2021-12-29 Meeting Packet.pdf✓AII Agenda Items Properly Numbered
Contracts Completed and Signed
II 1295's Flagged for Acceptance
(number of 1295's )
All Documents for Clerk Signature Flagged
On this "lay of Acz, )J 2021 a complete and accurate packet
for0q+i� of t/ 2021 Commissioners Court Regular Session
Day Month
was delivered from the Calhoun County Judge's office to the Calhoun County
Clerk's Office.
(MiMA/
Calhoun County Judge/Assistant
COMMISSIONERSCOURTCHECKLIST/FORMS
AGENDA
I'IUII(_t 111 INifi=t II"I(i
Richard lH . Meyer
County judge
David Hall, Commissioner, Precinct I
Vern Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Gary Neese, Commissioner, Precinct 4
NOTICE OF MEETING
The Commissioners' Court of Calhoun County, Texas will meet on Wednesday,
December 29, 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: pT��O'cLocK�M
Y. Call meeting to order. DEC 2 3 2021
ANNAM.GOODMAN
l2r�Invocatlon. Dou LEFI'CAFiOUTY,TEXAS
z BY:
'3r. Pledges of Allegiance.
, eGeneral Discussion of Public Matters and Public Participation.
' 5. Hear report from Memorial Medical Center.
Consider and take necessary action to approve the use of the RHC COVID-19 Testing
and Mitigation Program funds in accordance with program requirements to provide a job
retention payment to employees of Memorial Medical Center from said funds and to
provide for guidelines to receive same. (RHM)
1
/. Consider and take necessary action to move the Wednesday, February 23, 2022 meeting
to Monday, February 28, 2022 to allow the Judge and Commissioners to attend the VG
Young Institute of County Government School for Commissioners Courts. (RHM)
8. Consider and take necessary action to approve the Agreement between Calhoun County
and Ben E. Keith for the Annual Supply Contract for Inmate Food Services for the
Calhoun County Adult Detention Center for the period beginning January 1, 2022 and
ending December 31, 2022 with the option to renew yearly if agreeable with both the
successful bidder and Calhoun County and authorize the County Judge to sign the
Agreement. The bid was awarded on November 24, 2021. (RHM)
Page 1 of 2
NC)IIf- I OF P✓It:i IIN(,
9. Consider and take necessary action on a GLO Application for Renewal of Coastal Lease
No. CL960002 Keller Bay, in Calhoun County and authorize the County Judge to sign the
application and affidavit. (JB)
0. Consider and take necessary action to declare the attached equipment, as
Surplus/Salvage to be used as a trade-in and remove from Waste Management's Fixed
Asset inventory. (VL)
ri. Consider and take necessary action to authorize Commissioner Lyssy to trade in a 1993
HYPAC C530-AH, Asset # 22-0267 for a 2014 Bomag BW27RH, serial number
�861538231006. (VL)
�2. Consider and take necessary action to remove the following equipment from the
Constable, Precinct 4 inventory: Vidac Camera and software (stolen), Copysync printer
(stolen), Motorola XTL 2500 Control Station (returned to VCS), Motorola XTL Radio
(returned to VCS). (RHM)
73. Consider and take necessary action to transfer a Copysync Computer/Laptop, charger,
antenna, and software to IT and remove from Constable, Precinct 4 inventory. (RHM)
34. Consider and take necessary action to declare as Waste a Motorola XTS 1500 radio and
�,rremove from Constable, Precinct 4 inventory. (RHM)
i5. Consider and take necessary action on any necessary budget adjustments. (RHM)
1 Approval of bills and payroll. (RHM)
Richard H. Meyer, Cour
Calhoun County, Texas
A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street,
Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for
at least 72 hours precedingthe scheduled meetingtime, For your convenience, you may visit the county's website at
www.calhouncotx.org under "Commissioners' Court Agenda' for any official court postings.
Page 2 of 2
NOTICE OF MEETING — 12/29/2021
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
][caddie Smith, Deputy Clerk
NOTICE OF MEETING
The Commissioners'Court of Calhoun County, Texas will meet on Wednesday,
December 29, 2021 at 10:00 a.m. in the Commissioners' Courtroom in the County
Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas.
AGENDA
The subject matter of such meeting is as follows:
1. Call meeting to order.
Meeting called to order at 10:00a.m. by Judge Richard Meyer
2. Invocation.
Commissioner David Hall
3. Pledges of Allegiance.
US Flag- Commissioner Gary Reese
Texas Flag- Commissioner Vern Lyssy
4. General Discussion of Public Matters and Public Participation.
Happy New Year!
5. Hear report from Memorial Medical Center.
Pass
Page 1 of 4
NOTICE OF MEETING — 12/29/2021
6. Consider and take necessary action to approve the use of the RHC COVID-19 Testing
and Mitigation Program funds in accordance with program requirements to provide a job
retention payment to employees of Memorial Medical Center from said funds and to
provide for guidelines to receive same. (RHM)
Roshanda Thomas explained.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pct 2
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
7. Consider and take necessary action to move the Wednesday, February 23, 2022 meeting
to Monday, February 28, 2022 to allow the Judge and Commissioners to attend the VG
Young Institute of County Government School for Commissioners Courts. (RHM)
Approved to do away completely with February 28, 2022 Meeting.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pct 2
SECONDER: Joel Behrens, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
8. Consider and take necessary action to approve the Agreement between Calhoun County
and Ben E. Keith for the Annual Supply Contract for Inmate Food Services for the
Calhoun County Adult Detention Center for the period beginning January 1, 2022 and
ending December 31, 2022 with the option to renew yearly if agreeable with both the
successful bidder and Calhoun County and authorize the County Judge to sign the
Agreement. The bid was awarded on November 24, 2021. (RHM)
Peggy explained agreement that Sara has approved.
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 on a GLO Application for Renewal of Coastal Lease
No. CL960002 Keller Bay, in Calhoun County and authorize the County Judge to sign the
application and affidavit. (JB)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Joel Behrens, Commissioner Pct 3
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 2 of 4
NOTICE OF MEETING— 12/29/2021
10. Consider and take necessary action to declare the attached equipment, as
Surplus/Salvage to be used as a trade-in and remove from Waste Management's Fixed
Asset inventory. (VL)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
11. Consider and take necessary action to authorize Commissioner Lyssy to trade in a 1993
HYPAC C530-AH, Asset # 22-0267 for a 2014 Bomag BW27RH, serial number
861538231006.(VL)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
12. Consider and take necessary action to remove the following equipment from the
Constable, Precinct 4 inventory: Vidac Camera and software (stolen), Copysync printer
(stolen), Motorola XTL 2500 Control Station (returned to VCS), Motorola XTL Radio
(returned to VCS). (RHM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: Joel Behrens, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
13. Consider and take necessary action to transfer a Copysync Computer/Laptop, charger,
antenna, and software to IT and remove from Constable, Precinct 4 inventory. (RHM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
14. Consider and take necessary action to declare as Waste a Motorola XTS 1500 radio and
remove from Constable, Precinct 4 inventory. (RHM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 3 of 4
NOTICE OF MEETING — 12/29/2021
15. 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
16. Approval of bills and payroll. (RHM)
MMC
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
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: 10:17 a.m.
Page 4 of 4
NOTICE OF MEETING — 12/29/2021
Richard H. Meyer
County judge
David Hall, Commissioner, Precinct 1
Vern Lyssy, Commissioner, Precinct 2
Joel Behrens, Commissioner, Precinct 3
Gary Reese, Commissioner, Precinct 4
Kaddne Smith, Deputy Clerk
NOTICE OF MEETING
The Commissioners'Court of Calhoun County, Texas will meet on Wednesday,
December 29, 2021 at 10:00 a.m. in the Commissionners' Counrtroom in the County
Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas.
AGENDA
The subject matter of such meeting is as follows:
1. Call meeting to order.
Meeting called to order at 10:00a.m. by Judge Richard Meyer
2. Invocation.
Commissioner David Hall
3. Pledges of Allegiance.
US Flag- Commissioner Gary Reese
Texas Flag- Commissioner Vern Lyssy
4. General Discussion of Public Matters and Public Participation.
Happy New Year!
Page 1 of 13
#5
NOTICE OF MEETING — 12/29/2021
5. Hear report from Memorial Medical Center.
Pass
Page 2 of 13
#6
NOTICE OF MEETING — 12/29/2021
6. Consider and take necessary action to approve the use of the RHC COVID-19 Testing
and Mitigation Program funds in accordance with program requirements to provide a job
retention payment to employees of Memorial Medical Center from said funds and to
provide for guidelines to receive same. (RHM)
Roshanda Thomas explained.
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 13
RHC COVID-19 Testing Program Grants -Proposal for Use
Memorial Medical Center received funds under the RHC COVID-19 Testing Program in 2020. We
received $49,461.42 per clinic, totaling $98,922.84. These funds must be fully expended by 12/31/2021.
The intent of this grant is to allow facilities to continue operations in order to provide COVID testing.
Allowable Expenses:
• Supplies to provide free COVID-19 testing including: Test kits, Swabs (Cannot claim for testing
that is reimbursed by any other source)
• PPE
• Workforce costs including training, hiring, temporary housing, hiring bonuses and retention
payments.
We are proposing to use these funds as employee retention payments for full time and part time
employees. Employees would need to sign an agreement to work the next 90 days in order to be eligible
for the retention payment. The breakdown would be as follows:
174 Eligible Full Time employees x $554.19 = $96,429.06
9 Eligible Part Time employees x $277.08 = $2493.72
Total: $98922.78
NOTICE OF MEETING— 12/29/2021
7. Consider and take necessary action to move the Wednesday, February 23, 2022 meeting
to Monday, February 28, 2022 to allow the Judge and Commissioners to attend the VG
Young Institute of County Government School for Commissioners Courts. (RHM)
Approved to do away completely with February 28, 2022 Meeting.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pct 2
SECONDER: Joel Behrens, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 4 of 13
NOTICE OF MEETING— 12/29/2021
8. Consider and take necessary action to approve the Agreement between Calhoun County
and Ben E. Keith for the Annual Supply Contract for Inmate Food Services for the
Calhoun County Adult Detention Center for the period beginning January 1, 2022 and
ending December 31, 2022 with the option to renew yearly if agreeable with both the
successful bidder and Calhoun County and authorize the County Judge to sign the
Agreement. The bid was awarded on November 24, 2021. (RHM)
Peggy explained agreement that Sara has approved.
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Vern Lyssy, Commissioner Pct 2
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 5 of 13
December 20, 2021
To: Judge Meyer
From: The office of the County Auditor
For the Calhoun County Adult Detention Center
Please place the following item on the Commissioners Court Agenda for December 29, 2021:
Consider and take necessary action to approve the Agreement between Calhoun County and
Ben E. Keith for the Annual Supply Contract for Inmate Food Services for the Calhoun County
Adult Detention Center for the period beginning January 1, 2022 and ending December 31,
2022 with the option to renew yearly if agreeable with both the successful bidder and Calhoun
County and authorize the County Judge to sign the Agreement. The bid was awarded on
November 24, 2021.
TO COMMISSIONERS COURT:
PLEASE NOTE — Form 1295 was submitted with their bid and included in the bid information
when Commissioners Court awarded the bid on November 24, 2021.
AGREEMENT FOR THE
ANNUAL SUPPLY CONTRACT FOR
INMATE FOOD SERVICES FOR THE
CALHOUN COUNTY ADULT DETENTION CENTER
STATE OF TEXAS
COUNTY OF CALHOUN
This agreement is by and between CALHOUN COUNTY acting through their ADULT
DETENTION FACILITY (hereinafter called the "DETENTION FACILITY") and Ben E
Keith (hereinafter called "PROVIDER') and is for the furnishing of food and non-food items
to the DETENTION FACILITY.
The effective date of this agreement is January 1, 2022 and is for a period of one year from
that date. This agreement will end on December 31, 2022. This agreement has the option to
renew yearly if agreeable with both the PROVIDER and the DETENTION FACILITY and
approved by Calhoun County Commissioners Court. Written request for renewal from the
PROVIDER must be approved by Commissioners Court prior to the end date of the
preceeding contract.
The food and non-food items to be provided are set out in the attached Invitation to Bid Form
and Attachment to Invitation to Bid Form — Additional Bid Items and said prices will be
honored for the one year period. Any items ordered not on the attached Invitation to Bid Form
or the Attachment to Invitation to Bid Form — Additional Bid Items shall be provided at Cost
Plus 12 % basis. The DETENTION FACILITY, their representative and/or the County
Auditor's office may audit the Cost Plus 12% basis at any time and the PROVIDER will
provide the DETENTION FACILITY, their representative and/or the County Auditor's office
with documentation necessary for this audit at no additional charge.
The DETENTION FACILITY agrees to pay for said food and/or non-food items upon
presentation of an invoice and verification that said food and/or non-food items have been
delivered and received.
PROVIDER will use its best efforts to provide quality products and good and healthy food
but makes no warranties express of implied about their fitness for use.
PROVIDER will provide products that are needed for inmates with high blood pressure,
diabetics or for religious reasons.
Page 1 of 4
PROVIDER will offer other equipment, services or products used in kitchen at free of charge,
discounted price, or Cost Plus ,% basis if available. These products include dispensers
for coffee, chemicals and other products used in kitchen.
PROVIDER may not add any other charges and/or fees to the bid price.
All bid prices shall be good for the entire bid period.
If an item(s) is substituted, the item(s) must be of equal or lower in price. The substituted
item cannot go over the bid price for that item taking into consideration the pack size and
quantity.
Deliveries will be made at specific times (at least twice a week) and in sufficient quantities to
ensure that there will be sufficient food on hand at the jail to make and provide all meals.
Deliveries will be made between Monday and Friday between the hours of 7:00 AM to 10:00
AM and 1:00 PM to 4 PM in order not to disrupt the jail kitchen in preparing meals.
Should an ordered item(s) not arrive as ordered, wrong item(s) is delivered, or item(s) is
delivered damaged, PROVIDER will deliver the correct or substitute item(s) within 24 hours
from the date the missing or damaged item(s) was supposed to be delivered. No extra charges
and/or fees will be allowed to be billed to correct the error or damaged item(s).
Should the PROVIDER not be able to supply an item(s) to the DETENTION FACILITY, the
DETENTION FACILITY may purchase the item(s) from another source without being in
conflict with this agreement.
Liquid items will be delivered in plastic crates to prevent damages when stacked.
A sales representative from the PROVIDER shall contact the Jail Administrator, the Jail
Administrator's appointed representative and/or Jail Kitchen Officer at least monthly, in
person, to discuss any issues or new products offered. New products shall be offered to the
DETENTION FACILITY at the lowest possible cost plus 12% and PROVIDER shall provide
information to the DETENTION FACILITY on the calculation of this cost and shall be
subject to audit by the DETENTION FACILITY, their representative and/or the County
Auditor's office at no additional charge.
All products on the Invitation to Bid Form and Attachment to Invitation to Bid Form —
Additional Bid Items are speculative products and should not be considered as firm products
to be purchased during the term of the agreement.
Order processing shall be made available by fax and / or website.
Page 2 of 4
By acceptance of this agreement PROVIDER agrees to notify the Jail Administrator and/or
Sheriff of any solicitations from employees of Calhoun County for services not officially
associated with the DETENTION FACILITY'S operations.
PROVIDER is prohibited from offering, giving, selling, supplying, or conveying in any way
or form, products for personal use to employees of Calhoun County. Samples may be
provided to the DETENTION FACILITY for use within the facility for evaluation purposes.
Agreement Documents consist of the following:
1. This Agreement
2. Invitation to Bid Form
3. Attachment to the Invitation to Bid Form — Additional Bid Items
4. Bid Specifications
5. Calhoun County, Texas — General Conditions
All disputes or protests will be held in Calhoun County, Texas.
IN WITNESS WHEREOF, the undersigned have executed this agreement to be effective as of
January 1, 2022.
A }/
SIGNED AND ACCEPTED this thew � day of J/)ece m pe l' , 2021.
ACKNOWLEDGEMENTS ON FOLLOWING PAGE
Page 3 of 4
DETENTION FACILITY:
CALHOUN COUNTY, TEXAS
COUNTY ADULT DETENTION CENTER
Richard H. Meyer, CalhoAn Bounty Judge
PROVIDER:
BEN E KEITH COMPANY
District Sales Manager
Signature &Title
Emily Lynch
Typed or Printed Name
Attest: Qo
Title: District Sales Representative
211 S Ann St, 3`d Floor, Ste 301
Port Lavaca, TX 77979
17635 Ben E Keith Way
Mailing Address
Selma, TX 78154
City, State, Zip Code
Page 4 of 4
Calhoun County, Texas
Calhoun County Adult Detention Center
INVITATION TO BID FORM
ANNUAL SUPPLY CONTRACT FOR
INMATE FOOD SERVICES
Bid Number 2022.04
January 1, 2022 thru December 31, 2022
With the option to renew yearly (one year terms) if agreeable with both the successful bidder and Calhoun County.
Bidder's Name and Address
Ben E Keith
17635 Ben E Keith Way
Selma, TX 78154
• PLEASE TYPE. IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE.
• WHITE OUT IS NOT ACCEPTABLE
• ITEM OR ITEMS NOT BIDDING: MARK "NA" UNDER COST OR LEAVE BLANK
• ADDING ITEMS: LIST ON A SEPARATE PAGE AND NOTE AS AN ATTACHMENT TO THE INVITATION TO BID FORM
• SEE SPECIFICATIONS AND GENERAL CONDITIONS FOR COMPLETE REQUIREMENTS
• BE SURE TO COMPLETE, SIGN AND DATE THE LAST PAGE OF THE INVITATION TO BID FORM
PLEASE NOTE:
The bidder may request the Invitation to Bid Form be emailed to them in the Excel Format.
If the bidder requests the Invitation to Bid Form be sent to them in the Excel Format, the bidder understands that
the form and/or format shall not be changed in any way.
The bidder shall not delete and/or add items to the Invitation to Bid Form.
THE BIDDER UNDERSTANDS THAT BY CHANGING THE FORM AND/OR FORMAT OF THE INVITATION TO BID FORM
IN ANY WAY SHALL DISQUALIFY THEIR BID.
The Excel Format may be requested only as a means to enter the required information.
Requests for the Excel Format of the Invitation to Bid Form must be sent to Peggy Hall, Assistant Auditor, at
peggy.hall@calhouncotx.org or by calling 361-553-4610.
Page 1 of 17
Invitation to Bid Form - Annual Supply Contract for Inmate Food Services —CONTINUED
Item #
Pack / Size
Pack/Size
If different
from Listed
Brand
Description
Cost
EMMATE on
How often
Used:
136576
1 / 40 lb
4/31b
Sunrich
Apples Sliced Solid Pack Fresh
$35.39
Weekly
009848
1 24 / 2 oz
SunriGh
Apple Slice Red
$15.27
Weekly
125049
6 / #10
Ellington
Apple sauce Unsweet
$31.69
Weekly
125048
6410 #10
llington
Apple Sauce Sweet
$33.18
weekly
530824
1 1300 ct
Fastnesy
Bacon Precooked Thin
$53.29
Weekly
01756
1130 lb
Coverwgn
Bacon Slab Sliced Raw
$76.89
Weekly
398821
12 16 ct
Lenders
Bagel Plain Sliced 2.3 oz
$18.19
Weekly
696005
615 lb
Clabgirl
Baking Powder
$57.59
Quarterly
696130
24 / 1 lb
Hosptlty
Baking Soda
$19.67
quarterly
018004
1140 lb
Packer
Bananas green tip
$24.48
Weekly
811196
2 / 7 lb
th/Home
Base - Beef Granular
$37.38
quarterly
124194
2 / 9 lb
Kth/Home
Base - Chicken Flavor Paste
$42.78
quarterly
774007
1 / 5 oz
Moormick
Basil Ground
$11.67
Quarterly
774010
1 1 / 5 oz
Mcormick
Basil Leaf
$5.91
quarterly
774911
1 / 1 lb
Mcormick
Bay Leaves
$11.88
Quarterly
650061
6 / #10
Aliens
Bean Baked Oven Prepared
$38.68
Weekly
123884
6 /#10
Ellington
Bean Chili Homestyle
$70.48
Weekly
650070
6 / #10
Aliens
Bean Chili Chuck Wagon Max
$30.88
Weekly
334355
1 / 20 lb
Mrkn/Fc
Bean Cut Green Bean - Frozen
$22.18
Weekly
650010
6/ #10
Aliens
Bean Cut Green Bean - Canned
$30.88
weekly
334355
1 / 20 lb
Mrkn/Fc
Bean Green Regular Cut
$22.18
Weekly
158788
6 / #10
Bushbest
Bean Kidney Dark Red
$28.78
quarterly
122432
1 / 20 lb
Ellington
Bean Baby Lima Bean - Dry
$25.47
quarterly
122437
1 / 20 lb
Ellington
Bean Navy Pea Dry
$18.28
quarterly
650082
6 /#10
Bushbest
Bean Pinto Fancy
$26.39
Weekly
652031
1 / 50 lb
Gransabr
Bean Pinto Triple Clean Dried
$35.78
Weekly
111698
6/ #10
Lakeside
Bean Pork and Beans Fancy
$27.37
Weekly
650085
6 / #10
Ranchsty
Bean Ranch Style Fancy
$39.69
Weekly
Page 2 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services - CONTINUED
Item#
Pack/Size
Pock/Size
1fdifferent
from Listed
Brand
Description
Cost
FSnMTEon
Often
HOW Useed:d:
782002
6/#10
Aliens
Bean Retried
$37.07
Weekly
117441
6 / #10
Bushbest
Bean Vegetarian Baked Beans
$38.28
Weekly
546001
4 / 5 lb tub
Tx Chili
Beef BBQ Beef Chopped with Sauce
$55.59
Weekly
504853
5 / catch
Swift
Beef - Brisket Boneless 120 No Roil
$3.69/lb
Quarterly
501004
2 / 7 lb avg
Wilson
Beef - Roast Top Round Cooked
$4.99/lb
Quarterly
506080
8 / 10 lb avg
Packer
Beef Ground Fine 73127
$2.25/lb
Weekly
506104
4014 oz
Holten
Beef - Patty 4/1 with Tvp
$25.79
Weekly
168480
40 / 4 oz
Holten
Beef - Patty Breaded
$51.54
Weekly
509345
9013 oz
Tndrbd
Beef - Patty Flame Broiled
$92.32
Quarterly
509306
102 / 2.5 oz
Tndrbd
Beef Patty Charbroiled pre-cooked
$88.24
Quarterly
504750
3124 lb avg
Cargill
Beef Shoulder Clod
$3.47/lb
Quarterly
508013
40 / 4 oz
Beko
Beef Steak Fritter Natural 4/1 Raw
$35.77
Weekly
154223
2/5 lb
4/51b
Texas Fd
Beef Stew Meat
$93.38
Weekly
510413
160 / 1 oz
Advance
Beef Steak Finger Breaded Cooked 1 oz
$41.98
weekly
24 / 8 oz
Biscuits Buttermilk 10 at
NA
Monthly
398435
96 11.65 oz
Rotelias
Biscuits Dinner Rolls Thaw & Serve
$28.79
Weekly
140607
216 12.2 oz
Ellingtn
Biscuits Dough Southern Style
$36.49
Weekly
290073
8124 oz
Frsh/Kth
Bread Sandwich Wheat Loaf
$16.67
weekly
290020
8124 oz
Frsh/Kth
Bread Sandwich White Loaf
$14.49
weekly
106047
6/12 doz
Gransabr
Bread Tortillas Corn
$25.27
Weekly
408617
18 / 24ct
Max Orig
Bread Tortillas Flour
$23.97
Weekly
547106
12 / 1 lb
Farmind
Bologna Turkey Club
$42.27
Weekly
335209
1 120 lb
Mrkn/Fc
Broccoli Cuts
$19.27
Weekly
808022
12 / 49 oz
Vanes
Broth Chicken
$35.89
Quarterly
2 120 ct
Bun Hamburger Wheat
NA
I Weekly
161826
6 / 8 ct
Orowheat
Bun Hamburger wheat
$13.87
Weekly
155868
2 120 ct
Mrsbaird
Bun Hamburger white
$9.37
weekly
106518
6 / 9 ct
5/12ct
Frsh/Kth
Bun Hamburger white
$11.22
Weekly
290220
6 / 12 a
Frsh/Kth
Bun Hot Dog
$13.98
Weekly
168497
72 / 4 oz
64/4oz
Tinas
Burrito Beef & Bean
$23.68
Weekly
385147
1 64 / 4 oz
Eimontry
Burrito Beef & Bean Red Chili
$36.89
Weekly
Page 3 of 17
Invitation to laid Form - Annual Supply Contract for Inmate Food Services — CONTINUED
Item #
Pack / Size
Pack/Size
if different
from Listed
Brand
Description
Cost
ESTIMATE on
How often
used:
092005
1150 lb
Packer
Cabbage Green
$26.67
Monthly
691402
615 lb
Contmill
Cake Mix Chocolate
$29.29
Monthly
691402
615 lb
Contmili
Cake Mix Devils Food
$29.29
Monthly
691401
6 15 lb
Contmill
Cake Mix White
$29.38
Monthly
691400
615lb
Contmill
Cake Mix Yellow
$29.38
Monthly
117566
1 112 of
Mrkn/Fc
Cantaloupe Fresh
$33.38 1
Weekly
098010
1 150lb sack
Packer
Carrots Jumbo
$20.88
Weekly
336335
1212lb
Mrkn/Fc
Carrots Diced
$24.37
weekly
113583
6 /#10
Lakeside
Carrots Sliced Canned
$28.88
Weekly
336151
1 / 20lb
Mrkn/FC
Carrots Smooth Sliced
$22.47
Weekly
113583
6 / #10
Lakeside
Carrots Sliced Medium
$28.88
Weekly
337112
1120 lb
Mrkn/Fc
Cauliflower LQF
$23.98
Monthly
102012
1 140 lb
Mrkn/Fc
Celery Fresh
$26.67
weekly
799100
4126 oz
Kelloggs
Cereal Bulk Com Flakes
$25.68
Weekly
799224
12 128 oz
Quaker
Cereal Cream of Wheat
$26.88
Weekly
799226
12128 oz
HOsptlty
Cereal Farina Enriched
$23.28
Weekly
799116
4 / 45 oz
MOM
Cereal Bulk Frosted Flakes
$34.78
weeSy
799120
4146 oz
MOM
Cereal Bulk Fruit Dyno Bites
$35.49
Weekly
799276
4139 oz
Cheerios
Cereal Bulk Honey Nut Cheerios
$53.19
Weekly
799204
1 150 lb
Quaker
Cereal Oats Rolled #5
$26.52
Weekly
799114
6 136 oz
MOM
Cereal Bulk Raisin Bran
$37.07
Weekly
799103
4135 oz
MOM
Cereal Rice Tootie Fruitie
$32.09
Weekly
761010
615lb
Gldhrvst
Cheese American Melt Loaf
$74.67
Monthly
133070
615 lb
Hilidale
Cheese Product American 120 Slices
$69.99
Weekly
121802
415 lb
Schreibr
Cheese American 184 Slices
$46.47
Weekly
121801
415 lb
Schreibr
Cheese Cheddar Shredded Imitation
$34.88
quarterly
740078
215 lb
Gldhrvst
Cheese Cheddar Jack Shredded
$26.08
Weekly
016181
2/5 lb
Schreibr
Cheese Cheddar & Mont. Jack Shreeded
$58.37
Weekly
158931
215 lb
4/51b
Daisy
Cheese Cottage Cheese Sin Curd 4%
$29.98
weekly
Page 4 of 17
Invitation to Bid Form - Annual Supply Contract for Inmate Food Services --CONTINUED
Item tt
Pack / Size
Pack/Size
if different
from Listed
Brand
Description
Cost
ESTIMATE on
How often
Used:
742022
10 / 3 lb
Gldhrvst
Cheese Cream Cheese Loaf Grade A
$60.29
Monthly
761010
6 / 5 lb
Gldhrvst
Cheese Melting Loaf Yellow
$74.67
Monthly
107524
4 / 5 lb
6/51b
1950-127
Cheese Mozzarella Reg Shredded
$75.67
Monthly
759001
215 lb
Gldhrvst
Cheese Pimento Cheese Spread
$40.58
Monthly
121922
6129 oz
Gldhrvst
Cheese Powdered Cheese Mix
$44.27
Weekly
158882
615 lb
Welcomed
Cheese Queso Melt
$59.07
weekly
487156
4110 1b
Packer
Chicken Boneless Skinless Chicken Thighs -
Plain
$85.27
Weekly
167546
1110 ib
1/401b
Martin
Chicken Boneless Skinless Chicken Thighs -
Flavored
$81 78
Weekly
487831
60 / 3.1 oz
67/2.4oz
Brkbush
Chicken Breast Patty Breaded
$32.88
Weekly
115457
16013 oz
Minutemn
Chicken Patty Breaded Cooked
$62.87
weekly
114922
2 / 5 lb
Tyson
Chicken Breaded Chicken Fritter
$26.78
Weekly
122494
107 11.5 oz
Jones
Chicken Breakfast Patty
$35.38
quarterly
$8422
2 / 5 lb
Plathvst
Chicken Diced All White Cooked
$43.67
Weekly
487431
52 / 3 oz
Smrtsrve
Chicken Breast Fillet Fajita
$46.83
Monthly
122391
1 / 10 lb
4/101b
Texas I'd
Chicken Fajitas Sliced Chicken Raw
$111.17
Weekly
487365
2 / 5lb
Perdue
Chicken Fajita Strip Cooked
$41.67
Monthly
102198
2 / 5 lb
Gransabr
Chicken Fajita Meat Lacocina
$3.59/Ib
Monthly
487080
1 / 10 lb
Supreme
Chicken Fajita Thigh Meat Frozen
$44.38
Monthly
487856
4110 lb
Packer
Chicken Leg Meat Bonless
$77.38
Weekly
126814
1 120 lb
Dixie
Chicken Nuggets Raw
$20.89
Monthly
487156
4110 lb
Packer
Chicken Thigh Meat Raw Frozen
$85.27
Monthly
123884
4 / 4 lb
6/#10
Ellingtn
Chili Frozen - With Beans
$70.48
Weekly
106559
6 / 5 lb
Cocinagr
Chili Frozen - Without Beans
$60.28
1 Weekly
123884
6 / n10
Ellingtn
Chili Canned -With Beans
$70.48
1 Weekly
123883
6 / #10
Ellingtn
Chili Canned - Without Beans
$91.78
Weekly
123885
6 / #10
Ellingtn
Chili Hot Dog Sauce W/meat
$57.57
Monthly
8/1 lb
Fritos
Chip Frito Cam Bulk
$16.24
Weekly
f9399
9126
10116 oz
Deeprivr
Chip Potato Kettle
$32.48
Weekly
Page 5 of 17
Invitation to Bid Form -Annual Supply Contract far Inmate Food Services - CONTINUED
Item#
Pack/Size
Pack / Size
if different
from Listed
Brand
Description
Cost
Estimate on
Often
Used:
Used:
699514
6116 oz
Lays
Chip Potato Regular Bulk
$16.41
Weekly
699253
a / 16 oz
Ruffles
Chip Potato Ridged Ruffled
$21.06
Weekly
106058
612 lb
Gransabr
Chip Tortilla Yellow Round
$19.09
weekly
168684
3150 ct
2/50ct
Fritolay
Chip Variety
$33.14
Weekly
774022
115 lb
SpiceCls
Cinnamon Ground
$27.67
Monthly
692113
1110 lb
Snowflak
Coconut Sweetened Coconut
$27.88
Monthly
640345
12 / 2 lb
6/21b
ElgtnCof
Coffee Traditional
$87.79
Weekly
1212 lb
Coffee Can
NA
Weekly
640555
42 11.25 oz
S&D
Coffee Todays Gourmetw/Filter
$19.89
Weekly
92071
4 15 Ito ct
Mrkn/Fc
Coleslaw Mix Shredded
$19.48
Weekly
772015
1110 lb
Homestyl
Cookie Chocolate Chip
$23.28
Weekly
772021
1110lb
Homestyl
Cookie Oatmeal Homestyle
$21.22
Weekly
772023
1 110 lb
Homestyl
Cookie Sugar Homestyle
$20.57
Weekly
772010
115lb
6/13.3oz
Keebler
Cookie Vanilla Wafers
$14.47
Weekly
432441
320 / 1 oz
Valuzone
Cookie Dough Chocolate Chip
$46.19
Weekly
432442
320 11 oz
Valuzone
Cookie Dough Oatmeal Raisin
$49.98
Weekly
432443
32011 oz
Valuzone
Cookie Dough Sugar
$43.28
Weekly
650172
6 / #10
Aliens
Com Cream Style
$37.29
Monthly
338602
1120 lb
Mrkn/Fc
Com cut
$21.29
Weekly
338837
612 lb
Freds
Com Com Nuggets Sweet Battered
$31.38
Weekly
125734
6 / #10
Ellingtn
Com Whole Kernel Fancy Canned
$29.98
weekly
124525
240 / .67 oz
Ellingtn
Com Dogs No Sticks
$38.67
weekly
2401.67 oz
Com Dogs Turkey Mini - No Sticks
NA
Weekly
691056
6 15 lb
Pioneer
Combread Mix Homestyle
$32.68
Weekly
117439
613.5 lb
Ellingtn
Combread Stuffing Mix
$58.69
Monthly
119165
1125 lb
Ellingtn
Cornmeal
$10.09
quarterly
772080
20012 pk
Honymaid
Crackers
r Wrapped Graham Honey Mid - Individually
$21 48
Monthly
771314
12116 oz
Nabisco
Crackers Saltine - Bulk
$36.18
Weekly
771332
50012 pk
Lancc
Crackers Saltine - Individually Wrapped
$12.57
Monthly
771510
300 12 pk
500/2Ct
Lance
Crackers Cafe Club
$17.38
Monthly
639071
24 / 12 oz
N Joy
Creamer Non Dairy Canister
$40.29
Weekly
104930
1 / 4.51b
Gransabr
lCumin Ground
$24.07
Quarterly
Page 6 of 17
Invitation to Bid Form - Annual Supply Contract for Inmate food Services - CONTINUED
Item #
Pack / Size
Packl Ske
if different
from Listed
Brand
Description
Cost
Estimate on
Often
NowUsed:
Used:
119441
4/1 gal
Ellingtn
Dressing Coleslaw
$41.75
Quarterly
674077
200 / 12 gm
PPI
Dressing PC Italian Packets
$14.78
Monthly
119440
4/1 gal
Ellingtn
Dressing Lt Italian Dressing Gallon
$24.9$ 1
Monthly
119442
41 1 gal
Ellingtn
Dressing Ranch Buttermilk Gallon
$47.74
Quarterly
674146
200 112 gm
PPI
Dressing PC Ranch Buttermilk
$16.49
Weekly
122557
18 13,2 oz
Ellingtn
Dressing Ranch Mix
$26.18
Weekly
164879
6011.5 oz
Ellingtn
Dressing PC Thousand Island
$13.87
Monthly
662323
4/1 gal
Select
Dressing Honey Mustard
$55.38
Monthly
122648
12124 oz
Ellingtn
Drink Mix Fruit Grape Powdered
$33.68
Weekly
122645
12124 oz
Ellingtn
Drink Mix strawberry Powdered
$33.68
Weekly
122642
12124 oz
Ellingtn
Drink Mix Fruit Punch Powdered
$33.68
Weekly
122647
12 / 24 oz
Ellingtn
Drink Mix Pink Lemondade Powdered
$33.68
weekly
122644
12124 oz
Ellingtn
Drink Mix Peach Powdered
$33.68
Weekly
630281
121 1.8 oz
Crystigt
Drink Mix Sugar Free Fruit Punch Powdered
$46.97
Weekly
630280
1212.2 oz
C St) t
ry 9
Drink Mix Sugar Free Pink Lemonade
Powdered
$46.97
Weekly
118454
15 12 lb
Ellingtn
Egg Mix Scrambled w/2% Milk
$40.67
Weekly
118455
1 120 lb
Ellingtn
Eggs Whole Liquid wicitric
$49.08
Weekly
118455
2120 lb
Egg Whole Liquid w/citric
$49.08
weekly
016522
200/1 oz
153/1.25oz
Echolake
Egg Scrambled Patty Round
$33.98
Weekly
138229
1 110 lb
Papettis
Egg Hard Cooked Peeled
$24.07
Weekly
122785
11200 ct
Packer
Egg Fresh Shell Jumbo USDA
$31.07
weekly
385417
9011.75 oz
Femando
Enchilada Cheese 10F
$26.17
weekly
777035
1 / Pt
MConmick
Extract Vanilla Imitation
$4.10
Quarterly
117880
1 / 15 lb
Admiral
Fillet Swai Fillet 5-7 oz
$58.38
weekly
455779
1 / 10 lb
Fpi
Fish Strip 1.5 oz Breaded
$39.29
Weekly
451711
4 / 10lb
Packer
Fish Pollock Fillet 4-6 oz
$103.17
Weekly
151727
1110 lb
Highline
Fish Pollock Rect Breaded Wg
$37.71
weekly
119163
1/50 lb
Ellingtn
Flour All Purpose
$16.07
Monthly
536111
80 / 2 oz
Farmland
Franks All Meat 8/1
$26.59
Monthly
492029
215lb,
Butterbl
Franks Turkey
$20.27
Monthly
137957
6 15 It,
Farmers
French Fries RC 318 IN
$21.58
Weekly
125647
61 #10
KthNaly
Fruit Cocktail X Lt Syrup
$49.99
Weekly
125646
6 / #10
Kth/Valy
Fruit Mix Lt Syrup
$49.47
weekly
Page 7 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services -CONTINUED
Item #
Pack f Size
Pack/Size
if different
from Listed
Brand
Description
cost
ernMATEon
How often
Used:
104929
1 / 7lb
1/6.51b
Gransabr
Garlic Granulated
$29.77
Monthly
767052
24 / 3.14 oz
Jello
Gelatin Cup
$10.08
Monthly
122655
12124 oz
Ellingtn
Gelatin Mix Mixed Assorted Citrus
$34.67
Monthly
767043
12124 oz
Royal Fd
Gelatin Mix Lime
$28.17
Monthly
122654
12 / 24 oz
Ellingtn
Gelatin Red Variation
$34.67
Monthly
027120
1 / 35 lb
Packer
Grapefruit Ruby Choice 40
$39.78
weekly
797058
61 13 oz
Morrison
Gravy Mix Brown Country Style
$21.58
Monthly
797060
1 6114 oz
Pioneer
Gravy Mix Chicken
$23.19
Monthly
797246
6124 oz
Morrison
Gravy Mix Peppered
$17.38
Monthly
797237
6111.3 oz
Pioneer
Gravy Mix Pork Roast
$26.29
Monthly
797240
6111.3 oz
Pioneer
Gravy Mix Turkey Roasted
$21.58
Monthly
012362
6 / 3 lb
Packer
Greens Mustard Greens
$20.78
weekly
538680
2 / 10-12 lb
Menumstr
Ham Buffet style
$2.51/lb
weekly
127801
6 15 lb
4/101b
Hormel
Ham Chopped
$146.78
Quarterly
538043
4 / 3 lb
6/21b
Breadrdy
Ham Pre -Sliced
$43.07
Quarterly
2 / 13 Ib
Ham Shaving Cooked 4 x 6 Deli
NA
weekly
2 / 10-12 lb
Ham Shaving Smoked Boneless
NA
Quarterly
128886
4 / 3 It,
HIIShire
Ham Sliced Smoked
$59.67
Quarterly
155869
2120ct
Mrsbaird
Hamburger Buns
$9.97
Weekly
361069
12012.2 oz
Ore Ida
Hashbrowns Golden Patty
$29.69
Weekly
650337
6 / 3 lb
Goldngrl
Hashbrowns Redi Shred
$46.09
Weekly
361030
6 / 3 lb
Traditnl
Hashbrowns Lqf Shredded
$25.27
Weekly
It 30 lb
Honey Dew Melon US #1 8 at
NA
weekly
290220
6 / 12 ct
Frsh/Kth
Hot Dog Buns
$13.98
weekly
123003
215 lb
Ellingtn
Hushpuppies Regular Round
$17.97
Weekly
405128
4 15 lb
Hagys
Hushpuppies Homestyle
$34.69
weekly
766108
1 / 12 lb
Richs
Icing Chocolate
$25.80
Quarterly
766107
1112 lb
Richs
Icing Vanilla
$23.27
Quarterly
677092
200 / .5 oz
Heinz
Jelly PC Assorted Cup
$13.78
Monthly
677036
2001.5 oz
Smuckers
Jelly PC Grape Cup
$12.48
Weekly
318011
70 / 4 oz
Ard Frm
Juice Apple 100% Carton Carton
$12.38
weekly
318034
70 / 4 oz
Ard Firm
Juice orange 100% Carton
$14.50
weekly
Page 8 of 17
Invitation to Bid Form -Annual Supply Contractfor Inmate Food Services —CONTINUED
Item#
Pack/Size
Pack/Size
if different
from lrsted
Brand
Description
cost
rsnMan:on
How often
Used:
146968
100019 gr
1906
Ketchup Individual Packets
$18.78
Weekly
122416
6/#10
Kth/Home
Ketchup Standard
$26.57 1
Weekly
138201
1 1 case
Mrkn/Fc
Lettuce Iceberg
$39.67
Weekly
123065
4 15 lb
Mrkn/Rss
Lettuce Shred 1/4 Inch
$29.18
Weekly
148179
90015 gr
912/5gr
Landolak
Margarine PC Cup Spread
$ 22.97
Monthly
129724
432 114 gr
Gldhrvst
Margarine pcks
$29.49
119460
30 It lb
Ellingtn
Margarine Solids Pure Vag
$34.39
Monthly
800711
12116 oz
Jetpufed
Marshmallows Jet Puffed
$24.68
quarterly
111293
4/1 gal
Kens
Mayonnaise Heavy Duty Gallon
$40.97
Monthly
170220
200112 gm
Flavrfrs
Mayonnaise PC
$18.47
weekly
1 / 30 lb
Melons Honey Dew US #1 8 at
NA
Weekly
104374
2 15 lb
Bonici
Meatballs Beef & Chicken
$42.28
Weekly
522410
320 / .5 oz
Advancep
Meatballs Flame Broiled
$53.68
Weekly
509618
7613.15 oz
Smartpic
Meatloaf Patty Deluxe
$88.28
Weekly
798022
24114 oz
Magnolia
Milk Condensed Sweetened
$48.87
Monthly
798001
24112 oz
Velvet
Milk Evaporated
$24.69
Monthly
798059
1 / 25lb
Ramsen
Milk Powdered Skimmed NF
$57.78
Monthly
Milk Powdered Homo Vitamin D
NA
Monthly
171984
4/1 gal
Oakfarms
Milk 2% Reduced Fat 1 Gallon
$19.69
Weekly
71983
411 gal
Oakfarms
Milk Homo Vitamin D 1 gallon
$20.57
Weekly
284410
2511/2 pt
Oakfarms
Milk 1% Reduced Fat 1/2 pint cartons
$9.47
Weekly
119825
2511/2 pt
Dairypur
Milk 2% Reduced Fat 1/2 pint cartons
$9.37
Weekly
119826
251112 pt
Dairypur
Milk Homo Vitamin D 1/2 pint cartons
$9.67
Weekly
124165
4/1 gal
KthNaiy
Mustard Prepared Gallon
$12.99
quarterly
160130
500 15.5 gr
Frenchs
Mustard PC Pouch
$12.69
Weekly
Page 9 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services — CONTINUED
Item #
Pack / Size
Pack/Size
if different
from Listed
Brand
Description
Cost
ESTIMATE on
How often
Used;
119462
6/1 gal
Ellingtn
Oil Butter Flavored
$83.30
Monthly
119462
6/1 gal
Ellingtn
Oil Pan & Grill Trans Fat Free
$83.30
1 Monthly
698007
6 117 oz
Pam
Oil Pan Spray
$21.47
Monthly
779032
1135 lb
Bunge
Oil Shortening Clear Fry
$43.08
Monthly
342131
1120 lb
Pictswt
Okra Cut 1/2 inch Grade A
$17.99
Weekly
325205
1120 lb
Beko
Okra Cut Heavily Breaded
$20.47
Weekly
124370
6 12 lb
Ellingtn
Okra Cut Breaded Southern Style
$13.88
Weekly
775002
1 / 3 lb
Mcormick
Onion Dried Flakes Chopped
$13.48
Monthly
155091
415 lb
Taylorfm
Onion Sliced
$49.59 1
Monthly
155030
1150 ib
Packer
Onion Yellow Jumbo Sack
$24.77
Monthly
031111
1 135lb
Mrkn/Esn
Oranges Fresh
$34.17
Weekly
031112
1135 lb
Mrkn/Esn
Orange Choice
$43.09
Weekly
134842
6/#10
Ewimport
Oranges Mandarin Oranges Broken Lt
$51.07
Weekly
774929
1112 oz
Txcustom
Oregano Ground
$9.69
Quarterly
168088
144 11.2 oz
Krusteaz
Pancake Original - Frozen
$21.30
Weekly
774727
1110 oz
Mcormick
Parsley Flakes
$14.47
Quarterly
151773
215 lb
Bellacib
Pasta Egg Noodle Wide 1121nch
$15.48
Monthly
151772
2110 lb
Bellacib
Pasta Elbow Macaroni
$19.98
Monthly
151784
12116 oz
Bellacib
Pasta Lasagna Ribbed
$15.97
Monthly
151778
2 110 lb
Bellacib
Pasta Spaghetti Thin 101nch
$19.98
Monthly
125643
6 / #10
KthNaly
Peaches Sliced Extr Lt Syrup
$47.77
Weekly
125648
6 / #10
KthNaly
Peaches Diced Extra Lt Syrup
$47.77
Weekly
165099
6 15 lb
Ellingtn
Peanut Butter creamy
$49.39
Weekly
170314
200 10.75 oz
Jif
Peanut Butter Pc
$40.99
Weekly
125641
6/#10
KthNaly
Pears Sliced Light Syrup
$48.39
weekly
113580
6/#10
Lakeside
Peas Blackeyed
$28.59
Weekly
104049
1120 lb
12/21b
Sunfield
Peas Peas & Diced Carrots Frozen
$22.19
Weekly
343503
1 / 20lb
Simplegd IPeas
Green
$23.57
Weekly
Page 10 of 17
Invitation to Bid Form -Annual Supply Contractfor Inmate Food Services -CONTINUED
Item #
Pack / Size
Pack/Size
1f different
from Listed
Brand
Description
Cost
ESTIMATEon
Often
HowUsed:
12574
6/#10
KthNaly
Peas Sweet Mixed
$34.28
weekly
774165
11 18 oz
S icecls
Pepper Black Gound Fine Pure
$9.47
Monthly
685214
12 127 oz
Rosarita
Peppers Chili Diced Green
$51.27
Monthly
165010
1/1 1/9 Bulk
Mrkn/Esn
Pepper Bell Green Chopper
$23.38
Monthly
110417
6/#10
Gransabr
Pepper Jalapeno Nacho Sliced
$28.07
Quarterly
774829
1 / 7 lb
TXcustom
Pepper Lemon Seasoning
$23.58
Quarterly
100059
4/1 gal
Bstmdpro
Pickles Dill Relish
$24.09
Monthly
680023
1 / 5 gal
Chefsupr
Pickles Dill Sliced Hamburger
$20.59
Monthly
430075
6 143 oz
Chef P
Pie Pumpkin 101nch PreBaked
$39.88
Quarterly
600379
6181 oz
Dole
Pineapple Chunks in Extra Lt Syrup
$39.55
weekly
134844
6/ #10
Ewimport
Pineapple Sliced in Juice
52.98
Weekly
600373
6 / #10
Dole
Pineapple Tidbits in Juice
$47.38
Weekly
384029
128 13.31 oz
Tons
Pizza Breakfast Turkey Sausage
$52.97
Monthly
384420
9614.48 oz
Tonys
Pizza Pepperoni Whole Grain
$54.19 1
Monthly
653001
3618 oz
Fanc frm
Popcorn Kit All In One
$26.77
Monthly
153400
6 / 6-8 lb
Smithfld
Pork Loins Boneless
$2.13/lb
Monthly
544251
40 13.75 oz
Advance
Pork Patty Breaded Cooked
$35.87
Monthly
532351
52 13.1 oz
Qtf
Pork Patty Rib Shape Cooked
$44.57
Monthly
532010
46 / 3.5 oz
Advance
Pork Rib Patty
$51.38
Monthly
532421
8013 oz
Kingcmnd
Pork Rib Patty w/BBD Sauce
$58.27
1 Monthly
650337
6 / 2.51b
GOldngrl
Potato Hashbrown Redi Shred
$46.09
Weekly
650332
6/#10
6/5.31lb
Basic
Potato Instant with milk
$56.17
weekly
170105
1150 lb
Mrkn/Esn
Potato Idaho #2
$24.17
weekly
169149
1160 lb
Mrkn/Fc
Potato Red #2
$22.27
weekly
170050
1 / 501b
Mrkn/Fc
Potato Russet 10 oz US #2
$22.27
Weekly
170048
Mrkn/Fc
Potato Russet 80 ct IDA
$25.28
Weekly
650380
6/#10
Princela
Potato Sweet Cut Fancy
$37.58
weekly
123013
8 15 lb
Madeira
Potato Tater Bites Seasoned
$41.19
1 weekly
360811
6 / 51b
Ore lda
Potato Tater Tots
$47.28
Weekly
650314
6/#10
Allens
Potato White Diced
$32.57
Weekly
765086
6/#10
M hmtwn
Pudding Banana
$29.07
Weekly
765085
6/#10
Myhmtwn
Pudding Chocolate
$29.57
weekly
765037
24 13.625 oz
Jelio
Pudding Chocolate Sugar Free
$13.08
Weekly
148023
6/#10
Thankyou
Pudding Lemon
$39.29
Weekly
123296
6/#10
Eliin to
Pudding Tapioca
$37.19
weekly
765084
6/#10
Myhmtwn
Pudding Vanilla
$28.69
weekly
168464
6 / #10
1 3/#10
1 LUckif
Pudding Vanilla Sugar Free
$24.18
Weekly
Page 12 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services -CONTINUED
Item#
Pack/Size
Pock/Size
if different
from Listed
Brand
Description
Cost
ESTIMATE on
How often
Used:
800042
241611 oz
Vlypride
Raisins Individual Packs
$38.89
Weekly
800058
1 24 115 oz
Sunmaid
Raisins Golden Seedless
$53.98
Weekly
786203
6 / #10
Chefboy
Ravioli Beef RTU
$59.97
weekly
654044
1 150lb
Producer
Rice Long Grain
$19.17
Weekly
654060
1 160 lb
Comet Ri
Rice Long Grain Parboiled 4% Broken
$21.77
weekly
100059
4/1 gal
Bstmdpro
Relish Dill Premium
$24.09
1 Monthly
127018
4 15 lb
Mrkn/Rss
Salad Mix Lettuce in Bag
$30.18
Weekly
768119
1 130 lb
1/321b
Rons
Salad Potato Homestyle
$49.73
Monthly
547118
384 / .5 oz
Smithfld
Salami All Meat Sliced
$45.97
Weekly
676026
1 / 25 lb
Morton
Salt Iodized Table
$7.07
quarterly
660017
4 / 1 gal
Lil Pig
Sauce BBC
$19.39
Monthly
660556
6 /#10
Gehls
Sauce Cheese
$40.27
Weekly
660583
6 / #10
Mipueblo
Sauce Cheese Nacho
$40.17
Weekly
600060
24 / 14 oz
6/#10
Oceanspr
Sauce Cranberry Jellied
$39.89
quarterly
168550
4 / 1 Gal
2/.5gal
Gransabr
Sauce Enchilada Mild RTU
$14.98
Weekly
60220
6 / #10
Lavictor
Sauce Enchilada Mild RTu
$39.28
Weekly
785065
4 / #10
Manwich
Sauce Manwioh Sloppy Joe
$29.09
Weekly
168549
4 / 1 Gal
2/.5gal
Gransabr
Sauce Picante Mild Gallon
$14.67
Monthly
125659
6 / #10
Ellingtn
Sauce Pizza
$29.58
Weekly
124163
4/1 gal
Ellingtn
Sauce Soy Sauce Gallon
$20.77
Monthly
125660
6 / #10
Ellingtn
Sauce Spaghetti RTU
$31.07
Weekly
169281
200 / 9 gr
Flavfrs
Sauce PC Taco
$8.78
weekly
674096
600 / 9 gr
Heinz
Sauce PC Taco
$28.07
weekly
674812
200/7/16 oz
Kraft
Sauce Tarter Creamy Packets
$16.17
Weekly
125658
6/#10
Ellingtn
Sauce Tomato Fancy
$25.17
Weekly
660298
4/1 gal
Caj Chef
Sauce Worcestershire
$19.09
quarterly
541205
2 / 5 lb
Alamo
Sausage Beef Breakfast Chorizo
$25.49
Weekly
122494
107 11.5 oz
lJones
Sausage Chicken Patty Cooked
$35.38
Weekly
Page 12 of 17
Invitation to Bid Form - Annual Supply Contract for Inmate Food Services - CONTINUED
Item#
Pack/Size
Pack/Size
if different
from listed
Brand
Description
Cost
ESTIMATE on
How Often
used:
492773
12811.25 oz
J Dean
Sausage Turkey Cooked
$39.88
Weekly
41029
215 lb
Alamo
Sausage Chorizo Pork Raw
$26.68
Weekly
539067
215 lb
Tenn Prd
Sausage Ground Bulk Raw Mild
$24.47
weekly
541578
2001.8 oz
256/.75oz
Tenn Prd
Sausage Link Natural .8 oz Cooked
$37.29
weekly
541587
9211 oz
192/1 Oz
Beko
Sausage Link Mild 1 oz Cooked
$35.17
Weekly
549125
215 lb
Pizzano
Sausage Pork Topping Cooked
$25.61
Weekly
158485
1110 lb
J Bar B
Sausage Smoked Rope Cooked
$23.78
Weekly
540018
154 11.25 oz
Tenn Prd
Sausage Patty Cooked
$36.07
Weekly
774458
12117 oz
Chachere
Seasoning Creole
$32.37
quarterly
115570
1 18lb
Chachere
Seasoning Creole Original
$13.69
quarterly
774434
1 124 oz
1/30oz
Mcormick
Seasoning Mexican Rub Mix
$11.78
quarterly
774450
1 123 oz
MCormick
Seasoning Montreal
$9.63
quarterly
774396
114.51b
MCOrmick
Seasoning Salt Traditional
$13.30
Monthly
60606
6115 oz
MCormick
Seasoning Sloppy Joe Mix
$26.77
Weekly
660714
1 124 oz
MCormick
Seasoning Taco
$10.67
quarterly
779032
1135 lb
Bunge
Shortening Clear Fry Liquid
$43.08
Monthly
808040
12150 oz
Campbells
Soup Chicken Noodle
$45.69
Monthly
808030
12150 oz
Campbells
Soup Cream of Chicken
$48.81
Monthly
808061
12150 oz
Heinz
Soup Cream of Mushroom
$47.07
Monthly
12150 oz
Soup Cream of Potato
NA
Monthly
808090
12150 oz
Campbells
Soup - Tomato
$36.59
Monthly
808100
12150 oz
Campbells
Soup -Vegetable
$51.77
Monthly
669027
415 Ito
Daisy
Sour Cream Cultured
$23.27
Monthly
61 #10
Spinach Chopped Fancy
NA
Weekly
200098
Vol Fill
Packer
Squash Zucchini Mad 18-25
$25.09
weekly
697100
24/ 1 lb
Argo
Starch Corn
$19.97
quarterly
117439
613.5 lb
Ellin to
Stuffing Mix Combread
$58.69
weekly
780009
1212 lb
Imperial
Sugar Brown light in Bag
$27.88
Monthly
140073
1 150 lb
Unitedsu
Sugar Pure Cane Extra Fine
$30.97
Weekly
140073
1 150 lb
Unitedsu
Sugar Pure Cane Granulated
$30.97
weekly
781005
1212 lb
Imperial
Sugar Powdered White
$27.88
quarterly
677255
100I 1 oz
Smuckers
Syrup PC Pouch -Cup
$13.59
Weekly
793036
1 10011 oz
Smuckers
Syrup PC Pouch -Cup Sugar Free 1 oz
$16.17
Monthly
Page 13 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services — CONTINUED
Item#
Pack/Size
Pack/Size
if different
from Listed
Brand
Description
Cost
ESnMATE on
Often
FbUseed:d;
U
168936
96 / 1 oz
Elgtntea
Tea Bags 1 oz
$18.27
Weekly
167861
96 / 1 oz
Ceylonat
Tea load Filter Pouch 1 Gal
$23.87
Weekly
211111
1 / 25 lb
Packer
Tomatoe Bulk Cafe
$26.67
Weekly
125654
6 / #10
Ellingtn
Tomatoe Diced in Juice
$25.87
Weekly
171913
12 / 28 oz
Del Sol
Tomatoe Diced With Green Chilis
$24.57
Monthly
210114
1 125 lb
Packer
Tomato Roma #2
$23.38
Weekly
791075
6 / #10
Jubilee
Topping Chocolate Fudge
$71.59
Monthly
122650
12 / 1 lb
Ellingtn
Topping Whip Mix Add Water
$36.07
Quarterly
134852
6166.5 oz
Ewimport
Tuna Chunk Light in Water
$70.29
Monthly
492954
1211 lb
Butterbl
Turkey Breast Lunchmeat Combo
$32.18
Weekly
492131
218-9 lb
Jennie O
Turkey Breast Oven Roasted
$2.19/lb
Monthly
492291
2 / 9.9.5 lb c
Carolina
Turkey Breast Smoked Skinless
$2.00/lb
Monthly
100167
4110 lb
Carolina
Turkey Ground Tubes 80/20
$40.17
Weekly
492682
2 / 7-8 lb
Carolina
Turkey Ham Buffet Deluxe
$1.78/Ib I
Weekly
5 15 lb
Turkey Medallion Roasted
NA
Monthly
492681
215 lb
Butterbl
Turkey Ham - Diced Cured
$23.27
weekly
492773
12811.25 oz
J Dean
Turkey Sausage Patty Cooked
$39.88
Weekly
139312
6 / #10
Lakeside
Vegetables - Mixed Fancy
$32.39
Weekly
104049
1120 lb
Sunfield
Vegetables - Blend Peas & Carrots
$22.19
Weekly
125737
61 #10
Ellingtn
Vegetables For Stew Fancy Chunky
$31.77
Monthly
349198
12 / 2 lb
Mrkn/Fc
Vegetables - Blend Stir Fry
$45.69
Monthly
344137
1120 lb
Mrkn/FC
Vegetables - Mixed 5 Way
$21.78
Weekly
127425
12112 ct
Ego
Waffles
$23.19
Weekly
650380
1 6 / #10
Princela
Yams - Cut
$37.58
Monthly
697001
20 / 1 Ib
Saf
Yeast Saf Instant Red Label
$63.57
Quarterly
Page 14 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services —CONTINUED
Item#
Pack/Size
Pack/Size
if different
from Listed
Brand
Description
cost
Fs"MATE
How often
used:
NON FOOD ITEMS:
883595
10 / 100 at
Disco
Apron, Plastic Full Length Mad Wt 24x42
$105.27
quarterly
883597
1 / 10o ct
Disco
Apron, Plastic White Disposable
$11.99
quarterly
875379
11500 ct
Wet Pak
Bag Ice 10lb Draw String
$65.87
875027
1 / 2000 of
Essntial
Bag Sandwich w/Flip Top
$33.27
quarterly
875403
1 / 500 ct
Reynolds
Bag Sandwich Reclosable 6.5x6
$17.66
Quarterly
875405
11500 ct
Reynolds
Bag Zip Seal Quart
$33.59
Quarterly
875321
11200 ct
Reynolds
Bag Freezer Reclosable 1 Gallon
$23.78
Quarterly
129707
1 / 250 ct
Essntial
Bag Reclosable Zip 1 Gallon
$37.58
Quarterly
875322
11100 ct
Reynolds
Bag Freezer Reclosable Zip 2 Gallon
$24.07
Quarterly
114852
11500 at
Duro
Bag - White Paper Bag
$28.09
885225
12812 oz
SSDC
Cleaner Floor Degreaser
$44.08
Quarterly
64 12 oz
Coffee Filter Packs
NA
Monthly
138524
2 1100 ct
Pactiy
Container Foam Hngd 3-c White
$27.77
Quarterly
860041
40 125 ct
Dart
Cup, Foam 12 oz
$45.48
Monthly
860060
40 125 ct
Essntial
Cup, Foam 16 oz
$65.67
1 Monthly
860042
101100 ct
Dart
Cup Lids for 12 oz
$29.39
Monthly
860045
10 / 100 ct
Dart
Cup Lids 12L Trans Slotted
$28.77
Monthly
860117
10 / 100 ct
Dart
Cup Lids for 16 oz
$34.98
Monthly
860055
101100 ct
Dart
Cup Lidis for 16L Trans Slotted
$29.39
Monthly
887097
2 / 1 gal
SSDC
Detergent Paramount Heavy Duty
$81.98
weekly
887056
1 / 5 gal
Essntial
Detergent Speed Clean
$104.79
weekly
887056
1 / 5 gal
V�YI Sal
Detergent Dishwasher
$104.79
Weekly
Page 15 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services —CONTINUED
Item#
Pack/Size
Pack/S/ze
if different
from Listed
Brand
Description
Cost
won
Now often
used:
877019
1 / roll
Reynolds
Film 18 x 1000 Clear Wrap
$27.18
Monthly
876063
1 / roll
Medallon
Foil 18 By 1000
$81.07
876111
1 / roll
Durable
Foil 24 x 500 #633 EX H
$151.18
Monthly
888048
4 / 10 a
Scotchbr
Grill Cleaning Pad
$64.69
weekly
883860
10 / 100 ct
Cellucap
Gloves Clear Plastic Large
$18.08
Weekly
883757
10 / 100 ct
Valugard
Gloves Vinyl Powder Free Large
$46.99
Weekly
883769
10 / 100 ct
Valu and
Gloves Vinyl Powder Free Xlarge
$46.99
Weekly
883708
11144 ct
DISCO
Hairnet Dark Brown Light Weight
$17.89
Weekly
117334
1/roll
Cambro
Label 100%Dissolvable
$17.09
Weekly
878231
11250 ct
Daymark
Label 2 x 3 Dissolvable Use By
$16.09
Weekly
875476
111000 ct
Dixie
Liner Pan Lift Off Grease
$46.28
Monthly
162196
11250 ct
Wallace
Meal Kit (K F S Napkin) MW W
$19.77
quarterly
115577
1as
Johnritz
Mitt - Oven Mitt Black17
$10.07
877036
1/roll
Reynolds
Plastic Wrap
$22.47
Monthly
887078
1 / 5 gal
Essntial
Rinse Aid Fast Dry
$137.47
Weekly
885915
6/1 qt
SSDC
Sanitizer Redi San Rtu
$26.19
Weekly
154099
4 1500 ct
10/500ct
Cellocor
Straws 7.75 Jumbo Clear Wrap
$51.89
Monthly
BE SURE TO COMPLETE, SIGN AND DATE THE NEXT PAGE Page 16 of 17
Invitation to Bid Form -Annual Supply Contract for Inmate Food Services —CONTINUED
Food and Non -Food Items not listed on this Invitation to Bid Form shall be provided at:
Cost Plus 12 %Basis
Other equipment, services or products used in the DETENTION FACILITY'S Kitchen will be offered at:
Free of Charge, a Discounted Price, or Cost Plus % Basis
Example: Dispensers for coffee, chemicals and other products
Bidder understands that Calhoun County or their representative may audit the Cost Pius Percentage Basis at any
time and the documentation necessary for this audit will be provided at no additional charge to Calhoun County.
Attachment(s) to Invitation to Bid Form: X YES NO
The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm,
partnership or individual has not prepared this bid in collusion with any other bidder, that the contents of this bid as
to prices, terms or conditions of said bid have not been communicated by the undersigned nor by their employees or
agents to any official, employee or agent of Calhoun County or any other person engaged in this type of business
prior to the official opening of this bid.
The undersigned affirms that they have not given, offered to give, nor intends to give at any time hereafter any
economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to any official,
employee or agent of Calhoun County in connection with this bid.
The undersigned affirms that they have read the entire Invitation to Bid Packet and fully understands and has
followed all requirements.
FAILURE TO SIGN BELOW SHALL DISQUALIFY THE BID
Date: October 11th, 2021
Authorized Signature & Title:
Type Name & Title of Authorized Signature: Emily Lynch. DSM
Phone Number: 361-205-4070
Email: eslynch@benekeith.com
Exceptions and/or Variations from Specifications and/or Additional Notes:
Page 17 of 17
Attachment to Invitation to Bid Form- Additional Bid Items
Item #
Pack/Size
Pack/Size if
different
from Listed
Brand
Description
Cost
ESTIMATE
on How Often
Used:
Menu Analysis, Dietician, etc
No Charge
398824
72/3oz
Lenders
Bagel Cinnamon Raisin Sliced
$21.89
115464
160/3oz
Minutemn
Beef & Chicken Patty 3 Oz Clod
$114.87
509403
S4/3oz
Beko
Beef Salisbury Steak Cooked
$43.06
510193
240/Soz
lKingcmnd
Beef Steak Finger Brd Ckd Wg
$64.17
290306
6/8ct
Mrsbaird
Bun Crustini Sandwich 4.5 In
$10.18
455030
1/151b
Harvest
Catfish Nugget Breaded 2-40z
$38.67
799855
4/32oz
M 0 M
Cereal Bulk Crispy Rice
$26.09
799116
4/45oz
M 0 M
Cereal Bulk Frosted Flakes
$34.78
799127
4/50oz
Kelloggs
Cereal Bulk Granola Lowfat
$56.29
799080
4/44oz
M 0 M
Cereal Bulk Hone nut Scooters
$48.09
132429
300/loz
Gldhrvst
Cheese Cream PC Cup
$18.67
134206
2/51b
Tyson
Chicken Breast Diced Griled
$37.27
110640
2/51b
Tyson
Chicken Breast Pulled Cooked
$42.08
104890
2/51b
Tyson
Chicken Meat Diced 1/21n
$40.29
487529
4/51b
Tyson
Chicken Thigh Diced Raw
$43.18
115169
36/3oz
Minh
Egg Roll Pork & Veg Roller Grl
$27.79
380264
80/2oz
Le Gourm
Egg Roll Vegetable
$23.77
401205
5/21b
Farmrich
French Toast Stick
$24.07
600116
6/N10
Celebrty
Mandarin Orange Whole Segments
$46.37
149335
37/4.25oz
Dr rae r
Meatless Black Bean Burger
$44.07
372073
48/4.25oz
Mornstar
Meatless Black Bean Burger
$75.58
372090
200/.75oz
Mornstar
Meatless Chicken Nugget
$60.88
172464
2/Slb
Beyond
Meatless Chicken Tender
$68.38
165031
4/2.51b
Hormel
Meatless Chorizo Crumble
$60.57
372084
48/3.4oz
Gardnbrg
Meatless Garden Burger Blk Bn
$58.58
372081
48/3.4oz
Gardnbrg
Meatless Garden Patty
$58.58
372100
112/1.3oz
Mornstar
Meatless Sausage Patty
$55.47
372067
4/8ct
Ratners
Meatless Veggie Griller 5 Oz
$35.49
100855
14/15oz
Kin cmnd
Meatloaf Pull Apart
$59.28
151786
2/101b
Bellacib
Pasta Penne Rigate
$20.39
145785
1/101b
Trident
Pollock Stick Brd 1 Oz
$36.67
532421
80/3oz
Kin cmnd
Pork Rib Patty W/Bbq Sauce
$58.27
107369
2/51b
Gransabr
Pork Tip For Taco Especial
$3.37/lb
157429
4/31b
Gldnti r
Rice Vegetable Fried
$41.07
111495
180/loz
Schubert
Roll Dinner Par -Baked
$26.07
660122
1/1gal
Kikkoman
Sauce Teriyaki
$11.97
164128
200/1.76oz
Gokouju
Spring Roll Vegetable 1.760z
$40.07
167053
400/.88oz
Gokouju
Spring Roll Vegetable Mini
$37.78
385792
120/1.5oz
Rodri uz
Tamale Beef In Husk 1.5 Oz
$35.87
385179
341/.75oz
Posada
Taquito Shredded Beef
$71.29
451914
1/101b
Sea Best
Tilapia Fillet 3-5 Oz
$28.89
128990
1/101b
Westedge
Tilapia Fillet I f 5.5-6 Oz
$25.59
105126
1/101b
Perdue
Turkey Burger Homestyle
$32.89
492254
30/5.33oz
Butterbl
Turkey Burger Mediterranean
$30.89
492949
2/51b
Butterbl
Turkey Diced White
$30.59
492990
2/101b
Butterbl
Turkey Ground Bulk Chub
$36.67
492954
12/1Ib
Butterbl
Turkey Lunchmeat Combo
$32.18
150188
1/401b
Shendoah
Turkey Thighs Bnls Skinless
$97.78
349245
1/201b
Mrkn/Fc
Vegetable Blend California
$22.88
349350
1/201b
Mrkn/Fc
Vegetable Blend Capri Mix
$26.67
349450
1/201b
Mrkn/Fc
lVegetable Blend Oriental Mix
$28.57
349609
12/2lbs
Mrkn/Fc
lVegetable Blend Scandinavian
$29.69
349650
1/201b
Mrkn/Fc
lVegetable Blend Winter Mix
$22.88
Attachment to Invitation to Bid Form -Additional Bid Items
164989
1/81b
Whitemtn
Yogurt Greek Plain
$24.78
285775
6/32oz
Dannon
Yogurt Plain Original Lowfat
$17.38
108099
4/61b
Dannon
Yogurt Vanilla Dannon Pro
$36.27
283934
6/32oz
Dannon
Yogurt Vanilla Low Fat
$17.38
113016
48/4oz
Yoplait
Yogurt Variety Pack light
$23.19
283861
48/4oz
Li ht&Ft
Yogurt Variety Pack
$20.37
283256
48/4oz
Yo lait
Yogurt Variety Rasp/Peach Ori
$22.30
BID SPECIFICATIONS
ANNUAL SUPPLY CONTRACT FOR
INMATE FOOD SERVICES
BID NUMBER 2022.04
Commissioners Court of Calhoun County, Texas is requesting SEALED BIDS for the Annual Supply
Contract for Inmate Food Services at the Calhoun County Adult Detention Center, located at 302 West
Live Oak Street in Port Lavaca, Texas.
The Calhoun County Adult Detention Center is hereinafter called "DETENTION FACILITY".
INVITATION TO BID PACKET
The complete Invitation to Bid Packet can be downloaded from the County's website,
www.calhouncotx.org (under Bid Notices and Results, Bid Notices 2022) or by contacting Peggy Hall,
Assistant Auditor, at peggy.hall@calhouncotx.org or 361-553-4610.
The complete Invitation to Bid Packet must be used in preparing the bid. Calhoun County does not
assume any responsibility for errors or misinterpretations resulting from the use of incomplete sets of
the Invitation to Bid Packet.
SUBMISSION OF SEALED BIDS
SEALED BIDS ARE DUE BEFORE 2:00:00 PM, TUESDAY, NOVEMBER 9, 2021 in the County Judge's Office,
Calhoun County Courthouse, 211 South Ann Street, 3`d Floor, Suite 301, Port Lavaca, Texas.
ALL BIDS (one original and three copies) shall be delivered to the office of the Calhoun County Judge in
a SEALED 9 x 12 or larger envelope and CLEARLY MARKED on the outside of the envelope: BID NUMBER
2022.04, ANNUAL SUPPLY CONTRACT FOR INMATE FOOD SERVICES
If the SEALED BID is sent by Ups, FeclEx, or other delivery service, the outside of this envelope must be
clearly marked: BID NUMBER 2022.04 ANNUAL SUPPLY CONTRACT FOR INMATE FOOD SERVICES.
SEALED BIDS may be hand delivered or mailed to:
Honorable Richard H. Meyer, County Judge
Calhoun County Courthouse
211 South Ann Street
3rd Floor, Suite 301
Port Lavaca, Texas 77979.
A late delivery with an early postmark will not suffice.
Calhoun County does not accept faxed or emailed bids. Any bid received after the due date and time
will not be opened.
Page 1 of 11
Calhoun County is not responsible for the delivery of your bid to the office of the County Judge or
delivery to the wrong office. If you choose to send your bid by postal delivery, it is recommended that
you call the County Judge's office at 361-553-4600 to verify receipt of your bid prior to the bid due date
and time.
The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative is
the official clock that shall be used in determining the time the bid is received and the time the bids
will be opened. No bids will be accepted after the due time and date has been reached.
Calhoun County accepts no financial responsibility for any cost incurred by and BIDDER in the course
of responding to these specifications
BID TERM
The bid shall be in effect for a period of one (1) year beginning January 1, 2022 and ending December
31, 2022 with the option to renew yearly (one year terms) if agreeable with both the successful bidder
and Calhoun County. Each yearly renewal must be approved by Commissioners Court prior to the end
date of the contract.
BID INFORMATION If REQUIREMENTS
To submit a valid bid, read the entire Invitation to Bid Packet for all required information that must
be included and all required forms (see page 5) that must be returned and/or filled out, signed and
dated and returned with your bid.
Calhoun County is always very conscious and extremely appreciative of the time and effort you have
expended to submit a bid. If you will not be submitting a bid, we would appreciate you indicating or
your "No Bid" response any requirements of this bid request which may have influenced your
decision to "No Bid".
Calhoun County is not responsible for errors if the Bid Forms are handwritten. It is recommended
that all information submitted by the vendor on the Bid Forms be typed. If handwritten, must be in
ink and legible. White out is not acceptable.
The bidder may request the Invitation to Bid Form be emailed to them in the Excel Format. If the bidder
requests the Invitation to Bid Form be sent to them in the Excel Format, the bidder understands that
the form and/or format shall not be changed in any way. The bidder shall not delete and/or add
items to the Invitation to Bid Form. The bidder understands that by changing the form and/or format
in any way shall disqualify their bid. The Excel Format may be requested only as a means to enter the
required information. Requests for the Excel Format of the Invitation to Bid Form must be sent to
Peggy Hall, Assistant Auditor, at peggy.hall@calhouncotx.org or by calling 361-553-4610. Bidder must
request the Excel Format. The Excel Format will not be sent with the Invitation to Bid Packet. It must
be requested from the County Auditor's office, Peggy Hall, Assistant Auditor.
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Page 2 of 11
• All charges, fees, and/or delivery/transportation fees must be included in the bid price. No
other charges, fees, and/or delivery/transportation fees may be added unless noted as an
exception on the Invitation to Bid Form. Exceptions may void the bid.
• All bid prices shall be firm for the entire bid period
• Once awarded, if an item(s) is substituted, the item(s) shall be equal or lower in price. The price
of the substituted item(s) shall not be more than the awarded bid price for that item(s). The
price of the substituted item(s) may be lower than the awarded bid price.
• Bids submitted in any other Invitation to Bid Form format shall not be considered. Any
alterations to the Invitation to Bid Form shall disqualify the bid.
• Bids submitted must be legible.
• Deliveries will be made at specific times (at least twice a week) and in sufficient quantities to
ensure that there will be sufficient food on hand at the DETENTION FACILITY to make and
provide all meals.
• Deliveries shall be made between Monday and Friday between the hours of 7:00 AM to 10:00
AM and 1:00 PM to 4:00 PM in order not to disrupt the DETENTION FACILITY kitchen in
preparing meals.
• Should an ordered item(s) not arrive as ordered, wrong item(s) is delivered, or item(s) is
delivered damaged, the successful bidder will deliver the correct or substitute item(s) within 24
hours from the date the missing or damaged item(s) was supposed to be delivered. No extra
charges and fees shall be allowed to be billed to correct the error or damaged items(s).
• Should the successful bidder not be able to supply an item(s) to the DETENTION FACILITY, the
DETENTION FACILITY may purchase the item(s) from another source without being in conflict
with the contract.
• Liquid items shall be delivered in plastic crates to prevent damages when stacked.
• A sales representative from the provider shall contact the Jail Administrator, Assistant Jail
Administrator, their appointed representative, or kitchen officer at least monthly, in person, to
discuss any issues or new products offered. New products shall be offered to the DETENTION
FACILITY at the lowest possible cost plus percentage basis as stated on the Invitation to Bid
Form and successful bidder shall provide information to the DETENTION FACILITY on the
calculation of this cost.
• All food and non-food items on the Invitation to Bid Form are speculative products and should
not be considered as firm products to be purchased during the term of the agreement.
• Bidder shall provide products that are needed for inmates with high blood pressure, diabetes
or for religious reasons.
Page 3 of 11
• If bidder cannot supply a food or non-food item, mark "NA" on the Invitation to Bid Form in the
price column next to that item. If a bidder marks a food or non-food item "NA", the DETENTION
FACILITY may purchase this food or non-food item from another source without being in conflict
with the bid or contract.
• If bidder wishes to suggest alternate, comparable or less costly products, please do so on a
separate page marked as an attachment and if applicable, noting the appropriate page and line
number on your suggestion with pack size and price.
• Products and services available from the successful bidder but not listed on the Invitation to Bid
Form shall be available free of charge, at a discounted price, or Cost plus the percentage basis
stated on the Invitation to Bid Form on such products and services used in the DETENTION
FACILITY kitchen, such as dispensers for coffee, chemicals, etc.
• Food and Non -Food items not listed on the Invitation to Bid Form shall be provided at Cost plus
the Percentage basis stated on the Invitation to Bid Form and successful bidder shall provide
information to the DETENTION FACILITY on the calculation of this cost. The Calhoun County
Auditor's Office and the Detention Facility may audit the Cost plus Percentage basis at any time
and the successful bidder shall provide the documentation necessary for this audit at no
additional charge.
• Order processing shall be made available by in person, phone, fax and/or website.
• All bids received will be considered final, no changes accepted.
• Bidders are prohibited from offering, giving, selling, supplying, or conveying in any way or form,
products for personal use to any official, employee or agent of Calhoun County. Samples may
be provided to the DETENTION FACILITY for use within the DETENTION FACILITY for evaluation
purposes.
• Bidder agrees to notify the Sheriff or Jail Administrator of any solicitations from any official,
employee or agent of Calhoun County for services not officially associated with the DETENTION
FACILITY operations.
• Once the Invitation to Bid Packet is approved by Calhoun Count's Commissioners Court and
Commissioners Court has authorized the Calhoun County Auditor's Offices to advertise for bids,
no questions may be answered unless in the form of an addendum that is approved by
Commissioners Court. All addendums are released by the County Auditor's Office.
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Page 4 of 11
REQUIRED INFORMATION/FORMS TO BE RETURNED WITH THE INVITATION TO BID
• Invitation to Bid Form, page 1-17 (plus attachments, if applicable)
• Affidavit
• Bidder Information Form
• Certificate of Interested Parties, Form 1295 — Must return when submitting your bid
• Proof of Liability Insurance— Return a copy of your current Certificate of Liability Insurance with
your bid. This will provide proof that you carry at least the minimum required coverage.
Once the bids are awarded, the bidder that is awarded the bid must provide a Certificate of
Liability Insurance that reflects that Calhoun County (certificate holder) is an additional insured
on general liability subject to the conditions of the additional insured.
• Conflict of Interest Questionnaire, Form CIQ— Every bidder doing business with Calhoun County
or seeking to do business with Calhoun County must complete Box 1 and sign and date in Box
7. Whether or not a conflict exists determines the other information to include on the form.
• Certification Regarding Debarment & Suspension and Other Responsibility Matters
• Certification Regarding Lobbying
• Disclosure of Lobbying Activities - If Not Applicable, bidder must mark NA, sign and date
• House Bill 89 Verification
• Residence Certification
• W-9
GENERAL INFORMATION
Addenda
No oral statement from any person shall modify or otherwise change or affect the terms, conditions or
specifications stated in the bid. Any interpretations, corrections or changes to this bid will be made by
addenda and approved by Commissioners Court. Once the addendum is approved by Commissioners
Court, the Calhoun County Auditor's Office will send the addendum to each bidder that received an
Invitation to Bid Packet and posted on the County's website, www.calhouncotx.org, under Bid Notices
and Results, Bid Notices 2022. No addendum can be sent out until Commissioners Court has approved
the addendum.
Assignment
The successful bidder shall not sell, assign, transfer or convey any Contract resulting from this bid, in
whole or in part, without the prior written consent of the Calhoun County Commissioners Court.
Audit
Bidder shall permit the DETENTION FACILITY, their representative and/or the County Auditor's office
to read, review, audit, and copy all records pertaining to this bid at no additional charge.
Page 5 of 11
The DETENTION FACILITY, their representative and/or the County's Auditor's office may audit the Cost
plus Percentage basis at anytime and the successful bidder shall provide the documentation necessary
for this audit at no additional charge.
Award of Bid
Calhoun County reserves the right to reject any or all bids, including without limitation the rights to
reject any or all nonconforming, nonresponsive, unbalance or conditional bids and to reject the bid of
any bidder if the County believes that it would not be in the best interest of the DETENTION FACILITY
to make an award to that bidder, whether because the bid is not responsive or the bidder is unqualified
or of doubtful financial ability or fails to meet any other pertinent standard or criteria established by
Calhoun County. Calhoun County reserves the right to waive all informalities not involving price, time
or changes in the bid, waive technicalities, and to negotiate contract terms with the successful bidder.
Calhoun County Commissioners Court shall be the solejudge in determining which bid shall be the most
advantageous to Calhoun County.
Calhoun County may conduct such investigations as Calhoun County deems necessary to assist in the
evaluation of any BID and to establish the responsibility, qualifications and financial ability of bidder.
Bid Form
The Invitation to Bid Form is included in the Invitation to Bid Packet.
All blanks on the Invitation to Bid Form shall be completed by printing in ink or by typewriter.
Bids by corporations shall be executed in the corporate name by the president or a vice-president (or
other corporate officer accompanied by evidence of authority to sign). The corporate address and
state of incorporation shall be shown below the signature.
Bids by partnerships shall be executed in the partnership name and signed by a partner, whose title
shall appear under the signature and the official address of the partnership shall be shown below the
signature.
All names shall be typed or printed in ink below the signature.
The Addendum, if any, shall be acknowledged on the Invitation to Bid Form.
Evidence of authority to conduct business as an out-of-state corporation in Texas shall be provided.
State license number, if any, shall also be shown.
Bidders / Bids
All bidders and the bid each bidder submits shall comply with all Federal, State, County and local laws
governing or covering this type of service.
Page 6 of 11
Certificate of Interested Parties (Form 1295)
Calhoun County Commissioners Court WILL NOT consider for action any bid with a business entity
unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the
provision of the law under which the business entity is exempt.
Certificate of Liability Insurance
A copy of proof that the bidder has Liability Insurance shall be submitted with the bidder's bid.
Once the bid is awarded and before commencing work, the successful bidder shall be required, at their
own expense, to furnish the Calhoun County Auditor within ten (10) days of notification of award with
a certificate(s) of liability insurance (Form ACORD 25 or equivalent) showing, at least, the minimum
required insurance coverage as stated in the Calhoun County General Conditions.
If successful bidder at any time neglects, refuses to provide, or cancels the insurance required, Calhoun
County shall have the right to terminate the bid and Contract or pursue any remedy available by law.
Insurance coverage requirements in the bid and contract will in no way be construed as limiting the
scope of indemnification.
Conflict of Interest
No official, employee, or agent of Calhoun County shall have financial interest, direct or indirect, in this
bid except on behalf of Calhoun County as an official, employee, or agent. Any willful violation of this
section shall constitute malfeasance in office, and any official, employee, or agent guilty thereof shall
be subject to disciplinary action under applicable laws, statutes and codes of the State of Texas. Any
violation of this section, with the knowledge, expressed or implied of the company, corporation, firm,
partnership, or individual contracting with Calhoun County shall render the bid voidable bythe Calhoun
County Commissioners Court.
Contract
This request for bid and submitted documents, when properly accepted by Calhoun County, shall
constitute a Contract equally binding between the successful bidder and Calhoun County. No different
or additional terms will become a part of this bid and contract with the exception of an Addendum or
Amendment approved by Calhoun County Commissioners Court.
Disclosures of Fees and/or Charges
No other fees, taxes and/or charges shall be billed to the DETENTION FACILITY unless noted as an
exception to this bid. If exceptions are made to this bid, they shall be listed at the end as an attachment.
Exceptions may void the bid.
Equal Employment Opportunity
Bidder shall ensure that no discrimination will occur against employees and applicants for employment
because of their ethnic background, gender, age, religious practice, familial status, disability, or limited
English language proficiency.
Page 7 of 11
General Conditions
The Calhoun County's General Conditions (Calhoun County, Texas — General Conditions) are a part of
the Bid Specifications.
Governing Law
The bid shall be governed and construed according to the laws of the State of Texas.
For any disputes, Calhoun County, Texas shall be the County of venue for any suit involving any dispute
that may arise under this bid and contract. The bid and contract is performable in Calhoun County,
Texas.
Minimum Standards for Responsible Prospective Bidders
A prospective bidder shall affirmatively demonstrate their responsibility. A prospective bidder shall
meet the following requirements:
• Have adequate financial resources, or the ability to obtain such resources as required
• Be able to comply with the required or proposed delivery schedule
• Have a satisfactory record of performance
• Have a satisfactory record of integrity and ethics
• Be otherwise qualified and eligible to receive the award
Calhoun County may request representation and other information sufficient to determine bidder's
ability to meet these requirements listed above.
Notices
Any notice required to be given underthe provisions of this BID shall be in writing and shall be delivered
in person or sent by registered or certified mail, return receipt requested to the parties at the following
addresses:
DETENTION FACILITY: BIDDER:
Calhoun County
Attn: Calhoun County Judge
Richard H. Meyer
211 South Ann Street, Suite 301
Port Lavaca, Texas 77979
Telephone: 3 61-5 5 3 -4600
Fax: 361-553-4444
With a copy of any notices to each of the three (3) below addresses:
1. Calhoun County Adult Detention Center
Attn: Rachel Martinez, Jail Administrator
302 West Live Oak Street
Port Lavaca, Texas 77979
Page 8 of 11
2. Calhoun County Sheriff
Attn: Bobbie Vickery
211 South Ann Street, Suite 105
Port Lavaca, Texas 77979
3. Calhoun County Auditor
202 South Ann Street, Suite B
Port Lavaca, Texas 77979
Either party may designate a different address by giving the other party written notice.
Performance of Bid / Contract
Calhoun County reserves the right to enforce the performance of this bid and contract in any manner
prescribed by law or deemed to be in the best interest of the County and the Inmates in the DETENTION
FACILITY in the event of breach or default of award.
Public Information Act
All governmental information is presumed to be available to the public. Certain exceptions may apply
to the disclosure of the information. Governmental bodies shall promptly release requested
information that is not confidential by law, either constitutional, statutory, or by judicial decision, or
information for which an exception to disclosure has not been sought. Bidder waives any obligations
to the release to the public of any documents submitted in accordance with the bid.
Sales Tax
Calhoun County is by statute exempt from State, City and County Sales Tax and Federal Excise Taxes on
items provided for use by Calhoun County; therefore the bid shall not include these taxes.
Signing of Contract
Once the award of the bid is approved by Commissioners Court, the Calhoun County Auditor's Office
shall issue a Notice of Award and the required number of unsigned counterparts of the Contract to the
successful bidder for proper signatures. Within ten days thereafter the successful bidder shall sign and
deliver the required number of counterparts of the Contract to Calhoun County.
Submittal of Confidential Material
Any material that is to be considered as confidential in nature shall be clearly marked as such by the
BIDDER and will be treated as confidential by Calhoun County as allowed by the Local Government
Code.
SUCCESSFUL BIDDER
Successful bidder shall defend, indemnify and hold Calhoun County and all its officers, agents and
employees harmless from all suits, actions or other claims of any character, name and description
brought forth for or on account of injuries or damages received or sustained by any person, persons,
or property on account of any direct or indirectly negligent act or fault of the successful bidder or of
Page 9 of 11
any agent, employee, subcontractor or supplier in the execution of, or performance under, any
Contract which may result from the award of the bid.
Successful bidder shall pay any judgement with cost which may be obtained against Calhoun County
growing out of such injury or damages.
Successful bidder shall procure and maintain, with respect to the subject matter of this bid and
Contract, appropriate insurance coverage including, as a minimum, general liability and property
damage, workers' compensation and employer's liability insurance with adequate limits to cover
bidder's liability as may arise directly or indirectly from work performed under terms of this bid and
Contract. Certification of such coverage shall name Calhoun County as an additional insured and be
provided to the County upon request.
Term and Termination
The term of the bid shall be for a one (1) year period beginning on January 1, 2022 and ending on
December 31, 2021 and continue in full force and effect for the one (1) year period unless terminated
in accordance with the terms of this bid.
Before the end of the initial bid and contract term, the bid and contract has the option to renew yearly
(one year terms) if agreeable with both the successful bidder and Calhoun County. Each yearly renewal
must be approved by Commissioners Court prior to the end date of the contract.
The bid and contract may be terminated by either party at any time for any reason upon giving sixty
(60) days written notice to the other party of such termination. The successful bidder shall state therein
the reasons for such cancellation. Prior written notice shall be delivered in person or sent by registered
or certified mail, return receipt requested, proper postage paid and properly addressed to: 1) Calhoun
County Adult Detention Center, Attn: Rachel Martinez, Jail Administrator, 302 West Live Oak Street,
Port Lavaca, Texas 77979; 2) Calhoun County Sheriff, Attn: Bobbie Vickery, 211 South Ann Street, Suite
105, Port Lavaca, Texas 77979; 3) Calhoun County Judge, Attn: Richard H. Meyer, Calhoun County
Courthouse, 211 South Ann Street, Suite 301, Port Lavaca, Texas 77979; and 4) Calhoun County Auditor,
202 South Ann Street, Suite B, Port Lavaca, Texas 77979.
Either party has immediate termination rights for cause.
Venue
The bid will be governed and construed according to the laws of the State of Texas. All disputes shall
be held in Calhoun County, Texas. This bid is performable in Calhoun County, Texas.
Intentionally Left Blank
Page 10 of 11
IT IS UNDERSTOOD THAT the Commissioners Court of Calhoun County, Texas reserves the right to waive
any formality or irregularity, accept or reject any and/or all bids, to accept the bid deemed most
advantageous to and in the best interest of Calhoun County. The award of the bid shall be made to the
responsible bidder, whose bid is determined to be the most beneficial to Calhoun County and Calhoun
County Inmates, taking into consideration the relative importance of price and other factors set forth
in the Invitation to Bid.
BIDS SHALL include the Invitation to Bid Form, attachments, if applicable, and all Required Forms. Any
interlineations, alterations, or erasures made before receiving time shall be initialed by the signer of
the bid, guaranteeing authenticity. The Invitation to Bid Form and all Required Forms shall be manually
signed in ink by a person having the authority to bind the bidder in a Contract and placed in a SEALED
envelope. The outside of the SEALED envelope shall clearly be marked with the bid number and name.
LATE BIDS will be considered void and unacceptable. Calhoun County is not responsible for delivery of
your bid to the office of the County Judge or delivery to the wrong office. If you choose to send your
bid by postal delivery or other delivery service, it is recommended that you call the County Judge's
office at 361-553-4600 to verify receipt of your bid prior to the bid due date and time. The cell phone
in the County Judge's office or cell phone of the County Auditor's Representative is the official clock
that will be used in determining the time the bid is received and the time the bids will be opened.
BIDS will be received and publicly acknowledged at the location, date and time stated in these
specifications. Bidders, their representatives and interested persons may be present at the bid
opening. Bids will be reviewed bythe DETENTION FACILITY and once completed, their recommendation
will be presented to Commissioners Court for the award. After the award, the awarded information
will be available on the County's website (www.calhouncotx.org, under Bid Notices and Results, Results
2022) or by contacting Peggy Hall in the Auditor's office at 361-553-4610 or
peggy.hall@calhouncotx.org.
Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not
discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion,
age or handicapped status in employment or the provision of services. Section 3 Residents, Minority
Business Enterprises, Small Business Enterprises, Women Business Enterprises, and Labor Surplus Area
Firms are encouraged to submit bids.
Page 11 of 11
CALHOUN COUNTY, TEXAS
GENERAL CONDITIONS
General Conditions apply to all advertised Invitations to Bid (hereinafter called Bid), Request
for Proposals (hereinafter called RFP), Request for Qualifications (hereinafter called RFQ),
Contracts/Agreements/Leases (hereinafter called Contract); however these may be
superseded in whole or in part by the scope, special requirements, specifications or special
sections of Texas Government Code and/or Texas Local Government Code.
Governing Law:
Bidder/Vendor is advised that the Bid, RFP, RFQ, and/or Contract shall be fully governed by the
laws of the State of Texas and that Calhoun County may request and rely on advice, decisions
and opinions of the Attorney General of Texas and the County Attorney concerning any portion
of the Bid, RFP, RFQ and/or Contract.
All parties agree that the venue for any litigation arising from this Bid, RFP, RFQ, and/or Contract
shall be held in Port Lavaca, Calhoun County, Texas.
Completion of Bid, RFP, RFQ, and/or Contract Forms:
Once the Bid, RFP, RFQ, and/or Contract is released for bidding, Calhoun County will not answer
any questions except through an addendum that has been approved by Calhoun County
Commissioners Court or at a mandatory pre -bid meeting.
Complete, sign, and return to the Calhoun County Judge's Office the required number of Bid
forms, RFP forms, RFQ forms, and/or Contracts, and any other required information by the day
and time the Bid, RFP, RFQ, and/or Contract is due.
The Bid, RFP, RFQ, and/or Contract must be signed and dated by an officer, employee or agent
who is duly authorized to execute this Bid, RFP, RFQ, and/or Contract, and affirms that this
company, corporation, firm, partnership or individual has not prepared this Bid, RFP, RFQ and/or
Contract in collusion with any other bidder/vendor orany official or employee of Calhoun County,
and that the contents of this Bid, RFP, RFQ and/or Contract as to prices, terms or conditions of
said Bid, RFP, RFQ and/or Contract have not been communicated by the individual signing nor
by any employee or agent to any other person engaged in this type of business or to any official
or employee of Calhoun County prior to the official opening of this Bid, RFP, RFQ and/or
Contract.
The use of liquid paper or white out is not acceptable and may result in the disqualification of the
bidder's/vendor's Bid, RFP, RFQ, and/or Contract. If an error is made, the bidder/vendor must
draw a line through the error and initial each change. All responses typed or handwritten in ink
must be clear and legible.
Page 1 of 13
Submission of Sealed Bid, RFP, RFQ, and/or Contract:
All Bids, RFPs, RFQs, and/or Contracts must be delivered to the County Judge's Office in a SEALED
envelope. When submitting a SEALED Bid, RFP, RFQ, and/or Contract the envelope must be taped
and/or glued closed in order for it to be accepted as a SEALED Bid, RFP, RFQ and/or Contract.
The bidder/vendor must submit the original and required number of copies of their completed
Bid, RFP, RFQ, and/or Contract and any additional required information/forms in a SEALED
envelope to the Calhoun County Judge's Office, Calhoun County Courthouse, 211 South Ann
Street, V Floor, Suite 301, Port Lavaca, Texas. The Bid, RFP, RFQ and/or Contract will specify
the date and time due.
The cell phone in the County Judge's office or the cell phone of the County Auditor's
Representative is the official clock that will be used in determining the time the Bid, RFP, RFQ
and/or Contract is received and the time the Bid, RFP, RFQ and/or Contract will be opened. A
late delivery with an early postmark or delivery of the Bid, RFP, RFQ and/or Contract to the wrong
office will not suffice. The door to the County Judge's office will be closed once the due date
and time has been reached and no other bids will be accepted.
Calhoun County will not be responsible for the delivery of your Bid, RFP, RFQ and/or Contract to
the office of the Calhoun County Judge. Calhoun County is not responsible for late deliveries due
to postal mail or other mail delivery services delays. Calhoun County is not responsible for the
delivery of the Bid, RFP, RFQ and/or Contract to the wrong office. Calhoun County does not
accept faxed or emailed Bids, RFPs, RFQs, and/or Contracts. If the bidder/vendor would like to
confirm the delivery of their Bid, RFP, RFQ and/or Contract, the bidder/vendor may call the
Calhoun County Judge's office at 361-553-4600. Late Bids, RFPs, RFQs, and/or Contracts will not
be accepted. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be opened
and shall be considered void and unacceptable.
Bids, RFPs, RFQs, and/or Contracts must be submitted in a SEALED 9 x 12 or larger envelope,
addressed as follows: Richard H. Meyer, County Judge, Calhoun County Courthouse, 211 S. Ann
St., Suite 301, Port Lavaca, TX 77979.
The outside of the SEALED envelope must be clearly marked: SEALED BID (RFP, RFQ or Contract)
and the name of the Bid, RFP, RFQ or Contract.
If the Bid, RFP, RFQ and/or Contract is sent by UPS, FeclEx or other delivery service, the outside
of this envelope must be clearly marked: SEALED Bid (RFP, RFQ or Contract) and the name of the
Bid, RFP, RFQ or Contract.
Withdrawal of Bid, RFP, RFQ, and/or Contract:
A bidder/vendor may withdraw their Bid, RFP, RFQ and/or Contract before Calhoun County's
acceptance of the Bid, RFP, RFQ and/or Contract without prejudice to the bidder/vendor, by
submitting a written request for its withdrawal to the Calhoun County Judge and mail or hand
deliver to the address the Bid, RFP, RFQ and/or Contract was submitted to.
A Bid, RFP, RFQ and/or Contract that was opened are not subject to amendment, alteration, or
change for the purpose of correcting an error in the Bid, RFP, RFQ and/or Contract price. Bids,
Page 2 of 13
RFPs, RFQs, and/or Contracts containing an error may be offered "as is" or withdrawn by the
bidder/vendor in accordance with applicable State Laws.
Opening and Award of Bid, RFP, RFQ, and/or Contract:
Bidders/vendors are invited to be present at the opening and awarding of the Bid, RFP, RFQ
and/or Contract.
Governing Forms:
In the event of any conflict between the terms and provisions of these conditions, the Bid, RFP
or RFQ specifications or contract, if applicable, shall govern. In the event of any conflict of
interpretation of any part of this overall document, Calhoun County's interpretation shall govern.
Addendums:
When specifications are revised, the Calhoun County Auditor's Office will send each
bidder/vendor that received a Bid, RFP, RFQ and/or Contract packet the addendum once it has
been approved by Calhoun County Commissioners Court. No addendum can be sent out until
Calhoun County Commissioners Court has approved the addendum.
Indemnification/Hold Harmless:
The successful bidder/vendor shall defend, indemnify and hold Calhoun County and its officials,
agents, and employees harmless from all suits, actions, or for personal injury, death and/or
property damage arising from any cause whatsoever, resulting directly or indirectly from
bidder's/vendor's performance. Bidder/vendor shall procure and maintain, with respect to the
subject matter of this Bid, RFP, RFQ, and/or Contract, appropriate insurance coverage including,
as a minimum, general liability and property damage, workers' compensation, employer's liability
and auto insurance with adequate limits to cover bidder's/vendor's liability as may arise directly
or indirectly from work performed under terms of this Bid, RFP, RFQ and/or Contract.
Certification of such coverage shall name, by policy endorsement, Calhoun County as an
additional insured and be provided to Calhoun County upon request.
Waiver of Subrogation:
Bidder/vendor and bidder's/vendor's insurance carrier shall waive any and all rights whatsoever
with regard to subrogation against Calhoun County and its respective officials, employees, and
insurers as an indirect party to any suit arising out of personal or property damages resulting
from bidder's/vendor's performance under this Bid, RFP, RFQ and/or Contract. Insurers and all
policies of insurance provided shall contain a provision and/or endorsement stating that the
insurance carriers and underwriters waive all rights of subrogation in favor of Calhoun County
and its respective officials, employees, and insurers.
Bonds:
If the Bid, or RFP, requires submission of bid or proposal guarantee and performance bond, there
will be a separate page explaining those requirements. Bids or RFPs submitted without the
required bid bond or cashier's checks are not acceptable.
Taxes:
Calhoun County is exempt from all sales tax (state, city and county sales tax) and federal excise
taxes. Tax exempt forms will be furnished upon request to the Calhoun County Auditor's Office.
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Pricing:
Prices for all products/goods, services, and/or contracts shall be firm for the duration of the Bid,
RFP, and/or Contract and shall be stated on the Bid, RFP, and/or Contract form. Prices shall be
all inclusive. All prices must be written in ink or typewritten and must be legible.
Pricing on all transportation, freight, and other charges are to be prepaid by the bidder/vendor
and included in the Bid, RFP, and/or Contract prices. If there are any additional charges of any
kind, other than those mentioned above, specified or unspecified, bidder/vendor must indicate
the items required and their costs or forfeit the right to payment for such items. Additional
charges added to the Bid, RFP, and/or Contract prices may void the Bid, RFP, and/or Contract.
Where unit pricing and extended pricing differ, unit pricing prevails.
Inspections:
Calhoun County reserves the right to inspect any products/goods or service location for
compliance with specifications and requirements and needs of the using department before
accepting them.
When applicable, Calhoun County reserves the right to enter upon any County leased premises
at any time to inspect said premises.
Testing:
Calhoun County reserves the right to test equipment, supplies, materials, and products/goods
bid, proposed, and/or agreed upon for quality, compliance with specifications and abilityto meet
the needs of the user. Should the equipment, supplies, materials, products/goods and/or
services fail to meet requirements and/or be unavailable for evaluation, the Bid, RFP, and/or
Contract is subject to rejection.
Material Safety Data Sheets:
Under the "Hazardous Communications Act", commonly known as the "Texas Right To Know
Act", a bidder/vendor must provide to Calhoun County with each delivery, material safety data
sheets which are applicable to hazardous substances defined in the Act. Failure of the
bidder/vendor to furnish this documentation will because to reject any Bid, RFP, and/or Contract
applying thereto.
Awards:
Calhoun County reserves the right to award this Bid, RFP, RFQ, and/or Contract on the basis of
lowest and/or best Bid, RFP, RFQ, and/or Contract that met specifications in accordance with the
laws of the State of Texas, to waive any formality or irregularity, to make awards to more than
one bidder/vendor, to reject any or all Bids, RFPs, RFQs, and/or Contracts and to be the sole judge
in determining which Bid, RFP, RFQ, and/or Contract will be most advantageous to Calhoun
County.
Calhoun County will evaluate and may award a Bid, RFP, RFQ, and/or Contract based on lowest
and/or best Bid, RFP, RFQ and/or Contract meeting specifications. "Lowest and/or best Bid, RFP,
RFQ, and/or Contract' means a bid or offer providing the best value considering associated direct
Page 4 of 13
and indirect costs, including transport, maintenance, reliability, life cycle, warranties, the
county's past experience with the bidder/vendor and customer service after a sale.
Calhoun County reserves the right to accept and/or reject any/all of the options Bid, any/all of
the RFPs, any/all of the RFQs, and/orany/all of the Contracts as it deems to be in the best interest
of the County. An award is final only upon formal execution by Calhoun County Commissioners
Court.
Per Local Government Code, Sec. 262.027, Calhoun County reserves the right to reject all Bids,
RFPs, RFQs, and/or Contracts and to go out for new Bids, RFPs, RFQs, and/or Contracts.
In the event of tie Bids, RFPs, RFQs, and/or Contracts, the winning Bid, RFP, RFQ, and/or Contract
is determined per the Texas Local Governmental Code 262.027(b).
Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does
not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender
identity, religion, age or handicapped status in employment or the provision of services. Section
3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business
Enterprises, and labor surplus area firms are encouraged to submit Bids, RFPs, RFQs, and/or
Contracts.
Assignment:
The successful bidder/vendor may not assign, sell, sublease or otherwise transfer the Bid, RFP,
RFQ and/or Contract without first obtaining the written approval of Calhoun County
Commissioners Court.
A change in ownership or management shall cancel the Bid, RFP, RFQ and/or Contract unless a
mutual agreement is reached with the new owner or manager to continue the Bid, RFP, RFQ
and/or Contract under the awarded provisions and approved by Calhoun County Commissioners
Court.
Term of the Bid, RFP, RFQ, and/or Contract:
If the Bid, RFP, RFQ, and/or Contract is intended to cover a specific time period, said time will be
given in the specifications, instructions, and/or contracts.
Obligation of the Bid, RFP, RFQ, and/or Contract:
Bids, RFPs, RFQs, and/or Contracts are awarded only upon formal execution by Calhoun County
Commissioners Court. If a contract is required, the Calhoun County Judge or other person
authorized by Calhoun County Commissioners Court must sign the contract before it becomes
binding on Calhoun County. No person is authorized to sign contracts until authorized by Calhoun
County Commissioners Court. Calhoun County is not responsible for any contract signed without
Commissioners Court approval.
Delivery:
All items shall be shipped F.O.B. inside (or site location) delivery unless otherwise stated in the
specifications. Default in promised delivery (without accepted reasons) or failure to meet
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specifications, authorizes Calhoun County to purchase supplies from the next lowest
bidder/vendor that met specifications.
Resections:
Articles not in accordance with samples and specifications must be removed by the
bidder/vendor at the bidder's/vendor's expense.
All disputes concerning quality of equipment, supplies, materials, products/goods, and/or
services delivered under this Bid, RFP, RFC, and/or contract will be determined by Calhoun
County Commissioners Court or their designated representative.
Termination:
Calhoun County reserves the right to terminate the Bid, RFP, RFQ, and/or Contract for default if
the bidder/vendor breaches any of the terms therein, including warranties of bidder/vendor or
if the bidder/vendor becomes insolvent or commits acts of bankruptcy. Such right of termination
is in addition to and not in lieu of any other remedies, which Calhoun County may have in law or
equity.
Default may be construed as, but not limited to, failure to deliver the proper products/goods
and/or services within the proper amount of time, and/or to properly perform any and all
services required to Calhoun County's satisfaction and/or to meet all other obligations and
requirements.
Bids, RFPs, RFQs, and/or Contracts may be terminated without cause upon thirty (30) days
written notice to either party unless otherwise specified. The bidder/vendor or Calhoun County
must state therein the reasons for such cancellation. Calhoun County reserves the right to award
cancelled Bid, RFP, RFQ, and/or Contract to the next lowest and best bidder/vendor that met
specifications and is deemed to be in the best interest of Calhoun County.
Delinquent Property Taxes:
Calhoun County reserves the right to reject any Bid, RFP, RFQ and/or Contract submitted by a
bidder/vendor owing delinquent property taxes to Calhoun County, Texas.
If the bidder/vendor subsequently becomes delinquent in the payment of Calhoun County taxes
this may be grounds for cancellation of the Bid, RFP, RFQ, and/or Contract. Despite anything to
the contrary, if the bidder/vendor is delinquent in payment of Calhoun County taxes at the time
of invoicing, bidder/vendor assigns any payments to be made under this Bid, RFP, RFQ and/or
Contract to the Calhoun County Tax Assessor Collector for the payment of delinquent taxes.
Certificate of Interested Parties — Form 1295
Section 2252.908 was added to the Government Code by the 84th Texas Legislature through
adoption of House Bill 1295.
Senate Bill 255 adopted by the 85th Legislature Regular Session amended the law effective for
contracts entered into or amended on or after January 1, 2018.
Page 6 of 13
Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly
traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract
with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a
gas utility as defined by Section 121.001 of the Utilities Code.
Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury
by an authorized representative of the business entity.
The Texas Ethics Commission promulgated rules to implement the law and established an online
portal: https://www.ethics.state.tx.us/whatsnew/elf_info_forml295.htm.
The law states that a County may not enter into a contract with a business entity unless a
Certificate of Interested Parties (Form 1295) has been completed and provided to the County at
the time the contract is considered for action by Commissioners Court.
The term "business entity" includes a sole proprietorship, partnership or corporation (whether
for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an
existing contract (Bids, RFPs, and/or RFQs also require Form 1295).
The law does not apply to a Bid, RFP, RFQ, and/or Contract between the County and another
governmental entity or state agency.
The county is required to file Form 1295 with the state within thirty (30) days of approving a
contract, and/or awarding a Bid, RFP, RFQ, and/or Contract with a business entity. Governmental
transparency is the objective of the law.
A business entity must generate Form 1295 online. A business entity must use the application at
the Texas Ethics Commission website to enter the required information on Form 1295 and print
a copy of the completed form, which will include a certification of filing that will contain a unique
certification number and date filed in the box marked "Office Use Only" located at the top right
hand corner of the form.
An authorized agent of the business entity must sign and complete the bottom portion of the
printed copy of the form affirming under the penalty of perjury that the completed form is true
and correct.
Calhoun County Commissioners Court will not consider for action any Bid, RFP, RFQ and/or
Contract with a business entity unless it is accompanied by a completed and signed Form 1295 or
a signed statement declaring the provision of the law under which the business entity is exempt.
No later than thirty (30) days after Calhoun County Commissioners Court approves a contract, or
awards a Bid, RFP, and/or RFQ with a business entity, the Calhoun County Clerk will file
acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. The Texas
Ethics Commission will post the completed Form 1295 to its website within seven (7) business
days after Calhoun County acknowledges receipt of the form.
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Debarment:
Bidder/vendor certifies that at the time of submission of its (their) Bid, RFP, RFC, and/or Contract,
the bidder/vendor, as well as the bidder's/vendor's principals, are not on the federal
government's list of suspended, ineligible or debarred bidders/vendors and that the
bidder/vendor and its (their) principals have not been placed on this list between the time of the
Bid, RFP, RFQ and/or Contract submission and the time of execution of the Bid, RFP, RFC, and/or
Contract.
A print out of the search results, including principals, if any, from the System for Award
Management (www.SAM.gov) that includes the record date must be included with the
bidder's/vendor's Bid, RFP, RFQ, and/or Contract.
If bidder/vendor or its (their) principals are placed on this list during the term of the Bid, RFP,
RFQ, and/or Contract, the bidder/vendor shall notify the Calhoun County Auditor. False
certification or failure to notify may result in termination of the Bid, RFP, RFQ, and/or Contract
for default.
Invoices and Payments:
All invoices are subject to approval by the Calhoun County Auditor's Office.
Invoices shall be billed to Calhoun County to the attention of the County Department that the
invoice pertains to and, if applicable, have all necessary backup information needed.
Invoices shall be itemized (detailed) and free of sales tax (state, city and county sales tax) and
federal excise taxes, if applicable.
Invoices that are not billed to Calhoun County to the attention of the County Department that
the invoice pertains to, not itemized (detailed) and/or free of sales tax (state, city and county
sales tax) and federal excise taxes, if applicable, may be returned to the bidder/vendor for
corrections. Calhoun County will not incur any fees and/or charges for this request and/or delay
in payment of the invoice(s) that was originally submitted incorrectly.
Approval of payment of all invoices will be made once the purchase order and invoice(s) are
properly and timely submitted to the Calhoun County Treasurer's Office by the appropriate
County department. Each County department is responsible for submitting their purchase orders
for payment to the Calhoun County Treasurer's Office by the deadline time and date set forth by
the Treasurer's office. No payment can be made or mailed out until approved by Calhoun County
Commissioners Court. Purchase order due dates/times and Commissioners Court dates/times
are subject to change.
Calhoun County's obligation is payable only and solely from funds available for the purpose of
this purchase. Lack of funds shall render the order null and void to the extent funds are not
available and any delivered but unpaid goods will be returned to the seller by the county.
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Gratuities:
Calhoun County may, by written notice to the bidder/vendor, cancel any order and/or service
without liability, if it is determined by Calhoun County that gratuities, in the form of
entertainment, gifts, or otherwise were offered or given by the bidder/vendor, or any agent or
representative of the bidder/vendor to any official, employee, or agent of Calhoun County with
a view toward securing a Bid, RFP, RFQ, Contract, order, and/or service.
In the event a Bid, RFP, RFQ, Contract, order, and/or service is canceled by Calhoun County
pursuant to this provision, the County shall be entitled, in addition to any other rights and
remedies, to recover or withhold the amount of the cost incurred by bidder/vendor in providing
such gratuities.
Warranty Product:
Bidder/vendor warrants that products/goods sold to and/or services provided to Calhoun County
shall conform to the highest commercial and/or professional standards in the industry and laws
established by the U.S. Department of Labor, U.S. Department of Homeland Security,
Occupational Safety and Health Administration and OSHA Act of 1970.
In the event products/goods sold and/or services provided do not conform to OSHA Standards,
where applicable, Calhoun County shall return the product/item for correction or replacement
at the bidder's/vendor's expense. In the event that services do not conform to OSHA Standards,
Calhoun County may immediately stop the services and seek reimbursement for said services at
the bidder's/vendor's expense.
In the event the bidder/vendor fails to make the appropriate correction within a reasonable time,
correction made by Calhoun County shall be at the bidder's/vendor's expense.
Bidder/vendor shall not limit or exclude any implied warranties and any attempt to do so shall
render this Bid, RFP, RFC, and/or Contract voidable at the option of Calhoun County.
Bidder/vendor warrants that the products/goods and/or services furnished and/or performed
will conform to the specifications, scope of work, general conditions, drawings, and/or
descriptions listed in the Bid, RFP, RFC, and/or Contract and to the sample(s) furnished by
bidder/vendor, if any.
In the event of a conflict between the specifications, scope of work, general conditions, drawings,
and/or descriptions, the specifications shall govern.
All products/goods must be new, in first class condition, unless otherwise specified. The design,
strength and quality of materials must conform to the highest standards of manufacturing
practice.
Products/goods, and/or services supplied and/or performed under this Bid, RFP, RFQ, and/or
Contract shall be subject to Calhoun County's approval.
Successful bidder/vendor shall warrant that all products/goods and/or services shall conform to
the proposed specifications and/or all warranties as stated in the Uniform Commercial Code and
Page 9 of 13
be free from all defects in material, workmanship and title. Any products/goods and are services
found defective or not meeting specifications shall be picked up and promptly replaced or
corrected to Calhoun County's satisfaction by the successful bidder/vendor at no expense to
Calhoun County.
Cancellation:
Calhoun County shall have the right to cancel for default all or any part of the undelivered portion
of an order and/or services if bidder/vendor breaches any of the terms hereof including
warranties of bidder/vendor, or if the bidder/vendor becomes insolvent or files for protection
under the bankruptcy laws. Such rights of cancellation are in addition to and not in lieu of any
other remedies, which Calhoun County may have in law or equity. Calhoun County shall not incur
any fees and/or charges related to the cancellation. The bidder/vendor shall be responsible for
any fees and/or charges that are related to the cancellation.
Force Maieure:
Force Majeure means a delay encountered by a party in the performance of its obligations under
this Bid, RFP, RFQ and/or Contract, which is caused by an event beyond the reasonable control
of that party. Without limiting the generality of the foregoing, "Force Majeure" shall include but
not be restricted to the following types of events: acts of God or public enemy; acts of
governmental or regulatory authorities; fires, floods, epidemics or serious accidents; unusually
severe weather conditions; strikes, lockouts, or other labor disputes; and defaults by
subcontractors.
In the event of a Force Majeure, the affected party shall not be deemed to have violated its
obligations under this Bid, RFP, RFQ, and/or Contract, and the time for performance of any
obligations of that party shall be extended by a period of time necessary to overcome the effects
of the Force Majeure, provided that the foregoing shall not prevent this Bid, RFP, RFQ and/or
Contract from terminating in accordance with the termination provisions.
If any event constituting a Force Majeure occurs, the affected party shall notify the other parties
in writing, within twenty-four (24) hours, and disclose the estimated length of delay, and cause
of the delay.
Waiver:
No claim or right arising out of a breach of any Bid, RFP, RFC, and/or Contract can be discharged
in whole or in part by a waiver or renunciation of the claim or right unless the waiver or
renunciation is supported by consideration and is in writing signed by the aggrieved party.
Applicable Law:
To the extent it is applicable, this Bid, RFP, RFQ and/or Contract shall be governed by the Uniform
Commercial Code. Whenever the term "Uniform Commercial Code" is used it shall be construed
as meaning the "Uniform Commercial Code" as adopted in the State of Texas as effective and in
force on the date of this Bid, RFP, RFQ and/or Contract. Otherwise, Texas state and federal law
shall apply.
Page 10 of 13
Prohibition against Personal Interest in Bids, RFPs, RFQs, and/or Contracts:
No official, employee, or agent of Calhoun County shall have financial interest, direct or indirect,
in any Bid, RFP, RFQ, and/or Contract with Calhoun County, or shall be financially interested,
directly or indirectly, in the sale/lease to Calhoun County of any land, materials, supplies, or
service, except on behalf of Calhoun County as an official, employee, or agent. Any willful
violation of this section shall constitute malfeasance in office, and any official, employee, or agent
guilty thereof shall be subject to disciplinary action under applicable laws, statutes and codes of
the State of Texas. Any violation of this section, with the knowledge, expressed or implied of the
company, corporation, firm, partnership, or individual contracting with Calhoun County shall
render the Bid, RFP, RFQ, and/or Contract involved voidable by the Calhoun County
Commissioners Court.
Insurance:
Proof (copy of bidder's/vendor's current insurance) of the below listed insurance may be
required to be returned with the Bid, RFP, RFQ, and/or Contract.
As additional security for Calhoun County and as separate obligations of bidder/vendor not in
conjunction with any other provisions of the Bid, RFP, RFQ, and/or Contract, bidder/vendor
agrees to carry and maintain during the term of the Bid, RFP, RFQ, and/or Contract the minimum
insurance coverages stated below.
Before commencing work, the successful bidder/vendor shall be required, at his own expense, to
furnish the Calhoun County Auditor within ten (10) days of notification of award with a
certificate(s) of liability insurance (Form ACORD 25 or equivalent) showing, at least, the following
minimum insurance coverage to be in force throughout the term of the Bid, RFP, RFQ, and/or
Contract. Higher rates and/or additional coverage may apply depending upon type of Bid, RFP,
RFQ and/or Contract.
General Liability ($100,000/$300,000 or greater)
Workers' Compensation (at Statutory Limits)
Employer's Liability ($1,000,000 or greater)
Auto Insurance ($100,000 BIPP/$300,000 BIPO/$100,000 PD or greater)
Professional Liability Insurance (if applicable)
Farm Liability Insurance (if applicable)
Coverages shall apply on an occurrence basis.
The certificate(s) must reflect, by policy endorsement, that Calhoun County, Texas is an
additional insured on all required policies.
Each certificate of liability insurance (Form ACORD 25 or equivalent) to be furnished by successful
bidder's/vendor's insurance agent shall include, by endorsement to the policy, a statement that
a notice shall be given to the Calhoun County Auditor by certified mail thirty (30) days prior to
cancellation, material change, or non -renewal in coverage.
Calhoun County's receipt of orfailure to object to any insurance certificates or policies submitted
by the bidder/vendor does not release or diminish in any manner the liability or obligations of
Page 11 of 13
the bidder/vendor or constitute a waiver of any of the insurance requirements for the Bid, RFP,
RFQ and/or Contract.
Replacement certificate(s) of liability insurance (Form ACORD 25 or equivalent) evidencing
continuation of such coverage and naming, by policy endorsement, Calhoun County as an
additional insured, shall be furnished to the Calhoun County Auditor's office prior to the
expiration of the current policies.
Should bidder/vendor at any time neglect, refuse to provide, or cancel the insurance required,
Calhoun County shall have the right to terminate the Bid, RFP, RFQ and/or Contract or pursue
any remedy available by law.
The insurance coverage requirements in the Bid, RFP, RFC, and/or contract will in no way be
construed as limiting the scope of indemnification.
OSHA Requirements:
Bidder/vendor must meet all Federal and State OSHA requirements.
The bidder/vendor hereby guarantees to Calhoun County that all materials, supplies, equipment
and/or services listed on the Bid, RFP, RFQ, Contract, Purchase Order or Invoice shall conform to
the requirements, specifications and standards promulgated by the U.S. Department of Labor
under the Occupational Safety and Health Act of 1970, as amended and in force at the date
hereof.
Protest Procedures:
All protests and disputes will be held in Port Lavaca, Calhoun County, Texas.
Any actual or prospective bidder/vendor who believes they are aggrieved in connection with or
pertaining to a Bid, RFP, RFQ, and/or Contract may file a protest. The protest must be delivered
in writing to the Calhoun County Auditor's Office, in person or by certified mail return receipt
requested prior to award. The written protest must include:
Name, mailing address and business phone number of the protesting party;
Appropriate identification of the Bid, RFP, RFQ, and/or Contract being protested;
A precise statement of the reasons for the protest; and
Any documentation or other evidence supporting the protest and any alleged claims.
The Calhoun County Auditor's Office will attempt to resolve the protest, including at the County
Auditor's option, meeting with the protesting party. If the protest is successfully resolved by
mutual agreement, written verification of the resolution, with specifics on each point addressed
in the protest, will be forwarded to Calhoun County Commissioners Court.
If the Calhoun County Auditor's Office is not successful in resolving the protest, the protesting
party may request in writing that the protest be considered by Calhoun County Commissioners
Court. Applicable documentation and other information applying to the protest will be
forwarded to Calhoun County Commissioners Court, who will promptly review such
documentation and information.
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If additional information is required, Calhoun County Commissioners Court will notify the
protesting party to provide such information. The decision of Calhoun County Commissioners
Court will be final.
Public Information Act:
All governmental information is presumed to be available to the public. Certain exceptions may
apply to the disclosure of the information. Bidder/Vendor waives any obligation to the release
to the public of any documents submitted in accordance with the Bid, RFP, RFQ and/or Contract.
Governmental bodies shall promptly release requested information that is not confidential by
law, either constitutional, statutory, or byjudicial decision, or information for which an exception
to disclosure has not been sought.
CALHOUN COUNTY AUDITOR
To request information from Calhoun County, please contact:
Cindy Mueller
Calhoun County Auditor
Calhoun County Courthouse Annex II
202 S Ann St, Suite B
Port Lavaca, TX 77979
Phone: 361-553-4610
Fax: 361-553-4614
Email: cindy.mueller@calhouncotx.org
To request a Bid, RFP, and/or RFQ packet from Calhoun County, or information on how to obtain
a packet, please contact:
Peggy Hall
Assistant Auditor
Calhoun County Courthouse Annex II
202 S Ann St, Suite B
Port Lavaca, TX 77979
Phone: 361-553-4610
Fax: 361-553-4614
Email: peggy.hall@calhouncotx.org
Bids, RFPs, and/or RFQs may also be viewed on Calhoun County'swebsite, www.calhouncotx.org,
under Bid Notices and Results.
Page 13 of 13
#9
NOTICE OF MEETING— 12/29/2021
9. Consider and take necessary action on a GLO Application for Renewal of Coastal Lease
No. CL960002 Keller Bay, in Calhoun County and authorize the County Judge to sign the
application and affidavit. (JB)
RESULT: APPROVED [UNANIMOUS]
MOVER: Joel Behrens, Commissioner Pct 3
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 6 of 13
Joel Behrens
Calhoun County Commissioner, Precinct 3
24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (36I) 893-5346 —Fax (361) 393-5309
Email: icel.behrens(@,calhouncotx.ors
9
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: Agenda Item
Dear Judge Meyer:
Please place the following item on the Commissioner's Court Agenda for December 29, 2021.
• Please Consider and Take Necessary Action on Application for renewal of Coastal Lease No.CL960002
Keller Bay, in Calhoun County with GLO and have Judge Meyer sign the Coastal Lease Renewal
Application and Affidavit.
Sincerely,
Joel Behrens
Commissioner Pct. 3
STATE OF 'TEXAS
HBPAI
y `S. ryry
6
W T
�. n
GENERAL LAND OFFICE
APPLICATION FOR RENEWAL OF COASTAL LEASE
GLO ID: CL960002 Expiration Date: September 30, 2020
Please type or print in the blanks below all applicable information. If information requested is not applicable,
indicate by placing N/A in the blank. ISSUANCE OF THE COASTAL LEASE FOR WHICH YOU HAVE
APPLIED IS CONTINGENT UPON VERIFICATION OF THE INFORMATIONSUBMITTED, PAYMENT OF
APPROPRIATE FEES, AND COMPLLANCE WITHALL APPLICABLE REGULATOR YREQUIREMENTS.
I. Applicant Information (Responsible Party Under Contract):
A. Name: Calhoun County
Mailing Address: 211 South Ann Ste 301
City/State/Zip: Port Lavaca, TX 77979-4249
Telephone: Home:
Work: _(361) 553-4600
Cell Phone: (512) 925-3040
Fax: (361) 553-4444
Email Address: kfinster@calhouncotx.org
B. Please list any changes/corrections to demographic information above in the spaces below if
applicable:
provided
Name:
Mailing Address:
City/State/Zip:
Telephone: Home:
Work:
Celt Phone: (361)-920-2173
Fax:
Email Address:
ouncotx.org
II. Signature plicant(s): Calhoun County
t
By:
Signature
Title
K. cy,ard A. Meycr
1z12-61Iz,
Printed Name
Date I�
Information collected by electronic mail and by web form is subject to the Public (formation Act, Chapter 552, Government Code.
CL960002
dlindley I CuSta C000001
APPereuRenewCL 090114
STATE OF TEXAS
COUNTY OF CALHOUN
COASTAL LEASE RENEWAL AFFIDAVIT
The undersigned being first duly sworn on oath, states as follows:
l . The undersigned is the grantee under Coastal Lease No. CL960002 (the "Cu');
2. The undersigned has applied to the General Land Office (the "GLO") to renew the CL for an additional term;
3. The undersigned has complied with all of the terms of the CL during its term and has complied with all of the
guidelines and rules of the GLO and the School Land Board (the "SLB") applicable to the CL;
4. The undersigned has not made any improvements, additions, or modifications to the Premises, as shown on the
exhibit, attached hereto and incorporated herein by reference, during the term of the CL, without the advance
written consent of the GLO; and
5. The undersigned acknowledges that the SLB and the GLO will rely on the truth of the statements contained
herein in issuing the renewal of the CL. In the event that any of the statements herein prove to be untrue, the
renewal CL shall be subject to immediate termination, which will require that the undersigned remove all
structures from the Premises.
GRANTE Ihoun County
r
By: a
Signature
i a
Printed Name
12-12 zl
Date
ACKNOWLEDGMENT
STATE OF §
COUNTY OF §
This ' ument was acknowle ged`bbeefo a me on the ZG% YZt day of V"� �+'�'� �LJ 20�
by for Calhoun County.
!dA@BELIMASSEL
*1 My Notary ID # 132012524
a Ott*'• EWM May 14, 2023
L\4uurr L�u,1 rrrcJ
Notary Public, State of `a�Z
My commission expires: tJ �I Z3
—SIT
Information collected by electronic mail and by iveb form is subject to the Public Information Act, Chapter 552, Government Code.
CL960002 Cus[omerll): C000000686
dlindley 2 AooRenewCL 090114
TEXAS GENERAL LAND OFFICE
APPLICATION FOR RENEWAL OF COASTAL LEASE
NOTES:
1. The application will be reviewed by the GLO Field Office to verify site conditions. Lessee will be advised
regarding term length, special conditions, and payment amounts. It will then be submitted to the Texas School
Land Board (SLB) for consideration. if approved by SLB, a contract will be prepared and sent to Lessee for
signatures.
2. Lessee is advised that in accordance with the easement agreement, unless renewed on a timely basis, hold -over
occupancy beyond the expiration date of the easement is subject to increased lease payment amounts.
3. Lessee is advised that in accordance with provisions of the easement agreement, if the agreement is not renewed,
all private property and man-made improvements must be removed and the premises returned to pre -easement
conditions within 120 days of the expiration date.
CL960002 CuslomerlD: C000000686
dlindley 3 MaRenewCL 090114
Keller Bay
Tide Level: -1.5' HWM
Water Visibility: 1'
Unvegetated
Submerged
Unvegetated
Submerged
TITLE: Calhoun County / CL960002
COMPANY: Texas General Land Office
DRAWING SCALE: tin : 20ft
Unvegetated
Submerged
MR
Oyster Reef 0%
a
Natural Shoreline Approximate State
Boundary (HWM)
(Rip -rap Located on uplands)
-1'HWM :>:•:.....::.:.:
p•..•..•16ft........
►f6 RiFY✓.;. }5 ft.�; i-h
T.. ............
Approximate State Boundary (HWM) x Concrete
3 Boat Ramp
Bulkhead Elevation: 5'.HWM
HWM
10.166 Acres Tract Part 17
of the William Arnold
Survey, Abstract 2
Upland Elevation: S' H WM
Upland Vegetation: Manicured Lawn
DATE OF INSPECTION: 3/2S/2010
CREATOR: mharding
MODIFIED BY: JZepiin
# Zo
NOTICE OF MEETING—12/29/2021
10. Consider and take necessary action to declare the attached equipment, as
Surplus/Salvage to be used as a trade-in and remove from Waste Management's Fixed
Asset inventory. (VQ
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 7 of 13
Vern Ly
Calhoun County Commissioner, Precinct #2
5812 FM 1090
Port Lavaca, TX 77979
December 20, 2021
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge Meyer:
F�St�[c or rf+
oMrY or cn��
Please place the following item on the next Commissioners' Court Agenda
(361) 552-9656
Fax (361) 553-6664
• Consider and take necessary to declare the attached equipment, as
Surplus/Salvage to be used as a trade in and remove from Waste
Management's Fixed Asset inventory.
Sincer ly,
q
r
,,
Vern Lyssy
Commissioner, Pct. 2
VUIj
12/22/2021
CALHOUN COUNTY
SURPLUS/SALVAGE DECLARATION REQUEST FORM
Department Name: Waste Management
Requested by: Commissioner Vern Lyssy
Inventory Reason for Surplus/Salvage
#11
NOTICE OF MEETING— 12/29/2021
11. Consider and take necessary action to authorize Commissioner Lyssy to trade in a 1993
HYPAC C530-AH, Asset # 22-0267 for a 2014 Bomag BW27RH, serial number
861538231006.(VL)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 8 of 13
Vern Lyssy
Calhoun County Commissioner, Precinct #2
5812 FM 1090
Port Lavaca, TX 77979
December 21, 2021
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge:
(361) 552-9656
Fax (361) 553-6664
Please place the following item on the next Commissioners' Court Agenda
• Consider and take necessary action and allow Vern Lyssy to sign
paperwork to trade in 1993 HYPAC C530-AH, Asset #22-0267; and
• To purchase 2014 Bomag BW27RH SN: 861538231006
Vern Lyssy
Commissioner, Pct. 2
VL/Ij
ANDERSON MACHINERY COMPANY
P.O Box 48o6 P.O Box 662 P.O Box 200380 P.O Box 140916 5309 U.S. Hwy 59 N.
Corpus Christi, TX 78469 Pharr, TX 78577 San Antonio, TX 78220 Austin, TX 78714 Victoria, TX 77905
SALES ORDER & SECURITY AGREEMENT
SOLD TO: Calhoun County Pct. 2
ADDRESS: 5812 FM logo
CITYISTATE: Port Lavaca, Tx 77979
SHIPTO: Calhoun CountyPct.2 barn.
DESCRIPTION PRICE
(1) 2014 Bomag BW27RH serial #86153823loo6 with 2,758 approximate hours.
P.O. 305VL
FREIGHT CHARGES:
TRADE IN / DISCOUNTS: Trade In info found on trade-in tab of this worksheet.
NET SELLING PRICE:
HEAVY EQUIPMENT PROPERTY TAX: 0.2073%
DIESEL EQUIPMENT SURCHARGE: 1.50%
SALES & USE TAX / TAX ID#: 8,25%
3
83,874.00
6,500.00
77,374.00
TOTAL CASH PURCHASE PRICE $ 77,374.00
First payment due by 1z-31-2.oz1: $ 38,687.00
Unpaid balnce due by 1-31.2022: $ 38,687.00
PAYABLE AS FOLLOWS: Due upon receipt of AMCOVT invoice or above mentioned terms.
The Buyer agrees to purchase the above products from Seller at the price set forth above and on the terms stated on the face
and reverse side herto. All payments due or to become due herunder are payable at the offices of ANDERSON MACHINERY
COMPANY - Victoria, Victoria County, Texas. Buyer grants to Seller a security interest in said products in accordance with the
terms and provisions on the reverse side herto. Buyer warrants that the used machinery traded In is completely free of all liens
and encumbrances except as specifically noted herein.
To contact Anderson Machinery Company about this account, call (361) 575-8111. This contract is subject in whole or in part to
Texas law which is enforced by the Consumer Credit Commissioner, 26ol N Lamar Blvd, Austin, Texas 78705-4207. Phone (512)
479-1285 or (800) 538.1579• Contact�he commissioner relative to any inquiries or complaints.
ANDERSON MACHINERY
BUYER: Calhoun County Pct. 2
TITLE: j` (n, L )0ATE: rl,�.-aa� TITLE: DATE:
(Not valid unless signed by an—bffeer'of Anderson Ma� mpany)
ANDERSON MACHINERY COMPANY
P.O Box 4806 P.O Box 662 P.O Box 200380 P.0 Box 140916 5309 U.S. Hwy 59 N.
Corpus Christi, TX 78469 Pharr, TX 78577 San Antonio, TX 78220 Austin, TX 78714 Victoria, TX 77905
SALES ORDER & SECURITY AGREEMENT
SOLD TO: Calhoun County Pct. 2
ADDRESS: 5812 FM 1090
CITY/STATE: Port Lavaca, Tx 77979
SHIP TO: Calhoun County PCt.2 barn.
DESCRIPTION PRICE
(1) 2014 Bomag BW27RH serial #861538231oo6 with 2,758 approximate hours.
P.O. 305VL
FREIGHT CHARGES:
TRADE IN / DISCOUNTS: Trade In info found on trade-in tab of this worksheet.
NET SELLING PRICE:
HEAVY EQUIPMENT PROPERTY TAX: 0.2073%
DIESEL EQUIPMENT SURCHARGE: 1.50%
SALES & USE TAX / TAX ID#: 8,25%
83,874.00
6,5oo.00
77,374.00
TOTAL CASH PURCHASE PRICE # 77 374.00
First payment due by 12-31.2021: $ 38,687.00
Unpaid baince due by 1-31.2022: $ 38,687.00
PAYABLE AS FOLLOWS: Due upon receipt of AMCOVT invoice or above mentioned terms.
The Buyer agrees to purchase the above products from Seller at the price set forth above and on the terms stated on the face
and reverse side herto. All payments due orto become due herunder are payable atthe offices of ANDERSON MACHINERY
COMPANY -Victoria, Victoria County, Texas. Buyer grants to Seller a security interest in said products in accordance with the
terms and provisions on the reverse side herto. Buyer warrants that the used machinery traded In is completely free of all liens
and encumbrances except as specifically noted herein.
To contact Anderson Machinery Company about this account, call (361) 575-8111. This contract is subject in whole or in part to
Texas law which is enforced by the Consumer Credit Commissioner, 2601 N Lamar Blvd, Austin, Texas 78705-4207. Phone (512)
479-1285 or (800) 538-1579• Contact the. commissioner relative to any inquiries or complaints.
ANDERSON MACHINERY
BUYER: Calhoun County Pct. 2
TITLE: L-�-(n, 1 /BATE: `i,�-dp�'tC TITLE: DATE:
(Not valid unless signed by an erof Anderson MaT chinery Company)
Board® PRICING WORKSHEET FOR STANDARD ANDEBSO
EQUIPMENT PURCHASES
Wi
ooyerarbe Pwah"I.R
Thefollowing detials shall be provided with any BuyBoad purchase order (Fax Purchase Order to (8001211-5454
Prepared By: JOSHUASMITH
BuyBoard Vendor: ANDERSON MACHINERY Vendor Phone: 210-661-2366
[Address P.O. to:] PO BOX 200380 Vendor Fax: 210-661.4971
SAN ANTONIO TX 78220.0380 Vendor Toll Free
Date Prepared 12/20/2021
Government Agency: Calhoun County Pct #2 Gov. Agency
[Ship to:] Anderson Machinery Company [Bill to:]
5309 US Hwy 59 N. Victoria TX 77905
Contacts Name: Gov. Agn. Phone No:
Calhoun County Pct #2
Calhoun County Pct #2
5812 FM 3090 Port Lavaca TX 77979
G. A. Fax No:
Product Description: One (1) USED 2014 Bomag BW27RH, SN: 861538233006, w/ approx 2,758 hrs
I: BuyBoard Contract #597.19 Price List: ITEM 51
Base Price $ 85,585.71
II: Base Bid Options: (Itemize Below)
* Canopy Included * UNIT SOLD AS IS WITH NO WARRANTY
* And all standard equipment Included
*
* *
* *
* *
Subtotal $ Subtotal
$ -
Contract List Price Total
$
III: Subtotal of I + 11 =>
$ 85,585.71
IV: Discount: 2% BuyBoard Contract Price:
$ 83,874.00
V: Non -Base Options (Itemize below) NON -BASE = 0.00%
%
* FOB AMCO Victoria
*
Subtotal $ - Subtotal S -
VI Unpublished Options added to Contract Price (Subtotal of Co. 1 & Col 2) $
VII: Total of IV+VI $ 83,874.00
VIII: Quantity Ordered Units: 1 x "E" $ 83,874.00
Ix: Trade-in or other Credit(s) TRADE IN: 1993 HYPACC530-AH, SN: 109A22201973 w/ approx 2,527 hrs $ (6,500.00)
x: TOTAL PURCHASE PRICE INCLUDING VIII + IX
Contract Effective Dates: 12/1/2019 through 11/30/2022
PRICE GOOD TILL 12-31-21, SUBJECT TO AVAILABILITY
Fax all Purchase Orders to BuyBoard at (800) 211-5454
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1of1
Complete Nos. i - 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:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2021-827195
Anderson Machinery Company
Victoria, TX United States
Date Filed:
2 Name o governmenta en ty or state agency that Is a party to the contract for which the form is
1112912021
being filed.
Date Acknowledged:
Calhoun County
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.
AMCO-VT 123
Equipment rentals or purchases
Nature of interest
A Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
intermediary
Anderson Machinery Company
- Victoria, TX United States
X
5 Check only if there is NO. Interested Party,
6 UNSWORN DECLARATION
My name is \ C:.�' � -`� ,and my date of bulh is —
.`
My address is t
(sheet) (city) (stale) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
z 40State ay of iJU"a+.b' 6
Executed in V 4: County, of
( anth) (year).
Signature of auth" ze agent of contracting b sin s Ity
( decant)
Forms provided by Texas Ethics Commission
#12
NOTICE OF MEETING — 12/29/2021
12. Consider and take necessary action to remove the following equipment from the
Constable, Precinct 4 inventory: Vidac Camera and software (stolen), Copysync printer
(stolen), Motorola XfL 2500 Control Station (returned to VCS), Motorola XTL Radio
(returned to VCS). (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 9 of 13
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Calhoun County, Texas
WASTE DECLARATION REQUEST FORM
Department Name: Calhoun County Constable PCT#4
Requested By: Louis E Warren
Inventory
Number Description Serial No. Reason for Waste Declaration
554-0023
Vidtac camera hardware
Stolen form installers vehicle
554-0021
Motorla xt12500 mobile
high power complete
with all options and
accessories
Returned to vcs for new radio
554-0021
computer/laptop, printer,
charger,antenna and
install
Computer is outdated, printer and
antenna was stolen from installers
vehicle
554-0025
Xts1500 m 1.5 portable
radios/emergency
communication project
68TGWE716,718,71
9,720
Outdated radio unuseable
554-0027
Xt12500 motorola
astrop25 vhf/emergency
communication projrct
518CHF0606
Returned to vcs for new radio
7
✓!
� 6-t/
#13
NOTICE OF MEETING— 12/29/2021
13. Consider and take necessary action to transfer a Copysync Computer/Laptop, charger,
antenna, and software to IT and remove from Constable, Precinct 4 inventory. (RHM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 10 of 13
Calhoun County, Texas
DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM
Requested By: L2 OQ2uti lkxlkl�
Inventory Serial
Number Description No. Transfer From/To Department
5"54 -
#14
NOTICE OF MEETING— 12/29/2021
14. Consider and take necessary action to declare as Waste a Motorola XTS 1500 radio and
remove from Constable, Precinct 4 inventory. (RHM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pct 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
Page 11 of 13
Calhoun County, Texas
WASTE DECLARATION REQUEST FORM
Department Name: Precinct 4 Constable
Requested By: Constable Louis Warren
Inventory
Number Description Serial No. Reason for Waste Declaration
755490275XTS 1500 Portable Radio 68TGWE716, 718, Outdate and unusable
719,720
#15
NOTICE OF MEETING — 12/29/2021
15. 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 12 of 13
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#16
NOTICE OF MEETING — 12/29/2021
16. Approval of bills and payroll. (RHM)
MMC
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pct 1
SECONDER:
Vern Lyssy, Commissioner Pct 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese
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: 10:17 a.m.
Page 13 of 13
December 29, 2021 2021 APPROVAL LIST - 2021 BUDGET
COMMISSIONERS COURT MEETING OF
12/29/21
BALANCE BROUGHT FORWARD FROMAPPROVAL LIST REPORT PAGE 20
$182,059.49
AT&T MOBILITY
EMS ADMIN & AMBULANCE CELL PHONES
A/P
$
377.09
FRONTIER COMMUNICATIONS
LIBRARY PORT LAVACA PHONE SERVICE
A/P
$
323.72
QUILL
AUDITOR - (3) KEYBOARDS (1) MOUSE
A/P
$
163.88
WHITE TRASH SERVICES
EMS S. STATION & RB4 TRASH PICK UP
A/P
$
657.43
TOTAL VENDOR DISBURSEMENTS:
$
183,581.61
TOTAL AMOUNT FOR APPROVAL:
I/
$
183,581.61
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---December 29 2021
TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES
TOTAL PAYABL' ES, PAYROLL AND ELECTRONIC(BANK PAYMENTS. $794;263.$9'
TQTALTRANSEERSEETWEEN FUND$_ $,_ _249,79452'
TOTAL NURSINGrHOME UPL EXPENSES
TZOTAL, WTER-GOVERNMENT TRANSFERS $
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---December 29 2021
PAYABLES AND PAYROLL
12/22/2021 Weekly Payables
685,848.15
12/22/2021 Patient Refunds
2,758.19
12/2812021 McKesson-3400 Prescription Expense
2,583.41
12/28/2021 Amerisource Bergen-340B Prescription Expense
674, 17
12128/2021 Payroll Liabilities for supplemental payroll -Payroll Taxes
18,802.28
12/23/2021 Supplemental Payroll
82,802.06
Prosperity Electronic Bank Payments
12/20-12/24/21 Pay Plus -Patient Claims Processing Pee
181.23
12/22/2021 ExpertPay- child support
614.20
T&AL PAYABLES PAYE. 6LL AMO ELECTRONIC; BANWPA MIENTS`
TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES
12/2212021 MMC Operating to Ashford -correction of OIPP payment deposited into MMC
3.772.55
Operating
12/22/2021 MMC Operating to Solera-correction of NH QIPP payment deposited into
2,244.91
MMC Operating in error
12/22/2021 MMC Operating to Fort bend -correction on NH QIPP payment deposited into
1,526.47
MMC Operating
12122/2021 MMC Operating to Broadmoor-correction of NH QIPP payment deposited into
1,559.18
MMC Operating
12/22/2021 MMC Operating to Crescent -correction of NH Insurance and QIPP payment
9,577.27
deposited Into MMC Operating is error
12/2212021 MMC Operating to Golden Creek -correction of NH insurance and QIPP
46,481.20
payment deposited into MMC Operating in error
12/2212021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment and
23,735.02
QIPP deposited into MMC Operating
12/22/2021 MMC Operating to Tuscany Village -correction of NH Insurrace and QIPP
31,948,25
payment deposited Into MMC Operating
12/2212021 MMC Operating to Bethany -correction of NH insurance and medicare payment
71,446.98
deposited into.MMC Operating in error
MEDICARE ADVANCE PAYMENT RECOUP
1212812021 Broadmoor to Bethany -correction of Broadmoor medical recoup taken from
11,662.25
Bethany
12/28/2021 Broadmoor to Tuscany Village -correction of Broadmoor medical recoup taken
5,461.85
from Tuscany Village
12/28/2021 Crescent to Tuscany Village -correction of Crecenl medicare recoup taken
5,461.85
from Tuscany Village
12/28/2021 Crescent to Bethany -correction of Crecent medicate recoup taken from
11,662.25
Bethany
1212812021 Salera to Bethany -correction of Solera medicate recoup taken from Bethany
11,662.25
12/2812021 Solera to Tuscany Village -correction of Solera medicare recoup taken from
5,461.85
Tuscany Village
TRANSFER OF FUNDS BETWEEN NURSING HOMES
$ 7944140*
1212812021 Gulf Pointe Plaza -PP -correction of MMC insurance payment deposited into
110.49
Gulf Pointe Plaza -PP in error
12128/2021 Gulf Pointe Plaza -PP -correction of Broadmoor insurance payment deposited
8,020.00
into Gulf Pointe Plaza -PP in error
4OlUTRANSFIA6'BETWEEWFUND$
$ 249,7902
NURSING HOME UPL EXPENSES
12/28/2021 Nursing Home UPL-Cantex Transfer
1,080,735.94
12128/2021 Nursing Home UPL-Nexion Transfer
117,105.28
12/28/2021 Nursing Home UPL-HMG Transfer
98,891.71
12/28/2021 Nursing Home UPL-Tuscany Transfer
137,387.27
12128/2021 Nursing Home UPL-HSL Transfer
235,729.98
QIPP CHECKS TO MMC
12/28/2021 Ashford 48,884.90
12128/2021 Broadmoor 20,230.25
12/2812021. Crescent 16,733.34
12/26/2021 Fort Bend 19,756.67
1212812021 Solera 19,370.25
12128/2021 Tuscany 28,966.40
TOTAL NURSING HOME UPL EXPENSES $ 1';823,791.99
TOTAL INTER-GOUERN,MENTTRANSFERS $,
GRAND TOTAL DI88URSEMENT$ APP,RONED December 29, "2D24 $ 2;887,856.30
Page 1 of 16
RECEIVED BY THE
COUNTY AUDITOR ON
2021 MEMORIAL MEDICAL CENTER
72/2C?12221
Qg, AP Open Invoice List
CALHO�I�JCOUNTY,TEXAS
0
ap_open_invoice.templale
Due Oates Through:01/1212022
Vendor# Vendor Name Class Pay Code
R1200 ADT COMMERCIAL
Invoice# C mment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Not
143072506 12120120 12/05/20 12/30/20 49.18
0.00
0.00
49.18 ✓
FIRE MONITORING
Vendor Totals Number Name Gross
Discount
No -Pay
Net
P1200 ADT COMMERCIAL 49,18
0.00
0.00
49.18
Vendor# Vendor Name Class Pay Code
/
10958 ALLYSONSWOPE v/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount.
No -Pay
Net
122221 12122/2012/22/2012130/20 3,084.75
0.00
0.00
3,084.75
CONTRACT EMPLOYEE
Vendor Totals Number Name Gross
Discount
No -Pay
Net
10958 ALLYSON SWOPE 3,084.75
0.00
0.00
3.084.76
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
171633 /j. 12120/2012/13/2001/07/20. 4350
0.00
0.00
43.50
WATER
Vendor Totals Number Name Gross
Discount
No -Pay
Net
A2218 AQUA BEVERAGE COMPANY 43.50
0.00
0.00
43.50
Vendor# Vendor Name Class Pay Code
A0400 AUREUS RADIOLOGY LLC t,,/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross
Discount
No -Pay
Net
2406904✓ 12/2O/2012/13/2001/12/20. 2,080.00
0.00
0.00
2,680.00
Ly
TRAVEL LAB STAFFING ( 11124 ^ IX12.1 at) 5411 % b1, 1
2407046 f 12/20/20. 12/t 3/2001112120. 2,7(10-00
0,00
0.00
2,760.00 ✓
TRAVEL LAB STAFFING blMo Kicl.
2407115 Wf12/20/2012/1312001/12120. 2,629.75
0.00
0.00
2,629.75
TRAVEL LAB STAFFING tlll2q-13-ty� 31� i}a4J 1(i,t15
Vendor Totals Number Name Gross
Discount
No -Pay
Net
A0400 AUREUS RADIOLOGY LLC 8,069.76
0.00
0.00
8,069.75
Vendor# Vendor Name Class Pay Cade
/
B1150 BAXTER HEALTHCARE ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross
Discount
No -Pay
Not
73122166 ✓ 12/21/2012/06/2012/31/20 40.69
0.00
0.00
40.69 ✓
SUPPLIES
73150330 12121/20 12108/20 01/02/20 656.92
0.00
0.00
656.92 ✓
SUPPLIES
Vendor Totals Number Name Gross
Discount
No -Pay
Net
61150 BAXTER HEALTHCARE 697.61
0.00
0.00
697.61
Vendor# Vendor Name Class Pay Code
B1220 BECKMAN COULTER ING f M
Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
NO -Pay
Net
`Comment
5450646 ✓ 12115/2012/1312001/07/20 5,016.58
OAO
0.00
5,016,68
MAINTENANCE CONTRACT
,✓
109516907✓/ 12/1512012113/2001/12120.. 139.94
0.00
0.00
139.94,/
SUPPLIES
file:///C:/Usersleheiman/cpsilmemmed.cpsinet.com/u985471data_51tmp_cw5report4862... 12/22/2021
Page 2 of 16
109521938 ✓ ' 12115/20 12J14/20 01/08/20.
14.90
0.00
0.00
14.90 ✓
SUPPLIES
109521937 12115/20. 12/14/2001/08/20,
14.90
0.00
0.00
14.90
SUPPLIES
109525193 >/ 12/20120.. 12/15/2001/09/20
1,268.45
0.00
0.00
1,288.45
109531525 ,/ 12/20/20 12/16/20 01/10/20
11120.51
0.00
0.00
1,120.51
SUPPLIES
.
109531166 V I PJ20/2012/16/2001/10/20.
71,35
0.00
0.00
71.35
FREIGHT
109532225 v/' 12121/2012/16/2001/10/20
139.34
0.00
0.00
139,34 ✓
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
B1220 BECKMAN COULTER INC
7,805,97
0.00
0.00
7,805.97
Vendor# Vendor Name Class Pay Code
B1320 BEEKLEY CORPORATION ✓ M
Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross
Discount
No -Pay
Net
INV1491448 �`� 12/20/20 12115/20 12/20/20
411.95
0.00
0.00
411.95
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
B1320 BEEKLEY CORPORATION
411.95
0.00
0.00
411.95
Vendor# Vendor Name Class Pay Code
12324 BLUE CROSS BLUE SHIELD /
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
121721 12/22/20. 12/1712001101/20
224,137.57
0.00
0.00
224,137.57
JANUARY 2022
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12324 BLUE CROSS BLUE SHIELD
224,137.57
0.00
0.00
224,137.57
Vendor# Vendor Name Class Pay Code
80437 C R BARD INC M
✓f
Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross
Discount
No•Pay
Net
46529552 t% 12/20/20. 12/10/2001/09/20
150.00
0.00
0.00
150.00
SUPPLIES
83504233 ✓! 1020r20. 12/13/20 01/12/20
786.90
0.00
0.00
785.90
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
B0437 C R BARD INC
936.90
0.00
0.00
936.90
Vendor# Vendor Name Class Pay Code
11224 CABLES AND SENSORS ✓
Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
12272 1 PJ20/20 12MW20 01/06120,
115,00
0,00
0.00
115.00
SUPPLIES
123089 ,./ 12/20/20 12/13/20 01/12/20.
150.00
0.00
0.00
150.00
SUPPLIES
122722 ,/ 12/21/2012107/2001/06/20.
116.00
0.00
0.00
115.00
SUPPLIES
123089 f 12/21120. 12I31200111PJ20
150.00
0.00
OX0
150.00
SUPPLIES
Vendor Totals Number Name
Grass
Discount
No -Pay
Net
11224 CABLES AND SENSORS
530.00
0.00
0.00
530.00
Vendor#Vendor Name Class Pay Coda
file:/IIC:/Users/eheiman/cpsi/memmed.cpsinct.com/u985471data_5/tmp_cw5report4862... 12/22/2021
Page 3 of 16
10550 CAREFUSION 2200,INC /
Invoice# Comment Tran Dt Inv Dt Due Dt
Check Pay Gross
Discount
No -Pay
Net
9109919550 ✓ 12121/20. 12/08/20 01/07/20 394.91
0.00
0.00
394.91
vr'
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10650 CAREFUSION 2200, INC
394.91
0.00
0.00
394.91
Vendor# Vendor Name Class
Pay Code
14260 CAREFUSION SOLUTIONS, LLC ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
1001803B36-5 ✓+ 12121/20.12107/2001101/20
V7S%,tV 1,93j551
0.00
0.00
1,9?/51 9lmw
PYXIS EQUIPMENT
-
VendorTotalsNumber Name
Gross
Discount
No -Pay
Net
pv �r�
14260 CAREFUSION SOLUTIONS, LLC �� 94P 1,93V,51
0.00
0.00
1,93fi.51
Vendor# Vendor Name Class
Pay Code
i
18264 CERVEV, LLC ./
Invoice# . Comment hart Dt Inv Dt Due Dt
Check DPay Gross
Discount
NaPay,
Net
13726 ,% 12/21/20. 1PJ1012001104/20
1,699.00
0.00
0.00
1,699,00 �f
SPLIT BILLING MONTHLY FEE
.
Vendor Totals. Number Name
Gross
Discount
No -Pay
Net
13264 GERVEY, LLC
1,699.00
0.00
0.00
1,699.00
Vendor# Vendor Name Class
Pay Code
12768 GHEMAQUA ../
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
7611901 12/21/2012/10/2012/20/20
518.75
0.00
0.00
516.75
WATER TREATMENT SERVICE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12768 GHEMAQUA
518.75
0.00
0.00
518.76
Vendor# Vendor Name Class
Pay Code
C1730 CITY OF PORT LAVACA �/� W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
121421B 12/21/201P114/2001/05/20
65A9
0.00
0,00
65.49 ✓'
WATER - REHAB NOV21
121421C 12121/20 12/14/20 01/05/20.
62.29
0.00
0.00
62.29
WATER - CLINIC NOV21
121421A 12/21/20. 12/14/2001/05/20.
27.04
0.00
0.00
27.04 ,jam
HOSPITAL WATER NOV 21
121421 12/21/201 V14/2001/05/20.
1,896.30
0.00
0.00
1,896.30 ✓'-
WATER SERVICE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
C1730 CITY OF PORT LAVACA
2,051.12
0.00
0.00
2.051.12
Vendor# Vendor Name Class
Pay Code
C1166 COASTAL OFFICE SOLUTONS �/' W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
OEOT192151 ✓ 12/20/2012/10/2012/20/20.
1,939.78
0.00
0.00
1,939.78
SUPPLIES
OEOT192152 c% 12/20120 12113120 12124120
708.84
0.00
0.00
708,84
SUPPLIES
OEOT192201 ,i 12121/2012/16/2012/26/20
507.77
0.00
0.00
507.77 f "
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
C1166 COASTAL OFFICE SOLUTONS
3,156.39
0.00
0.00
3.156.39
file:///C:/Users/eheiman/cpsi/menimed.cpsinet.corn/u985471data_51tmp_cw5report4862... 12/22/2021
Page 4 of 16
Vendor#Ventlor Name Class
Pay. Code
11616 CONTROL SOLUTIONS �/
invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
C8222917 ✓ ` I PJ21120, 12/03/20 01/02/20.
64.00
0.00
0.00
64.00
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11615 CONTROL SOLUTIONS
64.00
0.00
0.00
64.00
Vendor# Vendor Name Class
Pay Code
14080 CORROHEALTH, INC. ✓_
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
50874 V. 12/20/20. 12103/2001/02/20
1,743.45
0.00
0.00
1,743.45
CODING SERVICES
_
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
14080 CORROHEALTH, INC.
1,743,45
0.00
0.00
1,743.45
Vendor# Vendor Name Class
Pay Code
10008 CUSTOM MEDICAL SPECIALTIES ✓%
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
J
289231 ,/ 12/21/20 12115/20 01112/20
654.80
0.00
0.00
654.80 �/-
SUPPLIES
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Not
10006 CUSTOM MEDICAL SPECIALTIES
654.80
0.00
0.00
654.80
Ventlor# Vendor Name Class
Pay Code
10368 DEWITT POTH & SON v'
Invoice# ,Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
6657940✓� 12116/201211312001/07/2G
105.72
0.00
0.00
105.72
/.SUPPLIES
6658080 ✓ 12/15/20IV13/2001107/20.
22.18
0.00
0.00
,
22.18 nr'
SUPPLIES
6651280 ar' 12117/2012/06/20 01/07/20
204.64
0.00
0.00
204.64 j
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10368 DEWITT POTH & SON
332.64
0.00
0.00
332.54
Vendor# Vendor Name Class
Pay Code
10789 DISCOVERY MEDICAL NETWORKING %'
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
NaPay
Net
MMC121521✓ 12/21/2012/15/2012/21/20
157,386.93
0.00
0,00
157,386.93 ✓
PHYSICIAN SERVICESDECt-1 r
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10789 DISCOVERY MEDICAL NETWORK INC 157,386.93
0.00
0.00
157.386.93
Vendor#Vendor Name Class
Pay Code
12044 DRIESSEN WATER INC. (CULLIGAN) ✓
Invoice# Comment Tran Dt Inv Dt DueOt
Check D Pay Gross
Discount
No -Pay
Net
1430270311302021 a,/ 12121/2011/30/2012/22/2o
4.00
0.00
0.00
4.00
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12044 DRIESSEN WATER INC. (CULLIGAN)
4.00
om
0.00
4.00
Vendor# Vendor Name Class
Pay Code
11046 E-MDS, INC r`I
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
478812 .%" 1212012012/13/2012/13/20
9,919.00
0.00
0.00
9,919.00 N/l
HOSTING SUBSCRIPTION OTF
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Page 5 of 16
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11046 E-MDS, INC
9,919.00
0.00
0.00
9,919.00
Vendor# Vendor Name Class
Pay Code
14264 ECONO AIR CONDITIONING /
Invoice# Comment Tram Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
7048 f 1212212012/19/2012/19/20
695.00
0.00
0.00
695.00
REPAIRS -fll
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
14264 ECONO AIR CONDITIONING
695.00
0.0D
0.00
695.00
Vendor# Vendor Name Class
Pay Code
11284 EMERGENCY STAFFING SOLUTIONS
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
40844 ✓/12/21/20. 12/31/2001/10120
40,062.50
0.00
0.00
40,062.50�
ED PHYSICIAN FEES {lil-VD k)
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11284 EMERGENCY STAFFING SOLUTIONS 40,062.50
0.00
0.00
40,062.50
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
760002220 ,% 12120/20, 12116/2001/10/20
42.76
0.00
0.00
42.75 d✓'
FREIGHT
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
F1100 FEDERAL EXPRESS CORP.
42.75
0.00
0.00
42.75
Vendor# Vendor Name Class
Pay Code
10003 FILTER TECHNOLOGY CO, INC ✓
Invoice# . Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
112324 12A 5/2012/07/2001/07/20
410.26
0.00
0.00
410.26
-SUPPLIES
111822 y' 12115/2012107120 01/07/20
46.03
0.00
0.00
46.03 r'
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10003 FILTER TECHNOLOGY CO, INC 456.29
0.00
OAO
450.29
Vendor# Vendor Name Class
Pay Code
j
10788 FIRETROL PROTECTION SYSTEMS ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
100757131 ✓ 12/21/2012109/2012/19/20
760.00
0.00
0.00
760.00
QTRLY INSPECTION FIRE ALA
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10788 FIRETROL PROTECTION SYSTEMS 760.00
0.00
0.00
760.00
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
6358549 f 12/16/2012102/2001107/20
85.00
0,00
0.00
85.00
SUPPLIES
6744236 1 PJ20/20. 1PI09/2001103/20.
687.75
0.00
0.00
687.75
SUPPLIES
6500094 ✓ 12121/2012/06/2012/3V20
28.30
0.00
0.00
28.30
SUPPLIES
6659252 12121/2012/OO/2001/02/20
329.79
0.00
0.00
329.79
UPPLIES
6500093 e/ 12121/20 12/00120 01/03/20
28.30
0.00
0.00
28.30
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SUPPLIES
6744237�/ 12121/2012109/2001/03/20.
744.42
0.00
0.00
744.42
SUPPLIES
6500087 12/2t/2012/0912001/03/20
169.32
0.00
0.00
169.32 v�
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
F1400 FISHER HEALTHCARE
2,072.88
0.00
0.00
2,072.88
Vendor# Vendor Name Class Pay Cade
12944 FRASIER HEALTHCARE CONSULTING, t/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net.
19143 �- 12120/20 12/06/20 01/12/20
16,046.12
0.00
0.00
16,046.12
COLLECTIONS
may%
-
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12944 FRASIER HEALTHCARE CONSULTING,
16,046.12
0.00
0.00
16,046.12
Vendor# Vendor Name Class Pay Code
13960 G & S MANAGEMENT GROUP LLC
Invoice# Comment Train Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
340383876 ✓/ 12/2012012113/2001/12/20
1,379.53
0.00
0,00
1,379.53 ✓�
TRASH SERVICES
340388878 ✓" 12/20/20. 12N3/2001/12/20
338.09
0.00
0.00
338.09
TRASH SERVICE
,
340383877 �/ 12120/20, 12113/2001/12/20
254.42
0.00
0.00
254A2
TRASH SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
13960 G & S MANAGEMENT GROUP LLC
1,972,04
0A0
0.00
1,972,04
Vendor# Vendor Name Class Pay Code
14248 GE MEDICAL SYSTEMS INFO TECH
Invoice# pomment Tran Dt Inv Dt Due Dt Check DPay Gross
Discount
No -Pay
Net
3610380 ✓ 12115/201210912001/08/20,
622.68
0.00
0.00
622.68 yam.
SUPPLIES
,.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
14248 GE MEDICAL SYSTEMS INFO TECH
622.68
0.00
0.00
622.68
Vendor# Vendor Name Class Pay Code
G1210 GULF COAST PAPER COMPANY U'' M
Invoice# Comment Tran Dt Inv Dt Due Dt Check a Pay Gross
Discount
No -Pay
Net
2151954 ✓/ 12/13/2012/07/20 011061220.
32.53
0.00
0.00
SUPPLIES
2151953 12N 31201 W0712001/06/20
32.53
0.00
0.00
32.53
SUPPLIES
2162207 ✓ 12/13/201 PJ07/2001106/20
867.17
0.00
0.00
867.17
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
G1210 GULF COAST PAPER COMPANY
932.23
0.00
0.00
932.23
Vendor# Vendor Name Class Pay Code
11562 HEALTHCARE FINANCIAL SERVICES ✓
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
100552378 Yi 12/20/20 12/08/20 01/01/20
7,447.86
0.00
0.00
7,447.86 F; '
LEASE
100552376 ✓ 12/20/2012108/2001/01/20
4,919.41
0.00
0.00
4,919.41 ✓"
LEASE
100552377.{ 12120/2012108/2001/01/20.
7,154.17
0.00
0.00
7,154.17
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Page 7 of 16
LEASE
100552379 ✓ 1 PJ21/201211312001/01/20, 1,797.44
0.00 0.00
1,797A4 ej
LEASE
Vendor Totals Number Name Gross
Discount No -Pay
Net
11552 HEALTHCARE FINANCIAL SERVICES 21,318.88
0.00 0.00
21,318.88
Vendor# Vendor Name Class Pay Code
H1227 HEALTHCURE INSURANCE SERVICES t -
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount No -Pay
Net
2536 ✓ 12120/20 12/08120 01/01/20 23,52 44
0.00 0,00
23,�9.44 aa,4g1.
RENEWAL 2022
.
Vendor Totals Number Name Gross
Discount No -Pay
Net
H1227 HEALTHCURE INSURANCE SERVICES 23,09.44
0.00 0.00
23,/29.44 a
Vendor# Vendor Name Class Pay Code
14256 INFICARE HEALTH, INC. -"
Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross
Discount No -Pay
Net
MMC082621 �.r` 12/21/20, 08/2612009/26/20 2,232.00
0.00 0.00
2,232,00
TRAVEL NURSE STAFFING (f 11W- g ld44111, Nis loK,,l
MMC090221 „/' 12/21/20. 09/0212010/02120, 2,232.00
0.00 0.00
2,232.00
TRAVEL NURSE STAFFING ($Ia7-1110d-Id-1) It 1t
j
MMC090921 ✓ 12/2112009/0912010/09/20. 325.00
0-00 0.00
2,325.00 t�
TRAVEL NURSE STAFFING (A 10 Jill I O I J AI� It
MMC091621✓/12/21/20 09/16120 10/16/20, 3,456.50
0.00 0.00
3,456.50 ✓
TRAVEL NURSE STAFFING ( 4 110 - 1111(t1 �-I) h tt
MMC092322 12121/2009/23/2010/23120 3,410.00
0.00 0.00
3.410.00 r✓
TRAVEL NURSE STAFFING LA 11-1 - y I as 1�-I) t'
MMC093022 y+� 12/21/20. 09/30/20 10/30/20 2,294,00
0.00 0.00
2,294.00 y�
TRAVEL NURSE STAFFING 0IA4-qho Ia'I1\ tr '%,
MMC100722 ,% I PJ21/20 10/07120 11/07/20 2,309.60
0.00 0.00
2,309.50
TRAVEL NURSE STAFFING (.1u I6 I - 10101 h-\) 11 11
MMC101422 / 1PJ21/20 10/14/20 11/14/20 2,340.50
0.00 0.00
2,340.50
TRAVEL NURSE STAFFING (, w 10Y - 10liq Ia-() It
t.
MMC102122 12121120 10/21/20 11/21/20 2.356.00
0.00 0.00
2,356.00
TRAVEL NURSE STAFFING (IeIIS- I01.�-I4' 4 h
MM0102822 yf 12121120. 10/28/2011/28/20 2,263.00
0.00 0.00
2,263,00 y,r'
TRAVEL NURSE STAFFING (t01aa- t01d81J-I) It 't
MM0110421 12/21/20 11/04/20 12/04/20. 1,488.00
0.00 0.00
.
1,480.00 t %
TRAVEL NURSE STAFFING (lu 17J1- I l l o�{ Ialj t I It
MMC111121 ✓/12121/201111112012/11120. 2,294.00
0.00 0.00
2,294.00 t-/'
rt 11
TRAVEL NURSE STAFFING 0 I05- 11111I'31)
MMC111821 12/21/2011118/2012/18/20 M1 2,294.00
0.00 0.00
2,294.00
TRAVEL NURSE STAFFING (Il11;L- n11t j,�A) tt 4
MMC112521 / 12/21/20 11/25/20 12(25/20 2,278.50
0.00 0.00
2,278.60 t✓
TRAVEL NURSE STAFFING L it 11 It- I 1 I I&- I a t ) ,( `t
MMC110221 ✓f12/21/2012102/2001/02120 2,325.00
0.00 0.00
2,325.00
TRAVEL NURSE STAFFING (Ii IJ-4 - i ti IuJ'1 Y1� Ir It
MMC120921 ✓ 12121/2012/09/2001109/20 2,263,00
0.00 0.00
2,263.00 ✓f
TRAVEL NURSE STAFFING (11IU3-ta.loalr�)
.
Vendor Totals Number Name Gross
Discount No -Pay
Net
14256 INFICARE HEALTH, INC. 38,161.00
0.00 0.00
38,161.00
Vendor# Vendor Name Class Pay Code
J0150 J & J HEALTHCARE SYSTEMS, INC ✓
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Page 8 of 16
Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
927399951 6/ 12116/20 12107120 01/07/20
885.52
0.00
0.00
885.52 L,/
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
J0150 J & J HEALTHCARE SYSTEMS, INC
885.52
0.00
0.00
885.52
Vendor# Vendor Name Class Pay Code
K1000 KEEP U NEAT DRY CLEANERS W
Invoice# Comment Tran Dt Inv Ot Due Dt Check 0• Pay Gross
Discount
No -Pay
Net
120221 11130/20. 11130/2001/07120
50.10
0.00
0.00
50.10
LAUNDRY
082621 12/21/20,08/2612012121/20.
20.10
0.00
0.00
20.10
091621 . 12/21120 09116/20 1 PJ21/20.
393.80
0.00
0.00
393.80 ✓
092821 12/21/20 09/28/20 12121/20
74.20
0.00
0.00
74.20
LAUNDRY
102021 12/21/20.10/20/20 12/21/20,
32.00
0.00
0.00
32.00
LAUNDRY
102021A 12/21/20 10/20/20 12121/20,
176A0
0.00
0.00
176.10 ./
LAUNDRY
102721 12/21/20 10/27/20 12/21120
24.10
0.00
0.00
24.10
LAUNDRY
110221 12/21/2011/02/2012/2l/20
12,20
0.00
0.00
12.20
LAUNDRY
111621 12/21/20.11116/2012121/20,
44.00
0.00
0.00
44.00 'f
Vendor TotalE Number Name
Gross
Discount
No -Pay
Net
K1000 KEEP U NEAT DRY CLEANERS
826.60
0.00
0.00
826.60 f
Vendodt Vendor Name Class Pay Code
L1640 LOWE'S HOME CENTERS INC,/ w
Invoice# Comment Tran Ot Inv Or Due Dt Check D Pay Gross
Discount
No -Pay
Net
120221 1PJ2112012/0212012/28/20
54.73
0.00
0.00
54.73
INTEREST UjfL�
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
L1640 LOWE'S HOME CENTERS INC
54.73
0.00
0.00
54.73
Vendor# Vendor Name Class Pay Code
10972 M G TRUST
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
121621 12120120.12120/2012120/20
640.86
0.00
0.00
640.86
PAYROLL DEDUCTIONS
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10972 M G TRUST
640.66
0.00
0.00
640.86
Vendor# Vendor Name Class Pay Code
11612 MASA GLOBAL BUILDING ✓/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
1149784MKMMC 12/20/2001/01/2001/12120
1,744.00
0.00
0.00
1,744.00
PAYROLL DEDUCT JANUARY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11612 MASA GLOBAL BUILDING
1,744.00
0.00
0.00
1,744.00
Vendor# Vendor Name Class Pay Cade
M2827 MEDIVATORS M
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Page 9 of 16
Invoice# Comment
TranDt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
91161699 ✓
12/16120. 19JO7120 OV07/20.
202.80
0.00
0.00
202.80
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
M2827 MEDIVATORS
202.80
0.00
0.00
202.80
Vendor# Vendor Name
Class
Pay Code
M2470 MEDLINE INDUSTRIES INC ,/ M
Invoice# Comment
Tran Ot Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
1975742894 ✓
12A 3120. 11/24/2001/07/20
403.00
0.00
0.00
403.00 v^'
SUPPLIES-
1963622223 ✓
12/1 6/20 08/24120 01107/20
3,855.46
0.00
0.00
3,855.46
SUPPLIES
1973304472 N
12/16/2011/05/2001107120,
9.21
0.00
0.00
9.21 y,/
SUPPLIES
1977262128 v
12/16/2012/07/20 01/07/20
952.69
0.00
0.00
952.69
SUPPLIES
1977262133 ✓
I PJ1 6120 1 PJ07/20 01/07/20
62.32
0.00
0.00
62.32
SUPPLIES
1977262135 6/
12/10/2012 O7120 01/07/20
125.09
0.00
0.00
125.09 V/
SUPPLIES
1977262137
12/1612012/07/20 01107/20.
72.10
0.00
0.00
72.10
SUPPLIES
1975742896 f
12117/2011/24/2001/07/20.
4,138.32
0.00
0.00
4,138.32
SUPPLIES
1975899327 ,/
12/17/2011/25/20 01107/20.
20.74
0.00
0.00
20.74
SUPPLIES
1978036936
12/20/20 12/13/2o 01/o7/2o.
10.45
0.00
0.00
10A5
SUPPLIES
1978036937,/
12/2O/201PJ13/2001/07/20
10.45
0.00
0.00
10.45 y/
SUPPLIES
1978288280 ,/
12/20/20.12M/20 01109120.
96.76
0.00
0.00
96.76
SUPPLIES
1978345107 1,/
12/20/20 1PJ1512o 01/09/20,
213.45
0.00
0.00
213.45 y✓
SUPPLIES
1978345110
1 PJ2012012/1512001/09120.
62.96
0.00
GAO
62.96 ✓
SUPPLIES
1978288277 „/
12/2O/2012/15/2001/09/20
11.70
0.00
0.00
11.70
SUPPLIES
1978845109 v/
12/20/201211512001/09/20,
183.83
0.00
0.00
183.83
SUPPLIES
1978288291 ✓/
1PJ20/2012/15/2001/09/20
3,1%54
0.00
0.00
3,119.54 ✓
SUPPLIES
.
19782BB281 ✓
12/20/20. 1211512001/09/20
88.34
0.00
0.00
88.34
SUPPLIES
1978288284
12120120 1 PJ15/20 01/09/20
21101.90
0.00
0.00
21101.90 v`
SUPPLIES
1978288295 V'
12120/2012115/20 01109/20.
9.74
0.00
0.00
9.74 v'
SUPPLIES
1978288276 ,J
12120/2012115/2001/09/20,
4.60
0.00
0.00
4.60
SUPPLIES
1978345105 ../
12/2O/2012/15/2001/09/20
200.42
0.00
0.00
200.42
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Page 10 of 16
SUPPLIES
1978346106
12/20/20 12/15/20 01109/20,
552M
0.00
0.00
552.96
SUPPLIES
1702296542A✓
IPJ21/20. 03/28/2012/21/20,
372.04
0.00
0.00
372.04
INTEREST
1702315059A,Z',
12/21/2004/25/2012121/20
327.81
0.00
0.00
327.81 v/l
INTEREST
1702334384A/
12/2l/2005123/2012/21/20
292.52
0.00
0.00
292.52 �/-
INTEREST
1702353435A/
12/21/20. 0612712012/21/20
404.47
0.00
0.00
/
404.47 ✓
INTEREST
1702370277A,/
1212112007/25/201221/20.
295.63
0.00
0.00
295.63 %
INT REST
1702390459
1212112008/22/2012/21I20.
329.97
0.00
0.00
329.97
INTEREST
1702422788✓
12/21/2010/2412012/2l/20
428.02
0.00
0.00
428.02
INTEREST
1702439247.1
1221/20. 11/21/2012/21120,
88.85
0.00
0.00
88.85
INTEREST
1702456836 ✓
1221/2012/3112012121120.
66.56
0.00
0.00
66.56 v'
INTEREST
1702555083 �/�
12/2112001/23/2012/21/20,
436.86
0.00
0.00
436.86 j
INTEREST
1702470506,/
12121/20 01/23/20 12/21/20
87.26
0.00
0.00
87.26
INTEREST
1702581156 ,/
12/21/20 07/24/20 08/18/20
9.07
0.00
0.00
9.07
INTEREST
1702638222 ✓/
12/21120. 111202012/15120
681.96
0.00
0.00
681.96,r
INTEREST
1702652771AJ
12/21/2011/2012012115/20,
215.61
0.00
0.00
215.51 -
INTEREST
1975774428
12121/2011/2412012119120.
85.71
0.00
0.00
85.71
SUPPLIES
1975882870
12/2l/2011/24/2012/19/20
112.59
0.00
0.00
112.59
SUPPLIES
1975774429 ✓/
12/21/201124/2012J19120
57.14
0.00
0.00
57.14 V`-
SUPPLIES
1975774430
1 PJ21120. 11/24/2012/19/20
85.24
0.00
0.00
85.24
SUPPLIES
1976409975 1, /
12/21/2012/01/2012/26/20
285.52
0.00
0.00
285.52
SUPPLIES
1976409973rf
121211201y01/2012J26/20
901.09
0.00
0.00
901.09
SUPPLIES
197726130 ✓
12/21120. 12 O7120 01/01/20
120.38
0.00
0.00
120.38 �rf
SUPPLIES
1977504830 ✓
12121/2012/08/2001102/20.
158.13
0.00
0.00
158.13 �..
SUPPLIES
1977545229 �''
1PJ2112012/09/2001/03/20.
$14.12
0100
0.00
814.12
SUPPLIES
✓
1977548200
12/21/2012109/2001103/20
41.83
0.00
0.00
41.83
SUPPLIES
file://JC:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report4862... 12/22/2021
Page 11 of 16
1978288278 ✓ 12121/2012/15/2001/09/20.
11.90
0.00
0.00
11.90
SUPPLIES
t/
1978345111A ,r' 12/22/2012115/2001/09/20
193.15
0.00
0.00
193.15 -
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
M2470 MEDLINE INDUSTRIES INC
23,209.36
0.00
0.00
23.209.36
Vendor# Vendor Name Class
Pay Code
12248 MEMORIAL MEDICAL CENTER ,j
Invoice# Comment Tran Dt Inv Ot Due Dt
Check DPay Gross
Discount
No -Pay
Net
122121 12121/20. 12/21/20 12/21/20
14.50
0.00
0.00
14.50
PETTY CASH
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12248 MEMORIAL MEDICAL CENTER
14.50
0.00
0.00
14.50
Vendor# Vendor Name Class
Pay Code
10963 MEMORIAL MEDICAL CLINIC
✓'
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
121621 12120/20, 12/20/20 1 PJ20/20
226.10
0.00
0.00
226.10 ✓�
PAYROLL DEDUCTION
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10963 MEMORIAL MEDICAL CLINIC
226.10
0.00
0.00
226.10
Vendor# Vendor Name Class
Pay Code
M2621 MMC AUXILIARYGIFT SHOP r1 w
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D, Pay Gross
Discount
No -Pay
Net
121621 12/20/20 12/16/20 12116/20.
324.16
0.00
0.00
324.15
PAYROLL DEDUCT
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
M262t MMC AUXILIARY GIFT SHOP
324.15
0.00
0.00
324AS
Vendor# Vendor Name Class
Pay Code
10536 MORRIS & DICKSON CO, LLC
Involce# Tran Dt Inv Dt Due Ot
Check D Pay Gross
Discount
No -Pay".
Net
/33amment
7e55539 12/21/20 12/15/20 12/25/20.
17.44
0.00
'0.00
17.44
INVENTORY
i
7654859 ✓ 12/21120. 12/15/2012J25/20
88.30 _
0.00
0.00
88.30
JNVENTORY
7654479 �% 12/21/20 12/15/20 12/25/20
/f2,59
0.00
0.00
12.59 ✓
VENTORY
CM94587
✓I 12/21/2012/1512012/25/20//%
-570.61
0.00
0.00
-570.61 f'
CREDIT
7655002/ 12/21/20. 121�5/2'012/25/20
248.27
0.00
0.00
248.27,�.''
INVENTORY r
7655540 ✓/ 122//21120 12/15/20 12/25/20
167.48
0.00
0.00
167.48
INVENTORY,/
7654480 f �/ 12r21/2012115/2012/25/20
99.70
0.00
0.00
99.70
INVENTORY
CM94588✓ / 12/21120. 12/15/20 12/25/20
-968.06
0.00
0.00
-968.06 ✓
EDIT
SM94589 �� 12121/2012/15/2012/25/20
-92.08
0.00
0.00
-92.08 f
�.{/
C-' CREDIT
Vendor Totals Number Name
Gross
Discount
No -Pay
N
10536 MORRIS & DICKSON CO, LLC
-996.97
0.00
0.00
996.97
Vendor# Vendor Name Class Pay Code
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Page 12 of 16
14124 MSH HEALTH SERVICES LLC
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
MMC0027 12/22/20 12/06/20 12/06/20
4,630.00
0.00
0.00
4,630.00 -
TRAVEL NURSE STAFFING
✓
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
14124 MSH HEALTH SERVICES LLC
4,630.00
0.00
0.00
4,630.00
Vendor# Vendor Name Class Pay Code
M2659 MXR IMAGING, INC ✓- M.
Invoice# Comment Tran Dt Inv Dt Due Ot Check DPay Gross
Discount
No -Pay
Net
8800841593 ✓ 12120/2012/08/2001107/20.
183.15
0.00
0,00
183.15
SUPPLIES
Vendor TotalsNumber Name
Grass
Discount
No -Pay
Net
M2659 MXR IMAGING, INC
183.15
0.00
0.00
183.15
Vendor# Vendor Name Class Pay Code
12388 NATIONAL FARM LIFE INSURANCE
Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross
Discount
No -Pay
Net
0551390 / 12/21/2012121/2001/01/20.
✓PAYROLL
3,468.73
0.00
0100
3,468.73
DEDUCT
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12388 NATIONAL FARM LIFE INSURANCE
3,468.73
0.00
0.00
3,468.73
Vendor# Vendor Name Class Pay Code
10188 NATUS MEDICALINC
�.
Invoice# Comment Ten Dt Inv Dt Due Dt Check D'Pay Gross
Discount
No -Pay
Net
1041289248 t I PJ21/2012110/2001/04120.
SUPPLIES
1,631.32
0.00
0.00
1,531.32
Vendor TalalENumber Name
Gross
Discount
No -Pay
Net
10188 NATUSMEDICALINC
1,531.32
0.00
0.00
1,531.32
Vendor# Vendor Name Class Pay Code
11472 OCCUPRO LLC
Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross
Discount
No -Pay
Net
24107 12/07/20 12/07/20 01/06/20
487.47
0.00
0.00
487.47
�+'
PROVIDER/MNTHLY SUPPOR-
Vendor Total- Number Name
Gross
Discount
No -Pay
Net
11472 OCCUPRO LLC
487.47
0.00
0.00
467.47
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
31908486,/ 12120/2012/0712001/01/20.
1,137.51
0.00
0.00
1,137.51
SERVICE CONTRACT
.
31924517,/ 12/21/20. 12/10/2001/04/20
191.25
0.00
0.00
191.25v,%
SUPPLIES
Vendor TotalE Number Name
Gross
Discount
No -Pay
Net
01500 OLYMPUS AMERICA INC
1,328.76
0.00
0.00
1,328.76
Vendor# Vendor Name Class Pay Code
11069 PABLO GARZA
Invoice# Comment Tran Dt Inv Dt Due Dt Check Dr Pay
Gross
Discount
No -Pay
Net
122121 1 PJ22/20, 12121/2012/30/20.
2,608.13
GAD
0.00
2,608.13
CONTRACT EMPLOYEE (.I IX `2d 12 1
Vendor Total=,Number Name
Gross
Discount
No -Pay
Net
11069 PABLO GARZA
2,608.13
0.00
0.00
2,608.13
Vendor# Vendor Name Class Pay Code
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Page 13 of 16
10162 PARTSSOURCE,LLC
Invoice# C`gmment Tran Dt Inv Ok Due Dt
Check Dd Pay Gross
Discount
No -Pay
Net
04126989 ✓ 12/20120 12116/20 01/01/20 141.41
0.00
0.00
141.41
SUPPLIES
',
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10152 PARTSSOURCE, LLC
141.41
0.00
0.00
141.41
Vendor# Vendor Name Class
Pay Code
P1800 PITNEY BOWES INC yV
,i
Invoioe# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Not
1019625102 12121/2012/10/2001/09/20, 527.64
0.00
0.00
527.64
POSTAGE
Vendor Totals Number Name
Gross
Discount
No -Pay
Not
P1800 PITNEY BOWES INC
527.64
0100
0.00
527.64
Vendor# Vendor Name Class
Pay Code
11932 PRESS GANEY ASSOCIATES, INC. ✓,1
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
INDO0506101 !� 12120/20. 11/30/2012/30/20 2,523.79
0.00
0.00
2,523.79
SURVEY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11932 PRESS GANEY ASSOCIATES,
INC. 2,523.79
0.00
0.00
2,523.79
Vendor# Vendor Name Class
Pay Code
12480 PRO ENERGY PARTNERS LP ,,,,/
Invoice# Comment Tran Dt Inv Dt Due Ot
Check D Pay Gross
Discount
No -Pay
Net
21110600 ,/ 12/20/2011/30/2012115/20.
2,71724
0.00
0.00
2,717.24
NATURAL GAS
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12480 PRO ENERGY PARTNERS LP
2,717.24
0.00
0.00
2,717.24
Vendor# Vendor Name Class
Pay Code
10699 SIGN AD, LTD. „ /
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
269278 ,% 12/21/2012/1612012/26120.
400.00
0,00
0.00
400.00
MARKETING
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10699 SIGN AD, LTD.
400.00
0.00
0.00
400.00
Vendor# Vendor Name Class
Pay Code
11298 SOUTH TEXAS BLOOD & TISSUE CEN
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
107019318 v/ 12/21/20 12/15/20 01/09/20.
3,922.00
0.00
0.00
3,922.00 , '-
BLOOD BANK
/
CM5984 ✓ 12/21/20 I PJ1612001109120
•3,081.00
0.00
0.00
-3,081.00 ✓..�
CREDIT
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11296 SOUTH TEXAS BLOOD & TISSUE CEN 841.00
0.00
0.00
841.00
Vendor#Vendor Name / Class
Pay Code
C1010 SPARKLIGHT ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
ND -Pay
Net
1216218 12J21120. 12/21/2012121/20
1,687.26
0.00
0.00
1,687.26
CABLE
121621A 12J21/20 IPJ21/20 12121120.
205.53
0.00
0.00
205.53
CABLE
121621 12/21/2012J21/2012/21120
2.459.19
0.00
0.00
2,459.19
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Page 14 of 16
Vendor Totals Number Name
Gross
C1010 SPARKLIGHT
4,351.98
Vendor# Vendor Name Class
Pay Code
12288 SPBS CLINICAL EQUIPMENT SRVC
Invoice# Comment Tran Dt Inv O Due Dt
Check D, Pay Gross
INVO10732 ✓ 12121/2012/0312012/03/20
13,384.80
BID MED SERVICES
Vendor Totals Number Name
Gross
12288 SPBS CLINICAL EQUIPMENT SRVC 13.384.80
Ventlor# Vendor Name Class
Pay Code
14100 STAFFING FIRST ✓'
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
211093 ,/ 12/20/2011/01/2011/17/2G
3,062.50
TRAVEL NURSE STAFFING
Vendor Total. -Number Name
Gross
14100 STAFFING FIRST
3,062.50
Vendor# Vendor Name Class
Pay Cede
/
S2694 STANFORD VACUUM SERVICE ,/ M
Invoice# Comment Tran Dt Inv Ot Due Dt
Check D Pay Gross
688559 „ / 12/20120 12/17/20 12117/20
390.00
GREASETRAP
Vendor Total. -Number Name
Gross
S2694 STANFORD VACUUM SERVICE 390.00
Vendor# Vendor Name Class
Pay Code
S2830 STRYKER SALES CORP i,/ M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
9201953122> 12/21120 12/DB/20 12/21/20.
4.382.16
SUPPLIES
Vendor Totals Number Name
Gross
S2830 STRYKER SALES CORP
4,382.16
Vendor# Vendor Name Class
Pay Code
10735 STRYKER SUSTAINABILITY
Invoice# Comment TranDt Inv Dt Due Dt
Check D, Pay Gross
4325885 �' 12/21/20 12/08/20 01/07/20
3.066.83
SUPPLIES
Vendor Totals Number Name
Gross
10735 STRYKER SUSTAINABILITY
3,066.83
Vendor# Vendor Name Class
Pay Code
13880 TEXAS SELECT STAFFING ./
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
0018785510791N 12/20/2012/16/2012/16/20
9,979.30
TRAVEL NURSE STAFFING
Vendor Totals Number Name
Gross
13880 TEXAS SELECT STAFFING
9,979.30
Vendor# Vendor Name Class
Pay Code
Discount No -Pay
0.00 0.00
Discount No -Pay
0.00 0,00
Net
4,351.98
Net
13.384.80
Discount
No -Pay
Net
0.00
0.00
13,384.80
Discount
No -Pay
Net
0.00
0.00
3,062.50
Discount
No -Pay
Net
0.00
0.00
3,062.50
Discount
No -Pay
Net
0.00
0.00
390.00
v,
Discount
No -Pay
Net
0.00
0.00
390.00
Discount
No -Pay
Net
0.00
0.00
4,382.16
Discount
No -Pay
Net
0,00
0.00
4,382.16
Discount No -Pay Net
0.00 0.00 3,066.83 ✓,,
Discount No -Pay Net
0.00 0.00 3,066.83
Discount No -Pay Net
0.00 0,00 9,979.30 ✓
Discount No -Pay Net
0.00 0.00 9,979.30
13616 TRIOSE, INC ,!
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay
TRIO97233 , - 12/20/20. 12/10120 12125/20 493.76 0.00 0.00
FREIGHT
Vendor Totals Number Name
Net
493.76
Gross Discount No -Pay Net
file:///C:/Usersleheimanlcpsilmemmed.cpsinet.com/u98547/data 5/tmp_pw5report4862... 12/22/2021
Page 15 of 16
13616 TRIOSE, INC
493.76
0.00
0.00
493.76
Vendor# Vendor Name Class Pay Code
14208 TRUSTED HEALTH, INC L/
Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross
Discount
No -Pay
Net
INV7115 12/20/20. 12/11/2001110120
6,642.50
0.00
0.00
6,642.50
i/fRAVEL NURSE STAFFING
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
14208 TRUSTED HEALTH, INC
6,642.50
0.00
0.00
6,642.50
Vendor# Vendor Name Class Pay Code
U1064 UNIFIRST HOLDINGS INC ,-i'
Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross
Discount
No -Pay
Net
8400383463 �/ 12/1612012/13/2001/07120
2,270.25
0.00
0.00
2,270.25
LAUNDRY
v--
8400383437,/ 12/15/20. 1211312001/07120
45.15
0.00
0.00
45.15✓
LAUNDRY
8400383438 12/16/20. 12113/2001/07/20.
47.80
0.00
0.00
47.80
.LAUNDRY
8400383818 �/ 12/20/2012/16/2001/10/20
89.20
0.00
0.00
89.20
LAUNDRY
8400383799✓ 12121/20 12/16/20 01/10120,
79.43
0.00
0.00
79.43 "1'
LAUNDRY
8400383785� 12/21/20 12116/20 01/10120,
170.59
0.00
0.00
170.59
LAUNDRY
8400383786 ✓� 12121120. 12/16/2001/10120.
199,32
0.00
0.00
199.32
LAUNDRY
8400383783 _' 12/21120, 12/16/20 01/10/20
137.13
0.00
0.00
137.13
LAUNDRY
8400383804 % 1PJ21/2012/16/2001/10/20,
1,479.55
0.00
0.00
1,479.55
LAUNDRY
8400383782/ 1PJ211201PJ1612001/10/20
42.72
0.00
0.00
42.72
LAUNDRY
8400382420 ✓ 112/22/20. 11/29/2012124/20
1,991.83
0.00
0.00
1,991.83
LAUNDRY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
U1064 UNIFIRST HOLDINGS INC
6,552.97
0.00
0.00
8,552,97
Vendor# Vendor Name Class Pay Code
/
V0554 VCS SECURITY SYSTEMS ✓ w
Invoice# Comment Tran Dt Inv Dt Due Dt Check D" Pay Grass
Discount
No -Pay
Net
236510 �% 12/22/20. 10/05/2011/04/20
1,244.00
0.00
0.00
1,244.o0
SERVICES
236609✓/ 12/22/2010105/2011/04120.
5,151.00
0.00
0.00
5,151.00
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
V0554 VCS SECURITY SYSTEMS
6,395.00
0.00
0.00
6,395.00
Vendor$ Vendor Name Class Pay Cade
V1058 VICTORIA ANESTHESIOLOGY ✓ w
Invoice# Comment Tran Dt Inv Dt Due Dt Check D" Pay Gross
Discount
No -Pay
Net
100121 12/20/20 12/17/20 12/17120
1,169.91
0.00
0.00
1,169,91
SHORTFALL FOR ADMIN FEE:
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
V1058 VICTORIA ANESTHESIOLOGY
1,169.91
0.00
0.00
1,169.91
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Page 16 of 16
Vendor#Vendor Name Class
Pay Code
12208 WAGEWORKS
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
121621 1 W20/20. 12116/2012/16/20
3,337.29
PAYROLL DEDUCTIONS
Vendor Total! Number Name
Gross
12208 WAGEW_ ORKS
3,337.29
Vendor# Vendor Name Class
Pay Code
W1D40 WATERMARK GRAPHICS INC ✓� M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
134373 12/21 /20 10/29/20 11128/20.
193.27
SUPPLIES
Vendor Totals Number Name
Gross
W1040 WATERMARK GRAPHICS INC
193.27
Vendor# Vendor Name Class
Pay Code
11110 WERFEN USA LLC ✓`
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
9310039714 Z 11/30/20. 11/22/2001/07/20.
1,202.01
SUPPLIES
9111067782 i 12117/2011/11/2001/07/20
662.35
SUPPLIES
Vendor Total: Number Name
Gross
11110 WERFEN USA LLC
1,864.36
Report Summary
Grand Totals: Gross Discount
686,086.31 0.00
6;'t': rl: I I ,
3Nb°.1
APPROVED ON
DEC 22 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
Discount No -Pay Net
0.00 0.00 3.337.29
v'
Discount No -Pay Net
0.00 0.00 3,337.29
Discount No -Pay Nei
0.00 0.00 193.27
I/
Discount No -Pay Net
0.00 0.00 193.27
Discount No -Pay Net
0.00 0.00 1,202.01 L/
0.00 0.00 662.35
Discount No -Pay Net
0.00 0.00 1,864.36
No -Pay Net
0.00 686,086.31
3wwIr.+U t I18K.00
py j wwc hi 'Kl; gaar' 'ma.8x
,yN►a-
P� U ww4l �A Vgwt
Doh, �9g.lr
file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp_cw5report4862... 12/22/2021
DATEA67E a' pgy THE
MEMORIAL 14EDICAL CENTER
PAGE 1
TII�P'08`!Ya' AUDROR ON
f
EDIT LIST FOR PATIENT REFUNDS
ARID=0001 APCDEDIT
DEC 2 2 2021
PATIENT
PAY PAT
WEER PAYEE NAME
DATE
AMOUNT CODE TYPE DESCRIPTION GL NUM
... ENtaOUN COUNTY.'f t`9f517E-----------------------------------------------------------
r
_---------_------------- _---------------
1
12202I
40.00 ✓ 2
REFUND FOR
122021
68.12 „/ 2
REFUND FOR
122021
58.10 i 2
REFUND FOR
122021
125.00 ✓ 2
REFUND FOR
122021
25.00 ✓'� 5
REFUND FOR
122021
125.00✓ 2
REFUND FOR
122021
1258.38 f 3
REFUND FOR
✓
122D21
112.80 ,/ 2
REFUND FOR
122021
17.80 ✓ 2
REFUND FOR
-----------------------------------------------------
122021
_--------------------------------
927.99 ,/2
REFUND FOR
------- .................... -----------___-
ARID=D001 TOTAL
...................... .---------------------------------------
2758.19
'---------------------------------------------
-------'.__._.___._----
TOTAL
APPROVED ON
DEC 2 2 2021
BY COUNTY AUDITOR
CAWOUN COUNTY, TEXA6
2758. 19
m=RCJJVIY
STATEMENT
As of:12/24/2021
Page:002
Toorders, Paled cecktoyour
amount, coach and ratum this
COmppnY� 9000
dub W Kh your remittance
DO: 8115
As of: IV2412021 Pegs: 002
MEAORAL MEDICAL CENTER
VIA ACH DEBIT
AMT DUE for
Territory.-
Mall to: CanP: 8000
Statement for InlOtmalion only
Information
ANT DUE R D VIA ACH DEBIT
61
B15 N VINOINIA STNt£T
532538
Cut::
r information
Statement for infarmatbn only
POW LAVACA TX 71979
121
Data: 12/25/2021
cum: 632536 PLEASE CHECK ANY
Date: 12/25/2021 ITEMS NOT PAID I,)
filling Due
late— Date
etimal Ammnlpy�59 fi
Number UMe(
Number Reference _
Cash
Description Discount
Amount P
(gross) F
Amount P Receivable
(net) F Number
tF column Iegeral: P = Past Due Item, F = Future Due Item, blank = Current Due Item
"DTAL National Acct 632636
MEaOPIAL M®ICAL CENTER
Subtotals: 2.646.74 USD
'Inure Due:
0.00
Due If Mid On Time:
If Pe18 By 12128/2021,
USD
2,583.41 ✓
Rat Due:
519.84- Pay This Amount: 2,5113.41 USO
Disc ION it Patti late:
63.33
Ad Payment
2F51.97 If Pald After 12128/2021,
Due If Pa1E Late:
19/07/2017
Pay this Amount: 2.646.74 USD
USD
2.646.74
1o65ft. �.,
1 rU4U•rh
I 'l'/•'LJ -
5`1''i1;. T
APPROVED 0"
DEC 2 8 20ZI
BY COUNTY AUDITOR
CALHOuN couNtV, TEXAS
for AR Inquiries please contact 800-867-0333
MSKESSON STATEMENT A4 of: 1212412021 Page: 001
C-POy. soon
OC: ails
VJALMART 1096/MM MED PHS AMT DUE R@AITTED VIA ACH DEBIT TertIIory: 400
MEMORIAL MEDICAL CENTER Statement for Information only
VICKY KALISE3( Customer: 256342
815 N VIRGINIA ST Date: 12/25/2021
PORT LAVACA TX 77979
9111ng Due Recelvable silo' Account ?6 Cash Amount P
W. Date Number Were. Description Discount (arose) F
:uelamer Number 256342 WALMART 1098IMEM MED PHS
WIS/2021
12/26/2021
7313212682
1217210936
1151mmice
0.01
0,83
2/20/2021
12/28/2021
7313116709
21459019
1151nvoice
4.03
241.55
2/20/2021
12/26/2021
7313116710
21482052
1151nvoice
0.82
40.83
V2012021
12/28/2021
7313307821
1217210841
1951nve1ce
0.02
0.95
2/21/2021
12/28/2021
7313443826
21572201
1151nv6ce
0.01
0.63
2/21/2021
1228/2021
7313443827
21618675
1151nvoice
0.16
2/2U2021
1228/2021
7313443828
21626749
1151nvoice
0.03
1.27
,A
- 2/21/2021
12/28/2021
7313607791
1220211011
1151nvoice
7.09
354.62
2/22/2021
12/282021
7313729742
21711008
1151nvolce
5.36
260.98
2/22/2021
12/28/2021
7313858583
1221210805
1951nvoice
2.75
137.42
2/22/2021
12/28/2021
7313858504
1221210911
1151nvoice
1.89
94.39
2/23/2021
12/282021
7314004756
21785558
1151nvotce
3.50
175AI
2/23/2021
12/28/2021
7314004757
21785558
1151nvoice
3.43
171.48
2/2W2021
12/28/2021
7314145671
1222210006
1151nvolce
0.17
8.47
2/23/2021
12128/2021
7314146672
1222210725
1951nvoice
3.91
195.70
6 column legend: P = Peel Due Ilea, F =
Elders Due Item, blank =
Camara Due Item
"OTAL Customer Number
258342 WAIMART
1098/MHa M® PNS
Subtalala:
1.692.19
USD
Mum Due: 0.00
If Paid By /2/28/2021,
V9 Due: 0.00 Pay This Amount: 1,658.36 USD
a# Payment 11.814.44 If Paid After 12/282021,
2/202021 Pay this Amount: �r �1,692A9 USD
APPFlOVED ON
DEC 28 2021
6v COUNTY AUDI fOR For AR Enquirilease contact 800-867-0333
CALNDUN COUNTY, TMAS es p
To ensure Proper credit to your
account, detach and Mum this
stab with your remMarlca
As of: 1212412021 Page: 001
Mail to: Cg 8000
AMT DUE ReATTED VIA ACH D®IT
Statement Icr Information only
Dust: 256342 PLEASE CNSCK ANY
Data: 12/25/2021 ITEMS NOT PI'y'I
AI�D(1)___..-._-_I
Amount P Re-celvahle
- __._.
(net) F-Number
0.62 " 7313212882
236.72 ✓ 7313116709
40.01 1 7313116710
0.93 7313307821
0.62 7313443826
0.16 ✓ 7313443827
1.24 ✓ 7313443828
347.53 ,( 7313607791
263.60 ,i 7313729742
134.67 ✓ 7313858583
92.50 ✓ 7313858584
171.61 y 7314004756
168105 ,� ]31900475]
8.30 / ]3141 g5871
191.79 ✓ 7314145672
Due If Paid On Time:
USD
1,658.35 ✓"
Disc last If field late:
33.84
Due If Paid Late:
USD
1,692.19
MSKESSON
STATEMENT
C mpw, a000
CVS PHCY 7006/10EMORIA PHS
AMT DUE REMITTED VIA ACH OMIT
MEMORIAL MEDICAL CENTER
Statement for information only
VIC" I(ALISEK
015 N VIRGINIA
PORT IAVACA TX 77979
As of: 12/24/2021
Page: 001 To assume proper credit to your
account, detach and mum this
stub with your remittance
OC; 8115
As of: 12t24/2021 Paga: 001
Mail to: Comp: 8000
Territory: 400
AMT DUE REMITTED VIA ACH DEBIT
Customer. 262252
Statement for Information Only
Dale: 12/25/2021
Cust: 262252 PLEASE CHECK ANY
Date: 12/2512024 O EMS NOT PAID (�)
filling Due
Hecelvabliailcoal Account bMbs�t6 Cash
)aio Date
Number Reference Description Discount_
— _
:mourner Number 262252 CVS PHCY 7006/MEMOPoA PHS
2/23/2021 12/28/2021
7314006341 1499368 115hrmice 0.04
T column legend: P = Past Due Item, F = Future Due Item, blank = Curtest Due Item
-OTAL• Customer Number 262252 CVS PHCY 7006IMBtOPoA PHS
Subtotals: 1.85 USD
Mum Oue:
0.00
If Palo By 1212812021,
es1 Due:
0.00 Pay This Amount:
eel Payment
11.814.44 If Paid After 12/28/2021,
2/20/2021
Pay this Amount:
APPROVEDON
DEC 2 8 2921
HYCOUNTYAUDITOR
CALHOUN COUNTY, TEXAS
Amount P
(gross) F
Amount P
(rout) F
Number
Number
1.85
1.81 ✓
7314006341
O
Due If Pall On Time:
USE) 1.61
1.81 USD 010 but if paid late:
0.04
Due if Paid We:
1.85 USE, USD 1.65
For AR Inquiries please contact 800-867-0333
MWESSON
STATEMENT
comomr SON
H® MY PC 490/MEM MC PHS
AMT DUE REMITTED VIA ACH DEBIT
MEMORIAL MEDICAL CENTER
Statement Icr information Only
VICKY KAUSE(
815 N VIRGINIA ST
PORT LAVACA TX 77979
As of: 12/24/202 t
Pago: 001 To ensure pmpw cmdK to your
Scooted, detsch and retwn this
stub w8h your remittance
OC: 8115
As of: 1212412021 Page: 001
Mall I. Comp: 8000
Territory: 400
AMT DUE REMITTED VIA ACH OMIT
Curtaner. 464450
Statement for information only
Date: 12/25/2021
Cum: 464450 PLEASE CHECK ANY
Date: 12/25/2021 ITEMS NOT PAtO (v)
thing Due
RN nvablrraIIwOI Account
gape
Cash
late Date --
Number
tleierewe Description
Discount
;Wonwr Number 464450
H® MY FC 490/MEM MC PHS
2/20/2021 12/28/2021
7313100429
55,789034 IIsInvoice
6.44
2/22/2021 12/28/2021
7313718082
55.794320 116lnvoico
7.71
2/22/2021 12/28/2021
7313718064
55094393 1151nvolce
1.07
2/23/2021 12/28/2021
7313987949
55096803 11 Slnvoice
6.02
'F Ntumn legend: P = Past Due Item, F = Future Due
Item, blank = Current Due Item
'OTAL• Customer Number 464950 H® MY PC 990IMEM
MC PHS
Subtotals
1,061.96 LED
)pure Due:
0.00
If Paid By 1212912021,
Amount P
(goes) f
Amount P
(rwU F
RN.INS, e
Number
3.
3.7✓
7313100429
38585.46 45
377]].]4 ✓
7313718062
53.41
52.34 `�
7313718064
300.95
294.93 ✓
7313987999
Met on.: 0.00 Pay This Amount: 1,04D.74 LSD
.ast Payment 11.814.44 If Paid After 1212812021,
2/20/2021 Pry this Amount: 1,061.98 USD
APPROVED ON
DEC 28 2021
By GOUNTY AUDITOR
CALHOUN COUNTY, TEXAS
For AR Inquiries please contact 800-847-0333
Due If Read On Time:
LED
1,040,741/
DIN lost N paid late:
21.24
Due It Paid Late:
USD
1,061.98
STATEMENT
C pm,y. 8000
CVS PHCY 7475/MEM MC MS AMT DUE REMITTED VIA ACH DEBIT
MEINOMAL MEDICAL CENTER Statement for Information only
VICKY KAUSBK
815 N VIRGINIA ST
PORT IAVACA TX 77979
As of: 1212412021
Page: 001 To ensure Weller credh to your
account, detach and Mum this
aide with your remhtaoue
OC: 8115
As of: 12/24/2021 Page: 001
Mall he comp: 8000
Territory: 900
AMT DUE VIA DEBIT
Customs: 835938
Statement far inlormelicn only
for information my
Date: 12V25/2021
filling Oue
Neeewabie'ationel Account MAPS
late Date
Number Reference Description
)ustoms Number 835438
CVS PHCY 7475/MEM MC PHIS
2/21/202/ 12/21/2021
7313678104 1292811 115Cre4h
2/21/2021 12/21/2021
7313678105 1292811 115Credlt
2/23/2021 12/28/2021
7314197373 1500461 1151nvoice
W column legend: P =
Past Due Item, F = Future Due Nam, blank = Curren Duo Item
'OTAL Customer Number 835438 CVS PHCY 7475/MB4 MC PH$
Sublatals:
:inure Due:
0.00
It Pam By 12/26/2021,
hIst Due:
519.84- Pay This Amount:
am Payment
11,814.44 If Paid After 1212812021,
2/20/2021
Pay this Amount:
APPROVED ON
DEC 29 Z021
BY COUNTY AUDITOR
CALNOUN COUi`RY, r XAI3
cum: 835438
PLEASE CHECK ANY
Date: 12/25/2021
ITEMS NOT PAID (e)
cam
Cash Amount P
ou Olscni (gross) F
Amount P
(rre[) F
Nble
Number
315.66- P
315.88P ✓
731367810
209.16- P
204.18. P v
)3136]6105
6.99 349.60
342,61 ,/
7314197373
170.24. USD
Due U Pam On Time: _
USD 177.23- ✓
177.23. USD 01. lost If paid late:
6.99
Due If Paid late:
170.24- USD USD 170.24-
For AR Inquiries please contact 800-867-0333
MSKESSON STATEMENT As of: 12/24/2021
Page: 001
TO chooseproper credit to your
account, delcch and return this
saw
stub with your remittance
DC: 8115
As of: 12/24/2021 Page: 001
HES PHCY 0434/MEv1 M® PHS pMT DUE REMITT® VIA ACM DEBIT Territory: 400
Mall to: Comp: ullo
MEMORIAL MEDICAL CENTER Statement for information only
AMT DUE REMITTED VIA ACH DEBIT
VICKY KAUSEf Customer. 190813
Statement for Information only
815 N VIRGINIA ST Date: 12/25/2021
PORT LAVACA TX 77979
Cust: 190813 PLEASE CHECK ANY
Datm 12/25/2021 ITEMS NOT PAID (�)
xallowd Aerwunl 963&p538
Llling Due Numbabl0' DmHF Olm
late — pate Number Reference Description Dlseount
Amount P
(gross) F
An1011nt P NReceivable
(net) F Number —
umber
:uetomer Number 190613 NO PHCY 04341ME4 N ED PHIS
W22/2021 12/28/2021 7313713812 2017041251 1151nvolce 1.22
60.96
59.74 s/ 7313713812 O
'F C lumn legend: P = Past Due Item, F = FL1urs Due Item, blank = Curren Due Hem
'DTALA' mitenew Number 190813 H® PHCY 0434IMEM MED PHS
Subtotals: 60.96 USD
'Were Due: 0.00
Due If Paid On Time:
If Pald By 1212812021,
USD $9.74 ✓
his1 Due: 0.00 Pay This Amount: 59.74
USD
01. last If Paid late:
1.22
eat Payment 6.677.44 If Pold After 1212812021,
Due If Peld late:
2/1312021 Pay this Amount: 60.96
USD
USD 60.96
APPROVED ON
DEC 28 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
For AR Inquiries please contact 80("67-0333
STATEMENT Statement Number: 62198155
AmerisourceBergen- Date: 12-24-2021
1 Or 1
AMERISOURCESERGEN DRUG CORP
WALGREENS 412494 340E
12727 W. AIRPORT BLVD.
MEMORIAL MEDICAL CENTER
1001352841037028186
SUGAR LAND TX 77478.6101
1302 N VIRGINIA ST
• PORT tAVACA T( 77979-2509
DEA: RA0289276
Sat -Fn Due in 7days
866451-9655
AMERISOURCESERGEN
P.O. Box 905223
Not Yet Due:
0.00
CHARLOTTE NC 28290-5223
Current.
674.17
Past Due:
0.00
Total Due:
674.17
Account Balance:
674,17
mccount AlcavtTy
Document Due
Reference
Purchase Order
Document
Original Last Receipt Amount Received
Balance
Date Date
Number
Number
Type
Amount
12-20-2021 12-31-2021
30774474%
164005
Invoice
410.46
0.00
410.46.,E
12-20-2021 12-31-2021
3071447457
164006
Invoice
0.09
0,00
Doll
12-20.2021 1231-2021
W77447488
164008
Invoice
36.02
0.00
36,02 L'
12-20-2021 12-31.2021
3077490303
164056
Invoice
5.67
0.00
5.67
12-20.2021 12-31-2021
30774903M
164057
Invoice
29.72
0.00
29.72 ✓
12-21-2021 12-31-2021
3077629720
Wear
Invoice
19.54
oco
19.54 ✓
12-224021 12-31-2021
3077803005
164076
Invoice
5.49
0.00
5.49
1-
1243-2021 12-31.2021
3077964607
164085
Invoice
158.00
0.00
158.00
✓
12-23-2021 12-314021
3077954608
164086
Invoice
9.18
0.00
9.18
Current
1-16 Days
16-30 Days
31-60 Days
61-90 Days
91.120 Days
Over 120 Days
6]4.1]
0.00
0.00
0.00
0.00
0.00
0.00
Reminders
YOU for Your Payment
F
Amount
Due Date
Amount
1289.00)
12.31.2021
674.17
Total Due:
674;17
APPAOVEDON
DEC 28 2021
BY COUNTY AUDITOR
CALROUN GOURTY, TEXAS
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"
ETIF FEDERALTAX DEPOSIT ENTER 1"
"ENTER 2-DIGIT TAX FILING YEAR"
"ENTER 2-DIGIT TAX FILING ENDING MONTH"
1ST QTR - 03 (MARCH) -Jan, Feb, Mar
2ND QTR - 06 (JUNE) - Apr, May, June
3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept
4TH QTR -12 (DECEMBER) - Oct, Nov, Dec
"ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN"
"1TO CONFIRM"
"ENTER W/CENTS AMOUNT OF SOCIAL SECURITY"
"ENTER W/CENTS AMOUNT OF MEDICARE"
"ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING"
F1116-DIGIT SETTLEMENT DATE"
"1 TO CONFIRM"
ACKNOWLEDGEMENT NUMBER
CALLED IN BY:
CALLED IN DATE:
CALLED IN TIME:
#### ENTER:
### E:7_-___]
V1
It
$
18180228:
1
12,431.00
$
2,924.82
$
3,446.46
1
F:WP•Payroll FileslPayroll Taxes12021V126 R2 MMC TAX DEPOSIT WORKSHEET 12,16,21 R2 xls 1212312021
Rua Bate: 12/22(21 FBORIAL R D'XAL CENin"R Page 90
Tine: 16:28 Payroll Register 1 Bi-weekly y P2REG
Pay Perim 12/03/21 - 12/14/22 Run3 2
Final Sumtary
'-- P a y C o d e S u m m a r y--------------------------
Payed Description Era OTjSRjwzjFmjc3j
n.....____._._..__..____................................
EXTRA WAGES N N N
P PAID -TIME -OFF 117.61 N N N N
---------.-- D e d
u c t i c n S
Grass Cade
Amm-
..................................
98922.78 A/R
A/R2
1BB0.56 ADVAMC
AWARDS
BOOTS
CAFE N
CAFE-2
CAFE-1
CAFE-5
012-C
CAFE-F
CAFE-F.
CAFR-L
CAPE.;
CHILD
CLINIC
CREDUN
00 ADV
DEP-IF
D.S-LF
EATCSE
FECTA:4
FICA-D
6215.56 r-:P.STC
FIE FE
-.CRT D
GIFT S
GRANT
OIL
ROSP-1
LEAF
LEGAL
ReALE
RMIS
M:SCi
M!CSER
OTHER
PAI
PP. FIN
RELAY'
SAME
SCRUBS
ST-TX
STOMDF
51ONE2
S„DEN
SUNIa
SUNiND
SUIISID
SUNVIS
TSA-2
TSA-2
TSA-P
TSA-R
UNIFOR
UWlRBS
S u m m a r y----•---------------------------
A/R3
BCBS'2I
CAFE -I
CAFE-:
w-Z-0
_62.51 CAT: 1
CANCER
C04RIN
DENTAL
EAT
3446.46 F:C;-K,
FLU S
F TA
GAP -TN
ID TFT
NASA
NISC
NATFMi
PHI...
REPAY
SiONON
$'ONE
SL'IACC
SMILIF
SURING
TSA-C
7055.70 TUTION
-16.26
'462.41
'••••--•--•-•-------- Grand Totals: 117.61------- ! Grass: 100803.36 Deductions: 18001.30 Net: MUM 1
CheCkS Door:- FT 175 PT 9 Other Female :69 male 15 Credit OverAmt Zerdet Tem Total: 164
•................................................................................... ............... ............................�
12-1p,cy dah--
DEC 2 :
�Y COUN" '-\UDITOR
C"OUN C=• J14TV, TE>th�
MEMORIAL MEDICAL CENTER
PROSPERITY BANK
FOR OPERATING ACCOUNT-- December 20, 2021- December 26, 2021
Dale Bank Desc lotion
12/24/2021 PAY PLUS ACHTRANS452579291101000691630357
12/24/2D21 AMERISOURCE BERG PAYMENTS 01ON07768 2200002
12/23/2021 PAY PLUS ACHTRANS 452579291101000690948581
12/23/2021 IRS USATAXPYMT 2201757838661366103601000209
12/22/2021 PAY PLUS ACHTRAN5452579291101000699983400
12/22/2D21 EKPERTPAY ExPERTPAY 74600341191000017744798
12/22/2021 MEMORIAL MEDICAL PAYROLL 746003411113122650
12/21/2021 PAY PLUS ACHTRAN5452579291103000699154517
12/21/2021 MCKESSON DRUG AUTO ACH ACH0484453291OW0138
12120/2022 VOEBFILE TAX PYMT DO 902104464089 21000027230
12/20/2021 PAY PLUS ACHMANS452S792911010MG98179608
MMCNotes
-3rd Party Payor Fee
-3408 Drug Program Expense
- 3rd Parry Payor Fee
-Payroll Taxes
. 3rd Party Payer Fee
-Child Support Payment -Payroll Ending •••'•••'
-Payroll
- 3rd Party Payor Fee
- 3408 Drug Program Expense
Sales Tax
-3rd Party Payor Fee
I - T/ 12/28/2021
Anthony Richardson, CF
Memorial Medical Center AA"Wd,.A 12.92.21 CL
PROSPERITY BANK
ELECTRONICTRANSFERS FOR OPERATING ACCOUNT —ESTIMATED ACHS
Date
Anthony Richardson, CFO v
Memodal Medical Center
6- MMC Not..
269-u1.1 +
1H^ZU =
93 091, na -
26.7
614.20
292+ 41
9.4
cl4.44
113' Ic 9
9U^9UI -.
,99r41b1.
APPAOVEDON
DEC 2 8 2021
Q7..lvlus
CPI
Amount
6 • S
i
5 0
28.0,.t
1 N • 2 1i �-
$ 289
$ .. 18t20 �
2 !i • � i
$ RL6.3p
9 U • `J U
s "111s9:a a
$ 11,814.44'
�x i-p•
$ 1,182.sgA#-
6 1 4• 2 U =
$ L 9Q.90t w;•.. ;
181.2> -
614.2U
-na,-139A6 795 4
399,H13.15
s99,,1i�•r,
i f151 -
Amount I 1 I
I IL.
799, 4s
BYCOUNTyO.' U 20D
CALHOUN IS TE%A8
Page 1 of 1
RECEIVED BY THE
COUNTY AUDITOR ON
MEMORIAL MEDICAL CENTER
z zza 2 2 2021
0
AP Open Invoice List
07:4
ap_open_invoice.template
Dates Through: 01l13/2022
%0Ao ®tlNfi2kIN1MaTEXAS Class Pay Code
11816 ASHFORD GARDENS
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
121521 12/20/20 12/15/20 01/13/20 3,772.65
0.00
0.00
OCTOBER OIPPt&2 SEPT OF
Vendor Total: Number Name Gross
Discount
No -Pay
11816 ASHFORD GARDENS 3,772.55
0.00
0.00
Report Summary
Grand Totals: Gross Discount
No -Pay
3,772.55 0.00
0.00
APPROVED ON
DEC 22 2021
BY COUNTY AUDITOR
CAW OUN COUNTY, TEXAS
Net
3,772.55
Net
3,772.55
Net
3,772.55
file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report3671... 12/22/2021
Page 1 of 1
RECEIVED 13Y THE
COUNTY AUDITOR ON
t, �eMEMORIAL MEDICAL CENTER � G 2021 AP Open Invoice List 0
Dates Through: Oi/13/2022 ap_open_invoice.templale.
CAWWOMMA NWS Class Pay Code
11828 SOLERA WEST HOUSTON .,/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
121521 12/20/20 12/15/20 01/13/20 2,244.01 0.00 0.00 2,244.91
OCT OIPP 182 AND SEPT OIPI
Vendor Total=. Number Name Gross
11828 SOLERA WEST HOUSTON 2,244,91
Report Summary
Grand Totals: Gross Discount
2,244.91 0.00
APPROVED 014
DEC 2 2 2021
By COUNTY AUDITOR
CALHOUN COUNTY,TE%AS
Discount No -Pay Net
0.00 0.00 2,244.91
No -Pay Net
0.00 2,244.91
file:///C:/Users/eheiman/cpsi/memmed.cpsinet.coin/u985471data_5/tmp_cW5report8144... 12/22/2021
Page 1 of 1
RECEIVED BY THE
COUNTY AUDITOR ON
DEC 2 2 2021
12/22/2021
CALMWCOUNTY, TEXAS
MEMORIAL MEDICAL CENTER
AP Open Invoice List
Dates Through: 01/13/2022
0
ap_open_invoice.tempiate
Vendor# Vendor Name Class Pay Code
11820 FORTBEND HEALTHCARE CENTER ✓
Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
121521 12/20/2012115/2001/13/20. 1,526.47 0.00 0.00 1,526.47
OCT QIPPI&2 AND SEPT QIPF
Vendor Total, Number Name Gross
11820 FORTBEND HEALTHCARE CENTER 1,526.47
Report Summary
Grand Totals: Gross Discount
1,526.47 0.00
APPROVED ON
DEC 22 2021
By COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
Discount No -Pay Net
0.00 0.00 1,526.47
No -Pay Net
0.00 1,526.47
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Page 1 of 1
RECEIVED BY THE
COUNTY AUDITOR ON
DEC 2 2 2021
p�22� MEMORIAL MEDICAL CENTER
CALHo050 ATY, TEXAS AP Open Invoice List
Dates Through: 01/13/2022
Vendor# Vendor Name Class Pay Code
11832 BROADMOOR AT CREEKSIDE PARK ✓/
Invoice# Comment Tran Dt Inv DI: Due Dt Check D Pay Gross
121521 12/20/20 12/15/20 01/13/20 1,559.18
OCT QIPP 1&2 AND SEPT QIPI
0
ap_open_invoice.template
Discount No -Pay
0.00 0.00
Vendor Totals Number Name Gross Discount No -Pay
118$2 BROADMOOR AT CREEKSIDE PARK 1,559.18 0.00 0.00
Report Summary
Grand Totals: Gross Discount No -Pay
1,559.18 0.00 0.00
DEC 2 2 2021
BY COUNTY AUDITOR
CALI-IOUN COUNTY, TEXAS
Net
1,559.18
Net
1.559.18
Net
1.559.18
file;///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report6424... 12/22/2021
Page I of 1
RECEIVEDNDfrORON
MEMORIAL MEDICAL CENTER
/t2
FT 2021
2
AP Open Invoice List
a
IUK52B
ap_open_invoice.template
Dates Through: 01/13/2022
nc
�p1J�[�rQidt0M8Nsi i Class Pay Code
11824 THE CRESCENT ✓/
Invoice#
Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
120821
12/20/2012/08/2001/13/20 6,460.00
0.00
00
6,460,00
TRANSFER NI} in&vun.u- p�u.I dqsi{C,�-
� � anL�
.
121521
12/20/20 12/15120 01/13/20 3,117.27
0.00
0.00
3,117,27
TRANSFER Nl♦ rUy rj� cf &_tp(
Vendor Totals
Number Name Gross
Discount
No -Pay
Net
11824, THE CRESCENT 9,577.27
0.00
0.00
9,577.27
Report Summary
Grand Totals:
Gross Discount
No�Pay
Net
9,577.27 0.00
0.00
9,577.27
APPROVED ON
DEC 22 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEAS
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Page 1 of 1
RECEIVED BY THE
COUNTY AUDITOR ON
2021
MEMORIAL MEDICAL CENTER
pgwVe
AP Open Invoice List
07:51
.E Dates Through: 01/13/2022
n�a
CAU�&Q%ndor
Name
Class Pay Code
11836 GOLDENCREEK HEALTHCARE ✓'
Invoice#
Comment Tran Dt Inv Dt Due Dt Check DPay Gross
120821A
12120120. 12/08/2001/13120 3,684.05
TRANSFER �/q'jndUV^U' ofpktdj_V0SiACj_ Ir'A
121021E
12/20120. 12110/20 01/1/20 25.521.30
TRANSFER 1%
121021
12/2012012110/2001/13120 8,386.46
TRANSFER tl
121021A
12/20/20. 12/10/2001/13/20 1,143.47
TRANSFER L1
121521
12/20/20 12115/20 01/13120 7,745.92
OCT QIPP 1 &2 AND SEPT QIPI
Vendor Total: Number Name Gross
11836 GOLDENCREEK HEALTHCARE 46,481.20
Report Summary
Grand Totals:
Gross Discount
46.481.20 0.00
APPROVED ON
DEC 22 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
0
ap_open_Invoice.template
Discount
No -Pay
Net
0.00
0.00
3,684.05
11A11/lt-
l)iR,.,..
0.00
� 0.00 (�
0.00
25,521.30
1�
0.00
0.00
8,386.46
t.
0.00
0,00
1,143.474'�
It
0.00
0.00
7,745.92
Discount
No -Pay
Net
0.00
0.00
46,481.20
No -Pay
0.00
Net
46,461.20
file:///C:/Users/eheimarVepsi/memmed.cpsinet.com/u98547/data 5Amp_cw5report 1385... 12/22/2021
Page 1 of I
RECEIVEAUp�R E
COUNTY
MEMORIAL MEDICAL CENTER
0
� 2021 AP Open Invoice List
QU4/2
ap_open_invoice.template
Dates Through: 01/13/2022
Class Pay Code
CALr'ib0@"wrV"
12696 GULF POINTE PLAZA
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay
Grass
Discount
No -Pay
Net
120821 12�/120/2012/08/20 01/13/20
927.50
0.00
0.00
927.50
TRANSFER N R 1hSJYt ilt(R "1- G1t}7�j1 �'C..l
t2k1 wmf- UKt vw+
121021 12120/20 12/10120 01/13120
9,410.70
0.00
O. 0
9,410.70
TRANSFER N
Ik
121021A 12120/2012/1012001/13/20
11,141.80
0.00
0.00
11,141.80
TRANSFER It
it
121521 12/20/20 12/15/20 01/13/20
2,255.02
0.00
0.00
2,255.02 f
TRANSFER N lj- (jlhp VWJhm
.
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
12696 GULF POINTE PLAZA
23,735.02
0.00
0.00
23,735.02
Report Summary
Grand Totals: Gross Discount
No -Pay
Net
23,735.02 0.00
0.00
23,735.02
APPROVED ON
DEC 2 2 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
file:///C:IUsersleheiman/cpsilmemmed.cpsinet.com/ti98547/data_5/tmp_cwSreport9l 17... 12/22/2021
Page 1 of 1
g�(• e�uoRORON
UddK w�/2 21
door Name
13004 T {SAGE
OALt4OUN C
MEMORIAL MEDICAL CENTER
AP Open Invoice List
Dates Through: 01/13/2022
Class Pay Code
Invoice#
Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross
120821
12/20/2012/08/2001/13/20i
11,530.36
TRANSFER N} 10SU4 K(IL Fvjrkt d(VOSt'�e,.L
Ih'A
120921
12/20/20 12/09/20 01/13/20
184.00
TRANSFER
121021A
12/20/20 12110120 01/13120
2,331.08
TRANSFER r`
121021C
12/2012012/10/2001113/20
6,468,00
TRANSFER 4
121021
12/20/2012/1012001/13/20
695.25
TRANSFER It
121021a
12120/20 12110/20 01/13/20
3,260.46
TRANSFER. t,
121521
12/2012012/15/2001/13120
3,289.28
OCT QIPP 1 &2 AND SEPT OIPI
122121
12/21/20 12/21120 01113/20
5,189.82
MEDICARE REPAYMENT
Vendor Total; Number Name
Gross
13004 TUSCANY VILLAGE
31,948.25
Report Summary
Grand Totals:
Gross Discount
31,948.25 0.00
APPROVED ON
DEC 22 2621
13Y COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
0
ap_open_Invoice.template
Discount
No -Pay
Net
0.00
0.00
11,530.36 ./
Iv�n> c
Opr,w1-Y
0.00
0:00
11
184.00 L,/
0.00
0.00
2,331.08 VZ
I�
0.00
0.00
5,468.00 /
0.00
0.00
695.26
u
,
0.00
0,00
3,260.46 ✓
0.00
t•
0.00
3.269.28
0.00
0.00
5,189.82
Discount
No -Pay
Net
0.00
0.00
31,948.25
No -Pay Net
0.00 31,948.25
file:IIIC:/Users/eheiman/cpsi/mermned.cpsinet.com/u98547/data_5/tmp_cw5report7342... 12/22/2021
Page 1 of 1
C
AUDITOR ON
COUNTY
2 2021
MEMORIAL MEDICAL CENTER
1pf02
07:4g AP Open Invoice List
COUNTY, TEXAS
0
ap_open_invoice.tempiate
CA1 HPUN
Dates Through; 01M 3/2022
Vendor# Vendor Name
Class Pay Code
12792 BETHANY SENIOR LIVING
Invoice#
Comment Tran DI Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
120821E
1t�,2II/`2,ll0/2012/08/2001113/20
1,484.00
0.00
0.00
1,484.00 D/
TRANSFER �h(.:V1'4t u r7ntu.}-rlrp v„' Hrvl-
Iv W �''`iW-'^�
11�1 Km(— o �!
,
120821A
12120/20 12/08/20 01/13/20
27,304.56
0.00
Q0.00
27,304.56
TRANSFER 10
It
,
121021
12/20/20 12/10/20 01/13/20
38,070.97
0.00
0.00
38,070.97 t/
TRANSFER
121021A
12/20120 12110/20 01/13120
3,237.67
0,00
0.00
3,237.67,%
TRANSFER it
it
122121
12121120. 12121/2001/13/20
1,349.78
0.00
0.00
1,349.78 /
MEDICARE REPAYMENT
,✓
Vendor Totals
Number Name
Gross
Discount
No -Pay
Net
12792 BETHANY SENIOR LIVING
71.446.98
0,00
0.00
71,446.98
Report Summary
Grand Totals:
Gross Discount
No -Pay
Net
71,446.98 0.00
0.00
71,446.98
APPROVED ON
DEC 2 2 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, Tr_XA6
file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report3451... 12/22/2021
TremhrC Request for Transfer of Funds
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DEC 2 S 2021
CAAt OUN CCUNN, TIMS
PAYEE
AMOUNT
GULF POINTE PLAZA
CHECK REQUEST
MEMORIAL MEDICA CENTER
EXPLANATION: ECHO PAYMENTS OWED FROM GPP
DATE: 12/27/21
•1 �
DEC 28 2021
BY COUNTY AUNTOR _
CALHOUN COUNTY, TEXAS
G/L NUMBER:
REQUESTED BY: Mayra Martinez AUTHORIZED
GULF POINTE PLAZA
CHECK REQUEST
PAYEE
BROADMOOR
AMOUNT $6,020.00
EXPLANATION: ECHO PAYMENTS OWED FROM GPP
DATE: 12/27/21
APPROVEDON
DEC 2 8 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEXAS
G/L NUMBER:
REQUESTED BY: Matra Martinez AUTHORIZED
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12/27/2021
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12/27/2021
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Treasury Center
Quick View
Select Quick Vlaw Accounts
Select Group
Account: Number / Name
Groups
Add Grcup
Account Type
(DDA
Data reported as of Oec 27. 202
Account Number Current Balance
Available Balance
Collected Balance
Prior Day Balanc
Number of Accounts: 15
$7,917,146.82
$8,111,799.59
$7,917,146.82
$7,580,909A
'4551
CAL CO INDIGENT
S5,62209
$5,420.81
$5,622.09
S5,622.0
HEALTHCARE
'44S4
MEMORIAL MEDICAL I
NH GOLDEN CREEK
$141.435.23
S141,435.23
S141,435.23
$122,713.7
HEALTHCARE
•4365
MEMORIAL MEDICAL
CENTER -CLINIC SERIES
$535.99
$535.99
$635.99
$535.E
2014
'4357
MEMORIAL MEDICAL
$4,860,045.83
$4,898,85845
$4,660,045.83
54,763,632A
CENTER -OPERATING
'4373
MEMORIAL MEDICAL
CENTER -PRIVATE
S431,51
$431.51
$431.51
$431.E
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$353,179.61
S359,479.77
S353,179.61
$292,352,2
CENTER I NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTERINH
$222 712 79
✓
$266.994.47
$222,712.79
S218,135.1
BROADMQOR
'4411
MEMORIAL MEDICAL
$273,940.73
✓
S283,490.83
S273,940.73
S250,757.Y
CENTER I NH CRESCENT
'4446
MEMORIAL MEDICAL
$130,849A3
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$133,501.18
S130.849.13
$117,638
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•4438
MEMORIAL MEDICAL
CENTER I SOLERA AT
$277.017.03
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$277,017.03
$277,017.03
$244,375.2
WEST HOUSTON
.2998
MMC-MONEY MARKET
$1,109,095.73
$1.109,095.73
S1,109,095.73
$1,109,095.7
FUND
'6506
MMC -NH BETHANY
$235,876.92
9329,134.36
S235,876,92
S231.143.1
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA-
$99,003.43
$99.003.43
$99,003.43
S99,003A
MEDICARE/MEDICAID
'5433
MMC -NH GULF POINTE
$40,947.13
$40,947.13
$40,947.13
$40,947.1
PLAZA - PRIVATE PAY
'3407
MMC-NH TUSCANY
$166.453.67
S166.453.67
S166.453.67
$84.525.E
VILLAGE
httpsY/prosperityolbanking.mm/onlineMessenger
1/1
Memorial Medical Center
Nursing Home UPL
Weekly Nexion Transfer
Prosperity Accounts
12/27/2021
vroa u
Autount INUnn1nB P.O., rodaY's Bejinnlry "aunt to Be Tnnrferred to Nunan;
NurNn None Number Balance Tra"121 I ,Tnnrre, " De a'N Bolan. Hem.
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Aaprwed:Aij
MManY RIMaNren, CFO 12/tT/j021
APPROVED ON
DEC 2 S 2021
BY COUNTY AUDITOR
CALHOUN COUNTY, TEM8
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12/27/2021
Treasury Center
Quick View
Select Quick View Accounts
Select Group
Account Number/Name
Groups
Antl Group
Account Type
v
Search All
iDDA
Data repeeeu as of Dec 27 202
Account Number Current Balance
Available Balance
Collected Balance
Prior Day Balanc
Number of Accounts: 15
$7,917.146.02
$8,111,799.59
$7,917,146.82
$7,580,909A
•4551
CAL CO INDIGENT
S5,622.09
$5,420.81
$5,622.09
$5,622S
HEALTHCARE
`4454
MEMORIAL MEDICAL 1
NH GOLDEN CREEK
$141,435.23
$141.436,23
$141.435.23
$122,713.7
HEALTHCARE
'4365
MEMORIAL MEDICAL
CENTER - CLINIC SERIES
$535,99
S535.99
S535.99
$535.E
2014
'4357
MEMORIAL MEDICAL
$4.860,045.83
$4,898,858.45
S4,860,045.83
$4,763,632.4
CENTER -OPERATING
•4373
MEMORIAL MEDICAL
CENTER - PRIVATE
$431.51
S431.51
$431,51
S431
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$353.179.61
S359479.77
S353,179.61
S292,3522
CENTER INH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
$222.71279
$266,994A7
S222.712.79
$218,135.1
BROADMOOR
'4411
MEMORIAL MEDICAL
$273,940.73
S283,490.83
$273,940.73
$250,757.2
CENTER/NH CRESCENT
'4446
MEMORIAL MEDICAL
$130,849.13
S133,501.18
S130,849A3
$117,638.2
CENTER/NH FORT BEND
•4438
MEMORIAL MEDICAL
CENTER I SOLERA AT
$277.017.03
$277,017.03
$277,017.03
S244,375.c
WEST HOUSTON
'2998
MMC-MONEY MARKET
S1.109.095.73
S1,109.09573
S1.109.095.73
$1,109.095.1
FUND
•5506
MMC -NH BETHANY
$235.876.92
$329,134.36
$235.876.92
$231.143.1
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA -
$99,003A3
$99.003.43
$99.003.43
$99,003.4
MEDICARE/MEDICAID
'6433
MMC -NH GULF POINTE
$40,947.13
$40,947,13
$40,947.13
$40,947,1
PLAZA - PRIVATE PAY
'3407
MMC-NH TUSCANY
$166,453.67
$166,453.67
S166,453.67
$84,525.E
VILLAGE
i
https:Ilprosperity.olbanking.com/onlineMessenger
1!1
Memorial Medical Center
Nursing Home UPI.
Weekly HMG Transfer
Prosperity Accounts
12/27/2021
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12/27/2021
Quick View
Select Qulck View Accounts
Account Number I Name
Account Type
IF
Search All
DDA
Account Number Current Balance
Number of Accounts: l5
$7,917.146.82
'4551
CAL CO INDIGENT
55.622.09
HEALTHCARE
'4454
MEMORIAL MEDICAL 1
$141,435.23
NH GOLDEN CREEK
HEALTHCARE
'4365
MEMORIAL MEDICAL
$535.99
CENTER - CLINIC SERIES
2014
'4357
MEMORIAL MEDICAL
$4,860,045.83
CENTER -OPERATING
'4373
MEMORIAL MEDICAL
$431.51
CENTER -PRIVATE
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$353.179.61
CENTER / NH ASHFORD
'4403
MEMORIAL MEDICAL
$222 712 79
CENTER/NH
BROADMOOR
'4411
MEMORIAL MEDICAL
$273,940.73
CENTER/NH CRESCENT
'4446
MEMORIAL MEDICAL
$130.849.13
CENTER I NH FORT BEND
'4438
MEMORIAL MEDICAL
5277.017.03
CENTER I SOLERA AT
WEST HOUSTON
'2998
MMC-MONEY MARKET
51.109.095.73
FUND
•5506
MMC -NH BETHANY
$235,876.92
SENIOR LIVING
'5441
MMC -NH GULF POINTE
$99.003.43
PLAZA-
MEDICAREIMEDICAID
'S433
MMC -NH GULF POINTE
$40,947.13
PLAZA -PRIVATE PAY
47
MMC -NH TUSCANY
$166,453.67
VILLAGE
baps:Nprosperity.olbanking.wmlonlineMessenger
Treasury Center
Select Group
Groups
Atld Graup
Data reported as of Dec 27, 202
Available Balance Collected Balance Prior Day Balanc
$8,111,799.69 $7.917,146.82 $7,580,909.:
$5,420.81 $5,622.09 $5,622.0
5141,435.23
5741,435.23
$122.713.7
$535.99
$535.99
5535.E
$4,898.858.45
54,860,045.83
$4,763,632.4
$431.51
5431,51
$431
5359,479.77
$353,179.61
5292,352.2
5266,994.47
5222,712.79
$218,135.1
S283,490.83
$273,940.73
$250,757„
S133,501.18
5130,849A3
$117,638,°
5277,017.03
5277,01T03
5244,3751
S1.109.095.73
51,109,095.73
51,109,095.7
5329,134.36
S235.876.92
S231,143,1
$99.003.43
$99.003.43
$99.003.4
$40,947.13 $40,947.13 $40,947.1
$156,453.67 $166,453.67 $84,525.k
r 111
Memorial Meolcal Center
Nursing Home UPL
Weekly Tuscany Transfer
Prosperity Accounts
12/27/2021
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13/21/,3021 AMERIGROUPCORPO, E-PAYMENTUSUB3352111000
121M2021 WIRE OUT LINEAR ENTERPRISES, LLC 74,014.03
12/22/2021 Deposit -
12/22/3021 Deposit -
12/22/2021 Deposit
12/22IM21 MOUNAHEALTHCAR!MOUNAACN0102171242000011 -
12/22/2021 HNB-ECHO ROMIK RMT 746003C11440000204137 -
32/23/1U21 CK1088 9,649.92
12/23/2021 Moline HCef T% HCWIMPWPN12757170944200
12/23/2021 KS PUN ADMINISTHCCIAIMPMT 179111000021827 -
12/24/2021 NOVITAS SOLUTION HCCUIMPW IS76201420000187
MMC PORTION
QIPP/COMP4
Transfer -I
CUPP/Cempl
QIPP/Camp2 gIPP/[amp3 Elapse
QIPP71
NH PORTION
10,974,16
-16,132.20
3,74186
18,0113.111
1.870.98'.
17,452.15
17,452AS
4,829.m
4,829.00
7,784.73
-
7,784.73
13.075,13
8s881100
4,VAA3.
10,36a.0
2,11Z32
6,804.22
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6,684.22
446.17
448.17
14,D80.00
14,090,00
81,927.81
83,927.81
U.663.95 166,151.67 24,983.20 7,966.39 28,966.40 07.387.28
12127/2021
Treasury Center
Quick View
Select Quick View Accounts
Select Group
Account Number/Name
Groups
Add Group
Account Type
tDDA
Data reported as of Dec'27 2021
Account Number
Current Balance
Available Balance
Collected Balance
Prior Day Balanc
Number of Accounts: 15
$7,917,146.82
$8,011,494,91
$7,917,146.82
$7,580,909.f
'4551
CAL CO INDIGENT
$5.622.09
$6,420.81
$5,622.09
$5,622.0
HEALTHCARE
'4454
MEMORIAL MEDICAL/
NH GOLDEN CREEK
$141.435.23
$141,435.23
S141,435.23
S122,713.7
HEALTHCARE
'4365
MEMORIAL MEDICAL
CENTER - CLINIC SERIES
$535.99
S535.99
$535,99
5535.E
2014
'4357
MEMORIAL MEDICAL
$4,860,045.83
S4.891,811.21
S4,860,045.83
S4,763,632s1
CENTER -OPERATING
'4373
MEMORIAL MEDICAL
CENTER - PRIVATE
$431.51
$431.51
S431.51
S43Lf
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$353,179.51
$359,479.77
$353.179.61
S292,352.2
CENTER NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
$222 712.79
$266,994.47
S222,712,79
S218,135A
BROADMOOR
'4411
MEMORIAL MEDICAL
$273,940.73
S283,490.83
$273.940.73
$250,757.2
CENTER / NH CRESCENT
'4446
MEMORIAL MEDICAL
$130.849.13
$133,601.18
$130,849.13
$117,638.2
CENTER / NH FORT BEND
'4438
MEMORIAL MEDICAL
CENTER /SOLERA AT
$277,017.03
5277.017.03
S277,017.03
S244,375.2
WEST HOUSTON
'2998
MMC-MONEY MARKET
$1,109,095.73
S1,109,095.73
S1J09,095.73
S1,109,095.7
FUND
'5506
MMC-NH BETHANY
$235,876.92
S235.876.92
$235,876.92
S231,143.1
SENIOR LIVING
-
•5441
MMC -NH GULF POINTE
PLAZA-
$99.003.43
$99,003.43
$99.003.43
S99,003.4
MEDICARE/MEDICAID
'5433
MMC •NH GULF POINTE
$40,947, 13
$40,947.13
S40,94713
S40,947,1
PLAZA -PRIVATE PAY
'3407
MMC-NH TUSCANY
$166,453.67 ✓
S166,453.67
S166.453.67
$84,525.E
VILLAGE
https:lfprosperity.olbanking.com/onlinaMessenger
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Memorial Medical Center
Nursing Home UPL
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Prosperity Accounts
12/27/2022
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12/24/2021 HEALTH HUMAN SVC HCCLAIMPMT 1746WUI13U162
12/23/2021 04Pm11
12/23/2021 Deposit
12/22/2021 WIRE OUT BETHANY SENIOR LIVING, LTD
12/22/2021 Dep441t
12/22/2021 0ep4,it
12/22/2021 Deposit
12/22/M21 Oep4slt
12/22/2021 NOVITAS SOLUTION HCCLAIMPMT 676481420W0193
12122/2021 HEALTH HUMAN SVC HCCLAIMPMT 17460034113016 2
12/20/2021 DoNslt
12/20/2021 D4wsit
12/20/2021 HEALTH HUMAN SVC HCCLAIMPMT 1746MB4113016 2
MMC PORTION
gfPP/Comp1
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12,659.21 - .1.859,21
3.710.00 - 3111moo
2,024.67 - 7,024.67
2.968.00 - 2,969.D0
124,933.65 - 174,933,65
1,614.26 - 1.61A26
4,824.W 4,624,00
13,400.15 - 13A0015
2.852.92 - 1.052.92
310,965.51 235.R9.98 / 235.H9.98
12127I2021
Treasury Center
Quick View
Select quick View Accounts
Select Group
Account Number I Name
Groups
Add Gnxip
Account Type
[DDA
Data reported as of Dec 27 202
Account Number
Currant Balance
Available Balance
Collected Balance
Prior Day Balanc
Number of Accounts: 15
$7.917,146.82
$8,111,799.59
$7,917,146.82
$715801909.f
'4551
CAL CO INDIGENT
55.622.09
$5,420.81
$5,622.09
$5,622.0
HEALTHCARE
'4464
MEMORIAL MEDICAL /
NH GOLDEN CREEK
$141,435,23
$141,435.23
5141,435.23
5122,713.7
HEALTHCARE
'4366
MEMORIALMEDICAL
CENTER -CLINIC SERIES
$535.99
5535.99
S535.99
$535.£
2014
'4357
MEMORIAL MEDICAL
54,860,045.83
$4,898.858.45
54,860,045.83
54,763,632.4
CENTER - OPERATING
•4373
MEMORIAL MEDICAL
CENTER - PRIVATE
$431.51
$431.51
S431.51
$431.f
WAIVER CLEARING
'4381
MEMORIAL MEDICAL
$353,179.61
5359,479,77
5353,179.61
$292,352.2
CENTER/NH ASHFORD
'4403
MEMORIAL MEDICAL
CENTER/NH
$22271279
5266,994.47
$222,712,79
5218,135.1
BROADMOOR
'4411
MEMORIAL MEDICAL
$273,940.73
S283,490.83
5273,94013
S250,757.2
CENTER INH CRESCENT
'4446
MEMORIAL MEDICAL
$130.849.13
5133,501.18
$130,849.13
$117,638.2
CENTER / NH FORT BEND
*4438
MEMORIAL MEDICAL
CENTER /SCLERA AT
$277,017.03
5277,017.03
$277,017.03
5244.375.2
WEST HOUSTON
'2996
MMC-MONEY MARKET
51,109,095.73
$1.109.095.73
$1.109,095.73
51,109,095.7
FUND
'S506
MMC-NH BETHANY
$235.876.92
5329,134.36
5235,876.92
$231,143.1
SENIOR LIVING
'5441
MMC -NH GULF POINTE
PLAZA -
$99.003.43
$99,003A3
$99,003.43
599,003.4
MEDICARE/MEDICAID
-5433
MMC -NH GULF POINTE
$40.947,13
$40,947.13
540,947.13
$40,947.1
PLAZA - PRIVATE PAY
'3407
MMC -NH TUSCANY
$166,453.67
$166,453.67
$166.453.67
$84,525.E
VILLAGE
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