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2021-12-22 Meeting Packet.pdf
_ ABl Agenda Items Properly Numbered Contracts Completed and Signed Q� All 1295's Flagged for Acceptance (number of 1295's 3 ) (� All Documents for Clerk Signature Flagged On this��day ofA�2021 a complete and accurate packet for -2--2hkoff O� 2021 Commissioners Court Regular Session Day Month was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Cal Noun 6County COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOTICE OF MEETING—12/22/2021 Richard ]H . MCYer County judge David Hall, Commissioner, Precinct i 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, December 22, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. by Judge Richard Meyer 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. Happy Birthday Peggy Hall! Merry Christmas! Congratulations to Richard Parrish on his retirement. 5. Consider and take necessary action to make the attached changes to the Sick Leave Pool Policy and appoint Human Resources Administrator as the administrator of the Sick Pool. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 1 of 4 NOTICE OF MEETING— 12/22/2021 6. Consider and take necessary action to authorize Commissioner David Hall to sign a Lease/Purchase financing agreement with Welch State Bank for a 2022 Freightliner M2- 106 with Etnyre 2000-gallon Asphalt Distributor for the remaining balance of the purchase. (DH) Approved but to add that Judge Richard Meyer will sign off if needed. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Consider and take necessary action to approve the renewal option for the contract between Calhoun County and Janik Alligators LLC for the Green Lake Project Alligator Management and Nuisance Control for the contract year beginning January 1, 2022 and ending December 31, 2022 and authorize the County Judge to sign all necessary documents. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the Final Plat of Espiritu Santo Bay Resort. (GR) Terry Ruddick explained final plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve a Business Service Agreement with Infinium Broadband for the County Extension Office. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to approve the APPRISS (TX VINE) agreement for FY 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NOTICE OF MEETING— 12/22/2021 11. Consider and take necessary action regarding the bids that were received Thursday, December 9, 2021 for the Lane Road Drainage Improvements Project for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1. As the result of having a single bid, the project will need to be bid again at a future date. The unopened bid will be returned to the bidder. (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 declare the attached equipment from Veteran Services as Waste. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Consider and take necessary action to transfer the attached equipment from Justice of the Peace, Precinct 1 to IT. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action to transfer the attached equipment from the District Clerk to the Jail. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Consider and take necessary action to declare the attached equipment from the District Clerk as Surplus/Salvage. (RHM) Approve Laptop to go to IT to remove Hard Drive 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 — 12/22/2021 16. Consider and take necessary action to declare the attached equipment from the District Clerk as Waste. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 17. Accept Monthly Reports from the following County Offices: i. County Treasurer — October 2021 ii. Justice of the Peace, Precinct 4 — November 2021 iii. Tax Assessor -Collector —November 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 18. 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 19. Approval of bills and payroll. (RHM) County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Indigent 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: 10:21 A.M. Page 4 of 4 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, December 22, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 2111 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA (� The subject matter of such meeting is as follows: AT tl' I cELQ K an % Call meeting to order. '2. Invocation. 'Pledges of Allegiance. DEC 1 7 2021 COUN CLEflKNCAL UCOUNTY,TEXAS BY: 0 � General Discussion of Public Matters and Public Participation. Consider and take necessary action to make the attached changes to the Sick Leave Pool Policy and appoint Human Resources Administrator as the administrator of the Sick /Pool. (DH) `6. Consider and take necessary action to authorize Commissioner David Hall to sign a Lease/Purchase financing agreement with Welch State Bank for a 2022 Freightliner M2- 106 with Etnyre 2000-gallon Asphalt Distributor for the remaining balance of the purchase. (DH) Consider and take necessary action to approve the renewal option for the contract between Calhoun County and Janik Alligators LLC for the Green Lake Project Alligator Management and Nuisance Control for the contract year beginning January 1, 2022 and ending December 31, 2022 and authorize the County Judge to sign all necessary documents. (GR) %- Consider and take necessary action to approve the Final Plat of Espiritu Santo Bay Re ort. (GR) r Consider and take necessary action to approve a Business Service Agreement with Infinium Broadband for the County Extension Office. (RHM) Page 1 of 2 i0. Consider and take necessary action to approve the APPRISS (TX VINE) agreement for FY ��2022. (RHM) ii. Consider and take necessary action regarding the bids that were received Thursday, December 9, 2021 for the Lane Road Drainage Improvements Project for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1. As the result of having a single bid, the project will need to be bid again at a future date. The unopened bid will be returned to the bidder. (GR) tri-`Eonsider and take necessary action to declare the attached equipment from Veteran Services as Waste. (RHM) c/ 13. Consider and take necessary action to transfer the attached equipment from Justice of the Peace, Precinct 1 to IT. (RHM) k4. Consider and take necessary action to transfer the attached equipment from the District Clerk to the Jail. (RHM) i5. Consider and take necessary action to declare the attached equipment from the District Clerk as Surplus/Salvage. (RHM) T6. Consider and take necessary action to declare the attached equipment from the District Clerk as Waste. (RHM) il�Accept Monthly Reports from the following County Offices: County Treasurer — October 2021 4! II. Justice of the Peace, Precinct 4 — November 2021 Tax Assessor -Collector — November 2021 k Consider and take necessary action on any necessary budget adjustments. (RHM) J.9. Approval of bills and payroll. (RHM) Richard H. Meyer, County Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.orunder "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 #5 NOTICE OF MEETING — 12/22/2021 RiellnaTdl H. Meyer County judge David Hall, Commissioner, Precinct I Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 ][caddie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners'Court of Calhoun County, Texas will meet on Wednesday, December 22, 2021 at 10:00 a.m. in the Commissioners'Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. by Judge Richard Meyer 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. Happy Birthday Peggy Hall! Merry Christmas! Congratulations to Richard Parrish on his retirement. 5. Consider and take necessary action to make the attached changes to the Sick Leave Pool Policy and appoint Human Resources Administrator as the administrator of the Sick Pool. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 1 of 15 David E. Hall Calhoun County Commissioner, Precinct 91 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for December 22nd, 2021. Consider and take necessary action to make the attached changes to the Sick Leave Pool Policy and appoint Human Resources administrator as the administrator of the Sick Pool Sincer , Da E. Hall DEH/apt CALHOUN COUNTY SICK LEAVE POOL POLICY PURPOSE The purpose of the Calhoun County Sick Leave Pool is to provide additional sick leave days to County employees in the event of a catastrophic illness or injury, surgery, or disability that prevents an employee form active employment. Days may be applied from the Pool only after the employee has exhausted all accrued sick, vacation or compensatory time. (According to Chapter 157 Local Government Code Subchapter E) DEFINITIONS 1. A catastrophic illness or injury is defined as: A terminal, life -threatening, and/or severe condition or combination of conditions affecting the mental or physical health of the employee that requires the services of a licensed health practitioner for a prolonged period of time and that forces the employee to exhaust all accrued leave time (sick leave, vacation leave, and compensatory time) and to lose compensation from the County. 2. A licensed practitioner is: A practitioner, as a defined by the Texas Insurance Code, who practices within the scope of his/her license. ADMINISTRATION OF THE POOL 1. At the direction of the Commissioners' Court, the Director of Human Resources shall serve as the Pool Administrator. The Pool Administrator shall be responsible for developing mechanisms to transfer accrued sick leave into and out of the Pool; developing rules and procedures for the operation of the Pool; and developing forms for contributing leave to, or using leave from, the Pool. 2. The Pool Administrative Committee shall be composed of the following members: Plan Administrator, an Elected Official or Department Head, the County Auditor or a staff member, the HR Manager or a staff member, an Assistant County Attorney, and a non -supervisory employee. This committee shall be responsible for Calhoun County Commissioners Court receiving and viewing all applications for use of leave from the Pool. POOL 1. All regular full-time employees are eligible to join the Sick Leave MEMBERSHIP Pool by contributing a minimum of one day or a maximum of five days accrued sick leave. 2. New employees may join the pool after 12 months of continuous Employment. Days donated will be subtracted from their accrued leave. 3. After the Pool is established, employees will only be able to join at a time designated each year by the Pool Administrator or, in the case of new employees, immediately upon completion of 12 months of continuous service. Please notify Human Resource Director if wish to join at that time. 4. Membership enrollment forms must be submitted to the HR Department. Days donated will be subtracted from each member's accrued sick leave. Days donated become the property of the Calhoun County Sick Leave Pool and cannot be returned in the event of membership cancellation. 6. Employees on approved leave of absence will retain membership in the Pool and will not be required to donate additional days. To maintain the Sick Leave Pool, all members may donate a minimum of 1 day (8 hours) or a maximum of 5 days (40 hours) of sick leave at each open enrolment or at a time during the fiscal year designated by the Pool Administrator for general membership donations. Employees can donate up to 10 days (80 hours) at time of retirement or termination. Only one donation during the fiscal year is required to maintain membership in the Pool. Membership automatically renews each year on October 1. 8. At which anytime during the year, the Pool Administrator sees a major drop in the balance shall designate a membership drive for additional sick leave hours to be donated. Calhoun County Commissioners Court DAYS GRANTED 1. Days will be granted only for catastrophic illness or surgery or other disability, which necessitates an absence from work for five consecutive days or longer. In case of chemotherapy for cancer treatment, days can be granted after 1-4 days absence. 2. Pregnancy will not be covered by the Sick Leave Pool, but complications due to pregnancy or delivery will be considered. 3. The Pool may be used only by members for his/her personal illness or disability or for a family member whose illness and relationship to the employee meet the guidelines of the Family and Medical Leave Act and the Calhoun County Family and Medical Leave Policy. 4. Days requested for stress related illness will be granted for hospitalized days only. 5. The maximum number of days granted to an employee each year shall not exceed one-third of the total amount of time in the Pool at the time of the request or 90 days, whichever is less. 6. Days will not be axanted when an employee is receiving worker's compensation or long-term disability benefits. 7. A member of the pool, who exhausts all of his/her accrued paid leave and compensatory time to which the employee is otherwise entitled, may withdraw from the pool for a non -catastrophic illness the exact number of days the member had contributed that fiscal year. PROCEDURE 1. An eligible employee must apply to the Pool Administrator for permission to use time in Pool. 2. The Pool Administrator shall present the application to the Pool Administrative Committee, who shall determine eligibility. If the employee is determined to be eligible, the Pool Administrator shall approve the transfer of time from the Pool to the employee. The time shall be credited to the employee and shall be used in the same manner as accrued sick leave. Calhoun County Commissioners Court 4. An employee absent on sick leave assigned from the Pool is treated for all purposes as if the employee were absent on accrued sick leave. 5. If a member is critically ill and unable to file an application for sick leave from the Pool, his/her department head may submit an Application at the request of the employee's family. 6. At any time during the fiscal year, a member indicates they wish to donate some of their own time to a specific individual, the Pool Administrator and a Department Head will evaluate the request and make the necessary changes at their discretion. FINAL The Sick Leave Pool Administrative Committee shall have the final AUTHORITY approval/disapproval of employee applications and will have a decision within 5 business days of application. APPLICATION Applications for donation of accrued sick time to the Calhoun County FORMS Sick Leave Pool are available in the HR Office. Applications for withdrawal from the Calhoun County Sick Leave Pool are available in the HR Office. 0 Calhoun County Commissioners Court CALHOUN COUNTY SICK LEAVE POOL APPLICATION FOR SICK DAYS COMMITTEE DECISION FORM Name of Applicant Position Social Security Number Date Lost Time Began Number of Days Requested from Pool Request Approved by Committee Reason request denied: Signature of Committee Member / Date Signature of Committee Member / Date Date of Request Yes No Signature of Committee Member / Date Signature of Committee Member / Date Signature of Committee Member / Date Received by Pool Administrator on Signature of Pool Administrator Processed in Payroll on Signature of Payroll Manager 5 Calhoun County Commissioners Court CALHOUN COUNTY APPLICATION FOR SICK POOL DAYS NAME SS# DEPARTMENT POSITION First date absent for this illness Date returned to work or expected to return Number of days absent for this illness The above days requested are needed due to illness/injury described below: Date Signature of Employee or Family Member PLEASE RETURN THIS FORM TO THE POOL ADMINISTRATOR Calhoun County Commissioners Court CALHOUN COUNTY SICK LEAVE POOL MEMBERSHIP APPLICATION Membership in the Calhoun County Sick Leave Pool is available to all full-time employees who accrue sick leave benefits and have been employed for at least 12 months. I have read the rules and guidelines in the Calhoun County Sick Leave Pool Policy concerning the Pool and desire to become a member by donating one (1) to five (5) sick leave days to the Pool. I understand that these days, once donated to the Pool for membership, will be subtracted from my available sick leave days. All donations to the Pool become the property of the Pool and cannot be returned even upon cancellation of membership. My authorization to deduct days from my accumulated sick leave is verified by my signature below. Employee Department (Print Full Name) Social Security Number Number of days to be donated Signature Date I have read the above information concerning the County's Sick Leave Pool and I do not wish to become a member. Signature Date Social Security Number Department PLEASE RETURN THIS FORM TO THE HUMAN RESOURCE DEPARTMENT. Calhoun County Commissioners Court #6 NOTICE OF MEETING — 12/22/2021 6. Consider and take necessary action to authorize Commissioner David Hall to sign a Lease/Purchase financing agreement with Welch State Bank for a 2022 Freightliner M2- 106 with Etnyre 2000-gallon Asphalt Distributor for the remaining balance of the purchase. (DH) Approved but to add that Judge Richard Meyer will sign off if needed. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 15 David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for December 22nd, 2021. Consider and take necessary action to allow Commissioner David Hall to sign Lease Purchase financing on a 2022 Freightliner M2-106 w/Etnyre 2000 Gal. Asphault Distributer for remaining balance of purchase Sincer L Da E. Hall DEH/apt WELCH STATE BANK P.O. Box 129 396 S. Commercial Welch, Ok 74369 PH. 918-788-3373 FAX 918-788-3364 Member P D I C DATE: December 13, 2021 TO: David, Calhoun County, Pct #1 FROM: Allison, Welch State Bank REF: Lease Purchase Financing EQUIP: 2022 Freightliner M2-106 w/ Etnyre 2000 Gal. Asphalt Distributor COST less down #PMTs PAYMENT RATE $59,088.50 3 annual $21,189.91 3.47% ($218,177 less down $159,088.50) This quote is good for 30 days. First payment due in one year. Quote is subject to credit approval. $300.00 doc fee is included in proposal. Simple interest with no prepayment penalties. This quote is given for a "qualified tax-exempt obligation " within the meaning of Section 265(b)(3) of the Internal Revenue Code of 1986, if this is not a "qualified tax-exempt obligation" rate(s) will be higher. CONTRACT PRICING WORKSHEET Contract Date •. For MOTOR VEHICLES Only 11 i HT06-20 No.: 10/26/2021 Prepared: { 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. BaringAjency. {Calhoun County Contractor: iHouston Freightliner i Contec! .VerI1L ss y Y Prepared ; lAdemNeuse Peraon: my: Ph°net 1361-552-9 56 Phone: 1713-58MI48 P8": 1361-553-6664 Fax: {713-955-6282 Emali: ? m=.l s lhouncotx. amen: •.adam.neuseQstrhouston.com ProduCode; c! j DS neaodpaon; IM2-106, Conventional Cab, SBFA, SRA (PRL 20M)2(.)2.2 WN VALACXFCIMN74525 6.3147 sey, u7 i. r f � Description { Cost Description Cost 6.7 250 HP 660 LB FT TQ EIVOINE i 2408 LH/RH Electric W ndows 1 164 3500 RDS AUTO ION 33 S le 149 12,000 LB FLAT L 0 0 1 74 RS-21-230 21, An i, gac 159 21,000 LB 359 189" Wheelbase AM An ME } 218 � , Battery Disconne o r' ' 5 � RH Outboard Uncier MpTvltd Mrizuotal -AXnt&ani entM t. ffIffl. Front Tow Hooks 56 Air Cab Mounts 91 Btnyre 2000 Gallon Asphalt Distributor 138527 LED Marker Lights { 26 Subtotal From Additional Sheet(s):, Dual West Coast Minors w2H-RH Remote i 215 Subtotal B: i 152857 t: s t Description I p Cost Description � Cost MXL 17T Meritor Extbnded Luba Main Driveline ': 173 I Subtotal From Additional Sheet(s): Subtotal C: ': 173 Check: Total cost of Unpublished Options (C) cannot exceed 25% of the total of the Base Unit{ Price plus Published Options (A+B). For this transaction the percentage is: 09/( • Quantity Ordered: 1 X SubtotalofA+B+C: 216177 = SubtotalD;{ 216177 ` • ` ,' Subtotal E: 1000 1�8 Lcost Descriptioni Description 1 Cost Standard Freightliner Destination Charge 2700 Discount I •1700 i Subtotal F: i 1000 �C G i� L vx f.Nv pQ`91�,xs': �&. `s. •.7 218177 p 0M i ENNUI' �-, ,: ,•4„ g'{t, CERTIFICATE OF INTERESTED PARTIES FORM 1295 1011 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no Interested parties. CERTIFICATION OF FILING Certificate Number: 2021-832655 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Welch State Bank Welch, OK United States Date Filed: 12/14/2021 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to Mack or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 68169 Lease/Purchase Financing of Equipment 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 6 Check only if there Is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is,_QS.�S�('�-,-) jl� �)' and my date of birth i. My address is _ I declare under penalty of perjury that the foregoing is true and correct. Executed In ��((�� l y Counly, State of Ut0 (_, on the oYY�?Y'd204al—. (month) (year) ^�//�� A ll I1 WA a Signature of authorized agent of Vtracting business entity (Der.IarenO Pnrme movided 6v Ye— ck;— n........:•...:__ r--•----, •-��� ��:•:�� u�....... .... www.emms.suue.tx.Us Version V1.1.191b5cdc EQUIPMENT LEASE -PURCHASE AGREEMENT By and between Welch State Bank as Lessor and Calhoun County as Lessee Dated as of December 22, 2021 EQUIPMENT LEASE -PURCHASE AGREEMENT This EQUIPMENT LEASE -PURCHASE AGREEMENT (the "Agreement"), dated as of December 22, 2021, and entered into between Welch State Bank, P.O. Box 129, Welch, OK, 74369 ("Lessor") and Calhoun County, 211 S Anna St, Port Lavaca, TX, 77979 ("Lessee"), a political subdivision duly organized and existing under the laws of the State of Texas ("State"). WITNESSETH: WHEREAS, Lessor desires to lease the Equipment, as hereinafter described in Exhibit "A", to Lessee, and Lessee desires to lease the Equipment from Lessor, subject to the terms and conditions of and for the purposes set forth in this Agreement; and WHEREAS, Lessee is authorized under the Constitution and laws of the State of Texas to enter into this Agreement for the purposes set forth herein: NOW, THEREFORE, in considerations of the premises and the mutual covenants and agreements herein set forth, Lessor and Lessee do hereby covenant and agree as follows: ARTICLE I. Section 1.01. Definitions. The following terms will have the meanings indicated below unless the context clearly requires otherwise. "Agreement" means this Equipment Lease -Purchase Agreement and any schedule or exhibit made a part hereof by the parties hereto, together with any amendments to the Agreement made pursuant to Section 13.03 and 13.06. "Code" means the Internal Revenue Code of 1986, as amended. "Commencement Date" is the date when the term of this Agreement and Lessee's obligation to pay rent commences, which date shall be the date first above written. "Equipment" means the property described in Exhibit "A", Equipment Description, and all replacements, repairs, restorations, modifications and improvements thereof or thereto made pursuant to Section 5.04 or Article VIII. "Event of Default" means any event of default described in Section 12.01. "Issuance Year" means the calendar year in which this Agreement was entered into by Lessee and Lessor. "Lease Term" means the Original Term and all Renewal Terns. "Lessee" means the entity described as such in the first paragraph of this Agreement, its successors and its assigns. "Lessor" means the entity described as such in the first paragraph of this Agreement, its successors and its assigns. "Original Term" means the period from the Commencement Date until the end of the budget year of Lessee in effect on the Commencement Date. "Political Subdivision" means and shall include, but not be limited to, municipalities of the "State" and entities created by those municipalities. "Purchase Price" means the amount designated as such on Exhibit B hereto, together with all other amounts then due hereunder, that Lessee may, in its discretion, pay to Lessor to purchase the Equipment. "Renewal Terms" means the renewal terms of this Agreement, each having a duration of one year and a term coextensive with Lessee's budget year. "Rental Payments" means the basic rental payments payable by Lessee pursuant to Section 4.01. "Rental Payment Date" means the date upon which any Rental Payment is due and payable as provided in Exhibit B. "State" means the State of Texas. "Vendors" means the manufacturer of the Equipment as well as agents or dealers of the manufacturer from whom Lessor purchased or is purchasing the Equipment. ARTICLE H. Section 2.01. Representations and Covenants of Lessee. Lessee represents, covenants and warrants for the benefit of Lessor as follows: (a) Lessee is a political subdivision of the State duly organized and existing under the Constitution and laws of the State with full power and authority to enter into this Agreement, as specified in Texas Statutes, and the transactions contemplated hereby and to perform all of its obligations hereunder. (b) Lessee has duly authorized the execution and delivery of this Agreement by proper action by its governing body at a meeting duly called, regularly convened and attended throughout by the requisite majority of the members thereof or by other appropriate official approval, and all requirements have been met and procedures have occurred in order to ensure the validity and enforceability of this Agreement. (c) No event or condition that constitutes, or with the giving of notice or the lapse of time or both would constitute, an Event of Default exists at the date hereof. (d) Lessee has, in accordance with the requirements of law, fully budgeted and appropriated sufficient funds for the current budget year to make the Rental Payments scheduled to come due during the current budget year, and to meet its other obligations for the current budget year, and such funds have not been expended for other purposes. (e) Lessee will do or cause to be done all things necessary to preserve and keep in full force and effect its existence as a public body corporate and politic. (f) Lessee has complied with such public bidding requirements as may be applicable to this Agreement and the acquisition by Lessee of the Equipment. (g) During the Lease Term, the Equipment will be used by Lessee only for the purpose of performing essential governmental or proprietary functions of Lessee consistent with the permissible scope of Lessee's authority. The Equipment will have a useful life in the hands of Lessee in excess of the Original Term and all Renewal Terms. (h) Lessee will annually provide Lessor with current financial statements, budgets, proofs of appropriation for the ensuing budget year and other such financial information relating to the ability of Lessee to continue this Agreement as may be requested by Lessor. Should Lessor assign this Agreement, Lessee will provide updated certificates regarding the use of the Equipment and Lessee's compliance with the terns hereof. (i) Lessee will comply with all applicable provisions of the Code, including without limitation Sections 103 and 148 thereof, and the applicable regulations of the Treasury Department to maintain the exclusion of the interest components of Rental Payments from gross income taxation. (j) Lessee will use the proceeds of this Agreement as soon as practicable and with all reasonable dispatch for the purpose for which the Agreement has been entered into. No part of the proceeds of the Agreement shall be invested in any securities, obligations or other investments or used, at any time, directly or indirectly, in a manner which, if such use had been reasonably anticipated on the date of issuance of the Agreement, would have caused any portion of the Agreement to become "arbitrage bonds" within the meaning of Section 103(b)(2) or Section 148 of the Code and the applicable regulations of the Treasury Department. (k) Lessee represents and warrants that it is a governmental unit under the laws of the State with general taxing powers; the Agreement is not a private activity bond as defined in Section 141 of the Code; 95% or more of the net proceeds of the Agreement will be used for local governmental activities of Lessee; and the aggregate face amount of all tax-exempt obligations (other than private activity bonds) issued or to be issued by Lessee and all subordinate entities thereof during the Issuance Year is not reasonably expected to exceed $10,000,000. Lessee and all subordinate entities thereof will not issue in excess of $10,000,000 of tax-exempt bonds (including the Agreement but excluding private activity bonds) during the Issuance Year without first obtaining an opinion of nationally -recognized counsel in the area of tax-exempt municipal obligations acceptable to Lessor that the excludability of the interest components of Rental Payments on the agreement from gross income for federal tax purposes will not be adversely affected. Section 2.02. Certification as to Arbitrage. Lessee hereby represents as follows: (a) The Equipment has been ordered or is expected to be ordered within six months of the Commencement Date, and the Equipment is expected to be delivered and installed, and the Vendor fully paid, within one year of the Commencement Date. (b) Lessee has not created or established, and does not expect to create or establish, any sinking fund or other similar fund (i) that is reasonably expected to be used to pay the Rental Payments, or (h) that may be used solely to prevent a default in the payment of the Rental Payments. (c) The Equipment has not been and is not expected to be sold or otherwise disposed of by Lessee, either in whole or in major part, prior to the last maturity of the Rental Payments. (d) Lessee has not been notified of any listing or proposed listing of it by the Internal Revenue Service as an issuer whose arbitrage certificates may not be relied upon. ARTICLE III. Section 3.01. Lease of Equipment. Lessor hereby demises, leases and lets to Lessee, and Lessee rents, leases and hires from Lessor, the Equipment in accordance with this Agreement for the Lease Term. This Agreement shall be in effect and shall commence as of the Commencement Date. The Lease Term may be continued, solely at the option of Lessee, at the end of the Original Term or any Renewal Term for an additional Renewal Term up to the maximum Lease Term set forth in Exhibit B hereto. At the end of the Original Term and at the end of each Renewal Term until the maximum Lease Term has been completed, Lessee shall be deemed to have exercised its option to continue this Agreement for the next Renewal Term if Lessee budgets and appropriates or otherwise makes legally available funds to pay Rental Payments for such Renewal Term, unless Lessee shall have terminated this Agreement pursuant to Section 10.01. The terms and conditions during any Renewal Term shall be the same as the terms and conditions during the Original Term, except that the Rental Payments shall be as provided on Exhibit B hereto. Section 3.02. Continuation of Lease Term. It is the intent of Lessee to continue the Lease Term through the Original Term and all Renewal Terms and to pay the Rental Payments hereunder. Lessee reasonably believes that legally available funds in an amount sufficient to make all Rental Payments during the entire Lease Term can be obtained. Lessee and lessor acknowledge that appropriation for Rental Payments is a governmental function which Lessee cannot contractually commit itself in advance to perform and this Agreement does not constitute such a commitment. However, Lessee reasonably believes that moneys in an amount sufficient to make all Rental Payments can and will lawfully be appropriated and made available to permit Lessee's continued utilization of the Equipment in the performance of its essential functions during the Lease Term. Lessee will use funds appropriated for this Agreement for no other purpose than to pay the Rental Payments and other amounts due hereunder. Section 3.03. Nonappropriation. Lessee is obligated only to pay such Rental Payments under this Agreement as may lawfully be made from funds budgeted and appropriated for that purpose during Lessee's then current budget year. Should Lessee fail to budget, appropriate or otherwise make available funds to pay Rental Payments following the then current Original Term or Renewal Term, this Agreement shall be deemed terminated at the end of the then current Original Term or Renewal Term. Lessee agrees to deliver notice to Lessor of such termination at least 90 days prior to the end of the then current Original Term or Renewal Term, but failure to give such notice shall not extend the term beyond such Original Term or Renewal Term. If this Agreement is terminated in accordance with this Section, Lessee agrees to peaceably deliver the Equipment, at Lessee's sole expense, to Lessor at the location(s) to be specified by Lessor. ARTICLE IV. Section 4.01. Rental Payments. Lessee shall promptly pay Rental Payments to Lessor, exclusively from legally available funds, in lawful money of the United States of America, without notice or demand, in such amounts and on or before the applicable Rental Payment Dates set forth on Exhibit B hereto, at the address set forth on the first page hereof or such other address as Lessor or its assigns may from time to time request in writing. Lessee shall pay Lessor interest on any Rental Payment not paid on the date such payment is due at the rate of 12% per annum or the maximum amount permitted by law, whichever is less, from such date. A portion of each Rental Payment is paid as and represents payment of, interest, as set forth on Exhibit B hereto. Section 4.02. Rental Payments to Constitute a Current Expense of Lessee. Lessor and Lessee understand and intend that the obligation of Lessee to pay Rental Payments hereunder shall constitute a current expense of Lessee and shall not in any way be construed to be a debt of Lessee in contravention of any applicable constitutional or statutory limitation or requirement governing the creation of indebtedness by Lessee, nor shall anything contained herein constitute a pledge of the general tax revenues, funds or monies of Lessee. Section 4.03. RENTAL PAYMENTS TO BE UNCONDITIONAL. EXCEPT AS PROVIDED IN SECTION 3.03, THE OBLIGATIONS OF LESSEE TO MAKE RENTAL PAYMENTS AND TO PERFORM AND OBSERVE THE OTHER COVENANTS AND AGREEMENTS CONTAINED HEREIN SHALL BE ABSOLUTE AND UNCONDITIONAL IN ALL EVENTS WITHOUT ABATEMENT, DIMINUTION, DEDUCTION, SET-OFF OR DEFENSE, FOR ANY REASON, INCLUDING WITHOUT LIMITATION ANY FAILURE OF THE EQUIPMENT TO BE DELIVERED OR INSTALLED, ANY DEFECTS, MALFUNCTIONS, BREAKDOWNS OR INFIRMITIES IN THE EQUIPMENT OR ANY ACCIDENT, CONDEMNATION OR UNFORESEEN CIRCUMSTANCES. ARTICLE V. Section 5.01. Delivery, Installation and Acceptance of the Equipment. Lessee shall order the Equipment and cause the Equipment to be delivered and installed at the location specified on Exhibit A. When the Equipment has been delivered and installed, Lessee shall immediately accept the Equipment and evidence said acceptance by executing and delivering to Lessor an acceptance certificate acceptable to Lessor. Section 5.02. Enjoyment of Equipment. Lessor shall provide Lessee with quiet use and enjoyment of the Equipment during the Lease Term, and Lessee shall peaceably and quietly have, hold and enjoy the Equipment during the Lease Term, without suit, trouble or hindrance from Lessor, except as otherwise expressly set forth in this Agreement. Section 5.03. Location; Inspection. Lessor shall have the right at all reasonable times during regular business hours to enter into and upon the property of Lessee for the purpose of inspecting the Equipment. Section 5.04. Use and Maintenance of the Equipment. Lessee will not install, use, operate or maintain the Equipment improperly, carelessly, in violation of any applicable law or in a manner contrary to that contemplated by this Agreement. Lessee shall provide all permits and licenses, if any, necessary for the installation and operation of the Equipment. In addition, Lessee agrees to comply in all respects with all applicable laws, regulations and rulings of any legislative, executive, administrative or judicial body; provided that Lessee may contest in good faith the validity or application of any such law, regulation or ruling in any reasonable manner that does not, in the opinion of Lessor, adversely affect the interest of Lessor in and to the Equipment or its interest or rights under this Agreement. Lessee agrees that it will, at Lessee's own cost and expense, maintain, preserve and keep the Equipment in good repair and working order. Lessor shall have no responsibility to maintain, repair or make improvements or additions to the Equipment. Upon the request of Lessor, Lessee will enter into a maintenance contract for the Equipment with one or more Vendors. ARTICLE VI. Section 6.01. Title to the Equipment. Upon acceptance of the Equipment by Lessee, title to the Equipment shall vest in Lessee subject to Lessor's rights under this Agreement. Once all of the rental payments are made by Lessee, Lessor is divested of all right, title and interest in the equipment, and vested in Lessee. Additionally upon such instance, the terms of the lease -purchase agreement are fully performed, all obligations of the parties hereunder are terminated. Title shall thereafter immediately and without any action by Lessee vest in Lessor, and Lessee shall immediately surrender possession of the Equipment to Lessor upon (a) any termination of this Agreement other than termination pursuant to Section 10.01 or (b) the occurrence of an Event of Default. It is the intent of the parties hereto that any transfer of title to Lessor pursuant to this Section shall occur automatically without the necessity of any bill of sale, certificate of title or other instrument of conveyance. Lessee shall, nevertheless, execute and deliver any such instruments as Lessor may request to evidence such transfer. Upon termination of this Lease in accordance with Articles 3 and 12 hereof, at the election of Lessor and upon Lessor's written notice to Lessee, full and unencumbered legal title and ownership of the Equipment shall pass to Lessor, Lessee shall have no further interest therein, and Lessee shall execute and deliver to Lessor such documents as Lessor may request to evidence the passage of legal title and ownership to Lessor and termination of Lessee's interest in the Equipment. Section 6.02. Security Interest. To secure the payment of all of Lessee's obligations under this Agreement, Lessee hereby grants to Lessor a security interest constituting a first lien on the Equipment and on all additions, attachments and accessions thereto, substitutions therefor and proceeds therefrom. Lessee agrees to execute such additional documents, in form satisfactory to Lessor, which Lessor deems necessary or in form satisfactory to Lessor, which Lessor deems necessary or appropriate to establish and maintain its security interest and the security interest of any assignee of Lessor in the Equipment. Section 6.03. Personal Property. The Equipment is and will remain personal property. The Equipment will not be deemed to be affixed to or a part of the real estate on which may be situated, notwithstanding that the Equipment or any part thereof may be or hereafter become in any manner physically affixed or attached to such real estate or any building thereon. Upon the request of Lessor, Lessee will, at Lessee's expense, furnish a waiver of any interest in the Equipment from any party having an interest in any such real estate or building. ARTICLE VII. Section 7.01. Liens, Taxes, Other Governmental Charges and Utility Charges. Lessee shall keep the Equipment free of all levies, liens and encumbrances except those created by this Agreement. The parties to this Agreement contemplate that the Equipment will be used for a governmental or proprietary purpose of Lessee and that the Equipment will therefore be exempt from all property taxes. If the use, possession or acquisition of the Equipment by Lessee is nevertheless determined to be subject to taxation, Lessee shall pay when due all taxes and governmental charges lawfully assessed or levied against or with respect to the Equipment. Lessee shall pay such taxes or charges as the same may become due. Section 7.02. Insurance. At its own expense, Lessee shall cause casualty, public liability and property damage insurance to be carried and maintained in the amounts and for the coverage set forth in Exhibit G. All insurance proceeds from casualty losses shall be payable as hereinafter provided in this Agreement. Lessee shall furnish to Lessor certificates evidencing such coverage throughout the Lease Term. Alternatively, Lessee may insure the Equipment under a blanket insurance policy or policies which cover not only the Equipment but other properties. All such insurance shall be with insurers that are acceptable to Lessor, shall name Lessee and Lessor as insureds and shall contain a provision to the effect that such insurance shall not be cancelled or modified materially without first giving written notice thereof to Lessor at least 10 days in advance of such cancellation or modification. All such casualty insurance shall contain a provision making any losses payable to Lessee and Lessor as their respective interests may appear. With written consent of Lessor, Lessee may satisfy the insurance requirements of this Section 7.02 by self- insurance. Section 7.03. Advances. In the event Lessee shall fail to either maintain the insurance required by this Agreement or keep the Equipment in good repair and working order, Lessor may, but shall be under no obligation to, purchase the required insurance and pay the cost of the premiums thereof and maintain and repair the Equipment and pay the cost thereof. All amounts so advanced by Lessor shall constitute additional rent for the then current Original Term or Renewal Term and Lessee covenants and agrees to pay such amounts so advanced by Lessor with interest thereon from the due date until paid at the rate of 12% per annum or the maximum amount permitted by law, whichever is less. ARTICLE VIII. Section 8.01. Damage, Destruction and Condemnation. If (a) the equipment or any portion thereof is destroyed, in whole or in part, or is damaged by fire or other casualty or (b) title to, or the temporary use of, the Equipment or any part thereof shall be taken under the exercise or threat of the power of eminent domain by any governmental body or by any person, firm or corporation acting pursuant to governmental authority, Lessee and Lessor will cause the Net Proceeds of any insurance claim, condemnation award or sale under threat of condemnation to be applied to the prompt replacement, repair, restoration, modification or improvement of the Equipment, unless Lessee shall have exercised its option to purchase the Equipment pursuant to Section 10.01. Any balance of the Net Proceeds remaining after such work has been completed shall be paid to Lessee. For purposes of this Article, the term "Met Proceeds" shall mean the amount remaining from the gross proceeds of any insurance claim, condemnation award or sale under threat of condemnation after deducting all expenses, including attorneys' fees, incurred in the collection thereof. Section 8.02. Insufficiency of Net Proceeds. If the Net Proceeds are insufficient to pay in full the cost of any repair, restoration, modification or improvement referred to in Section 8.01, Lessee shall either (a) complete such replacement, repair, restoration, modification or improvement and pay any costs thereof in excess of the amount of the Net Proceeds, or (b) purchase Lessor's interest in the Equipment pursuant to Section 10.01. The amount of the Net Proceeds, if any, remaining after completing such repair, restoration, modification or improvement or after purchasing Lessor's interest in the Equipment shall be retained by Lessee. If Lessee shall make any payments pursuant to this Section, Lessee shall not be entitled to any reimbursement therefor from Lessor nor shall Lessee be entitled to any diminution of the amounts payable under Article IV. ARTICLE IX. Section 9.01. DISCLAIMER OF WARRANTIES. Lessee acknowledges and agrees that the Equipment is of a size, design and capacity selected by Lessee and that Lessor is neither a manufacturer nor a vendor of such Equipment. LESSOR MAKES NO WARRANTY OR REPRESENTATION, EITHER EXPRESS OR IMPLIED, AS TO THE VALUE, DESIGN, CONDITION, MERCHANTABILITY OR FITNESS FOR PARTICULAR PURPOSE OR USE OF THE EQUIPMENT OR ANY MANUFACTORER'S OR VENDOR'S WARRANTY WITH RESPECT THERETO. IN NO EVENT SHALL LESSOR BE LIABLE FOR ANY INCIDENTAL INDIRECT, SPECIAL OR CONSEQUENTIAL DAMAGE IN CONNECTION WITH OR ARISING OUT OF THIS AGREEMENT OR THE EXISTENCE, FURNISHING, FUNCTIONING OR LESSEE'S USE OF ANY ITEM, PRODUCT OR SERVICE PROVIDED FOR IN THIS AGREEMENT. Section 9.02. Vendors' Warranties. Lessor hereby irrevocably appoints Lessee its agent and attorney -in -fact during the Lease Term, so long as Lessee shall not be in default hereunder, to assert from time to time whatever claims and rights (including without limitation warranties) related to the Equipment that Lessor may have against the Vendors. Lessee's representation shall be against the Vendors of the Equipment and not against Lessor. Any such matter shall not have any effect whatsoever on the rights and obligations of Lessor with respect to this Agreement, including the right to receive full and timely payments hereunder. Lessee expressly acknowledges that Lessor makes, and has made, no representations or warranties whatsoever as to the existence or the availability of such warranties by the Vendors of the Equipment. ARTICLE X. Section 10.01. Purchase Option. Lessee shall have the option to purchase Lessor's interest in the Equipment, upon giving written notice to Lessor at least 60 days before the date of purchase except the final Rental Payment Date, at the following times and upon the following terms. (a) On the Rental Payment Dates specified in Exhibit B, upon payment in full of the Rental Payments then due hereunder plus the then applicable Purchase Price to Lessor; or (b) In the event of substantial damage to or destruction or condemnation of substantially all of the Equipment, on the day Lessee specifies as the purchase date in Lessee's notice to Lessor of its exercise of the purchase option pursuant to Article VIII, upon payment in full of the Rental Payments then due hereunder plus the then applicable Purchase Price to Lessor. ARTICLE XI. Section 11.01. Assignment by Lessor. Lessor's right, title and interest in, to and under this Agreement and the Equipment may be assigned and reassigned only in whole but not in part without the necessity of obtaining the consent of Lessee. Any assignment shall not be effective until Lessee has received written notice, signed by the assignor, of the name and address of the assignee. Lessee shall retain all such notices as a register of all assignees and shall make all payments to the assignee currently designated in such register. Lessee agrees to execute all documents, including notices of assignment and chattel mortgages or financing statements that may be reasonably requested by Lessor or any assignee to protect its interests in the Equipment and in this Agreement. Lessee shall not have the right to and shall not assert against any assignee or any claim, counterclaim or other right Lessee may have against Lessor. Section 11.02. Assignment and Subleasing by Lessee. None of Lessee's right, title and interest in, to and under this Agreement and in the Equipment may be assigned or encumbered by Lessee for any reason, except that Lessee may sublease all or part of the Equipment if Lessee obtains the prior written consent of Lessor and an opinion of nationally recognized counsel in the area of tax-exempt municipal obligations satisfactory to Lessor that such subleasing will not adversely affect the exclusion of the interest components of the Rental Payments from gross income for federal income tax purposes; except where the sub -lessee is a recognized municipality of the "State". Any such sublease of all or part of the Equipment shall be subject to this Agreement and the rights of Lessor in, to and under this Agreement and the Equipment. ARTICLE XII. Section 12.01. Events of Default Defined. Subject to the provisions of Section 3.03, any of the following events shall constitute an "Event of Default" under this Agreement: (a) Failure by Lessee to pay any Rental Payment or other payment required to be paid hereunder at the time specified herein; (b) Failure by Lessee to maintain required insurance coverage or to observe and perform any other covenant, condition or agreement on its part to be observed or performed, other than as referred to in subparagraph (a) above, for a period of 30 days after written notice specifying such failure and requesting that it be remedied is given to Lessee by Lessor, unless Lessor shall agree in writing to an extension of such time prior to its expiration; if the failure stated in the notice cannot be corrected within the applicable period, Lessor will not unreasonable withhold its consent to an extension of such time if corrective action is instituted by Lessee within the applicable period and diligently pursued until the default is corrected; (c) Any statements, representations or warranty made by Lessee in or pursuant to this Agreement or its execution, delivery or performance shall prove to have been false, incorrect, misleading or breached in any material respect on the date when made; (d) Any provision of this Agreement shall be at any time for any reason cease to be valid and binding on Lessee, or shall be declared to be null and void, or the validity or enforceability thereof shall be contested by Lessee or any governmental agency or authority if the loss of such provision would materially adversely affect the rights or security of Lessor, or Lessee shall deny that it has any further liability or obligation under this Agreement; (e) Lessee shall (i) apply for or consent to the appointment of a receiver, trustee, custodian or liquidator of Lessee, or of all or a substantial part of the assets of Lessee, (ii) be unable, fail or admit in writing its inability generally to pay its debts as they become due, (iii) make a general assignment for the benefit of creditors, (iv) have an order for relief entered against it under applicable federal bankruptcy law, or (v) file a voluntary petition in bankruptcy or a petition or an answer seeking reorganization or an arrangement with creditors or taking advantage of any insolvency law or any answer admitting the material allegations of a petition filed against Lessee in any bankruptcy, reorganization or insolvency proceeding; or (f) An order, judgment or decree shall be entered by any court of competent jurisdiction, approving a petition or appointing a receiver, trustee, custodian or liquidator of Lessee or of all or a substantial part of the assets of Lessee, in each case without its application, approval or consent, and such order, judgment or decree shall continue unstayed and in effect for any period of 30 consecutive days. Section 12.02. Remedies on Default. Whenever any Event of Default exists, Lessor shall have the right, at its sole option without any further demand or notice, to take one or any combination of the following remedial steps: (a) With or without terminating this Agreement, may declare all Rental Payments due or to become due during the Original or Renewal Term in effect when the default occurs to be immediately due and payable by Lessee, whereupon such Rental Payments shall be immediately due and payable; and (b) With or without termination of this Agreement, Lessor may enter the premises where the Equipment is located and disable the Equipment to prevent further use thereof by Lessee. In addition or alternatively, Lessor may take possession of any of all of the Equipment by giving written notice to deliver the Equipment in the manner provided in Section 12.03; in the event Lessee fails to do so within ten (10) days after receipt of such notice, Lessor may enter upon Lessee's premises where the Equipment is kept and take possession of the Equipment and charge Lessee for costs incurred in repossessing the Equipment, including reasonable attorneys' fees. Lessee hereby expressly waives any damages occasioned by such repossession. Notwithstanding the fact that Lessor has taken possession of the Equipment, Lessee shall continue to be responsible for the Rental Payments due with respect thereto during the Fiscal Year then in effect. (c) If Lessor terminates this Agreement and, in its discretion, takes possession and disposes of the Equipment or any portion thereof, Lessor shall apply the proceeds of any such disposition to pay the following items in the following order: (i) all costs (including, but not limited to, attorney's fees) incurred in securing possession of the Equipment; (ii) all expenses incurred in completing the disposition; (iii) any sales or transfer taxes; (iv) the balance of any Rental Payments owed by Lessee during the Original or Renewal Term then in effect; any disposition proceeds remaining after the requirements of the clauses (i), (ii), (iii), (iv), and (v) have been met shall be paid to Lessee; (v) the applicable Purchase Price of the Equipment and (d) Lessor may take whatever action at law or in equity may appear necessary or desirable to enforce its rights as the owner of the Equipment, and Lessee shall pay the reasonable attorney's fees and expenses incurred by Lessor in enforcing any remedy hereunder. Section 12.03. Return of Equipment; Release of Lessee's Interest. Upon termination of this Agreement hereunder prior to the payment of all Rental Payments or the applicable Purchase Price in accordance with Exhibit B: (i) Lessor may enter upon Lessee's premises where the Equipment is kept and disable the Equipment to prevent its further use by Lessee and (ii) Lessee shall promptly, but in any event within ten (10) days after such termination, at its own cost and expense: (a) perform any testing and repairs required to place the Equipment in the condition required by Section 5.04; (b) if deinstallation, disassembly or crating is required, cause the Equipment to be deinstalled, disassembled and crated by an authorized manufacturer's representative or such other service person as is satisfactory to Lessor; and (c) deliver the Equipment to a location specified by Lessor, freight and insurance prepaid by Lessee. If Lessee refuses to deliver the Equipment in the manner designated, Lessor may repossess the Equipment and charge to Lessee the costs of such repossession. Section 12.04. No Remedy Exclusive. No remedy herein conferred upon or reserved to Lessor is intended to be exclusive and every such remedy shall be cumulative and shall be in addition to every other remedy given under this Agreement now or hereafter existing at law or in equity. No delay or omission to exercise any right or power accruing upon any default shall impair any such right or power or shall be construed to be a waiver thereof, but any such right or power may be exercised from time to time and as often as may be deemed expedient. In order to entitle Lessor to exercise any remedy reserved to it in this Agreement it shall not be necessary to give any notice other than such notice as may be required in this Agreement. Section 12.05. Force Majeure. If by any reason of Force Majeure Lessee is unable in whole or in part to carry out its agreement on its part herein contained, other than the obligations on the part of Lessee contained in Article IV and Section 7.02 hereof, Lessee shall not be deemed in default during the continuance of such inability. The term "Force Majeure" as used herein shall mean, without limitation, the following: Acts of God, strikes, lockouts or other industrial disturbances; acts of public enemies, orders or restraints of any kind of government of the United States of America or the State or any of their departments, agencies or officials, or any civil or military authority; insurrections; riots; landslides; earthquakes; fires; storms; droughts; floods; or explosions. ARTICLE XIII. Section 13.01. Notices. All notices, certificates or other communications hereunder shall be sufficiently given and shall be deemed given when delivered or mailed by registered mail, postage prepaid, to the parties hereto at the addresses immediately after the signatures to this Agreement (or at such other address as either party hereto shall designate in writing to the other for notices to such party) and to any assignee at its address as it appears on the registration books maintained by Lessee. Section 13.02. Release and Indemnification. To the extent permitted by law, Lessee shall indemnify, protect, hold harmless, save and keep harmless Lessor from and against any and all liability, obligation, loss claim, tax and damage whatsoever, regardless of cause thereof, and all expenses in connection therewith (including without limitation counsel fees and expenses and any federal income tax and interest and penalties connected therewith imposed on interest received) arising out of or as the result of (a) the entering into of this Agreement, (b) the ownership of any item of Equipment, (c) the ordering, acquisition, use, operation, condition, purchase, delivery, rejection, storage, or return of any item of the Equipment, (d) or any accident in connection with the operation, use, condition, possession, storage or return of any item of the Equipment resulting in damage to property or injury to or death to any person, and/or (e) the breach of any covenant herein or any material misrepresentation contained herein. The indemnification arising under this paragraph shall continue in full force and effect notwithstanding the full payment of all obligations under this Agreement or the termination of the Lease Term for any reason. Section 13.03. Entire Agreement. This Agreement constitutes the entire agreement between Lessor and Lessee. There are no understandings, agreements, representations or warranties, express or implied, not specified herein regarding this Agreement or the Equipment leased hereunder. Any terms and conditions of any purchase order or other document submitted by Lessee in connection with this Agreement which are in addition to or inconsistent with the terms and conditions of this Agreement will not be binding on Lessor and will not apply to this Agreement. Lessee by the signature below of its authorized representative acknowledges that it has read this Agreement, understands it, and agrees to be bound by its terms and conditions. No waiver, consent, amendment, modification or change of terms of this Agreement shall bind either party unless in writing, signed by both parties, and then such waiver, consent, amendment, modification or change shall be effective only in the specific instance and for the specific purpose given. Section 13.04. Binding Effect. This Agreement shall inure to the benefit of and shall be binding upon Lessor and Lessee and their respective successors and assigns. Section 13.05. Severability. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision hereof. Section 13.06. Amendments, Changes and Modifications. This Agreement may be amended by Lessor and Lessee. Section 13.07. Execution in Counterparts. This Agreement may be simultaneously executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. Section 13.08. Applicable Law. This Agreement shall be governed by and construed in accordance with the laws of the State. Section 13.09. Captions. The captions or headings in this Agreement are for convenience only and in no way define, limit or describe the scope or intent of any provisions or sections of this Agreement. IN WITNESS WHEREOF, Lessor has executed this Agreement in its corporate name with its corporate seal hereunto affixed and attested by its duly authorized officers, and Lessee has caused this Agreement to be executed in its corporate name and attested by its duly authorized officers as of the date written above. LESSOR Welch State Bank By: Print Name: Allison McGuire Title: Assistant Vice President (SEAL) ATTEST: By: Print Name: Nissa Crossley Title: Notary Public LESSEE Calhoun By: Print Name: Richard Meve Title: County Judge EXHIBIT A TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. DESCRIPTION OF EQUIPMENT The following Equipment description is the subject of the attached Equipment Lease -Purchase Agreement. ON.. Description 1 2022 Freightliner M2-106 VIN#3ALACXFC3NDNF4525 with Etnyre 2000 Gal. Asphalt Distributor SN#58699 Together with all equipment, accessions, additions and attachments thereto. The Equipment is located at: Precinct #1 Lessee hereby certifies that the description of the Equipment set forth above constitutes an accurate description of the "Equipment", as defined in the attached Equipment Lease -Purchase Agreement. STATEMENT OF ESSENTIAL USE Please state below, or on the letterhead stationary of Calhoun County, a brief statement about why the equipment listed in Exhibit "A" has been', acquired. This statement should address the following questions: 1. What is the essential function(s) to be performed by the equipment? How long do you expect it will be used? 2. Does it replace equipment that performed this (these) same function(s)? If so, how many years was the previous equipment in use? 3. Was this equipment chosen through competitive bidding, or by another method? 4. Which internal fund will be used to make the lease payments? In answer to the above, the following is submitted: Calhoun ty P By: Richard Meyer Title: County Judge EXHIBIT B TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. RENTAL PAYMENT SCHEDULE Rate:3.479% Equipment Cost $218,177.00 LESS Down Payment $159,088.50 + Doc Fee $300.00 = $59,388.50 Date Payment Interest Principal Balance Loan 12/22/2021 59,388.50 1 12/22/2022 21,189.91 2,066.12 19,123.79 40,264.71 2 12/22/2023 21,189.91 1,400.81 19,789.10 20,475.61 3 12/22/2024 21,189.91 714.30 20,475.61 0.00 Grand Totals 63,569.73 4,181.23 59,388.50 Final payment may vary due to the actual date payments were received. Calhoun r- Meyer Title: County Judge EXHIBIT C TO EQUIPMENT LEASE -PURCHASE AGREEMENT ACCEPTANCE CERTIFICATE Welch State Bank P.O. Box 129 Welch, OK 74369 Re: Equipment Lease -Purchase Agreement, dated December 22, 2021 (the "Agreement") between Welch State Bank ("Lessor") and Calhoun County ("Lessee") Ladies and Gentlemen: In accordance with the Agreement, the undersigned Lessee hereby certifies and represents to, and agrees with, Lessor as follows: (1) All of the Equipment (as defined in the Agreement) has been delivered, installed and accepted on the date hereof. (2) Lessee has conducted such inspection and/or testing of the Equipment as it deems necessary and appropriate and hereby acknowledges that it accepts the Equipment for all purposes. (3) Lessee is currently maintaining the required insurance coverage. (4) No event or condition that constitutes, or with notice or lapse of time, or both, would constitute as Event of Default (as defined in the Agreement) exists at the date hereof. Acceptance Equipment Description: 2022 Freightliner M2-106 VIN#3ALACXFC3NDNF4525 with Etnyre 2000 Gal. Asphalt Distributor SN#58699 Calhoun C e ty C By: Richard Meyer Title: County Judge EXHIBIT D TO EQUIPMENT LEASE -PURCHASE AGREEMENT OPINION OF COUNSEL (On Counsel's Letterhead) Welch State Bank P.O. Box 129 Welch, OK 74369 As counsel for the Calhoun County ("Lessee"), I have examined duly executed originals of the Equipment Lease - Purchase Agreement (the "Agreement") dated December 22, 2021, by and between Lessee and Welch State Bank ("Lessor"), the proceedings taken by Lessee to authorize and execute the Agreement together with other related documents, and the Constitution of the State of Texas the ("State") as presently enacted and construed. Based upon said examination and upon such other examination as I have deemed necessary or appropriate, it is my opinion that: Lessee was duly organized and is validly existing under the Constitution and laws of the State as a political subdivision of the State. The Agreement has been duly authorized, executed and delivered by Lessee, pursuant to Constitutional, statutory and/or home rule provisions which authorized this transaction and Lessee's Resolution, attached as Exhibit F to the Agreement. The Agreement is a legal, valid and binding obligation of Lessee, enforceable in accordance with its terms. In the event Lessor obtains a judgment against Lessee in money damages, as a result of an event of default under the Agreement, Lessee will be obligated to pay such judgment. Lessee has complied with applicable public bidding requirements. To the best of our knowledge, no litigation is pending or threatened in any court or other tribunal, state or Federal, in any way affecting the validity of the Agreement. The signatures of the officers of Lessee which appear on the Agreement are true and genuine; we know said officers and know them to hold the offices set forth below their names. Lessee is a political subdivision within the meaning of Section 103 of the Internal Revenue Code and the related regulations and rulings. The Lessee has, in its Resolution, designated the Agreement as a "qualified tax-exempt obligation" under Section 265 (b)(3) of the Internal Revenue Code of 1986, as amended. Signature: Printed EXHIBIT E TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. CERTIFICATE OF CLERK OR SECRETARY OF LESSEE I, the undersigned, do hereby certify that I am the duly elected or appointed and acting Secretary/Clerk of the Calhoun County and I do hereby certify (i) that the officer of Lessee who executed the foregoing Agreement on behalf of Lessee and whose genuine signature appears thereon, is the duly qualified and acting officer of Lessee as stated beneath his or her signature and has been authorized to execute the foregoing Agreement on behalf of Lessee, and (ii) that the budget year of Lessee is from to Dated:By: tin li L go -r :M. / EXHIBIT F TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. RESOLUTION OF GOVERNING BODY At a duly called meeting of the governing body of the Calhoun County (the "Lessee") held on December 22, 2021, the following resolution was introduced and adopted: RESOLVED, whereas the governing body of Lessee has determined that a true and very real need exists for the acquisition of 2022 Freightliner M2-106 VIN#3ALACXFC3NDNF4525 with Emyre 2000 Gal. Asphalt Distributor SN#S8699 (the "Equipment"), Lessee desires to finance the Equipment by entering into an Equipment Lease -Purchase Agreement with Welch State Bank as Lessor and Calhoun County as Lessee (the "Agreement") according to the terms set forth in the Bid Proposal from Welch State Bank dated presented at the board meeting; and the Equipment will be used by Lessee for the purpose of: RESOLVED, whereas the governing body of Lessee has taken the necessary steps, including any legal bidding requirements, under applicable law to arrange for the acquisition of such equipment, RESOLVED, whereas the governing body hereby directs its legal counsel to review the Agreement and negotiate appropriate modifications to said Agreement so as to assure compliance with state law and local statutory law, prior to execution of the Agreement by those persons so authorized by the governing body for such purpose, BE IT RESOLVED, by the governing body of Lessee that: The terms of said Agreement are in the best interests of Lessee for the acquisition of such Equipment and the governing body of Lessee designates and confirms the following persons to execute and deliver, and to or attest, respectively, the Agreement and any related documents necessary to the consummation of the transactions contemplated by the Agreement. Name and Title of Persons to Execute and Attest Agreement: Richard Meyer, County Judge RESOLVED, Lessee covenants that it will perform all acts within its power which are or may be necessary to insure that the interest portion of the Rental Payments coming due under the Agreement will at all times remain exempt from federal income taxation under the laws and regulations of the United States of America as presently enacted and construed or as hereafter amended. Lessee hereby certifies that it has not issued or effected the issuance of, and reasonably anticipates that it and its subordinate entities shall not issue or effect the issuance of, more than ten million dollars ($10,000,000.00) of tax- exempt obligations during the 2021-2022 calendar year and hereby designates the Agreement as a "qualified tax- exempt obligation", as defined by Section 265 (b)(3) of the Internal Revenue Code of 1986, as amended. The undersigned further certifies that the above resolution has not been repealed or amended and remains in full force and effect and further certifies that the above and foregoing Agreement is the same as presented at said meeting of the governing body of Lessee. Cleric of Lessee„/rt Attachments: Related Board Minutes EXHIBIT G TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. INSURANCE REQUIREMENTS In accordance with the Equipment Lease -Purchase Agreement requirements for insurance coverage, the Lessee has instructed the insurance agent to issue: a. All Risk Physical Damage Insurance on the leased Equipment as defined in the Agreement, and in an amount at least equal to the then applicable Purchase Price of the Equipment, evidenced by a Certificate of Insurance and Long Form Loss Payable Clause naming Lessor "and/or its assigns" Loss Payee. b. Public Liability Insurance evidenced by a Certificate of Insurance naming "Lessor and/or its Assigns" as an Additional Insured and with the following minimum coverage: Equipment Description: 2022 Freightliner M2-106 VIN#3ALACXFC3NDNF4525 with Etnyre 2000 Gal. Asphalt Distributor SN#58699 $500,000.00 per person $500,000.00 aggregate bodily injury liability $300,000.00 property damage liability Insurance Agent (provide name, address and telephone number): Austin. TX 78768 512-478-8753 Proof of insurance coverage or a "Self -Insurance" Letter must be provided to Lessor prior to the time the Equipment is delivered. EXHIBIT H TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated December 22, 2021 Between Welch State Bank as Lessor and Calhoun County as Lessee. CERTIFICATE OF BANK ELIGIBILITY This Certificate of Bank Eligibility is entered into and executed by the Calhoun County as Lessee, supplementing and adding to the Equipment Lease -Purchase Agreement (the "Agreement'). Lessee hereby certifies that it has not issued or effected the issuance of, and reasonably anticipates that it and its subordinate entities shall not issue or effect the issuance of, more than ten million dollars ($10,000,000.00) of tax- exempt obligations during the 2021-2022 calendar year and hereby designates the Agreement as a "qualified tax- exempt obligation", as defined by Section 256 (b)(3) of the Internal Revenue Code of 1986, as amended. Lessee: on County r By: R chard eyer Title: County Jude INVOICE INSTRUCTIONS Please fill in below the address that invoices for the payments should t b'e sent to: Person/Department: ("d Wy,IYLi SS ,0-n 2 r l JCr t) i t yQ Name Street/P.O. Box c2p P, S Ana 5+ City, State, Zip Pnr4 La yaLc TV 7 74 7 Equipment Lease -Purchase Agreement between Welch State Bank as Lessor and Calhoun County as Lessee dated December 22, 2021 Equipment Description: 2022 Freightliner M2-106 VIN#3ALACXFC3NDNF4525 with Etnyre 2000 Gal. Asphalt Distributor SN#58699 Purchase Order or other information that must be on the invoice: Name and phone number of person to contact if payment is not received by due date: Name: OEM 1"( d 9a-t' - g a Phone Number ( ) 3& 1- S.Sa ya ,on 8038-GC Information Return for Small Tax -Exempt (Rev. octonarzoz,) Governmental Bond Issues, Leases, and Installment Sales ► Under Internal Revenue Code section 149(e) Department of the Treasury Caution: if the issue price of the Issue Is $100,000 or more, use Farm 8038-G. Internal Revenue Same, ►An toeww.rm.nnulFm-MelPf:e my lnatn,nnnne n,.n the mteet r,.r,....,ee.... OMB No. IM-0047 r issuers name 2 $suers employer khartiaaatlon number(EIN) Calhoun County 74.6001923 a Number and street (or P.O. box If mail Isn't delivered to street address) Room/sulte 211 S Anna St 4 City, town. or post office, state, and ZIP code a Report nun bar(FavIRS Use Only) Port Lavaca, TX 77979 6 Name and title of oflletr or other employee of Issuer or designated contact person wham the IRS may can For more information 1 7 Telephone number of oflloer or India representative Anna Goodman. County Clerk Be Issue price of obligation($) (see instructions) . . . . . . . . . . . . . . . . . . . to Issue date (single issue) or calendar date (consolidated). Enter date in MM/DD/YYYY format (for example, 01/0112009) (see instructions)► 1212212MI 9 Amount of the reported obligation(s) on line 8a that is: a For leases for vehicles . . . . . . . . . . . . . . . . . . . . . . . . . b For leases for office equipment . . . . . . . . . . . . . . . . . . . . . . . . c For leases for real property . . . . . . . . . . . . . . . . . . . . . . . . . d For leases for other (see instructions) . . . . . . . . . . . . . . . . . . . . . . e For bank loans for vehicles . . . . . . . . . . . . . . . . . . . . . . . . . f For bank loans for office equipment . . . . . . . . . . . . . . . . . . . . . . 9 For bank loans for real property . . . . . . . . . . . . . . . . . . . . . . . In For bank loans for other (see Instructions) . . . . . . . . . . . . . . . . . . . . I Used to refund prior issue(s) . . . . . . . . . . . . . . . . . . . . . . . . j Representing a loan from the proceeds of another tax-exempt obligation (for example, bond bank) k Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 If the issuer has designated any issue under section 266(b)(3)(1t)(i)(111) (small issuer exception), check this 11 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check this box (see instructions) . . 12 Vendor's or bank's name: Welch State Bank -------emifi-...._nnut...........................................--------- 73.0.-----..-.........---------- 13 Vendor's or bank'$ employer identifcation number: 73.o5o4eao as 63,569.73 Be 63,569.73 eb go 9d Be 9F 9 9h 9i 9j 9k box . . . . . ► 0 . . . . ► ❑ .... ---------------_- SlSignature 9 t Under penalties of onfury, I declare that I have examined this return and accompanyingg schedulas and statements, and to the best of my knowledge and lief, they are true, correct, and complete. I fuller declare that I consent to the IRS'a disclosure of the Issuer's return information, as necessary to process this return, to the person(,) that l have authorized above. and Consent ' Richard Meyer, County Judge Signature of issuer's eNM1odzed representative Data Type or print name and title Paid Pdnt/rype preparer's name Preparers Signature Data Chock El it "N Preparer U Only SB Only Fire's me.address Firm. edtlresa P Phone no. Phone no. Future Developments Who Must File pay a penalty in lieu of arbitrage rebate. See For the latest information about developments Issuers of tax-exempt governmental the instructions for line 11. later. related to Farm 8038-GC and its instructions, obligations with Issue prices of lees than Filing a consolidated return for multiple such as legislation enacted after they were $100,000 must file Form 803&GC. issues. For all tax-exempt governmental published, go to www.1rs.gov/Fcrm8038GC. Issuers of a tax-exempt governmental obligations with leave prices of less than Generallnstructions obligation with an Issue price of $100,000 or $100,000 that aren't reported on a separate Form 8038-GC,anIssuer must file a Section references are to the Internal Revenue more must fileFarm $038-G,Infornation Return for Tax -Exempt Governmental Bonds. p consolidated Information return including all such issues Issued within the calendar year. Code unless otherwise noted. FiliIssngasepareteretum for single Issue. have the option to file a separate Thus, an Issuer may file a separate Form Purpose of Form Farm 8 Forte 803&GC far anytax-exemptwith 8038-GC for each of a number of small issues Form 8038 Form Is used blithe issuers of tax- governmental obligation with an issue price of and report the remainder of small Issues Issued during the calendar year on one t governments] exempt governmentalobligations to provide the IRS with the Information required by less than $100,000. ,000. An Issuer of a tax-exempt bond used to Issues aco Form 80 issue, However, if the Issue a issue, a separate Farm monitor the is finance construction expenditures roue files G must be must b filed the IRS notice givepenalty requirements requirements of sections 141 through 150. of sections 141 separate Form GCfor far each issue to give of the election ay at of the election to pay a penalty in lieu of of notice to the IRS that an election was made to S that an arbitrage rebate. - For Paperwork Reduction Act Notice, sea instructions. Cat. No. 64106E Form 8038-GC (Rev,10-2m21) NOTICE OF MEETING — 12/22/2021 7. Consider and take necessary action to approve the renewal option for the contract between Calhoun County and Janik Alligators LLC for the Green Lake Project Alligator Management and Nuisance Control for the contract year beginning January 1, 2022 and ending December 31, 2022 and authorize the County Judge to sign all necessary documents. (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 3 of 15 Gary D. Reese County Commissioner County of Calhoun Precinct 4 December 14, 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 December 22, 2021. • Consider and take necessary action to approve the renewal option for the contract between Calhoun County and Janik Alligators LLC for the Green Lake Project Alligator Management and Nuisance Control for the contract year beginning January 1, 2022 and ending December 31, 2022 and authorize the County Judge to sign all necessary documents. L GDR/at P.O. Box 177 - Seadrift, Texas 77983 - email: earv.reese ircalhouncom.om - (361) 785-3141 - Fax (361) 785.5602 ___-- RENEWAL OPTION 4" THE CONTRACTFOR WHEREAS,, Calhoun County hereinafter called "COUNTY" and Jamk Alligators J.LC hereinafter called "JANIK" did enter into a contract dated December 30, 2019 for the CONTRACT beginning January 1, 2020 and ending December 31, 2020 In the CONTRACT, the COUNTY did grant unto JANIK the option to renew yearly upon Commissioners Court approval prior to the and date of the preceding contract and both the COUNTY' and JANIKagreeto said renewal. THEREFORE, the CONTRACT term shall be extended for an additional year, the additional year running from January 1, 2022 and continuing through December 31, 2022. COUNTY and JANIK agree that during the Additional Year, the contract will continue as written. tXECUT8131his, -2021. I,TEXAS Calhoun County, Texa 211 S Ann St, Ste 301 Port Lavaca TX 77979 Mir .•. . •IN ev ► F.. 4 �111i!eAS CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Complete No. 1- 4 and 6 if there are Interested parties. Complete Nos.1. 2, 3, 5, and 6 0 there are no Interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number. 2021-832627 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. ]anik Alligators LLC El Campo, TX United States Date Filed: 12114/2021 Name of governmentalentry at or state agency t s a parry to a contract or w cb a forms bNng filled. Calhoun County Texas Date Acknowledged: 3 Provide the Identification number used by the governmental entity or slate agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2022 2022 Greenlake Project Alligator Management and Nuisance Control 4 Name of Interested Parry City, State, Country (place of business) Nature of interest (cheek applicable) Controlling Intermediary 5 Check only if there is NO Interested Parry. ❑X 6 UNSWORN DECLARATION I ` My name is �j�L,,/ 1 ;. WA) I �"� and my date of birth is My address is (street) (dry) Iap (auney) I declare under penalty of perjury that the foregoing is true and correct. Executed in ✓" ,1 A.A— j0 N County, State of , on the day of gkL. 20_Ltj. (month) (Year) V S(gnature ofPlitharize gent o ontracting business entity Waterloo corms pruvrueu uy renew euncs Cuunnissrun www.emrrs.sta{ell(.us Version V3.1.191blicdc ■ J Landowner's Affidavit CITES TAGS STATE OF TEXAS: COUNTY OF CALHOUN: Before me, the undersigned authority, on this day personally appeared Richard H. Meyer known by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is Richard H. Meyer, I own/manage 6,461.08 acres in Calhoun County (ies), Texas, known as Calhoun County Green Lake Project located about 10 miles from Port Lavaca, Texas and lying in the Howard Keton Survey A-265; LA Guerineer Survey A-259: I & G N R R Survey A170 & A172: Joseph Timmons A-147; John Pollan A-128; Manuela Venitz A-39; Manuel Lopez A-25. I have authorized Larry W. Janik to serve as my agent from August 01, 2022 until September 01, 2022, for purposes of arranging Department surveys as deemed necessary (by TPWD) and collection of CITES TAGS allotted to me from the Texas -('arks and Wildlife Department on my behalf. Richard H. Meyer Print Name 211 S. Ann St, Suite 301 Address Port Lavaca, Texas 77979 Address Sworn Ito and subscribed before ,me by &Zk. Y , on the z2�'�•�' day of Q�-(iCf/h�t�•�5/ , 2021 , certified and wit sed by my hand and seal of official. MAE BELLE CASSEL .; My NoteryID # 132012524 Expires May 14, 2023 Notary of Public, State of Texas M ae t llC, ss�I Print Name My commission expires: Landowner's Affidavit NEST COLLECTION STATE OF TEXAS: COUNTY OF CALHOUN: Before me, the undersigned authority, on this day personally appeared Richard H. Meyer . known by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is Richard H. Meyer . I own/manage 6,461.08 acres in Calhoun County lies), Texas, known as Calhoun County Green Lake Project located about 10 miles from Port Lavaca. Texas and lying in the Howard Keton Survey A 265; LA Guerinaer Survey A-259• I & G N R R Survey A170 & A172 Joseph Timmons A 147; John Pollan A-128• Manuela Venitz A-39; Manuel Lopez A-25. I have authorized Larry W. —Janik to serve as my agent from June 01, 2022 until August 15, 2022, for purposes of arranging Department Surveys as deemed necessary (by TPWD) and collection of NEST STAMPS allotted to me from the Texas Parks and Wildlife Department on my behalf. Signature /7/- Richard H Meyer Print Name 211 S. Ann St Suite 301 Address Port Lavaca Texas 77979 Address Sworn to and subscribed before me by �/ � on the sc ZZh,J) day of �/lY C � 2024, certified and w essed by my hand and seal of official. rrr+�w� € MAEBELLECASSEL My No ID # 132012524 i:+^ Of Expires May 14, 2023 Notary of Public, State of Texas E A a t✓ del l� � ss>✓ 1 Print Name /I My commission expires: I �23 RENEWAL Contract for the Green Lake Project Alligator Management & Nuisance Control Beginning January 1, 2021 and Ending December 31, 2021 Renewal approved by Commissioners Court December 23, 2020 RENEWAL OPTION FOR THE CONTRACT FOR GREEN LAKE PROJECT ALLIGATOR MANAGEMENT & NUISANCE CONTROL THE STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County hereinafter called "COUNTY' and Janik Alligators LLC hereinafter called "JANIK" did enter into a contract dated December 30, 2019 for the CONTRACT beginning January 1, 2020 and ending December 31, 2020 In the CONTRACT, the COUNTY did grant unto JANIK the option to renew yearly upon Commissioners Court approval prior to the end date of the preceding contract and both the COUNTY and JANIK agree to said renewal. THEREFORE, the CONTRACT term shall be extended for an additional year, the additional year running from January 1, 2021 and continuing through December31, 2021. COUNTY and JANIK agree that during the Additional Year, the contract will continue as written. EXECUTED this the Z3Yd' day of _i/ _2020. COUNTY: CALH N UNTY, TEXAS I Richard H. Meyer, Cachou unty Judge Calhoun County, Texas 211 S Ann St, Ste 301 Port Lavaca TX 77979 ATTEST: AN j6DMAN, H UN COUNTY CLERK B , Deputy de El Campo TX 77437 Landowner's Affidavit Nest Collection STATE OF TEXAS; COUNT OF Calhoun Before me, the undersigned authority, on this day personally appeared Richard Me earknown by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is Richard Meyer . I manage 6461.08 acres in Calhoun County (ies), Texas, known as Calhoun County Green Lake Proiect located about 10 miles from Port Lavaca. Texas and tying in the Hnward Ttetn„ A Ica. r c,...e.. ^ Timmons A-147• John Pollan A-128 Manuela Venitz A 39 Manuel Lopez A-25 ! I have authorized Lang W. Janik to serve as my agent from June 01, 2021 until August 15, 2021, for purposes of arranging Department surveys as deemed necessary (by TPWD) and collection of nest stamps allotted to me from the Texas Parks and Wildlife D, nt on my behalf. r Signature Richard Meyer Print Name 211 S. Ann St. Address Port Lavaca Texas 77979 Sworn to and subscribed before me by :f _ on Z day of , 202-5, certified and witnessed by my hand and seal of Icial. racy MAE BELLE CASSEL MyN0kgjO#132012524 s"es.i°a E*"Meyt4.2023 Notary of Public, State of Texas e relic asscl (Print Name) My commission expires: �s) Z 3 1 Landowner's Affidavit CITES TAGS STATE OF TEXAS: COUNT OF Calhoun Before me, the undersigned authority, on this day personally appeared Richard Meyer known by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is Richard Meyer , I manage 6461.08 acres in Calhoun County (ies), Texas, known as Calhoun County Green Lake Project located about 10 miles from Port Lavaca. Texas and lying in the Howard Keton Survey A-265: LA Gueringer Survey A-259: I & G N R R Survey A170 & A172: Joseph Timmons A-147: John Pollan A-128 Manuela Venitz A-39: Manuel Lopez A-25 . I have authorized Larry W. Janik to serve as my agent from August 01, 2021 until September 01, 2021, for purposes of arranging Department surveys as deem sary (by TPWD) and collection of CITES TAGS allotted to me from the Texas Parks and Wil ife artment on my behalf. r SigAsture Richard Meyer Print Name 211 S. Ann St. Address Port Lavaca, Texas 77979 Swornto and subscribed before me by i on 2 34-A- day of , 20 2D. certified and witnessed by my hand and seal o fficiai. ,.� MAEBELLECASSEL My NotW ID # 132012524 Expkes May 14, 2023 / h -A Notary of Public, State of Texas (Print Name) My commission expires: 5 4-Z3 CONTRACT Green Lake Project Alligator Management & Nuisance Control Beginning January 1, 2020 and Ending December 31, 2020 Approved by Commissioners Court December 30, 2019 Green Lake Project Alligator Management & Nuisance Control Contract This agreement is between Janik Alligators LLC (hereinafter referred to as Janik) and Calhoun County (hereinafter referred to as County) for the management of alligators upon Calhoun County's Green Lake Project land and waters for a one-year term beginning January 1, 2020 and ending December 31, 2020, with the option to renew yearly. Janik agrees that all activities under this agreement shall be in compliance with rules established by Texas Parks and Wildlife Department and taws of the State of Texas. Jan& holds Nuisance control Alligator Permit Numbers NACP01 and NACP02 from the Texas Parks and Wildlife Department (hereinafter referred to as TWPD). Janik agrees to keep these permits current and in force at all times during the course of this agreement. Janik agrees to conduct surveys, including night count surveys and helicopter nest surveys, to effectively perform the needed alligator management and submit documentation to TPWD to secure all available alligator tags and nest stamps. All cost associated with the surveys will be the responsibility of Janik. Janik agrees to remove all alligators for which tags are received from TPWD, to remove all alligators deemed to be a nuisance, and to remove such alligator eggs as authorized by TPWD from the Green Lake Project land and waters. The County grants only Jawk and his employees authorization to enter the Green Lake Project land and waters as needed to execute this agreement. No guided hunts will be allowed on the Green Lake Project land and waters. No P party subbing of any portion of this contract will be allowed. Jam'k shall have sole rights to receive alligator nest stamps and to harvest alligator eggs from the Omen Lake Project land and waters and all costs of alligator tags and stamps shall be bome by Janik. Janik agrees to pay to the County (per bid awarded December 23, 2019) the sum of $300 for each alligator nest harvested and 50% of all funds received for each alligator harvested from the Green Lake Project land and waters prior to the end of October each calendar year. Janik agrees to pay the cost of each alligator CITES tag. Janik agrees that all equipment and supply cost associated with the harvest of alligator eggs and alligator removal will be its responsibility. Janik agrees to provide copies of all documentation and maps showing alligator nest OPS coordinates to Calhoun County or its designated agent when submitted to TPWD. A copy of the alligator documentation required by TPWD along with sales receipts for the alligators will be provided to the County at the end of each collection season and JaWk agrees to furnish the Calhoun County Auditor with any information needed to verify and confirm the payments made under this agreement. It is agreed that this agreement may be cancelled without cause by either party by providing 30 day written notice to the other party. The parties agree that this agreement shall not be changed or modified except by written agreement signed by both parties. This agreement is executed and will be performed in Calhoun County, Texas. Executed the 3e day of December, 2019 Calhoun County, Texas 211 S. Arm, Suite 301 Port Lpk—i Texas 77979 Meyer, Janik Alligators LLC 3244CR 410 Landowner's Affidavit Nest Collection STATE OF TE COUNTY OF: Before me, the undersigned authority, on this day personally appeared Richard er , known by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is Richard Meyer , I own / manage 6461.08 acres in Calhoun county Qes), Texas, known as Calhoun County Green Lake Protect located about. 10 miles from Port Lavaca. Texas and lying in the Howard L no ez A_25 I have authorized Larry W. Janik to serve as my agent from June 019 2020 until August 15, 2020, for purposes of arranging Department surveys as deemed necessary (by TPWD) and collection of nest stamps allotted to me from the Texas Parks and Wildlife Department o y behalf. ` L �t sigutme Richard Meyer Print Name F to and s cribed before , 2020, certltled 211 S. Ann. Suite 301 Addren Port Lavaca TX 77979 My commission expires:C Ali-423 Landowner's AMdavit CITES TAGS STATE OF COUNTY OF�irc...� Before me, the undersigned authority, on this day personally appeared Richard Weyer [mown by me to be a credible person, who being by me duly sworn, on oath deposes and says: "My name is appeared Richard Meyer . I manage 6"1.08 acres in oun county (ies), Texas, known as Calhoun County Green Lake Project located about i1,0 miles from Port Lavaca Texas and lying in I have authorized Larry W. Jauik to serve as my agent from August 01, 2020 until September 01, 2020, for purposes of arranging Department surveys as deemed necessary (by TPWD) and collection of CITES TAGS allotted to me from the Texas Parks and WildiifeDepartment on bebaM slgodme Richard Meyer MUMOMe 211 S. Ann, Suite 301 Adde Port Lavaca TX 77979 0 NOTICE OF MEETING— 12/22/2021 8. Consider and take necessary action to approve the Final Plat of Espiritu Santo Bay Resort. (GR) Terry Ruddick explained final plat. 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 15 Gary D. Reese County Commissioner County of Calhoun Precinct 4 December 14, 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 December 22, 2021. • Consider and take necessary action to approve the Final Plat of Espiritu Santo Bay Resort. �erely, Gary D. Reese GDR/at P.O. Box 177 —Seadrift. Texas 77983 —email: earv.reese a calhouncmx.ore — (361) 785-3141 —Fax (361) 785-5602 f i4i q t 5S5C Wa` 33u: 3vu 3-3 p n3 2 x 'HIRR 0 33 > OWN RIP a UOMP m �eO�� $8 11 d� ae"g3 N N r �a 16=APB a �oa•ooH aaoM -^ •I.0 '� 6 I � oossxsnuzx � � � V �u xl•i mos� s `o a vo9 eni m §l�e_mx� m a 8 8 ^ �] .a:Ejie..ex a em „xN,.e x s o'er~-ZI s a V I^ tl aq'^nQo w a IGWlo � -C gee •� C�",,.,� 8 ✓� ~[ os zs� „�o�e� usoii� NEN V :v of �� 'T StRlix� POOH 29]Llpssimse¢ux i�o: c a'�iz. f.z x„�Beil• b 0-1 wnsnr sns aexmas uo'us ` $ c@ y_I �Isa I. IIm ro VtiT 9z sz � - sz - a m ,89'LOS E�„49�9E.8ZN "' 2 p " a U N ai �;ea i° a�� m. � q- Age"ea may^ off°UH� m^ O 1401 M lg l n viaw A NO AO win id to E viol' 3a�3 2 y of ne nn yxF� � l �boP �' y ilk �111HFI�a 8gaemaa�s �y g �Q HIM, g Cog Op O E _la; Iy av6'��s@g S2 Oy I. nn 48 qz �y o=s.` €Pa HEW ss� x a z Nor =s A OW aka € " �. fi' Sq 7' 8 P xtt`� OR' pS 'g4§a� `ryq"+Lni7 RogY d age g n�,§� "i GEa �fi,n Cal ial *� v w #9 NOTICE OF MEETING — 12/22/2021 Consider and take necessary action to approve a Business Service Agreement with Infinium Broadband for the County Extension Office. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 15 Infinium Broadband Business Service Agreement Welcome to Infinium and thank you for using Infinium's products, equipment and services (the "Services"). The Services are provided by Infinium, a division of Victoria Electric Cooperative, Inc. ('NEC"), located at 5502 US Highway 59, Victoria, Texas 77905. All notices required under the Terms should be sent to the following: Inriniumsuoporili)victorlgelgctyic.coop (361) 582-5550 The Infinium Terms of Service (the "Terms") means the terms specified in this document and any accompanying policies incorporated into the Terms. By agreeing to the Terms, you represent that you are at least eighteen years old and capable of entering into a legally binding agreement on behalf of yourself and others in your residence that may use the Services. By signing up for or using the Services, you agree to the Terms. 1. The Services (a) Internet Service. Infinium provides a number of service plans for Internet access (the "Service Plan" or "Service Plans"). The various Service Plans have their own rates, terms, and conditions. Information about the Service Plans can be found at hupt!rwww.(nfmium coog or at httoa/www.victorinelectric.c000. (b) Equioment. Infinium guarantees to support the Services to Customer's premises through the duration of the Residential Service Agreement. In order to carry out this support, Infinium shall install, maintain, service, operate and upgrade on the premises cable and fiber optic line, internal wiring, amplifiers, routers, converters and other equipment necessary for the provision of the Services ("Equipment"). Except for all internal wiring which resides within the Customer premise as of the date of installation (`Internal Unit Wiring"), the Equipment will be owned by and remain the property of Infinium, whether or not attached to or incorporated in the Premises, and Customer will not have or obtain any right, title or interest therein. It is Customer's responsibility to return any and all external equipment to Infinium (i.e. converters, routers, set top boxes, etc.). Customer will be responsible for the cost of any and all unretumed equipment. The Equipment fees are subject to change and can be found at hap:: www Infinium coop or http;,+rwww,vigMrhmlgctric coop. From time to time, Infinium may offer equipment that you may purchase in connection with the Services under separate terms to be provided with such equipment. (c) Software. Customer authorizes Infinium to install software upgrades on any Equipment provided by Infinium. Customer also agrees not to use the Infinium Equipment for any purpose other than using the Services. Any and all software provided by Infinium is the property of Infinium and/or its suppliers and licensors. Infinium hereby grants customer a nonexclusive, nontransferable license to install and use on Subscriber's computers, devices, and/or system(s) the software for use solely in connection with the Internet Service. Customer's license to use any software provided by Infinium and its suppliers and licensors is contingent upon customers compliance with all use and other restrictions contained in the Service Agreement. It is a material breach for Customer to copy, duplicate, reverse engineer or in any way modify, change, tamper with or interfere with any software provided to customer by Infinium. Upon any termination or expiration of the Service Agreement or the disconnection of customers Internet Service, this license will terminate and customer agrees to then destroy all copies of the software that were delivered to customer (including by erasing and deleting the software from customer's computer system). (d)Construction and Installation. Infinium provides the construction and installation ofequipment necessary to deliver the Services. Construction and installation fees are subject to change. Construction means the connection from the Infinium network to the Network Jack attached to the exterior of your residence. Installation means running the Fiber Cables from the Network Jack to the Network Box in the interior of your residence. Basic Installation includes attaching the receiver, transitioning the cables from the exterior wall (Network Jack) through the interior wall to the Network Box placed close tothe transition point. Advanced and custom installations will require payment ofadditional fees. Infinium will only begin construction and installation of equipment after you have been informed of the fees, including any applicable credits or rebates; and authorized the work to begin. Infinium may allow repayment of construction or installation fees in installments. (e) Installation of Equipment. You agree to provide Infinium with all necessary access to the premises at the address you signed up for the Services so that the equipment necessary to receive the Services may be installed and configured. You agree that Infinium may install equipment on the exterior and interior of buildings on your premises (including but not limited to laying underground conduit and/or affixing equipment to the outside of buildings on your premises) at any reasonable location. You also agree that Infinium may use, and that you have the necessary permissions to approve Infinium's use of, existing facilities, including existing wiring in and around your residence, to complete the installation services. If you rent or otherwise do not own the premises, you may be asked to provide written evidence that you have received all permissions necessary for Infinium to perform installation services. If Infinium incurs any costs or losses, including attorneys' fees, because you did not get the necessary authorization(s) for Infinium to install the equipment required for the Services, you are responsible for reimbursing Infinium for those costs or losses. Acceptance of the Terms does not guarantee that Infinium will install or provide any Services. We may require a separate agreement with you or your landlord in order to install the Services. (g) Service Requests. You may call (361) 582-5550 to report any service problems. If the problem cannot be solved over the telephone, a service order will typically be scheduled within forty-eight hours of the initial call. Service calls for service impairment are at no additional charge unless the resolution is related to equipment or set-up not provided by Infinium which will be billed at $75.00 first hour and additional hours at $50.00 perlhour. Customer negligence, custom hook-ups or customer convenience related to routine operation of Service. Infinium assumes no responsibility for the quality or condition of the receiver (TV set) used or any other Customer Equipment. 2. Term, Automatic Renewal, and Cancellation (a) Tenn. The Services require a (12) month initial term (the "Minimum Service Tenn"). Unless you notify Infinium that you wish to cancel the Services, Infinium will automatically renew the Services on a month to month basis at the applicable rate in effect at the time. (b) Cancellation by You. You may cancel the Services at any time for any reason by notifying Infinium in writing or via email. Your notice is effective thirty (30) days after Infinium receives it. If the Services are cancelled prior to the end of the Minimum Service Term, you shall pay the lump sum amount for the months remaining on the Service Plan in place. You shall also pay all other fees and charges accrued or otherwise payable under the Terms. (c) Termination by Infinium. Infinium may cancel your Services if you fail to pay amounts owing when due, breach any of the terms of this Agreement, or for any other business reason. For a termination in accordance with this paragraph, you remain liable for all unpaid fees and other charges accrued or otherwise payable under the Terms. (d) Payment upon Cancellation. You understand that you will incur fees and charges as a result of your receipt and use of the Services. You also understand that you are required to pay the full amount of the Minimum Service Term. By giving Infinium your credit or debit card account information at any time, you authorize Infinium to apply this method of payment, in accordance with applicable law, to satisfy any and all amounts due upon cancellation. 3. Billing and Payment In return for receiving the Services, you promise to pay Infinium as follows: (a) Recurring Charges. You will pay in advance, at our rates in effect at the time, for all Services ordered by you or anyone who uses the Equipment or who uses the Services, with or without your permission, until the Services are canceled. The outstanding balance is due in full each month. Infinium may, in its discretion, accept partial payments, which will be applied to the oldest outstanding statement. No "paymentin full" notation or other restrictive endorsement written on your payments will restrict Infinium's ability to collect all amounts owing to Infinium. If you do not pay by the invoice date, Infinium may reduce your Services to a minimum service level, at rates in effect at the time, restrict the availability or renewability of your Services options, require immediate payment for Services ordered, or deactivate your Services. (b) Disconnection/Reconnection. If payment is not received within twenty (20) days after the invoice date, lnfiinium will reduce your services for ten (10) days to two (2) megabits per second. If payment is not received following the reduced services period, Infinium reserves the right to disconnect service. Disconnected accounts have a reconnection fee of $20.00 plus payment of past due balances. Infinium may require a deposit before activating your Service. The amount of the deposit will not exceed one- year monthly fees. (c) Taxes. You will pay all state and local taxes or other governmental fees and charges, if any, which are assessed including any such taxes, fees or charges assessed against discounted fees or service credits. (d) Construction. Installation and Other Administrative Fees. Infinium will charge fees that arise in specific circumstances to those customers responsible for them. These fees include construction, installation, activation, additional equipment, late charges, change of service charges, deactivation, and returned payment. This list is not exclusive, and Infinium reserves the right to modify these fees to charge additional fees. These fees, and any other applicable fees, maybe reviewed at httpllwww.lnfinium.cooe or at http::4!www.victoriaelectric.c000. (e) Billing Statements. Infinium will send you a statement for each billing cycle. If deposits are required it will need to be paid up front. Customer will be required to pay first month up from for first month service. Installation services will need to be paid upfront. FTH packages can have prorated amounts from the date of sign up for Aid to Construction cost to your cycle billing in addition to your package amount for duration of 12 months. Every month there after you will be billed your Infinium package amount. The statement will show: (I) payments, credits, purchases and any other charges to your accounts, (2) the amount you owe Infinium and (3) the payment invoice date. (0 Billing. Disputes. If you have questions, you must contact Infinium within 30 days of receiving the statement in question. Undisputed portions of the statement must be paid by the invoice date to avoid possible reduction or deactivation of the Services. (g) Collection Costs. If you fail to pay any amounts you owe Infinium you may be subject to collections by Infinium or your account may be referred to a third- party collection agency. To the extent permitted by law, you will pay Infinium any costs and fees Infinium reasonably incurs to collect amounts you owe. 4. Acceptable Use Policy -Use of Infinium's Broadband Internet Services is subject to the following Acceptable Use Policy. Customer agrees not to use or attempt to use, or allow third parties to use or attempt to use, the Services provided to Customer for any of the following purposes, whether by transmission or storage: (a) To use any Infinium equipment for anything other than its intended purpose; (b) To violate or encourage the violation of the legal rights of others; (c) For any unlawful, invasive, infringing, defamatory, or fraudulent purpose; (d) To intentionally distribute viruses, worms, Trojan horses, corrupted files, hoaxes, or other items of a destructive or deceptive nature; (e) To operate servers for commercial purposes other than personal, non-commercial use of servers that complies with this policy including using virtual private networks (VPN) to access services in Customer's home and using hardware or applications that include server capabilities for uses like multi -player gaming, video-conferencing, or home security systems; (f) To generate or facilitate sending unsolicited bulk commercial email or spam email; (g) To resell or repackage, with or without charge, the Services for use by individuals other than those with whom Customer shares his or her residence. The Infinium service is sold for end users only and Customer agrees not to use the Service for operation as an Internet Service Provider or for a Web Hosting enterprise or to provide services to a third party in any manner or through any direct or indirect arrangement. If Customer wishes to use the Services to provide internet service to others, Customer must enter a separate agreement with Infinium that specifically authorizes Customer to do so; (h) To interfere with the use ofthe Services or the equipment used to provide the Services; and (i) To alter, disable, interfere with, or circumvent any aspect of the Services, including but not limited to security features of the Services. Examples of system or network security violations include, without limitation, the following: (1) Unauthorized access to or use of data, systems or networks, including any attempt to probe, scan or test the vulnerability of a system or network or to breach security or authentication measures without express authorization of the owner of the system or network; (2) Unauthorized monitoring of data or traffic on any network or system without express authorization of the owner of the system or network; (3) Interference with service to any user, host or network including, without limitation, mail bombing, flooding, deliberate attempts to overload a system and broadcast attacks; or (4) Forging of any TCP-IP packet header or any part of the header information in an email or a newsgroup posting. Customer is responsible for all activity on the Services provided to Customer by Infinium, whether such activity is undertaken by Customer or someone else. If Customer uses Services in a residence or other location not owned or controlled by Customer, third -party agreements may exist which impact the Services. Infinium is not a party to such agreements and therefore is not responsible for nor bound by such agreements. If Infinium determines that the address at which Customer receives Services is not associated with the type of premises contracted for within Customer's Service Agreement, Infinium may require Customer to transition to another type of account in order to continue providing Services. This transition may include an increase in fees for the Services. Failure to comply with this provision may result in suspension and/or termination of the Services. Infinium reserves the right to modify this Acceptable Use Policy at any time, effective upon posting of the modified Policy to this URL: http:i www,infinium.coon. Infinium Broadband Service may not be available in all areas. S. Resale and Redistribution services are intended for the personal use of Customer and other occupants and guests within your residence. Customer agree not to resell or repackage the Services or otherwise make them available to anyone outside of your Residence. 6. Security Infinium makes an effort to keep its network secure, but no network security is perfect. Customer is responsible for implementing appropriate security measures when using the Services, including taking whatever steps are necessary to ensure that your data is not accessed by unauthorized third parties. Infinium is not responsible for any damages to users of the Services that may be caused by unauthorized third parties. You agree to take reasonable measures to protect the security of your computer, including maintaining at your cost an up-to-date version of anti -virus and/or firewall software to protect your computer from malicious code, programs or other internal components. You are solely responsible for the security of any device connected to the Service, including any data stored on that device. You shall take all necessary steps to avoid actions that result in the abuse of a resource on the network. Examples of abuse of resources include without limitation: open news servers, open SMTP servers, unsecure wireless routers, and unsecure proxy servers. In the instance when the Customer is using a wireless router, Infinium requires that any wireless network be secure and encrypted. Open, unencrypted wireless networks are strictly prohibited. Should an issue arise, Customer is required to address the problem in a timely fashion. Failure to address an issue after notification will be considered a violation of this Acceptable Use Policy. 7. Privacy Infinium takes your privacy seriously. You understand and agree that information provided to and collected by Infinium in connection with the Services is subject to the Infinium Privacy Policy, which is incorporated into the Terms. 8. Network Management Infinium uses various network management techniques to protect our network, systems, equipment, services, and users from harm, ensure reliable, quality services to our users, and improve our services. 9. Commitment to Online Safety Infinium is committed to online safety for minors, and Infinium complies with all applicable laws related to protecting minors online. This includes reporting cases of child abuse or exploitation to the National Center for Missing and Exploited Children. You can access additional information about minors' online safety by visiting MMM agitttec,org,, 10. Copyright ("DMCA") Policy (a) Infinium Copyright Policy. Infinium respects the intellectual property rights of others and expects its users to do the same. In accordance with the Digital Millennium Copyright Act of 1998, the text of which may be found on the U.S. Copyright Office website at http:ilwww.copyright.govllegislationidmca.pdf, Infinium will respond expeditiously to claims of copyright infringement committed using the Infinium Services if such claims are reported to Infinium's Designated Copyright Agent identified in the sample notice below. (b) Notification by copyright owner. If you are a copyright owner, authorized to act on behalf of one, or authorized to act under any exclusive right undercopyright, please report alleged copyright infringements taking place on or through the Site by completing the following DMCA Notice of Alleged Infringement and delivering it to Infinium's Designated Copyright Agent. Upon receipt of Notice as described below, Infinium will take whatever action, in its sole discretion, it deems appropriate, including removal of the challenged content from the Site. (c) Sample notice. DMCA Notice of Alleged Infringement ("Notice") I. Identify the copyrighted work that you claim has been infringed, or - if multiple copyrighted works are covered by this Notice - you may provide a representative list of the copyrighted works that you claim have been infringed. 2. Identify the material or link you claim is infringing (or the subject of infringing activity) and to which access is to be disabled, including at a minimum, if applicable, the URL of the link shown on the Site or the exact location where such material may be found, 3. Provide your company affiliation (if applicable), mailing address, telephone number, and, if available, email address. 4. Include both of the following statements in the body of the Notice: • "I hereby state that 1 have a good faith belief that the disputed use of the copyrighted material is not authorized by the copyright owner, its agent, or the law (e.g., as a fair use)." • "I hereby state that the information in this Notice is accurate and, under penalty of perjury, that I am the owner, or authorized to act on behalf of, the owner, of the copyright or of an exclusive right under the copyright that is allegedly infringed." S. Provide your full legal name and your electronic or physical signature. Deliver this Notice, with all items completed, to Infinium's Designated Copyright Agent: Copyright Agent Infinium PO Box 2178 Victoria, Texas 5502 US Highway 59 Victoria, Texas 77902 E-mail: Infinhunsupport,alvictoriaelectric.copp(361) 582-5550 11. Changes in the Terms Infinium reserves the right to change the Terms on which it offers Services. You should review the Terms regularly. Infinium will maintain the Terms and accompanying policies that are incorporated into the Terms at: http:e infinium.coop or httns"www.victoriaelectric.coop. Infinium will post notice of modifications to the Terms on this page by indicating the date the Terms were modified. If you do not agree to the modified Terms for a Infinium Service, you must notify Infinium. Infinium may cancel your subscription if you do not accept the modifications. 12. Limits on Infinium's Responsibility (a) Service Interruptions. Infinium provides all Service(s) on an "AS IS" and "AS AVAILABLE" basis. Services may be interrupted from time to time for a variety of reasons. Infinium is not responsible for any interruptions of the Services that occur due to acts of God, power failure or any other cause beyond its reasonable control. If an interruption of a significant length of time occurs that is within Infinium's reasonable control, upon your request, Infinium will provide what it reasonably determines to be a fair and equitable adjustment to your account to make up for such Services interruption. This will be your sole remedy and Infinium's sole duty in such cases. (b) WARRANTY DISCLAIMER. EXCEPT AS PROVIDED HEREIN, INFINIUM MAKES NO WARRANTY REGARDING ANY SERVICE, SOFTWARE, OR EQUIPMENT, WHICH IS PROVIDED AS IS. ALL SUCH WARRANTIES, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, ARE EXPRESSLY EXCLUDED. YOU BEAR THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE EQUIPMENT AND ARE RESPONSIBLE FOR THE ENTIRE COST OF ANY NECESSARY REPAIR. (c) Limitations of Liability. INFINIUM IS NOT RESPONSIBLE FOR ANY DIRECT, INDIRECT, SPECIAL, CONSEQUENTIAL, INCIDENTAL OR PUNITIVE DAMAGES OR LOSSES RELATING TO OR ARISING OUT OF THE USE OF OR INABILITY TO USE THE EQUIPMENT, SOFTWARE, OR ANY SERVICE, WHETHER BASED ON NEGLIGENCE OR OTHERWISE EVEN IF INFINIUM OR ITS LICENSORS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, OR FOR ANY CLAIM BY A THIRD PARTY. (d) Indemnification. Customer will indemnify, save, hold harmless and defend Infinium and all employees, officers, directors and agents of Infinium (collectively, "Indemnified Parties") from and against all claims, damages, losses, liabilities, suits, actions, demands, proceedings, attorney's fees and expenses threatened, asserted or filed by a third party against any of the Indemnified Parties arising out of relating to the use of Services by Customer, including any violation of the Infinium Acceptable Use Policy. (0 Warranty Services. You agree that this Agreement does not provide for, and the Services do not include, any warranty services orother services that Infinium might provide separately, including, without limitation, any fee based or other programs. 13, Miscellaneous (a) Notice. Notices to you will be deemed given when personally delivered, addressed to you at your last known address (the address you designate as your billing address) and deposited in the U.S. Mail (which may include inclusion in your billing statement), or sent via Internet to the e-mail address you provided to Infinium. Your notices to Infinium will be deemed given when received at the address or telephone number on the first page of this Agreement. (b) Applicable Law and Venue. The interpretation and enforcement of this Agreement and any disputes related to your agreements or service with Infinium shall be governed by the rules and regulations of the Federal Communications Commission, other applicable federal laws, and the laws of the State of Texas. You agree that any lawsuits brought against Infinium must be filed in Victoria County, Texas. (c) Other, This Agreement and any lease, activation, programming, or other Service commitment agreement that you entered into in connection with obtaining Services or Equipment constitute our entire agreement. No salesperson or other representative is authorized to change it. If any provision of the Terms is declared by a competent authority invalid; that provision will be deleted or modified to the extent necessary, and the rest of the Terms will remain enforceable. The terms ofthis Agreement that expressly or by their nature survive termination shall continue thereafter until fully performed. Customer (c) Other. This Agreement and any lease, activation, programming, or other Service commitment agreement that you entered into in connection with obtaining Services or Equipment constitute our entire agreement. No salesperson or other representative is authorized to change it. If any provision of the Terms is declared by a competent authority invalid; that provision will be deleted or modified to the extent necessary, and the rest of the Terms will remain enforceable. The terms of this Agreement that expressly or by their nature survive termination shall continue thereafter until fully performed. Customer Signature ,If/ r_ /` �� _. ___ Date / Z —ZZ-- CERTIFICATE OF INTERESTED PARTIES FORM 3.295 1of1 Complete NOS. 1- 4 and 6 if there are Interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2021-832209 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Infinium Broadband Internet Victoria, TX United States Date Filed: 12/13/2021 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Extension Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Calhoun County As -built Fiber Optic Internet Construction and Services 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 I �i�" L �'0,1 tyl,✓f ��) and my date of birth is. My address is + (street) (city) (state) (zip cuue) (country) I declare under penalty of perjury that the foregoing is true and correct. c �w -� {�/ Executed iny C unty, State of /�, on the lb day of IJI�� 20/�R. (month) (year) Signature of auth !Z'ed agent of co trdoN g business entity (Declarant) rums provided by Texas Ethics commission www.ethics.state.tx.us Version V1.1.191b5cdc # io NOTICE OF MEETING — 12/22/2021 10. Consider and take necessary action to approve the APPRISS (TX VINE) agreement for FY 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 15 . o Calhoun County 202 S. Ann Street Port Lavaca TX 77979 APPRISS" INSIGHTS Current Charge Details INVOICE a> TX Office of Attorney General - GS TX Office of Attorney General - GS R +�i:R: k�i�'l* v`L:. rk r t' �, $ Y. wYat 3ISFi� 3'i:_ e�.:a (Jfn.VINE pry "f' �r '• `l �()' Monthly LV'u'clt L19liteS S} • / 1 •� 1 11 I - SUBTOTAL TAX TOTAL CHARGES PAYMENTS BALANCE DUE For questions on your invoice, please send an email to acctgdept@appriss.com or call 1 866 277 7477 Remittance Slip Please remit payment to Appriss Insights PO Box 639033 Cincinnati OH 45263-9033 Routing #: 083002342 Deposit #: 7146720326 Tax ID: 61-1371324 Customer Invoice Due Date Amount Due Amount Paid $ 1,996.58 $ 0.00 $ 1,996.58 $ 0.00 $ 1,996.58 Calhoun County INV104537 12/31 /2021 1,996.58 Office of the Attorney General Grants Administration Division Office of the Attorney General Statewide Automated Victim Notification Services (SAVNS) Fiscal Year 2022 Invoice Select Invoice Quarter Place an "X" to the right of the applicable quarter(s) 1st Quarter 47 end Quarter Li 3rd Quarter Li 4th Quarter Li To submit your reimbursement request save the Invoice, FSR, and Salary Detail Sheet as one PDF document and send via email to: Grants-Financial@oag.texas.gov Date of Invoice: ® ° Invoice #: INV9 66 Texas TIN: 1-74-6001923-9 Organization Name: Calhoun County Mailing Address: 202 S. Ann St. City: Port Lavaca State: TX Zip Code: 77979 Contact Person: Candice Villarreal Title: 1 st Asst. Auditor Email Address: candice .villarreal(a)calhouncotx OrD Telephone: 361 553-4611 Month of Service Grant Number: PICA Code: Amount of Claim Nov-21 2218451 10352 $1,991.30 Note - 1: Invoice must be received for the prior quarter by the 5lh of the next month following the end of each quarter. Description of Services: Note 2: Reimbursement for services rendered on a contract basis under the Statewide Automated Victim Notification Service (SAVNS) Grant to the Office of the Attorney General (Term: September 1, 2021 to August 31, 2022). Note - 3: None of the costs billed under this invoice have been charged to any other state or federal grant, contract, or any other funding source. I certify that the expenses being requested for reimbursement are correct and unpaid. Note - 4: The amount of claim must not exceed the amount stated in 'Total Due" line on the Certified Vendor Invoice. Authorized Official or Designee Signature Note - 5: Must be signed by the Authorized Official or Alternate Designee � Z—� .—Z/ Signature of Authorized ial or Alternate Designee Date {n/ 1, f G y 0. r. Typed Name of Authorized OWIcial or Alternate Design6e and Title f For OAG Use Only Date Received by Grants Administration Division of the DAG: GAD Fiscal Approval / Date Date Received by OAG-Accounting: 9xx KEN PAXTON ATTORNEY GENF.NAI. OF TEXAS Statewide Automated Victim Notification Service (SAVNS) FY 2022 Quarterly Verification of Continuing Production Record The purpose of this record is to establish a regular schedule for the Grantee to provide an update regarding the Texas SAVNS Program. The intent is to ensure that the Grantee is aware of the ongoing status of its Texas SAVNS Program functionality and continuing production. The OAG will crosscheck Grantee verifications with those of the Certified Vendor. Yes No ` N/A I Grantee Responsibility As of the date below, SAVNS jail Records are on production and available. `. As of the date below, SAVNS Court Records are on production and available. o/ County SAVNS Problem Log notes all problems and resolutions. Program Coordinator/Grant Contact keeps a SAVNS grant file. Check `Yes', cNo' or IN/A' for each box. The primary responsibility for signing this verification is the Designated Authorized Official. Unchecked or checked 'No' boxes require an explanation in the Explanation/Comments Box. CO n Verification: t _ .i signature v R.(d,frd 4. to'e.-e- " Printed Name Title /Z^ /-- 2— Date / Explanation/Comments: *** This completed and signed document must be submitted as an attachment to the quarterly invoice in order for payment to be made on your County's behalf, for costs associated with Annual Maintenance. Please keep a copy in your grant file. SAVNS Quarterly Verification of Continuing Production Record FY 2022 h��ttNEyC� d � � IZEN 1?AXTON ATTORNEY GL"NERAL OF TliXAS Invoice Certification Required by Texas Grant Management Standards This completed and signed form is required to be included with each reimbursement request submitted to the Grants Administration Division. Grant Program Grant Number Grantee Name CC& 0 d an Invoice Month and Year I Ica 0 el I By signing this statement, I, acting in my official capacity as the Authorized Official or Alternate Designee for the above stated Grantee, certify the following: By signing this document, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the state award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. Authorized Official or Alternate Designee PrinteZIL74��2 �.I"Authorized Official or Alternate Designee Title: y�� Authorized Official or Alternate Designee Signature: Date: _I Z- 2.�,- 'Z/ r From: "OAG-GRANTS@oag.texas.gov (OAG-GRANTS)" <OAG-GRANTS@oag.texas.gov> To: OAG-GRANTS <OAG-GRANTS@oag.texas.gov> Date: 12/09/2021 02:09 PM Subject: OAG Grantees - New Financial Reimbursement Certification Requirement 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. Dear Grantees, The new Texas Grant Management Standards requires a distinct certification for all reimbursement requests made for grant awards. This certification is designed to assure that expenditures are proper and in accordance with the terms and conditions of the state award and approved project budgets. The Grants Administration Division will begin implementing this required certification in January 2022 when the new Texas Grant Management Standards takes effect. Please complete and sign the attached PDF and submit it each month with your Combined Reimbursement Forms for all requests starting with your December 2021 reimbursement request. Respectfully, The Grants Administration Division Attachments: File: Invoice Certification Required by Texas Grant Size: Content Type: Management Standards .pdf 144k application/pdf #11 NOTICE OF MEETING— 12/22/2021 11. Consider and take necessary action regarding the bids that were received Thursday, December 9, 2021 for the Lane Road Drainage Improvements Project for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1. As the result of having a single bid, the project will need to be bid again at a future date. The unopened bid will be returned to the bidder. (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 15 Gary D. Reese County Commissioner County of Calhoun Precinct 4 December 16, 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 December 22, 2021. • Consider and take necessary action regarding the bids that were received Thursday, December 09, 2021 for the Lane Road Drainage Improvements Project for Calhoun County, Texas - Texas General Land Office Contract No. 20-065-064- C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1. As the result of having a single bid, the project will need to be bid again at a future date. The unopened bid will be returned to the bidder. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: gar .reese(cDcalhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 #12 NOTICE OF MEETING — 12/22/2021 12. Consider and take necessary action to declare the attached equipment from Veteran Services as Waste. (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 8 of 15 Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: VIT4�2-9,IJ ui `-15:5 CZ'sOj Requested By: ,Q""j Inventory Number Description Serial No. Reason for Waste Declaration #13 NOTICE OF MEETING— 12/22/2021 13. Consider and take necessary action to transfer the attached equipment from Justice of the Peace, Precinct 1 to IT. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9of15 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Department Name: Justice of the Peasce Precinct 1 Requested By: Hope Kurtz Inventory Description Serial No. TRANSFER FROM/TO Number DEPARTMENT #14 NOTICE OF MEETING— 12/22/2021 14. Consider and take necessary action to transfer the attached equipment from the District Clerk to the Jail. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 15 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM — 2021' Requested By: Anna Kabela Calhoun County District Clerk Inventory Number Descri tion Serial No. Transfer From/To Department Fellows Shredder PS-77Cs from District Clerk to Jail #15 NOTICE OF MEETING — 12/22/2021 15. Consider and take necessary action to declare the attached equipment from the District Clerk as Surplus/Salvage. (RHM) Approve Laptop to go to IT to remove Hard Drive 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 15 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM - 2021 Department Name: Requested By: Inventory Number Description District Clerk's Office Anna Kabela Reason for Surplus/Salvage Serial No. Declaration Lenovo T400 L nton Windows- obsolete able 2 drawer wooden to metal legs) not needed P Printer CNBCL 180F9 not needed odiak iz400 Scanner 47 70092 not needed 3attery Backup and SurRE Protector not needed uill.com Titanium Shre der 120102102 not needed o itech Wireless Keypac not needed luetooth Wireless Keypzd Desktop MX5000 not needed P Compaq CPU MXL35217X7 not needed #16 NOTICE OF MEETING — 12/22/2021 16. Consider and take necessary action to declare the attached equipment from the District Clerk as Waste. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pet 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 15 Calhoun County, Texas WASTE DECLARATION REQUEST FORM - 2021 Department Name: District Clerk's office Requested By: Anna Kabela Inventory Number Description Serial No. Reason for Waste Declaration Shredder GBC 130X broken Holmes Rotating Fan broken 9�,e� tZ/I�/zoZ. #17 i NOTICE OF MEETING— 12/22/2021 17. Accept Monthly Reports from the following County Offices: I. County Treasurer — October 2021 ii. Justice of the Peace, Precinct 4 — November 2021 iii. Tax Assessor -Collector — November 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 13 of 15 1211512021 08:53 CALHOUN CO AUDITREAS f AX)3615534614 P.0011003 CALHOUN COUNTY TEXAS COUNTY TREASURER'S REPORT MONTH OF, OCTOBER 2031 BEGINNING F(INDRAJANCR RECEIP73 DISBURSEMENTS FUNDRAJANCB OPIFUND GENERAL 3 26.606.561.23 6 940.569.15 3 1.939.102.82 3 25301327.79 AIRPORTMAJNTENANCE 3 62,99118 117.04 2466.91 60,547.31 APPELLATEJUDICIAL SYSTEM 1,268.61 135.35 1,403.97 COASTALPROTEC170NPUND 3 2,282,31938 $50.03 31325M 2,274.644.46 COUNTY AND DIST COURTTBCH FUND $ 7.910.43 31.93 - 7.949.36 COUNTY CHILD ABUSE PREVENTION FUND $ 734.07 0.37 - 73444 COUNTY CHILD WELFARE BOARD FUND $ 755.99 R8.22 - 844.21 COUNTY JURY FUND 3 43134 2339 454,93 COURTHOUSE SECURITY 3 276,13SA3 1.662.74 7.895.00 249,923.17 COURT INITIATRD GUARDIANSHIP FUND 3 12,716,83 123.62 - 12,840,45 DISTCLK RECORD PRESERVATION FUND 3 39,515.14 331.29 39.910.42 COURT REPORTERS SERVICE FUND 3 48239 24.93 507.52 CO CLK RECORDS ARCHIVE FUND 3 311,936.22 5.089,85 317.025.07 COUNTY SPECIALTY COURT FUND 3 3,907.76 164,34 3,974,10 DONATIONS 3 105,867.39 1.700,11 107.567.50 DRUGRJWI COURT PROGRAM FUND -LOCAL 3 23,95SB7 2330 25.978.57 JUVENILE CASE MANAGER FUND 5 17.908.00 210.11 507.09 17,619.02 FAMILY PROTECTION FUND 5 14,164.13 94,03 - I4E58.16 JUVENILE DELINQUENCY PREVENTION FUND S 0,236.22 2.64 9.258.86 GRANTS 5 500,617A6 3,447.43 21,593.01 484,471.88 JUSTICECDURTTECIINOLOGY 3 93,694.36 747,28 479.99 93.951.65 JUSTICE COURT BUILDING SECURITY FUND 3 6,671.39 30A3 - 6,701.R2 LATERAL ROAD PRECINCT #1 S 31.38 4,3043Z - 4.336.10 LATERAL ROAD PRECINCT42 S 31.36 4,304.72 - 4,336J0 LATERAL ROAD PRECINCTA3 3 31.39 4,304.72 - 4,336.10 LATERAL ROAD PRECINCP44 3 31.39 41304.72 - 4.336.10 JUROR DONATIONS- VETERANS SERICE OFFICE 3 8.00 - 8.00 JUROR DONATIONS - HUMANE SOCIETY d 797.91 56.00 - 843.91 PRE7RIALSERVICES FUND 3 95.128.14 624.26 - 85.812.40 LOCAL TRUANCY PREVENT70NJDIVERSION FUND S 12,6001)a 754.21 13.354.29 LAWLIBRARY S 213.919.92 970.95 1,149.13 213.810.72 LAW RNF OFFICERS STD. EDUC.(LEOSE) S 29.417.17 $.35 29,423.55 POC COMMUNITY CENTER S 16,10732 2,504.59 2,554.09 16.058,03 RP-COROS MANAGRMRNT-DISTRICT CLERK S 9,39530 179.68 - 9,575.18 RECORDS MANAGEMENT -COUNTY CLERK 5 207,26733 5,089.32 - 212,356,63 RECORDS MONT&PRESERVATION $ 37,902,75 332.35 - 38.235.61 ROAD&BRIDGEGENERAL S 1.659.052b5 23.178.01 - 116SL230.66 6MILEPIERIBOAT RAMP INSURAMINT S 35,704.36 10.11 35.714.53 CAPITAL PROW- BOGGY BAYOU NATURE PARK 3 198,733.80 - 191,731.90 CAPITAL PROD AMERICANRBSCUE PLAN ACT 3 2,067,666.50 - 34.391.94 2,013.314.56 CAPITAL PROD- KING FISHER BRACH PARK 3 60,000.00 60.000&0 CAPITAL PROD- CDBG DR INFRASTRUCTURE $ 76,017,90 45,53035 32.487.75 CAPITAL PRO) CHOCOLATE BAYOU BOAT RAMP 3 176.410.01 - 176.030.01 CAPITAL PROD- ELECTION MACHINES $ 0.21 0.21 CAPITAL PROJ-RB INFRASTRUCTURE 6 83M71.51 55,090.29 775.477.22 CAPITALPRGJRNRRGYTRZ4I S 166.3S0.65 49,MN.10 44,Q&94 171.830B1 CAPITAL PRO) AIRPORT RUNWAY IMPROVEMENTS S 14,972.13 - 14,972.13 CAPITAL PROI MAGNOLIA BEACH EROSION CONT S 113.000,00 - - 175,D00.00 CAPITAL PROD EVENT CENTER CAPITAL PRO) FIRE TRUCKS & SAFETY EQUIP S 125.927,09 3 6,440.68 - 125,927.09 6,446.68 CAPITAL PRO) -GREEN LAKE PARK 3 7,140.74 70,21R79 70.210.19 7,16E.74 CAPITAL PRO) HATERIUSPARKJBOATRAMP $ 20,242.36 - - 20,24236 CAPITAL PRO) PORT ALTO PUBLIC BEACH $ 1,484.70 - - 1,494.78 CAPITAL I= HURRICANE HARVEY FEMA 3 54,914.6E - 54,914.68 CAPITAL PROJ IMPROVEMENTS PROJECTS S 344.369.10 - 344,369.10 CAPITAL PROD HOSPITAL IMPROVEMENTS 3 2,94g602.66 2194g602.66 CAPITAL PROJ•MMC LOANS 3 4,000,000.00 4,000,000110 ARREST FEES 5 868,24 192.94 - I'mus RAIL BOND FEES (HE 1940) 3 1,170,00 630.00 - 1,300.00 CONSOLIDATED COURT COSTS(NBW) S 4,139RB 1,165R6 - 5,304.14 CONSOLIDATED COURT COSTS 2020 S 22,16633 10.300.64 - 32,467.17 DNATERNNGFUND S 34R41 0.51 349.02 DRUG COURT PROGRAM FUND -STATE S 141.11 Ifi.10 12.2 ALS 43990 fi60.16 1140 i Paso I of 3 1211512021 08:54 CALHOUN CO AUDITREAS 0:43615534614 P.0021003 COUNTY TREASURER'S REPORT MONTHOF. OCTOBIM 2021 BEGINNING ENDING FUND FUNDRALAN s RECEIPTS DISBURSEMENTS FUND BALANCE OPERATING FUNDS• BALANCE FORWARD S 43,890,66D.16 S 1,140,960S1 S 2,253.947.48 B 42,777,073.19 ELECTION SERVICES CONTRACT 03,310.22 2308 2.279.30 81.055.00 ELECTRONIC PILING PPE FUND 3.111.71 1,244.51 4.355.22 O.m EMS TRAUMA FUND LJ95.76 405.96 - 1,6D272 PINES AND COURT COSTS HOLDING FUND 7.847.31 7.847.31 INDIGENTCIVILLEGALSERVICE 63230 301.m 18.80 921.30 JUDICIAL FUND(ST. COURT COSTS) 8.61 1.65 - 10.26 JUDICIAL& COURT PERSONNEL TRAINING FUND 104.19 230.00 - 734.18 IUDICIAI. SALARIES FUND JUROR DONATION -TX CRIME VICDMS FUND JUVENILE PROBATION RESTITUTION LIBRARY GIFT AND MEMORIAL 3.339.62 408M 6257 40,355.73 IA7039 Bm I IA9 - 5,0I0AO 416.00 62.57 40,367.2E MISCELLANEOUS CLEARING 10.104.75 9503 434.64 9,145.15 1 'uMABLEDRMSM 2,000,m - 2,0mm STATECIVILFEEFUND 4,937AO 1,97150 176.29 6,732.61 CIVIL JUSTICE DATA REPOSITORY FUND 3.03 135 - 4.99 JURY REIMBURSHMEM'PBR 31039 11631 - 435.30 SUB71TLECFUND SUPP OF CRIM INDIGENT DEFENSE TIME PAYMENTS 10,040.50 I55D4 774.05 4.729.77 58.25 149.14 - 14.77D27 213.29 92L19 TRAFFIC LAW FAILURE TO APPEAR UNCLAIMED PROPERTY TRUANCY PREVENTION AND DIVERSION FUND BOOYCAMPIJIAEP JUVENILE PROBATION 1.402.15 12.685.49 2260 147,43 188.022.60 2620 88.29 55A2 RO38435 99.59 47 74.89 1,66475 12,773.7E 193.71 147A3 230232.26 SUBTOTALS S 44263.254.61 5 1,241.57659 S 2.308.693.20 S 43,196,1 6.07 TAXES IN ESCROW 11,234.11 0.00 IS 34.11 TOTAL OPERATING FUNDS dAe I 17 OTHER FUNDS D A FORFEITED PROPERTY FUND SHERIFFNARCOnCFORFEITURPS CERT OFOB-CRTHSE REP SERIES 2010 13.292,76 20.745.47 34.48030 1.69 2.776.22 897A1 6.044.33 - 13,294.45 17,477.36 35.377.71 CERT OFOB-CHTHOUSE I&S SERIES 101E 49.592.91 1.168.65 49.761.66 CAL.CO.PEES&FINES 155069.50 131,104,3t 103 20.28 133 52.69 MEMORIAL MEDICAL CENTER OPERATING MONEYMARKET 3Al2.781.34 1.108.632.49 5.814,135.7E 235.39 4,017.022.93 S 5.229,894m S 1.108.867.28 INDIGENT HEALTHCARE, 5,019.21 7.429.71 7,429.79 3.019.26 PRIVATE WAIVER CLEARING FUND 431.41 0.03 - 431A6 CLINIC CONSTRUCTION BURIES 2014 NHASHFORD NHBROADMOOR Nu CRESCENT NHFORTBEND NHSOLERA NHGOLDENCREEK NH SOLF.RA DACA NH ASHFORD DACA NH BROADMOOR DACA 533.85 21.363.23 33.751.99 58.373.22 ISX9193 98,434.56 15,548.32 0.00 0.00 0.00 0.07 332.010.50 409.006.35 320,571.0E 95.402.53 383,191.91 395.25203 - 392,254.15 300,933.3E 31S.432.22 79,44236 517.644.66 339,100,67 - - 535.92 221.309.53 141.893.02 63,51403 34,220.00 163,981.E1 75.699.41 0.0 0.00 plop NH GULP POINTE-PRIVATE PAY NH GULF POINT PLAZA MEDICARE MEDICAID 372.53433 7.460,32 319.942.85 220,341.77 499,872.75 200,795.64 191.604,44 36,006AS NH BETHANY SENIOR LIVING NHTUSCANYLIVING TOTAL MEMORIAL MEDICAL CENTER FUNDS 74.601.19 68930.86 fl04681.20 386.533.26 70.393.23 259786.97 86,889.16 1 6 m,21 S 9.896.824.45 S 7,7111,132.71, S 7 DRAINACR DISTRICTS NO.6 NO.8 NO.10-MAINTENANCE NO. 11-MAINTENANCIVOPERA-11M NO. II -RESERVE TOTAL DRAINAGE DISTRICT FUNDS 28,770.33 133,763.56 201,691.54 79.162.87 W.541.11 77.35 17.04 10.90 236.30 28.7E 3720 18.00 59.80 3,442.7E $ 28,818.a8 133,762.60 201.690.54 75,956.45 225,576.84 418,22 s 66SAWAll CALHOUN COUNTY WCIDm OPERATING ACCOUNT PAYROLLTAX TOTALWCIDFUND$ CALHOUN COUNTY PORT AUTHORITY S 259.913.90 1.294.05 0.00 0,00 46,89539 16638 S 223.01841 S 1127.77 5 27LIMM 0.00 4706iff 22C145,13 MAINTENANCE AND OPERATING s 49 93.01 5 41,97 3 49394.N CALHOUN COUNTY PROSTBANK 2 20.87 L015.07 S 069,306.45 S g 8d 64 S 70,496907.99 TOTAL MMC, DR. DIST„ NAV. bill, WCI0 & FROST S s0,904.621.05 S ll,290,W3,19 S 101IS619=91 TOTAL ALL FUNDS $ 61A08,342.03 Pagc 2 of 3 12115/2021 08:54 CALHOUN CO AUD/TREAS O:AX)3615534614 P.0031003 COUNTY TREASURER'S REPORT MONTH OF, OC OBER2021 BANK RECONCILIATION LESS. CERT.OFDEPI FUND OUTSTNOODEP/ PLUS: CHECKS DANK FUND BALANCE OTNDIIITEMS OUTSTANDING BALANCE OPERATING • S 43,211,970.18 315.20 277,430.63 S 43,489,085.61 OTHER D A FORFEITED PROPERTY FUND 13.294.43 - 13,294.45 SHERIFF NARCOTIC FORFEITURES 17,477.36 - 533.33 13,010.69 CERT OFOB-CRTHSE REPSERIS 2010 35,377.71 - - 35,377.71 CERT OF OR-CRTHOUSE WS SERIES 2012 49,701.06 - 49.761.66 CAL. CO FEES & FINES 153,552.68 19.637.78 14,645.86 178.361.26 MEMORIAL MEDICAL CENTER OPERATING; 5.229.694.11 748.567.32 5,978,481,43 MONEY MARKET 1.101107.119 1,10%1167.86 INCIDENT HEALTHCARE 5.019.26 7.358.93 7,791.39 5,441.71 PRIVATE WAIVER CLEARING FUND 451.46 - - 431.46 CLINIC CONSTRUCTION SERIES 2014 535.92 - - 131.92 NH ASHFORD 221,309.58 - - 221,309.S8 NH BROAOMOOR 141,895.01 - - 141.995.02 NH CRESCENT 63,514.03 - - 63,514.03 NHFORTBEND 34,220.00 - - 34.220.00 NH SOLERA 163.981.01 - - 163,981.81 NH GOLDEN CREEK 75.699.65 - - 75.699.68 NH SOLERA DACA 0.00 - 0,00 NH ASHFORD DACA 0.00 0.00 MI BROADMOOR DACA 0.00 0.00 NH 13MFFOINTPWVATEPAY 191,604A4 191,604A4 NH GULF POINTE PLAZA MEDICARE MEDICAID 36,006.45 36,006.45 NH BEIHANY SENIOR LIVING 86,889.16 56,869.)6 NHTUSCANY VILLAGE 195,677.15 195,677.15 DRAINAGE DISTRICT: No.6 28.819.49 - 28,618A8 NO.9 133,762.60 - 16.aD 137,750.69 NO.10 MAINTENANCE 201.690.34 201,69D.54 NO.11 MAINTENANCE/OPERATING 75.936.43 - 75.956.45 NO. 11 RESERVE 225.376.94 - - 225,576.94 CALHOUN COUNTY WCID61 ••.. OPERATING ACCOUNT 223,018.51 - - 223,019.51 PAYROLLTAX 1,127.77 - - 1.127.77 CALHOUN COUNTY PORT AUTHORITY.... MAWMNANCUIOPERA71KG 49.394.98 - - 49.394.93 CALHOUN COUNTY-" FROSTBANK 2,015.87 - 2.015.87 996 52 S WX9.1127.1-4 i444 THE DEPOSITORY FOR CALHOUN COUNTY WCID IS INTERNATIONAL BANK OF COMMERCE•PORTLAVACA 4f• THE DEPOSITORY FOR CALHOUN CO. NAVIOA17ON DISTRICT IS FIRST NATIONAL BANK -PORT LAVACA ••.• THE DEPOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK • AUSTIN, TEXAS THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS PROSPERITY BANK, PORT LAVACA Court coats and fees collected and reported may not be current and o-dat ue to non-complian a blyother county ofESges. I hereby certify that the current balances are correct to all monies at have IN reO ved by hiCo Sty iYeasurer as of the ate of this report. 0 ^� RHOI1rDAS. KOKENA COUNTY TREASURER Page 3 of 3 12-13-21;16:43 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 1/ 4 FAX COVER SHEET DECEMBER 7, 2021 FROM: JUSTICE COURT PCT. 4 CALHOUN COUNTY 103 W. Dallas Street, P.O. Box S20 Seadrift. Texas 77983 PHONE: 361-785-7082 FAX: 361-785-2179 TO: CountyJudeeoffiice Ref: Money Distribution Report FAX: 361-553-4444 NOTE: The NOVEMBER 2022 report is attached Please eive me a call if you have any questions PAGES TO FOLLOW: —4_ INCLUDING THIS COVER PAGE Thank you, Judge-wesfey j. ifunt 12-13-21;16:43 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 2/ 4 ff -2m T •I' ' ...r,d REV18E00112020,.'„:''.. .' � ' W26 132.22 ei'i.'.. ill s, 12,90 1 0.77 •F'�rr _ ea.00 e0A0 ' a�r,'•:',,'4�, ago 13A1 '" •' 93.60 G.,' . , . 1p OR 12.000 47 212.00 7A =,W 1001 ,7FC 0.00 2020 12.76 TIME R5,00 2020 V..OF 0.31 7RW 6000 SO 22170 Dog OFF , VA !FEE 1R0.00 FEC ACC NOF 30.00 PAY 1052 FEE 70,00 FEE KPO KP,R A6S YCIE P$F ;INE 1,407.66 NO IWF 200.00 ;7 Pr1' /ER /ER VSF e�L.. seea,rT ii I A. 4 . I. Ypli �' •eN1,.5.h���,r� r ili,i .r . :rrr i'i�;�i,i'I,.i,,ry :; .��:A�Si: �' ern; r;I!:1"•h'��n yI �fl 4j 1' I '•r' Y � A 'ail - •, ..I,'' Y ; r '• A "AMONNTr <.;:.:1 ;+' , ' L v'. •i ,! r r+:a': r('1•. (�'',' •. ' O,CO IRNCWOF 6A. RWUWIIN0012Rup1EMRW ic;O,Oar Pg1ENCW000.0.RWu0PINp0leluWIMIM 'Yi 0.OD:, M1OIGiNCWOE ErR Afi00EmIN0010WAAEAEM '��, �� '�'O.RU MA,pImftYCC RN. g000NI11NOtl1iwgOWRNR •H : 00p'RGIEIx0.VRG GR,REOUEBIINCRI2WRIEMCMQFRERIMEN 0.00'r,; r. ., AMOUNT TS'rr .•1 2, 0,lp�,.',.;r:;�;;.r,y,�URLTro11uroY1fttlw1010,, rrrr . . 12-13-21;16:43 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 3/ 4 12/6/2021 ACCOUNTNUMSER OR 1000-ODl-45014 OR 1000.001-44190 CR 1000-001-44364 CR 1000.001-44010 CR 1000-001-44064 OR 1000-001-44090 OR 1000-001-49110 OR 1000.001-44322 OR 1000-001-44145 CR 1000-999.20741 OR 1000.999.2D744 CR 1000-999.20746 OR 1000.999.20746 CR 100"99-20770 CR 2670-ODl-44064 CR 2720-001.44064 OR 2719-001-44064 CR 2599.001-44064 CR 273D-001.44064 CR 2669-001-44064 OR 7020.999.20740 CR 7070-999-20610 CR 7070-9$$-20740 CR 7072-999-20$10 OR 7072-999-20740 OR 7860.999.20610 OR 7860.999.20740 OR 7860-999-20810 OR 7860-999-20740 CR 7950.999.20610 CR 7950-999-20740 COURT NAME; JUSTICE OF PEACE NO.4 MONTH OF REPORT: 0 YEAR OF REPORT: 0 ADMINISTRATIVE FEES. DEFENSIVE DRIVING CHILD SAFETY TRAFFIC ADMINISTRATIVE FEES EXPUNGEMENTFEES MISCELLANEOUS STATE ARREST FEES DPS FEES P&W FEES TABC FEES DR 7070-999.10010 OR 7072.999.10010 OR 7860-999-10010 OR 7860-999-10010 DR 7950,999.10010 ACCOUNTNAME FINES SHERIFF'S FEES AMOUNT 1,497.68 97.50 0•QD 0.77 15.75 60.25 0.00 0.00 TOTALADMINISTRATIVEFEES CONSTABLE FEES -SERVICE 76.77 JP FILING FEES 75.00 COPIES / CERTIFIED COPIES 125.00.00 OVERPAYMENTS (LESS THAN $10) TIME PAYMENT REIMBURSEMENT FEE 0.00 SCHOOL CROSSING/CHILDSAFETY FED 0.00 DUE TO STATE -DRIVING EXAM FEE 0.00 DUE TO STATE-SEATBELT FINES 0.00 DUE TO STATE -CHILD SEATBELT FEE 0.00 DUE TO STATE -OVERWEIGHT FINES 0.00 DUE TO JP COLLECTIONS ATTORNEY . 0 TOTAL FINE$, ADMIN. FEES 6 DUE TO STATE $2221.70 ,093.63 COURTHOUSE SECURITY FUND JUSTICE COURT SECURITY FUND $55.28 JUSTICE COURT TECHNOLOGY FUND $3.00 JUVENILE CASE MANAGER FUND $50.79 LOCAL TRUANCY PREVENTION & DIVERSION FUND $5.00 COUNTY JURY FUND $47.22 $0.94 14.00 2.00 0.00 TOTAL STATE ARREST FEES . 100 6 CCC-GENERAL FUND CCCSTATE 1.00 139.73 155.25 STATE CCC- GENERAL FUND STATE CCC-STATE 55,45 465,45 554.55 STF/SUBC-GENERAL FUND STF/SUBC-STATE 1.50 26.50 30.00 STF- EST 9/1/19- GENERAL FUND STF- EST 9/1/19- STATE .50 850 204.06 212.56 TP-GENERAL FUND TP-STATE 12.50 12.50 25.00 Page 1 of 2 12-13-21;16:43 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 4/ 4 12/6/2021 CR 7480.999-20610 CR 7480.999-20740 CR 7866-999.20610 CR 7865.999.20740 CR 7970.999.20610 CR 7970-999-20740 CR 7505.999-20510 CR 7505.999-20740 CR 7857-999-20610 CR 7857-999-20740 CR 7856-999.20610 CR 7856.999.20740 CR 7502-999.20740 7998-999-20701 CR 7998.999.20740 CR 7403.999-22$$8 REVISED 01/29/20 COURT NAME: JUSTICE OF PEACE N0, 4 MONTH OF REPORT: 0 YEAR OF REPORT: 0 CIVIL INDIGENT LEGAL-GEN. FUND CIVIL INDIGENT LEGAL -STATE .50 1.50 OR 7480-999-iom 2 30.00 CRIM-SUPP OF IND LEG SVCS-GEN FUND CRIM-SUPP OF IND LEG SVCS-STATE 0.65 DR 7865499.10010 5.86 6, 57 TIJFTA-GENERAL FUND TUFTA-STATE 0.00 DR 7970-999-10010 0.00 0.00 JPAY - GENERAL FUND JPAY -STATE 1 95 DR 7505-999-10010 17.57 19.52 JURY REIMB. FUND- GEN. FUND JURY REIMB. FUND- STATE 1.30 DR 7857-999-10010 11 7! 13.01 CIVIL JUSTICE DATA REPOS, GEN FUND 0.00 OR 7856.999-10010 CIVIL JUSTICE DATA REPOS,- STATE 0.00 0.00 JUD/CRT PERSONNEL TRAINING FUND DR 7502-999-10010 -STATE 0,00 , 0.00 JUVENILE CASE MANAGER FUND DR 7998-999-10010 TRUANCY PREV/DIV FUND - STATE 3.2E 3 26 6.51 ELECTRONIC FILING FEE DR 7403.999-10010 50.00 50.00 TOTAL (Distrlb Re to 0 erAc 9 p ct) $3,374.77 DUE TO 071fERS (Ois(rjb Req Adchd) CALHOUN COUNTY ISD DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS $ WILDLIFE FINES 0.00 WATER SAFETY FINES 170.00 TOTAL DUE TO OTHERS 0.00 $170.00 TOTAL COLLECTED -ALL FUNDS $3,644.77 LESS; TOTAL, TREASUERB RECEIPTS 50.00 OVER/(SHORT) $3,544.77 1 Page 2 of � z' zz z/ SUMMARY TAX ASSESSOR -COLLECTORS MONTHLY REPORT NOVEMBER 2021 COLLECTIONS DISBURSEMENTS Title Certificate Fees 389 $ 6,122.00 Title Fees Paid TXDOT $ 3,177.00 Title Fees Paid County Treasurer Salary Fund $ 1,945.00 Motor Vehicle Registration Collections $ 117,778.07 Disabled Person Fees $ 70.00 Postage $ Global Additonal Collections $ - Paid TXDOT $ 96,332.64 Paid TXDOT SP $ 15,427.28 Paid County Treasurer $ - Paid County Treasurer Salary Fund $ 4,677.56 DMV CCARDTRNSFEE $ 1,410.60 $ - GLAdditonalCollections $ - GLOBAL (IBC) Credit/Debit Card Fee's $ 1,333.07 GLOBAL Fees In Excess of Collections $ 77.53 MERCH SERVICES STATEMENT $ - Additional Postage- Vehicle Registration $ - PaidCountyTreasurer- Additional Postage $ - Motor Vehicle Sales &.Use Tax Collections $ 487,955.01 Paid State Treasurer $ 487,955.01 Special Road/Bridge Fees Collected $ 15,540.00 Paid County Treasurer -R/B Fees $ 15,640.00 Texas Parks & Wildlife Collections $ 2,817.00 TPW GLOBAL CC TRANSACTION FEES $ 85.09 GLOBAL ADDITIONAL COLLECTIONS $ - Paid Texas Parks & Wildlife $ 2,636.30 Paid County Treasurer Salary Fund $ 281.70 P&W CCARDTRNSFEE $ 85.09 GLOBAL Additonai Collections $ - GLOBAL (IBC) Credit/Debit Card Fee's $ 108.89 GLOBAL In Excess/Shortage of Collections $ (23.80) Boat/Motor Sales & Use Tax Collections $ 29,403.81 Paid State Treasurer $ 27,933.62 Paid County Treasurer, Salary Fund $ 1,470.19 TABC 5% CO COMMS FOR MONTH OF $ - TABC 5% CO COMMS FOR MONTH OF $ - Paid County Treasurer, Salary Fund $ - County Beer & Wine Collections $ 1,006.00 Paid County Treasurer, County Beer & Wine $ 954.75 Paid County Treasurer, Salary Fund $ 50.26 INTEREST EARNED ON OFFICE ACCOUNT $ 294.78 Paid County Treasurer, Nev. East $ 0.23 Paid County Treasurer, all other districts $ 294.66 INTEREST EARNED ON PARKS AND WILDUFE ACCOUNT $ 2.35 Paid County Treasurer, Interest on P&W Ace $ 2.35 INTEREST EARNED ON REFUND ACCOUNT $ 0.06 Paid County Treasurer, Interest on Refund Ace $ 0.06 Business Personal Property -Misc. Fees $ 1,177.71 Paid County Treasurer $ 1,177.71 Excess Funds $ _ Paid County Treasurer $ _ Overpayments $ 44.27 Current Tax Collections $ 870,684.95 Penalty and Interest - Current Roll $ _ Discount for early payment of taxes $ 18,087.47 Delinquent Tax Collections $ 9,464.83 Penalty & Interest - Delinquent Roll $ 4,942.05 Collections for Delinquent Tax Attorney $ 4,116.30 Advance - FM & L Taxes $ _ Advance - CountyAdValoremTaxes $ 844,361.14 Paid County Treasurer - Nev. East $ 757.50 Paid County Treasurer - all other Districts $ 21,929.99 Paid County Treasurer- Delinq Tax Atty. Fee $ 4,115.30 Payment in Lieu of Taxes $ _ Paid County Treasurer - Navig. East $ _ Paid County Treasurer - All other Districts $ _ Special Farmers Fees Collected $ 36.00 Paid State Treasurer, Farmers Fees $ 35.00 Hot Check Collection Charges $ _ Paid County Treasurers, Hot Check Charge $ _ Overage on Collection/Assessing Fees $ Paid County Treasurer, overage refunded $ _ Escheats $ Paid County Treasurer -escheats $ TOTAL COLLECTIONS $ 1,660,527.28 TOTAL DISBURSEMENTS $ 1,560,527.28 TOTAL OF ABOVE RECEIPTS PAID TO STATE AND COUNTY $ 1,550,527.28 aA� gad KERRIBOYD Tax Assessor -Collector t RIGHARD HPEYER County Judge #18 NOTICE OF MEETING — 12/22/2021 18. 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 14 of 15 2(§§ !Ga■ 000 z z z � § ■§ =±m�m m8 ±ft�� §m■ � \\kB§k 9 § § z � k \ § § § z z z _§ § � $ a ) cn B v) ■E $@ 2] k \ `a §k ■| \§ m§ �( rk ( v! z| q ® ■§ ■§ 200 00 ■ )j z Z§ k �§§ ®- %zz Mk § §°�■ m| z ■ § ) ) ) _ m Mf m) t000 Z) § 0� o= k/«gym _) o/ � 28§ | -G©m � �- k k §m0 9 § 3 c m k v) §\I m m m �| s w § § �k ■ % 3:0) �■ :: ■. 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TS N O O O N O O T IER V EA O (A EA V O T N O O O O N O $s� N N N q N 9 9 W W O J J O T F fA O 0 0 � J O CO O O O 0 0 N 0 a n 0 z m 3 W mm m z C n Ic z m z lA m 6 C N N v' M' ma a l' M z I 0 -4 �I 0' 9 n 0 C z N C v n m m m n c mm m m mD o z zZ m �c m A [�z L �I U)m A of 0 O m e 00 zz Us Zq� ER 0 O c fH v _ ME z =_ a= m= a= ti= m= eS4_ j N `�'' (I1 O C m c, CO) - 0 r m c Cl) a T zs m= mzz 3= 000 m= z= 00 �_ N yZZ S = m O A H O $ T O O O T _ y 0 = r r S = T v� m=_ O O O O m= O o00 z= zc N4 W N� G1i= W coo T W w coo �sZ T = 2 O O O x a O z 0 0 � qc p 0 o m A 4 C 4 A zzmm 0z > m A `�0 mm3m: {Nm D A m A e r3nzzzz 00000 e �0000 Z Z Z Z Z y Z Z Z Z s o N O O � n 0 r S� i e�p�e�p to EA Efl to fA T 1'A 0 0 0 0 0 sus= ee�e e A W V o 9 O c z N I c v a m m rrn n r c v § B § § M; § o �; ■.■ »: % ) w \ ) - ■: �: \ 2 z: ( § °' m: 'o: m - § »; ; ■ �! , ■ ; § �| § § ® �) �2 & � § . -0! »! A) ■; m: z: z; 0 «■t m ( 2 ) 1# � § § � ■ m = -n z m ■ m) z mo= 0 § § M) 2 ) Z) A ■ q a q= , m - z § § §) 2 M� r o \ co § m) >= § § §) § % M( § .1) #19 NOTICE OF MEETING— 12/22/2021 19. Approval of bills and payroll. (RHM) County RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Indigent 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: 10:21 A.M. Page 15 of 15 December 22, 2021 2021 APPROVAL LIST - 2021 BUDGET COURT MEETING OF BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 34 12/22/21 $360,501.69 FICA P/R $ 53,395.06 MEDICARE P/R $ 12,792.66 FWH P/R $ 34,173.19 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 4,830.00 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 1,516.15 CALHOUN COUNTY INDIGENT HEALTH CARE A/P $ 5,471.38 GULF COAST HARDWARE MAINT BLDG PARTS & SUPPLIES A/P $ 671.64 QUILL AUDITOR -OFFICE SUPPLIES A/P $ 585.62 TOTAL VENDOR DISBURSEMENTS: 473,937.39 ✓ $ PAYROLL FOR 12-23-21 P/R S 312,526.68 TOTAL PAYROLL AMOUNT: $ 312,526.68 1/ CALHOUN COUNTY INDIGENT HEALTH CARE TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: $ 5,471.38 $ 5,471.381/ CALHOUN COUNTY OPERATING ACCOUNT - TRANSFER FUNDS FOR HIGHER INTEREST RATE TO MONEY MKT / TOTAL AMOUNT FOR APPROVAL: $ 791,935.45 V MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL•LIST•FOR---:Decem6er22 2021'. by: DC INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES HEB Pharmacy (Medimpact) Pharmacy Reimbursement 80.66 MMCenter (in -patient $0/ Out -patient $353.78 / ER $0) 353.78 Memorial Medical Clinic 921.08 SUBTOTAL 1,366.62 Memorial Medical Center (indigent Healthcare Payroll and Expenses) 4,166.67 Subtotal 5,522.19 Co -pays adjustments for November 2021 00:04 Reimbursement from Medicaid 0.00 COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER mm DESCRIPTION OF GOODS OR SERVICES QUANTITY UNIT PRIC TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $5,472.19 approved by Commissioners„Codxton12/22/2021 1000-001-46010 oVE?lii)Jer io,(-2b21 Interest', ($0.81) $5,471.38 COUNTY AUDITOR APPROVAL ONLY y 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 T THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD C DIT N AND REQUEST THE COUNTY TREASURER TO PAY THE ABOU 0 CATION. BY: 12/20/2021 N js- 1(y� N a 0, z O .�5zz-� N [Zy- •VVVJ? w oz v DEPARTMENT HEAD DATE ®IHS Issued 12/16/21 Source Description Source Totals Report Calhoun Indigent Health Care Batch Dates 1210112021through 12/01/2021 For Source Group Indigent Health Care For Vendor: All Vendors Amount Billed 02 Prescription Drugs 08 Rural Health Clinics 14 Mmc - Hospital Outpatient Expenditures Reim6/Adjustments Grand Total APPROVED ON DEC 2 0 ZM BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS 80.66 980.00 931.00 2,027.51 -35.85 1,991.66 EXPENSES COPAYS TOTAL Amount Paid 80.66 921.08 353,78 1,391.37 -35.85 1,355.52 4,166.67 5.522.19 <50.00> 6,472.19 y ©iHS Source Totals Report Issued 12/16121 Calhoun Indigent Health Care Batch Dates 0210212021 through 12101/2021 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 22,368.00 2,132.69 01-2 Physician Services- Anesthesia 4,758.00 1,215.52 02 Prescription Drugs 886.93 886.93 05 Lab/X-Ray 11,719.15 135:25 08 Rural Health Clinics 5,239.00 4,962.65 13 Mmc - Inpatient Hospital 71,611.19 25,653.50 14 Mmc - Hospital Outpatient 106,317.10 34,271.98 15 Mmc - Er Bills 21,695.00 6,942.40 Expenditures 244,945.03 76,551.58 Reimb/Adjustments -350.66 -350.66 Grand Total 244,694.37 76,200.92 EXPENSES 45,833.37 122,034.29 COPAYS <760.00> TOTAL 121,274.29 Bill To: Calhoun County 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Date: 12/6/2021 Invoice # 363 For: Nov-21 �!` �h'zt�ar.=. ?31,'1.- k"^ Funds to cover Indigent program operating expenses. $ 4,166.67 Total $ 4,166.67 VIA Anthony Richardson tz., APPROVED Interim CFO ON DEC 2 f) 621 BY COUNTY AUDITS" CALHOUN COUNTY, ;—. S Calhoun County Indigent Care Patient Caseload 2021 Approved Denied Removed Active Pending January 2 0 0 11 5 February 0 0 0 it 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 1 1 1 6 5 December Monthly Avg 1 0 1 9 6 December 2020 Active 9 Number of Charity patients 203 Number of Charity patients below 50% FPL 81 Calhoun County Pharmacy Assistance Patient Caseload 2021 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 3 5 0 23 $28,636.00 December YTD PATIENT SAVINGS $213,553.00 Monthly Avg 2 3 0 16 $19,413.91 0 December 2020 Active 87 P A Y k E MEMORIAL MEDICAL CENTER ffDCi® Y CHECK REQUEST CALHOUN COUNTY INDIGENT ACCOUNT Date Requested: 12/6/21 AMOUNT $50.00 FOR ACCT. USE ONLY ❑ Imprest Cash ❑A/P Check Mail Check to Vendor ❑ Return Check to Dept GANUMBER: 50240000 EXPLANATION: TO TRANSFER INDIGENT CO -PAYS FROM OPERATING ACCOUNT TO THE INDIGENT REQUESTED BY: Mayra Martinez AUTHORIZED BY: fv + RUN DATE: 12/06/21 MEMORIAL MEDICAL CENTER PAGE 159 TIME: 13:14 RECEIPTS FROI4 11/01/21 TO 11/30/21 RCMREP G/L RECEIPT PAY CASH RECEIPT DISC COLL GL CASH NUMBER DATE NU14BER TYPE PAYER AMOUNT AMOUNT NUMBER NAME DATE INIT CODE ACCOUNT ...................................'------------------•"--......_....._.._.............---......._.......-------------------------- 50240,000 11/19/21 608360 CA 10.00 10.00 00/00/00 PGC 2 50240.000 11/11/21 607592 CA 10.00 10.00 00/00/00 PLB 2 50240.000 11/18/21 608319 CA 30.00 10.00 00/00/00 PLB 2 50240,000 11/24/21 60886D CA 10.00 10.00 00/00/00 PLB 2 50240.000 11/24/21 608917 CA 10.00 10.00 00/00/00 PLB 2 **TOTAL** 50240.000 COUNTY INDIGENT COPAYS 5D.00 50510.000 11/01/21 605986 CA CAFE 165.60 165.60 00/00/00 KAM 2 50510.000 11/01/21 605987 VI CAFE 320.58 320.58 00/00/00 KAM 2 50510.000 11/01/21 605988 MC CAFE 77.51 77.51 00/00/00 RAM 2 50510.000 11/01/21 605989 AS CAFE 17.67 17.67 00/00/00 KAM 2 50510.000 11/01/21 605992 VI CURBSIDE 28.53 28.53 00/00/00 KAM 2 50510.000 11/01/21 605993 MC CURSSIDE 56.75 56.75 00/00/00 KAN 2 50510.000 11/01/21 605994 US CURBSIDE 94.67 94.67 00/00/00 KAM 2 50510.000 11/05/21 607023 CA CASH 253.37 253.37 00/00/00 KAM 2 50510.000 11/05/21 607024 VI CAFE 230.35 230.35 00/00/00 KAN 2 50510.000 11/05/21 607025 MC CAFE 23.62 23.62 00/OD/00 KAN 2 50510.000 11/05/21 607026 US CAFE 11.02 11,02 00/00/00 KAM 2 50510.000 11/05/21 607027 AE CAFE 7.52 7.52 00/00/00 KAN 2 50510.000 11/05/21 607028 VI CURBSIDE 150.51 150.51 00/00/00 KAM 2 50510.000 11/05/21 607029 MC CURBSIDE 9.41 9.41 00/00/00 KAM 2 50510.000 11/05/21 607030 US CURBSIDE 8.32 8.32 00/00/00 KAM 2 50510.000 11/05/21 607031 CE CAFE 13.22 13.22 00/00/00 RAH 2 50510.000 11/08/21 607206 CA CAFE 331.34 331.34 00/00/00 RAH 2 50510.000 11/08/21 607207 VI CAFE 241,10 241,10 00/00/00 RAN 2 50510.000 11/08/21 607208 MC CAFE 75.65 75.65 00/00/00 KAN 2 50510.000 11/08/21 607209 VI CURBSIDE 76.64 76.64 00/00/00 RAN 2 50510.000 11/08/21 607210 MC CURBSIDE 41.62 41.62 00/00/00 KAN 2 50510.000 11/08/21 607211 US CURBSIDE 20.98 20.98 OD/00/00 KAN 2 50510.000 11/11/21 607766 VI CAFE 177.71 177.71 00/00/00 KAN 2 50510.000 11/11/21 607773 VI CAFE 177.71- 177.11- 00/00/00 KAN 2 50510.000 11/12/21 607767 MC CAFE 73.32 73.32 00/00/00 KAN 2 50510.000 11/12/21 607768 US CAFE 12.60 12.60 00/00/00 KAH 2 50510.000 11/12/21 607769 AS CAFE 6.37 6.37 O0/00/00 KAM 2 50510.000 11/12/21 607770 VI CURBSIDE 20.85 20.85 O0/00/00 KAM 2 50510.000 11/12/21 607771 MC CURBSIDE - 9.41 9.41 00/00/00 KAM 2 50510.000 11/12/21 607772 CA CAFE 200.87 200.07 00/00/00 KAM 2 50510.000 11/12/21 607775 VI CAPE 177.71 177.71 00/00/O0 KAM 2 50510.000 11/15/21 607941 CA CAFE 251.43 251.43 00/00/00 KAM 2 50510.000 11/15/21 607942 VI CAFE 240.35 240.35 00/00/00 KAN 2 50510.000 11/15/21 607943 MC CAFE 69.29 69.29 00/0010D KAN 2 50510.000 11/15/21 607944 AN CAFE 12.54 12.54 00/00/00 KAN 2 50510.000 11/15/21 607945 VI CDRBSIDE 81.95 81.95 00/00/00 KAN 2 50510.000 11/15/21 607946 MC CURBSIDE 47.03 47.03 00/00/00 KAM 2 50510.000 11/15/21 607947 US CURBSIDE 9.41 9.41 00/00/00 KAN 2 50510.000 11/15/21 607951 CK CAPE 10.82 10.82 00/00/00 KAM 2 50510,000 11/16/21 608028 CA CAFE 169.36 169.36 00/00/00 KAM 2 50510.000 11/16/21 608029 VI CAFE 121.07 121.07 00/00/00 KAM 2 50510.000 11/16/21 608030 MC CAFE 77.09 77.09 00/00/00 KAM 2 50510.000 11/16/21 60B031 AE CAFE 7.43 7.43 00/00/00 KAM 2 50510.000 11/16/21 60B034 VI CURBSIDE 19.91 19.91 00/00/00 MAN 2 50510.000 11/16/21 608035 MC CURBSIDE 7.78 7.78 00/00/00 KAM 2 6*,b 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 13312 11/30/2021 ""4551 Page 1 of 2 11/01/2021 Beginning Balance $5,441.71 3 Deposits/Other Credits + $7,379.74 8 Checks/Other Debits - $7,228.51 11 /30/2021 Ending Balance 30 Days in Statement Period $5,592.94 Total Enclosures 10 �DEPOSITVOTHER CREDITS�� Date Description Amount 11/04/2021 Deposit $7,358.93 W-0'jk' 11/24/2021 Deposit $20.000'b ON OD(Ar6 11 /30/2021 Accr Eaming Pymt Added to Account $0.81 g Check Number Date Amount Check Number Date Amount Check Number Date Amount F' 12495 11-O8 $1,718.08 12498 11-10 $103.63 � 12501 11.08 $69.96 12496 11-09 $815.81 12499 11-12 $106.39 12502 11-08 $4,166.67 12497 11-09 $95.43 12500 11-09 $152.54 v Date Balance 11-01 $5,441.71 11-04 $12,800.64 11-08 $6,845.93 Date Balance 11.09 $5,782.15 11-10 $5,678.52 11-12 $5,572.13 *' Below is an itemization of the Earnings paid this period. *' Interest Paid This Period $0.81 Annual Percentage Yield Earned Interest Paid YTD $19.37 Days in Earnings Period Earnings Balance MEMBER FDIC �ENOER Date Balance 11-24 $5,592.13 11-30 $5,592.94 0.15 % 30 $6,584.11 NYSE Symbol "PB" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---December 22, 2021 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES,.PAYRQLLAND ELECTRONIO BANK PAY AhENTS $854,205.34 / TOTAL TRANSFERS BETWEEN FUNDS TOTAL NURSING HOMR UPL.EXPENSES TOTAL INTER -GOVERNMENT TRANSFERS $ _ 348,253:68_ $ 1,518ASC85,'✓ $_ 57 985, 63 GRAN6TOTAI;D,ISBURSEMENTSAPPROVEDZecember22,9021 $ 2j777109r79" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---December 22 2021 PAYABLES AND PAYROLL 12/16/2021 Weekly Payables 12/16/2021 Emergency Staffing Solutions- emergency physcian services 12/20/2021 McKesson-340B Prescription Expense 12/20/2021 Amerisource Bergen-340B Prescription Expense 12/20/2021 Payroll Liabilities -Payroll Taxes 12/20/2021 Payroll Prosperity Electronic Bank Payments 12/13/2021 Cleargage-Patient Financing Service TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 12/1612021 MMC Operating to Ashford-carrection of medicare payment deposited into MMC Operating 1211612021 MMC Operating to Solera-correction of NH insurance payment and medicare. deposited into MMC Operating in error 1211612021 MMC Operating to Fort bend -correction on NH medicare payment deposited into MMC Operating 12116/2021 MMC Operating to Broadmoor-correction of NH medicare payment deposited into MMC Operating 12/18/2021 MMC Operating to Crescent -correction of NH insurance and medicare payment deposited into MMC Operating in error 12116/2021 MMC Operating to Golden Creek -correction of NH insurance and medicare Payment deposited into MMC Operating in error 12/1612021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment deposited into MMC Operating 12/16/2021 MMC Operating to Tuscany Village -correction of NH Insurrace payment deposited into MMC Operating 12/16/2021 MMC Operating to Bethany -correction of NH insurance and medicare payment deposited into MMC Operating in error MEDICARE ADVANCE PAYMENT RECOUP 12/20/2021 Broadmoor to Bethany -correction of Broadmoor medical recoup taken from Bethany 12/2012021 Broadmoor to Tuscany Village -correction of Broadmoor medical recoup taken from Tuscany Village 12/2012021 Crescent to Tuscany Village -correction of Crecent medicare recoup taken from Tuscany Village 12/20/2021 .Crescent to Bethany -correction of Crecent medicare recoup taken from Bethany 12/20/2021 Solera to Bethany -correction of Solera medicare recoup taken from Bethany 12120/2021 Solera to Tuscany Village -correction of Solera medicare recoup taken from Tuscany Village TRANSFER OF FUNDS BETWEEN NURSING HOMES 12/2012021 Gulf Pointe Plaza -PP -correction of MMC insurance payment deposited into Gulf Pointe Plaza -PP in error 12/20/2021 Gulf Pointe Plaza -PP -correction of MMC Clinic Insurance payment deposited into Gulf Pointe Plaza -PP in error 1212012021 Gulf Pointe Plaza -PP -correction of Ashford insurance payment deposited into Gulf Pointe Plaza -PP in error 12/20/2021 Gulf Pointe Plaza -PP -correction of Tuscany Insurance payment deposited into Gulf Pointe Plaza -PP in error 12120/2021 Gulf Pointe Plaza -PP -correction of Bethany insurance payment deposited into. Gulf Pointe Plaza -PP in error TOTAL:TRAWS,FERS BETWEEN FUNDS 406,374.57 46,542.50 11,814.44 289.00 93,090.66 295,704.03 109,40 280.74 22,542.62 63,227.62 11,396.92 50,869.06 45,681.52 10,797.05 3,647.04 17,452.16 12,859.21 674.89 2,594.91 2,594.91 674A9 674.89 2,594.91 14,714.39 1,188.54 73,629.16 4.829.00 3,710.00 NURSING HOME UPL EXPENSES 12/20/2021 Nursing Home UPL-Cantex Transfer 852,407.76 12/20/2021 Nursing Home UPL-Nexion Transfer 189,123.52 12/20/2021 Nursing Home UPL-HMG Transfer 41,220.59 12/20/2021 Nursing Home UPL-Tuscany Transfer 74.014.03 $' ;346r253:8# 1212OM21 Nursing Home UPL-HSL Transfer NURSING HOME BANK FEES 12/152021 Ashford -Enhanced analysis fee OIPP CHECKS TO MMC 12/20/2021 Ashford 12/20/2021 Broadmoor 12/20/2021 Crescent 12/20/2021 Fort Bend 12/20/2021 Solera 12/20/2021 Tuscany TOTAL,NURSING HO[d1E UAL E XPENSES 310,965.51 86.26 15,879.84 6,572.17 6,853.95 6,417.30 6,464.00 9,649.92 $ '1;618,664.85 INTER•GOVERNMENTTRANSFERS 12/20/2021 IGT DSRIP DY10 R2 be paid on January 05, 2022 57,995.83 TOTAL INTER-0O- VERNMENS TRANSFERS $ 67,996,03 GRAND TOTAL' DISBURSENIENT.S APPROVED DBCembet-22,;2U21 $ 2,777,169:70 RECEIVED BY THE COUNTY AUDITOR ON DEC 16 2021 CALH1D1fMANIMITY, TEXAS 09:59 MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 01105/2022 Vendor# Vendor Name J Class Pay Code 10995 ABILITY NETWORK (SHIFTHOUND) / Invoice# Co ment Tran Ot Inv Dt Due Ot Check D Pay Gross 21 M0184071 12/06120. 12/OS/20 01/02/2o. 616.28 SCHEDULING SERVICES Vendor Totals Number Name Gross 10995 ABILITY NETWORK (SHIFfHOUND) 616.28 Vendor# Vendor Name Class Pay Code Page 1 of 19 0 ap_open_invelce.template Discount No -Pay Net 0.00 0.00 616.26 Discount No -Pay Net 0.00 0.00 616.28 10950 ACUTE CARE INC / ' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV508 ✓ 12108/20. 1212012012130120 1,400.00 0.00 0.00 1,400.00 RFID FEE Vendor Totals Number Name Gross Discount NO -Pay Net 10960 ACUTE CARE INC 1,400.00 0.00 0.00 1,400.00 Vendor# Vendor Name Class Pay Code 13180 ADVANCED STERILIZATION PRODUCT , / Invoice# Comment Tran Ot Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 8020358883 t1 12/06120.11 /29/2012/29/20 20.00 0.00 0.00 20.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 13180 ADVANCED STERILIZATION PRODUCT 20.00 0.00 0.00 20.00 Vendor# Vendor Name Class Pay Code A1746 ALPHA TEC SYSTEMS INC ,.,f M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net INV00099759A,/" 12/15/20.1110312012103/20, 15.00 0.00 0.00 15.00 ✓ FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net A1746 ALPHA TED SYSTEMS. INC 1SAO 0.00 0.00 15.00 Vendor# Vendor Name Class Pay Code A2218 AQUA BEVERAGE COMPANY �' M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 171632 I PM/20. 11/30/2012/25/20 44,40. 0.00 0.00 44.40 �/ (- WATER FOR LAB Vendor Totals Number Name Gross Discount No -Pay Net A2218 AQUA BEVERAGE COMPANY 44.40 0.00 0.00 44.40 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC ,% Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /Comment 2399398 12/0812012/06/20 01/05/20. 787.25 ✓ 0.00 0.00 787.25 TRAVEL LAB STAFFING (tt11N1-z1)R4W1ttns 2399196 ✓ 12/08/2012/O6/2001/05/20 2,680.00 0,00 0.00 2,680.00 TRAVEL LAB STAFFING 010 1- tt Izwlvi 5h; btey 2399325 12/06/2012(06120 01/OS/20 2,43225 0.00 0.00 2,432,25 % TRAVEL LAB STAFFING ttlt2a(- ltlmtglsI) SitvloldJ� _ 2391700 y� 12115/2(111/2012012129/20 2,680.00 0.00 0.00 2,680.00 q✓ LAB STAFFING ttltlSl- It Its I.21)OLLJI K& /TRAVEL 2391618 ✓ 12/15/20. 11/29/201 PJ29/20 1,104.00 0.00 0.00 1,104.00 ✓ TRAVEL LAB STAFFING (1t 11 a -1 tllri A-t) gjwv o i Lt,,, . file_!//C:/[Jserv/eherman(ensi/memmed cnsinFt rnm/nAR547/ eta 5/tmn nw5rrnnrtR06 19/161?n9/ Page 2 of 19 231483 ✓ 12/15/20 11/29/20 12/29/20. 971.50 0.00 0.00 971.50 TRAVEL LAB STAFFING &Kk,%Aj , Vendor Totals Number Name Grass Discount No -Pay Net A0400 AUREUS. RADIOLOGY LLC 10,655.00 0.00 0.00 10,655.00 Vendor# Vendor Name Class Pay Cade B1150 BAXTER HEALTHCARE ✓`J W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 72981335 ✓ 12/15120.11126/2012/20/20. 136.22 0.00 0.00 136,22 SUPPLIES 730000632 12/15/20.11129/2012124/20 321.01 0.00 0.00 321.01 y/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 457,23 D.00 0.00 457.23 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC d% M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 109472454 �% 11/30/2011/29/2012/24/20. 80.47 0100 0.00 80.47 SUPPLIES 109480170 ,% 11/30/20, 12/01/20 12/26/20. 16115 0.00 0.00 161.75 SUPPLIES 109479658 ✓ 11/30/2012101/2012126/20. 181.13 0.00 0.00 181.13 SUPPLIES 109471691 �,%� 12/08/20, 11/29/20 12/24/20 44.59 0.00 0.01) 44.59 SUPPLIES , 109483587,% 12/OS/20 12/02/20 12/27/20 85.90 0.00 0.00. 85.90 SUPPLIES 109484379 /' 12Po8/20.12/021201PJ27120 51.18. 0.00 0.00 51.18 . SUPPLIES 109485372 ,, / 12/0812012/02/20 12/27/20 1,772.90 0.00 0.00 1,772.90 SUPPLIES 7306994 12r08/20 12/02/20 12/27/20 6,26726 0.00 0.00 6,267.26 ✓ SUPPLIES 109486632 ✓ 12/08/2012/03/2012/28/20, 1,847.55 0.00 0.00 1,847.55 SUPPLIES 109486851 e/ 12/08/20.12/03/2012/28/20 246.70 0.00 0.00 246.70 S,UPPLIES . 109486778 tr 12/08/20. 1 PJ03/2012/28/20 697.27 0.00 0,00 697.27 ✓� SUPPLIES 109486421 ✓' 12/08/20 12/03/20 12/28/20 51.18 0.00 0.00 51.18 SUPPLIES 109486693✓ 1210812012(05/2012/30120. 14,108.29 0.00 0.00 14,108.21) SUPPLIES 109488424 ✓ 1210812012/0512012/30/20 85.30 0.00 0.00 85,30 ,_z SUPPLIES , 109491251 ✓ 12108/20,1210612012/31/20 45.97 0.00 0,00 45.97 SUPPLIES . 109493295 ✓ 12108/2012/06/20 12/31/20 68,43 0.00 0.00 68.43 SUPPLIES 1094-01650 yam^' 12/08/20.1210612012/31/20. 68.43 0.00 0.00 68.43 ✓ SUPPLIES 109493236 , / 12(08/2012/06/2012/31/20 46.00 0.00 0.00 46.00 ./ file:///C:Nsers/eheiman/cnsi/memmed.cnsinet_com/n9R547/data S/tmn rwSrPnnrtRF')A 1)/IA/7m1 Page 3 of 19 SUPPLIES 109493799✓ 12108/2012/0612012131120 l,16O.63 0.00 0.00 1,160.63 SUPPLIES 109490837,E 12/0812012/06/20 12/31120, 142.20 0.00 0.00 142.20 SUPPLIES 109493983 ✓/12/03/20.12/06/2012131120 02.48 0.00 0.00 82.48 ✓ SUPPLIES 109493874.i 12/08/2012108/20 12/31/20 68.43 0.00 0.0D 68.43 1Z SUPPLIES 109497955 1VO812Q 12/07/20 01/01120. 393.88 0.00 0.00 393,88 r% 100499551 12/09120, 12107/20 01101/20. 499.68 0.00 0.00 499.68 ✓� SUPPLIES 109497039 ✓ 12/08/201 PJ0712001/01/20 1,305.37 0.00 0.00 1,305.37 r' SUPPLIES 5450363 d/ 12/13/20,12/05/20 12/30/20 6,249.42 0.00 0.00 6,249.42 f' SUPPLIES 1095053291/ 12/15/20.12/08/2001/02/20, 2,559.33 0.00 0.00 2,559.33✓ SUPPLIES 109511321 ✓ 12/15/20,12110/20 01/04/20. 131.64 0.00 0.00 131.64 ✓' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 38,503.36 0.00 0.00 38,503.06 Vendor# Vendor Name Class Pay Code 12600 BIOFIRE DIAGNOSTICS LLC ./} Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1280148815 ✓ 12/13120 12101/20 01/01/20, 13,950.00 0.00 0.00 13,950.00 ✓- SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 12800 BIOFIRE DIAGNOSTICS LLC 13,950.00 0.00 0.00 13,950.00 Vendor# Vendor Name Class Pay Code B0437 C R BARD INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 83413710 ✓ 12/13120. 11/2212012/22120 786.90 0.00 0.00 786.90 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B0437 C R BARD INC 786.90 0.00 0.00 786,90 Vendor# Vendor Name Class Pay Code 14120 CALHOUN COUNTY EMS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 21110005f 11/30/2R 12(01/2012/31/20. 5,720.00 0.00 0.00 5.720.00 EMS SERVICES ito13t-Ii 3a1u) Vendor Totals Number Name Gross Discount No -Pay Net 14120 CALHOUN COUNTY EMS 5,720.00 0.00 0.00 5,720.00 Vendor# Vendor Name Class Pay Code 13992 CARIANIT HEALTH PARTNERS,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 130t94 12106/201001/2012124120. 4,663.75 0.00 0.00 4,663.75' TRAVELNURSESTAFFING (11123- It12,1,.t) FVy6VS 130176 0,/� 12/08/2012/Ot/2012/30/20 528000 11 1.2-t 1-2A) 0.00 0.00 5,280.00 TRAVEL NURSE STAFFING C 1 I IT,3 - file:///C:/Usets/eheiman/ct>si/memmed.onsinet-com/ii9R547/clatn 5/tmn ew5rPnnrt3Z69A Page 4 of 19 130409 / 1211312Q 12/08/20 01/05/20, 840A0 0.00 0.00 840.00 � - TRAVEL NURSE STAFFING lit 117( 1 �%) FWbu5 Vendor Totals Number Name Gross Discount Ne-Pay Net 13992 CARIANT HEALTH PARTNERS 10,783.75 0.00 0,00 10,783.75 Vendor#Vendor Name Class Pay Code 14236 CARRIER CORPORATION v,' Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 90164371A ✓ 12108/20.11129/2012129/20, 21,830,00 0.00 0.00 21,830.00 ✓� CHILLER RENTAL Vendor Totals Number Name Gross Discount No -Pay Net 14236 CARRIER CORPORATION 21,830.00 0.00 0.00 21,830.00 Vendor# Vendor Name Class Pay Code C1992 COW GOVERNMENT, INC. „% M Invoice# Comment Tran Ot Inv Dt Due or Check D Pay Gross Discount No -Pay Net P315681 12115/2012/0212001/01/20. 5,868.62 0.00 0.00 5,388.62 y% SUPPLIES (0 LbV0TIh,4 PL, 16) rvt5or-Ftc�tr,� . P370318 f 12/15/20. 12/03/2001/02/20 617.14 0.00 0.00 617,14 yJ SUPPLIES P322755 V,% 12115/20. 12/03/2001102120 2,333.60 0.00 0.00 2,333.60 SUPPLIES P434527 % 12J16/2012106/2001/05/20 235.01 0.00 0.00 235.01 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1992 CDW GOVERNMENT, INC, 6,574.37 0.00 0.00 8,574.37 Vendor# Vendor Name Class Pay Code 10786 CLINICAL PATHOLOGY >r' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 176562021110 1 PJ15120. 11/3012012125120, 14,397.01 0.00 0.00 14,397.01 Vendor Totals Number Name Gross Discount No -Pay Net 10786 CLINICAL PATHOLOGY 14,397.01 0.00 0.00 14,397.01 Vendor# Vendor Name Class Pay Code 13336 COCA COLA SOUTHWEST BEVERAGES ii Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 24165200403 w/ 12/15/20.12/15/2001/07/20. 453.41 0.00 0.00 453.41 ✓ DRINKS Vendor Totals Number Name Gross Discount NaPay Net 13336 COCA COLA SOUTHWEST BEVERAGES 45SAl 0.00 0.00 453.41 Vendor# Vendor Name Class Pay Code 10006 CUSTOM MEDICAL SPECIALTIES v.' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 208577 a'` 12/O6/E0. 12J01/2012/31126 327.66 0.00 0.00 327.65 a/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10006 CUSTOM MEDICAL SPECIALTIES 327.65 0.00 0.00 327.65 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -pay Net 6644620 y// 12/06/2012/01/2012/26/20. 165.60. 0.00 0.00 105.60 t% SUPPLIES v1 9/6645200 12M6/20.12/02/201 PJ27/20 121.58 0.00 0.00 121.58 file:///C:/Users/eheiman/cosi/memmed.cl3sinet.com/u98547/data 5/tmn cw5rennrtR6?.6.. 12/160091 Page 5 of 19 SUPPLIES 6640231 ✓ 12/07/20. 12/06/2012/31120. 85.22 0,00 0.00 85.22 SUPPLIES r j ! 6644480✓ 12/08/2012/01/2012/26/20. 75.05 0.00 0.00 75.05 SUPPLIES 66510o0 ✓ 12/08/2012/06/20 12/31/20 722.50 0.00 0.00 722.50 ✓ SUPPLIES 6650930 ✓ 12108120. 12/06120 I P(31/20 30.38 0,00 0.00 30.38 SUPPLIES 6652710 12/1312Q 12/08/20 01/02/20 161.46 0.00 0.00 161.46 ,t✓ SUPPLIES 6640182 �/! 12/13/2012108120 01/02/20 32.84 0.00 0.00 32.84 SUPPLIES 6651970 ✓ 12J13/20, 1 W0712001/01/20 137.31 0.00 0.00 137.31 SUPPLIES 6651940 y✓ 12/13120. 12/07/2001/01120 132.16 0.00 0.00 132.16 �✓ 5 SUPPLIES 650660 V/ 12/15/20. 12(1o/20 01/04/20 1,480.00 0.00 0100 1,480.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 3,164.10 0.00 0.00 3,164.10 Vendor# Vendor Name Class Pay Code 11011 DIAMOND HEALTHCARE CORP ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net IN20055062 ✓ 1211312012/0112012/20/20 31,144,58 0.00 0.00 31,144.58 ✓ BEHAVORiAL HEALTH NOV 2C / IN20055074 y 12/13120. 12N1/20 i2/26/20. 2,600.00 0.00 0.00 2.500.00 ✓ INPATIENT ASSMT. NOV 2021 IN20055063 �% 12/13/20. 12/011201212WO 19,166.67 0A0 0.00 19,166.67 CPR NOV 2021 Vendor Totals Number Name Gross Discount No -Pay Net 11011 DIAMOND HEALTHCARE CORP 52,811.25 0.00 0.00 62,81126 Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL v' Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross Discount No -Pay Net FW-6571 ✓ 11/30/2011/30/2012/25/20. 105.00 0.00 0.00 105.00 PEST CONTROL FW-6244 �% 11/30/20 111 0/20 12J30/20 505.00 0.00 0.00 505.00 s+'' PEST CONTROL Vendor Totals Number Name Gross Discount No -Pay Net 11291 DOWELL PEST CONTROL 610.00 0.00 0.00 610.00 Vendor# Vendor Name Class Pay Code 12484 EL CAMPO REFRIGERATION �✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 60708 J/ 12/15/20 12/01/20 01/01/20. 083.75 0.00 0.00 583.75 ✓( SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 12484 EL CAMPO REFRIGERATION 683.75 0.00 D.OD 683.76 Vendor# Vendor Name Class Pay Code 10042 ERBE USA INC SURGICAL SYSTEMS,/- Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross Discount No -Pay Net file:///C:/Users/eheiman/cpsi/Memmed.cpsinet.com/u98547/data 5/tmo cw5renort8626... 12/16/2021 Page 6 of 19 718146 ✓ 12t06/2012101/2012131/20 139.50 0.00 0.00 139.50 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10042 ERGE USA INC SURGICAL SYSTEMS 139.50 0.00 0.00 139.50 Vendor# Vendor NameClass Pay Code / C2510 EVIDENT t/ M Invoke# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net A2112031378 / �/ 12/13120,12/03/20 12/28l20 17;615.60 0.00 0.00 17;515.00 ✓ SUPPORT 991569� 12/15120.10/22/2011/16/20. 481.99 0.00 0.00 481.99 SHIPPING Vendor Totale Number Name Gross Discount No -Pay Net C2510 EVIDENT 17,996,99 0.00 0100 17,996,99 Vendor# Vendor Name Class Pay Code / 10689 FASTHEALTH CORPORATION Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Grass Discount. No -Pay Net 12B21mme / 12/15/20, 12/01/2012/16/20 95.00 0.00 0.00 05.00 sTANDARD SSL - 2022 Vendor Totals Number Name Gross Discount No -Pay Net 10689 FASTHEALTH CORPORATION 95.00 0.00 0.0 95.00 Vendor# Vendor Name Class Pay Code / F1100 FEDERAL EXPRESS CORP. W Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 758429302 V`12/OB/20.12/02/2012127/20 50.04 0.00 0,00 50.84 FREIGHT 759157857 y✓� 12/15/20 12/09/20 01113=0 43.78 0.00 0.00 43.78 FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 94.62 0.00 0.00 94.62 Vendor# Vendor Name Class Pay Code 14092 FIRST CONNECT CENTER LLC „f Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3327 11/29/20. 11/23/20 12/23/20 125.00 0100 0.00 125.00 TRAVEL NURSE STAFFING t11 IW- Ill$LI-2.1j Gotra" 3326 11/29/2011/23/2012/23/20 4,625.00 0.00 0.00 4,625.00 TRAVEL NURSE STAFFING i It I IV -11't K 1240 3324 11/20/20. 11/23/20 1PJ23120 4,593.75 0.00 0.00 4,593.75. ✓� TRAVEL NURSE STAFFING( %t 12-111N 1 8lrnhatK 3372 ✓ 12/06/20. 12101/2012/31/20 4,218,75 0.00 0.00 4,218.75 TRAVEL NURSE STAFFING lit lla-I 1lie, 1 '7^t� R"Kkn�, Vendor Totals Number Name Gross Discount No -Pay Net 14092 FIRST CONNECT CENTER LLC 13.562.50 0.00 0.00 13,562.50 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1706921 1211312010/2112011/15120 11631.96 0.00 0.00 1,631.96 SUPPLIES 6358550 ,/ 12113/20 12/02/2012(27/20 11.40 0.00 0.00 11.40 SUPPLIES 6094721 12/15/20 11/24/20 1?/19/20 50.38 0.00 0.00 50.38 ✓ SUPPLIES f11e:///C:/Users/eheiman/cpsi/rnemmed.cpsinet.com/u98547/data 5/tmp cw5report8626... 12/16/2021 Page 7 of 19 6149630 12/15/20.11129120 12/24/20 180.36 0.00 0.00 1130.36 ✓ SUPPLIES 6200780 ✓ 1PJ151PO 11/30/20 12/25/20 8.10 0.00 0.00 8.10 y' SUPPLIES 6422996 V//12/15/20 12/03/20 12/28/20. 157.15 0.00 0.00 157.15 SUPPLIES Vendor Total:NUmber Name Grass Discount No -Pay Net F1400 FISHER HEALTHCARE 91039.35 0.00. 0.00 2,039.35 Vendor# Vendor Name Class Pay Code 11163 FRONTIER,,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 120221 12/15/20, 12/02/2012127120 1,122.84 0.00 0.00 1,122.84 TELEPHONE . Vendor Totals Number Name Gross Discount No -Pay Net 11183 FRONTIER 1,122.84 0.00 0.00 1,122.84 Vendor# Vendor Name Class Pay Code 10283 GE HEALTHCARE Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net 6002004902 12113/20. 12/0112012/26/20. 86.67 0.00 0.00 86.67 ✓' MAINT CONTRACT DEC 2021 6002004829 12/13120, I PJOI12012/26/20 660.00 0,00 0.00 680.00 r/ , MAINT CONTRACT DEC 2021 , 6002004931 ✓/ 12113/20.12/01/2012/26120 5,665.83 0.00 0.00 5,685.83 ✓ MAINT CONTRACT DEC 2021 6002005087 ✓ 12/13/2012101/2012/26/20. $68.16 0.00 0.00 868.16 U,/ MAINT CONTRACT DEC 2021 6002004830 „/ 12/1312012/01120 12/26/20. 572.33 0.00 0.00 572.33 d!r MAINT CONTRACT DEC 2021 6002004901 ✓` 12/13/20.12(Ot/2012/26/20 3,588.58 0100 0.00 31586&58 r MAINT CONTRACT DEC 2021 6GO2004903 „/ 12/1612012/01/2012126120 61.67 0,00 0.00 61.67 1% MAINT COMTRACT DEC 2021 Vendor Totals Number Name Gross Discount No -Pay Net 10283 GE HEALTHCARE 11,523.24 0.00 0.00 11,523.24 Ventlor! Vendor Name Class Pay Cade 10901 GENESIS DIAGNOSTICS „rf Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Grass Discount No -Pay Net 52659 rj 1PJ13/20. 11/29/2012J29/20. 121.46 0.00 0.00 121.46 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10901 GENESIS DIAGNOSTICS 121.46 0.00 0.00 121.46 Vendor# Vendor Name Class Pay Code W1300 GRAINGER ✓� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 0141975723 12/15/2012(06/201 PJ31/20 22,40 0.00 0.00 22.40 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net W1300 GRAINGER 22.40 0.00 0.00 22.40 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net file:///C:/Users/eheiman/ci)si/memmed.evsinet.com/u98547/data 5/tma ew5reoort8626... 12/16/2021 Page 8 of 19 2146237 „/J 11130/2011/24/2012/24120 40.02 0.00 0.00 40.02 SUPPLIES / e+� Vendor Totals Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 40.02 0:00 0.00 40.02 Vendor# Vendor Name Pay Cade /Class 10804 HEALTHCARE CODING & CONSULTING ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 117/23 ✓ 12/15/20 11/30/20 12/30/20 1,371.50 0.00 0.00 1.371.50 e/y CODING SERVICES Vendor TotalsNumber Name Gross Discount No -Pay Net 10804 HEALTHCARE COOING & CONSULTING 1,371.60 0.00 0.00 1,371.50 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES ✓r Invoice# Comment Tran Dt Inv Dt Due Dt Check0 Pay Gross Discount No -Pay Net ' 100546785✓ 11/29/2011/27/2001/01/2Q 4,610.62. 0.00 0.00 4,610.52 t/ LEASE Vendor Totals Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 4,610.52 0.00 0.00 4,610.52 Vendor# Vendor Name Class Pay Code H0031 HEB CREDIT RECEIVABLES DEPT308 ,,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 653876 / 12/07/20. 10/30/2012/2S/20. 91.63 0100 0:00 i 91.63 SUPPLIES 272612 ✓ 12/07/20 10/31/20 12/25/20, 10.41 0.00 0.00 10.41 SUPPLIES 632231 „% 12/07/20.11/01/2012/25/20 44.65 0.00 0.00 44.65 r/ f SUPPLIES 451845 ✓ 1210712011/02/2012/25120, 28.51 0.00 0.00 28.51 ✓'�� SUPPLIES 254584 ✓ 12/07/20.11/02/2012125/20 46.20 0.00 0.00 46.20 ✓ SUPPLIES 537420 ✓ 12/07/2011/02/2012126/20 2.64 0.00 0.00 2.64 /SUPPLIES 268808 ✓ 12/07120.11104/20 12/25/20 19.80 0.00 0.00 19.80 ✓/ / SUPPLIES 087317 ✓ 12107/2011/06/2012125/24 142.63 0.00 0.00 y 142.53 SUPPLIES 696818 12/07/2011/07/2012(25/20 16.70 0.00 0.00 15.70 SUPPLIES 093242 ,✓' 12/07/2Q 11/08/2012125/20 17.73 0.00 0,00 17.73 SUPPLIES 468264 ✓ 12r07/20.11/10/2012/25/20 53.13 0.00 0.00 53.13" SUPPLIES 710183 12/07/20.11/12/2012/25/20. 3`S � y 39.;6 0.00 0.00 36.t4ll 34 SUPPLIES 416264 V 1 W07/2011/13/2012/25/20 127S7 0.00 0.00 127,87 SUPPLIES 523406 f 12/07/20 11/14/20 12/25/20 18.83 0.00 0.00 18.83 ✓f SUPPLIES 732839 ✓ 12/07/20 11/15/20 12/25/20 50.25 0.00 0.00 50.25 SUPPLIES file:///C:/Users/eheiman/cDsi/memmed.cl)sinet.conVu98547/data 5/tmn cw5renort8626... 12/160.091 Page 9 of 19 165812 ✓ 12/07/201 V20/2012/25/20. 72.73 0.00 0.00 72.73 ✓f, rSUPPUES 618585 ,% 12107/2011/21/2012/25/20 29.44 0.00 0.00 29.44 /.SUPPLIES 821949 ✓ 12107M.. 11122/2012/25/20. 23.94 0.00 0,00 23.94 / SUPPLIES ! 135568 12107/20.11/22/2012/25/20 64.09 0.00 0.00 64.09 SUPPLIES 765473 �/� 12/07/20, 11123/2012/25/20. 29.00 0.00 0.00 29.00 y!f SUPPLIES S 972304 ,/ 12/0712011/23/2012/25/20. 14.88 0.00 0.00 14.88 SUPPLIES 064619 /' 12/07/20. 11/26/2012/25/20. '-I (,�!• 9 / 21y1S1 0.00 0.00 21.. 9 UPPLIES 439232 12/07/20.11/2712012125/20. 62.13 0.00 0.00 62.13 yr' SUPPLIES OC-51002 12/07/20.11/29/2012/25/20, 0.18 0.00 0.00 0.18 OC-61001 12/07/201.1/29/2012125120 2.49 0.00 0.00 2.49 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0031 HEB CREDIT RECEIVABLES DEPT308 1,02476 0.00 040 1,02/76 Vendor# Vendor Name Class Pay Code 00 7- 11586 HHSC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grosse� Discount No -Pay Not 110321 12/15/20. 11/03/2012/14/20 H I0j , U7 9457U0 0.00 0.00 9,45.00 q? 5 • VO HOSPITAL LICENSE RENEWAI Vendor Totals Number Name Gross Discount No -Pay Net 11588 HHSC 6j11j.L0 94VOO 0.00 0.00 94VO f Vendor# Vendor Name Class Pay Code 140416 HOLOGIC INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 9923618 J 11122/20. 11/1112012/26/20. 472.50 0.00 0.00 472.50 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 472.50 0.00 0.00 472.50 Vendor# Vendor Name class Pay Code 12932 INTRADO // Invoice# Comment Tran Dt Inv Dt Due Dt Check Dr Pay Gross Discount No -Pay Net INVO02393765 12/13/20. 10/31/2011/30120. 690.41 0.00 0.00 600,41 HOUSE CALLS Vendor Totals Number Name Gress Discount No -Pay Net 12932 INTRADO 690.41 0.00 0.00 69DA1 Vendor# Vendor Name Class Pay Cede 11200 IRON MOUNTAIN ' Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net GCMM804 „% 11/30/2011/30/2012/30/20. 546.31 0.00 0.00 646.31 ✓ RECYCLE SERVICES Vender Totals Number Name Gross Discount No -Pay Net 11200 IRON MOUNTAIN 546.31 0,00 0.00 546.31 Vendor# Vendor Name Class Pay Cade file;///C:/Users/cheiman/evsi/memmed.ensinct.com/u98547/data 5/tmn cw5rennrtR626... 12/16/2021 Page 10 of 19 11264 ITA RESOURCES, INC yr� W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grose Discount No -Pay Net 121521 12/15/20 12/16/20 12/15/20 26,075.83 0.00 0.00 26,075.83 RESPIRATORY DEC 2021 ✓ Vendor Totals Number Name Gross Discount No -Pay Net 11264 ITA RESOURCES, INC 26,075,83 0.00 0.00 26,076.83 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC ,- Invoices! Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 927274155 11/30/20,11126/2012/26/20. 1,070.22 0.00 0.00 1,070.22 INVENTORY 027275694 �! 12/06/20 1 M6120 12/26/20 596.01 0.00 0.00 596.01 SUPPLIES 927340795 s% 12/15/20,12/02/20 01101120, 36.50 0.00 0.00 sem SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Not J0150 J & J HEALTH CARE SYSTEMS, INC 1,702.73 0.00 0.00 1,702,73 Vendor# Vendor Name Class Pay Code 11600 LEGALSHIELD Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 121521 12/15120,12/14/2012/14/20. 660.30 0.00 0.00 560.30 PAYROLLDEDUCT , Vendor Totals Number Name Gross Discount No -Pay Net 11600 LEGAL SHIELD 660.30 0.00 0.00 560.30 Vendor# Vendor Name/ Class Pay Code 12628 LEGATO / � Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net C2169 12/15/2011/30/2012/30/20. 851.25 0.00 0.00 651.25 MARKETING Vendor Totals Number Name Gross Discount No -Pay Net 12628 LEGATO 851.25- 0.00 0.00 851.25 Vendor#Vendor Name Class Pay Code 14244 LONESTAR COMMUNICATIONS, IN Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount. No -Pay Net 100595 W I 12/13/201210812001/05/20, 1,871.22 0.00 0= 1,871.22 SERVICES 100594 � 1211=012/00/20 01/05/20 625.00 0.00 0.00 625.00 PURCHASE SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 14244 LONESTAR COMMUNICATIONS, IN 2,496.22 0.00 0.00 2,496.22 Vendor#Vendor Name Class Pay Code 11796 LUSY'S FUDDRUCKERS RESTAURANTS Invoice# Comment Tran Dt Inv or Due Dt Check D' Pay Gross Discount No -Pay Net INV00005113 �.%' 12/15/20. 11/3012012130/20 23,341.08 0.00 0.00 23,341.08 Vendor Totals Number Name Gross Discount No -Pay Net 11796 LUBY'S FUDDRUCKERS RESTAURANTS 23,341.08 0.00 0.00 23.341.08 Vendor# Vendor Name Class Pay Code M2178 MCKESSON MEDICAL SURGICAL INC ,j Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 18793765 .E IPJ1312011123/2012/15/20 258.71 0.00 0.00 258.71 filet//C;ftJsera/eheiman/rnai/memmPd rnainPt rnm/n4R547/data 5/trnn 17/1 F/'7n71 Page ll of 19 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay M2178 MCKESSON MEDICAL SURGICAL INC 258.71 0.00 0.00 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. A/P v,.� Invoice# Comment Tran Dt Inv Ol Due Dt Check D Pay Gross Discount No -Pay 30236061 12/15/20AW14/2012/14120 34,20 0.00 0,00 Vendor Totals Number Name Gross Discount No -Pay 10613 MEDIMPACT HEALTHCARE SYS, INC. 34.20 0.00 0100 Vendor# Vendor Name Class Pay Code M2827 MEDIVATORS M Invoice# Comment Tran Dt Inv Ot Due Dt Check 0 Pay Gross Discount No -Pay 91143874 ✓ 12/06/20,12101/2012131/20. 202.80 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay M2827 MEDIVATORS 202.80 0.00 0.00 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC �% M Invoice# Comment Tran Dt Inv Dl Due Dt Check D Pay Gross Discount No -Pay 1976299720 / 12(06/20.11/30/20 12/25/20. 96.76 0.00 0.00 SUPPLIES 1976299726 ✓ 1=6/20.11/30/2012125/20. 75.00 0.00 0.00 SUPPLIES 1976299727 ✓ 12106/2011/30/2012125120 2,331.92 0.00 0.00 SU PLIES 1976290724 12106/2011/30/2012/25/20, 140.09 0.00 0.00 SUPPLIES 1976299718 ✓ 12106/2011/30/2012125/20. 9.50 0.00 0.00 SUPPLIES 1976209725 „/ 12/O6/20. 11/3012012/25120 681.35 0.00 0.00 SUPPLIES 1976299723 u/ 12/06/20 11/30/20 12125120 2,074.66 0.00 0.00 SUPPLIES 1976299729 „/ 12/06/20.11/30/2012/25/29.. 1,274.03 0.00 SUPPLIES 1973858170 f 1211312011/10/2012/05/20. 102,46 0.00 SUPPLIES 1974808285 ✓' 12113/2011117/20 12112120, 127.64 SUPPLIES � 1975742891 ,/ 12/13/20. 11/24/20 12119/20. 54.90 SUPPLIES i 1975742895 �/ 12/1312011124/20 12/19/20, 402.97 SUPPLIES 1975742897 ✓ 12113/20.11/24/20 12119120. 836.64 SUPPLIES / 1975899329 ✓ 12MMO.. 11125/2012120/20. 6.38 SUPPLIES 1975899329 12/13/2011 /26/20 12/20/20. 83.34 SUPPLIES 1976PO9716 ,/ 12/13/2011/30/2012125/20. 78.06 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Net 258.71 Net $4.20 Net 34.20 Net 202.80 Net 202.80 Not 96.76 75.00 ` 2,331.92 140.09 9.50 v'z 681.35 ",' 2,074.56 1,274.03 102.46 ✓ 127.64 54.90 c/ 402.97 836.64 % 5.38 ✓ 83.34 ✓ 0,00 0.00 78.06 1% file:///C:/1Jsers/eheimRn/cnci/memmeri.rncinet.cnm/a9R547/data 5/tmn o.wSrennrtR69A 1Wl6/91"11)1 Page 12 of 19 SUPPLIES 19769299721 WINK 11/30/20 12/25/20. SUPPLIES 1976425475 12/13/20 12/01/20 12/26/20, SUPPLIES 1976425476 y 1PJ131PO 12/0112012126/20. SUPPLIES 1976425473 12/13120. 1210112012/26/20. SUPPLIES 1976425474 y! 12/13/20,1210112012/26/20. SUPPLIES 1976736649 y// 12/13/20. 12102/2012127/20 SUPPLIES 1976566340 12/13/2012102/20 12/27/20 SUPPLIES 1976566349./ 12/13/20.12/02/2012/27/20 SUPPLIES 1976566350 ✓ 12113/2012/02/2012/27/20 SUPPLIES 19771SS774 /' 12I 3/20. 12107/2001101120 SUPPLIES 1977262146 ✓/ 12/15/2012/07/2001/01/20 SUPPLIES 1977262145 7 12115/20,12/0712001/01/20. SUPPLIES 19772621471/ 12/1572012107/2001101/20. SUPPLIES 1977262131 �� 12115/20. 1 PJ0712001/01/20. SUPPLIES 1977262144 .// 12/15120.1 PJ07120 01101/20. SUPPLIES 1977262140 ✓ 12115/20 12107120 01101/20 SUPPLIES 1977262141 12/15/2012/07/20 01/01/20 SUPPLIES 1977262139 / 12115120.1M-1120 01/01/20 SUPPLIES 1977262142 1/ 12/15/20.12/07/20 01/01/20 SUPPLIES 197726213E ✓/ 12/16/20 12/07120 01/01120 SUPPLIES 1977262134 ✓/ 12115/20 12/07/20 01/01120 SUPPLIES 1977262143 ✓ 12115/20.12/07/20 01101/20. SUPPLIES 1977359768 / 12/15/20. 1210812001/02/20 SUPPLIES 1977359790 12/15120,12/08/20 01/02/20 SUPPLIES 1977359783 , / 1211512012108/2001/02/20 SUPPLIES 32.28 0.00 0.00 32.28 yf 123.00 0.00 0.00 123.00 32.46 0.00 0.00 32.46 82,62 0.00 0.00 82.62 ✓ 33.67 0.00 0.00 33.67 .% 491 A9 0.00 0.00 491.49 226.68 0.00 0.00 226.68 0% 72.10 0.00 0.00 72.10 72.10 0.00 0.00 72.10 1,877,62 0.00 0.00 1,677.62 ✓ 42.77 0.00 0.00 42.77 i 18.87 D.00 0.00 18.87 173.88 0.00 0.00 173.88 44.38 0.00 0.00 44.38 27.72 0.00 0.00 27.72 489.74 0.00 0.00 480.74 ✓j 930.43 0.00 0.00 930.43 v✓ 66.60 0.00 0.00 86.60 s f' 18.89 0.00 0.00 18.89 132.18 0.00 0.00 132.18 5.06 0.00 0.00 5.06 27.72 0.00 0.00 27.72 2,292.54 0.00 0.00 2.292.54 123.00 0.00 0.00 123.00 20.74 0.00 0.00 20.74 file;///C:/Users/eheiman/cnsi/memmed_cncinetrnm/n9R547/data 5/tnln rwsrannrtR06 19/16/7tt171 Page 13 of 19 1977359785 / 12 I5120, 12/08/20 01/02/20 52.64 0.00 0.00 52.64 SUPPLIES 1977369784 „i' 12/15/20.12J08/20 0110PJ20 25.96 0.00 0,00 25.98 SUPPLIES 1977359787 ✓- 12/15/2012108/20 OIMPJ20 826.18 0.00 0.00 825,18 SUPPLIES Vendor TotalE Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 16,766.92 0.00 0.00 16,766.92 Vendor# Vendor Name Class Pay Code M2821 MMC AUXILIARY GIFT SHOP i ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 120921 1013/20. 12JO912012/23/20 294.18 0.00 0.00 294.18 PAYROLL DEDUCTS , Vendor Total: Number Name Gross Discount No -Pay Net M2621 MMC AUXILIARY GIFT SHOP 294,18 0.00 0.00 294.18 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC Y Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -pay Net 7629687 ,✓ 12(15/2012r08/2012/18/20 1,765.54 0.00 0.00 1,765.54 INVENTORY 7623629 12/15/201 PJ07/2012117/20 37.14 0.00 0.00 37.14 INVENTORY 5334 / 12/15/2012107/2012117120, -0.09 0.00 0100 -0.09 INVENTORY CM92947 12/15120 12/08/20 12/18/20 -27.78 0.00 0,00 -27.78 CREDIT 7628842 f 12115/20. 12/08/20 12/18/20 0.97 0.00 0.00 0.97 INVENTORY 7627042 ✓ ` 1PJ15120, 12/08/201PJ18120 772.00 0.00 0.00 772.00 INVENTORY 7629685 12N6/2012/08/2012J18/20. 629.26 0.00 0.00 629.26,,,- INVENTORY 7628843 ✓/ 12/15/20. 12/OB120 12118/20. 279.45 0.00 0.00 279.45 /INVENTORY CM92946 ✓ 1211512012/08/2012118120. -588,00 0.00 0.00 -58800 CREDIT 7629688 ✓ 12r15/20. 12/08/2012J18/20 109.40 0.00 0,00 109.40 f INVENTORY 7629686 �' 12/15/20. 12J08/2012M 8/20. 59180 0.00 0,00 599.80 INVENTORY . CM93242 �,:� 12/15120,12109/2012/19/20_ -122.95 0.00 0.00 -122.95 (- CREDIT 6265 ✓ 1211512012/09/2012/19/20. -2,760.94 0,00 0.00 -2,760.94 ✓r CREDIT 7634146 ✓ 12J15/2012J09/2019J19120. 3.31 0.00 0.00 3.31 ,.1' INVENTORY 5999 � 12J15/2012/09/2012119/20 -0.01 0.00 0.00 -0.01 ./ CREDIT 7639414 12/15/20. 12/12/20 12/22(20 82.32 0.00 0,00 02.32 ✓ INVENTORY 7641347 .� 12115/2012J12r201212PJ20 465.54 0.00 0,00 465.54 filet///ClI L¢ers/eheiman/rtnai/mPmmPd ensinrt onm/n9R547/Aatn 5/tmn Pwr%rPnnrtR(.7Fi 17/1411)Ol Page 14 of 19 NVENTORY 7639415 12/15/201211212012122/20. 478.35 0.00 0.00 478.35 INVENTORY 7642881 �r 12/15/20, 12/13/2012/23/20 19.48 0.00 0.00 19.48 ✓' /INVENTORY 7646380 ,/ 12/151201PJ1812012/23/20 710.03 0.00 0.00 710.03 ✓� INVENTORY , 7646361 v ' 12/15/20.12/13/20 12/23/20 15A2 0.00 0.00 15.42 INVENTORY , 7642882 J 12115/20. 12/1$/2012123/20. 68.76 0.00 0.00 68.76 ✓� INVENTORY CM94297 ✓f 12/15/20 12/14/20 12124/20. -20.90 0.00 0.00 -20.90 CREDIT CM94298 Z 12115120. 12/14/20 12/24/20. -275.61 0.00 0.00 •275.51 0/ INVENTORY . 7651340 19J1512012/14120 IM4120 5,465,00 0.00 0.00 5,465.00 , - INVENTORY . 7650991 �1/ 12115/20. 12/14/20 12/24/20, 59.30 0.00 0.00 59.30 ✓' INVENTORY . 7650990 ,/' 12/15/2Q 12/14/20 12/24/20. 9.59 0.00 0.00 9.59 INVENTORY 7648055 ✓/ 12/15/20,12/14/2012/24120. 3,446.15 0.00 0.00 3,445.15 INVENTORY 7650092. ✓ 12115120, 1 PJ14/2012/24/20. 20.54 0.00 0.00 20.54 INVENTORY , 7648056 .%` 12/15/20 12/14120 12/24/20 6,791.17 0.00 0.00 6,791.17 ✓� INVENTORY 7651339 J 12/15/20.12/14/20 I V24/20 1,926.00 0.00 0.00 1,926.00 f INVENTORY / CM94296 ✓ 12/15/20121141201 W24120 -585.18 0.00 0.00 -585.18 CREDIT 7(339416A J 12116/2012(12/2012/22/20. 3,6767 0.00 0.00 3,575.17 INVENTORY . Vendor Totals Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 22,997.33 0.00 0.00 22,9)67.33 Vendor# Vendor Name Class Pay Code 14124 MSH HEALTH SERVICES LLC J Invoice# Comment Tran Ot Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net MMC0029 r/ 12/15/20. 1211412012114/20, 2,806.56 0.00 0.00 2.806.56 J TRAVEL NURSE STAFFING j (l1R_I'L49 17_1) i MMC0028 / 12(15120,1211412012114/20. 4,728.75 0.00 0.00 4,728.75 / TRAVEL NURSE STAFFING (31aK�Nc4_ _ Vendor Totals Number Name Gross Discount No -Pay Net 14124 MSH HEALTH SERVICES LLC 7,535.31 0.00 0.00 7,535.31 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC v� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8800824048 „�� 11 /09/201012PJ2011/21/20 920.08 0.00 0.00 920.08 8800835100 J 12/13/20 11/22/20 12/22/20. 144.84 0.00 0.00 144.84 SUPPLIES file:///C:/Users/eheiman/cpsi/menimed.cpsinet.com/u98547/data 5/tmn cw5report8626... 12/16/2021 Page 15 of 19 8800836909 ✓ 12113/20 11/29/20 12/29/20, 947.20 0.00 0.00 947.20 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2659 MXR IMAGING, INC 2,012.12 0.00 0.00 2,012.12 Vendor# Vendor Name Class Pay Cade 13548 NACOGDOCHES TRANSCRIPTION Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 57 12/08/20. 12/02/2012(30/20 75✓ 315.98 .0.00 0.00 315.98 TRANSCRIPTION SERVICES , Vendor Totals Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 316.98 0.00 0.00 315.98 Vendor# Vendor Name Class Pay Code 01500 OLYMPUS AMERICA INC „� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 31848425 12108/20. 11/2312012/23/20, 116.96 0.00 0.00 116.96 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net 01500 OLYMPUS AMERICA INC 116.96 0.00 0.00 116.96 Vendor# Vendor Name Class Pay Code 01416 ORTHO CLINICAL DIAGNOSTICS Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 1852159868 %� 12115120, 12/02/20 01/01/20 278.61 0.00 0.00 278.61 SUPPLIES ,. Vendor Totals Number Name Gross Discount No -Pay Net 01416 ORTHO CLINICAL DIAGNOSTICS 278,61 0.00 0.00 278.61 Vendor# Vendor Name Class Pay Code 11166 PARA v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D•Pay Gross Discount No -Pay Net 9951 ✓'� 12/01/2012/O112012/31120. 3,084.00 0A0 0.00 3,084.00 REVENUE INTEGRITY PROGR Vendor Totals Number Name Gross Discount No -Pay Net 11155 PARA 3,084.00 0.00 0.00 3,084.00 Vendor# Vendor Name Class Pay Code 13988 PAYCHEX, ADVANCE FBO ✓ Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 008157 IPJ13120 1PJ08120 12/08120. 3,675.00 0.00 0.00 3,675.00 4F, TRAVEL NURSE STAFFING I00-4-02b 1Z1)`-+-�IAAK U , Vendor TotalsNumber Name Gross Discount No -Pay Net 13988 PAYCHEX, ADVANCE FBO 3,675.00 0.00 0.00 3,675.00 Vendor! Vendor Name Class Pay Cade P2100 PORT LAVACA WAVE 1,� W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 102921 12/13120,10/31/2011/25120 25D.00 0.00 0.00 250.00 ✓'� ADVERTISING Vendor Totals Number Name Gross Discount No -Pay Net P2100 PORT LAVAGA WAVE 250.00 0.00 0.00 250.00 Vendor! Vendor Name Class Pay Code P2200 POWER HARDWARE ,.-� W Invoice# Comment Tran Dt Inv of Due Dt Check D Pay Gross Discount No -Pay Net ' A78599 11/30/2011/05/2012131/20. 29,25 0.00 0.00 29.25 � SUPPLIES 4 _ file-111r-IT laarc/ahnima»/rnci/mPmmorl n,lCfY1P}pnyryl,lOQGA%IfI9L9 rl+n . 11114mng1 Page 16 of 19 A79117 11/30/20.11/22120 1PJ31120 15.60 0.00 0.00 15.60 /SUPPLIES A7✓ 9338 11/30/20.11/30/20 12/31/20 6.29 0.00 0.00 6,29 y/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net P2200 POWER HARDWARE 51.14 0.00 0.00 51.14 Vendor# Vendor Name Class Pay Code 11252 FIX WASTE SYSTEMS LLC v,,' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net ,/ 3473 v" 12/09/20. 12/01/2012131/20, 60.00 0.00 0,00 60.00 �- PHARMACUTICAL WASTE , Vendor Totals Number Name Gross Discount No -Pay Net 11252 FIX WASTE SYSTEMS LLC 60.00 0.00 0.00 60.00 Vendor* Vendor Name Class Pay Code 11488 S&R ELECTRIC Invoice# Comment Tran Dt Inv Dt DueDt Check D Pay Gros Discount No -Pay Net 0100 08/11/20 OY0412001/07/20 78273 0.00 0.00 // 782/13 PURCHSERV ✓j Vendor Totals Number Name Gross / Discount No -Pay Net 11488 S&R ELECTRIC 782A3 0.00 0.00 782/3 Vendor# Vendor Name Class Pay Code // 10936 SIEMENS FINANCIAL SERVICES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 656382200009686 rJ 12/15/2011/29/2012124/20 1,333.33 0.00 0.00 1,333.33 RENTAL Vendor Total: 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 S3960 STERICYCLE, INC ✓'! Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount. No -Pay Net 4010556361 12/13/2D.12/01/2012/31/20 2,570.70 0.00 0.00 2,570.76 DISPOSAL Vendor Totals Number Name Gross Discount No -Pay Net S3960 STERICYCLE, INC 2,670.76 0.00 0.00 2.570.76 Vendor# Vendor Name Class Pay Code 13528 STRYKER FLEX FINANCIAL r� Invoice# Comment Tran Ot Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 776568 J 11/29/20A 1/0912001/01120 ✓ 1,294.26 0.00 0.00 1,294.26 �. RFA MACHINE , Vendor Totals Number Name Gross Discount No -Pay Net 13528 STRYKER FLEX FINANCIAL 1,294.26 0.00 0.00 1,294.26 Vendor# Vendor Name Class Pay Code S2830 STRYKER SALES CORD ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9201936242 / 12/13/20 I PJ0312001/03/2D 1,460.72 0.00 0.00 1,460.72 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net S2830 STRYKER SALES CORP 1.460.72 0.00 0.00 1,460.72 Vendor# Vendor Name Class Pay Code 10736 STRYKER SUSTAINABILITY Invoice# Comment Tran Dt Inv Dt Due Dt CheckD Pay Gross Discount No -Pay Net r-I-Mr.rtT�... r,.t,.,:...,...i--- ci.__rn11 ei"nnI Page 17 of 19 4316633 w/ 11/30/20. 11/24/20 12/24/20. 2,340.00 0,00 0.00 2,340.00 Vr SUPPLIES Vendor TotalsNumber Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABILITY 2,340.00 0.00 0.00 2,340.00 Vendor# Vendor Name Class Pay Code T2539 T-SYSTEM, INC ✓ ' IN Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 50385 11/30120.11/27/2012127120 431.42 0.00 0.00 431.42 L", LICENSE Vendor Totals Number Name Gross Discount No -Pay Net T2539 T-SYSTEM, INC 431.42 0.00 0.00 431.42 Vendor# Vendor Name Class Pay Cade 10765 TEXAS HOSPITAL ASSOCIATION //• �� Invoice# Comment Tran Dt inv DI Due Dt Check D Pay Gross Discount No -Pay Net 1900102682 ✓ 12/15120, 1210312012/14/20 10,919.00 0.00 0.00 10,919.00 ' MEMBERSHIP 2022 Vendor Totals Number Name Gross Discount No -Pay Net 10765 TEXAS HOSPITAL ASSOCIATION 10,919.00 0.00 0.00 10,919.00 Vendor# Vendor Name Class Pay Code 13880 TEXAS SELECT STAFFING Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 001873551079IN y,/ 1211312012/09/2012/09/20, 10,12720 0.00 0.00 10,127.20 TRAVEL NURSE STAFFING (I}� W E 1t, �YL•r-i{Il0.RI�. • 'It Srk VA_ Vendor Totals Number Name Gross Discount No -Pay Net 13880 TEXAS SELECT STAFFING 10,127.20 0,00 0.00 10,127.20 Vendor# Vendor Name. Class Pay Code / 14012 TK ELEVATOR CORPORATION ✓ ` Invoice# Comment Tran Dt Inv Dt Due Dt CheckD Pay Gross Discount No -Pay Net 5001697955 ,/ 12/15/2012/06/20 IPJ06/20 846.00 0.00 0.00 846.00 ELEVATOR REPAIR Vendor Totals Number Name Gross Discount No -Pay Net 14012 TK ELEVATOR CORPORATION 846,00 0.00 0.00 846.00 Vendor# Vendor Name Class Pay Code 11067 TRIZETTO PROVIDER SOLUTIONS / Involce# Comment Tran Dt Inv Or Due Dt Check D Pay Gross Discount No -Pay Net 35FK122100 V 12/15/2012/0;/2012/26/20 1,747.77 0.00 0.00 1,747.77 PT STATEMENTS Vendor Totals Number Name Gross Discount No -Pay Net 11067 TRIZETTO PROVIDER SOLUTIONS 1,747.77 0.00 0.00 1,747.77 Vendor# Vendor Name Class Pay Code 14203 TRUSTED HEALTH, INC _/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net INV6982 ..//• 12/1312012/04/2001/03/20. 7,506.88 0.00 0.00 7,506.88 TRAVEL NURSE STAFFING Itti-J-4-II 1 WjiiipnLd INV6743 ,,/ 12/1512011/30/2011130/20, 3,062.50 0.00 0.00 3.062.50 TRAVEL NURSE STAFFING ( to J -W --Z1) Wi l`i ct KI, Vendor Totals Number Name Gross Discount No -Pay Net 14208 TRUSTED HEALTH, INC 10,669.38 0.00 0.00 10,669.38 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC Z Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net file:///C:/Users/eheiman/ensi/memmed.cnsinetenm/u9R547/date 5/tmn ow5rennrtRF76 19/1F/�1191 Page 18 of 19 8400382395 ✓ 1113012011/29/20 12/24/20 47.80 0.00 0.00 47,80 I%% LAUNDRY 8400382894.E 11/30/20. 11/2912012/24/20. 46.15 0.00 0.00 45.16 f LAUNDRY 8400382738,/ 12106/2012/0212012/27/20 170.02 0.00 0100 170.02../ LAUNDRY 8400382772 V ' 12/06/20.12/02/2012/27/20, 112.36 0.00 0.00 112.36 f' LAUNDRY 8400383299 12/13/20.12/09/2001/03/20. 109.63 0.00 0.00 109.63 ✓ LAUNDRY 8400383263 �/ 12113120. 12/09/20 01/03/20 194.43 0.00 0.00 194A3 ,/ LAUNDRY 8400383261 ,% 121151201019120 01/0312Q 42.72 0.00 0100 42.72_, , LAUNDRY 8400383264 ,/ 12/16/2012/09/2001/03/20. 181.39 0.00 0.00 181.39 LAUNDRY 8400383285 �/ 12/15/20. 12/09/20 01103/20. 1,610.02 0.00 0.00 1,610.02 LAUNDRY 8400383262 ✓ 12/15/20. 12/09/20 01/03/20, 137.13 0.00 0.00 137.13 LAUNDRY 8400383265. 12116120 12109120 01/03/20, 199.32 0.00 0.00 192.32 LAUNNRY 8400383279 ✓,, 12/15/20.12/09/2001/03120, 79.43 0.00 0.00 79,43 11/ LAUNDRY 8400$82753 �/ 12/16120.1210212012127/20 79.43 0.00 0.00 79.43 LAUNDRY i 8400382737 .r' 12/16/2012/0212012/27120. 137.13 0.00 0.00 137.13 LAUNDRY 8400382739,j' 12/18/2012/02/2012/27l20. 176.21 0.00 0.00 178.21 LAUNDRY 8400382736 12/16/20.12/02/2012/27/20. 42.72 0.00 0.00 42.72 LAUNDRY 8400,982740 ✓/ 12/16/2012102/20 IPJ27120 199.32 0.00 0.00 199.32 �f LAUNDRY 8400382758 -1 12/16/20 12/02/20 IPJ27/20 1,432.55 0.00 0.00 1,432.55✓ LAUNDRY 8400382914 ✓/ 12/16/20 12/06/2012/31120 45.15 0.00 0.00 45.16 LAUNDRY 6400382915 , f 12/16/20.12/06/20 12/31/20. 47.80 0.00 0.00 47.80 �. LAUNDRY 8400352941 ✓` 12/16120 12/06/20 12/31/20, 2,208.02 0.00 0.00 2,208.02 f LAUNRY Vendor TotalE Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 7,297.73 0.00 0.00 7,297.73 Ventlor# Vendor Name Class Pay Code U1200 UNITED AD LABEL CO INC �� M Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 925543188 y1 12115/20.12J01/2012126/20. �� a q 1 1`1 165, 0.00 0.00 165�14 I5=•5'-� SUPPLIES . Vendor Totals Number Name Gros Discount No -Pay Net U1200 UNITED AD LABEL CO INC I .9i 1654 0.00 0.00 16Y14 file:///C:/Users/eheiman/ensi/memmed.cnsinet-enTn/u9R547/data 5/tmn nw5rPnnrtR676 i?IiAnm1 Page 19 of 19 Vendor# Vendor Name Class Pay Code 11018 WEBPT, INC y/ Invoice# Co ment Tran Dt Inv Dt Due Dt Check D Pay Gross INVI S1175 12113/20.10/12/20 10/12/20. 97.20 PROVIDER SUBSCRIPTIONS Vendor Totals Number Name Grass 11018 WEBPT, INC 97.20 Vendor# Vendor Name Class Pay Code Z1000 ZIMMER BIOMET M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 120911NL8844 ,, 12/13/2011/23/2012123120. 11.76 SUPPLIES Vendor Totals Number Name Gross Z1000 ZIMMER BIOMET 11.76 Report Summary Grand Totals: Gross Discount 407,141.85 0.00 Lj APPROVED OAI DEC 16 2021 CALYHO N COU��Tam, Discount No -Pay Net 0.00 0.00 97.20 Discount No -Pay Net 0.00 0.00 97.20 Discount No -Pay Net 0.00 0.00 11.76 j Discount No -Pay Net 0.00 0.00 11.76 No -Pay Net 0.00 407,141.85 P9 y 1 uay.V> + load. 2-4 II n � �gr{y.uo7 P51t< wr h'Uvt �7 18a.l37 P5 4-169- file:///C:fUsers/eheiman/cpsi/memmed.cDsinct.com/u98547/data 5/tmo cw5renort8626... 12/16/9,021 RECEIVED BY THE COUNTY AUDITOR ON DEC 16 2021 MEMORIAL MEDICAL CENTER 2/ 6/ CALHOUNI GbUN t7, TEXAS AP Open Invoice Ust 0 11:08 ep_opan invoica.templa[e Dates Through: 01/0512022 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS Invoicell Comment Tran DI Inv Dt DueOt Check D Pay Gross Discount No -Pay 40783 ✓ 12/16/20 11/30/20 12/10120 6,480.00 0.00 0.00 WEEKEND COVERAGE ER / 40809 ✓ 12/16/20 12/16/20 12/26/20 40,062.50 0.00 0.00 PHYSICIAN STAFFING DEC 1.15 Vendor Tolah Number Name Gross Discount No -Pay 11284 EMERGENCY STAFFING SOLUTIONS 46,542.50 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 46,542,50 0.00 0.00 APPROmam DEC 16 2021 BY COUNTY A1JDITOA CALHOUN COUNTY, T" Page 1 of 1 Nei 6,480,00 40,062.50 Net 46.642.50 Net 46,542.50 file:///C:/Users/ofleiman/cpsi/memmed.cpsinet.com/u985471data_51tmp_cw5report8175... 12/16/2021 MSKESSON STATEMENT As of: 12/17/2021 .Merv: ..no DO: 8115 MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACM DEBIT Tannery; AP Statement for information only 815 N VIRGINIA STREET Cumomx 632536 PORT LAVACA TX 77979 Data: 12/18/2021 Page: 009 To ¢more Proper ere6h to your atmount, dataeh ant Mum this club with your remhtemr A9 al: 12/17/2021 Pegs: 002 Melt to; Carp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only Cum: 632536 PLEASE CHECK ANY Sense 1211812021 ITEMS NOT PAID (1) umlaml Account 0.0.aap5�o Slling Due Number 0' uruer Cash (WO4 P Amount P Number e tale Dets Number Rolarenas Deacrlpllan Dlaount (gross+ F (net) F Number T column la9an l: P m Pam Due Item, F a Fmum Due Item, blank = Canes Due Item 'OTAL National Amet 632536 MEMORIAL MEDICAL CENTER Subtotalm 12,055.52 USO Llure Due: 0.00 If Paw BY 1212112021, %m Due: 0.00 Pay This Amount: 11.814.44 LED Ad Payment 2.451.97 It Pow Attu 12/2112021, 18/07/2017 Pay this Amount: 19.066.62 USD 662•i%; . 14 44 .. pPPROVEDON DEC 20 2021 CALHODUN COUNTY-TTEXAS For AR Inquiries please contact 800-867-0333 Om It Paid On Time: USED 11.814.44 Dim lam It paw Ime: 241.08 Due If Paw Late: USD 12,055.52 MSKESSON STATEMENT "° °b ,2"]/2D2, Pa9°' °°' aoc�t, dotaer CddMit um;„;; b c Ise: a00o dub w°0 your raminenoo DC: B115. As of: 12/17/2091 Paga: 001 WALMART 10981MW MID FH9 qMT DUE PBAITTED VIA ACN OEDIT Territory: 400 Mall to: Comp: 8000 MEMORIAL MEDICAL CENTER Statement for Information only AMT DUE REMITTED VIA ACH DEBIT VICKY KAUSEX CUUMW. 256342 Statement for information only 816 N VIRGINIA ST Date: 12/18/2021 PORT LAVACA TX 77970 Cud: 256342 PLEASE CHECK ANY Date: 12/16/2021 ITEMS NOT PAID to) )ate" Dete cedl°nal Account 6 Nmbe blp��retice _._._OaecrlPli°n Oisount Amaelt F q¢a ble Amount F Num :.dam. Number 266342 WALMART 109SIMEM MED PHIS 2/13/2021 19/21/2021 731170842U 20950248 1151nvolee 26.46 1,273.16 1,247.701/ 7311T08420 2/13/2021 12/21/2021 7311708421 20977390 1151nvolce 3.88 193.92 190.04✓ 7311]OB421 2/13/2021 12/21/2021 7311708422 20077300 116favolce 0.02 0196 0.93 ✓ 7311708422 013/2021 12/21/2021 7311708423 21001015 if 6lnvolce 9.76 487.31 417.56✓ 7311708423 2/13/2021 12/21/2021 7311708424 2/070546 1161nvolee 5.38 268.98 263.60 ✓ 73'1708424 2/14/2021 12/21/2021 7312009814 21149609 1161nvolce 0.16 0116 ✓ 7312009814 2/14/2021 12/21/2021 7312144962 1213210918 1151nvalae 7.43 371,74 364.31 / 7312144862 2/15/2021 12/21/2021 7312259118 21186961 1161nvolce 7.97 398.50 390.62 ✓ 7012269118 2H6/2021 12/91/2021 7312404667 1214210839 1151nv°loo 33.92 1.696,17 1,082.25 ✓ 7312404667 2/16/2021 1W21/2021 7312404658 1214210912 1961nvol" 5.87 343,64 330.77 ✓. 7312404668 2/16/2021 12/2112021 7312573744 21960387 1151nvoice D18 0.16✓ 7312573744 2/16/2021 12121Y2021 7312717344 12l5210855 1161nvo1ce 15.73 786,39 770.60 ✓ 7312717344 2/17/2021 12/21/2021 7312831711 21334987 1151nvoloe 5.38 269.14 263.76 ✓ 7312831711 2/17/2021 12/2112021 7312a31712 21334987 1151nvolue 0,24 12.13 11,89 ✓ 7312831712 2/17/2021 12/2V2021 7312831713 213BI242 I61nvaice 12.94 647.12 634.1a ✓ 7312831713 2/17/2021 12/21/2021 7312956748 1216211003 115lnvoice 7.88 393.19 386.33 1/ 7312966748 2/1712021 /2/21/2021 7312956749 1216210740 1961nvoice 12.72 536.11 623,39 ` ?312956749 IF column legend: P e Pad Due item, F e ROW. Due Item, blank o Cunent Oua Item 'OTAL Customer Number 256342 WALMART 1096IMEM MED PHIS 9udotale: 7.779.86 USO 'utum Due: ,ast Due: a& Payment 2/13/202APPROVEDON DEC 20 2021 0.00 If Pond By 1212112021, 0.00 Pay This Amount: 6,577.44 If Pale After 12/21/2021, Pay this Amount: Due If Paid On Time: LED 7,623.31, ✓ 7,623.31 LED Disc lost II paid We: 156.55 Due U Paid late: 7,778.80 USD LED 7.778.86 CAWOUNCOUNTY,T O For Alt Inquiries please contact 800-867.0333 MSKESSON STATEMENT As of: 12/17/2D21 Page: 001 To eRwum proper small to your seMITI, "soh and Mum this a awy.. Paso stub with your remmame OC: 8115 As of: 12/17/2021 Page; 001 CVS PHCY 7006/MEAORIA PHS AMT DUE REMITTED VIA ACH DEBT Territory: 400 Mall to: Comp: 8000 MEMORIAL MEDICAL CENTER Statement for information only AMT DUE REMITTED VIA ACH DEBIT VICKY KALISEC Customer: 282252 Statement for Information only 815 N VIRGINIA Dote: 1211812021 POW LAVACA T% 77979 cud! 262252 PLEASE CHECK ANY -- Data: 12/18/2021 ITEMS NOT PAID (A) Netlanal Account filling Due Hecateal6 ¢1��d5t18Cash Amount P Amount P Rmewnble )ate Date Number Reference Description Dlmoum (gmn) F (net) F Number fuatomer Number 262252 CVS PHCY 7006/11EMORIA PHS -_---'- 2/16/2021 12/21/2021 7312566564 1488316 115lnvolce all 10.60 10.39 ✓ 7312560664 O T autumn legend: P = Past Due Item, F v Future Due Item, blank = Current Due Item 'OTAL Customer Number 262262 CVS PHCY 7006/MEAORIA PHS SublMals: 10.60 USD -Aunt Due: 0.00 Due It Pohl On Time: If Paid By 12181/2021, USD 10.39 oat Due: 0.00 Pay This Amount: 10.39 USD Dim loaf If Palo few 0.21 Ad Payment 6.901,55 If Paid After 1212112021, Due If Paid We: 112212021 Pay this Amounl: 10.60 USD USD 10.60 APPROVED ON DEC 20 2RI SYCOUNTYAUDITOR CAW OUN COUNTY, TEXAS For AR Inquiries please contact 800-867-0333 NIkRCs.MMW1Y STATEMENT qB o: 12/1712021 cmiea+y: emu OC: 6116 HER PHY PC 490/MW MC PHS AMT DUE REMITTED VIA ACH DEBIT Territory: 400 MWORIAL MEDICAL 0134TEi Statement for iniormalicn only VICKY KAUSMK Customer. 464450 815 N VIRGINIA ST Date: 12/1812021 PORT LAVACA TX 77970 Page: 001 To Sneure Proper Credit to your acWum, detach and Mum this stub with your remittance An of: 12/172021 Pegg: 001 Mall to: Camp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement tar information only Cust1 464450 PLEASE CHECK ANY Date: 12/18/2021 ITEMS NOT PAID (+) den g Due Recelvable"A"onel ACownt 9JJ86 Cash Amount P Am m P Rooelvable late Data Number Reterence Deeetlpl(on Dlsaounl (gross) F (rleiI P Number :uatomer Number 464450 HEM MY FC 490IMM MC PHS 2/14/2021 12/212021 7319000523 65078349 1151nvoice 45,98 2,299.17 2,""I'll ✓ 7312000523 2/152021 12/2/12021 7312249473 55.780706 11 Simoice 15.47 773AI 757.94✓ 7312249473 2/16/2021 12/21/2021 7312553020 SWI14023 1161nvolce 10.35 517.38 507.03✓ 7312553020 2/17/2021 12/21/2021 T312806835 55.788273 1151nvolce 0.20 0.20✓ 7312806835 -F column IegonO: P = Past Due Hem, P a Funds Due Rom, blank = Current Dun Rem WAL; Customer Number 464450 HES MY PC 411011111911 MC PHS SubtoUls: 3.590.10 USD More Oue: 0.00 Due If Rem On Time: If Pam By 1212112021, USO 3.518.36 y' del Due: 0.00 Any This Amount: 3,518.30 USD 01. feet R paid Imo: 71.80 AN Payrn rd 6,677.44 If Paid Alter 1212=021, Due It Mid tots: 2/13/2021 Pay this Amount) 3,590,18 USO USO 3,590.18 APPROVED ON DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY. TEXAS For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT conomr;eaoo CVS PHCY 7475/MEM MC PHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for Information only VICKY KAUSEK 815 N VIRDINIA ST PORT LAVACA TX 77979 As of: 12/17/2021 Page: 001 To ensure pmpx oredK to your account, detach and mtum this stub with your mmmems DC: 8116 As of: 12/17/2021 Page: 001 Mall to: Comp: 8000 Territory: 400 AMT DUE REMITTED VIA ACH OMIT Cuelomar: 835430 Statement for information only Ome: 12/18/2021 cum: 835438 PLEASE CHECK ANY Date: 12/18/2021 HEMS NOT PAID (.r) Nitlng Due Recenvebljimlonal Aaaount W'�Y6 Cash Amou t P Amount p Kaoelvable )eta Date Number Reference Dnacdptlon Dlsco h (grass`' F (net) F Number )ustomm Number 835438 CV8 PHCY 7475/MEM MC PHIS 21161202/ 12/21/2021 7312754689 1480314 1151nvoice 13.52 675.90 662.38 7312754689 O T column Mgamiz P = Past Due Itsm, F c Future Out Item, blank = Current Due Item 'OTAL• Customer Number 835438 CVS PHCY 7475/MM MC PHS Subtotals, 075.00 USD Whim Due: 0.00 Due If Pald On Time If Paid By 1212112021, USD 862.30 ,am Dee: 0.00 Pay This Amount: 062.38 USD DI. lost if Feld late: 13.62 aM Payment 6,677.44 N Paid After 1212112021, Due N PaM Late: 2/1312021 Pay this Amount: 675.90 USD USD 675.90 ApPROVE06N DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY,TEXAS 4' For AR Inquiries please contact 800-867-0333 STATEMENT Statement Number: 62172733 AmerisourceBergen- Date: 12-17-2021 1 or AMEMSOURCESERGEN DRUG CORP WALGREENS AIM94 340E 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER iG0135284 r 037028186 SUGAR LAND TX 77476.6101 1302 N VIRGINIA ST PORT LAVACATX 77979.2509 set - Fri Due in 7days DEA: RA0289276 866-451-9855 AMERISOURCESERGEN Not Yet Due: 0.00 P.O. Box 905223 CHARLOTTE NC 28290.5223 Cunene 289.00 Past Due: Q00 Total Due: 289.00 Account Balance: 289.00 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 12.134021 12-24-2021 3D76054600 163917 Invoice 8.09 0.00 8.09 1243.2021 12-24-2021 3076654601 163818 Involve 11.44 0.00 11.441 12-13-2021 12-24-2021 3OM54602 163919 Invoice 38A2 0.00 38,42 12-1 -2021 1224.2021 30MB8896 163965 Involve _ 3544 Coo 35.14 � 12.14-2021 12-24-2021 31376819509 163971 Invoice, 79.46 0.00 79.46 12-14-2021 12-24-2021 3076819620 163972 Involve 6.03 0.00 12-15.2021 12-24-2021 3076970693 163982 Involve 79.46 0.00 12-15-2021 12-24-2021 3076970594 163983 Involce 8.03 0.00 J20O3 12-16-2021 12.24-2021 3077138843 163992 Invelce 20.03 0.00 Current 146 Days 16.30 Days 31.80 Days 61.90 Days 91.120 Days Over 120 Days 289.00 0.00 0.00 0.00 0.00 0.00 0,00 Thank You for Your Payment Date Amount 12.17-2021 (2,325.57) DEC 20 2021 BYCOUNTYAUDITOR CALHOUN COUNTY, TEXAS Reminders Due Date Amount 12.24-2021 280.00 Total Due: "'289i00i a TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" FIACKNOWLEDGEMENT NUMBER ### ENTER: 121 A $ 93090,66 1 $ 47,593.96 $ 11,669.90 $ 33,826.80 CHECK S CALLED IN BY: CALLED IN DATE: CALLED IN TIME: # WFlnance 5ha*AP-Payroll Files\Payroll Taxes@021426 R1 MMC TAX DEPOSIT WORKSHEET 12.18.21 R1.x1s 1211712021 F:m Date: 12l17!21 MEMORIAL i:E➢ICAL C7NTER Pace _G9 i4:44 0avrc1l C,i,ter r 2i-"r.'ee%iy ! P2REG Pay Period k103121 - 12I16i21 Run; Final Samnary �- -Pay Code Summary------•----- PayCd Description Mrs 10 ........... I ...... .--------------- REGULAR PAY-91 9315,50 1 REGULAR Pal'-51 191150 . REGULAR PAY-S! 343.50 2 REGULAR, PAY-S2 2190.25 2 REGULAR PAY-S2 116.00 3 REGULAR PAY-S3 118B.75 3 REGULAR PAY-S3 66.75 C CALL PAY 2529.75 D DOUBLE. TIME 3.75 C DOUBLE TIME 30.50 D NUKE TIME 50.00 D DDUBLE TIME 4.00 D DOUBLE TIME 13.50 D DOUBLE TIME 24.00 E EXTRA HAGES 8 EXTRA NAGES F FUNERA6 LEAVE 32.00 I IMSERVICE 3.00 E EXTENDED -ILLNESS -BANK 3.4.00 P PAID -TIME -OFF 64.0E P PAID -TINE -OFF 1034.40 X :ALL PAY 2 96.00 Y 111WCURVES 2 .ALL PAY 3 96.00 v COVID-FFCP.A 16.00 I .-.................._-.-- .-.................._-.-- D e d u c t i e n s EIROICHI ............................................... Grass I Code Amount , N 193475.B3 A!R 5`.0.00 A!P.2 1 N t4 '9927.07 A7VANC AWARDS N W5.96 CAFE 3 CAFE-1 N 51825.33 CAPE-3 .CAFE-4 li 3226.00 CAFE-C CAFE-➢ N 32941.24 CAFE-H 19632.14 CAFE -I N 2643.9E CAFE-P CANCER N 5059.5E CLINIC. 226.10 COMBIN N 05.13 ➢9 ADV DENTAL N 23EL 27 Di5-LF EAT N 4044.04 FE➢IFX 33826.80 FICA -AI N 23P.2C KRSTC FLEE S N 1244.76 FORT D KTA ti 3032.2E GRANT GRP-ir. N N 20.0C EDSP-I ID TFT N N 584.75 LEGAL 260.26 MAGA N , 513.68 METVIS 861.70 MISC N 114.OI MMCEHR NATFML 11 7831.2E PMI PHP.i N ,l' 1559A3 RELAY REPAY N 256C2.71 S^=MQ SIGIIC41 N i92.00 SIONDF 640.86 STOVE N N 45.0E ST➢D£14 SU7I.ACC N 289.0E SUNIND 700.64 SUIILIF t3 19E.44 SURVIS SURCHG TSA-2 TSK TSA-R 29801.71 TCTION UR/Hos S u m M. a r y------------- � 25.00 AiR3 BOOTS 'ATE-2 CAFE-_ 1611.57 CAFE-F CAFE-L CHILD 720,41 359.26 CREDUN DEP-LF EA7SH 5834195 rich-0 21196.98 3337.25 FIX FE GIFT S 767.58 GT.L LEAF 853.50 MEALS 113,26 MISCI 1734.43 OTHER. PH FIN SANS ST-TX STONE2 116.23 SLNILL 747.73 735.07 SOSTD 1165.01 450.00 TSA-1 TSA-P DRIFOR 478.24 '-------------------- Grand Totals: 19391.23....... r Gros:: 4257,39.49 Deductions: 130035.46 CFee<s Count:- FT 193 PT 10 Otter 33 Female 215 Male 2C Credit D:'erAnt 7 Eerollet Ter, ....................................... .--------------------------- .---------------- -1- .................. Net: 29570C 03 ) Total: 235 ................... �k� dale, iz.az.a-� MEMORIAL MEDICAL CENTER PROSPERITY BANK OPERATING ACCOUNT --- December 13, 2021- December 19, 2021 Date Bank Desatotion MIMIC Notes 12/17/2021 AMERISOUBCE BERG PAYMENTS 01000077682100002 - 340B Drug Program Expense 1211612021 PAY PLUS ACHTRAN5452579291 101000696414289 -3rd Party Payer fee . 12/15/2021 PAY PLUS ACHTRANS 452579291 10100069SS47164 3rd Party Payer Fee 12/15/2021 TEXAS COUNTY ORS RECEIVABLE 0419 21000022600 - Retirement Funding 12/14/2021 PAY PLUS ACHTRANS 452579291 101000694339573 - 3rd Party Payer Fee 12/1412021 MCXESSON DRUG AUTO ACH ACH04839337 910000139 .340B Drug Program Expense 12/13/2021 PAY PLUS ACFITRAN5452579291101000693329259 -3rd Party Payer Fee 12/13/2021CLEARGA13E lLC C1.1!ARGAGE. BOOEB6861,159N48R 242 -Patient Financing Service December 20, 2021 Anthony Richardson, CFO �I Memorial Medical Center '7}Rgpwura 1d"l y'a"I CE. PROSPERITY BANK - kwgyuk 1d.0B-34 Cc- ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT -ESTIMATED ACHS rF Date DBScriipian 1/5/2022 la nuary 2022 DSRIP DY 10 R2 IGT Payment 60 0 " December 20, 2021 Anthony Richardson, CFO Memorial Medical Comer CPSI"Handwritten Amount Check" 4 2 325 57,2E 500255 184'. k- 301077 ill 11, 301078 142891;14 s±1E.+ 200309 +ji1aN28 71 301079 6,677.44 500256 301080 1 152,284.29 MMC Notes Amount p��I pioh 1 • t5 4 j'j L17 PALur�ats� " IUJ 57;905;8, 2tltl- I=i 57,995.83 jRIJ' I4, - . J 9 U • I ri :. 39U"14 11 UU Transaction Summary Transaction Complete Trace Texas Health and Human Services Commission Memorial Medical Center Operating County Payment Total $57,995.83 1/5/2022 Bank Routing and Account Number Settlement Date DSRIP Amount $57,995.83 Entered By Marley Moehri Page No: 1 of 1 Run Date: 1211 W2021 Run Time: 13:18:32 Marley Moehrig From; Jason Anglin Sent: Tuesday, December 14, 2021 3:17 PM TO: Marley Moehrig; Roshanda S. Thomas Cc: Anthony Richardson Subject: FW: January 2022 DSRIP DY10 R2 IGT Notification - RHP 03 Attachments: DY10 Round 2 January 2022 Affiliation Summary for Publication.xlsx; DY10 Round 2 January 20221GT Summary for Publication.xlsx Did you receive? You will find MMCs underRHP3. Je=-on Anglin, CEO Memorial Medical Center 815 N Virginia St Port Lavaca, TX 77979 Office 361-552-0240 Fax 361-552-0220 From: HHSC PFD DSRIP Payments <PFD_DSRIP Payments@hhs,texas.gov> Sent: Tuesday, December 14, 20213:13 PM To: aafrancis@houstonmethodist.org; abacan@bcm.edu; Alejandra Padierna<Alejandra.padierna@myburke.org>; alex.lim@mhmraharris.org; Alice.Hsieh@uth.tmc.edu; Amanda <_Simmons@premierin.com>; amanda.callaway@harrishealth.org; amanda.darr@texanacenteccom; Amanda _ Sim mons@Premierinc.com; amathis@calumbusch.com; amber.haig@houstontx.gov, anaelle.moal@uth.tmc.edu; Andrew.Casas@uth.tmc.edu; anewton@chambershealth.org; angelina.esparza@houstontx.gov; anna.arage@gulfbend.org; anthony.scarlatella@mhmraharris.org; April.Sanders@mhmraharris.org; bchance@stlukeshealth.org; Bethany Miller <bemiller@texaschildrens.org>; Beth.Cloyd@harrishealth.org; beth.duncan@texanacenteccom; bfkalmus@mdanderson.org; bhajovsky@calumbusch.com; bprachnow@matagordaregional.org; Brian Gurbach <Brian.Gurbach@texanacenteccom>; bsansom@hcphes.org; catherine.McAfee@bcm.edu; caushattaranch@yahoo,com; cbelk@houstonmethodist.org; cdemoya@stlul<eshealth.org; Ridge,Celina elina.ridge@houstontx.gov>; charrison@mehop.org; COChua-Faustino@houstonmethodist.org; connie.almeida@fortbendcountytx.gov, corrigan@bcm.edu; cottey@gl-law.com; Danny.Corprew@houstontx.gov; darlyn1868@gulfbend.org; Deborah.Banerjee@houstontx.gov; Debra.J.Ryan@uth.tmc.edu; denise.leblanc@stctr.org; desiree.vrazel@ecmh.org; devin.bradberry@houstontx.gov; dherolt@cmcvtx.org; dina.hermes@goldenplains.drg; dlevans3@texaschildrens.org; dmak@ecmh.org; dmbenson@mdanderson.org; dmoore@mmcportlavaca.com; Don.Powell@harrishealth.org; Donna.W.Valenzuela@uth.tmc.edu; dthompson5@stiukeshealth.org; Ecl.Buchanan@THECB.state.tx.us; ed.sturdivant@fortbendcountytx.gov; ekta.patel@columbia.edu; elizabeth.cloyd@harrishealth.org; ellen.catoe@texanacenteccom; elwell@gl-law.com; epatel2@houstonmethodist.org; erica.brown@theharriscenter.org; etyrrell@houstonmethodist.org; fawan@obmc.org; ferguson@gl-law.com; georgia.thomas@memorialhermann.org; gwendolyn.curlee@phs.hctx.net; gz03S7@gulfbend.org; Glenn Zengerle <gzengerle@gulfbend.org>; harold.dutton@phs.hctx.net; hbeal@jpshealth.org; Hchung@houstonmethodist,org; hdutton@hcphes.org; hferguso@mdanderson.org; hoxfordiv@benoxford.com; hstein@houstonmethadist.org; Ijett@brazoscountytx.gov; irocha@ecmh.org; jacquea@dhchd.org; jacquelyn.minter@fortbendcountytx.gov; James.L.Vitt@uth.tmc.edu; janaew@dhchd.org; Jason Anglin <JAnglin@mmcportlavaca.com>; jdtenhaken@hcphes,org; jeanne.wallace@mhmraharris.org; Jeff.Jackson@bmd.hctx.net; Jeff.Sliwinski@HCAHealthcare.com; jeff1896@gulfbend.org; jessica,granger@harrishealth.org; jessica.hall@harrishealth.org; jfreudenberger@obmc.org; jhammel@obrnc,org; jhughson@gonzaleshealthcare.com; jill.tenhaken@phs.hctx.net; Jimmie.Ng@houstontx,gov; jjanek@ricemedicalcenter.net; jjett@brazoscountytx.gov; jmhatt@mdanderson.org; JMShephard@mdanderson.org; joanmatthews784@gmail.com; John.Cramer@rnemorialhermann.org; johneaton@stlukeshealth.org; Joseph.Dygert@harrishealth.org; JPElliott@houstonmethodist,org; jpickett@mmcportlavaca.com; jray@obmc.org; jtodd@obmc.org; Judy.Harris@houstontx.gov; Julie, Rabat-Torki@harrishealth.org; julie.t.page@uth.tmc.edu; jvanek@columbusch.com; Karen.LaFontaine@harrishealth.org; Kate,Johnson@TexanaCenter.com; Kaye.Reynolds@fortbendcountytx,gov; kbarrett@bcm.edu; kcox@obmc.org; keena.pace@TheHarrisCenter,orgj Kevin.Dlllon@uth,tmc.edu; kevin.lin@harrishealth.org; kirklanci ft-law.com; kmrose@texaschildrens.org; konczal@gl- law.com; kord,quintero@memorialhermann.org; kristen.edge@memorialhermann.org; kxbartle@texaschildrens,org; kzieren@stlukeshealth.org; larry,martin@hcahealthcare.com; laura.gates@memorialhermann.org; Iaura5325@gulfbend.org; lauriem@gulfcoastcenter.org; lazanga@matagordaregional.org; Ibecker@hcphes.org; Idcrusor@texaschildrens,oeg; Lee.Hughes@newlighthealthcare.com; Lesile.DeLaO@phs.hctx.net; Ifoxhall@mdanderson.org; Iharvey@ecmh.org; Iharvey@mmcportlavaca,com; ihodge@obmc.org; linda1830@gulfbend,org; ling-lun,chien@theharriscenter.org; Lizette.Escamiila@memorialhermann,org; Ilebouef@trhfoundation.org; Iluedeker@gmall,com; Lori.Dochoda@harrishealth.org; Irmcstay@texaschildrens.org; MaCristina.Sitarz@memortalhermann.org;magruda@obmc.org; mapatel2@texaschildrens.org; maria.sprague@steward.org; Mary,Pastore@uth.tmc,edu; mbenton@StlukesHealth.Org; and,kendrick@fortbendcountytx,gov; mdbrown@tamu.edu; Melanie Taylor <melanie.taylor@myburke,org>; michael.norby@harrishealth.org; miavaid@mdanderson.org; mjgetz@houstonmethodist.org; mjspanihel@ricemedicalcenter.net; mkinyo@trhfoundation.org; mkiock@matagordaregional.org; mlongoria@ecmh.org; moorerea@nacmem,org; Morgan@gl-law.com; nathalie.cardona@phs,hctx.net; ncastillo@ricemedicalcenter,net; NChl@houstonmethodist.org; neelyk@gulfcoastcenter,org; Nicole.lievsay@harrishealth.org; Nnabuchi,T.Akpeh@uth.tmc.edu; ntudor@ecmh.org; Oscar.8allarta@uth.tmc.edu; peggys@bcm.edu; phamilton@chambershealth.org; PHarrison2@houstonmethodist.org; pstewart@gonzaleshealthcare,rom; reprater@mdanderson.org; rford@iasishealthcare.com; rgeorge@ricemedicaleenter.net; Roshanda S. Thomas <rthomas@mmcportlavaca.com>; Richard. Ervin @hca healthca re.com; Richard, Ford@steward.org; Richi.Chaudhry@MemorialHermann.org; rlenfant@obmc.org; robert,hjllier@harrishealth.org; Robina.A.Philipose@uth.tmc.edu; romel.walker@theharriscenter.org; rpelley2@houstonmethodist.org; RSBello@mdanderson.org; Roshanda S. Thomas <rthomas@mmcportlavaca.com>; russell,meyers@midland-memorial.com; rwicke@columbusch.com; sahar,m,gashgai@uth,tmc.edu; sam.Karim@harrishealth.org; Sandra,K.Tyson@uth.tme.edu; Sarah Kalinowski@Premierinc.com; Sarah schauman@premierinc.com; sbulle@stlukeshealth,org; scampos@houstonmethodist.org; scarruth@obmc,org; scgilmor@mdanderson.org; Sean Kim <Sean.Kim@TheHarrisCenter.org>; setexasrhp@harrishealth.org; sgularte@chambershealth.org; shannon,evens2@hcahealthcare.com; sharif,z,mansur@uth.tmc.edu; Sharon,lkeler@hcahealthcare.com; Shawton.Han leins@hcahealthcare.com; shena.timberlake@texanacenter.com; shernandez@ricemedicalcenter. net, sherrie@wshd-tx.com; simmotnschiro@yahoo.com; spuria@gl-law.com; sschauman@nexerainc.com; ssmith@matagordaregional.org; Stephen,orrell@harrishealth.org; steve,hand@memorialhermann.org; Schnee,Steven B <steve.schnee@mhmraharris.org>; Sukhvir.sandhu@harrishealth.org; Sukhvir,Sandhu@memorialherrnann.org; swathi.gurjala@harrishealth.org; swu2@houstonmethodist.org; tabak@bcm.edu; tatyana,johnson@fortbendcountytx.gov; tcheaney@chambersheaith.org; thomas,aardahl@stctr.org; tina.hanks@stctr,org; tlilie@columbusch.com; tnguyenS@obmc.org; tsinclair@bcm.edu; tzalman@ecmh.org; ushah@hcphes.org; Van,Dernetriades@memorialhermann,org; vausborn@stlukeshealth.arg; Victoria,Nikitin@harrishealth.org; vlpowers@hotmall.com; vonderau@sbcglobal.net; Wayne Young <Wayne.young@TheHarrisCenter.org>,, wel.guo@theharriscenter.org; whudson@hcphes,org; william.bryant@houstontx.gov; yxshi2@texaschildrens.org Cc: Brown,Adam (HHSC) Oclam.Brown04@hhs.texas.gov>; Chang,Sylvla (HHSC) <sylvia.chang@hhs.texas,gov>; Corzine,Ketha (HHSC) <Ketha.Corzine@hhs,texas.gov>; Okoniewski,Amanda (HHSC) <Amanda,Okoniewski01@hhs.texas.gov>; HHSC Texas Healthcare Transformation and quality Improvement Program <TXHealthcareTransformation@hhsc,state.tx.us>; Wade,Tonika (HHSC) <Tonika.Wade@hhs,texas.gov> Subject: January 2022 DSRIP DY10 R2 IGT Notification - RHP 03 [WARNING -Remote attachments, VERIFY SENDER] 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. Anchors/Government Entities/Providers: Please carefully review this message in its entirety making note of the information provided which pertains to the DY1O Delivery System Reform Incentive Payments fDSRIPI. Attached are the following files: DSRIP Notification- DY10 Round 2 January 2022 Affiliation Summary and DY10 Round 2 January 2022 IGT Summary workbooks. These workbooks Include DY10 DSRIP payments and DY9 Carryfonvard Reporting, The DY10 Round 2 January 2022 Affiliation Summary workbook has separate tabs for each Regional Healthcare Partnership (RHP) and contains the Intergovernmental Transfer (IGT) needed, by affiliation, for DY10 Round 2 DSRIP payments and DY9 Carry Forward. The DY10 Round 2 January 2022 IGT Summary workbook has separate tabs for each RHP and contains the total IGT needed by each IGT Entity for the DY10 Round 2 DSRIP payments and DY9 Carryforward Reporting. Providers a55an determine their estimated,pdyment amoyint by dividing Cgiumn M of the DYW Round 2 January 021 Affiliation Summary by the state share of the curcent FMAP. The current FMAP is 0.660/6/33.009%. The Transformation Waiver Team will email the Anchors information to share with providers regarding how much will be paid by Category and measure on Friday, December 17, 2021. Health and Human Services Commission (HHSC) Provider Finance Department Is unable to answer questions regarding this information. Please send any questions regarding this information to T� i-i ea I thcarcTra nsfo rrnatf omfil h hscsta ta. iy. us HHSC requires that the appropriate TexNet bucket is used for DSRIP Reporting IGTs. The DSRIP Reporting IGT should be placed in DSRIP. IGT Entities may choose to IGT less than the required amount for DSRIP Reporting payments; however, all affiliated providers and metrics will be paid proportionately. IGT may not be directed towards specific providers, Categories, or metrics. A screen shot/.pdf of the confirmation/trace sheet or email of the confirmation number if the TexNet is submitted over the phone is required and must be emailed to PFD DSRIP Pavments0hhs.texas.gov. We are requesting that all government entitles enter their IGT transactions into TexNet no later than January 4th with a Settlement Date of January 5th. No IGT's submitted after January 5th will be accepted. HHSC Accounting will request the Comptroller to issue payments according to the following estimated schedule: Tuesday, January 04, 2022 1 Last date for Public entities to enter TexNet and submit Trace Sheet Wednesday, January O5, 2022 TexNet Sweeps (Settlementdate of funds) Wednesday, January 19, 2022 1 Payment issue date for Transferring Hospitals "Big 6" Friday, January 28, 2022 I Payment issue date for Non -Transferring Hospitals I Information regarding TexNet Connect can be found at i �tt�s:!: wmotrc;her.texas.nov/programs; s�stemsi dOCS.'9ia-i193. Thank you, HHSC Provider Finance Payments Texas health and Human Services Commission North Austin Complex. PO Box 149030, Mail Code H-400 4601 Guadalupe St Tustin. TX 78751 PN jiv TEXAS t, Health and Human ; Services Confidential., This transmission is confidential and inzended solely for the use of the individual cr entfty to which rtisoddressed. if you �sceive this transmission in errorplease notify sender and remove ail copies from ;roux computer. Page 1 of 1 p&oErM) BY THE COUNTY AUDITOR ON DEC 16 2021 12/16/2021 MEMORIAL MEDICAL CENTER 0 CALHOLM&PUNTY, TEXAS AP Open Invoice List ap_apen_invoica.template Due Dates Through: 01/06/2022 Vendor# Vendor Name Class Pay Code 11816 ASHFORD GARDENS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Grass Discount No -Pay 121421 12/15/2012/14/20 01/06/20 22,542.62 0.00 0.00 MEDICARE REPAYMENT Vendor Total; Number Name Gross Discount No -Pay 11816 ASHFORD GARDENS 22,542.62 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 22,542,62 0.00 0.00 APPROVED ON DEC 16 2021 BY COUNTY AUDIM CALHOUN COUNTY, TEXAS Net / 22,542.62 Net 22,542.62 Net 22,642.62 Ale-IIIr-IT Tne.,./..t..:...,.«I---:/«,,..,..--A,.....:_.—. ca__ In1111nnn, 1211712021 09:50 MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 01106/2022 0 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 120321 1 2J1 3/20 12103120 01/06/20 648.99 0.00 0,00 TRANSFER {J� IY1Sl)&w. {# KI&tpviles Ikb Mul betYL 121421 12/1712012114/2012/14/20 62,580.63 0.00 0.00 MEDICARE REPAYMENT Vendor Totals Number Name Gross Discount No -Pay 11828 SOLERA WEST HOUSTON 63,227.62 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 63,227.62 0.00 0.00 DEC 16 2021 C AILHCO1 J--GUNTY To" Page 1 of 1 Net 646.99 62,580.63 y/ Net 63,227.62 Net 63,227.62 file:i/lC:lUsers/eheiman/epsilmemmed.cpsinet.com/u98547/data 5/tmp_ow5report8476... 12/17,12021 12/17/2021 MEMORIAL MEDICAL CENTER 09:49 AP Open Invoice List Due Dates Through: 01/06/2022 Vendor" Vendor Name Class Pay Code 11620 FORTBEND HEALTHCARE CENTER Invoice# Comment Tran Dt Inv 01 Due Ot Check D Pay Gross 121421A 12/17120 12(14120 12/14120 11,396.92 MEDICARE REPAYMENT Vendor Totals Number Name Gross 11820 FORTBEND HEALTHCARE CENTER 11,396,92 Report Summary Grand Totals: Gross Discount 11,396.92 0.00 DEC 16 2021 BY COUNTY AUD1TOii CALHOUN COUNTY, TEW Page I of 1 0 ap_open_involce.template Discount No -Pay Net 0.00 0.00 11,396.92 �- Discount No -Pay Net 0.00 0.00 11,396.92 No -Pay Net 0.00 11,396.92 tile://1C:lUsersleheimanlepsilmemmed.cpsinct.com/u98547/data_5/tmp_cw5report6418... 12/17/2021 RECEIVED BV THE COUNTY AUDITOR ON DEC 16 2021 f2�ls�an MEMORIAL MEDICAL CENTER CALHOUNCl3OWTE%AS AP Open Invoice List 10:03 Due Dates Through: 01/06/2022 Vendor# Vendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK ✓ Invoice# Comment Tran Ol Inv Dt Due Dt Check D, Pay Gross 121421 12/15/20.12/14/20 01/06/20 50,869.06 MEDICARE REPAYMENT Vendor Totals Number Name Gross 11832 BROADMOOR AT CREEKSIDE PARK 50,869.06 Report Summary Grand Totals: Gross Discount 50,869.06 0.00 APPROVED ON DEC 16 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Page 1 of 1 0 ap_open_invcice.tempiate Discount No -Pay Net 0.00 0.00 50,869.06 Discount No -Pay Net 0.00 0.00 50,869.06 No -Pay Net 0.00 50,869.06 fi1,111r-/r /...,..:a„e.,,..,e,t,....;__+,,,..., I-AOCn v M_, ,, c4..._ 1�fi el�Agj Pape I of 1 MEMORIAL MEDICAL CENTER 12/17/2021 0 AP Open Invoice List 09:50 ap open_invoice.tomplate Due Dates Through: 01/0612022 Vendor#Vendor Name Class Pay Code 11024 THE CRESCENT Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 1201218 12/13i20 I W01 I2001106/20 2.228.00 0.00 0.00 2.226.00 / ✓ TRANSFER N1 Ivlwv'rku i?tj1µ,}.ionp(y .Iy, 41 il,1, w`1kj- 120321A 1211312012/0312001/06/20 480,00 0.00 0.00 Q 480.00 TRANSFER 121421E 12115120121141200V06/20 42,975.52 0.00 0.00 42,975.52 MEDICARE REPAYMENT Vendor Total: Number Name Gross Discount No -Pay Net 11824 THE CRESCENT 45,681.52 0,00 0.00 45,681.52 Report Summary Grand Totals: Gross Discount No -Pay Net 45.681.52 0.00 0.00 45,681,52 APPROVED ON DEC 16 2021 BY COUNTY AUDITOR CAwoUN COUNTY, TEXAS Rle:ll/C:/Users/eheimatlfcpsi/memmed.cpsinet.com/u985471data_51tmp_ew5report9918... 12/ 17/2021 Page I of 1 COU CNTTYY AEUDDRbR ON DEC 16 2021 MEMORIAL MEDICAL CENTER 12/16/2021 0 AP Open Invoice List CALHOUNVOONTy, TE)(AS Due Dates Through: 01/06/2022 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 120221 12113/2012/0212001/06/20 1,108.27 0.00 0.00 TRANSFER 0 j Vu0 u- ggmIF oi4.po,.Ae L IhT ?A*"- OpUv- 120821 12/13/20.12/08/20 01/06/20 9,688.78 0.00 6 0.00 MEDICARE REPAYMENT Vendor Total. Number Name Grass Discount No -Pay 11836 GOLDENCREEK HEALTHCARE 10,797.05 0.00 GAO Report Summary Grand Totals: Gross Discount No -Pay 10,797.05 0.00 0.00 DEC 16 2021 BY COUNTY pU© TOR CALHOUN0E�UN—TVi ➢fA�b Net 1,108.27 ./ 9,688.78 ✓� Net 10,797.05 Net 10,797.05 file:///C:/Users/eheiman/cosi/memrned.cnsinct.com/u98547/data 5/tmn cw5rennrt7131... 19./16/),O?l RECEIVED BYTHE COUNTY AUDROR ON DEC 16 2021 CAL HOUNI&JITI 1 TEXAS 10:04 Vendor# Vendor Name 12696 GULF POINTE PLAZA >/ MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 01/06/2022 Class Pay Code 0 ap_open_invcice.template Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 120321 12/13120.12/03/20 01/06/20 3,547.04 0.00 0.00 TRANSFER tjW jhWWt11L P t OhiqL u� 1 I" VWL_ 0KKvl / Vendor Totals Number Name Gross Discount o No -Pay 12696 GULF POINTE PLAZA 3,547.04 0.00 0.00 Grand Totals: APPROVEO ON DEC 16 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Page 1 of 1 Net 3,547.04 Net 3,547.04 Report Summary Gross Discount No -Pay Net 3,547.04 0.00 0.00 3,547.04 4:IA-///f'-/Tf...�/ot,-;,.,,,/r-,;/...e...--,4,..,... +c/....._ ,ter, rrq„�, Page 1 of I RECEIVED BY THE COUNTY AUDITOR ON DEC 16 2021 12/16/2021 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List CAU-IOUNRUNTY, TEXAS ap_openJnvoice.template Due Dates Through: 07106/2022 Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check U Pay Gross Discount No -Pay Net 120121E 1I2/1312012/01/2001/06/20 12,731.00 0.00 0.00 12,731.00 u TRANSFER N1{ InSVY4kt2 { 6I V(X4i'1n,k it,.I` l&WJL. apt.wl� 120221 12113/2012/02/2001/06/20 741.00 0.00 0.00 741.00 TRANSFER tc 1, 1 P0321 12/13/2012l03/2001/06/20. 2,433.36 0.00 0.00 2,433.36 ✓ TRANSFER 120721 12/13/20. 12/07/2001106120, 1,546.79 0.00 0.00 1,546.79 TRANSFER 1% /r Vendor Totals Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 17,452.15 0.00 0.00 17,452.15 Report Summary Grand Totals: Gross Discount No -Pay Net 17,452.15 0.00 0.00 17,452.15 APPROM ON DEC 16 2021 CATOR LHOUN COUNTY, NTY (TEXAS file:l/IC:/Usersleheiman/epsi/memmed.cpsinet.coralu98547/data_S/tmp_cw5report6721... 12/16/2021 RECEIVED BYTHE COUNTY AUDITOR ON DEC 16 2021 12/16/2021 CALHOU%�09UNTY,TP_XAS MEMORIAL MEDICAL CENTER AP Open Invoice List Due Dates Through: 01/08/2022 0 ap_open Invoice.template Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING ,/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay 120121A 12/13120.1210112001106/20. 12,618.95 0.00 0.00 TRANSFER VW 1y1.1V W0_ 93*Ll dt,{td6lila jAlD IWL upon.}'u�X/ 120821 12/13/20 Y2/O8/2001/06120, 240.26 0.00 U 0.00 MEDICARE REPAYMENT Vendor Totale Number Name Gross Discount No -Pay 12792 BETHANY SENIOR LIVING 12,869.21 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 12,859.21 0.00 0.00 APPROVED ON DEC 16 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Page 1 of 1 Net 12.618.95 ✓ 240.26 0/ Net 12,859.21 Net 12,859.21 itla-///('-/T ... ;o +c/t...... ..c....-.., a.']ncn ,nr, chnn, Request for Transfer of Funds na�nmP: Dah PegI ILIWD]1 PIN, MEOICARE NequnnOby: TAIUMGOROON-BUSINESS OFFICE MPNAGER flequeite/temEll 11'L'•!mily n41 an -I rYO�R PequnroYE MOne mm.be[ 3615530500 D6Ukt0e Cnunry Calbeun wat, Bel6an. 5emoe OrinP INM Namu lafaum Oa[e Sfury , WREO amolouNment iwe.EPevme igmk= ANNUltaf P..Et UWkR..PmNEESE A[Il4n neele4[n e[ hN[ ae Euntl[N km N/A N/A 13110120B ER EFt61802Ud CVWPWDOS6B69 6)d.BE ]NE BRWOMORE CREENSIDF OUPIWRY ADVANCE PMe TO be filled out Memodtl Medical Center. mh e D ] PpptOvetlb): E f DEte Of lnnfhrv. I] ]S ]0 Pmm Pe[lllty. -: ..NtUUB To q[IlltyBETHEMNY Amounu 6741 BppROWDOM DEC 2 0 2021 BY COUNTY AUDITOR c"OUN COUNTY, TEXAS Request for Transfer of Funds "tWe p'. tim Peptented 1LOU PIT., MEDICARE PepuesRd by: PACHFLANMeM Repueseohemall ryylne ..A'.q Pepueet." o[w nVmber E13170.53C4 ow. -coo., Mil HtlIIry WSGNYVIIAU end EOe Lin.�_N,v4my.— JVnni9_•5L21'I�L1li'1a nd[nexame I6 6 TVpeMp.rmml irme6[€EIL P.rmSp6 sM1eu1.. xumber (xlmxumbae edmn ae.e.e. mete]. nrmner]. ]3 r xuEEE Nobbeki] kfp.. 5 ].roL]t eN616Mee 6473 WO/CVOAPWNE6969 E.Wa.n :IRWUIREP� $ A6160E11PIXQl36969 $ [rt 5 sessa eh6161510 WOKVOAflWNE6669 $ I... Do. T.I.1 from Brwdmwr TIITAL E59d.W 3.594.9L 4A18` To be filled out by Memodel Method Cenbe:: Dale xeeelwa: APP:ueed by oam[reamhr. Dam Eedni,: To ftwR : AmaunC 1E/mlml CCLEVENGER ]E/EyxOn 'ePOADMO0P -WSCANY= -2.594.91- APPROVED ON DEC 20 2021 BYCOUNTVAUDITOR CALHOUN COUMY, TENA9 Request for Transfer of Funds hdnsler p' Daft Requested 1:.1].3] Payer Mf01M, R[queslld by: PA MRWNRUS fl[quesWls emil flequeslafs phone n4mper 11i-])033W ObW,t ar[aunp SWORM .1111y NSl'AXY VILIAGF APPRDVED ON DEC 20 2021 sV COUNTY AUDITOR CALHOUN COUNTY,TEXA9 Request for Transfer of Funds TMn51le!'. me. Reluelod .116/rUl %meLELUM1! P." MEMARf pemNGnu MYIFviw Ebb Rvqunleb be IATUM GORDON-SUSINESSOFFICE WNAGER NmunrylnlhnepNnen vwryelmenlwnmupmm4 pinw nMtl![w olvwgeW pim RlgYlelOfelmill I,n,!,; E,i.l ir_ •Merl Nem1b..M6eMwend Ameu.M P.—I 1. member."" men. fle.1 Requeewrs prone end pvmlwnav AM. W: __r_L `!JryyS4yY5_! number 361-5510500 ObMttartaunly I.Ihmjr,ygrLni nlrnlllar__ FMlu , B.Nr'SMlm UAq PtllenLxame R 1! ww.nl Servke R! IREO !I a Typpofyavme aPyyEGE xow a I fim w.em HnGe L]er Fune.11 EYNURa. N L N/A WA 1]t]O2l EFT ERwwal CVMRM19557 GMA9.IECRESENT AUXILURY ADVANCE PM] IC]TAL 67419 T.MRYM out ..d.1 Medkal QM n. pr !. n9Rmv<d refit LEVEx R w[e Mvmsllr: ] Fmm Qnnn: :RE !'AN I" TO.u.:. REMANY Amount: 614,99'.' - DEC 20 2021 BY COUNTY AUDITOR. CALHOUN COUNTY, T EXAn Request for Transfer of Funds Tianlle..: Sete ReobeeRe 12117/m21 P." MEMARE Reque[tedby: IRIUM GORDON- UUSINESS OFFICE MANAGER 111u..ofsemall _NOIAl.-IL-Ii_ Reque re pore numbern M SIOSm .1w. o. County Calhoun Henry SON, So, ., Ln, keaM EOB eetlmlep WerPer:n.ntnnmulmenl. pluse e—Id.[OeolMeryeld o.. S[leynn�nr�rrnn I.rv�)rU nyrrr.rr_yrW �!n{1!1�1♦_n�IR Palle. N.me RE R 0[IedServke U D D dPo Tyoeo/Paunre 1p2NLNL LM1 An anneetlf tl-[nln maeaee. rrrre.m N/A N/A 12/I6/2021 on FiT61&301 CVMR000018170 63e,09 Soler. Won H.ueloo RUMRIARYAWANCE PMT TOTAL 67eA9 L. be filled pul Mtn lMWI.1Cen1[n Sl, Rete 2 20 1 Appmeedby: M.E.0oll Wlean1 n Dn pmm HNlpil, To 'e"Ift �. BETIMY-- Pmeunlzl: 6yA89. DEC 2 0 2021 By COUNTY CALHOUN COUNTY, Request for Transfer of Funds Lfansfeb: Dale bebue[I!d 12,17.21 Pbyn Mf01ZAPf RPqueeled AY: bACHLLAMANS RlpulalPls Re9ueelall pl:Pne numbef 213-270-SM DIIDIIt IetlYnly 9MZDP14 'wea, TDSCANYMLAGE Polknl Neme 9a1ee15enlee hose/hvment ANlunnxd/0.d mar �6Q111RF, pJ �{QIf�LQ3 pNeel Psumenf �p�(�� plJmt9L {M1pwnan tiv[YNumber Llnlm Numher lund[llw a [NI l9 uw.NR.m, j/gEey S1EG31 ffT 5 i.Po[D WO/CVDARDIOD181TO Due Tueuby from Solera R.IIRI ffe S Ldo BROISSW3 e6182510 WO/WDARODMI8170 5 Sole. Due iu,,e, I1A5.11 "I 5 Svs ea eh61F1510 WO/CVOARp',p01Rllp L. 5 feL.x f,wn Due Tuscany Oom Sole[n TOTAL E,591.91 2,599.91 g To be 011ed oul Memotlel Mldkal[enbr; mn M[elued: ILEN2@1 Apprmed hy: CCIfVEHGFR DaM df lmm/eD vlavzan : :SOIEIIR- Too illtV: io fNlllly: IUffAHV Pmeunf: E,591,91-' APPROVED OR DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS P MIVIC - A �d CHK'K REQUEST Daz-, 12/20/21 y APPROVED ON DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY, YOt AIVIIOUM," 14714.39 G/L NUMBER: EXPLANATION: Echo repayment BY: C Clevenger AUTHORIZED BY: FOR AC(7. USE ONLY HAI/P 1-11edz 11 Mail Check to Vendor I]RetuinChad, toDg!pt 1 q ArE-I'VT0RfAtVEn1rAt-CtN-,FER OqF-Pair'k� CHK-K REQUEST MMClinic Date RWquested: 12/20/21 APPROVED ON y DEC 20 20,11 Olrnprcist Cash E 19A/P Check BY COUNTY AUDITOR CALHOUN COUNTY, TFXAG El Mail Chcck to Vendur C []Return Chpd, to Copt AMIDUMI 1188.54 EXPI-6,NATION: Echo repayment G/! NIUNIRER: REQUE_STff) a V: C Clevenger Al;IV: MEA9119RAL PAMIGAIL CENTER �Jjf pwj� CHECK REQUEST Ashford Date Requested: 'A Y APPROVED ON DEC 20 2021 A I'D � By COU , MIS CALHOUNM � AMOUNT 73629.16 GI'L NUMBER: EXPLAMATION: Echo repayment CCIevenger i,Y: 12/20/21 FOR USE ONLY Flimprest Cash FJA/P Chec", Nlail Ch,-6,, to Vendor llpetuin Check to Dept it i 'cf`1E 1 E R CHECK REQUEST r Tuscany Ucle Requested: APPROVED ON e: — — DEC 20 Z021 E BY COUNTY AUDITOR ---- --- rALHOUN COUNTY. TEXAS AN"i0U1%'i 4829.00 C/1. �'LlIfOBE! Echo repayment kMFLP nJAI'IOAI: REQUP STEM E}: CClevenger Ai}TH0M!ZFj) �!>i 12/20/21 FOR ACC, USE ONLY 4mPres` Cash EJA/P Ched: DMail Check Co Vendor DR2turo Chem Dept P Bethany E t 54F fbKAy CHECK REQUEST Date Requested; 12/20/21 APPRGVMON DEC 20 2021 --------- - -- --syC0MMAV=R CALHOUN CCUNTV,TM8 AMOUNT 3710.00 G/L NUIVISE�: FXPLANAFION: Echo repayment REQUI-S! 1: D BY' C Clevenger ;",LMCNIIZED BY: FOR ACC; . USE ONLY 0 FIA./P (heck E,Maii Check to Vendor L 17, TO Cept Memorial Medical Center Nursing Home UPL Weekly Centex Transfer Prosperity Accounts 12/22/2021 9m3w1 I.W. Att«m NDMNa Aa vmalM smnmrN AmMm19 ee3nmfem6mxurNnr NV Name Nun6ir M4MA 1Is lnnrl Mln Di Wr Nnni N20 .H.33L03 iBA6509 ✓xiY,U39.39 Tr5g. xi0.105.x6 :26,093.20 MnY MNnte 3i0,10516 1% Vi1Nn[e WiW In MhMa Malina01PP IV9.W 15,819.91 1/ WINTIP2ST 1615 ✓ _ NOVINTIx857 15.99 ✓ DBLINRNLST Aary)L 6ibnmRnnsifrnmt Sx4053.xo f t Y .%Vs.60 L/IA9,19366 )61.419.I3 / I61,39515 171,836.16 /// MnYMNMe I81.798.I5 NMnq lerveln&lam 100.0D mull.wPP 6,5]2.1].// Medbfe 0ym1 a+n010Ntlum9 Muflan, 674.85 L/ rd awed'.T., 2592916� DRIx�PNl9t 1i.t8/ NOVINTFBEfT 9.79 ./ O[CINIEIIEST "Jun B3llMenpn3rnrAml 17W6.0 59.319, 19 ✓59,1Po W ✓151.1010, 5/ ISg12IS2 i 318,937d2 DanY Mlm[e 155,222.22 ✓ VarNnce Lemin BNem 10000 ✓ M.113N lay" MetlbWPYml0we0M8etMM 5.853.95 670.99 �/. MbIw PWNawed 10TW3iW 2,59A91 I' 433.0 - 99,883.71 d M,35142 /.219.]S�E2d11.is APPROVED ON 148 BY COUNTY AUDITO CALHOUN COUNTY, TO 214]'70/. ., r u f-E . !.II�! � l 1. � fOfMnuvn9nwm. 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Is 12/20/2021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number 7 Name Groups Account Type Add Group k1y Groups Search All ODA Data reported as of Dec 20. 2011 3 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8,182,637.37 $8,281,418,96 $8.182,637.37 $7,950,968.57 '4551 CAL CO INDIGENT 55,622.09 S5,622.09 S5.622.09 $5,622.09 HEALTHCARE '44 4 MEMORIAL MEDICAL NH GOLDEN CREEK $213.453.47 $218,165.47 $213,45347 S181,818.80 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $535.99 S535.99 S535.99 5535.99 2014 '435 MEMORIAL MEDICAL $5.375,234.01 $5,358.83727 $5,376.234.01 $5,314,649.72 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.51 S431,51 $431.51 $431.51 WAIVER CLEARING '4381 MEMORIAL MEDICAL S240,105,26 j S252,380.15 $240,105.26 S213,530.49 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH S181,198.25 ✓ S195,972.09 S181.798.25 S168,183.27 BROADMOOR '4411 MEMORIAL MEDICAL S158.922.22 ✓ S194.079.22 S158222.22 5156,091.88 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $99,319,31 ✓ $108,679.83 S99,319.31 S96.098.62 CENTER I NH FORT BEND '4438 MEMORIAL CENTER I SOLESOLERA AT $224.575.02 v S243,298.03 S224,575.02 $191485.29 WEST HOUSTON '2998 MMC -MONEY MARKET S1. 109,095.73 $1. 109,095.73 $1109,095.73 S1,109.095.73 FUND '5506 MMC-NH BETHANY $311,112.45 $331,18952 5311,112.45 $284,652.08 SENIOR LIVING '5441 MPAC -NH GULF POINTE PLAZA - S103,748.63 $103.748.83 5103.748,83 5103.748.83 MEDICAREIMEDICAID 'S43a MMC -NH GULF POINTE S75,619.28 $75.619.26 S75,619.28 S41,260.32 PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY $83,763.95 $83.763.95 $83.763,95 S83,763.95 VILLAGE hltps://prosperity.clbanking,com/onllneMessenger r 111 Memorial Medial Center Nursing Home UPL Weekly Nexian Transfer Prosperity Accounts 12/22/2021 PwvW . An'.,mt Bodoni" Nurdn H. Humber Bah.TennLn,O., .- 29,497.54 ✓ 0,742.49 e. Now; OnNbvbnm.ofum Ss=w19be",rened to menunlnP home HoW2, Each account hm a bwe babnce 0/510 thotAIMC de➢ofHM fo open occoonf. APPROM'ON DEC 20 2021 BY COUNV AIUi CAWOUNCOUNII'1 § Tod.". BoSlnnin" Amnon, to Bo TrenHettM to NYMn( 213.45347 Bonk&Once 113p53.A7 Ve�ia,2e Laxwme.Unce Imm Sap.darelPPUndlmlbu.ed 2e,1a3.13 OCr IN3ENE53 11.52 NDVINIEkm I2.31 DECINrENEST "JUS! bna/rran.ler No'1t1Ac`�\I 1l9/./1L11E35/2���EEE\ // Ap Anth... Wdurdwn,Ceo U/2 nzi rwx wetW r,.ml.nlxx urin.col., wmm.M2ontBowmb.,\NN urt n.mnr wmm.ry tz26.21..1v 1]Il)J]WI f[119 Wi)/1w{ 1919/INNSfIPSi NCD3tlMYN9W5996i69119 W17ANI Gn4MMMyMV 000ICt1f%6))N155512111090 I]/16l]wl CX IM WI6/]wl CXtis WIMM n tN wlEpwl IN.. I]Awxwl mm 12/I6/2021 0.rm1 W0/2w1 rSORMN9DMi NfDfIVAISi]W35f9]691Y9 WW2w1 0.MM WSUxwI 6 .' u/W2w1 M..' ti/If/2021 rSYS)IMWSIMr BXCDSIN9r NSWSSSf269V 9 li/IS/lMl IStS/IMWIIMrBXCOfi1M!S6IW5596)691i9 R/ll/lwl wtw. "C.IA1M9M) i(P 329INwN)OM) I2/Ilpwl G010FNCMFXMFASi MIM Mr1]1011C 91pRV1159 tyu/xoxl noun xvmAN svu4<uim9mrvl6wiunoux MMCIOMION art/w �I 91T• 51JCgYl IlLr f m. avr/C .Ia an/mmri oxr/C9mN ar9n raMMDM 230.96 1.71959 1,Ib.90 21AKII 2ami.11 k.311/ 14uNf ly%9JM/ 2.4XII 24slin / I - "IN9"INIll,6w s, 60.35 - I3i66Ms1 I,OSAS ;NI.II ii,ixl.11 p392. - i,filw I.112.0 N51.w IALM I 1.M .A. .it 101 iillA1 3.1231, 0.742.x r 441,714,41 z 24%MAI 12/2012021 Quick View Select Quick View Accounts Account Number I Name Account Type Ssarch All Account Number Number of Accounts: 15 '4551 CAL CO INDIGENT HEALTHCARE '4454 MEMORIAL MEDICAL i 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 INH ASHFORD '4403 MEMORIAL MEDICAL CENTERINH BROADMOOR '4411 MEMORIAL MEDICAL CENTER INH CRESCENT '44A MEMORIAL MEDICAL CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTERISOLERAAT WEST HOUSTON •2998 MMC-MONEY MARKET FUND '5506 MIMIC NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- MEDICAR&MEDICAID '5433 MIMIC -NH GULF POINTE PLAZA - PRIVATE PAY •3407 MMC -NH TUSCANY VILLAGE Treasury Center Select Group Groups ndd Group My Grcups Current Balance Available Balance $8,182,637.37 $8,281,418.96 $5,622.09 $5,622.09 5213.453.47 % $218,165.47 hllps:lrprosperity.olbanking.comlonlineMessenger Collected Balance 58,182,637.37 55,622.09 $213.455,47 asof Dec 20, 2021 3 Prior Day Balance $7,950,968,57 S5,622.09 $181.816 80 S535.99 5535.99 5535.99 $535.99 55,375,234.01 $5,358.837.27 $5,375234.01 55.314.649.72 5431.51 S431.51 5431.51 5431.51 $240,105.26 5252,380.15 5240,105.26 5213,530.49 5181,798.25 5195,972.09 S181.798.25 $168.183.27 $158,222.22 5194,079.22 $158,222.22 $156091.88 $99,319.31 5108,679A3 599.319,31 896,098.62 5224.575.02 5243,298.03 S224,575.02 S197a85.29 51,109,095.73 $1,109.095.73 $1,109,095.73 $1,109,095.73 $311,112.46 $331,189.52 $311.112.45 $264,652,08 5103,748.83 $103,746,83 S103,70,83 S103,748.83 $75,619,28 575,619.28 575.619.28 S41,260,32 $83,763,95 $83,763,95 583,763,95 583.763.95 r 1!1 Memorial Meditai Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 12/22/2021 1. Nnaxt bb .Y<mnl bElnNp v,ndxE bnuNmdt< X 4e MxN< Tm<IwAM Trx11 rl p<Clnxed 0, Tod '<b x NJ<me NUNNxne _ Y 1R.(4).<6 al.}669d <O.B<IF )4.61418 ]3.313.60 bnYbl,nx mote mwm blbtt 3W.00 UNIN"FIEOECNO VNYMENTS (NO OREU"U GE WNTEX WN TND AMOUM YRf 11411]t WpMnOINUndbMMlod a1A41.16 FGwp)ml wvdln MMC I4.1"w FeNoplmewTdl<TbunY v. E;mN, tWxdb MMWnN um EtlwpymecUTtlm4.tlFyRb�YS l.)SdW view�- R ~ 1 O—Nx N N2 Nan, Nwnbr_ N<t<: (AYy6ofoeme/avo51,LW wiNOe Vanflln<dfn M<nUninENwx. NaeL E<tll IXtaweNx<hxeEolonxaf.510J rNo1 MNCtlepofttMfOro<nottWnl. li m DEC 20 2021 BY COUNTY Al�,D1F._ CALNOUN COUtnvnivr 'Tf�xP,5 .INRaTsi WA, o✓ NOVINRNST uss ORINRIIER Mfu<e b1aK,RM<Nr Mot 11]1aN v M1WMtnM bndlp Txx1mN In lmauu Lnl bNn[e 10)A4E3 Nrxnx 1xr<x arlrn[< q IOJM F<NRblmnniFx<,dtRAMnww )I.Nf.16 ✓ warrues, is NWINRPEIT 4A1 !/ OFCIXRIIEIT adlUrt a,IxxeR<,Mx.4n1 ]O.NI]4 TOT&MNTFERS 4IiE2434" y roFW, Mtlwny RXRxdxry IS/SS/3021 LWM W<NNinm4npN0%Trxdx SummuyVNltOurmlMlNUnirmrMfummrry f}]0.31.tlu t .. .. TrsnllerAut I2/»hP23'cwH4N Wn44Te CCE/CTROp11B31ff514 Ulm S21I6/1011 HNB-ECHO HCCWMPMT 74NW421440002507$3 A/ 21 HNB ECHO IICCIMMPMT 741M3411 HN00210562 12/14/2021 ION I0Al2.16/ ]l/N/2031 1056 510.99� I3/l9/2021 ID55 1,023d0/ 12/1412021 1052 1.6B5.1S/ 11114/3011 USE 1T,N00V IL14/2021 1060 1,646.Oo / 1211412021 IN] 18,870W/ 1211412O21 109E 11,694.50 / 12/N/1o21 1957 118?000 / IL1212021 HNB-ECNOHCCWMPMT)4W0IO11MPoPoM55N 1211312021 HN5. ECHOHCCIAIMPMT 246003411N0000219252 12/11/2021 HUMRNR CHAOISB NCCUIMPMT 6249BI4100001018 MMCPORTION Wvv/Cpmp4 NH TmOA92•In COPP/COmpl OIPP/Camp] gegCampS uw QIPPll PORTION 34,355.33 MAN )8U HE.1 47.04 4104 616i) 2351 5.118 I6 61. m 23,52 5)11136 )3]N.90 /40.N].Rf ]pA6l.)2 MMC OORTI0N 5 F 01PP/C N% NH T.NfHDV! Tm0� E6pP/Nmpi OI1P10m12 CENlCOmPI up" OIPPTI PORTION R/I613023 0e1m1t ]LS22 03 27.5220, 12/15/1021 WIRE out 4M05ERVICES, me 8),)H 63 - I]/li/)OH 0epmll 76.11504 76.1150, 82.)N.61 SOI.N).11 10.657.13 1N.O1LS3 14A]9.53 iN.129A1 12/20/2021 Treasury Center Quick View Select Quick View Accounts Select Group AcCOUnt Number I Name Groups Account Type Add Group My Groups Search r All (DDA Data reported as of Dec 20. 20C!1 3 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts; 15 $8,182,637.37 $8,281,418.96 $8,182.637.37 $7,950,968.57 '4551 CAL CO INDIGENT $5,622.09 $5.622.09 S5,622.09 S5,622.09 HEALTHCARE '4�54 MEMORIAL MEDICAL / NH GOLDEN CREEK 321JA53.47 S218,165.17 $213,45347 S181,818.80 HEALTHCARE •4385 MEMORIAL MEDICAL $535.99 S535.99 $535.99 $53599 CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL $5.375,234,01 S5,358.837.27 $5,375,234.01 $5.314.649.72 CENTER - OPERATING '4373 MEMORIAL MEDICAL $431.51 S431,51 S431.51 S431.51 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL S240. 105.26 S252,380.15 S240 105.26 S213,530A9 CENTER/NH ASHFORD 4403 MEMORIAL MEDICAL S181,798.25 3195,972.09 S181798.25 S168,183.27 CENTER INH BROADMOOR '4411 MEMORIAL MEDICAL S158,222.22 S194.079.22 $158.22222 S156,09L88 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $99.319.31 $108.679.83 $99,319.31 $96,09B.62 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $224.575.02 S243.298.03 $224,575.02 $191A85.29 WEST HOUSTON '2998 MMC •MONEY MARKET S1.109.095.73 S1,'09.095.73 $1.109.095. 73 S1.109.09573 FUND 'S506 MMC-NH BETHANY S311,112.45 S331,189.52 S311112A5 $284,652.08 SENIOR LIVING '5441 MMC •NH GULF POINTE PLAZA- S103,748.83 1 S103.748.83 $103.748,83 $103,748.83 MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE $75,619.28 ,/ S75.619.28 $75.619.28 S41,260.32 PLAZA -PRIVATE PAY '3407 MMC •NH TUSCANY S83.763 95 S63.763.95 S83.763,95 $83.763.95 VILLAGE htlps;7lprosperity,olbenking.comlonlineMessenger to Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 12/22/2023 41,18147 Grote .l hoo.Sf,tbod groN/mNt.r d000pname. N.IIl: f.rexf.wt�m.emlMl.Ml./jrCe M.IMM[tllylttpl. opn.r/dNl. DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS iunwmmM rmavy Trwo."d t. "06.1 p'. a3A6195 �. 7y,ofq.o3 Va-n. utv.lolult— DNA MNin.yaa 'A".9, MfgGRf 1o1AVM..MMC ,U,.rt%I,.. .M, �YiiH.N—ty,o14.03 MIM1myI1M i.ro QO 12/16/2021 ION 12/16/2021 INS 12/15/1021 INS IV16/2021 1036 12/16/2021 2087 12/16/2011 Owlit 12/16/2021 NOVITASSOLVTION HCMIMPW676201420000135 12/15/1031 MOUNA HEAITHCAq MOUNA4CN 01019369420000i7 12115/2021 NOVRAS SO11R10N XCCIAIMPM1676201421MI163 12/14/2021 1082 12/14/2021 Deposit 12/14/2021 Deposit MMC PORTION QIPP/Comp4 T.W.e-0ut tteneler•In QIPP/Comp! QIPP/Comp3 QIPP/Comp3 6lspte QIPP TI NX PORTION 10.32273'/ 10.493.99� - 13,721.05 / - 2,893.71/ - 25,909.77/ - 27,439,70 - 27,438.79 - 8,783.18 - 8,783.18 10,665 93 $03.90 2,031.03 9.64992 1.01642 68.91 68.91 29,112.000 - 91,505.92 - 91.SO5.92 - i 3,073.00 30t3.00 98.95315 141,535.79� 8,633.90 1,032.03 9,609.92 131.38682 1212012021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Account Type Adrl Group My Groups Search F All DOA Data reported as o1 Dec 20. 2021 3 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8,182,637.37 $8,281,418.96 $8,182,637.37 $7,950,968.57 '4551 CAL CO INDIGENT 55,622.09 $5,62.2.09 $5.622.09 55.622.09 HEALTHCARE •4454 MEMORIAL MEDICAL I NH GOLDEN CREEK S213453.47 5218,165.d7 5213,453.47 $181.818.80 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 5535.99 5535.99 $535.99 5535.99 2014 •4357 MEMORIAL MEDICAL $5,375,234.01 55,358,837.27 55,375,234.01 55,314,649.72 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE 5431.51 5431.51 5431.51 5431.51 WAIVER CLEARING '4381 MEMORIAL MEDICAL $240.105.26 5252,380.15 5240 105.26 5213,530.49 CENTER INH ASHFORD •4403 MEMORIAL MEDICAL CENTERINH 8181.798.25 S195,972.09 S181,798.25 $168,183.27 BROADMOOR '4411 MEMORIAL MEDICAL $158.222.22 5194,079.22 $158,222.22 $156.091.86 CENTER INH CRESCENT '4446 MEMORIAL MEDICAL $99,319.51 $1.08,679.83 $99.319.31 $96,098.62 CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT 9224,575.02 5243.298.03 $224.575.02 $191.485,29 WEST HOUSTON '2999 IdMC-MONEY MARKET 51,109,095.73 51,109,095.73 Sl A09,095.73 51,109,095.73 FUND •5506 MMC-NH BETHANY 5311,112.45 5331,189.52 5311,11245 S284,652.08 SENIOR LIVING 'S441 MMG-NH GULF POOJTE PLAZA- $103.748.83 5103,748.83 5103,748.113 $103,748.83 MEDICAREIMEDICAID '5433 MIMIC -NH GULF POINTE $75,61928 $75,619.28 $76,619.28 S41,260.32 PLAZA - PRIVATE PAY -3407 / MMC-NH TUSCANY $83.763.95 ! 583,763.95 $83,763.95 $83,76395 VILLAGE hltps:/lprosperity.olbanking,com/onllneMessenger 1/1 Memorial Medial Center Nursing Home UPL Weekly HSLTransfer ProsperityAccounts 12/22/2021 F. PWin) 4 wnlmlo kR-O BV." M1dm11 Tllmlrmdtu Nun Mom Nlrntt Trrmlrn0uf rmlmin fWdmd M T •M Mn Wmn Nv Nomr 311.1121) I310,96951 Nnk WU... )11.Itttf l/ V.'W¢ tearembhnn Imm MINRR)ST [CNRGlS J AtlIuN WNNSRr Im Rm )Sq.%t91 NWr. mry6danm o/owrfsggawlNb nemfvrNminenunNgho-ne. roved; - / t� NH[a:9ttM1a[eWTFuloMehi�unf[o/SfWMoIMM[tle9mnrdloopna[wn! NUpnYRklu en,60 I1/31/1011 DEC 2 0 Z021 BY COUNTY AUDITOR CALHOUN COUNTY, TWO r:y,N.,r.n W, on Tnn0wtu—.Wgt1{b-6 V9s rnmsnsummn.zzoxl.rL '- - MMC POMION OIPP/Camp6 I _ { Tmnf/er4lut Tronshr•In CUPP/Comp, g1PP/CPmp2 OIPP/Cpmp3 &1u,se GIPPTI NN PORTION 12/17/2022 NOVITAS SOLUTION HCCIAIMPMT 67MBI 420000/59 - 10,12343 - 10,11343 12/17/2021 HEALTH HUMAN SVC NCCUUMPMT 124600341130162 16.33694 - 16,336.94 12/10/2021 Gepm1, 2.392,01 - 289241 12/16/2021 Oepm13 - 103.95795 - 103,957.95 12/1S12021 WIRE OUT 6ETHANY SENIOR LIVING. LTG 99,664.53 12115IW21 NPmn - 7,410.00 - 7,410.00 32/14/2021 O4p Ud - 101,143.0 - 101,14S.11 12/14JM21 Oepmil - 360.39 - 35039 12113JM21 DoWit 59,609.02 59,609A2 12/13/2021 OepmN - 9,603.56 - 9,603.56 991668.53 10,%SSI 310165.51 1212012021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Account Type Adtl 3roup by Groups [DDA Data reported as of Der. 20, 2021 3 Account Number Current Balance Available Balance Collected Balance Prior Day Balance Number of Accounts: 15 $8,182,637.37 $8,281,418.96 $8,182,637.37 $7,950.960.57 '4561 CAL CO INDIGENT 55,622.09 55,622.09 $5,622 09 55,622 09 HEALTHCARE -44,54 MEMORIAL MEDICAL NH GOLDEN CREEK $213,453.47 $218.165.47 5213.453.47 $181.818.80 HEALTHCARE '4385 MEMORIAL MEDICAL. CENTER - CLINIC SERIES $535.99 5535.99 5535.99 5535.99 2014 '1357 MEMORIAL MEDICAL 55.375.234,01 55.358.837,27 55,375,234.01 $5,314,649,72 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431,51 5431.51 5431.51 S431.51 WAIVER CLEARING '4381 MEMORIAL MEDICAL 5240,105,26 5252,380.15 5240.105.26 $213530,49 CENTER lNH ASHFORD '4403 MEMORIAL MEDICAL CENTER INil $181.798.25 51,95,972.09 SIBI 798.25 $168.183.27 BROADMOOR '4411 MEMORIAL MEDICAL $158,222.22 5194,07922 5158,222.22 $156,091,88 CENTER! NH CRESCENT '4446 MEMORIAL MEDICAL 599.319.31 $108,679.83 599.319.31 $96,098.62 CENTER I. NH FORT BEND '4436 MEMORIAL MEDICAL CENTER I SOLERA AT $224,575.02 $243,298.03 5224,575.02 $191 485.29 WEST HOUSTON '2998 MMC-MONEY MARKET 51,100,095.73 51. 109,09513 $1,109,095.73 51,109,095.73 FUND '550G MMC -NH BETHANY $311,112A5 5331.189.52 5311.112A5 $284,652.08 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA - 5103,748.83 5103,748.83 $103,748.83 5103,748,83 MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE $75.619.28 $75,619,28 575,619.28 541,260,32 PLAZA. PRIVATE PAY '3407 MMC -NH TUSCANY $83763.95 $83.763.95 $83, 763.95 S83763.95 VILLAGE r Mips:llprosperily,olbanking,comfonlineMessenger 111 MA L If". !Vlt. l_.) 1' .. (Jr-- N i E. Fti �_'H C.l�it. RE i�.t �._I Y_. j I MMC �[6iliiNb( 12/20/21 APPROVEDON - DEC 2 0 2021 BY COUNTY AUDITOR CA[,4OUN COUNTY, TEXAS .M,0 j .rl 15879,84 T Molina QIPP October .1D. CClevenger _! 4� fVIEMORIAL 1,)IEDICPdL r-ENIFFER CHECK REQUE-T mmc BroaJmwY 12/20/21 y E E. ANIOUNT 6572.17 APPnovm()N DEC 2 0 2021 13Y COUNTY AUMTOR CALHOUN COUNTY, TEXAS R A j 3) C,N1 Li D V --- ------- ME OR!Ai MIEDICAL CENTER Q (-'H E C H K R - [i PS-1 MIVIC Da,- 12/20/21 APPROVED ON DEC 2 0 2021 13Y COUNTY AUNTOR CALHOUN COUNTY , YW§ 5853,95 N F 10 N Molina QIPP October 0 t j -�15 I-, By C Clevenger _7 I J'SIF 11%Nt T 17 -ail Y E E IMEIVIOMAi IVIEL)lr'A' CENTER,L H F. (7 K R E Q U E 51 -F mmc Fort 12/20/21 AppROVEDON 1-UP :C-1, USE ON DEC 2 0 2021 By COUNTY AUDITOR 1 l 2 GAWOUN COUN'fy'TE"r' it iVIEN/1 MAL MEDICAL AL CF1.1 CHF('K R C')1U ..S-i MMC S1olm, 12/20/21 :gat= iieq. e_I' APPROVED ON !' DEC 20 2021 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS° — -- ----' ! 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