ 180.00 RESTITUTION DUE TO OTHERS 100DA9020 $ - ATTORNEY FEB -COURTAPPOINTED 1000d9030 $ - $ - APPELLATEFUND(TGC)FEE 2620 030 $ 35.00 $ 30.00 $ MOD TECHNOLOGY FUND 2663A,1030 $ 68.18 $ HEAR COURTHOUSESECURITYFEE 2670�030 $ 35.00 $ 156.28 $ 477.00 $ 30.00 $ 698.26 COURT INITIATED GUARDIANSHIP FEE 2672-0 030 $ 120.00 $ 120DO COURT RECORD PRESERVATION FUND 2673A,1030 $ 70.00 IS - $ 60.00 $ 130.00 COURTREPORTER SERVICE FUND"•NEW2020" 267444030 $ 45.06 IS 45.06 RECORDS ARCHIVE FEE 2675�030 $ 4,460.00 $ 4,460.00 COUNTYSPECIALTY COURT "NEW2020" 2676 030 $ 300.43 $ 300.43 COUNTYIURYFUND "NEW2020" 2679 030 $ 15.02 $ 15.02 DRUG& ALCOHOL COURT PROGRAM 269S,UD30-005 $ 48.34 $ 48.34 JUVENILE CASE MANAGER FUND 2699 033 $ - $ - FAMILY PROTECTION FUND 270644030 $ 30.00 $ 30.00 JUVENILE CRIME& DELINQUENCY FUND 2715d 030 $0.00 $ - PRE-TRIAL DIVERSON AGREEMENT 2729,W034 $ 100.00 $ 100.00 IAWUBARYFEE 2731-44030 $ 210.00 $ 210.00 $ 420.00 RECORDS MANAGEMENT FEE - COUNiYCLERKK 2738d 380 $ 5.05 $ 4,580.00 $ 4,585.05 RECORDS MANGEMENT FEE -COUNTY 2739-04030 $ 30.00 $ 420.95 $ 30.00 $ 480.95 FINES -COUNTY COURT 274045040 $ 5,972.69 $ 5,972.69 BOND FORFEITURE 274045050 $ - $ - STATE POLICE OFFICER FEES - STATE (OPS)(20%) 7020-20740 $ 3.56 $ 3.56 CONSOLIDATED COURT COSTS -COUNTY 7070-20510 $ 9.14 $ 9.14 CONSOLIDATED COURT COSTS -STATE 7070-20740 $ 82.27 $ 82.27 CONSOUDATEDCOURTCOSTS-COUNTY "NEW2020" 7072-20610 $ 236.75 $ 236.75 CONSOLIDATED COURTCOSTS-STATE ."NEW2020"" 7072-20740 $ 2,130.77 $ 2,130.77 JUDICIAL AND COURT PERSONNEL TRAINING-ST(100%) 7502-20740 $ 35.00 $ - $ 30.00 $ 65.00 DRUG& ALCOHOL COURT PROGRAM -COUNTY 7390-20610 $ 9.67 $ 9.67 DRUG& ALCOHOL COURT PROGRAM -STATE 7390-20740 $ 38.67 $ 3B.67 STATE ELECTRONIC FILING FEE - CIVIL 7403-22987 $ 180.00 $ - $ 180.00 $ 360.00 STATE ELECTRONIC FILING FEE CRIMINAL 7403-22990 $ 10.10 $ 10.10 EMSTRAUMA-COUNTY(10%) 7405-20610 $ 587.36 $ 687.36 EMS TRAUMA - STATE (90%) 7405-20740 $ 65.26 $ 65.26 CIVIL INDIGENT FEE -COUNTY 7480D0610 $ 3.50 $ 3.00 $ 6.50 CIVIL INDIGENT FEE -STATE 7480-20740 $ 66.50 $ 57.OD $ 123.50 JUDICIAL FUND COURT COSTS 7495-20740 $ 30.28 $ 30.28 JUDICIAL SALARY FUND - COUNTY (10%) 7505-20610 $ 0.66 $ 0.66 JUDICIAL SALARY FU ND - STATE (90%) 7505-20740 $ 5.95 $ 5.95 JUDICIAL SALARY FUND (CIVIL & PROBATE) -STATE 7505-20740-005 $ 252.00 $ 252.00 $ 504.00 TRAFFIC LOCAL(ADMINISTRATIVE FEES) 7538-22884,1000-44359 $ 12.00 $ 12DO COURT COST APPEAL OFTRAFFIC REG HP APPEAL) 7538-22895 $ - BIRTH -STATE 7855-20780 $ 102.60 $ 102.60 INFORMAL MARRIAGES -STATE 7855-20782 $ - S - JUDICIAL FEE 7855-20786 $ 240.00 $ - $ 240.00 $ 480.00 FORMAL MARRIAGES - STATE 7855-20788 $ 420.00 $ 420.00 NONDISCLOSURE FEE - STATE 7855-20790 $ - $ - $ - $ - TCLEOSECOURT COST - COUNTY (10%) 7856-20610 $ 0.01 $ 0.01 TCLEOSE COURT COST - STATE (90%) 785620740 $ 0.09 $ 0.09 JURY REIMBURSEMENT FEE -COUNTY (10% 7857-20610 $ 0.44 $ 0.44 JURY REIMBURSEMENT FEE -STATE (90%) 7857-20740 $ 3.97 $ 3.97 STATE TRAFFIC FI NE - COUNTY IS%) 7860-20610 $ - $ - STATE TRAFFIC FINE- STATE (95%) 7860-20740 $ - $ - STATE TRAFRCFINE-COUNTY(4%) 9/1/2019 7860-10610 $ 8.00 $ 8.00 STATE TRAFFIC FINE -STATE (96%) 91112019 7850.20740 $ 192.00 $ 192.00 INDIGENT DEFENSE FEE -CRIMINAL - COUNTY (10%) 7865-20610 $ 0.22 $ 0.22 INDIGENT DEFENSE FEE -CRIMINAL -STATE(90%) 7865-20740 $ 1.99 $ 1.99 TIME PAYMENT - COUNTY (50%) 7950-20610 $ 12.50 $ 12.50 TIMEPAYMENT-STATE(50%) 7950-30740 $ 12.50 $ 12.50 BAIL JUMPING AND FAILURE TO APPEAR COUNTY 7970-20610 $ - BAIL JUMPING AND FAILURE TOAPPEAR -STATE 7970-20740 $ - DUE PORT IAVACNPD 9990-99991 $ 33.72 $ 33.72 DUE SEADRIFT PC 9990-99992 $ 4.30 $ 4.30 DUE TO POINT COMFORT PO 9990-99993 $ - $ - DUE TOTDASPARKS &WILDLIFE 9990-99994 IS $ - DUE TOTEXAS PARKS& WILDLIFE WATER SAFETY 9990-99995 $ - DUETOTABC 999D99996 $ - DUE TOATTORNEY ADUTEMS 999099997 $ - DUE TOOPERATING/NSF CHARGES/DUETOOTHERS 7120-20759 $ $ 15.00 1 $ (810.00) $ $ (795.00) $ 2,016.BO $ 12.307.05 $ 22.180.25 $ 2,025.00 $ 38,529.10 TOTAL FUNDS COLLECTED $ 38,529.10 (0.00) FUNDS HELD IN ESCROW: $ - AMOUNT DUE TO TREASURER (2DWS): $ 39,288.08 TOTAL RECEIPTS: 1 $ 38,529.10 AMOUNT DUE TO OTHERS (LESS SF'S): $ (756.98) 1012 TREASURER REPORTS.Nu 11y11p21 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION OCfOBER 2021 CASH ON HAND, REGISTRY OF COURT FUNDS (PROSPERITY) BEGINNING BOOK BALANCE 9/30/2021 $ 96,356]4 FUND RECEIVED $ 1,500.00 "BALANCE OF CASH BONDS" $ 67,262.00 DISBURSEMENTS ENDING BOOK BALANCE 10/31/3021 $ 90,356.74 "OTHER REGISTRY ITEMS" $ 16.042.24 'IBC CASH BOND CHECKS" $ 7,052.50 BANK RECONCILIATION REGISTRY OF COURT FUNDS ENDING BANK BALANCE 10/31/2021 $ 101.251.74 "TOTAL REGISTRY FUNDS" $ 90,356.74 OUTSTANDING DEPOSITS" $ - OUTSTANDING CHECKS" $ 10,895.00 Reconciled. $ - RECONCILED BANK BALANCE 10/31/2021 $ 80,356.74 CERTIFICATES OF DEPOSITS HELD IN TRUST - PROSPERITY BANK CD's Date Issued r..Balance. Purchases! Withdrawals :Balance 9/30/2021 .. Interest . 10131121. 10440 1/241201B $ $ $ 10441 V24/2018 $ 10,286.14 $ 1.30 $ 10,287.44 10442 1/24/2018 $ 1,276.19 $ 0.16 $ 1,276.35 10443 1/25/2018 $ 1,276.19 $ 0.16 $ 1,276.35 10WI 1/25MO18 $ 9,637.41 $ 1.21 $ 9,638.62 1044S 1/25/2018 $ 9,637.41 $ 1.21 $ 9,638.62 10446 1/25/2018 $ 9,637.41 $ 1.21 $ 9,638.62 10449 6/9/1955 $ 20,356.08 $ 20,356.08 104M 3/2/2018 $ 3,594.80 $ 3,594.80 10455 3/2/2018 $ 3,594.80 $ 3, 10486 8/26/2020 $ 5,920..6 $ $ 5,920594.80A6 TOTALS: $ 75,216.49 $ 5.25 $ $ 75,221.74 /v ",//a'/'Z 11/9/2021 l Submitted by: Anna M Gwdman, County Clerk Date ichard Meyer, Calhoun Coun u e Date 2 OF2 REPORTS.Na 1152021 COURT NAME: MONTH OF REPORT YEAR OF REPORT CODE ADMINISTRATION FEE -A[ BREATH ALCOHOL TESTING -1 CONSOLIDATED COURT COSTS - STATE CONSOLIDATED COURT COST-2 LOCAL CONSOLIDATED COURT COST- 2 COURTHOUSE SECURITY -( CIVIL JUST DATA REPOS FEE- CJDRA CORRECTIONAL MANAGEMENT INSTITUTE - CHILD SAFETY - CHILD SEATBELT FEE - CI CRIME VICTIMS COMPENSATION - ( DPSC/FAILURE TO APPEAR - OMNI - OF ADMINISTRATION FEE FTA/FTP (aka OMNI)- 2 ELECTRONIC FILING 1 FUGITIVE APPREHENSION GENERALREVENUE- CRIM - IND LEGAL SVCS SUPPORT - JUVENILE CRIME & DELINQUENCY JUVENILE CASE MANAGER FUND -J( JUSTICE COURT PERSONNEL TRAINING J( JUROR SERVICE FEE - LOCAL ARREST FEES C PARKS & WILDLIFE ARREST FEES - PY\ STATE ARREST FEES -E SCHOOL CROSSING/CHILD SAFETY FEE .-S SUBTITLE C - SU STATE TRAFFIC FINES- EST 9.1.19- E TABC ARREST FEES - l TECHNOLOGY FUND - TRAFFIC - l LOCAL TRAFFIC FINE- 2 TIME PAYMENT -TI TIME PAYMENT REIMBURSEMENT FEE- 21 TRUANCY PREV/DIVERSION FU LOCAL & STATE WARRANT FEES- WE COLLECTION SERVICE FEE-MVBA- CS DEFENSIVE DRIVING COURSE - D DEFERRED. FEE -L DRIVING EXAM FEE- PROV FILING FEE- FFEE & C\ FILING FEE SMALL CLAIMS- FF COPIES/CERTIFEDCOPIES - INDIGENT FEE -.CIFF or IN JUDGE PAY RAISE FEE -JF SERVICE FEE-. SF OUT -OF -COUNTY SERVICE. F ABSTRACT OFJUDGEMENT - ALL WRITS - WOP / ) DES ETA FINE - C LOCAL FINES - LICENSE & WEIGHT FEES - PARKS & WILDLIFE FINES - SEATBELT/UNRESTRAINED CHILD FINE - E VJUDICIAL & COURT PERSONNEL TRAINING-. OVERPAYMENT ($10 & OVER) - C OVERPAYMENT (LESS. THAN $10) - C RESTITUTION - F PARKS & WILDLIFE -WATER SAFETY FINES - I TOTAL ACTUAL MONEY RECEI ENTER LOCAL WAI STATE WAI f[aPi171gi.9- TO CCISD - 50% of Fine on JV case TO DA RESTITUTION FUND UND OF OVERPAYMENTS -OF-COUNTY SERVICE FEE H BONDS TOTAL DUE s_ REVISED 01/30/20 401.82 970.00 224.00 40.19 0.58 4.83 30.00 90.00 20.09 65.0040.18 ,(I 88.95 \\/ 10.00 53.27 105.04 606.02 40.19 10.50 36.36 83.17 20.09 7.72 1,065.60 126.00 225.a0 54.00 60.28 150.00 150.00 3,211.42 _ 119.00 45.00 287.50 AMOUNT IRECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT $7.72 RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT AMOUNT )Do PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0.00 1PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 287.50 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT(IF REQUIRED) $287.50 _ AMOUNT $8,419.60 lCalculate from ACTUAL Treasurers Receipts $8,419.60 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 11/3/2021 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: SEPTEMBER YEAR OF REPORT: 2021 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45013 FINES 3,229.27 CR 1000-001-44190 SHERIFF'S FEES 123.74 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 46.86 ADMINISTRATIVE FEE- 156.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44363 TOTAL ADMINISTRATIVE FEES 202.86 CR 1000-001-44010 CONSTABLE FEES -SERVICE 300.00 CR 1000-001-44063 JP FILING FEES 225.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 83.17 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,065.60 TOTAL FINES, ADMIN. FEES & DUE TO STATE $5,229.64 CR 2670-001-44063 COURTHOUSE SECURITY FUND $108.54 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $10.05 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $104.19 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $65.00 CR 2730-001-44063 LOCAL TRUANCY & PREVENTION DIVERSION FUN $80.00 CR 2669-001-44063 COUNTYJURYFUND $1.60 STATEARRESTFEES DPS FEES 12.20 P&W FEES 2.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 14.20 CR 7070-999-20610 CR 7070-999-20740 CR 7072-999-20610 CR 7072-999-20740 CR 7860-999-20610 CR 7860-999-20740 CR 7860-999-20610 CR 7860-999-20740 CR 7950-999-20610 CR 7950-999-20740 CR 7480-999-20610 CR 7480-999-20740 CCC-GENERAL FUND 40.18 CCC-STATE 361.64 DR 7070-999-10010 401.82 DR 7860-999-10010 STATE CCC- GENERAL FUND 97.00 STATE CCC- STATE 873.00 970.00 STF/SUBC-GENERAL FUND STF/SUBC-STATE 5.25 99.79 STF- EST 9/1/19- GENERAL FUND 24.24 STF- EST 9/1/19- STATE 581.78 606.02 TP-GENERAL FUND 0.00 TP-STATE 0.00 DR 7950-999-10010 0.00 CIVIL INDIGENT LEGAL-GEN. FUND 2.70 CIVIL INDIGENT LEGAL -STATE 51.30 DR 7480-999-10010 54.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 11/3/2021 COURT NAME: JUSTICE OF PEACE NO.3 MONTH OF REPORT: SEPTEMBER YEAR OF REPORT: 2021 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 2.01 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 18.08 DR 7865-999-10010 20.09 CR 7970-999-20610 TL/FTA-GENERAL FUND 1.54 CR 7970-999-20740 TL/FTA-STATE 3.09 DR 7970-999-10010 4.63 CR 7505-999-20610 JPAY-GENERAL FUND 6.03 CR 7505-999-20740 JPAY-STATE 54.25 DR 7505-999-10010 60.28 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 4.02 CR 7857-999-20740 JURY REIMB. FUND- STATE 36.16 150 DR 7857-999-10010 40.18 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.06 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 0.52 DR 7856-999-10010 0.58 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND -STATE 45.00 DR 7502-999-10010 45.00 7998-999-20701 JUVENILE CASE MANAGER FUND 10.05 CR 7998-999-20740 TRUANCY PREVENT/DIVERSION FUND- STATE 10.05 DR 7998-999-10010 20.09 CR 7403-999-22889 ELECTRONIC FILING FEE 90.00 DR 7403-999-10010 90.00 TOTAL (Distrib Reg to Oper Acct) $8,030.95 DUE TO OTHERS (Distrib Reg Attchd) CALHOUN COUNTY 0.00 DA - RESTITUTION 0.00 REFUND OF OVERP 287.50 OUT -OF -COUNTY SI 0.00 CASH BONDS 0.00 PARKS & WILDLIFE 101.15 WATER SAFETY FIN 0.00 TOTAL DUE TO OTHERS $388.65 TOTAL COLLECTED -ALL FUNDS $8,419.60 LESS: TOTAL TREASUER'S RECEIPTS $8,419.60 REVISED 01/30/20 OVER/(SHORT) f Page 2 of 2 #16 NOTICE OF MEETING— 11/17/2021 16. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 13 of 14 :o :z �§ i ;L 2' U) . ) z % § § 21 \� 21 21 jW � \k i kk � ■z =o B §ee §n ■wa. Lou \( k< b§ Bk) 21 al § k § ( § ;k :o :z :■ :12 2' % U) ;A■ Z U. J cx Z LU g Z Z LL ewe L o Lci m N O N w rx = o 0 0 C W f9 f9 m 0 N 0 Oi N N H ui uS uS =o� Ea EM = W o000 3wL o�N 0 vi O C Sri o N vi = z EF �i =W o000 0 Ea =I EW = O Q W � fJ3 fA f9 19 M _ O _y ¢ a =V W O O W _> =1 a °z rc U) EJ " z z z F N CDo�g J C cai =_12 zzzZ gw _� W16 y rnrnrn z w a ui O! g FW- w U _ =W Z w w =W J =g ffi o a W > =Z a w U _Z W w U 2 EW �Ur Eg J M W >> U a g d WWUzi Q lo 0 0 <o N r = a a =r omw w =i. � a = F EW coo 0 =L =W _ Q W _ v E � O o 0 � w m n V o z aorr� N _W z z 2 z (D( N -> zz2 w W F =W _N L Ms ¢ w EZ y =0 a zzQ =y F =Z =W W _W z =W J _g _a a } O r y U w =Z o W J W c f. a 5 U ui G = o o x Z n _� W � iF. 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Z § )§ 4-4Uj : « § § e § B ; &2 (D\ ; .� d . LLI ■ - & §I] § ) :§ :z L:LLI B \\ :) % 0 L{ iZ § ®; :§ [ k[ . � 'UJ § § §§ -- � ■ G; a■a #17 NOTICE OF MEETING — 11/17/2021 17. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Image/Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned: 10:24 a.m. Page 14 of 14 November 17, 2021 2021 APPROVAL LIST - 2021 BUDGET COMMISSIONERS COURT MEETING OF 11/17/21 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 18 $128,879.97 FICA P/R $ 55,291.66 MEDICARE P/R $ 13,131.52 FWH P/R $ 38,480.07 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 4,830.00 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 1,516.15 TEXAS COUNTY & DISTRICT RETIREMENT SYSTEM P/R $ 248,840.89 TMPA P/R $ 370.00 AT&T MOBILITY EMS - ADMIN & AMBULANCE CELL PH, A/P $ 493.87 CALHOUN COUNTY NAVIGATION DISTRICT OCTOBER 2021 TAC COLLECTION A/P $ 1,984.27 CITY OFSEADRIFT LIBRARY -WATER A/P $ 82.25 K-C LEASE SERVICE, INC CAPITAL PROJECT- RB INFRASTRUCTURE -FLOOD AT $ 44,568.33 FRONTIER COMMUNICATIONS JP4-PHONE SERVICE AT $ 226.16 RITCHIE BROS AUCTIONEERS INC RB3 - 2004 GOOSENECK TRAILER AT $ 11,706.63 SEAPORT LAKES WATER SYSTEM EMS - &STATION WATER BILL AT $ 33.00 SPARKLIGHT EMS - CENTRAL STATION CABLE AT $ 175.54 WCID NO. 1 OCT TAX COLLECTIO A/P $ 7,832.17 PAYROLL / ELECTION JUDGES AND CLERKS 11/02/21 TOTAL PAYROLL AMOUNT: CALHOUN COUNTY OPERATING ACCOUNT - TRANSFER FUNDS FOR HIGHER INTEREST RATE TO MONEY MKT CALHOUN COUNTY INDIGENT HEALTH CARE TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: CALHOUN COUNTY OPERATING ACCOUNT - TRANSFER FUNDS FOR HIGHER INTEREST RATE TO MONEY MKT P/R $ 5,798.20 ✓ $ 5,798.20 / A/P $ 7,750000.00 ✓/ A/P $ 12:178.74 ✓ $ 7,762,178.74 ✓ TOTAL AMOUNT FOR APPROVAL: $ 8,326,419.42 ✓ I MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL` LI$t FOR ----November 17 2021 by: CT INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES HEB Pharmacy (Medimpact) Pharmacy Reimbursement 33.93 MMCenter (In -patient $O/ Out -patient $6,515.54/ ER $1,014.72) 7,530.26 Victoria Anesthesiology Assoc 468.73 SUBTOTAL 8,032.92 Memorial Medical Center (indigent Healthcare Payroll and Expenses) 4,166.67 Subtotal 12,199.59 Co -pays adjustments for October 2021 (44b); Reimbursement from Medicaid 0.00 IM COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES QUANTITY UNIT PRIG TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $12,179.59 approved by Commissioners Court.onll/17/2021 1000-001-46010 October 31; !,2021' Int'e"rest ($0.85) p $12,178.74 COUNTY AUDITOR APPROVAL OM THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD C ON AND REQUEST THE COUNTY TREASURER TO PAY THE ABO IGATION. 11/17/2021 N G� Y 0m«. 0 w m C_�i 1BY: DEP TMENT HEAD DATE ©IHS Issued 11/02/21 Source Description Source Totals Report Calhoun Indigent Health Care Batch Dates 10/31/2021 through 11/01/2021 For Source Group Indigent Health Care For Vendor: All Vendors Amount Billed 01-2 Physician Services -Anesthesia 02 Prescription Drugs 14 Mmc - Hospital Outpatient 15 Mmc - Er Bills Expenditures Reimb/Adjustments Grand Total 1,716.00 33.93 20,252.02 3,171.00 25,180.95 -8.00 26,172.95 EXPENSES COPAYS TOTAL APPROVED ON NOV 10 2021 i BY v CALHOUN COUNTY AUDPTG« Amount Paid 468.73 33.93/ 6,515.54 1,014.72/ 8,040.92 -8.00 8,032.92 4,166.67 12,199.59 <20.00> 12,179.59 / ©NHS Source Totals Report Issued 11/02/21 Calhoun Indigent Health Care Batch Dates 02/01/2021 through 11/01/2021 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 23,599.00 2,309.91 01-2 Physician Services -Anesthesia 4,768.00 1,215.62 02 Prescription Drugs 904.15 904.15 05 Lab]X-Ray 11,719.15 135.25 08 Rural Health Clinics 5,219.00 5,001.57 13 Mmc - Inpatient Hospital 71,611.19 25,653.50 14 Mmc - Hospital Outpatient 117,330.11 37,740.28 15 Mmc - Er Bills 28,239.00 9,036.48 Expenditures 263,723.65 82,340.71 Reimb/Adjustments -344.05 -344.05 Grand Total 263,379.60 R 81,996.66 EXPENSES 41,666.70 123,663.36 COPAYS <710.00> TOTAL 122,953.36 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Date: 10/12/2021 Invoice # 362 For: Oct-21 Bill To: Calhoun County DESCRIPTION AMOUNT Funds to cover Indigent program operating expenses. $ 4,166.67 Anthony Richardson Interim CFO Total $ 4,166.67 IN NOV 10 2021 BY Vi CALHOUN COUNTY AUDIT( rZ Calhoun County Indigent Care Patient Caseload 2021 Approved Denied Removed Active Pending January 2 0 0 11 5 February 0 0 0 11 7 March 1 1 2 10 5 April 2 0 0 12 6 May 0 0 1 11 9 June 0 0 1 11 9 July 0 0 1 10 4 August 0 0 2 8 5 September 0 0 0 6 6 October 0 0 0 6 9 November December YTD Monthly Avg 1 0 1 10 7 December 2020 Active 9 Number of Charity patients 217 Number of Charity patients below 50% FPL 84 Calhoun County Pharmacy Assistance Patient Caseload 2019 Approved Refills Removed Active Value January 7 0 0 7 $8,589.00 February 4 0 0 11 $10,869.00 March 2 6 1 12 $14,515.00 April 2 2 0 14 $14,719.00 May 1 3 0 15 $14,765.00 June 3 5 0 18 $22,563.00 July 2 4 0 17 $22,897.00 August 1 2 0 18 $22,546.00 September 0 4 0 18 $24,250.00 October 2 6 0 20 $29,204.00 November December YTD PATIENT SAVINGS $184,917.00 Monthly Avg 2 3 0 15 $18,491.70 0 December 2020 Active 87 P A Y E F. MEMORIAL MEDICAL CENTER CHECK REQUEST CALHOUN COUNTY INDIGENT ACCOUNT Date Requested: 11/8/21 AMOUNT $20.00 FOR ACCT. USE ONLY e. 7ImprestCash �� A/PCheck NOV 1 � � Mail Check to Vendor cssatitar�Return Check to Dept G/L NU M BE R: 50240000 EXPLANATION: TO TRANSFER INDIGENT CO -PAYS FROM OPERATING ACCOUNTTO THE INDIGENT REQUESTED BY: MAYRA MARTINEZ AUTHORIZED BY: ! I V ENTERED RUN DATE: 11/02/21 MEMORIAL MEDICAL CERM PAGE 142 TIME: 10:03 RECEIPTS FROM 10/01/21 TO 10/31/21 RCMREP G/L RECEIPT PAY CASH RECEIPT DISC COLL GL CASH NOW DATE ME TYPE PAYER AMOUNT AMOUNT NUMBER NAME DATE INIT CODE ACCOUNT 50240.000 10/01/21 602227 10.00 00/00/00 PM 2 50240.000 10/08/21 603396 247.90 00/00/00 PLB 2 50240.000 10/15/21 604045 10.00 00/00/00 PLB 2 50240.000 10/25/21 606248 247.90- 00/00/00 PLB 2 #*TOM** 50240.000 COUNTY INDIGENT COPAYS 20.00 PROSPERITY BANK? Statement Date Account No THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13287 10/31/2021 "**4551 Page 1 of 2 sSTATEMENT. SUMMARY Public Fund Contractual Ckg wint'Account No "i":`4551 i. 3 Deposits/Other Credits + $35,753.26 7 Checks/Other Debits - $35,793.32 10/31/2021 Ending Balance 31 Days in Statement Period $5,441.71 Total Enclosures 9 LD!P05ITS/0THER CREDITS Date Description Amount 10/05/2021 Deposit $35,682.41 :C'o � 10/28/2021 Deposit $70.00 p 10131 /2021 Accr Earning Pymt Added to Account $0.85 gCheck Number Date Amount Check Number Date Amount Check Number Date Amount 12483 10-14 $50.79 12486 10-06 $48.57 12489 10-08 $332.08 12484 10-12 $135.25 12487 10.06 $30,910.80 12485 10-06 $4,166.67 12488 10-12 $149.16 DAILY ENDING BALANCE Date Balance Date Balance Date Balance 'off 10-01 $5,481.77 10.08 $5,706.06 10.28 $5,440.86 10-05 $41,164.18 10-12 $5,421.65 10-31 $5,441.71 10-06 $6,038.14 10.14 $5,370.86 o� N W� EARNINGS SUMMARY " Below is an itemization of the Earnings paid this period. " Interest Paid This Period $0.85 Annual Percentage Yield Earned 0.15 % Interest Paid YTD _ $18.56 Days in Earnings Period 31 Earnings Balance $6,638.41 MEMBER FDIC g NYSE Symbol "PB" I WN MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 17, 2021 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC; BANK PAYMENTS $ 218,263.20 TOTAL TRANSFERS BETWEEN FUNDS $ 212,41%64, TOTAL NURSING HOME UPL EXPENSES '$, 67%669.81 TOTAL INTER -GOVERNMENT TRANSFERS $ GRANMTOTAL°DISBURSEMENTS APPROVED, November 17, 2021 $ ;1,110,36166 ✓ MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 17, 2021 PAYABLE$ AND PAYROLL 11/12/2021 Weekly Payables 195,775.77 11/12/2021 Patient Refunds 2,909.52 11/12/2021 Citibank Credit Card -see attached 1,440.71 11/15/2021 McKesson-340B Prescription Expense 9,543.86 11/15/2021 Amerisource Bergen.3408 Prescription Expense 610.80 Prosperity Electronic Bank Payments 11/10/2021 Credit Card & Lease Fees 5,295.74 11/2012021 Sales Tax for October 2021 1,182.97 11/1212021 Cleargage-Patient Financing Service 109,18 1118-1111212l Pay Plus -Patient Claims Processing Fee 166.25 11/1212021 ExperlPay- child support 1,228.40 TOTAL PA,yABGES,'PAYI20LL AND,ELE ,TRONIC'BANLt PAYMENITS $, 218,;263,24 TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 11112/2021 MMC Operating to Solara-correction of NH insurance payment deposited into 4,277,00 MMC Operating in error 11/1212021 MMC Operating to Golden Creek -correction of NH insurance payment 13,054,62 deposited Into MMC Operating in error 1111212021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 25.513.68 deposited into MMC Operating 11/1212021 MMC Operating to Tuscany Village -correction of NH Insurrace payment 29.118.77 deposited into MMC Operating 11112/2021 MMC Operating to Bethany -correction of NH insurance payment deposited 20,838.51 into MMC Operating in error MEDICARE ADVANCE PAYMENT RECOUP 11115/2021 Broadmoor to MMC Operating -correction of Broadmoor medicare recoup 266.98 taken from MMC Operating 11/15/2021 Broadmoor to Golden Creek -correction of Broadmoor medical recoup taken 192.37 from Golden Greek 11/15/2021 Crescent to MMC Operating -correction of Crescent medicare recoup taken 266.98 from MMC Operating 11115/2021 Crescent to Golden Creek -correction of Crescent medicare recoup taken from 192.37 Golden Creek 11115/2021Solera to MMC Operating -correction of Solera medicare recoup taken from 266.98 MMC Operating 11/1512021 Solera to Golden Creek -correction of Solera medicare recoup taken from 192.37 Golden Creek 11/15/2021 Tuscany to MMC Operating -correction of Tuscany medicare recoup taken 266.98 from MMC Operating 11/16/2021 Tuscany to Goiden Creek -correction of Tuscany medicare recoup taken from Golden Creek 192.37 TRANSFER OF FUNDS BETWEEN NURSING HOMES 11/15/2021 Gulf Pointe Plaza -PP -correction of MMC insurance payment deposited into 54,114A3 Gulf Pointe Plaza -PP in error 11/152021 Gulf Pointe Plaza -PP -correction of MMC Clinic Insurance payment deposited 3,481,10 into Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Ashford insurance payment deposited Into 6,790.13 Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Broadmoor insurance payment deposited 4,914.00 into Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Crescent Insurance payment deposited 1,995.00 into Gulf Pointe Plaza -PP in error 11/1512021 Gulf Pointe Plaza -PP -correction of Fort Bend insurance payment deposited 14,890.72 Into Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Solera insurance payment deposited into 11,672.00 Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Golden Creek insurance payment 14,214.88 deposited into Gulf Pointe Plaza -PP in error 11/15/2021 Gulf Pointe Plaza -PP -correction of Tuscany Insurance payment deposited into 5,707.01) Gulf Pointe Plaza -PP in error TOTALTRANSFEkSzMEgTWEENxUNQ& $; _ 2123419:51;' NURSING HOME UPL EXPENSES 11/15/2021 Nursing Home UPL-Cantex Transfer 281,736.98 11/1512021 Nursing Home UPL-Nexlon Transfer 81,482,37 11/15/2021 Nursing Home UPL-HMG Transfer 13,617.37 11/15/2021 Nursing Home UPL-Tuscany Transfer 40,525.05 11/1612021 Nursing Home UPL-HSL Transfer 161,695.71 QIPP CHECKS TO MMC 11/16/2021 Ashford 35,886.09 11/15/2021 Broadmoor 16,050.49 11/15/2021 Crescent 7,926.26 11/1612021 Fort Bend 16,979.65 11/15/2021 Solaro 14,051.39 1 V15/2021 Tuscany 10,718.45 TOTAL NURSING HOME UPL EXPENSES, TOTAL INTEWOO1/ERNMENT TRANSFERS, $; 679r66981', GRAND TOTAL DISBiJRSEMENT$ APPROVED November 1T 2021 $= 1 110,352.06 Page 1 of 14 MEMORIAL MEDICAL CENTER 11/11/2 21 y -Q;r' AP Open Invoice List 0 Due Dates Through: 11/2412021 ap_open_invoice.template Ventlor# Vendor Name Class Pay Cade 11283 ACE HARDWARE 15521 r / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 158110 1 11/05/201010112011/18/20 69.99 0.00 0.00 69,99 ✓ SUPPLIES 1,98267 „ / 11/05/20 10/05/20 11/16/20 24.57 0.00 0.00 24,57 SUPPLIES 158285 t,/ 11/05120 10/06120 11/18120 13.99 0.00 0.00 13.99 ✓ SUPPLIES 158316,✓ 11/06/20 10/07/20 11/18120 5.01 0.00 0.00 J 6.01 SUPPLIES � 158415 .% 11/05/2010/1112011/18/20 1958 0.00 0.00 19.5E ✓/ SUPPLIES 158435 ✓F 11/05/20 10/11120 11118/20 16.99 0.00 0.00 16.99 SUPPLIES 158427 ✓ 11105120 10111120 11/18/20 3.58 0.00 0A0 3.58 ✓ SUPPLIES 158398 ✓ i 1/05/2010/1112011/18/20 23.96 0.00 0100 23.96 SUPPLIES 158701 11/05/20 10/20/20 11/18/20 50.98 0100 0.00 50.98 SUPPLIES 158799 ✓ 11/05/20 10/22/20 11/18/20 4.59 0.00 0.00 4,59 SUPPLIES 158992 y' 11/05/2010/28/201112PJ20 43.83 0.00 0.00 43.83 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11283 ACE HARDWARE 15521 278.07 0.00 0.00 278.07 Ventlor# Vendor Name Class Pay Code 14150 AGAPITA CANTU ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110421 11105/2011/04/2011118120 50.00 0.00 0.00 50.00 MONEY RETURNED Vendor Totals Number Name Gross Discount No -Pay Net 14180 AGAPITA CANTU 50.00 0,00 0,00 50.00 Vendor# Vendor Name Class Pay Cade A1680 AIRGAS USA, LLC- CENTRAL DIV ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9116961814 ,, 10/31/20 10/25120 11124/20 227.48 0.00 0.00 227,48 NITROUS OXIDE 911891 5737 �% 11105/2010/2112011/18/20 309.20 0.00 0.00 309,20 OXYGEN Vendor Totals Number Name Gross Discount No -Pay Net A1080 AIRGAS USA, LLC -CENTRAL DIV 536,68 0.00 0.00 536.68 Vendor# Vendor Name , Class Pay Code A1705 ALIMED INC. >/ M Invoice# Comment Tran Dt Inv Dt Due Ot Check D-Pay Gross Discount No -Pay Not 03691464�/ 11/09/20 10129/20 11/13/20 120.76 0.00 0.00 120.76 / SUPPLIES file:///C:/Users/ehe,iman/cpsilmemmed.epsinet.com/u98547/data 5/tmp_cw5report1573... 11/11/2021 Page 2 of 14 Vendor Totals Number Name Gross Discount No -Pay Net A1705 ALIMED INC, 120.76 0.00 0,00 120.76 Vendor# Vendor Name Class Pay Code 10958 ALLYSON SWOPE ✓� Invoice# Comment Tran Dt Inv Dt Due Ut Check D-Pay Gross Discount No -Pay Net 111221 11111/20 11/12120 11118120 3,071.25. 0.00 0.00 3,071.25 ✓- CONTRACT EMPLOYEE Vendor Totals Number Name Gross. Discount No -Pay Net 10958 ALLYSON SWOPE 3,071.26 0.00 0.00 3,071.25 Vendor# Vendor Name Class Pay Code / A0400 AUREUS RADIOLOGY LLC ./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2355351 / 10/27/20 10/25/2011124/20 2,428.75 0100 0.00 2,428.75 TRAVEL LAB STAFFING 2355034,% 10/2712010/25/2011/24/20 2,680.00 0.00 0.00 2,680,00 TRAVEL LAB STAFFING 2355247 v/ 10/2712010/2512011/24/20 2,760.00 0.00 0.00 2,760.00 a' TRAVEL LAB SERVICES Vendor Totals Number Name Gross Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 7,888.75 0.00 0.00 7,868.75 Vendor# Vendor Name Class Pay Code 12800 AUTHORITYRX •/ Invoice# Comment Tran Dt. Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1220 J'' 11/09/201404/2011/04120 9,885.00 0.00 0,00 9,885.00 �•= 340E ADVANCED CAPTURE 1231 ✓ 11109/20 11/04/20 11/04120 11000.00 0.00 0.00 1,000.00 .% CLAIMS SUBMISSION Vendor Total -Number Name Gross Discount No -Pay Net 12000 AUTHORITVRX 10,085.00 0.00 0,00 10,885.00 Vendor# Vendor Name Class Pay Code A2600 AUTO PARTS & MACHINE CO. 1% • W Invoice# Comment Tran Dt Inv Dt Due Dt Check 0, Pay Gross Discount No -Pay Net 968881 ✓ 11/05/20 10/08/20 11/18/20 28,68 0.00 0100 28.68 tf'� SUPPLIES 970922 11/08/20 11/03/20 11/18/20 63.67 0.00 0.00 63.67 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net A2600 AUTO PARTS & MACHINE CO. 92.35 0.00 0.00 92.35 Vendor# Vendor Name Class Pay Code 11247 AVENO NETWORKS 11r'/ Invoice# ,Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 12665 ,/l 11/05/2011/01/20. 11/18120 20,272.67 0.00 0,00 20,272.57 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11247 AVENO NETWORKS 20,272.57 0.00 0.00 20,272.57 Vendor#Vendor Name Class Pay Code �- 81150 BAXTER HEALTHCARE ✓ W Invoice# Comment Tran Dt Inv Dt Due Ot Check 0 Pay Gross Discount No -Pay Net 72596839 ✓ 11/06/2010/25/2011/19/20 1,009.01 0.00 0.00 1,009A1 SUPPLIES 72835752 ,/ 11108/20 10/28120 11/22/20 136.22 0.00 0.00 136.22 file:///C:/Users/eheimardcpsi/memined.cpsinet.com/u48547/data_5/tmp_ew5report 1573... 11 /11/2021 Page 3 of 14 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 1,145.23 0.00 0.00 1,145,23 Vendor# Vendor Name Class Pay Code , 11544 BAY STORAGE ,/ Invoice# Comment Traitor Inv or Due Dt Check DPay Gross Discount No -Pay Net 110921 11 /09/20 11109/20 11/18/20 2,010.00 0,00 0.00 2,010.00 6 MTHS UNIT 175, 180, 191 Vendor Totals Number Name Gross Discount No -Pay Net 11544 BAY STORAGE 2,010.00 0.00 0.00 2,010,00 Vendor# Vendor Name Class Pay. Code B1220 BECKMAN COULTER INC M Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /Comment 5448657 ✓ 10/31/2010130/2011124/20 3,507.27 0.00 0.00 3,507.27 LEASE Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 3,507.27 0.00 0.00 3,507.27 Vendor# Vendor Name class Pay Code B1680 BOUND TREE MEDICAL, LLC �i' M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 84275163 .i' 11/08/2011/0312011/18120 186.89 0.00 0.00 186.89 L'' SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net B1680 BOUND TREE MEDICAL, LLC 186.89 0.00 0.00 188.89 Vendor#Vendor Name Class Pay Code i 12740 BUILDING KID STEPS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net OCT2021 11/09/201110412011/18120 11013.00 0.00 0.00 1.01100 SPEECH THERAPY OCT2021A 11109120 11109/20 11/18120 1,039.00 0.00 0.00 1,039.00 SPEECH THERAPY OCT2021B 11109/20 11/09120 11/18120 1,200.00 0.00 0.00 1,200.00 4 „' SPEECH THERAPY OCT2021D 11 Y09/20 11/09/20 11/18/20 50.00 0.00 0.00 50.00 �! SPEECH THERAPY OCT2021C 11/09/20 11/09120 11/18120 1,062,00 0.00 0.00 1,052.00 SPEECH THERAPY Vendor Totals Number Name Grass Discount No -Pay Net 12740 BUILDING KID STEPS 4,354.00 0.00 0.00 4,354.00. Vendor# Vendor Name Class Pay Code 11295 CALHOUN COUNTY INDIGENT ACCOUN Involce# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110821 11/11/2011/09/2011/08/20 20.00 0.00 0.00 20,00 yi COPAYS Vendor Totals Number Name Gross Discount No -Pay Net 11295 CALHOUN COUNTY INDIGENT ACCOUN 20.00 0.00 0.00 20,00 Vendor# Vendor Name Class Pay Code C1325 CARDINALHEALTH 414, INC. ✓ w Invoice# Comment Tran Dt Inv Dt Due Ot Check DPay Grass Discount No -Pay Net 8002671291 11110120 10/23/20 11/17120 246.56 0.00 0.00 246.65 1f SUPPLIES file:///C:/Users/eheimanlepsi/memmed.cpsinet.coin/u98547/data_5/tmp_ew5report1573... 11/11 /2021 Page 4 of 14 Vendor Totals Number Name Gross Discount No -Pay Net. C1325 CARDINAL HEALTH 414, INC. 246.55 0.00 0.00 246.55 Vendor# Vendor Name Class Pay Code 13028 CAVALLO ENERGY TEXAS LLC Invoice# Comment, Tran Dt Inv Dt Due DI Check D, Pay Gross Discount No -Pay Net 2129100160990$1 �% 11/01120 10/15/20 11/18/20 589.62 0.00 0,00 $89.62- ELECTRICITY 212910016099030 Z 11101120 10/15/20 11/18/20 1,369.99 0.00 0.00 1,369.99 ELECTRICITY 212910016099051. 11/01/201011512011/18/20 16,31 0.00 0.00 16.31 4/Z ELECTRICITY 212930016115148 111101/20,10/1912011122120 18.46 0.00 0.00 18.46 ELECTRICITY Vendor Totals Number Name Gross Discount No -Pay Net 13028 CAVALLO ENERGY TEXAS LLC 1,094.28 0.00 0100 1,994.28 Vendor# Vendor Name Class Pay Code 11202 CFI MECHANICAL INC Invoice# Tran Dt Inv Ut Due Dt Check D' Pay Gross Discount No -Pay Net /Comment y' SD14407 10/27/20 10119120 11/18/20 737.50 0.00 0.00 737.50 BNRPL-IES ft Rc.par Vendor Total; Number Name Gross Discount No -Pay Net 11202 CFI MECHANICAL INC 737.50 0.00 0.00 737.50 Vendor# Vendor Name Class Pay Code 11616 CONTROL SOLUTIONS V/ - Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay Net CS220133 ✓ 11109/20 10/25120 11/18/20 64.00 0.00 0.00 64,00 CALIBRATION Vendor Totals Number Name Gross Discount No -Pay Net 11616 CONTROL SOLUTIONS 64.00 0.00 0.00 64.00 Vendor# Vendor Name Class Pay Code C2157 COOPER SURGICAL INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6016136 u'`� 11105120 10/27120 11118120 330.80 0.00 0.00 330.80 ✓ SUPPLIES 6014364 j 11/09/2010/25/2011109/20 ✓SUPPLIES 905.11 0.00 0.00 905.11 Vendor Totals Number Name Grass Discount No -Pay Net C2157 COOPER SURGICAL INC 1,235.91 0.00 0.00 1,235.91 Vendor# Vendor Name Class Pay Code 10006 CUSTOM MEDICAL SPECIALTIES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 287108�/ 11105120 10/22/20 11/18/20 654.15 0.00 0.00 654.15 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10008 CUSTOM MEDICAL SPECIALTIES 664.15 0,00 0100 664.15 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON e// Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6606001 10/26/20 10/26/20 11/20/20 234,56 0,00 0.00 234.56 ✓ _ J,SUPPLIES 6606460a/ 10131/20 10125/20 11119120 23.99 0.00 0.00 23,99 tile:///C:/Users/ehei man/cpsi/niemmed.cpsinet.com/u98547/data_5/tmp_ew5report1573... 11 /11 /2021 Page 5 of 14 SUPPLIES 6606000 ./ 10/81/20 10125/20 11119120 159.99 0.00 0.00 159.991, SUPPLIES 6610291 ✓�. 10/31/20 10/28/20 11/22/20 5.95 0.00 0.00 5.95 ✓� SUPPLIES 6612190 /f 10/31/2010/29/2011123/20 ✓ 200.88 0.00 0.00 200.88 SUPPLIES 6610120 Z 1110V20 10/27/20 11/21/20 47.17 0.00 0.00 47.17 SUPPLIES 6610140 r% 11/01/20 10127/20 11/21/20 8.25 0.00 0.00 6.25 SUPPLIES 6545900 �,' 11/05/2009101/2011/18/20 23.08 0.00 0100 2$,06 V.i SUPPLIES O 6581091 j,' 11/051201010612011/18/20 2.62 0.00 0100 2.62 SUPPLIES 6588390 yf 11/05/2010/0812011/18/20 353.00 0.00 0.00 353.00 ✓ SUPPLIES 6588380 11/05/20 10/08/20 11/18/20 29.50 0.00 0.00 29.50 SUPPLIES 5587460 11/05/20 10/08120 11118120 25.56 0.00 0.00 25.56 SUPPLIES 6592810 „/ 11/05/20 10/13/20 11/18/20 220.50 0,00 0.00 220.50 ,/- SUPPLIES 6593901 "/ 11 Y05120 10120/20 11/18/20 $5.35 0.00 0.00 35.35 `J SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 1.368.40 0,00 0.00 1,368.40 Vendor# Vendor Name Class Pay Code 12904 DSHS - VITAL STATISTICS vj Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 111021 11110/2011110/2011/10120 3T00 0.00 0.00 37.00 BIRTH CERTIFICATE CORREC Vendor Totals Number Name Gross Discount No -Pay Net 12904 DSHS - VITAL STATISTICS 37.00 0.00 0.00 3T00 Vendor# Vendor Name Class Pay Code E0555 ESS ✓/ Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Grass Discount No -Pay Net 40736 11/10/201013112011/18/20 6.744.00 0.00 0.00 6,744,00 9/ COVERAGE -6 Dv. Bur had. Vendor Totals Number Name Gross Discount No -Pay Net E0555 ESS 6,744.00 0.00 0.00 6,744,00 Ventlor#Vendor Name Class Pay Code S0501 EVOQUA WATER TECHNOLOGIES LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 905121466 ,f� 11/05/20 10/28120 11/18/20 752.93 0,00 0.00 752.93 .% SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net $0501 EVOQUA WATER TECHNOLOGIES LLC 752.93 0.00 0.00 752.93 Vendor# Vendor Name Class Pay Code R1185 FARAH JANAK Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net file:///C:/Users/eheiman/cpsi/men2med,cpsinet.com/u98547/data_5/tmp_cw5report 1573... 11 / 11 /2021 Page 6 of 14 110521 11/05/2011/05/2011118120 7.80 0.00 0.00 7.80 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net R1185 FARAH JANAK 7,80 0.00 0.00 T80 Vendor# Vendor Name Class Pay Coda F1100 FEDERAL EXPRESS CORP, V/ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 754792925 ,% 11/05/2010/2812011/22/20 35,65 0.00 0.00 35.65 tj FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 35.65 0.00 0.00 35.65 Vendor# Vendor Name Class Pay Code 10788 FIRETROL PROTECTION SYSTEMS / Invoice# Comment Tran Dt Inv 01 Due DI Check D Pay Gross Discount No -Pay Net J 100750783 11/05/20 11/03/20 11/18/20 3,290.00 0.00 0.00 3,290.00 ✓ REPAIRS SPRINKLER 100750960,/ 11/0512011103/2011/18/20 4,585.00 0.00 0.00 4.585.00 y/ COMPLIANCE/INSPECTION Vendor Totals Number Name Gross Discount No -Pay Net 10788 FIRETROL PROTECTION SYSTEMS 7,875.00 0.00 0.00 7,875.00 Vendor# Vendor Name I Class Pay Code 14092 FIRST CONNECT CENTER LLC I Invoice# ;Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay Net 3087 V 10125/20 10/25/20 11/24/20 4,625.00 0.00 0.00 4.625.00 TRAVEL NURSE STAFFING Vendor Totals Number Name Gross Discount No -Pay Net 14092 FIRST CONNECT CENTER LLC 4,625,00 0.00 0.00 4,625.00 Vendor# Vendor Name Class Pay Cade F1400 FISHER HEALTHCARE M Invoice# Comment Tran Dt Inv Dt Due Ot Check O Pay Gross Discount No -Pay Net 2,983416 10/27/20 10/26/20 1 V20/20 623.76 0.00 0.00 623.76 SUPPLIES 2583415 f 1D/27/2010/26/2011/20/20 123,58 0.00 0.00 123.58 / , SUPPLIES 2884099 /% 11/05/20 10/28120 11/22120 808.08 0.00 0.00 B08.08 SUPPLIES 2740161 ✓ 11/09/2010/27/2011/21/20 207.11 0.00 0.00 207.11 ✓ SUPPLIES 2884101 �/� 11/09/2010/28/2011/22/20 82.96 0.00 0.00 82.96 SUPPLIES 3069280✓� 11/10/2010/29/2011/23/20 652,90 0.00 0.00 652.90 ✓ SUPPLIES 3069279 v/' 11/10120 10/29/20 11/23/20 157,16 0.00 0.00 157.15 ✓� SUPPLIES Vendor TotalENumber Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 2,655.54 0.00 0.00 2,655.54 Vendor# Vendor Name Class Pay Code 11784 HALF LEAGUE STORAGE �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110121 11/10/20 11101/2011/18/20 360.00 0.00 0.00 f 360.00 ✓ 3 MTHS UNIT 11, 12.35 NOV-J file:///C:/Users/eheiman/cpsi/meiiuned.cpsinet.com/u985471data_5/tmp_cw5report 1573... I 1 /11 /2021 Page 7 of 14 Vendor Total: Number Name Gross Discount No -Pay Net 11784 HALF LEAGUE STORAGE 360.00 0.00 0.00 860.00 Vendor# Vendor Name Class Pay Code H1100 HAYES ELECTRIC SERVICE w Invo1cB# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net A221102508 ✓' 11/05/20 11/0412011/18/20 125.00 0.00 0.00 / 125.00 V SUPPLIES rt5%Or YG{�lti✓ A221110104✓ 11/08/2011/01/2011118/20 125.00 0.00 0.00 125,00 SWP41ES- d¢ILkkWd Y1 JW r2.(r(µ- . Vendor Totale Number Name Gross Discount No -Pay Net 111100 HAYES ELECTRIC SERVICE 250.00 0.00 0.00 250.00 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 100630019 Jr11105/2011/01/2011/1820 372,39 0.00 0.00 372.39 ` LATE CHARGES 100536018 ✓ 11/052011/01/2011/18120 357.71 0.00 0.00 357.71 LATE CHARGES 10053602(1,/ ll/052o 11/01/2011/18/20 89.87 0,00 0.00 89.87 J FINANCE CHARGES 100536017 ✓ 11/05/2011101/2011/18/20 476.50 0.00 0.00 476.50 FINANCE CHARGE Vendor Totale Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 1,296,47 0.00 0.00 1,296.47 Vendor# Vendor Name Class Pay Code 12190 ICU MEDICAL, INC sZ Invoice# Comment Tran Dt Inv Dt Duo Dt Chock D Pay Gross Discount No -Pay Net 3088418 ✓ 11/09/2010/19/2011/0920 507.00 0.00 0.00 507.00 SUPPLIES Vendor Totale Number Name Gross Discount No -Pay Net 12196 ICU MEDICAL, INC 507.00 0.00 0.00 507.00 Vendor# Vendor Name Class Pay Code 11130 INTEGRA LIFESCIENCES ✓/ Invoice# Clomment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 26666990✓ 11/08120 10/28/20 11/08/20 873.00 0.00 0.00 873,00 -% SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11130 INTEGRA LIFESCIENCES 873.00 0.00 0.00 873.00 Vendor# Vendor Name Class Pay Code 11108 ITERSOURCE CORPORATION L invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 711414 ✓�' 11/05/20 11/01/20 11/18/20 250.00 0.00 0.00 250.00 Lj PHONE SUPPORT Vendor Totals Number Name Gross Discount No -Pay Net 11108 ITERSOURCE CORPORATION 250.00 0.00 0.00 250.00 Vendor# Vendor Name Class Pay Code K1000 KEEP U NEAT DRY CLEANERS y�� w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110321 11/05/20 11/03/20 11/18/20 24.10 0.00 0.00 24.10 LAUNDRY Vendor Totale Number Name Gross Discount No -Pay Nat file:///C:lUsers/eheiinaiilcpsilinemmed.cpsinet.com/u98547/data_5/tmp_cw5report1573... 11/11 /2021 Page 8 of 14 K1000 KEEP U NEAT DRY CLEANERS 24.10 Vendor# Vendor Name Class Pay Code / L0700 LABCORP OF AMERICA HOLDINGS ✓ M Invoice# Go{riment Tran Dt Inv Dt Due Dt Check D Pay Gross 71146021 ✓ 11/05/20 10/30/20 11/24/20 15.00 LAB SERVICES 707OP486 1//' 11/10/20 09/26/20 10120/20 79.25 Vendor Totals Number Name Gross L0700 LABCORP OF AMERICA HOLDINGS 94.25 Vendor# Vendor Name ; Class Pay Code 10972 M G TRUST Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 110421 11109/2011/04/2011/18/20 640.86 PAYROLL DEDUCTS Vendor Totals Number Name Gross 10972 M G TRUST 640,86 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC y/M Invoice# Comment Tran Dl Inv Dt Due Dt Check D Pay Gross 42006 10/31/20 10/27/20 11121 /20 16.36 11'119Wibt% PPLIES 1971985678 ,/ / 10/31/2010/27/2011/21/20 70.66 SU,?PLIES 1971985670 ✓ 10/31/20 10/27/20 11/21/20 100.98 SUPPLIES 1971985663 >!j10131/20 10/27/20 11121120 221.41 SUPPLIES 1971985672 / 10/3112010/27120 11/21/20 37.48 SUPPLIES 1971985673 y,%� 10/31/20 10/27/20 11/21/20 18.74 SUPPLIES 19710855658 ✓/10/31/20 10/27/2011/21120 48.02 SUPPLIES 0.00 0.00 24.10 Discount No -Pay 0.00 0.00 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00. 0.90 0.00 000 0.00 0,00 0.00 1971985675 ✓ 10/31/20 10/27/20 11/21/20 6.36 0.00 0.00 SUPPLIES 1971985691 tfr 10/31/20 10127/20 11121120 3,957.45 0.00 0.00 SUPPLIES 1971985676 ✓/ 10/31120 10/27/20 11/21/20 58.76 0.00 0.00 SUPPLIES 1971985668 LI/ 10/31/20 10/27120 11/21/20 2.47 0,00 0.00 SUPPLIES 1971985667 V/ 10/3112010/27/2011/21/20 76.32 0.00 0.00 SUPPLIES 1971985667✓ 10/3112010/27/2011/21/20 1,698.43 0.00 0.00 SUPPLIES 1971986400 ✓ 10/31/20 10/27120 11/21120 20.42 0.00 0.00 SUPPLIES 1971985679 „/ 10/31/2010/27/2011/21/20 91.26 0.00 0.00 SUPPLIES % 1971985680 ✓ 10/31120 10127/2.0 11/21120 1,138.86 0.00 0.00 16.00 Net 79.25 Net 94.25 Net 640.86 Net 640.86 Net 16.86 7o.66 ✓ 100.98 221.41 ✓ 37,48 ✓ 18,74 48,02 ✓ 6.36 3,957,45 58.78 L,/' 2.47 v'�'"`� 76.32 ✓` 1,698.43 ✓� 20.42 91.26 ✓ 1,138.86 1,✓ file:lllC:lUsersleheimanlcpsilmemmed.cpsinet.comlu985471data_51tmpicw5report1573... 11 /11 /2021 Page 9 of 14 SUPPLIES 1971985677 y/ 10/31120 10/27/20 11/21/20 109.80 0.00 0.00 109.80 f SUPPLIES 1971985697 �/' 10/31/201012712011/21/20 203.86 0.00 0.00 203.86 SU1LIES 1971985674 ✓ 10/3l/2010/2712011121/20 18.74 0.00 0.00 / 18.74 SUPPLIES 1971985698 ✓ 10131/20 10/27/20 11/21/20 30.39 0.00 0.00 30.39 SUPPLIES 1971985661 f 11/02/20 10/27/20 11/21/20 128.82 0.00 0.00 128.82 4 SUPPUES 1702620822 V 11/05/20 10123/20 11119/20 5M89 0.00 0,00 528.89 ✓' WTERESTCHARGES 1971764646✓ 11/05/20 10126/20 11120/20 4.89 0.00 0.00 4.89 SUPPLIES 1971764650/ 11/05120 10/26/20 11/20/20 201.16 0,00 0.00 201.16 ✓'� SU PLIES 1971764648 11/05/20 10/26/20 11/20/20 57.69 0.00 0.00 57.69 SUPPLIES 1971764652 11105/2010/26/2011/20/20 80.23 0,00 0.00 80,25 ✓� SUPPLIES 1967702177 11/05/20 09/25120 11/18120 39.71 0.00 0.00 M71 SUPPLIES 1967762181 ./ 11/08/20 09/25/2011/18/20 679.90 0.00 0.00 879.90 SUPPLIES 1967762175 y' 11/08/20 09/25/20 11/18/20 34.51 0,00 0.00 34,51 .ice SUPPLIES 1967762174 V/ 11108120 09/25120 11118120 100.98 OM 0.00 100.98.✓ SUPPLIES 1967762179 Vf 11/OEV2009/25/2011/18/20 179.17 0.00 0.00 179,17 orb SUPPLIES 1968289337 i,/' 11108/20 09130/20 11/18/20 6.92 0.00 0.00 8.92 ✓ SUPPLIES 1969957476 v1 11/08120 10/13/20 11/18/20 52.82 0.00 0.00 52,82 ✓� SUPPLIES 1972309854 vJ 11/08/20 10/29/20 11/23/20 188.42 0.00 0.00 188,42 SUPPLIES 1972309855 4/ 11/08120 10/29/20 11123120 291.10 0.00 0.00 291.10 SUPPLIES 1962730137 .% 11/09/2008/17/2009/11/20 64.83 0100 0.00 64.83 SUPPLIES 1963622215 11/09/20 08/24/20 09/18/20 54.89 OM 0.00 54.89 „✓J SUPPLIES 1963622235 ,% 11/09/20 08/24/20 09/18/20 4.160.68 0.00 0.00 4,160.68 SUPPLIES 1964917828 ;` 11/09/20 09/02/20 09127120 41.23 OM 0.00 41,23 SUPPLIES 1964917B35 ✓ 11/09120 09/02/20 09/27120 8.02 0.00 0.00 8.02 SUPPLIES 1965443120 ,i 11/09120 09108/20 10/03120 84.27 0.00 0,00 84.27 SUPPLIES file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp cw5reportl573... 11/11/2021 Page 10 of 14 1965443117 �' 11109/20. 09/08/2010/03/20 859.43 0.00 0.00 SUPPLIES 1965443118 ,/ - 11/09/20 09/08/20 10/03/20 44.58 0.00 0.00 SUPPLIES 1965443121 :' 11/09/2009/0812010/03/20 22.89 0.00 0.00 SUPPLIES 1965443119 ,% 11/09/20 09108/20 10/03/20 17,69 0.00 0.00 SUPPLIES 1966325505 .,' 11/09120 09115/20 10/10/20 85.28 0100 0.00 SUf PLIES 7966289339,E 11/09/2009/30l2010/25l20 4.75 0.00 0.00 SUP .LIES 1968289338 11/09/200913012010/25/20 17.18 0.00 0.00 SUPPLIES 1971764649�/ 11109/20 10/26/20 11120/20 136-47 0.00 0.00 SUPPLIES 1971764651 V/' 11/09/20 10/26120 11/20120 18,42 0.00 0.00 SUPPLIES 1971956072 11/09/20 10/27/20 11/21/20 2,044.40 0.00 0.00 SUPPLIES 1971956064 11/09/20 10/27/20 11/21120 649.91 0.00 0.00 SUPPLIES 1971956063 �/' 11/09/2010/27/2011/21/20 1,072.86 0.00 0.00 SUPPLIES 1971956061 �' 11/09/20 10/27/20 1 V21/20 48.26 0.00 0.00 SUPPLIES 1971985656 ✓e 1110912010/27/2011/21/20 188.00 0.00 0.00 SLIES 1971916069 17 11109/2010/27/2011/21/20 415.22 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay M2470 MEDLINE INDUSTRIES INC 20,543.26 0.00 0.00 Vendor# Vendor Name Class Pay Cade 10825 MEMORIAL MEDICAL CLINIC ✓- ICP Invoice# Comment Tran D1 Inv Dt Due Dt Check D Pay Gross 110521 11105120 11/05/20 11118/20 40.00 PAYROLLDEDUCTS 110421 11/09/20 11104120 11/18/20 460.00 PAYROLL DEDUCTS Vendor Totals Number Name Gross 10825 MEMORIAL MEDICAL CLINIC 500.00 Vendor# Vendor Name Class Pay Coda M2621 MMC AUXILIARY GIFT SHOP dF' w Invoice# Comment Tran Dt Inv IN Due Dt Check D Pay Gross 110521 11105/20 11/04/20 11118120 270.92 PAYROLLDEDUCT Vendor Total:Numbar Name Gross M2621 MMC AUXILIARY GIFT SHOP 270.92 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC 4, Invoice# Comment Tran Dt Inv or Due Ot Check D Pay Gross 859.43 44.58 22.89 f' 17.69 v� 8528 4,75 17.18 136.47 c/ 18.42 ✓ 2,044.40 649,91 1,072,86 48.26 188.00 415,22 Net 20,643.26 Discount No -Pay Net 0.00 0.00 40.00 s/ 0.00 0.00 460,00 ,,...� Discount No -Pay Net 0.00 0.00 500.00 Discount No -Pay Net 0.00 0.00 270.92 w r- Discount No -Pay Net 0.00 0.00 270.92 Discount No -Pay Net file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report1573... 11 /11 /2021 Page 11 of 14 7504166 ✓r 11109120 11/03/21) 11/13120 18.59 0.00 0.00 18.59 INVENTORY 7506814 1j 11 /09120 11103120 11/13/20 360.00 0.00 0.00 360.00 ,✓� INVENTORY 7505806 1, 11/09/20 11/03120 11113120 1,265.00 0.00 0.00 1,266.00 INVENTORY 7505949 i,! F 1110912011/03/20 11/13/20 5.18 0100 0100 5,18 INVENTORY 7505807 1f 11/09/20 11/03/20 1 V13/20 358.57 0.00 0.00 358.57 JNVENTORY 7506816 ✓ 11/09120 11103/20 11/13/20 389,87 0.00 0.00 389.87 INVENTORY 7506815 f 11/09120 11103120 11/13120 503.80 0.00 0.00 503.80 INVENTORY 7505805 v`� 11/0912011103/2011/13/20 2,438.17 0.00 0= 2,438.17 INVENTORY CM88532 �� 11/09/20 11/04/20 11/14/20 -4.18 0.00 0.00 -4.18 V CREDIT CM86534✓1 11/09/2011104/2011/14/20 -8,20 0.00 0.00 -8.20 CREDIT 7512029 11109/20 11/04/20 11/14/20 177.87 0,00 0.00 177.87 INVENTORY 7508835 r% 11/09/201110412011/14/20 643.77 0.00 0100 643.77 INVENTORY 7512028 11109/20 11/04120 11/14/20 389.87 0.00 0100 389.87 INVENTORY 7512026 / 11109120 11104/20 11114/20 27.31 0.00 0.00 27.31 INVENTORY 7512027 11/09/2011104/2011/14/20 7.78 0.00 0.00 7,78 IN ENTORY CM85533 u/ 11/09/20 11/04/2011/14/20 -955.35 0.00 0.00 -955.35 CREDIT 7518116 �� 11109/2011/07/2011/17/20 715.71 0.00 0.00 715.71 INVENTORY 7516110 ✓ 1110912011/07/2011117/20 3.747.67 0.00 0.00 3,747.67 ✓ INVENTORY 7518117 J 11/09/20 11/07/20 11/17/20 1,685.41 0.00 0.00 1,685.41 INVENTORY 7518116 11109120 11/07120 11/17/20 544.94 0.00 0,00 544.94 �• 4� INVENTORY Vendor TotalE Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 12,311.78 0,00 0,00 12,311.78 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC �� M -- Invoice# Co`lnment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8800822011 ✓ 10/31/20 10/19/20 11118120 687.31 0.00 0.00 687.31 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net M2659 MXR IMAGING, INC 687.31 0.00 0.00 667.31 Vendor# Vendor Name I Class Pay Code 13548 NACOGDOCHES TRANSCRIPTION / file:///C:/Users/eheiman/cpsi/menuned.cpsinet.com/u98547/data_5/tmp_cw5report1573... 11/11 /2021 Page 12 of 14 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 7532 / 11/05/20 11/05/20 11118/20 469.28 0.00 0.00 469.28✓' v TRANSCRIPTION SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 469.28 0.00 0.00 469.28 Ventlor# Vendor Name Class Pay Code '11472 OCCUPRO LLC Invoice# Cam em nt Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 23345 / 11/11/20 10/0712011/06/20 487.47 0.00 0.00 487.47 v PROVIDER LICENSURE Vendor Totals Number Name Gross Discount No -Pay Net 11472 OCCUPRO LLC 487.47 0,DD 0.00 487.47 Vendor# Vendor Name Class Pay Cade 01500 OLYMPUS AMERICA INC r% M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 31724378 wJ 11109/20 10/28120 11/22120 294.75 0.00 0100 294.75 L✓Z SUPPLIES _ Vendor Totale Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 294.75 0,00 0.00 294.75 Vendor# Vendor Name Class Pay Code 11069 PABLO GARZA V Invoice# Comment Tran DI Inv Dt Due Di Check D Pay Gross Discount No -Pay Net 111121 - 11/11/2011/11/2011/18/20 2,510.63 0.00 0.00 2,510.63 bx4vm4 wur(L 1uIat, - itIkI -&i Vendor Totals Number Name Gross Discount No -Pay Net 11069 PABLO GARZA 2,610.63 0.00 0.00 2,610.63 Ventlor# Vendor Name Class Pay Code 13988 PAYCHEX, ADVANCE FBO t/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 007362 11/05/20 11/03/20 11/18120 2,425.00 0.00 0.00 2,425.00 TRAVEL NURSE STAFFING Vendor Totals Number Name Grass Discount No -Pay Net 13988 PAYCHEX, ADVANCE FBO 2,425.00 0.00 0.00 2.425.00 Vendor# Vendor Name Class Pay Code 12708 POC ELECTRIC, LLC Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3429 of 11/08/20 11/02/20 11/18/20 900.00 0.00 0.00 900.00 f'J SERVICES-1-pwhiwLv.o f Vu-I-kwd jh ai( + .a,.,- . Vendor Total -Number Name Grass Discount No -Pay Net 12708 POO ELECTRIC, LLC 900.00 0.00 0.00 900.00 Vendor# Vendor Name Class Pay Code 11764 ROBERT POOR IOU EZ ✓Tran Invoice# Comment or Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 110921 11110/20 11109/20 11/18/20 38.83 0.00 0.00 33.83 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11764 ROBEPTROORIOUEZ 33.83 0.00 0.00 33.83 Vendor# Vendor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES Invoice# Comment Tran Dt knv Dt Due Dt Check DPay Gross Discount No -Pay Net 56382200004967 V 11110/20 10/30/20 11/18/20 1,333.33 0.00 0.00 1,333,33 file:///C:lUsers/eheimanlcpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5reportl573... 11 /11/2021 Page 13 of 14 LEASE Vendor Totals Number Name Gross Discount No -Pay Net 10936 SIEMENS FINANCIAL SERVICES 1,333.33 0.00 0.00 1,333.33 Vendor# Vendor Name Class Pay Code 12288 SPBS CLINICAL EQUIPMENT SRVC j Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 964226 v,/ 11/10/20 08/31/20 08131 /20 00.00 0.00 0.00 90.00 LABOR Vendor Totals Number Name Gross Discount No -Pay Net 12288 SPES CLINICAL EQUIPMENT SRVC 90.00 0.00 0.00 90.00 Ventlor# Vendor Name Class Pay Code 14100 STAFFING FIRST / Invoice# Comment Tran Dt Inv Dt Due Dt Check. D- Pay Gross Discount No -Pay Net 211046 ✓ 11/1012010123/20 11/18120 4,65625 0.00 0.00 4,656.25 TRAVEL NURSE STAFFING Vendor Totals Number Name Gross Discount No -Pay Net 14100 STAFFING FIRST 4,65625 0100 0.00 4,656.25 Vendor# Vendor Name Class Pay Code 10758 TEXAS SELECT STAFFING, LLC L' Invoice# Comment Tran Dt Inv Dt Due of Check D Pay Grass Discount No -Pay Net 001844851079 � 11105120 11103120 11118/20 9,503.70 0.00 0.00 9.503.70 LIZ TRAVEL NURSE STAFFING Vendor Totals Number Name Gross Discount No -Pay Not 10758 TEXAS SELECT STAFFING, LLC 9,503.70 0.00 0,00 9,503.70 Vendor# Vendor Name Class Pay Code / T2250 TK ELEVATOR CORPORATION ,J M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 3006259992 11/10/20 11/01120 11/01/20 1,354.38 0.00 0100 1.354.38 ELEVATOR REPAIR Vendor Totals Number Name Gross Discount No -Pay Net T2250 TK ELEVATOR CORPORATION 1.354.38 0.00 0.00 1,354.38 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 848e87988810/27/20 10/26/20 11119/20 55.83 0.00 0.00 55.83 6106SVO.�U 61DRY ., 8400379837 1/ 10/27/20 10/25/20 11/19/20 45.15 0.00 0.00 45.15 [lam LAUNDRY 8400$79861 10127/20 10125120 11/19/20 2,271.94 0,00 0.00 2,271.94' . LAUNDRY 84003801531,.E 11101120 10/28/20 11/22120 199.32 0.00 0,00 199,32 LAUNDRY 84003801641/ 11/01/20 10/28/20 11/22/20 86.15 0.00 0.00 86.15 U- ' LAUNDRY % 8400380162 11101/20 10/28/20 11/22/20 195.79 0.00 0.00 195.79 ✓ LAUNDRY 8400380148 '// 11/01/20 10/28120 11/22120 1AUNDRY 38.75 0.00 0.00 38.75 8400380161 -' 11/01/2010/281201112PJ20 207.51 0.00 0,00 207.51 ✓.%' LA. NDRY 8400380150 y 11107/2010/28/2011/22120 137.13 0.00 0.00 137.13 vet file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u48547/data_5/ttnp_cw5reportl573,.. 11 /11 /2021 Page 14 of 14 LAUNDRY 8400380170 y,' 11101/20 10/28/20 11/22/20 1,602.16 0.00 0.00 1.602.16 1% LAUNfJRY 84DO380183 �// 11/05/20 10128/20 11/22/20 182.74 0.00 0100 182.74 ✓ LAUNDRY Vendor Totals Number Name Gross Discount No -Pay Net U10134 UNIFIRST HOLDINGS INC 5,022.47 0.00 0.00 5,022.47 Vendor# Vendor Name Class Pay Cade 12400 UPDOX LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INVO0292022 ✓ 11/05/2010/31/2011/1B/20 880.01 0.00 0.00 880.01 FAXING/ INVO0284373 / 11/10/2009/30/2011/18/20 80.01 0.00 0.00 80.01 FAX � Vendor Totals Number Name Gross Discount No -Pay Net 12400 UPDOX LLC 960.02 0.00 0.00 960.02 Vendor# Vendor Name Class Pay Code V1058 VICTORIA ANESTHESIOLOGY ✓'- W Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 103121 10131/20 10/01/20 11/24/20 38.216.08 0.00 0.00 38,216.08 ANESTHESIOLOGY SERVICE: Vendor Totals Number Name Gross Discount No -Pay Net V1058 VICTORIA ANESTHESIOLOGY 38,216.08 0,00 0.00 38,216,08 Vendor# Vendor Name Class Pay Code 1380E VITA PERSONA LLC ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount Ne•Pay Net VP20212568 V1 11/05/20 11/04/20 11/18/20 1,948.26 0.00 0.00 1,946.26 j V SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 13808 VITA PERSONA LLC 1,948.26 0.00 0.00 1,948.26 Vendor# Vendor Name Class Pay Code 12208 WAGEWORKS '_�'' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110421 11109120 11104120 11118/20 3,344,79 0.00 0.00 3,344.79 tf PAYROLL. DEDUCTS Vendor Totals Number Name Gross Discount No -Pay Net 12208 WAGEWORKS 3,344.79 0.00 0.00 3,344.79 Vendor# Vendor Name Class Pay Code 12548 WAGEWORKS, INC v% Invoice# Comment Tran 01 Inv Dt Due Dt Check D- Pay Grass Discount No -Pay Not 103121 11/09120 11/01120 11/18120 28.53 0,00 0,00 28.53 ADMIN FEES 1021 DR46779 �/ 11/0912011/0112011/21/20 155,52 0.00 0,00 155.52 �f COBRA Vendor Totals Number Name Gross Discount No -Pay Net 12548 WAGEWORKS, INC 184.05 0.00 0.00 184.05 Report Summary Grand Totals: Gross Discount No -Pay Net 195,775.77 0.00 0.00 195,775.77 file:/!(C:/Usersleheimaiilcpsilmertuned.cpsinet.corn/u98547/data_5/tnip_pw5reportl573... 11 /11 /2021 i RUN DATE 11%11/2l WORIAL MEDICAL CENTER PAGE 1 TIME: 141 h EDIT LIST FOR PATIENT REFUNDS A.RIM001 APCDEDIT fit!2i// ! ? 2("iti a l PATIENT rr r, , PAY PAT NUMBER` ""'"i'FAYEE-99MI1.11V DATE AMOUNT CODE TYPE DESCRIPTION GL NUN RUN DATE: 11/11/21 MEMORIAL MEDICAL CENTER PAGE 2 TIME: 14:22 EDIT LIST FOR PATIENT REFUNDS ARID-0001 APCDEDIT PATIENT PAY PAT NUMBER PAYEE NAME DATE AMOUNT CODE TYPE DESCRIPTION GL NUM Aftsmsymm an Noll 12 2u?l oslazr,, aagmw�-1 CITIBANK CORPORATE CARD Account Statement GommMmIC.NAcoounl e�a ° Account Inquiries: ,,gp� `rA50N47ANOLIN 11i7``��" IHIa Tell Free: 1-(SDD)-248.4553 International: 1-(904)-954-7314. AGCcant Number: XXXX-XXX� TDD/Tfy: 1-(877)-505-7276 X Summary ofAccountActivity Send Notice of Billing Errors and Customer Service Inquiries to: CITIBANK, N.A., PO BOX 6125, SIOUX FALLS SD 571176125 Transactions Pon Trans 10/05 10104 .•n'."""'•"••'•• NOTICE MEMO ITEM(S) LISTED BELOW .......... 1OMS 8299 0$436841277300233592575 1 FSF'EMRSAFETYBHEALT 972-235.83307X far" 101D4 8299 05436841277300233592MB 2 AF FSP'EMR SAFETY d HEALT 972-235�330 TX 75243 USA v72,00 10n1 10108 1WO 9399 SW0721282091278001016 6299 054366412813t10244000687 3 TXDPSCR AEC& 572972-2a8 TX 75243 USA 78752 USA aN.004% 10111 10/11 10108 $299 05436841281300244000760 4 5 FSP'EMR SAFETY B HEALT 972-235833D TX FSp•EMR SAFETY B HEALT 972-235-833D TX 75243 wAz00 10109 6942 55432861282200934555881 6 AM24MIOp US•270&G1XG7 Ammmomlb3nNA 75243 USA 98109 f0/12 taltl 5942 66432861284200650659766 7 1132708740.77082 AN"MMPUS•27001AI1HT0 Am2n.ca"INVA USA 98109 USA Use '� t021 1020 8641 55429501299852906453354 8 1%7135292-82210 AHRA y19.35 b� 97944376M MA 90845335 USA r,/l48.W '! 1022 10121 9399 OS134371206000M21310 9 NPD5 NPOBHRSA,GOV 8W-7676732 VA 22033 USA �� 1022 1021 9389 051343712956000348021492 10 N79238663 NPD5NPD8.HR6A,GOV 600.7676732VA 220W USA �250 V 1022 1=1 9399 0513437129NOD0390215V 11 NPDB NPDD.HRSA.GOV 800-7676732 VA V�2.50 1= 100 S942 55432861294200597708526 12 N79239516. PJ !NMkIP US'2YlM4DO81 Arnw.wmINIIWA 220�' USA y/,{pp0 `.,%� 1022 1022 8999 W432861295200709045592 113-033825.28714 kM10B USA 'II95 fit% 10,72 1022 Be99 55432MI2952007090456TS 13 14 AMWOREDENTIAUNG 800621-&MS IL AMA•CREDENTIAUNG 800821.83351E 6061'I USA V44J0 1025 10r13 SB42 554328612962001B9708619 76 Amezon.com'ZY9U04X0250 S2 !Y9U Amm.wm11i11M1A 60811 USq N' V 71372n..onn 96109 USA „/88.79 ,/ NOTICE: SEE REVERSE SIDE FOR. IMPORTANT INFORMATION Page l OF ,,,= CITIBANK N.A. Cll PO BOX 6125 Account Number XXXX-XXXX-XXX SIOUX FALLS SO 57117.6125 Statement Closing Date November 03, 2021 CALHOUN COUPU tUASURGR Not an Invoke, moo - 0 2021 For your records only. JASON W ANGLIN CALHOUN COUNTY STE A 202 S ANN ST PORT LAVACA TX T7979.4204 DATE RECEIVEDIII 00006934902 Account: )0=-XXXX-X)= Transactions (con't) 1027 1026 9399 0513437130060DO43759239 16 NPOS NPDB.HRSA.GOV 900-767.6732 VA U032 USA V N79317064 'A,50 1027 10127 8999 55432861300200163478560 17 ANIA'CREDENTIALING 800.621-B3351L 60611 USA _/94.00 1029 10128 9399 04134371302600039324509 18 NPDS NPDS.HRSA.GOV 8DO-767-6732VA 22033 USA /40 V N79374412 1029 1029 8999 55432861302200819164284 19 ANW'CREDENTIAUNG 800.621.8335 IL 60611 USA J 44.00 11101 1029 7399 SSSOD801302083303116231 20 AURORA TRAINING ADVANT 4075424317 FL 32773 USA A19.00 c AURORAAUDIO LLC 11102 11l01 8398 SMIM61305200127000647 21 AORN INC 303755M CO 80231 USA / ✓ 225.00 qi ? Page 3 of 4 M Account: XXXX-)O=XX)a Page 4 of 4 • Ropmf a Loaf or SMMn Copy Mrmedomey: OWf leiephWarines ate open emy bay, paymmes:You maYmunea paymmllo your mdnidWlly baMOaN.wo. 11.1114m, 24 hN.. bay. 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To Wpin me depute W NbA pfa<ess, rash eWWtayencmvttaln • You may aloe Mapuro a W maMNn by ending V Cat You may maim O us On a semmk ahNt at Ne m debou s,KelMa on We from of Nun ammm.nt Da soli os pmamM, please nmay W tohlar Non W daysaMr Ole dam of Me balm hints s Me error be problem pit approved. In We labor plow 91va OR No folmYArg mmmupm; Yourame and amount..For. Far aerWlly Wlod CompagA=Npbf, N D CanpinY Immd and NOMtl W I nmmt rum W n Tea dblhtamount ofine pL* Me l ofran OuuNa NeeWrand Ony Meeral An We mar. rmme InlommWn N u butru abmtm km. Cuums. or tows. Llntenam Okm,Nz a Ne Cumoanv w faNMaer mat uaueceislN N Nedb,W.1 Page 2 o1 d MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 915 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 PHONE: (361) 552-6713 FAX: (361) 552-0312 FAX: (361) 552-0312 l Vendor Name: lck ✓L. lyuc Date: I l N 6 1 /c o p l Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account# Initiated Date Required Expenseq Department Deliver To Famt 9 9401 Line No. Qty. Catalog Number - Description Unit Cost Unit Mess, Extended �^ �ryCost 4 PALS g � C• S d�L- � s —• Est. Freight AMa2rn - Plw� CkJAAEst. Total Cost w I 1 °" LL TOTAL COST 0 Contact: Date: Dept. Director Quoted By: Dir. Nursing Buyer. E.T.A. Dir. Clinical Services Administrator t MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 -. PHONE: (361) 552-6713 FAX: (361)552--0131,2�A (^ FAX: I (361) 52-0312 Vendor Name: C_ it . Nt Y Date: I ` I K ;l- a r> j Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account # Initiated By: Date Required ExpenseN Department Deliver To Line No. Qty. Catalog Number Description Unit Cost Unit Mess. Extended Cost a 3 s ink f� j(4 L414, ,,./�W�lp 9AMA Lf -on 9 a-virtalled I. so f Gt7dYt plGsn(- t.adotGS wltVWIO. arwutr C: ddr' W6L4:t !J-GS Est. Freight Est. Total Cost TOTAL COST NnTFR' f�tNd?dY� - Vw\ MA-4t, Qicivu.l4- Iatr.LS f f-"'A m Contact: Quoted By: Buyer: Data: E.T.A. Dept. Director_ Dir. Nursing Dir. Clinical Services Administrator MEMORIAL MEDICAL CENTER PURCHASE ORDER Sill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 PHONE: (361) 552-6713 FAX: (361)552-0312 FAX: (361) 552-0312 Vendor Name: �-} &- P, L) � f (_,�'fjtL^-'_ " �/i '' Date: I l Vendor Address: P.O. # V— Account # V' Initiated B Da Expense p Department Form#9401 Deliver To 12u N , . _ ,i^ .rmher Description Unit Cost. Unit Extended ANA 44, 2 • 5 U 2o i.� LI a. �ln d.a ry IACilUL,. ` F j'�Y,vwyv a j a z .:i 1, 2 b u . .ANI8 G4e6(� 411&1 i ��w 5 e lG I'I ur2 I wvw 7 4 L.� I. n� T o W 1 I C?� -- Na�.� 0 _; p�� If k-10 Mt.W,6,--6v — Sut,,1.t�. ftt.aa��rL �'S•LJ to Eat. Freight Contact: Quoted By: Buyer. Date: E,T.A. Est. Total Cost TOTAL COST 4 ] 4q 0'-1 Dept. Direclor Dir. Nursing _ Dir. Clinical Services CFO Administrator MSKESSON STATEMENT As of: 11/12/2021 Company: e000 DC: 8115 MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBIT Territory: AP Statement for intonation only 815 N VIRGINIA STREET Customer: 632536 PORT LAVACA TX 77979 Date: 11/13/2021 Page: 002 To mass, (Koper credit to your accused, aeteen and return this stub with your remittances As of: 11/12/2021 Page: 002 Mall to: Camp: 0000 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only Cast: 632536 PLEASE CHECK ANY Date: 11/13/2021 ITEMS NOT PAID (v) _. _.. xettonal Account pp�gg5�e )Me Du¢ Numb abl9' DYaa' Cash (g—) P Amount P Nec0lvabl¢ )Me Date Number Reference DascHpibn Dlaeamt (goes) F (md) F Number IF column "and: P = Poo Due Item, F = Future Due near, blank = Cu.... Due Item TOTAL National Acm 632536 MEMORIAL MEDICAL CENTER Subtctals: 9.738.83 LED �dure Due: 0.00 If Paid By 1111612021, Nast Duo 10.20- Pay This Amoum: 9,543.86 USD Am Payment 2.451.97 If Paid After 1111612021, .8107/2017 Pay this Amount: 9,738.83 LED 6if91Y IM Set P@V 'I 5 2021 eItITPaAar4lw .� c%'"dam1': euraewr, x'Aow For AR Inquiries please contact 800-867-0333 Duo If Red On Time: LED 9,543.86 Disc last if paid late: 194.97 Due If Paid Late: LED 9,738.63 (�' VL"-- MSKESSON STATEMENT commnv: 1S00 WALMART 1098/MEM MED WE AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTHI for inlormation only VICKY KALISB( 815 N VIRGINIA 6T PORT LAVACA T% 77979 ^a°' "/,2/2D2/ DC: 8115 Territory: 400 Customer: 268342 Date: 11/13/2021 Page:°°' dit account, carbon ndrecu your eo anal, prop and rtuo our Uhle Stab w8h your ram8brlee Aati 11112/2021 Pegs:001 Mail to: Comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only Date: 252021 PLEASE SN CHECK ANY Dale: 11/13/2027 ITEMS NOT PAID (v) Account 8 Numberbl� i�b510 Leah Amount P Amount P Alfine"ca" ?sl We Due Data Number Raiemnce Descdptlon Diaeounl (grave) F Number (MI) F Number batamer Number 266342 WALMART 1098IMEM MED PHS 561.69 550A6✓ 7304753512 1/06/2021 11/16/2021 7304753512 1105210857 1151nvolce 11.23 0.31✓ 7304696711 1/08/2021 11/16/2021 7304696711 18630676 1151nvoice 0.01 0.32 424.39 415.90✓, 7304996712 1/08/2021 11/16/2021 7304696712 18635676 1151nvoice 8.49 1/00/2021 11/16/2021 7304696713 18709615 1151nvoice 0.01 0.63 0.62"/ 7304696713 7304696714 1/08/2021 11/16/2021 7304696714 18752937 1151nvolce 16.14 806.94 790.80✓ 1/08/2021 11/1612021 7304888320 1105210651 1951nvoice 2.52 126.13 12161 ✓ 7304888320 1109/2021 11/16/2021 7305191977 1106211248 1151nvoice 1.85 92.41 90.56 ✓ 7306191977 1/10/2021 11/1W2021 7305305230 18857631 1151nveice 11.83 591.73 579.90✓ ✓ 7305305230 1/10/2021 11/16/2021 7305305231 18861909 1151twoloo 13,86 693.22 679.36 7395305231 1/10/2021 11/16/2021 7305305232 18904697 1151nvolce 1.11 65.56 54.45 ✓ 7305305232 1/10/2021 11/16/2021 7305449367 1109210727 1951nveice 7.87 393.38 385.51 ✓ 7305449367 1/10/2021 11/1612021 7305449368 1109211022 1151nvoice 4.05 202.67 198.62✓ 7306449363 1/11/2021 11/16/2021 7305568562 18977014 1151nvoice 15.18 759.12 743.94 ✓ 7305568562 1/11/2021 11/1 M021 7305747032 1110210905 1ISInvolce 23.95 1,197.72 1,173.77 ✓ 7305747032 1 f12/2021 11/16/2021 7306646835 19005515 1151nvoice 10.45 622.35 511.90 ✓ 7305846035 1/12/2021 11/16/2021 7306840036 19005515 1151mmice 3.69 184.57 180.88 ✓ 7305846838 1112/2021 11/16/2021 7305546837 19050304 115lnvoice 11.37 568.55 557.181/ 7305846837 1/12/2021 11/16/2021 7305846838 19050304 11510vcice 11.29 564.39 553.10 ✓ 7306846838 1/12/2021 11/16/2021 7305846839 19066863 1151nvolce 10.95 547.41 536.46 ✓ 7305846839 V1212021 11/16/2021 7305979113 1111210709 1961nvoice 7.76 387.94 380,18 ✓ 7306979113 1/1212021 11/16/2021 7305979114 1111210752 11 Skeoica 0.81 40.52 3939.7711 7305970114 /✓/ 1 CAC S60 Ly9 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT Ones WAIMARr 10981ME4 MED PHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information VICKY KAUSE( only 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 11/12/2021 DC: 8115 Territory: 400 Customer: 256342 Dale: 11/13/2021 'Is Column legend: P = Past Due Item, ASTIO&WOCearn 1111AS36 blank = Current Due Item 'OTAL• Curtaner Number 256342 WALMARr 1096/MSAi M® PHS Subtotals: 8,721.64 USD inure Due: 0.00 It Pam By 1111012021, 'art Oua: 0.00 Pay This Amount: 8,547.22 USD asl Payment 10,629.05 If Pam Alter 1111612O21. 1/08/2021 PaY this Amount: 0,721.64 USD t3`^fgl7A6P N0f1 Y49 20A ta"s is .kwalHCpt GALI'r '94111i};a;", 3,M4S Page: 001 To Oman, proper Credb to your Moslem, detach and Item this pub with your remhtamee As of: I1/12/2021 Page: 001 Mall to: Cans: 0000 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only For AR Inquiries please Contact 800-867-0333 Curt: 256342 PLEASE CHECK ANY Data: 11/13/2021 ITEMS NOT PAID (w) i Due If Pam On Time: USD 8,547.22 DIM mat If paid late: 174.42 Due If Paid late: USD 8,721.64 MSKESSON STATEMENT coma�r saso WALMARr 5315/MBMRL MC PHIS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information only A/P 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 11/12/2021 Page: 001 To amura proper credit to your account, dMwh and return this stub With your remittance DC: 8195 As of: 11/1212021 Page: 001 Mail to: Comp: 6000 Territory.: 98 AMT DUE REMITTED VIA ACH DEBIT Customer: 845479 Statement for Information only Data: 11113/2021 Cunt: 945479 PUEA9E CHECK ANY Date: 11/13/2021 ITEMS NOT PAID (w) dIW.I Account 6 9lling Due Numb abl Cash Amount P Amount P NmberReceivable )ate Date Number Fblanv¢a Description Discount (gross) F (net) F Number 7unomer Number 945479 WALMART 531SIMMM MC PHS 1/10/2021 11/16/2021 7306417186 MH11092021 19511 0.01 0.32 0.31 / 73OS417186 W column legend: P = Past Due Item, F = Future Cue Item, blank = Current Due Item V 'OTAL• Customer Number 945479 WALMARr 5315/MBMRL MC PHS Sulddelc 0.32 USD idure Due: 0.00 Due If Paid On Time: It Paid By 11/1612021. USD 0.31 let Due: 0.00 Pay This Amount: 0.31 USD Of= Ion it paid late: 0.01 An Payment 9.079.18 If Paid After 11/1612021, Due It paw We: 0/2512021 Pay this Amount: 0.32 USD USD 0.32 A"gasi ae 4M P1011 i 5 2021 CI69i3NT t:'AYdrV3 CAT_:.SIN•: w3pka:4',':45G.1'3 For AR Inquiries please contact 800-867-0333 I ' / MSKESSON STATEMENT 0omn.r eaoo CVS PHCY 7475/MBA MC PHIS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information only VICKY KALISE( 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 11/12/2021 Page: 001 To ensure proper crrd8 to your moment. Ortxh am mum this stub with your remittance CC: 8115 As of: 11/12/2021 Page: 001 Mall to: Carp: 8000 Tentta to 400 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only Customer: 835438 Cate: 11/13/2021 Curt: 83543B PLEASE CHECK ANY Date: 11/13/2021 ITEMS NOT PAID (�) eHers" ACCWnt 6 01ng Due ReceiveN Cash Amount P Amount P Remivable )ate Date Number Re entries Description Dievounl (Bass) F (net) F Number :unaner Number 83543a CVS PHCY 7475/MEM MC PHS 1/11/2021 11/16/2021 7305743540 1440427 1151nvoice 4.69 234.61 229.92 ✓/ 7306743540 O m column regard: P = No Due Item, F = Rdles Due Item, blank = Cement Due Item 'OTAL' Customer Number 835438 CVS PHCY 7475IMEM MC PHS Subtatals: 234.61 USD inure Due: 0.00 Due If Rod On Them If Palo By 11/1612021, USO 229.92 f "ast Due: 0.00 Pay This Amount: 229.92 USD Oise lost If paid late: 4.89 art Payment 10.629.05 If Pant After 11116/2021, Due If Paid We: 1/08/2021 Pay this Amount: 234.61 USO USD 234.S1 T Y) a0N hf�'1�115 2021 Cattkier>; D:. .Dara.wlr.,wli,iocaa, If,-, —^.rot(+' dufas'8[•, vMUS For AR Inquiries please contact 800-867-0333 YX , MSKESSON STATEMENT As of: 11/12/2021 Page: 001 To (means Proper credit to your aamumdetach and rthis —near: e000 eWb with your remmmasamuv DC: 8115 As t: 11/12/2021 Page: 00 ED MY FC 490/MBa MC PHS AMT DUE RBAITTED VIA ACH DEBIT Territory; 400 Malll to: Carp: 8000 MEMORIAL MEDICAL CB TER Statement for information only AMT DUE REMITTED VIA ACH DEBIT VICKY KALISE( Customer. 484450 Statement for information only 815 N VIRGINIA ST PORT LAVACA TX 77979 Date: 11/13/2021 cue: 464450 PLEASE CHECK ANY Date: 11/13/2021 ITEMS NOT PAID (r) fillinDue NumberblNelioual Account )me )me Date Number Reference parmen Cast Description Discount Amount P (9mse) F Amount P Reeeleable (net) F Number lumomo Number 464460 HEB My PC 490/MEM MC PHS 1/12/2021 11/16/2021 7305818766 6SX728212 1151moice W column legend: P = Past Due Item, F = Future Due Item, blank = Curren Due Item "OTAL Customer Number 464450 HE3 MY FC 490/MEM MC MS Subtaals "lure Due: 0.00 It Will By 11/16/2021, tst Due; 0.00 Pay Tins Amount: am Payment 10,629A5 If Paid Alter 1111612021, 1/08/9021 Pay this Amount: APPINOPiaa atTC NOV 15 2021 O'laRati ?Aaaelor s� �e�r «aoe. x..•. �teraD 15.47 773.32 773.32 USD 757.85 ✓ 7305818766 O Due If Paid On Time: LED 757.85 t/ 757.86 USD Diet lost If geld late: r 15.47 Due It Paid late: 773.32 USD USD 773.32 For AR Inquiries please contact 800-867-0333 k�— / MSKE$SON STATEMENT AS of: 11112/2021 Pegs: 001 To enema paper Arafat to your account, detach and atum this Company: acne al with your remtttarge OC: Sits As of: 11/12/2021 page: 001 CVS PHCY 7008/MEMORIA PHIS AMT DUE REMITTED VIA ACH OMIT Territory: 400 Mail to: Comp: 8000 MEMORIAL MEDICAL CENTER Statement far Information only AMT DUE REMITTED VIA ACH DEBIT VICKY KAUSE( Customer. 262252 Statement for information only 815 N VIRGIAVAC IA Date: 11/13/2021 PORT LAVACq TX ]]979 Cum: 262252 PLEASE CHECK ANY Date: 11113/2021 ITEMS NOT PAID (�) -- filling Due We Data uua110nal Account bW6 Numisebia" Betel` Number Reference ash Cash Deeeriptlon Diecounl Amount P (groae) F --_ - Amount P Number (nen F Number :umamor Number 262252 CVS PHCY 70061MEMORIA PHS 1/12M021 11/12/2021 7306062382 1291727 115Credit 10.20- P 10.20. P ✓ 7306062382 O ^F column legend: P = lest Due Item, F = Future Due Item, blank = Current Due Item 'OTAL Customer Number 262252 CVS PHCY 7006/MEMOEA PHS Sumotms: 10.20. USD 'inure Due: 0.00 Due If Paid On Time: It Paid By 1111212021, USD 10.20.� em Due: 10.20. Pay This Amoum: 10.20- USD Cho tom H Palo late: 0.00 am Payment 10,629.05 N Peld After 11112/2021, Due H Paid late: 1/08/2021 Pay this Amount: 10.20. USD USD 10.20- OPI NO 15 L1021 C�Y00VaFG'.^{fI1MYaS1C /� P Y For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT C Mp.,: 00ao H® PHCY 0434/MBe MED PH$ AMT DUE REMITTED VIA ACH DEBIT MBMORIAL MEDICAL C134Tf31 Statement for Information only VICKY KALISE( 815 N VIRGINIA ST PCHT LAVACA TX 77979 As of: 11/12/2091 Page: 001 To ensure praiser credit to your account, Most, ena mtum this Nub with your munwanae DC: 8115 As of: 11/12/2021 Page: 001 Melt ta. Camp: 8000 Territory: 400 AMT DUE REMITTED VIA ACH DEBIT Statement for information only Customer. 190813 Data: 11/13/2021 cum: 190813 PLEASE CHECK ANY Date: 11/13/2021 ITEMS NOT PAID (1) 9111ng Due Assatvable atlanal AwWnt Wive Cagy Amount P Amount P Naeeh9da )ate Date Number 9atmerme Description Discount (grass) IF (rmt) —F Number :uatomM Number 190813 H® PHCY 0434/MFM MED PHS 12.60 7305826252 1(10/2021 11/16/2021 7305284867 2017038644 1151nvoice 0.33 12.66 0.05 2.65 2.60 ✓ 7305826252 1/12/2021 11/16/2D21 7305826252 2017038717 1151nvalce W eolumn Iegenti: P = Past Due Item, F = Mum Due Item, blank = Current Due Item 'OTAU Customer Number 190813 H® PHOY 0434/MEM MED PHIS Subtdalia 19.14 USD Due 11 Will On Time: iture Due: 0.00 USD 18.76 If Pale By 1111612021, 18.76 USD also ION if paid late: last Due: 0.00 Pay This Amount: 0.39 aN Payment 10,629.05 II Paid After 1111612021, Due 1t Pale Late: USD 19.14 1/0012021 Pay this Amount: 19.14 USD Assn""" am W�415azi tiff"aw Ns"llra9 For AR Inquiries please contact 800-867-0333 V AN AmerisourceBergew STATEMENT Statement Number: 61959981 Date: 11-12-2021 AMERISOURCESERGEN DRUG CORP WALGREENS ei2494 340B 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER 10113712181113 70261B6 SUGARLANDTX 77479-6101 1302 N VIRGINIA ST • PORT LAVACA TX 77979-2509 ' DEA: RA0289276 ]days 866-451-9655 AMERISOURCEBERGEN P.O. Box 905223 1 Ot 1 CHARLOTTE NC 28290.5223 Not Yet Due: 0.00 Current 640.80 Past Due: 0.00 Total Due: 610.80 Account Balance: 610.60 ivity ue Reference Purchase Order Document Original Last Receipt Amount Received Balance P ate Number Number Type Amount A9-2021 3073119388 163477 Invoice 430.01 0.00 43801 -19.2021 3073119389 163480 Invoke 9.10 0.0 I 9.10 -19.2021 3073119080 163478 Invoice 5.03 O.OD 5.03 11-09.2021 11-19-2021 3073265285 163534 Invoice 7073 0.00 7073 j 11-11-2021 11-19.2021 3073533052 163551 Invoice 36.39 0.00 W.39 v 11-11-2021 11-19.2021 3073633053 163552 Invoice 8.03 OeD 8.03 11-12-2021 IIAS-2021 3073669894 163562 Invoice 51.51 0.00 11.51 i Current 1-15 Oays 16.30 Days 31.60 Days 81-90 Days 91-120 Days Over 120 Days 610.80 0.00 0.00 0.00 am 0.00 o.aD Thank You for Your Payment Date 11-12-2021 Amount (71811) ' }� 1 ' Reminders Due Date 11-19.2021 Amount B10.B0 Total Due: 610.80 AE[ W71m ew t,1011 15 2021 car"a'er.Pi\®CLr. cl-, •` D.t Wxv, W'4fa»D MEMORIAL MEDICAL CENTER PROSPERITYRANR OPERATING ACCOUNT— November8, 2021-November 14,2021 Date Bank Blasi 11/12/2021 PAY PLUS ACHTRANS 452579291301000693004803 11/12/2021 ERPERTPAY ERPERTPAY 74SM411910=10382754 11/12/2021 ERPERTPAY ERPERTPAY 74GM411 91000010367754 11/12/2021 CLEARGAGE LLC CLEARGAGE, 2OUFPYTT6W WRP 242 11/12/2021 AMERISOURCE BERG PAYMENTS 01W0077682100002 11/12/2021 M EMORIAL MEDICAL PAYROLL 740003411 113122650 11/12/2021 IRS USATARPYMT 22017161467796E 6103601009664 11/20/2021 PAY PLUSACHTRANS 452579291 101=692814063 11/10/2021 TSYS/TRANSFIRST DISCOUNT 393M982S416166110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 41399801992827 6110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 413998013323856110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 41399801332401 6110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 41399NI3324196110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 41399001368397 6110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 41399801332393 6110 11/10/2021 TSYS/TRANSFIRST DISCOUNT 393009825899466110 11/9/2021 PAY PUTS ACHTRANS 452579291 101000091901620 11/9/2021 MCRESSON DRUG AUTO ACH ACH0479112491OW0137 11/8/2021 PAY PLUS ACHTRAN54525792911DLOWS90801666 MMC No ez -3rd Party Payor Fee -Child Support Payment -Payr411 Ending "'•"" -Child Support Payment -Payroll Ending'•••'•^ - Patient Financing Service 340E Drug Program Expense Payroll Payroll Taxes - 3rd Party Payer fee Credit Card Processing Fee Credit Card Processing Fee -Credit Card Processing Fee - Credit Card Processing Fee -Credit Card Processing Fee Credit Card Processing Fee -Credit Card Processing Fee Credit Card Processing fee 3rd Party Payer fee 34US Drug Program Expense 3rd Party Payer Fee A� November 15, W21 Anthony Richardson, CFO Memorial Medical Center T rYr° PROSPERITYBANR ELECTRONICTRANSFERS FOR OPERATING ACCOUNT - ESTIMATED ACHS Date oeirrie0nn 11/20/2021 Sales Tax Sales Tax y \J < /�( November 15, 2021 Anthony Richardson, CFO Memorial Mythical Center MMCN4 425,SB9A8 Amount $ S1,182.97, 1,182.97 4w VIM I I.84 + 22^'l6 69.1 6g1 �Kpu}Y/Ay 611t°2U 614.2L, i7iI.PFgw� 169. Ib Lc Fits 585'^ii , 14u•b 64.9> 57'i°ITS 742•r_t , 656.11 , 2a41S-u_ 129 ulr 5.29-r9 166^<h I+2<N•4�j IUY^Ib 6r'199 a2„ I (1 f Q Confirmation: You Have Filed Successfully Sales and Use Tax Period Ending 10/31/2021 (2110) Taxpayer ID Taxpayer Name: Entered By: User ID: MEMORIAL MEDICAL CENTER Email Address: Reference Number: Taxpayer Address: Date and Time of Filing: 815 N VIRGINIA 5T PORT LAVACA, Tx Telephone Number: 11 /09/2021, 01:22:14 PM 77979-3025 IP Address:: PAYMENT SUMMARY Electronic Check Payment Reference Number: Type of Bank Account: Checking State Amount: S896.19 Trace Number. Accountholder Nama: Local Amount: 8286.78 Bank Rotating Number: ---- Amount to Pay: $1,182.97 Bank Account Number: Electronic Check: $1,182.97 Payment Effective Date: 11 /20/2021 CREDIT SUMMARY Credits Taken Are you taking credit to reduce taxes due on this return? No Licensed Customs Broker Exported Sales Did you refund sales tax for this filing period on items exported outside the United States based on a Texas Licenced Customs No Broker Export Certifications? LOCATION SUMMARY Lock Total Texas Taxable Taxable Sales Subjecttestate Subjectto Sales Purchases Tax (Rate .0625) Local Tax State Tax Due Local Tax Rate Local Tax Due 00004 14411 14411 0 14411 900.69 14411 0.02 288.22 SubTotal 14411 14411 0 14411 900.69 14411 288.22 Total Tax for Locations $1,188.91 Total Tax Due: S1,188.91 Timely Filing Discount: -85.94 Balance Due: $1,182.97 Pending Payments: -SOD0 Total Amount Due and Payable: ( State amount due is $896,19) ( Local amount due is $286.78 ) Page 1 of 1 MEMORIAL MEDICAL CENTER 11711, 2021 " - ' 0 n 1,2 52 AP Open Invoice List 7-z _raP.G.:>,t %t3_s:I ap_open_invoice.template •u rrn,:' Due Dates Through: 11/25/2021 Vendor#Vendor Name Class Pay Code 11626 SOLERA WEST HOUSTON ✓/ Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net 110321 11109/20 11103/20 11/25/20 4,277.00 0.00 0.00 4,277.00 TRANSFER Ng'IKUV/ K(C V�j (,lljioc.,'a 1'K� r&NIK- LW-. o Vendor Totals Number Name Gross Discount No -Pay Net 11828 SOLERA WEST HOUSTON 4,277.00 0.00 0.00 4,277.00 Report Summary Grand Totals: Gross Discount No -Pay Net 4,277.00 0.00 0= 4,277.00 fyp> ""W tm P@V 12 2021 tile:///C:/Users/eheimall/cpsi/menuned.cpsinet.com/u98547/data_5/tmp_cw5report7452... 11 /11 /2021 Page 1 of I MEMORIAL. MEDICAL CENTER 11/15/2021 0 AP Open Invoice List 07:49 ap open_involeeaemplale Dates Through: 11/25/2021 Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv 01 DueOt Check D Pay Gross Discount No -Pay Not 110221 11/09/20 11102120 11/25/20 609.29 0.00 0.00 609.29 L! �L TRANSFER 0Ni t llkItCL pvd}k.'�o(A.rld6't u( �-+ "4 110421A 11/10/20 11104120 11125/20 7.462.40 0.00 0 7,462,40 TRANSFER tl 1) / 110421 1Ill 0/20 1 VD4/2011125120 4,982.93 0.00 0.00 4,992,93 ✓ TRANSFER 11 j1 Vendor Tolal: Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 13.054.62 0.00 0.00 13,054.62 Report Summory Grand Totals: Gross Discount No -Pay Net 13.054A2 0.00 0.00 13,054.62 iF1 y3v 12 2011 i3AS.C°!N'#[Q,t9Atitlr4', `LnL'i file:///C:/Users/elieiman/cpsi/mennned.cpsinet.com/u985471data_5!tmp_ew5report3129... 11/t 5/2021 Page 1 of 1 i},dIJU 9 � _"dli 'CIO, 0AIRR9t,aar ret_Y I soa�tko1• 12:51 Vendor#i Vendor Name 12696 GULF POINTE PLAZA MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 11/25/2021 Class Pay Code 0 ap_open invoice.template Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 110121 11/0512011/0112011/25/20 2,760.06 0.00 0.00 TRANSFER MUVItN(R, VTt d4os;6; fk-h V 1.hAj' dVt Y-6L ,_,,��_ 110221 11/09/2011/02/201125120 2,856.00 0.00 TRANSFER 0 U 110221A 11/09/20 11/02/20 11/25120 18,917.80 0.00 0.00 TRANSFER rk 11 110321 11/09/20 11/03/20 11/25/20 979.82 0.00 0.00 TRANSFER II It Vendor Totals Number Name Gross Discount No -Pay 12696 GULF POINTE PLAZA 25,513.68 0.00 0.00 Grand Totals: Gross 25,613.68 Ar"a 4w (J.A!" &mrlrz x, '.s Report Summary Discount No -Pay 0.00 0.00 Net 2,760.06 2,856.00 ✓ 18,917.80 979.82 ✓ Net 26,513.68 Net 25,513.68 file:///C:/Usersleheimail/epsi/memmed.cpsinet.comlu98547/data_5/tmp_cw5 report7202... 11111 /2021 Page I of 1 MEMORIAL MEDICAL CENTER 11115/2021 0 07:47 AP Open Invoice List Dates Through: ti/2512021 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE invoice# Comment Tran Ot Inv DI Due Dt Check D Pay Gross Discount No -Pay Net 110121 11�/105/20 11/01/20 11125t20 8.531.69 0.00 0.00 8,531,60 TRANSFER �fI lh�ltM1iLf.0 � ' LtJ.(19N•4741 (A-h MWu- Ulk%- 110221A 11/U912011102/201 /2W20 7,030.48 0.00 0. 7,030.48 TRANSFER ll 11 . 1102218 1110912011/0212011125/20 927.50 0.00 0.00 92750 TRANSFER 0 11 110221 11/09/20 11/02/20 W25120 11,288.00 0.00 0.00 11,288.00 TRANSFER 1' 1� 110421 11/1 D120 11104/20 11125120 1,341.10 0.00 0.0o 1,341.10 1� TRANSFER 1t i1 Vendor Totals Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 29,118.77 0.00 0.00 29,118.77 Report Summary Grand Totals: Gross Discount No -Pay Net 29,118,77 0.00 0.00 29,11817 aw NOV 12 2011 04-74��rc.r file:/1/C:lUsers/eheiman/cpsi/memmed.cpsinet.com/u48547/data_5/tinp_cw5report7320... 1111512021 Page 1 of l r?ll� 11/11/t202 MEMORIAL MEDICAL CENTER 0 ,r18,n e:4'iS �Lii?F.Pt$y k':.'-aGia1 AP Open Invoice List ap_open_Involce.template Due Dates Through; 11/25l2021 Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran Dt Inv Dt Due Dt Check 0, Pay Gross Discount No -Pay Net 110121A 11/05120 11/01/20 11/25120 118.99 0.00 O.OD 118.99 yj TRANSFER NN inSan ut +-zlP.1N1S51�Q ih,1 11Aikt VVGW--t 110421A 11110/20 11/04/20 11125/20 9,763.78 0.00 0.00 9,763.78 TRANSFER it 11 . 1104218 11 /10/20 11/04/20 11125120 10,955.74 0.00 0.00 10.955.74 r/ TRANSFER a 'r Vendor Total: Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 20,838.51 0.00 0.00 20,838.51 Report Summary Grand Totals: Gross Discount No -Pay Net 20,838,51 0.00 0.00 20,838.51 APr"'nW aw N1011 12 2021 osiWaw AdANUM file:///C:/Users/eheiman/cpsihnenuned.cpsinet.com/u98547/data_5/tmp_cw5report5998... 11/11 /2021 for Transfer of wle Requested Payer Fam enM try: RequM&s email Rwes aphone Iwmher ladma I.Itte wAtlNub: 101— a Mmmmo M1v nmW m o bvx' Fetknl M. EU MIA NIA limm, Rrvke R IRFO 221512MI 1 B2O21 Tu@eEFrvmenl ER ER Bp�yBly_ ryvmeMeasFIR ft%W. CMANUMIllicbl Ame.w.e.e.R.b. N.eb errunesra e 127.79 149.19 R/A WA 2124.60 2,02.15 EM145462 EET6146789 NOARCUW26869 NwRNN2W69 BRWOMOORATCREEYSIOE BROAOMOORAT CREIMIOE TOiAC 181595 36698 TO Ee Nkaeut0 Memwbl Meal[9C<Oue aae vee 1 ss ae / ,apt wleeFkamre.: ae Fmmie011N: bear mggr. Ta fF[Illty: NM' P11:OYn1: ] R: 4pwR.tlwWerO.[e Yl: Raleplmmter. ArEF+oe7! Fmmfe011ry: ioiF[Illh: � AntlYRL• �lOV 15 2021 Request for Transfer of Funds nam)erP Osae NegveaNe .1111/2022 P." Nov.W NDAR W2e69 uq..Md bl; Camm Nooaer keynekhriem.0 E��o-.,w,•,,,•y�_ Pbene nnmherw.w,ah 903a7:-h412 OhWdl,Q.., Memorial Madltal Center iaalllry GaIden Creek lnlen.n.w:P.,.,.,.wavpm.nt N.m.P: .E0ee1w.:P.0 d.M yNen{Name Reh el3ervlte TveeeEPoymenl Pwment N (uMraASNnar4r ]0/2W2.21 EFi6133]G] 10657I EFi6133)6) MMA0 MS69 $ ..57 Ove W Wd., Creek from 16e 8roatlmoer Creeks 10/EW20E1 MOODS $ (8580 2fi6193375 WOAk00002069 $ 85.80 Ole Gdtlen Crek (rem the BroaO moos C.W }OTNI $ 11933) 19337 To be Nlkdam Memorial Medlnitenser. Nave ph SpMNetl by:.ewen n Nice pllranRee 1 1] oEt FmmFatllM/: IBNa moM• To iatllity: -,GO PepvMetra.le F1: R.k.eftrmMNef. wYY3P{'7�dd FmM Fa(lllly: p T.F. G3308.eNP '41"WU cSi�c:?llt' 24ut+TMI, "tlN9.N Request for Transfer of Funds Tt6nnerR: Data Requmm Payer Requerletl b, Requepolsem,l RwuLrIOYSORnne numher Olcbl[IorUunty Hdlity Pe1kM No., IBEGMA"D pu ofh 1. WAMM RAISELVIEnnta.[e TV &.,nnont Pay m[ h pr Ynneele6Nlrr Yn4el-Iar Nn![YI mm H/A WA 11/5/3021 EFT 3.1mm EFT6145462 WoRWW19S57 11].]9 THE[RESENT NA WA 11/W2M EFT 2b9115 EFT6146769 LYOARWW19557 149.19 THE[RESENT TOTAL 4815.95 I I 366.98 Toh011etl out Mem011tl MP41nIC4Men. App Re[e 11 1] 1 or 0 MFoclvlg: 11 ]] 3 ee[nnv To MRACIIN,' AmauM: � C]N`J, v NwenW ]nm[ernno M: Oele Oltnnrkn ToomwHN1Y 1 Te...t MV '� J .42I mount: A O..1r',Pz.tw c51t'AFYT ,'yl';y> �vi orte Req.lmd x1 1y/i0i1 Pa" NevNeS N0mR00001955] Re.uenetl by C.R. x..cer (fUar^=lwu fualJyoy at,ag¢M1emell efrMe pM1ene number m 903a72 84II Dhtdd.,Q. q Memmtlal Medleel Cenrm Frtlllly 6dden Oak Allenex.me E ul a o.h mUM, IRED o F. jepe.rwmxee Fii6133)6) EMM2375 hvmm�t aM6133]6) FF]619E3)5 NMRMIOS5) NMRON019557 lueare n. m.a. E. 5 Ra 185.80 S 85.60 I0k6/i@1 10/26/1021 5 106.5)1 $ I85.80 Duel. Gmd CmaNlmm)A.C.e.nl 0uel. Gddm Ree9lmm)Ae[raem _ lOTRL 5 119E3)I 19L3] ...,... .._.. ... __ )obefllletlmutb Meme.lal Madlul Gnler; ale Rem ve 1 x E Rammvea, C. Ca..111 U m 4t,m, nE ji,brl ]:1 Fmme.014. Wm¢m ).Fetllxy; enGm Pmeunb meuMNe..ml..On. q: WO.OEmr.Fen from Will, T. hdlll A .um: u�"emsPam ais NOV 15 2021 ftnilFQF'.tfOryya;. Request for Transfer of Funds rdnsrerR: pad Re9vesl<0 Poda Reques by: Rmeg.. ve RUaWl <mall RRone wmbe] DlN ., aunty ,.aiw patknextme U Pete elYrvke ]weelGevment E Pay:nyq[ fFi61I5162 NOAPOWJIBI70 �qa .mepxl 117A9 SOLfM WESINOUSTpN 3,131.BY N/A N/A 11/5/M31 fFt H1A NA 11/8/ID33 ER 2,691.25 EMM6789 MMK MIB1]B 119'. OMRAWf5THOUSMN TOTAL 1,815.95 366.98 Tabt RPe:lputb Memeaal Mtalml Rndr: ped ed 1 n 203v aa9ddd by: C wen er pad a(IFtnale:: 11'.I1i 31 MI FromiaOlid: `Toed ToiwRd: .:M amoum: WW WIlnMewmrs: p MFACmnilec Fmmclift y: IF A ..nt:: IaPYOiO^J)ID am<unl: aq MOO 15 2021 rlaa"W MINURI^., Request for Transfer of Funds Ranelerp: DO. Rol.mp.B 11/1U3021 WDARW0019110 r1P ePt[edo Payer Nwilal Ranobl:ee A6vlee end FOR Relented In, UNIna loop. pmomy Is Won aninata n weruyn.610, turnout plane omelet NO al o ppdn Wlm Re:q..e,[Tell ReAYa110h Non.n.oale number Ll:nn�•r �i mjl.tll 903d91-ee12 •pelee Y.meoeaMnan60unl AmWPymentkam MmlHlnmA6rbmubMl%IN l 9Y eMRemlkenroAdWeeW: 111,1.enN:n r n wen o WntnbprC..nW Memwbl MMInI CMter urpn Fapilhy Golden Creek More Ham. 00e05enk. tvn. ul Peumnnl ER6333767 p Int el .mlenn..a.a.b.ar IuneelawmM.l« 0/26/2021 $ 11065I ER6133767 MDAROW18170 $ 10657 Due to 6o7den Gnat from Solve Wul Homlon ID 26/3021 G.E .1 075 $ "AO EFE6143325 WDAROMMUG $ 9580 DYem Golden Cr.eklram5nl... Wen HouOYn 411992137 TOTAL 5 193.3i lla cull, Memorial Medksitenlen D 16 by: GCwen`"pefen Sr'rr) Icill,W: .nc..e- A" MTmw . .37mn o'..mn:mmbr..I.,: MOO 15 2O21 =A..nU U'fY6:eTi•; tiN11YL'41 Request for Transfer of Funds Ransler p: DM.M.tIY!!t!E vapr Re4uestedby: Re00eleMl Omeu Re9Yeswrs vnene numher OhNtt.,G fmllty EON Rduke[O: ee :4tn onr"ili4T �V9wmonpuraava_u_ mewGlmeNawm Vellent Ntme MENIM Oete OlServlte VIRFO TOG elyem:ent F r1yNLOl Xu he R en M1mhblveu:Nr rn N/A N/A 13/ 402 ER 1.1E0.80 C"619H6E NOAROBBW)986 11]]9 MH RVVNAGE N/A N/A IM202] w : 69L15 EMN6789 CVOAPOOCCOI9RE M1.19 795E VINAGE TOTAI 0.81€96 1 166.98 TO6e Nlkdoutb Memmlel Me61ra1Gnllr: @i EppmOe-nsla C. n .,.'E nrlen m F1 n ] 1 A.uft lily: Ylran ': T.F.,IIIW MM mle Ammunt '. 966.96 PrryrYetlThmlrrYG1}r Gtla oltnntler. Fram Fetlllry: 442rotl7� TO F!<IIIty: MW AmGnF. MOV 15 2021 CIUMWRn1d11106`4'. Request for Transfer of Funds Tnn[IerR: Wtl ftlu.M U121/2081 NOM0. 7985 Plem AlneM1: v+9er NWta[ gemlmnngtivlm endEOq Repueeted by Wlm NauPer gequwled++mPl tuygwxe_.mi�ertel:n[wii u,t 's Pllnne u number a S0.i-3]2A413 NPtlOPr Cnunty Memorial MedlnlCeMer Fa[IIIW GPIdM Oed ¢Ica�ylon3Ka:(o_ Iw W wmpeld Alm PoJIMName Oa)e o[SeMee IBFQVIEE➢I d) W e jyoe MPwmenl A�.Wl,l.dk....eea.m)., Pevmenl YN /Ynd. W.,[und[NI njwm21 FYT6133767 5 1106.W EFT6133)6) NOMOOCOOMRS 106.57 Ouua GOltlen GeaFfrgm iu[wn VIII e 10/26/10)1 EMU2375 $ 05.00 ER6W23)5 NDMOOWO)905 $ 05.00 PI¢10GdWM4eeM110m TY5[an VOIN e TOTAI $ 19).31 $ 193.3] TObe011edautb MemoaialMetlkal Cenmr. We Re[eM I 1 1 E] APPmYed �eYen srwnnflliry: IuuaM.. j(�\�, tl//ITV// TP h[Iltty: a to r Amdnn d. r WhPfennshrm°+N Fnmh[Illry: AmaunJA P-t; AL+P@lPJi � NOV 15 2021 GJdgF;3'dda ;iaPlygt:IF, O.1?_E:;pg4".FAAlkit.y..._`y GULF POINTE PLAZA CHECK REQUEST PAYEE Memorial Medical Center DATE: 11/15/21 "=&VAD r1011 15 2J;:1 AMOUNT $12,643.40 G/L NUMBER: REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE MEMORIAL MEDICAL CLINIC DATE: 11/15/21 �vz^:n��ncr cVuwr t - AMOUNT $830.07 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: (PAYEE ASHFORD GULF POINTE PLAZA CHECK REQUEST DATE: 11/15/21 A� �W.nl�F3M'7i1GP •u Z021 AMOUNT $6,790.13 G/L NUMBER: EXPLANATION:• PAYMENTS OWED FROM REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST AYEE BROADMOOR DATE: 11/15/21 a��sa��nn N0V 15 2021 c��za;wr,Y�ua= AMOUNT $4,914.00 G/L NUMBER: EXPLANATION: _ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST �YEE CRESCENT DATE: 11/15/21 aaa' Nov 15 ?rat AMOUNT $1,995.00 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: PAYEE FORT BEND GULF POINTE PLAZA CHECK REQUEST DATE: 11/15/2 1 Arvtr IrAM MK 14011 15 2,1t1 GhC/iCli'i� :iipfF&3s, 91.+L�!Y:'Ja•F' AAaIAYv','?4::;L6; �; AMOUNT $14,890.72 G/L NUMBER: EXPLANATION:H• PAYMENTS OWED FROM REQUESTED BY: Mayra Martinez AUTHORIZED BY: TI U n / GULF POINTE PLAZA CHECK REQUEST PAYEE SQLERA DATE: II/I5/21 ��'ftFCT�B MOO 15 2021 esuun�r �•.� AMOUNT $4,285.50 G/L NUMBER: EXPLANATION: ESHO PAYMENTS OWED FROM GPP REQUESTED BY: Mavra Ma tmnP7 AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST YEE _GOLDEN CREEK DATE, 11/1921 ss OV 15 2921 rt;zcarir."MUSAAm. AMOUNT $1,477.39 G/L NUMBER: REQUESTED BY: Mayra Ma in AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE TUSCANY DATE: 11/15/21 ,�'""Xc-Ara 4V AMOUNT $5,707 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Ma9 ra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE MEMORIAL MEDICAL CENTER DATE: 11/15/21 49 NOV 15 2021 e:,rrsrrwfr.�f�nouan AMOUNT $41,471.43 G/L NUMBER: EXPLANATION:ECHO '_ u i •W.• FROM REQUESTED BY: ayta3rtinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE MEMORIAL MEDICAL CLINIC DATE: 11/15/21 AMOUNT $2,651.03 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE SOLERA ttrt rp�, AMOUNT $7,386.50 G/L NUMBER: REQUESTED BY: Mayra Martinez AUTHORIZED BY: DATE: 11 / 15/21 GULF POINTE PLAZA CHECK REQUEST YEE GOLDEN CREEK DATE: 11/15/21 P10V 1 3 20021 CA(WH ar.o-.�inx r AMOUNT $12,737.49 G/L NUMBER; EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: Memorial Medical Center NUrsing Nome UPC Weakly Camex Transfer Prosperity Accounts 11/15/2021 q[aunt erDenlne qw Irn6Me )ea[Vr . x.mer3 ears. mN[m.oA .mmxn. a. M 1eD•an gm..Mlee. umm�mle x.Rae _ ._. �'_� PoS19.p6 9p,{a1.83 V9,3]SF9 uxw 139.i91 ]3 91r/69.ee Varian[4 Lew.In Ba.n[e MIENI4RWIQi 1Gp oo t ypp M914uQ{QIrP 33FB6 G9✓ OCT INTEREST I6.]3 f NOV INTEREST MCIMIE M "I.O.U./ne411[r, Rxlt 93,019F0 ✓ d p,6T9.De ✓y$36T]3 ✓{T,6a.99 ✓ 37,39131 f 21 131.1a OrnY B+bnQ ]7,)52A1 Vaepnee YwY3n BapMe Iwo we"GRWIC',Q, I3.05Y>9 MFOI[MFREIPYMINTTOOgOw CMER 19L37✓ MEOICMERIPAYMEWTOMMWNIC 266.9q�/ OCEINTERE91' 11.33/ NOVINTERew OEc"rPRACST ddlun Ba>n¢p[9n>Ier 6m1 23,131.I4y ��i�.i"'w. 63,916Ji fi5.e9B.66 �,333.e2 ✓ Bi.30a6 93,B50.01 Ben341Rn[C 6t'an?s V>INn[e levee In 4xMa ]WW gMERI4gOW W QIrP / ],926.26 ✓i MEDIWEREPAYMENTTOGO.M Cate. MIDIWE MPAYMEM TO 11231./ ,. MM QINIC 36699✓ OCTImERE3T =14 NOVINTUREST DEC RV eencr AdjuRR>I>N[eRf>ntlrrgml 53,e50At✓f j 39;104Ii E/]p,ODS.BO I/ 34]i1B0 f EVAul>na 36.BN54 36.Ma 54 p% 19.162.59 Veri{nro l.weln Ghrce AMEM6aOVPQp 1000) Q1pP $979.63 S/ OCEINYEREST I... NOVINKREST DECINIEAMT Adlur[ an ... A..V., , 16T62.1s y ._ 59,31LR SJSdjiLlli/30)913.p3 ✓ 111.591.E3 / 91SOs39 BrNYMYn[e 1115p1.{3 ✓ V>rirA[e h 46FT Eee.elrcNlrna WOOD AMwaaourQiarr I{.051.3Dsl.3s L [ R l + 1 LL T MEOICM!REPAYMENT70MMCONIC 1669B./ \/ 11,9iL,1 t ' 20ii S 3 B l IJ " LJ MWICMIREPAYMENTTOGENEE NCRED: EASY MF01[AREgEPAYM[HTTOOwOEN CRUK 11/16/33 70� 1923) I l MINTEREST Is 41 yy fyfi26D%1'6' `.It�111'1V R. (3 9 2 1 5 U t MOVw3EMn OECINTEAER la1 r,A'»,") _ AdiuN &bn[e/nmtler Aml 92.SPa,]e ✓ ♦;.:�1:1_si�"'[�u�oy.�) )O?A1TggNulAs — xei73693 xae: DnrymM,[r>gwrr6xm3e,Rxn Apeved: ' erWmeerdrnrn>m«vaAnr Anlh YRIM rd .CFO Nget.[aM1a[ryynl M1e>opneBYnxeaY llW )aq MME/rpTNN fe K>nnr[quR Il/1$/]62] I:IIIX WMlrir[namlNM Nl TrnaR3ummrrylipilNwmiOpVINUIL11NIlel3ummrry ll.L3)I:rp. ANH weelfyinmten\@nY Wa'nlYae werMMngmn\XWemhn\nx Fni Vov'nWa IIA}.nmru 11-14d1 d1. va{r MMCPMMQN {3�' avPrcvmW t�ryi3 ri. s'a Tnm�:gVl jga7rAy q9P/Cmrpl aPPI(anmi @I8/Camp) Aupe @MT NMpWn7.3 IIAN@I YN[COMMUHIfIRNCMIMPM])I6WItl1910L00 - 957,31 957.33 }I/8/IW1 AM(XSyMIt/PtOWQ{?�YM�ITEFfI]SfF)1t1{, - 'YV]J�,i- 9L,91fw. 3}.LSJ,FI: lfgkAB i1A0P$A{r IU!/]@1 XYMAIMOMAN MIM T31aw6]411=5l1 3U9/3@1 NGL(M XUMLNSVC MCCUIMPNT I)i609]il]9N9] HCC aj89A9 a.319.69 [I/1a1a1 WIPLOULKIt30W HUtT1[AgE[EH1FpLN G98nbA} - Illlmlal 5.90150 5.90110 tl/13/S@1 P9.il0.W - - I]/xal 0eearll IV - Cam11/lp]OEl FmnlVPupi]9CXCGUIMPML31FI11Y)b 11lYA 3f,619.0 39.62960 w,w1A3 W }ID111A9 V ]].WS.F 49,119iT ]l.Ffi.F 91MAI {V[Jiml.MlePgplWYt}MYO HA1YAf[i].td2339l1O,1t1000- ll/9%I@t HVMnN.1fNA0Hl lit[WMPMJ ]9F61 f10.]OOt]90 1V1Of20]t WIxf OUIGMMM[AIIXGp{C[Infplll I1/1]n@1 d1f3 u/anon aas Il/]Ul@I tle166 lvlinWL 1]romN mnP, , �,4.. IV4/2021 UMnUMTNGpE HCCWMPMT]maJfa JMP SVVXZI UN[MMMUNT'PLNCCWMPMi]MMM13910[N IU9/]al MYWJb 9g1Nl¢N1RC41MPMTa61a UP]WIF aNtl�fi,AlgEp6PnW tgA>O[P�PMtMt{921SYU't214YG. 1VN621 UNCMMNNpITNPLH MPMINRIU1 USH LJ29/1@t VNC COM PLHKWMPMi1MwWIl91LCM lVlnal NVMAJUINfWNGCUIM1MJ 19FMlJOLO]969U6 INS0 199/loll HUWNPCH110Hl HMLMNIMTI9 19000@7w JVd'lal WI@OUTGN HUtTJGMcwfMa "'OkUNC.MMUNIJYrIHKdN,NmI ..lI91 1 M'A I. Iv w2@I I. 1Vlin@i 619, IV12nO11 NUMSNA VJf cONCMIMPMi I9Plw MKW9J66@ gVk/1mi P2tr1/.P�apo4p_ca3ro CFNfMIW 1.1 BPAYMLNEfW1il¢9o.',. iVlaE@3 WA[OUi CAIinkHGITXGA[II IUa/2@I dim WIN. lx/1@I IXpmn MM[PORnON an/Fmw ZpatI • ,3 $➢liLtl6 a.ucemP2 aPr/WmP2 aPNtemP9 ela9ra ann xxwxnan - 9D;2Rp.vyE _-Ll.3M.F. }A8)A1- 'M'95oA0 Ui�1±6A9. 1,92fM 69]9W 1I,e61.9B - IB,222.98 316.i1 - . 9,969.W 9,969w a1,s63,)3 II.M091. 13.f033i 26,991bi 140wA9 2},fwA9 CPOxnIX1 apr/Lamµ 7nm1eL-sl¢ IDmIL3.!' mvP/cmr@ aPP/LYmP2 air/eYmo9 GMwe aPPn xx rox3an 9,261'1 - 9.1f0.80 i - a,I61.36 - 3132, 36369, - 11A11 )IL09 ifAlAh L92}j4 JAd5l6. 36.76]6 36A6 - 2.a13.R ;i91.1] . L0.1t63o 10.11630 l s.cM.w - s.w1.w n:nles If - - 6;62d 69 "n469 12,)99.9i. 1L31, 6.i1 . 1.9BG99 i.9BB.99 `BLiss.a asmf6 ✓ RIAi ISMIM ).936J6 vsW,A, MMcmRnm a ne,J 15� T.aMaNn mrr/6mµ awrcvmP2 apXIM, \YW 11',of morn xxoCAW A3;9f9ao :y.IWlf Ita)I[If\ 16A19kj' l,9i¢(f. B.M 61 I;F2.I . - L]as¢ - 2a12a¢ W.mw 46]4A0 v MGM NXIIItb 10.9A.M Is"MIS if/anal AmnlVwP in3GXCLWMPMTi1F]@6R 111DW IVSn@t UHITEONGL1NGPf MC(WMPM]]i6wM111]0]Si ll/VW NOVI]ASWLYTONHC WPMT3MW2=HQ 11/anW1 NUMANBGXA WB NUVAPME39FwidIlM2 tl/fnal XGLINNWI SVCNKUIM%AEt]904,13M]] ll/fM1i AM[NunGUPG6arocrir3[MSW]}91uail??e 1VV1@1 Amen'Vaup 1Y3[X[[WMIMi31F1SA]MlllwO tUVINI VXCWMBIVNIIP PlMKU1MPMC 1iwVH1l9tPP] WIn3V NIEANWIXLA31fCENnP3N WIMMI . ..1.1m,ECUI11F9MMI1ICw 1VJWMI UNCMMMUNIw PLX[[UIMPArtaWYtl91WJ] LIKO MUNR 11/1hnmi NOUIiu sULUSgN NUUIMPM]m6110i10gX1IPV WIN= ]U UM 61111 1111 )V1]n@I IXvmO WAtf mµcp¢nn¢n glvl/cmpl innX.r.an min (gHJp mn/eanpl wvrltbmet mrNwmM sUMe axn xn POxn¢x - lS,IOA1 - it,aw31 LA Lwn1s LwM]a$ I0%lz - IL1Fls ' iF2P1.22 4ti2.a If12v?a•. IAm1A4 'U: - DIM - 27" 11S,w - IL6RIG - 11AIa.16 Sb]l6 )9 - - 6Gn17 8,,8D.32 ' 1. CAM47 6,01,47 n,610.1 n.cM.9s - 6i] Li0L30 - 1,01.S0 / AA ! sA1A.M d 1*0513,L la,6gq 31JO21.31 WAIM UL M11 I9.I13M Ul.alb 11115/2021 Quick View Select Quick View Accounts Account Number I Name Account Type. Search All ODA Account Number Current Balance Number of Accounts: 15 $7,613,230.21 551 CAL CO INDIGENT HEALTHCARE $5.572.13 '4454 MEMORIAL MEDICAL I NH GOLDEN CREEK $81,593.88 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $535.92 2014 '4357 MEMORIAL MEDICAL S5,680,952.03 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.46 WAIVER CLEARING '4381 MEMORIAL MEDICAL 5129 491 72 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER / NH $37.752.31 BROADMOOR •4411 MEMORIAL MEDICAL $62.345.76 CENTER INH CRESCENT '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND S36,844.54 '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $111,591A3 WEST HOUSTON '2998 MMC-MONEY MARKET FUND 51,108,867.88 155013 MMC-NH BETHANY SENIOR LIVING S161,821,10 441 MMC -NH GULF POINTE PLAZA. S28,614.$2 MEDICARE/MEDICAID •5433 MMC -NH GULF POINTS PLAZA - PRIVATE PAY $115,013.18 '3407 MMC-NH TUSCANY VILLAGE $51,802.85 htlps:/lprosperity.olbanking.com/onlinaMessenger Treasury Center Select Group Groups Add Grnup Oata reported as ni Nov 15. 2U2 Available Balance Collected Balance Prior Day Bolan, W,902,616.47 $7,613,230,21 $7,727,375.4 $5,572.13 $5.572.13 $5.678.5 S178,819.34 581,593.88 524,214,E $535.92 $535.92 5535 S5,723,853.19 S5,680,952A3 S5,957,2669 S4$1.46 S431.46 $431.4 S178,247.32 S129,491.72 5132,618.2 $37,752.31 $37,752.31 $62,293.4 888.159.82 $62,345.76 $81 879 c $38,885.04 $36.844.54 $53,665.0 $114,296.25 $111,591.13 5139,186.E S 1, 108.867.88 $1,108,867.88 51,108,867.E S161,821.10 S161,821.10 514,175.2 $29.500.33 $28,614.32 5106.2 $176,268.98 $116.013.18 $99,4023 $59.595.40 $51.802.85 $46,852.5 t 1/i Memorial Medical [enter Nursing Home UPL Weekly Netion Transfer Prosperity Accounts 11/15/2021 4Mam A....t inning NUWn N9e me Nembar B52.07 6B,8Z.W 81,CBZ3i No, On4e Wlanaao/Aver SS000WHlbenemhrredm MesuWn9hame, Hart 2: Each ansaw Am 0 bate bviom P(S]W that MMC deOatlrM as open acmuar A,Tr&FTA" 11141 f`OVI 15 2021 CVUn ft,. Munam, Pendi t Ta ssel B,M.F.v Amount a Be Tranderr.d l9NunIN Selma Home 81,593.88 / 81,482.37 UsA6.1ence 82.593.80 ✓ V.ds Love in Balance 100.00 OCr INMW 1151 e/ NOVINTEREST OECINTERM Ad7uaeRlence/TnnderAmtj(%-/C��J�, B1,N1.3T Aoomvetla I -//� Anthony Ridartllan,tFO 131IS/1011 1:\NH WeeklYTnndm\xN UPI }nndn k'mmarv\]03t\Nemnber\NN NPliramter5ummary 11.1531.JY MP`e lLY]D13 R93RN36NRSi NR[DSRMi6336105R6]69l]9 31/43011 TWSIT NSIIRi]fiXCOSIEMt Nl66i6956i691]9 ll/B/;Wl R"AGIRRE T.RCD SRMt Nl66lS99Bi691]p 31/9/]OES P[NSCRSEMENTSEIMCEi1C55]3i195501691R0 SI/ID/]035 WINE OUT NEXION MIAMI AT GODEN GREEX S9,669.. 11/IW1011 GOLDENCREEXNEAITMENCDEPI22039693W[OIUS ll/l0/SOfI fWM NCCUIM]MT15180]59N 93M%]1056950 Si/3f/ID3S dM1 Rloo ]] R/l2/1013 ORPONt MMCPORNON y9P/(orMlL NN TNOWN, I o"id 0 DIPpx.P j NpP/Camp) OIPPtI PORTION i,96p,M I,S6oW 3,SSG.00 Ruma ]... - 1,636W ],9]DtiO nos 3,91d60 ]ene 66.4]9]6 - 66.inn 68.770% Ian] ✓ n.u:n IV15/2021 Quick View Select Quick View Accounts Account Number/Name Account Type Account Number Current Balance Number of Accounts: 15 $7.613.230.21 •4551 CAL CO INDIGENT 55,572,13 HEALTHCARE *4454 MEMORIAL MEDICAL / S81:593.88 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 •4357 MEMORIAL MEDICAL CENTER -OPERATING -4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER INH CRESCENT '4446 MEMORIAL MEDICAL CENTER INH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET FUND '5506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA - MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE htips:/Iprosperity.olbanking.com/onlineMessenger $535.92 S5,680,952.03 $431,46 $129,49112 S37.752.31 $62,345,76 $36,844.54 $111.591.13 S1,108,867.88 S161.821.10 S28,614.32 $115,013.18 $51,802.85 Treasury Center Select Group Groups Add Group Available Balance $7,902,616.47 $5,572.13 S178,819,34 $535,02 S5,723,853.19 5431.46 S178,24732 S37,752,31 $88,169,82 $38,885.04 $114.296.25 S1.108.867.88 S161,821,10 $29,500.33 $176.265.98 $59.595A0 Data Collected Balance $7,613,230.21 $5,572.13 $81,593.88 $538.92 S5,680,952.03 S431A6 S129,491,72 $37,752.31 $62,345.76 $36,844.64 $11159113 $1,108.867.88 S161,82110 $28,614.32 $115,013.18 S51,802.85 as of Nov 15, 202 Prior Day Balanc $7,727,375.4 $5,678--E 524.214.E S535.E S5,957,266.E S431.4 S132,818.2 $62,293.4 $81,879.< $53,665.0 S139.186.E S1,108.867.E $14,175.2 $iw2 $99,402.: $46,852 r 111 Memorial Medical Center Nursing Nome UPL Weekly HMO Transfer Prosperity Accounts 11/15/2021 Panrd, M Mee, 4dnnin IeMln) —11...0 Trandme0e ��yiEIn xqn< n,,•nt<I RH;; mm�Oul rm CY< <t a Oe nu TOOa Ee< ......ne. rah xom. _ <a,639.W 66.1A,49 ".37 ELnt Balanu 119,OIl.IB ✓ pm<e Wreln &4Rt Now ONIOEMIEIEOECHO PAYMFXTS INO Once WILL RF WRRRN EORMISAMOUNT YET) )R,9Nf0 /i01.91M0 EXROPATMGTTO MMC 1LN3.N ECNOPAYMFXTTOTOSGNY SMYSaOR LOIOIAYMLXYTOMMOIXIC a30.07 ECXOPAYMENYTOASHmm) 4TW.1),:x/ F(HOpAYM[N)TOOROA MOOR 4,11.E y fCHOPAYMENrro SOGM "S60 [MOPAYMNEI'TOdF9[FHT 1.99f.0] ✓/ EATWERE NFTUEMMCNgGR MMCIONONNOSTNATWLRF TRMPERREOIXGROR OExam MMCONIc[OIONNOfiINT WGFIRINl3ERREOIN gROR ),KIAI SOIFFKINOPOSWS ATWERETRAIl9EERREOINEGOR GdOEN gEEI[C[NONHOSTN0.TWFRFiRG115<FRREOIX GROR MIMRW "As NOVINTE ear v Atlluu Ralantt/rnM<reen Review Amount mBe Accent wUruON Panel, TnMm etlte Xunh Noma Nenaer Nwe r)w]M Dut .Tm �n cb .d Ca tlu TMa aM n &hare NW No < 3B.SOB.M - - 26,61"1, 13,61737 B Alluieu 23R1[92 Wnana NeYat]an<navonM[nunrnpAwne. Neft,2.Eaount hm0WeMerge 0JSIOOthae Noamunr. EOm RXO Wualn Balanre 200.00 "wen / ORINIFA6LT 63) ✓ NOVINICRGT OC[INIFAFST AQealpahmn(Yr<mletAmR '1M:6b.3fi.i MTA])RA!!]FFM IL)]l.11l V 'I/ v MOrowE: VV M<honYRBhaala0M1 q0 11/ISf1W{ ANH W<NIETramlenµ114RTunaln]ummaryNOitµnember{rIN UPITunRn Summv/ 1LM11.alu p Qp 011 Il/B/3031 NNB-ECHO XCMIMPMFA6003a1j 1400W22g550 ❑/8/2021 HN9-ECHOHCCIAIMPMT749NUI1440OWP9550 12/8/2021 HIS ECHO HCCLUMPMF JIM1111940000239550 11/9/2011 HIS ECHOHCCEMMPMT74600911440009229550 1IN2021 INS ECHO HCCUIMPMrl4M34ll 440W027BB6F 1l/8/2021 HIS ECHO NCCIAIMPW 74600-11 "0000128862 11/8/3021 HNB-ECHOHCCUktMlW2460034114400W228860 111012021 HIS-ECHOHCCNIMPMT246W341144000029W21 11/9/2021 NDCSWEEP FACN261 210601295403955WEFPFR 1 V9/2021 HNS'EO10 HC"lMPMTg6W1411440W0232113 11/9/2022 NOMARACHA DISK HCCIAIMPMT 9240024WW17M 11/IO12W1 NH9-ECHOHCCWMPMT7460134114400W224365 11/2012021 HN8•ECHOIICC4IMPP4T246W3411440M224368 111ID/2021 HNB - ECHO HCCIAIMPMTi4W03411 HW'W274365 I1/10/2021 AETNA HW HCCIAIMPMT 19220 V90311002022469 W12/1021 HNB'ECHOHCCWMPMT246WI411440000210MS 1 M12/2021 HIS, ECHO NCCEAIMpMr ZIM34114400002j089S 11/1212021 HNS-ECMQHCCWMPMT74MJW440000210S98 IVIV2021110MANACNADISBHCd MPM16249824200W2926 MMCPORTION TMn4FerAut TranHer-n �PPu QIPP/CMPI QIPP/CO-2 QIFPKemP3 P. QIPPT 440.46 PORNON 33.5 O ' '13.62 23,52 23.52 - 5.710.62 IBM L165.34 S,» O66 311.08 111B534 ' 623.34 31109 - 1022 62334 11,936 0 IM21 6.5670 I1,976.50 11.463.30 6.563.0 8432 11,46330 7p66.95 8932 1.429g FA86.95 - 2,450.00 1,447.19 9.633.36 5.430W ' 237,54 9,637.26 ' 35968 232.54 5,376.40 359.60 5,A6.4D _ 66,3>4A9. fifi 3 6' �`4P f h� 6 tY MMCPoRiION N".-.4Pm. v .a.{ ,...., g+ .� ' x'I`5' Tnn¢erAur Va "mnlo QIPP/CamMUE QIPP/CmnPi QIPP/fpnp2 NH 14ID/3p21 WIRFONT NMG SFRVICF54C QlpPICpmp3 by QI T PORTION Il/R/2021 D.p.A 2t,90344 IV12/2021 WPSTOFFICCONTRHCCUIMPMF222324WO321000 25,524.13 11/12/2011 HMtN HOM" SVC HCCWMPMT 04600341130132 2115W 86996 - 25,52113 2115W 666 96 2LW1 3p 5W 09 30.501.09 3L9P1.F4 90.8P2.18 91.A82,I8 1IM5/2021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number l Name Groups Account Type Add Group [ODA Data reported as of Nov 15 202 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $7,613,230.21 S7,902,616.47 $7,613,230.21 $7.727,375.4 551 CAL CO INDIGENT $5,572.13 $5,572.13 $5.572.13 $5,678.E HEALTHCARE 45 MEMORIAL MEDICAL NH GOLDEN CREEK $61,593.88 $178,819.34 $81.593.88 $24,214.E HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES S535.92 $535.92 $535.92 S535.E 2014 '4357 MEMORIAL MEDICAL CENTER . OPERATING S5.680,952.03 S5,723-,853.19 S5,B80,952.03 S5,957,266.E .4373 MEMORIAL MEDICAL CENTER . PRIVATE $431.46 5431.46 5431.A6 S431.4 WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER I NH ASHFORD $129,491.72 $178.247,32 S129,491.72 S132,818.e '4403 MEMORIAL MEDICAL CENTER/NH $37.752.31 $37,752.31 S37,752.31 $62,293.4 BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT $62,345.76 $88.169.82 $62,345.76 $81,879.< '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND S36,844.54 $38,885.04 $36,844.54 $53,665.0 '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $111,591,13 $114,296.25 $111,591,13 S139,186.9 WEST HOUSTON '2998 MMC-MONEY MARKET FUND S1,108,867.88 $1,108,867.88 $1.108.867,88 S1J08.867.E '5506 MMC-NH BETHANY SENIOR LIVING $161,821.10 $161.821.10 $161,821.10 $14,175.2 '6441 MMC -NH GULF POINTE PLAZA- $28.614.32 $29,500.33 S28.614.32 S106.11 MEDICAREIMEDICAID '5433 MMC-NH GULF POINTE S115,013.18 ✓ S176,26898 $115.013.18 $99,4022 PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE $51,802.85 $59.595.40 $51,802.85 S46,852.E https://prosperity,olbanking.com/ontineMessonger III Memorial MediCal Center Nursing Home UPL Weekly Tuscan Transfer Prosperity Accounts 11/15/2021 Y[[eunl Xunln Xam• F.W., N&E2 Each a myoress,Dooui cfan,lmramrnrnanmanamr. Natr 3: Each utta W t na, a ben Balrmv e/SIM Ilml MMC tlewnhd Fo [yen vamn,. .,I?ffifll6�t� dF5' i'aL1i 15 2021 t;t7G'gN 3Y✓ ;1Yi1IiE.7C 0.moun1M 0. Hnelnf inmlema Ea Y naNa Tca ,Be InnN 0•Iwe Nuy • Step},0f W,BR,Oa B+nY YDn[[ Il.b}BS Vnlann LUv[In B.lrn[• ]BOAS 1MENTTOMM yYP SO,a"S, NNE[ MfDICA0F0WINT a.v OGOMM M[WGIIEnfP0.YMfNTTO00IOEX LflFfX ]9)]1 //ff nGm•aa.n[Mgn.p,nmt eBsu area: ��Jff misExaa rnlhunv0l[0.[ ,an uo 1 82021 AMERIGNOUPCoAF0 &PAYMENTEE52 i a I Transfer -Out � / ,159341 113006 - 11/10/2021 WIRE OUT UNDAR ENTERPRISES. LIC 34.198.04 13/12/2022 ek1077 10.103.06 11/12/2021 Ck1076 316.21 11/12/2021 c1,1075 14,696AG 11/12/2021 8S PIAN ADMINIST NCCL WIPMT 179112OW22016 11/12/2021 Deposit MIME PORTION QIPP/Comp4 nnsfeMn gIPP/Comp1 QIPp/CamPl gIPP/[omp3 &WPse Own NN PORTION 21,436.89 6,63336 24,111 19,78M5 10,710A5 800.00 29,385.96 BB0.00 19,305.96 59,523.71 51703 85 6 633.36 10 80353 10,718.45 40,984.41 11/1512021 Quick View Select quick View Accounts Account Number / Name Account Type, Account Number Current Balance Number of Accounts: 15 $7.613,230.21 '4551 CAL CO INDIGENT $5,572.13 HEALTHCARE '4454 MEMORIAL MEDICAL NH GOLDEN CREEK $81,593.88 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 •4357 MEMORIAL MEDICAL CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING •4381 MEMORIAL MEDICAL CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL CENTERINH BROADMOOR •4411 MEMORIAL MEDICAL CENTER INH CRESCENT '4446 MEMORIAL MEDICAL CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET FUND '5506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE https:Ilprosperity.olba nking.comlonlineMessenger $535.92 $5,680.952.03 $431.46 $129.491.72 $37.752.31 $62,345.76 $36.844.54 $111,591.13 51,108,867.88 S161,821.10 $28,614,32 5115,013.18 S51.802.85'� Treasury Center Select Group Groups Atltl Group Available Balance $7,902,616.47 $5,672,13 S178,819.34 $535.92 55,723,853.19 S431.46 S178,247,32 $37,752.31 $88,169.82 $36.885.04 $114.296.25 S1,108,867.88 S161.821.10 $29,500.33 $176,268.98 $69,595.40 rcrea balance $7.613,230.21 S5,572.13 $81.593.88 $535.92 $5.680,952,03 S431.46 S129,491.72 $37,752.31 $62,345.76 $36,844.54 $111,591.13 S1108,867.88 S161,821.10 $28,614.32 $115,013.18 $51,802,85 as of Nov 15, 202 Prior Day Balanc $7,727.375.4 S5,678.E 324,214.E S535.9 S5.957266.E S431.4 S132,818.2 $62,293.1 581,879.E $53,665.0 S139,186.E S1 J08,867.E S14.175.2 $106.2 $99,402.3 $46,852.E 111 Memorial Medical Center Nursing Nome UPL Weekly NSLTransfer Prosperity Accounts 11/25/2021 e..ywm anon[ ammre to pe Fr<euns arllnnFE M.alnn rnnn.n.aw YnEYlanu 1Y.Bi1.10 Leweln Y4nu IOOW .INTrpESI nil NWINTEPEST EC1A.K i AdYE Ydirce/i leeimE 21LH9. Nn(r: nnN bdnn[ll of avH SS,Wro NVNbl nnn9/HrcllalhenuninPnom[ PPPrw[e. ' Norr Y.Felh enowthas ahmehWonee o/SIMIhnt MMCJepevfMroepvattnunl. pnNenypNb wM1 CEe El/IC/2621 , x,W 2@TW 04 t1@kv#' .f a N21 c4zuzyb,i :Zti11WXRC l:\NM WMI n.nnm\xx ullh fiuvf SIMm. VMI\ —Mbt nlfl ui4 Tnn11n5WMn4n 11,1511.01, 5� �y°yWs'4�Sl 11/e/1011 Dlpmlt 11/B/t 11/B/M101l HEALTH HUMAN 9VC HCCIAIMpMT 17460034113036I 11/0/1011 Oepmlt 11/10/2021 WIRE OUT BETHANY SENIOR LIVING, LTD 11/10/2021 Oepofit 11/12/2021 OepmH 11/12/2022 Oepmlt 11/12/1021 HEALTH HUMAN SVC HCCLAIMPMT 174WO342134162 MMCPORTION gIPP/CemPO Transfer-0ut Transfer -In gIPP/Comp! OIPP/Cemp2 gIPP/Comp3 &tepee gIPP TI NH PORTION 1,806.40 - 1,306.40 102.29 - 102.79 5.039.24 - 5,039.24 5,707.27 - 5.701.32 243,283.30 - 1.894.06 - 1,894.03 21,076,07 - 21,076.07 124,892.94 - 124,892.94 1,676.82 - 11676.82 243,283.10 d 1.695.]1 - 161.69571 11/15/2021 Quick View Select Quick View Accounts Account Number / Name Account Type. _ Account Number Current Balance Number of Accounts: 15 $7,613,230.21 '4551 CAL CO INDIGENT S5.572.13 HEALTHCARE '4454 MEMORIAL MEDICAL / $81.593.88 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL S535.92 CENTER - CLINIC SERIES 2014 '4367 MEMORIAL MEDICAL S5,680,952.03 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.46 WAIVER CLEARING •4381 MEMORIAL MEDICAL $129.49L72 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL $37.752.31 CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL $62.345.76 CENTER/NH CRESCENT '4446 MEMORIALMEDICAL S35,844.54 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL $111,591.13 CENTER l SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET 51,108,66788 FUND '5506 MMC-NH BETHANY S16L821.10 SENIOR LIVING '5441 MMC -NH GULF POINTE $28.614.32 PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $115.013.18 PLAZA -PRIVATE PAY ,3407 MMC-NH TUSCANY $51.802.85 VILLAGE https://prosperity.albanking.mm/onlineMessonger Treasury Center Select Group Groups Add Group Available Balance S7,902,616.47 $5.572.13 S178,819.34 $535.92 S5,723,853.19 S431.46 S176,247.32 $37,752.31 S88,169.82 $38,885.04 $114.295.25 $1,108.867.88 S161,821.10 $29,500.33 $176.268,98 $59.595A0 Collected Balance $7,613,230.21 $5,572.13 $81,593.68 5535.92 S5,680,952.03 S431.46 S129,491.72 S37,752.31 S62,345.76 $36.844.54 $111,591.13 S1,108,867.88 S161,821.10 $28.614.32 S115,013.18 S51,802.85 as or Nov 15, 202 Prior Day Balanc $7,727,375.4 $5,678._ $24,214.E S535.E 55,957266.5 $431.4 S132,818.2 $62,293.4 $81,879 E $53,665.0 S139,186.4 SI.108,867.E $14,175.2 $106." $99.402.? S46,852.E r m P A MEMOMAL MEDICAL CENTER 'L..HECK REQI 'SI MEMORIAL MEDICAL CENTER — &hfwj- [)ate Requested: 11/15/21 AMOUNT $35,886.09 EXPLANIATiON: AMERIGROUP Q4 QIPP t0 OUBTED By MAYRA MARTINEZ -- ----- --- - NOV 15 2021 FOR ACCT, USE ONLY r—limprest Cash nA/P,':he.d, 11 Mail Check to Vendor FiReturn Check. to Dept G/t NUMBER: 10255040 p MENADMAL AMEDICAL CENTER CHECK REQUE5,r MEMORIAL MEDICAL CENTER — 91o"Wor pate Requestej; 11/15/21 [-OR ACCT. USE ONLY nImprest Cash E[]AI'P Check ElMail Check to Vendor Return Cheek La Dept C-?arpjt,, I" I A1A.0 Ul NIT $15,050.49 (VL NUMBrp.: 10255040 EXPLANATION: AMERIGROUP Q4 QIPP Rf.Q,U rS -iffj BY: MAYRA MARTINEZ -3 I K/lEMORIAL MEDICAL CENTER "'HIECK REQUES-F MEMORIAL MEDICAL CENTER 0,11F Requested: 11/15/21 A y NOV '15 2021 AMOUNT $7,926.26 POR ACCT. USE ONLY DImprest Cash DA/P Check 11 Kfiziii Check to Vendor IE Return Check to Dept. GANUMBER: 10255040 fI CXP[ANATION; AMERIGROUP Q4 QIPP BY MAYRA MARTINEZ .. . ...... .. ------ F, A y --------- ---- .... .. — --------- IVIEN/10RIAL I"OEDICAL CENTER H IE(- K RcQl Ec,-r MEMORIAL MEDICAL CENTER — FWi—BtxA— Reque�l.tM: 11/15/21 --- — --- AMOUNT $16,979.65 VXPi AWAT[ON: AMERIGROUP Q4 QIPP FOR ACCT. USE ONLY FlImpe-t Call: []A/[> Check I] Mall C'hork to Vendor 1.1Return Chti.k W Dept GVLNUMEER: 10255040 fa 0 F. MAYRA MARTINEZ U F I) S .... ...... IN/lEMORiAll MEDICAL CENTER CHED". REQUE51 MEMORIAL MEDICAL CENTER 11/15/21 FOR A?C(,T, USE ONLY y Imp. est Cabh []A/I> Check 15 2021 PlVail Check to Vendor F. Return L" EI 111MOUNT $14,051.39 G1111 NUMBER: 10255040 -XPI -AWOION: AMERIGROUP Q4 QIPP q., MAYRA MARTINEZ E^ -- ---- N4EMOR AL MEDICAL CEN TER CHECK REQt JEST MEMORIAL MEDICAL CENTER-''TusS±vl Date Requested: 11/15/21 A 21,121 AMOUNT $10,718.45 EXPLAIVAT:ON: AMERIGROUP Q4 QIPP REQUESTED BY: MAYRA MARTINEZ FOR ACCT. 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