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2021-12-08 Meeitng packet.pdf/' Q a YE;;IVL All Agenda Items Properly Numbered _ Contracts Completed and Signed 4,ev _ All 1295's Flagged for #cceptance (number of 1295s ) & All Documents for Clerk Signature Flagged On this ,day of 2021 a complete and accurate packet for e4k/ of o 2021 Commissioners Court Regular Session Day Month was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. A - Ca oun County Judge/Assistant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOTICE OF MEETING — 12/8/2021 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 Kaddie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners' Court off Calhoun County, Texas will meet on Wednesday, December 8, 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 10:00 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag — Commissioner Gary Reese Texas Flag — Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Bobby Vickery suggest decorating the Courthouse Lawn with Christmas decorations. Decoration donations can be brought to Sherriff Bobby Vickery. Page 1 of 5 NOTICE OF MEETING — 12/8/2021 5. Consider and take necessary action to authorize Commissioner Hall to sign a State of Texas General Land Office Application for State Land Use Lease for Army Corps of Engineers permitting in reference to the Mitigation/Restitution project by Doug Jensen located in Blind Bayou. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 6. Consider and take necessary action to award the bid for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. (DH) Bid awarded to Derrick Construction Company, Inc. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to authorize using $58,575.00 from GOMESA Funds to enhance the project for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the final plat of the Jameson Subdivision, Port O'Connor, Texas. (GR) Henry Danysh explained the final plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve the Amended Plat of the Saltwater Haven No. 2 Subdivision, Port O'Connor, Texas. (GR) Scott Mason explained the final plat. Commissioners agreed to pass until next week. Page 2 of 5 NOTICE OF MEETING— 12/8/2021 10. Consider and take necessary action to cancel the Invitation to Bid, approved on November 17, 2021 for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013-C673 Port O'Connor, Texas. The Invitation to Bid is being cancelled due to the County receiving information from the Texas General Land Office on December 2, 2021 that the federal funds are not available and after GLO reached out to NOAA, NOAA is not sure when the federal funds will be available. The Texas General Land Office suggested the project hold off on going out for bids until the federal funds are available. At the County's request, the Texas General Land Office can process a contract extension beyond the March 31, 2022 deadline since the Special Award Condition (SAC) #8 is causing a delay. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to approve the increase in the County Clerk Surety bond from $7,000 to $75,000 per Local Government Code 82.001. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to authorize JP #3, Tanya Dimak, to sign a 36- month agreement with Sparklight for wife service. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Consider and take necessary action to approve the 2022 Order setting maximum salaries, making various appropriations, setting vacation policy and sick leave policy, setting policy on payment of hospitalization insurance premium, setting holiday schedule and setting other miscellaneous policy matters. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 5 NOTICE OF MEETING— 12/8/2021 14. Consider and take necessary action to accept a Law Enforcement Partners donation to the Sherifrs Office in the amount of $1,970.32 to be deposited into the Motivation account. (RHM) 15. Consider and take necessary action to authorize the Sheriffs Office to remove one (1) vehicle from fleet and send to auction; and send two (2) abandoned vehicles and one (1) seized vehicle to auction. Auction proceeds will be deposited back into the vehicle maintenance account. (See attached list.) (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: bavid'Hall, Commissioner PdI SECONDER: GaryReese, Commissioner`Pct 4 AYES: Judge iMeyer, Commissioner Hall, Lyssy, Behrens, Reese 16. Consider and take necessary action to accept a $8,002.00 grant from the Golden Crescent RAC trauma funds allocation for FY22. (RHM) 17. Consider and take necessary action to authorize the County Judge to sign an interlocal agreement with the Harris County Institute of Forensic Sciences for postmortem examinations for the period January 1, 2022 through December 31, 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVEI David Hall, Commissioned Pct i SECONDER: Uern Lyssy; Commissioner PcY2 Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 18. Accept report from the following County Office: i. Floodplain Administration — November 2021 ii. Justice of the Peace, Precinct 1— November 2021 iii. Justice of the Peace, Precinct 2 — November 2021 iv. Justice of the Peace, Precinct 5 — November 2021 T_ _ . A _f, NOTICE OF MEETING — 12/8/2021 19. 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 20. 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: 10:42 a.m. Page 5 of 5 I ivori( I nF ��/u 1-1 N(I i ');;,, o)l 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 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, ;December 8, 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 o g' %QI FILED The subject matter of such meeting is as follows: AT ' cLocK al M q Call meeting to order. DEC 0 3 2021 ANNAM.GOODMAN inv cation. coo B' PI ONN NTYTEW Pledges of Allegiance. General Discussion of Public Matters and Public Participation. 5. Consider and take necessary action to authorize Commissioner Hall to sign a State of Texas General Land Office Application for State Land Use Lease for Army Corps of Engineers permitting in reference to the Mitigation/Restitution project by Doug Jensen located in Blind Bayou. (DH) Consider and take necessary action to award the bid for the Chocolate Bayou Boat Ramp �— Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. (DH) 7. Consider and take necessary action to authorize using $58,575.00 from GOMESA Funds to enhance the project for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No BA-2020 — Calhoun County — 00038. (DH) i 8 Consider and take necessary action to approve the 1 plat of the Jameson Subdivision, Port O'Connor, Texas. (GR) ��1,& 4-1��s Consider and take necessary action to approve the Amended Plat of the Saltwater Haven No. 2 Subdivision, Port O'Connor, Texas. (GR) Page 1 of 3 I NU11(1 o MI1 11N(i 1'/8/)011 i0. Consider and take necessary action to cancel the Invitation to Bid, approved on November 17, 2021 for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013-C673 Port O'Connor, Texas. The Invitation to Bid is being cancelled due to the County receiving information from the Texas General Land Office on December 2, 2021 that the federal funds are not available and after GLO reached out to NOAA, NOAA is not sure when the federal funds will be available. The Texas General Land Office suggested the project hold off on going out for bids until the federal funds are available. At the County's request, the Texas General Land Office can process a contract extension beyond the March 31, 2022 deadline since the Special Award Condition (SAC) #8 is causing a delay. (GR) 71. Consider and take necessary action to approve the increase in the County Clerk Suretybond from $7,000 to $75,000 per Local Government Code 82.001. (RHM) 41 Consider and take necessary action to authorize JP #3, Tanya Dimak, to sign a 36- month agreement with Sparklight for wife service. (RHM) Y3. Consider and take necessary action to approve the 2022 Order setting maximum salaries, making various appropriations, setting vacation policy and sick leave policy, setting policy on payment of hospitalization insurance premium, setting holiday schedule wand setting other miscellaneous policy matters. (RHM) i4. Consider and take necessary action to accept a Law Enforcement Partners donation to the Sheriffs Office in the amount of $1,970.32 to be deposited into the Motivation account. (RHM) . Consider and take necessary action to authorize the Sheriff's Office to remove one (1) vehicle from fleet and send to auction; and send two (2) abandoned vehicles and one (1) seized vehicle to auction. Auction proceeds will be deposited back into the vehicle ,/maintenance account. (See attached list.) (RHM) i6. Consider and take necessary action to accept a $8,002.00 grant from the Golden Crescent RAC trauma funds allocation for FY22. (RHM) 17./Consider and take necessary action to authorize the County Judge to sign an interlocal agreement with the Harris County Institute of Forensic Sciences for postmortem examinations for the period January 1, 2022 through December 31, 2022. (RHM) i8. Accept report from the following County Office: F-IlFioodplain Administration — November 2021 ri! ustice of the Peace, Precinct 1— November 2021 , �3ustice of the Peace, Precinct 2 — November 2021 . Justice of the Peace, Precinct 5 — November 2021 Page 2 of 3 I r,diJ11(,( ()F lv/I'rl lll`J(i 1?/ Ol1 9. Consider and take necessary action on any necessary budget adjustments. (RHM) 20. Approval of bills and payroll. (RHM) a Richard H. Meyer, County ] dg Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda" for any official court postings. Page 3 of 3 #5 NOTICE OF MEETING — 12/8/2021 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 1£addie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, December 8, 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 10:00 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag — Commissioner Gary Reese Texas Flag — Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Bobby Vickery suggest decorating the Courthouse Lawn with Christmas decorations. Decoration donations can be brought to Sherriff Bobby Vickery. Page 1 of 17 NOTICE OF MEETING—12/8/2021 5. Consider and take necessary action to authorize Commissioner Hall to sign a State of Texas General Land Office Application for State Land Use Lease for Army Corps of Engineers permitting in reference to the Mitigation/Restitution project by Doug Jensen located in Blind Bayou. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 17 David E. Hall Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax (361)553-8734 Please place the following item on the Commissioners' Court Agenda for December 8th, 2021. Consider and take necessary action to allow Commissioner Hall to sign State of Texas General Land Office Application for State Land Use Lease for Army Corps of Engineers permitting in reference to Mitigation/Restitution project by Doug Jensen located in Blind Bayou Sincer Da E. Hall DEH/apt State of Texas Texas General Land Office Application for State Land Use Lease Surface Lease (SL) - Coastal FOR GLO USE ONLY Working File # Lease # Staff Initials Applicant/Official Company Name I ❑ Authorized Agent ❑ Company Contact Individual, Company, Partnership or Trust Name Contact Corporate Applicants, Fill out the Following Type of ❑ Person acting in own capacity Business ❑Corporation ❑ Limited Liability Company (LLC) ❑ Limited Partnership (LP) ❑ Sole Proprietor ❑ Government ❑ Estate ❑ Trust ❑ Other: Individual, Company, Partnership or Trust Name Agent/Company Contact ❑ Send contract copy to fTitle. First Name. Last Name. Salutation) Aeent/Comnanv Contact Work# L c/o or Attn Mailing Address street City, State, Zipr Email I Tax ID # State of Domicile If LP, Name of General Partner Name of President Name of Secretary Project Location Water Body(ies) State Tract(s) County(ies) GPS Coordinates (ifice. ,) Parcel ID (Assigned by the County Appraisal Distinct) Legal Description or Original Survey Name Project Address Adjacent Landowners Name Street Address Name Street Address Project Description (If additional space is needed, please continue descriptions on Page 3.) ❑ Dock ❑ Pier ❑ Boat Ramp ❑ Breakwater ❑ Dredging ❑ Other (describe below) Mobile # Texas General Land Office Surface Lease sL) Updated: 07/16/2021 Page 1 .173 Purpose of Proposed Lease Description of structure(s) and the materials to be used Description of facilities associated with the structure Method of installation, type of equipment to be used, and how it will be brought to the project site Describe Current Project Area Other Permits Marshes El Yes [I No Area Agency Permit# Date Submerged Grasses El Yes El No Area TPWD Conditional Permit Oyster Reefs El Yes El No Area U.S. Army Corps of Engineers Habitat Survey Done El Yes [I No Date Amount of State Land involved Water Depth(s) Texas General Land office Surface Lease(SL) Updated: 01/I6/20Z3 Page 2 ad Anticipated Start Date Expected Completion Date Desired Term PROJECT PLANS AND LOCATION MAP Attach two copies of project plans and location maps as described in the'General Instructions for all Applicants.' Copies of plans submitted for any Army Corps of Engineers permit may be used if they meet the specifications in'General Instructions. FEES AND ATTACHMENTS A. No fees are due at this time. B.Upon submission, include two completed copies of this application, including project maps and all applicable attachments. NOTE: Processing of this application will not begin until it is determined to be complete. Therefore, please be sure to include all information requested either within this application or in any of the attachments. ❑ By checking this box, I certify that all information contained in this application is true and accurate, and that I have read the Instructions for Preparing Exhibits information included in this application. Signature of Applicant/Agent Date Please include documentation to support authorization to sign on behalf of Corporation, LLC, LP, LLP, or GA Information collected by electronic mail and by web form is subject to the Public Information Act Chapter 552, Government Code. Texas General Land Office Surface Lease(SL) Updated: 07/16/2021 Page 3 of3 INSTRUCTIONS FOR PREPARING EXHIBITS FOR THE FOLLOWING TEXAS GENERAL LAND OFFICE APPLICATIONS: Miscellaneous Easements, Commercial Leases, Surface Leases, Sub -Surface Leases Maps (or plats) showing the location of proposed and as -built projects on State-owned lands are required as part of the General Land Office (GLO) application process. The following instructions are to be followed when applying for new work (proposed project), reporting as -built conditions for a previously approved project, or when the activity is a Miscellaneous Easement (Right-of-way), Surface Lease, or Sub -Surface Easement on State land. The information specified below represents minimum requirements of the GLO and additional information may be requested on a project -by -project basis to facilitate a full evaluation of the proposed activity. The information should be submitted along with the required application form. Each map or plat must conform to the specifications contained herein. An application is not considered complete and processing of the application will not be initiated until all information requested has been submitted and GLO staff has determined that it is adequate. Application fees and rent vary by project type. Please contact the Field Office or Permit Service Center for your area for details. You do not need to send any money at this time and will be invoiced accordingly. NOTE: Surveys and survey plats required by other entities, Federal, State, County and/or City, are PERMISSIBLE and USABLE for GLO applications provided they meet the following requirements. 1. Each map or plat should be 8 1h" x 11". 2. A one -inch margin should be left at the top edge of each sheet for binding purposes. 3. Any shading used to identify specific areas must be reproducible by ordinary copy machines. 4. Each map or plat submitted must have a title block identifying, at a minimum: (a) applicant name; (b) applicant address; (c) project name; (d) date of preparation; (e) name of preparer; and (f) project location including county, waterbody name, and state tract number. 5. The scale for each map or plat must be clearly indicated both digitally and by graphic scale. 6. Vicinity Maps - Exhibit A for each project application must be a Vicinity Map showing the general location of the proposed work. The Vicinity Map must be produced using either a U.S.G.S. 7.5-minute Topographic Map, a Texas Department of Transportation County Road Map, or navigation chart as its base layer. The project location should be indicated by a prominent arrow on the map. An 8 ih" x 11" Xerox copy from the original Topo, county map, or navigation chart showing the project location is sufficient. It is not necessary to submit the entire Topo or county map, so long as the map is appropriately identified as to the origin of the base information (e.g. name and date of base map information used). This is most easily accomplished by copying the legend of the base map and making it part of the Vicinity Map. 7. Project Site Map - Exhibit B for each project application should be a Project Site Map (in Survey Plat format) which provides specific project location information. The Project Site Map should be produced at sufficient scale and detail to enable field inspectors to locate the project on the ground with minimal difficulty. Demographic features such as road numbers, stream names, railroad crossings, corporate city limits, and other prominent locative features should be included on the Project Site Map. The project location should be indicated by a prominent arrow on the map and a North arrow must be provided. Annotation may be included on the map regarding distance of the project from known points (e.g. highway intersections, road -stream crossings, etc.). S. Detailed Project Plan -Exhibit C for each project application should be a Detailed Project Plan, consisting of an aerial plan -view (top view) drawing and a cross -sectional (side view) drawing of all proposed or existing structures on State-owned lands at the project site. Detailed Project Plans should contain, at a minimum: • Dimensions of all structures (existing and proposed) that will encumber State-owned lands at the project site. • The registration, easement, or lease numbers for any structures at the site previously authorized by the GLO (available from GLO field offices upon request). 0 Any applicable Corps of Engineers permit numbers covering the proposed work. Page 1- Top view drawing should contain, at a minimum: a. Location of the shoreline or banks if the project is on or adjacent to tidally influenced waters or crosses a state-owned river, stream, creek, or bayou. b. The direction of ebb and flow if in or adjacent to tidal waters, or the direction of water flow if the project crosses a river, stream, creek, or bayou. c. A North Arrow. d. The location of state tract lines (on tidally influenced lands), survey lines, or property lines, as applicable. e. The location of any marshes, submerged grass flats, oyster reefs, mud or sand flats, or other sensitive natural/cultural resources known to exist in the project area. f. The lines of mean high water and mean low water when applicable. Page 2 - Cross -sectional drawing should contain, at a minimum: a. The bottom profile of state-owned lands. b. The lines of mean high water and mean low water when applicable. c. If the project is a pipeline, the Detailed Project Plan cross -sectional drawing must include notation as to the outside diameter (OD) of all pipelines covered by the easement, and the relationship of the pipeline(s) to any other pipeline(s) in the immediate vicinity. Page 3 should contain, as applicable, an explanation of construction methodology, techniques, and equipment that will be used at the site. wc NOTICE OF MEETING — 12/8/2021 6. Consider and take necessary action to award the bid for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. (DH) Bid awarded to Derrick Construction Company, Inc. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 17 David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax (361)553-8734 Please place the following item on the Commissioners' Court Agenda for December 8th, 2021. Consider and take necessary action to Consider and take necessary action to award the bid for the Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County— 00038. Sincer , Da E. Hall DEH/apt r G&WENGINEERS, INC. 205 W. Live Oak • Port Lavaca, TX 77979 • p: (361)552-4509 • f: (361)552-4987 TBPE Firm Registration No. F04188 December 02, 2021 Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 S. Ann St., Yd Floor, Suite 301 Port Lavaca, TX 77979 RE: LETTER OF RECOMMENDATION Chocolate Bayou Boat Ramp Texas Parks and Wildlife Ramp Project No. BA-2020-Calhoun County-00038 Dear Honorable Judge & County Commissioners, Bids for construction of the above referenced project(s) were received at the County Judge's office until 2:00:00 p.m., Thursday, November 18, 2021, at which time said Bids were publicly opened and read aloud. The enclosed Bid Opening Table and Bid Itemized Table indicate there were a total of four bidders. We recommend awarding Derrick Construction Company, Inc. which is the lowest, most qualified, acceptable bid. We have worked with Derrick Construction Company, Inc. on many projects and they have proven to be qualified and capable of doing the required work for this project. Construction Contract packages will be prepared and delivered immediately to the contractors upon the award of the contracts. Please call me @ (361) 552-4509 if you have any questions. Sincerely, G & W Engineers, Inc. l'�c P. Mason, P.E. Enclosures: Bid Opening Table & Bid Itemized Table cc: file 9115.025 Engineering Consulting • Planning Surveying BID OPENING TABLE November 18, 2021 Chowlate Bayou Boat Ramp -Texas Parks and Wildlife Ramp Project No. BA-2020 - Calhoun County - 00038 for Calhoun County, Texas 2:00:00 pm BID ITEM CONTRACTORS Demck Construction Company, Inc. MB Western Industrial Contracting Co. Shirley R Sons Construction Co., Inc. TOTAL BASE HID AMOUNT $207,075.00 $489,516.00 $306,000.00 CALENDAR DAYS 120 120 80 01 OWNER'S OPTION: For adding to the Project Cost far furnishing materials, equipment and labor for the construction of a concrete bulkhead cap in lien oftha timber cap for the total length of vinyl bulkhead wall. $211,575.00 $52,330.0D $20,000.00 Bid Bond Yes Yes Yes Acknowledges Addenda Yes Yes No Certificate ofLiability insurance Yes Yes Yes SAM.GOV- System for Award Management Yes Yes No Affidavit Yes Yes Yee Certificate is interest Parties, Farm 1295 Yes Yes Yes Cenifcation Regarding Lobbying Yes Yes Yes Disclosure of Lobbying Activities Yes Yes Yes Certification Regarding Debarment& Suspension and Other Responsibility it.. Yes Yes Yes Conflict of Interest Questionnaire Farm CIO Yes Yes Yes House Bill 89 Verification Yes Yes Yes Residence Cetificate Yes Yes Yes W-9 Yes Yes Yes Assurances— Construction Programs Yes Yes Yes Doe, No 00415- Contractor's Corporate Resolution Yes YES Yee Doc. No. 00416-Noncollusion Affidavit Yes Yes Yes Doe. No. 00417—Touch Safety Systems Indemnity Agreement Yes Yes Yes Do.. No. 00420- Bidder Qualification Statement Yes Yes Ves Section 504 Certification Yes Yes Yes G S W Engineers. Inc., 205 W. Has Oak, Port Lavaca, TX 77979 Page 1 File 9115.025 G&W Enemas. In. ITEMIZED BID TABULATION Data November 18, 2021 205 Weat We oak Street Tlme'. 2'.00 p.m. Pon Lavaca, Texas 77979 Chocolate Bayou Boat Ramp -Texas Parks and Wildlife Ramp Project No. BA-2D20-Calhoun County-00038 Job No. 9116025 for Calhoun County, Texas BASE BID ITEM NO. DESCRIPTION UNIT OTY. Demck Construction Company, Inc MB Western Industrial Contrecung Co. Shirley a Sons Construction Co., Inc. 1 Mobilization and Insurance $7,200.00 $54.27500 $25,000.00 2 Construction and removal ofa temporary cofferdam to alowthe installation of a new concrete ramp Wth side walla LS 1 $4,800.00 $40.285,00 $30,000.00 3 Demolition and disposal of the existing concrete more including side walls LS 1 $7,200.00 $47,990.00 $20.000.00 4 Installation of the concrete moo(approx. 20'x 56') LS 1 $18,000.00 $75,3B5.00 $68.000.00 5 Installation of approximately 280 linear feet of vinyl sheet bulkhead including the limber cep, conetetefrod deadman and sand backfil LS 1 $154,065.00 $215,000.00 $144,000.00 6 Installation of drainage inlet and drain pipe LS 1 82,880.00 $13,130.00 $10.000.00 Installation of 25 ea. (6' dial and 4 ea. (8" dia.) guard posts LS 1 $5.250.00 $17,016.00 $4,000.00 8 Fill as required and reshaping site for proper drainage LS 1 $7.580.00 $26,435.00 $5.000.00 TOTAL BASE BID AMOUNT $207,075.00 S409,516.00 $306,ODD.00 TOTAL CALANDER DAYS 120 120 60 For secure to the Project Cost for furnishing materials, equipment and O1 labor for the construc8on of a concrete bulkhead cap in lieu of the timber LS 1 $211,575.00 $52,330.00 $20,0e0.00 cap for the total length of vinyl bulkhead wall NOTICE OF MEETING — 12/8/2021 7. Consider and take necessary action to authorize using $58,575.00 from GOMESA Funds to enhance the project for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 17 David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax (361)553-8734 Please place the following item on the Commissioners' Court Agenda for December 8th, 2021. Consider and take necessary action to Consider and take necessary action to authorize using $58,575.00 from GOMESA Funds to enhance the project for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. Sincer , Da E. Hall DEH/apt NOTICE OF MEETING— 12/8/2021 8. Consider and take necessary action to approve the final plat of the Jameson Subdivision, Port O'Connor, Texas. (GR) Henry Danysh explained the final plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 17 m o ui5 are Lo1d-Cac WS) ramp asod :sesb-zss (1sc) , 1VId IVNI3 .. aolxxaat :nx nPu Mm c . fi ' y m e<sa< srw •r5rnvl auad x33bea avb inn .• sbz '' • ONINNtlId • ONR NNs • ONIN33NION3 • `SZt��lQI�IQ� ip 9:Y� G ��g�� d � �9P•:�:1�9 3i 8 9 zR �� S9l!E &Q.gpy@pj qA 3a Q� Z53 QG 1 W�a gIo Old @Q 1G 6�� $®baaoybyE 9�Q �[�. Q 4i ml gigp G !�G$3 2 y e � � �ygtlCg i O Ri G d cn F O O jy # 9 s y 3g cn W a i3 i 6 9 n iA 6 a i88 O O ON> RillPp b jdE Y Q b lip, agG P 5 e G a o mill yo u m� QB i tQiG gz�G.p i If 4i i a OUTLOT 2 OUTBLOCK 12 OUTLOT 3 ssazdrore mzo.OW pp r i! R F bd !" eM R "s 8 i6s J 8gg 4a g8 .� Szk Air! \� �.` E. ��AEEa GAG 2 �i eazaarP i p P [ Wn8_ � P jj sxnb'arc smoP• i {a 2W1 Q Q i aarr i Q m �`n. m., snb'brx Urea• ^ ! 6 GyE Z Nq E- RE Rn Ze"g@p aN o ;GG 42@ Q � aA "-f i� ,00'0201 � 3.IO�PLPL4 d g z 101ilao) 11 j x301EI'mo 0 MUM #9 NOTICE OF MEETING — 12/8/2021 9. Consider and take necessary action to approve the Amended Plat of the Saltwater Haven No. 2 Subdivision, Port O'Connor, Texas. (GR) Scott Mason explained the final plat. Commissioners agreed to pass until next week. Page 6 of 17 ., p o AlIJ Atl9 �OOIG-2C (61b) Y.VAVI iUOd 8059-ZGG (190 ltlld WNld slaBl iJ. m 9estc srxn 'rOrW nrl Gaoa M 13]eus Jiro Mn 'm soz a o ° • 9NINNVId • ONK3ANns • 9NIN33N19N3 • o w s: b pppgg � d gib ag Y¢p?? 2 8 a e I 76 a0i .5a ti6Ql�z a 2 -,% I/1 C �05 00 mtPe'f,Uy 3%p %p 2 gk ff n°n d a 4 E: d^ a� 10 bab � ka � a sx%yy % ex, 6 a e n• 3? BOGGY A BAYOU oC A ° Sn �3 Pv N tl� W is..22B.n_ EE��JJJJ 8 z y_ >9W �OmCO m5 J I :[__-_ _ a _Tm�__a R__T«$E_-f_,_.-_ ------------- _-jYo_am wL _ -j_________�a/,__i________ 5 _ 'I pp L�A z -- ----------- CIV'i to n ,ggtl______•� _____�' tl �cmi �� RO 'S�� N______3. O �� s N ---; z -_ a — --- J' , , — 4_____�____{------__ ____, m ,,. gg d_�(_ I - - EI o a ________________ 9 ___ __________-_______� $ �______ __ 4 -__ ,Q � r , i C _ _ _� w � s euwywyL4.LJ j L_1 n¢1m.r�9 ! Ib 1 � k N a .xa i rC y_.T__——--------------- aq — J s�:s F g : Eg A. M.BZAGLHS-----_IN sg 9 N z N G & W ENGINEERS, INC. PH o m AD m • ENGINEERING • SURWE NG • PLANNING • n .. ~ r 20S W. UVE -AA STREET. PONT LAVACA, TEXAS 77979 C.rp APr' c N ZSOSO P :. TOW FIRM NO, 100221CO FINAL PLAT r " (Oep 552—sAD9: PORT LAVACA (979) 323-7IDS: SAY CITY # io NOTICE OF MEETING— 12/8/2021 10. Consider and take necessary action to cancel the Invitation to Bid, approved on November 17, 2021 for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013-C673 Port O'Connor, Texas. The Invitation to Bid is being cancelled due to the County receiving information from the Texas General Land Office on December 2, 2021 that the federal funds are not available and after GLO reached out to NOAA, NOAA is not sure when the federal funds will be available. The Texas General Land Office suggested the project hold off on going out for bids until the federal funds are available. At the County's request, the Texas General Land Office can process a contract extension beyond the March 31, 2022 deadline since the Special Award Condition (SAC) #8 is causing a delay. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 17 Mae Belle Cassel From: peggy.hall@calhouncotx.org (peggy hall) <peggy.hall@calhouncotx.org> Sent: Thursday, December 2, 2021 3:52 PM To: MaeBelle.Cassel@calhouncotx.org; Richard H Meyer Cc: Gary Reese; mglaze@urbanvictoria.com; Cindy Mueller Subject: Agenda Item for December 8th Attachments: Agenda - Cancellation of Bid.docx Mae Belle, I am sending the attached agenda item for Commissioner Reese. Gary and Matt, if you want to change the wording, contact Mae Belle immediately. Peggy 3&11-- Assistant Auditor Calhoun County 202 S. Ann St., Ste B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Calhoun County Texas Please place the following item on the Commissioners Court Agenda for December 8, 2021: Consider and take necessary action to cancel the Invitation to Bid, approved on November 17, 2021 for the Calhoun County Boggy Bayou Nature Park Improvements, Phase 1 Coastal Management Program Cycle 25 Texas General Land Office Contract No. 21-060-013-C673 Port O'Connor, Texas. The Invitation to Bid is being cancelled due to the County receiving information from the Texas General Land Office on December 2, 2021 that the federal funds are not available and after GLO reached out to NOAA, NOAA is not sure when the federal funds will be available. The Texas General Land Office suggested the project hold off on going out for bids until the federal funds are available. At the County's request, the Texas General Land Office can process a contract extension beyond the March 31, 2022 deadline since the Special Award Condition (SAC) #8 is causing a delay. (GR) #11 NOTICE OF MEETING— 12/8/2021 11. Consider and take necessary action to approve the increase in the County Clerk Surety bond from $7,000 to $75,000 per Local Government Code 82.001. (RHM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 17 Mae Belle Cassel From: Anna.Goodman@calhouncotx.org (Anna Goodman) <An na.Good man@ca Ihouncotx.org> Sent: Wednesday, November 10, 2021 2:24 PM To: MaeBelle.Cassel@calhouncotx.org Cc: Richard Meyer; David Hall; Vern Lyssy; joel.behrens@calhouncotx.org; Gary Reese Subject: Agenda Item - Increase County Clerk Bond Attachments: LGC 82.002 DEPUTY CLERK BONDS.pdf Good afternoon, Will you please add the following to the agenda: Approve increase in County Clerk Surety bond from $7000 to $75000 per Local Government Code Sec. 82.001. Anna M Goodman Calhoun County Clerk 361-553-4416 Only I can change my life. No one can do it for me. Carol Burnett CONFIDENTIALITY NOTICE: The information contained in this transmission may be strictly confidential. If you are not the intended recipient of this message, you are notified that you may not disclose, print, copy or disseminate this information. If you have received this transmission in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail may be a violation of criminal law. Your message is ready to be sent with the following file or link attachments: LGC 82.002 DEPUTY CLERK BONDS.pdf Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. Calhoun County Texas # Zz NOTICE OF MEETING—12/8/2021 12. Consider and take necessary action to authorize JP #3, Tanya Dimak, to sign a 36- month agreement with Sparklight for wife service. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 17 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2021-826305 Sparklight Phoenix, AZ United States Date Filed: 11/22/2021 2 Name of governmental entity or state agency that is a parry to the contract for which the form is being filed. Sparklight Date Acknowledged: (1 I 3o o2U a 1 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. n/a HSD, Phone, Video 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑x 6 UNSWORN DECLARATION 1 �q My name is ` ..q'o ` �V 1 e'W 'e r and my date of birth is My address is _. ts�roey (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. 11 ^ 77 ft Executed in V�Un, 4 t C (lYJ r�Counry, State of �, on the JU day of LN2Wt Istr20QL. (month) (year) y Sioniftuff of authorized age of contracting business entity f (Dec1 q Forms provided by Texas Ethics Commission www.ethics.state.tx,us Version V1.1.191h5cdc DocuSign Envelope ID: 0235F421-OA1B-4478-88F1-777F5CCBCD5F Sparklight Business Business Service Agreement Date: 10/6/2021 3:51 PM Sparklight Business Account Rep: Frank Ayala Sparklight System Address: Phone Number: 6023646562 210 E Earl] Drive Fax Number: 8885592040 Phoenix, AZ 85012 Customer Information Authorized Customer Representative Company Name: Justice of the Peace Pct 3 Full Name: Tanya Dimak Street Address: 112 Jones St Billing Telephone: (361) 987-2930 City/State/Zip: Point Comfort, TX, 77978 Fax: Billing Address: PO BOX 542 Contact Number: 361-987-2661 City/State/Zip: POINT COMFORT, TX 77978 Email: tanya.dimak@calhouncotx.org Sparklight ccount# 103673893 Taxes and Fees Not Included Service Service Description Quantity D3 Suite 50Mbps x 5Mbps 1 Business Wi-Fi 1 Installation Charge(May Include Construction): $0.00 Term (In Months): 36 Total: $82.69 ;Equipment Description Quantity Unit Price Total Fee Modem Lease 1 $8.99 $8.99 Y BE REVISED AFTERWARD. THOUGH VIDEO SERVICE FEES MAY BE INCREASED, HSD AND PHONE SEI _S WILL NOT BE INCREASED DURING THE TERM. SEPARATELY, THE EQUIPMENT FEES MAY BE RE\ SERVICE CHARGES ARE SUBJECT TO ADDITIONAL APPLICABLE LOCAL, STATE AND FEDERAL TAXES, SURCHARGES AS REQUIRED OR PERMITED BY LAW. >igning below, Customer represents and warrants to Sparklight that Customer has the authority to execute, del agrees to be bound by and comply with the terms of this Business Services Agreement and the General Terms ditions available at hftps://business.sparklight.com/le.gal/general-terms, which are incorporated herein by this refer( "General Terms'). THE GENERAL TERMS INCLUDE AN ARBITRATION SECTION, WHICH PROVIDES THAT ;TIES DESIRE TO RESOLVEANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATING TO THE BUSIN 'VICES AGREEMENT THROUGH ARBITRATION, AND BY AGREEING TO ARBITRATION, CUSTOMER IS GN CERTAIN RIGHTS, INCLUDING THE RIGHT TO TRIAL BY JURY. Sparklight may accept this Business Sen Page 1 of 2 DocuSign Envelope ID: 0235F421-OA18-4478-88F1-777F5CCBCD5F by (a) countersigning below; or (b) commencing to deliver the Service(s) specified in this Business Customer Authorized Signature 4Tany Name(Print) n/(/�j (,mar imak Date Page 2 of 2 #13 NOTICE OF MEETING— 12/8/2021 13. Consider and take necessary action to approve the 2022 Order setting maximum salaries, making various appropriations, setting vacation policy and sick leave policy, setting policy on payment of hospitalization insurance premium, setting holiday schedule and setting other miscellaneous policy matters. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 17 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Tuesday, November 30, 2021 4:26 PM To: r MaeBelle.Cdssel@calhouncotx.org Cc: clarri atkinson; Richard Meyer Subject: Agenda Item Request -Annual Salary Order Attachments: SALARY ORDER-2022.pdf Please place the following item on the agenda for December 8, 2021: • Consider and take necessary action to approve 2022 Order setting maximum salaries, making various appropriations, setting vacation policy and sick leave policy, setting policy on payment of hospitalization insurance premium, setting holiday schedule and setting other miscellaneous policy matters. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindy. mueller0calhouncotx.ore Calhoun County Texas 2022 ORDER PASSING MAIUMUM SALARIES, MAKING MONTHLY APPROPRHITIONS, AND PASSING HOLIDAY SCHEDULE WHEREUPON, on motion by Commissioner Lvssv, seconded by Commissioner Reese, and unanimously carried, on the 8th day of December, 2021, the Court ordered the following Order be adopted and entered: The various officials, supervisors, and permanent employees will be compensated for the Calendar Year 2022 not to exceed the following amounts: SEE SALARY SCHEDULE ATTACHED (Salary Schedule contains salaries for the Juvenile Probation Department. This department is administered by the Juvenile Board and is not included in the County's Budget or Financial Statements; however, the State Statutes indicate that these are employees of the County. These salaries are included for informational purposes only.) All County employees shall be paid on a bi-weekly basis (annual salary divided by the number of bi-weekly pay periods in the year). Each of the officials named herein shall fix the compensation of the employee(s) authorized for his department within the maximum amounts authorized by this Order. Each of said officials will complete and deliver the payroll forms to the County Treasurer to indicate the pertinent information for all employees covered by the Fair Labor Standards Act who were employed during the pay period; he will also see that the necessary exemption certificates and other information are furnished to the County Treasurer so that proper deductions may be made and records compiled for Federal Withholding Tax, Social Security Tax, Group Insurance, and Retirement Plan. SEE SALARY SCHEDULE ATTACHED In addition, employees are paid an overtime rate of one and one-half times the above rates. An administrative employee on call is paid an hourly rate of $1.00. A non -administrative employee on call is paid an hourly rate of minimum wage. Amounts shown in the attached Salary Schedule are for budgeting purposes only. PART-TIME OR TEMPORARY HELP The various officials/supervisors will be allowed to employ extra help at the following hourly rates ➢ Minimum - Federal Minimum Wage $ 7.25 ➢ Maximum - Skilled Help $ 15.00 ➢ License Differentials (per certification and if applicable): ➢ Pesticide/Herbicide $ 0.12 ➢ EMT Intermediate Certification $ 0.14 ➢ Vector $ 0.58 ➢ CDL $ 0.17 ➢ CDL-X (Hazmat endorsement) $ 0.26 ➢ K-9 $ 0.58 ➢ Paramedic License $ 0.58 ➢ Pesticide/Herbicide plus Vector $ 0.69 Payments may be made up to the amount authorized in each department budget, approved by the Commissioners Court in the 2022 Budget. The officials/supervisors affected by this Order will not obligate the County for the payment of any compensation in excess of the extra help allowance without prior authorization of Commissioners Court. These employees will be considered part-time or temporary employees of the County and will be subject to Federal Withholding Tax and Social Security Tax deductions. APPROPRIATIONS FOR CELL PHONE ALLOWANCE County Commissioners will be paid a bi-weekly set allowance as follows: Commissioner, Precinct No. 1 Commissioner, Precinct No. 2 Page No. 1 $69.23 Bi-Weekly $69.23 Bi-Weekly YOYY ORDER PASSING MANIMUM SALARIES. MAKING MONTNLY APPROPRNITIONS, Commissioner, Precinct No. 3 Commissioner, Precinct No. 4 $69.23 Bi-Weekly $69.23 Bi-Weekly APPROPRIATIONS FOR TRAVEL ALLOWANCE Officers, agents or employees of the County will be reimbursed for actual traveling expenses while out of the County on official County business or in attendance at conferences relating to County government up to the amount authorized in the 2022 budget for this purpose in accordance with the County's purchasing manual. Reimbursement will be requested on the travel form available in the office of the County Treasurer and will be filed, with supporting documentation, in the County Treasurer's Office within one month after the trip has been made. Certain personnel will be reimbursed for actual traveling expenses in the County in amounts not to exceed the appropriations authorized in the 2022 budget. Mileage reimbursement for the use of personal automobiles, which have been authorized, will be computed at the current rate set by the Internal Revenue Service for tax purposes with the following exceptions which will be paid a bi-weekly set allowance as follows: County Judge $296.15 Bi-Weekly Constables $296.15 Bi-Weekly IT Coordinator $ 92.31 Bi-Weekly Justices of Peace $238.46 Bi-Weekly Library Director $238.46 Bi-Weekly Nuisance Enforcement Officer $296.15 Bi-Weekly APPROPRIATIONS FOR CALHOUN COUNTYAPPRAISAL DISTRICT Payable in quarterly installments from the General Fund to the Calhoun County Tax Appraisal District: Appraisal Services Collection Services HOLIDAY SCHEDULE The Court set the following holiday schedule for the calendar year 2022: Presidents' Day Good Friday Memorial Day Independence Day Labor Day Veterans' Day Thanksgiving Day Christmas Day New Year's Eve New Year's Day $74,029.79 Quarterly $28,324.50 Quarterly Monday, February 21 Friday, April 15 Monday, May 30 Monday, July 4 Monday, September 5 Friday, November 11 Thursday, November 24 & Friday, November 25 Friday, December 23 & Monday, December 26 Friday, December 30 Monday, January 2, 2023 However, it was agreed that if any of the above holidays should fall on a non -working day, the employees should be allowed to observe the nearest working day preceding or following the holiday, as shown above. 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U U U U U U U U U U to U t/i U M O W Go W GO W W Ge n 4 tv z H N m H O n N A � ti xj W O N 3 O O O O O O O O O O O O O O O O O Cro" r r y O H�y H H H H H H O� J r- fA J W A J Nro A� b pa A A A A A A A N z � o 0 0 0 0 0 0 o O o o O o o O O O o n< 0 0 9 m m D 0 7y 9 '3, 0 m C7 ro ro ',� ro ro ro ro ro ro ro qM mG ro .y, O z N � y 49 £9 fpA� G9 69 69 69 69 (A 69 f9 r O J fA Jw W� A J Nw A% �O m A A A A A A A z H � N Y Ni O to A O� �O J A �D �O ..• .� ..• ..• .� ..• �'C O N m w 0 €r€ w #14 NOTICE OF MEETING — 12/8/2021 14. Consider and take necessary action to accept a Law Enforcement Partners donation to the Sheriff's Office in the amount of $1,970.32 to be deposited into the Motivation account. (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 17 11-29-'21 14:27 FROM- 361-553-4668 T-563 P0001/0002 F-558 CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553-4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: ACCEPT DONATION TO SHERIFF'S OFFICE DATE: DECEMBER 8, 2021 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR DECEMBER 8, 2021 * Consider and take necessary action to accept Law Enforcement Partners donation to the Sheriff's Office to be deposited into the Motivation account in the amount of $31970.32. Sincerely, Idli, - Bobbie Vickery Calhoun County Sheriff ;55- M -WOdJ Ld:V L 2,-6z- L L #15 NOTICE OF MEETING — 12/8/2021 15. Consider and take necessary action to authorize the Sheriff's Office to remove one (1) vehicle from fleet and send to auction; and send two (2) abandoned vehicles and one (1) seized vehicle to auction. Auction proceeds will be deposited back into the vehicle maintenance account. (See attached list.) (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 17 11-29-'21 11:04 FROM- 361-553-4668 T-562 P0001/0002 F-555 CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553-4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: VEHICLES FOR AUCTION DATE: DECEMBER % 2021 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR DECEMBER 8, M1 * Consider and take necessary action for the Calhoun County Sheriff's Office to remove 1 vehicle from fleet and send to auction. Also sent to auction 2 abandoned vehicles and 1 seized vehicle. Monies from auction proceed will go back into vehicle maintenance. See attached list. Sincerely, Bobbie Vickery Calhoun County Sheriff _ 11-29-'21 11:04 FROM- 361-553-4668 T-562 P0002/0002 F-555 VEHICLES TO COURT FOR AUCTION 12.8.21 FLEET 2003 FORD SUV VIN 1FMRU17W73LA22216 ABANDONED 2004 FORD U. VIN 1FWRU17W94LB57215 ABANDONED 2012 FORD F1SO VIN 1FTFW1CTG9CF894209 SEIZED 2020 LEXIS 4D VINJTHBF30G22001282 #16 NOTICE OF MEETING— 12/8/2021 16. Consider and take necessary action to accept a $8,002.00 grant from the Golden Crescent RAC trauma funds allocation for FY22. (RHM) Dustin Jenkins explained the grant. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 13 of 17 Mae Belle Cassel From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins) <Dustin.Jenkins@calhouncotx.org> Sent: Wednesday, December 1, 2021 12:01 PM To: Mae Belle Cassel Cc: Lori McDowell; Donna Hall Subject: Fwd: GC RAC FUNDS FOR FY22 Attachments: FY 2022 RAC TRAUMA FUNDS CHECK $8002.00.pdf Mae Belle, Could you please place the following on the next available Commissioners Court Agenda? To accept a grant of $8002.00 from the Golden Crescent RAC trauma funds allocation for FY22. A scan of the check is attached to this email. Very Respectfully, J. Dustin Jenkins, DMin, MBA, MTh, LP Director of EMS Calhoun County, TX From: "Lori.McDowell@calhouncotx.org (Lori McDowell)" <Lori.McDowell@calhouncotx.org> To: "Dustin Jenkins" <Dustin.Jenkins@calhouncotx.org> Date: Wed, 01 Dec 2021 09:50:12 -0600 Subject: GC RAC FUNDS FOR FY22 Hi Dustin, We have received our Golden Crescent RAC trauma funds for FY22 in the amount of $8002.00. Can you get it on the agenda for us to accept the trauma grant funds? Thanks, Lori McDowell, BS, LP, EMS Coordinator, CADS Assistant EMS Director Calhoun County EMS 705 Henry Barber Way Port Lavaca, TX 77979 (361)552-1140 lori.mcdowell@calhouncob(.org CONFIDENTIALITY NOTICE: The contents of this email message and any attachments are intended solely for the addressee(s) and may contain confidential and/or privileged information and may be legally protected from disclosure. If you are not the intended recipient of this message or their agent, or if this message has been addressed to you in error, please immediately alert the sender by reply email and then delete this message and any attachments. If you are not the intended recipient, you are hereby notified that any use, dissemination, copying, or storage of this message or its attachments is strictly prohibited. Calhoun County Texas J. Dustin Jenkins, DMin, MBA, LP Director of Emergency Medical Services 705 Henry Barber Way Calhoun County, TX GOLDEN CRESCENT RAC 2701 HOSPITAL DR VICTORIA, TX 77901-5749 ATTN SUSANN MORRISbN Pay to the Orqer 1769 37-65/1119 1109 Date $ 9406)1)�, 06 Dollars "s aoposit® # 17 NOTICE OF MEETING— 12/8/2021 17. Consider and take necessary action to authorize the County Judge to sign an interlocal agreement with the Harris County Institute of Forensic Sciences for postmortem examinations for the period January 1, 2022 through December 31, 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 14 of 17 HARRIS COUNTY INSTITUTE OF FORENSIC SCIENCES Luis A. Sanchez, M.D. 5µeni Exewlve Wrector & SCIENCE. SERVICE, INTEGRITY. Cblel Medical Examiner December 1, 2021 The Honorable Richard H. Meyer 211 South Ann Street, Suite 301 Port Lavaca, Texas 77979 Re: Interlocal Agreement of Postmortem Examinations by the Harris County Institute of Forensic Sciences Dear Judge Meyer: The attached Interlocal agreement between Harris County and Calhoun County will be presented to the Harris County Commissioners Court for approval on December 14, 2021. This agreement will cover the services to be provided by the Harris County Institute of Forensic Sciences for postmortem examination of decedent cases referred to this office, as well as related court testimony, if any for the period January 1, 2022 December 31, 2022. The Harris County Commissioners Court approved fee schedule states the cost of an autopsy is $2,887 and an external examination cost is $1,161. This agreement allows our agency to exercise discretion in determining which type of postmortem examination is appropriate. Attached is the approved fee schedule. We are attaching a copy of the agreement via email. Please sign the agreement and scan it to my email Nick.Turner(ailifs.hctx.net and my assistant, Lvdia.Waldroup(aJifs:hctx.net. Once approved by the Harris County Commissioners Court, we will return a fully executed agreement to you. Should you decide not to enter into this interlocal agreement for postmortem examinations, kindly return to my attention. If you have any questions, please contact me at (832) 927-5211. Sincer Nick Tu er Assistant County Attorney Office of the Chief Medical Examiner Harris County Institute of Forensic Sciences 1861 Old Spanish Trail Houston, Texas 77054 Office: 832.927.5211 Mobile: 713.539.3961 Fax: 832.927.0230 Enclosures 188501d Spanish Trail Houston Texas 77054 1 713-796.9292 1 713.796.68441F1 I hardsenttntnty nnvIA THE STATE OF TEXAS COUNTY OF HARRIS THIS INTERLOCAL AGREEMENT (the "AgreemenC) is made pursuant to chapter 791 of the Texas Government Code (the Interlocal Cooperation Act) and chapter 49 of the Texas Code of Criminal Procedure, and entered into by and between Harris County, acting by and through its governing body, the Harris County Commissioners Court, and Calhoun County (the "Requesting County"), acting by and through its governing body, the Polk County Commissioners Court. RECITALS: Pursuant to article 49.25 of the Texas Code of Criminal Procedure, Harris County has established and maintains the Harris County Institute of Forensic Sciences which includes the Office of Medical Examiner; The Requesting County does not have a medical examiner, and a justice of the peace is required to conduct an inquest into the death of a person who dies in the county under certain circumstances; If the justice of the peace determines that a postmortem examination is necessary, the justice of the peace may order that a postmortem examination of the body be performed by a physician; and The Requesting County desires to obtain the services of the Harris County Institute of Forensic Sciences (the "Medical Examiner") to perform postmortem examinations on persons who died in the Requesting County and to provide sworn testimony in connection with any inquest by a justice of the peace or any criminal investigation or prosecution conducted by a prosecuting attorney. NOW, THEREFORE, Harris County and the Requesting County, in consideration of the mutual covenants and agreements herein contained, do mutually agree as follows: TERMS: TERM The term of this Agreement shall begin on January 1, 2022 and end on December 31, 2022, unless terminated in accordance with the provisions contained herein. it. SERVICES A. Postmortem Examinations. Postmortem examinations will be performed by the Medical Examiner pursuant to chapter 49 of the Texas Code of Criminal Procedure. In those cases where a complete autopsy is deemed unnecessary by the Medical Examiner to ascertain the cause and manner of death, the Medical Examiner may perform an external examination of the body, which may include taking x-rays of the body and extracting bodily fluids for laboratory analysis. Written Request. When a justice of the peace in the Requesting County determines pursuant to article 49.10 of the Code of Criminal Procedure, that a postmortem examination is necessary on the body of a deceased person who died within their jurisdiction, the justice of the peace may request that the Medical Examiner perform an autopsy. Each request for a postmortem examination shall be in writing, accompanied by an order signed by the justice of the peace. However, the Medical Examiner shall have the discretion to perform an autopsy or external examination of the body based on his professional judgment. 2. Written Records. The following records shall accompany the body: (1) the completed form titled "Harris County Medical Examiner Out of County Investigator's Report" (attached hereto and incorporated herein); (2) the entire police report, including scene photographs and; (3) all relevant medical records, including hospital admission and emergency room records, if applicable. Failure to provide all necessary records may result in the Medical Examiner refusing to accept the body for a postmortem examination. 3. Body Bag. Each body transported to the Medical Examiner for a postmortem examination must be enclosed inside a zippered body bag and sealed in such a way as to insure integrity of evidence between the time of scene investigation and arrival at the Medical Examiner. The body bag shall have the deceased's name affixed to the outside. B. Laboratory Analyses. The Medical Examiner shall conduct a postmortem toxicological analysis, if appropriate, and any other tests considered necessary to assist in determining the cause and manner of death and identification. C. Testimony. Medical Examiner personnel performing services pursuant to this agreement shall appear as reasonably necessary to provide testimony in a criminal case before a district court of the Requesting County. The Requesting County agrees to use its best efforts to schedule the testimony of the Medical Examiner's personnel in such a manner to cause the least amount of disruption in their work schedule. D. Resorts. Within a reasonable time after the completion of a postmortem examination, the Medical Examiner will provide a written copy of the autopsy report to the justice of the peace who requested the autopsy. E. Transportation. The Requesting County shall have the sole responsibility for transporting the deceased to the Medical Examiner. Upon notification by the Medical Examiner that the autopsy has been completed, the Requesting County shall make arrangements for the deceased to be transported immediately to a funeral home. F. Training. The Medical Examiner will conduct an annual training seminar in Houston for justices of the peace, their court personnel and other criminal justice officials, including investigators. G. No Interment. Harris County shall have no responsibility for burying the remains of the deceased. Consistent with TEx. HEALTH & SAFETY CODE ANN. § 711.002(e), the Requesting County shall have sole responsibility for interment of the body. III. CONSIDERATION FOR SERVICES A. Autopsy Fees. In consideration for the services provided by the Medical Examiner, the Requesting County agrees to pay Harris County all costs and expenses associated with performing the autopsy in accordance with the following schedule: (a) Standard Autopsy Examination $2,887 per body (b) External Examination $1,161 per body B. Ancillary Tests. Ancillary tests (i.e. GSR tests) will be performed as deemed appropriate by the Medical Examiner at no additional cost. If further tests are requested by the Requesting County, but are deemed by the Medical Examiner not germane based on the circumstances of the case, the Medical Examiner may elect to decline the request, or to request that the laboratory of the HCIFS perform those tests with additional charges in accordance with the Fee Schedule, attached hereto and incorporated herein as Exhibit "A." C. Testimony. The Requesting County shall additionally pay Harris County for the time 'spent by the Medical Examiner's pathologists, the Chief Toxicologist, or other personnel providing sworn testimony in connection with a postmortem examination requested by the Requesting County. Testimony fee are in accordance with the Harris County Medical Examiner's Fee Schedule, attached hereto and incorporated herein as Exhibit "A." These rates shall apply also to pretrial preparation, attendance at pretrial conferences, travel time and any time spent waiting to provide testimony. D. Storage of Bodies. The Requesting County shall pay Harris County the additional sum of Forty Five Dollars ($45) per day for each body that remains at the Medical Examiner beyond three (3) days (including weekends and holidays) beginning the day after notification by the Medical Examiner that the body is ready to be released to the Requesting County. This provision shall survive termination of this Agreement and shall apply to any bodies currently remaining at the Medical Examiner. E. Invoice. Harris County shall submit an invoice to the Requesting County for post mortem services performed under this Agreement within thirty (30) days after the service is completed. 3 The Requesting County shall pay the total amount of the invoice within thirty (30) days of the date of receipt of the invoice by the Requesting County. If the Requesting County fails to pay any invoice within sixty (60) days after receipt, the Medical Examiner may refuse to accept any additional bodies for autopsy. F. Fair Compensation. Harris County and the Requesting County agree and acknowledge that the contractual payments contemplated by this agreement are reasonable and fairly compensate Harris County for the services or functions performed under this Agreement. G. Death Certificates. The justice of the peace who requested the postmortem examination be performed shall provide the Medical Examiner with a copy of the signed Certificate of Death no later than fourteen (14) days after receipt of the autopsy report. Failure to comply with this provision may result in termination of the contract by Hams County. IV. FUNDS A. Current Funds. The Requesting County agrees and acknowledges that the contractual payments in this Agreement shall be made to Harris County from current revenues available to the Requesting County. B. Certified Availability. The Requesting County has available and has specifically allocated $8,661.00, as evidenced by a certification of funds by the Requesting County's County Auditor. In the event funds certified available by the Requesting County's County Auditor are no longer sufficient to compensate Harris County for the services provided under this Agreement, Harris County shall have no further obligation to complete the performance of any services until the Requesting County certifies sufficient additional current funds. The Requesting County agrees to immediately notify Harris County regarding any additional certification of funds for this Agreement. C. Other Statutory Liability. This Agreement is not intended to limit any statutory liability of the Requesting County to pay for services provided by Hams County when the funds certified by the Requesting County are no longer sufficient to compensate Harris County for the services provided under this Agreement. D. Overdue Payments. It is understood and agreed that chapter 2251 of the Texas Government Code applies to late payments. V. TERMINATION A. Without Notice. If the Requesting County defaults in the payment of any obligation in this Agreement, Harris County is authorized to terminate this Agreement immediately without notice. B. With Notice. It is understood and agreed that either party may terminate this Agreement prior to the expiration of the term set forth above, with or without cause, upon thirty (30) days prior written notice to the other party. By the next business day following the first ten (10) days of the 4 subsequent calendar month after the effective date of such termination, Harris County will submit an invoice showing the amounts due for the month in which termination occurs in the manner set out above for submitting monthly invoices. Vl. NOTICE Any notice required to be given under the provisions of this Agreement shall be in writing and shall be duly served when it shall have been deposited, enclosed in a wrapper with the proper postage prepaid thereon, and duly registered or certified, return receipt requested, in a United States Post Office, addressed to the parties at the following addresses: To Harris County: Harris County Harris County Administration Building 1001 Preston, Suite 911 Houston, Texas 77002-1896 Attn: County Judge with a copy to: Harris County Institute of Forensic Sciences 1861 Old Spanish Trail Houston, Texas 77054 Attn: Chief Medical Examiner To Calhoun County: Calhoun County 211 South Ann Street Port Lavaca, Texas 77979 Attn: County Judge Either party may designate a different address by giving the other party ten days' written notice. VII. MERGER The parties agree that this Agreement contains all of the terms and conditions of the understanding of the parties relating to the subject matter hereof. All prior negotiations, discussions, correspondence and preliminary understandings between the parties and others relating hereto are superseded by this Agreement. VIll. VENUE Exclusive venue for any action arising out of or related to this Agreement shall be in Harris County, Texas. IX. MISCELLANEOUS This instrument contains the entire Agreement between the parties relating to the rights granted and the obligations assumed. Any oral or written representations or modifications concerning this instrument shall be of no force and effect excepting a subsequent modification in writing signed by both parties. This Agreement may be executed in duplicate counterparts, each having equal force and effect of an original. This Agreement shall become binding and effective only after it has been authorized and approved by both counties, as evidenced by the signature of the appropriate authority pursuant to an order of the Commissioners Court of the respective County authorizing such execution. APPROVED AS TO FORM: VINCE RYAN County Attorney By — NICK T ER Assistant County Attorney APPROVED: By -- LUIS A. SANCHE , M.D. Harris County Institute of Forensic Sciences Executive Director & Chief Medical Examiner HARRIS COUNTY By LINA HIDALGO County Judge Date Signed: CALHOUN OUNTY By: R CHARD H. MEY County Judge Date Signed: CERTIFICATION OF FUNDS Pursuant to section 111.093 of the Texas Local Government Code, I certify that the county budget contains an ample provision for the obligations of Calhoun County under this Agreement and that funds are or will be available in the amount of $8,661.00 to pay the obligations when due. C=AJ A4' 4 lAaXYO/ / Calhoun unty Auditor a/'31 Date Signed: �� 6 EXHIBIT "A" o� ,a�yp HARRIS COUNTY m�u INSTITUTE OF FORENSIC SCIENCES "�` SCIENCE. SERVICE. INTEGRITY. HCIFS Fee Schedule — Medical Examiner Services Effective January 1, 2015 Luis A. Sanchez, M.D. Executive Director & Chief IvlMical Examiner Service Description Unit Pricing Fees Post Mortem Examinations Full Autopsy Case $2,887 External Examination Case $1,161 Decedent Storage Day $45 Records: Reports, Permits, & Photo Reprints Copy Charge per Open Records Page $0.10 Images on CD (Plus copy charge) Each $11 Notarization of Document (plus copy charge) Document $7 Photo Reprints (3 %2 x 5) Print $3 Photo Reprints (8 x 10) Print $5 X-Ray Copy (per film) Film $6 Subpoena/Court Order Documents (plus copy charge) Hour $55 Professional Services Medical Examiner Expert Witness Testimony /Consultation Preparation Fees Fixed Fee $179 Medical Examiner, Travel & Witness /Consultation Hourly $139 Expert Witness Testimony / Consultation —Anthropology Preparation Fees Fixed Fee $81 Anthropology Travel & Witness /Consultation Hourly $70 Expert Witness Testimony / Consultation —Investigation Preparation Fees Fixed Fee $39 Investigator /Entomolo ist, Travel & Witness /Consultation Hourly $37 Crime Laboratory Expert Witness Testimon / Consultation Preparation Fees Fixed Fee $78 Laboratory personnel, Travel & Witness /Consultation Hourly $49 Prepared by HCIFS Approved 0812612014 1885 Old Spanish Trail, Houston, Texas 77054 1713-796-9292 i 713-796-6844 (F) I harriscounlytx.govlifs #18 NOTICE OF MEETING — 12/8/2021 18. Accept report from the following County Office: i. Floodplain Administration — November 2021 ii. Justice of the Peace, Precinct 1— November 2021 iii. Justice of the Peace, Precinct 2 — November 2021 iv. Justice of the Peace, Precinct 5 — November 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner PcL 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 15 of 17 Calhoun County Floodplain Administration 211 South Ann Street, Suite 301 Port Lavaca, TX 77979-4249 Phone: 361-553-4455/Fax: 361-553-4444 e-mail: karen.rinasz@calhouncotx.org November 2021 Development Permits New Homes — 4 Renovations/Additions — 0 Mobile Homes —1 Boat Barns/Storage Buildings/Garages - Commercial Buildings/RV Site -1 Tower Addition - 0 Total Fees Collected: $420 ENTER COURT NAME: : JUSTICE OF PEACE NO.1 ENTER MONTH OF REPORT NOVEMBER ENTER YEAR OF REPORT - - 2021 CODE AMOUNT - REVISED 01/29/20 CASH BONDS 0.00 ADMINISTRATION FEE-ADMF 80.00 BREATH ALCOHOL TESTING - BAT 0.0D .CONSOLIDATED COURT COSTS -CCC 243.02 - ,STATE CONSOLIDATED COURT COST-2020 5,690.46 LOCAL CONSOLIDATED COURT COST-2020 1,274.58 COURTHOUSE SECURITY -CHS 24.30 CJP 0.00 CIVIL JUSTICE DATA REPOSITORY FEE -CJDR 0.39 CORRECTIONAL MANAGEMENT INSTITUTE-CMI 0.00 - - --.CR 0.00 CHILD SAFETY -CS O.OD CHILD SEATBELT FEE- CSBF 0.00 - CRIME VICTIMS COMPENSATION -CVC 0.00 - DPSC/FAILURETOAPPEAR -OMNI-DPSC 111.93 ' ADMINISTRATION FEE FTA/FTP (aka 012020 60.03 ELECTRONIC FILING FEE -EEF 0.00 - - FUGITIVEAPPREHENSION - FA 0.00 GENERAL REVENUE -GR 0.00 CRIM.-IND LEGAL. SVCS.SUPPORT -IDF 12.15 JUVENILE CRIME& DELINQUENCY -JCD 0.00 JUVENILE CASE MANAGER FUND -JCMF 15.00 JUSTICE COURT PERSONNEL TRAINING -JCPT 0.00 JUROR SERVICE FEE -JSF 24.30 - LOCAL ARREST FEES -1 408.68 LEMI 0.00 LEOA 0.00 - - - LEOG 0.00 OCL 0.00 -.PARKS& WILDLIFE ARREST FEES -.PWAF 90.66 - STATE ARREST FEES -SAF 61.90 -- SCHOOL.CROSSING/CHILD SAFETY FEE -SCF 0.00 'I SUBTITLEC-SUBC 54.96 - -. STATE TRAFFIC FINES -EST 9.1.19-STF 2,478.92 - TABC ARREST: FEES -TAF 0.00 TECHNOLOGY FUND -TF 24.30 - TRAFFIC -TFC 5.56 LOCAL TRAFFIC FINE- 2020 149.37 <TIME PAYMENT -TIME 93.28 TIME. PAYMENT REIMBURSEMENT FEE-2020 122.09 TRUANCY PREVENTION/DIVERSION.FUND -TPDF 12.15 - - - - LOCAL & STATE WARRANT FEES- WRNT 558.21 - COLLECTION SERVICE FEE-MVBA-: CSRV 708.40 DEFENSIVE DRIVING COURSE -DOC 138.60 .DEFERRED FEE -.DFF 1,513.09' _ DRIVING EXAM FEE- PROVOL 0.00 -. FILING FEE - FFEE 30.00 - FILING FEE SMALL: CLAIMS -FFSC 0.00 - - - -- JURY FEE -.JF 0.00 - `.COPIES/CERTIFED COPIES - CC 0.00 INDIGENT FEE'-CIFF or INDF 6.00 JUDGE PAY RAISE FEE .-JPAY 36.45 :SERVICE FEE -SFEE 0.00 OUT -OF -COUNTY: SERVICE FEE 0.00 - '.ELECTRONIC .FILING FEE -EEF CV 10.00 EXPUNGEMENTFEE:-EXPG 0.00 EXPIRED. RENEWAL- EXPR 0.00. ABSTRACTOF JUDGEMENT -AOJ 0.00 ALL WRITS -WOP/WOE 300.00. DES FTA FINE -DPSF 679.00 - LOCAL FINES - FINE 5,075.92 'LICENSE &WEIGHT FEES -LWF 0.00 PARKS& WILDLIFE FINES :-PWF 3,466.00 SEATBELT/UNRESTRAINED CHILD FINE- SEAT 0.00 -JUDICIAL &.COURT PERSONNEL TRAININGJCPT O.OD '." OVERPAYMENT (OVER $10)-OVER 0.00 OVERPAYMENT ($10.AND LESS)- OVER 0.00 - - ` RESTITUTION . -REST 0.00 PARKS&WILDLIFE-WATER SAFETY FINES-WSF 104.00 - MARINE SAFETY PARKS&WILDLIFE'-MSO 0.00 TOTAL ACTUAL MONEY RECEIVED •_AMOUNT TYPE - - TOTAL WARRANT FEES 558.21 ENTER LOCAL WARRANT FEESr 214.63 IRECORD ON TOTAL PAGE GE HIU COUNTRYSOFINARE MO. REPORT - STATE WARRANT FEES $343.68-'RECORD ON TOTAL PAGE OF HIU COUNTRY SGFT ARE MO. REPORT DUE TO OTHERS - AMOUNT. - DUE TOCCISD-50%of Fine on JV cases 0.DO PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT DUE TO DA RESTITUTION FUND.' OAO FLEA 8E INCLUDE D.R. REQUESTINGDISBURSEMENT REFUND OF OVERPAYMENTS - -0.00 PLEASE INCLUDE D.R. REQUESDNGDISBUREEMENT OUT -OF -COUNTY SERVICE FEE 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT CASH BONDS 0.00' PLEASE INCLUDE D.R REQUESTING DISBURSEMENT(IF REQUIRED) .TOTAL DUE TO OTHERS . 0.00' - TREASURERS RECEIPTS FOR MONTH. - - - - AMOUNT - CASH,CHECKS,M.O.s&CREDIT CARDS 1 $23,662.70 lCalculate from ACTUAL Treasurers Receipts TOTAL TREAS. RECEIPTS 23,652.70 - _ MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/l/2021 bd IURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2021 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 6,290.27 CR 1000-001-44190 SHERIFF'S FEES 1,020.20 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 138.60 CHILD SAFETY 0.00 TRAFFIC 154.93 ADMINISTRATIVE FEES 1,653.12 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 1,946.65 CR 1000-001-44010 CONSTABLE FEES -SERVICE 300.00 CR 1000-001-44061 JP FILING FEES 30.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 122.09 CR 1000-00144145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 708.40 TOTAL FINES, ADMIN. FEES & DUE TO STATE $10.417.61 CR 2670-001-44061 COURTHOUSE SECURITY FUND $464.33 CR 2720-001-44061 JUSTICE COURT SECURITY FUND $6.08 CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $388.47 CR 2699-001-44061 JUVENILE CASE MANAGER FUND $15.00 CR 2730-001-44061 LOCAL TRUANCY PREVENTION & DIVERSION FUND $455.21 CR 2669-001-44061 COUNTY JURY FUND $9.10 STATE ARREST FEES DPS FEES 81.12 P&W FEES 18.13 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 99.25 CR 7070-999-20610 CCC-GENERAL FUND 24.30 CR 7070-999-20740 CCC-STATE 218.72 DR 7070-999-10010 243.02 CR 7072-999-20610 STATE CCC- GENERAL FUND 569.05 CR 7072-999-20740 STATE CCC- STATE 5,121.41 DR 7072-999-10010 5,690.46 CR 7860-999-20610 STF/SUBC-GENERAL FUND 2.75 CR 7860-999-20740 STF/SUBC-STATE 52.21 DR 7860-999-10010 54.96 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 99.16 CR 7860-999-20740 STF- EST 9/1/2019- STATE 2,379.76 DR 7860-999-10010 2,478.92 CR 7950-999-20610 TP-GENERAL FUND 46.64 CR 7950-999-20740 TP-STATE 46.64 DR 7950-999-10010 93.28 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS .'',I 12/1/2021 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2021 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.30 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 5.70 CR 7865-999-20610 CR 7865-999-20740 CR 7970-999-20610 CR 7970-999-20740 CR 7505-999-20610 CR 7505-999-20740 CR 7857-999-20610 CR 7857-999-20740 CR 7856-999-20610 CR 7856-999-20740 CR 7502-999-20740 7998-999-20740 7998-999-20701 7403-999-22889 REVISED 01/29/20 0.00 0.00 0.00 0.00 0.00 2,945.25 DR 7480-999-10010 6.00 CRIM-SUPP OF IND LEG SVCS-GEN FUND 1.22 CRIM-SUPP OF IND LEG SVCS-STATE 10.93 DR 7865-999-10010 12.15 TUFTA-GENERAL FUND 37.31 TUFTA-STATE 74.62 DR 7970-999-10010 111.93 JPAY- GENERAL FUND 3.65 JPAY - STATE 32.80 DR 7505-999-10010 36.45 JURY REIMB. FUND- GEN. FUND 2.43 JURY REIMB. FUND- STATE 21.87 DR 7857-999-10010 24.30 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.04 CIVIL JUSTICE DATA REPOS.- STATE 0.35 DR 7856-999-10010 0.39 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 TRUANCY PREVENT/DIV FUND - STATE 6.08 JUVENILE CASE MANAGER FUND 6.08 DR 7998-999-10010 12.15 l., ELECTRONIC FILING FEE - CV STATE 10.00 DR 7403-999-22889 10.00 TOTAL (Distrib Req to OperAcci) $20,629.05 DUE TO OTHE SI (Distrib Req Attchd) CALHOUN COINTV ISD DA - RESTITUTION REFUND OF OVERPAYMENT: OUT -OF -COUNTY SERVICE FE CASH BONDSi PARKS & WILDLIFE FINES WATER SAFETY FINES 88.40 TOTAL DUE TO OTHERS $3,033.65 TOTAL COLLECTED -ALL FUNDS $23,662.70 LESS: TOTAL TREASUER'S RECEIPTS $23,662.70 OVER/(SHORT) $0.00 Page 2 of 2 %ATE Oje` CALHOUN DISTRIBUTION REQUEST. COUNTY 201 West Austin DR# 450 A 44532 `C-� PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Hope Kurtz Address: Title: Justice of the Peace, Pct. 1 City: State: Zip:, Phone: ACCOUNT NUMBER. - DESCRIPTION. .AMOUNT. 7541-999-20759-999 JP1Monthly Collections - Distribution $20,629.05 NOVEMBER 2021. V# 967 TOTAL 20,629.05 C Signature of Official Date ENTER COURT NAME: : JUgTICE:OF PEACE NO. 2 ENTER MONTH OF REPORT nLC1V't.YY�,:y/' ENTER YEAR OF REPORT 2021 CODE .AMOUNT CASH BONDS ' 0.00' ` REVISED 03/04/16 - ADMINISTRATION FEE -ADMF 10.00 - BREATH ALCOHOL TESTING - BAT 0.00 CONSOLIDATED COURT COSTS-. CCC 623.98 STATE CONSOLIDATED COURT COST-. 2020 '2,647.77 LOCAL CONSOLIDATED COURT COST-:2020 - - 534.22 COURTHOUSE SECURITY-. CHS 66.39 CJP 0.00 CIVIL JUSTICE DATA REPOSITORY FEE -CJDR- 0.84 CORRECTIONAL MANAGEMENT INSTITUTE- CMI 0.00 CR 0.00 =: CHILD SAFETY -CS 0.00 CHILD SEATBELT FEE -CSBF 0.00 - .CRIME VICTIMS COMPENSATION -CVC 0.00 ` DPSC/FAILURE TO APPEAR -OMNI-OPSC ' 282.05 ADMINISTRATION FEE FTA/FTP (aka OMNI)- 2020 115.50 ELECTRONIC FILING FEE 30.00 FUGITIVE: APPREHENSION FA 0.00 GENERAL REVENUE - .OR '- 0.00 GRIM- IND LEGAL SVCS SUPPORT-.IDF 33.19 - JUVENILE CRIME .&' DELINQUENCY .-JCD 0.00 .JUVENILE CASE MANAGER FUND'-.JCMF 65.64 JUSTICE COURT PERSONNEL TRAINING-JCPT - 0.00 ' JUSTICE COURT SECURITY FUND -.JCSF 0.00 `JUROR SERVICE FEE -JSF '. 66.39 LOCAL ARREST FEES - LAF 204.61 LEMI '000 - LEOC 0.00 PARKS& WILDLIFE ARREST .FEES -PWAF 327 STATE' ARREST FEES -SAF 4289 SCHOOL CROSSING/CHILD SAFETY FEE -SCF OOD SUBTITLE C-SUBC 124.27 ' STATE TRAFFIC .FINE- EST .9.1.19-STF , 1.413.66 - - TABC ARREST FEES -TAF DOD TECHNOLOGY FUND TF 6639 - TRAFFIC -TFC 1244 LOCAL .TRAFFIC .FINE- .'.2020 84.64 TIME PAYMENT =TIME 138.88 ' TIME PAYMENT REIMBURSEMENT FEE '..:2020 167.09 TRUANCY'.PREVENT/DIVERSION FUND; TPDF 3319 LOCAL & STATE WARRANT FEES -WRNT 988.84 COLLECTION SERVICE FEE MVBA-CSRV 2,259.31 DEFENSIVE DRIVING COURSE-:DDC 4350 DEFERRED FEE -DFF 1,079.00 DRIVING EXAM FEE- PROV DL -0 DO - FILING :FEE -FFEE 1150D FILING FEE. SMALL CLAIMS -FFSC OOD COPIES/CERTIFED COPIES CC r 100D INDIGENT FEE -CIFF-or INDF - 24.0D - JUDGE PAY RAISE FEE -'JPAY 9960 '. SERVICE FEE-SFEE 90D0 OUT -OF -COUNTY SERVICE FEE OOD EXPUNGEMENTFEE -EXPG' 000 - EXPIRED RENEWAL -EXPR - 000 ABSTRACT OFJUDGEMENT -AOJ '0.06 ALL WRITS WOP/WOE 400 .DPS FTA FINE -OPSF 1,644.03 1. LOCAL FINES -FINE 6,137.57 LICENSE &:WEIGHT FEES -LWF '. 0.00 - - PARKS '.&:WILDLIFE FINES :-PWF 5D3.00 SEATBELT/UNRESTRAINED CHILD FINE - SEAT V- JUDICIAL& COURT PERSONNEL TRAINING FUND- JCPT 0.00 ` OVERPAYMENT ($10&OVER) '-OVER 0.00 ` OVERPAYMENT (LESS THAN $10) - OVER - '0.00 RESTITUTION -.REST - 0.00 PARKS & WILDLIFE -WATER SAFETY FINES-WSF -0.00 - - WCR 0.00 TOTAL ACTUAL MONEY RECEIVED- _ E79,763.05 TYPE: AMOUNT TOTAL WARRANT: FEES : 98884 - ENTER LOCAL WARRANT FEES 'r:$80.86 RECORD ON TOTAL PAGE OF HILL COUNTRY SOMME MO. REPORT STATE WARRANT FEES $607.98 RECORD ON TOTAL PAGE OF HILL COUNTRY SOMME Mo.REPORT DUE TO OTHERS: 'AMOUNT DUE TO CCISD- 50% o1 FIBS on JV Cases _ PLEASE INCLUDE D.R REQUESTING DISBURSEMENT DUE TO DARESTITUTION FUND 0.66 PLEASE INCLUDE OR REQUESTING DISBURSEMENT REFUND OF OVERPAYMENTS 0.00 MUSE INCLUDE OR REQUESTING DISBURSEMENT OUT -OF -COUNTY SERVICE FEE' 0.00 PlE6E INCLUDE OR REQUESTING DISBURSEMENT CASH BONDS 0.00 PLEASEINCLUDE DR REOUESTINGDISBURSEMENT(FREQUIRED) TOTAL DUE. TO OTHERS $0.00 - TREASURERSRECEIPTS FOR MONTH: AMOUNT CASH;:CHECKS,M.O.sB CREDIT CARDS _ . _ -_ _ -$19,753.05: Calculate from ACTUAL Treasurers Receipts. TOTAL TREAS. RECEIPTS i19 763.05 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/l/2021 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 2021 ACCOUNT NUMBER ACCOUNT NAME AMOUNT OR 1000-001-45012 FINES 7,857.05 OR 1000-001-44190 SHERIFF'S FEES 1,110.38 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 43.50 CHILD SAFETY 0.00 TRAFFIC 97.08 ADMINISTRATIVE FEES 1,204.50 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 OR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 1,345.08 OR 1000-001-44010 CONSTABLE FEES -SERVICE 90.00 OR 1000-001-44062 JP FILING FEES 115.00 OR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 OR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 OR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 167.09 OR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 OR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 OR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 OR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 OR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 OR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 2,259.31 TOTAL FINES, ADMIN. FEES & DUE TO STATE $12,943.91 OR 2670-001-44062 COURTHOUSE SECURITY FUND $236.77 OR 2720-001-44062 JUSTICE COURT SECURITY FUND $16.60 OR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $219.02 OR 2699-001-44062 JUVENILE CASE MANAGER FUND $65.64 OR 2730-001-44062 LOCAL TRUANCY PREVENTION & DIVERSION FUND $190.79 OR 2669-001-44062 COUNTYJURYFUND $3.82 STATE ARREST FEES DPS FEES 130.17 P&W FEES 1.05 TABC FEES 0.00 OR 7020-999-20740 TOTAL STATE ARREST FEES 131.23 OR 7070-999-20610 CCC-GENERAL FUND 62.40 OR 7070-999-20740 CCC-STATE 561.58 DR 7070-999-10010 623.98 OR 7072-999-20610 STATE CCC- GENERAL FUND 264.78 OR 7072-999-20740 STATE CCC- STATE 2,382.99 2,647.77 OR 7860-999-20610 STF/SUBC-GENERAL FUND 6.21 OR 7860-999-20740 STF/SUBC-STATE 118.06 DR 7860-999-10010 124.27 OR 7860-999-20610 STF- EST 9/l/2019- GENERAL FUND 56.54 OR 7860-999-20740 STF- EST 9/l/2019- STATE 1,357.02 DR 7860-999-10010 1,413.56 OR 7950-999-20610 TP-GENERAL FUND 69.44 OR 7950-999-20740 TP-STATE 69.44 DR 7950-999-10010 138.88 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/1/2021 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 2021 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 1.20 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 22.80 DR 7480-999-10010 24.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 3.32 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 29.87 DR 7865-999-10010 33.19 CR 7970-999-20610 TUFTA-GENERAL FUND 94.02 CR 7970-999-20740 TUFTA-STATE 188.03 DR 7970-999-10010 282.05 CR 7505-999-20610 JPAY-GENERALFUND 9.96 CR 7505-999-20740 JPAY-STATE 89.64 DR 7505-999-10010 99.60 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 6.64 CR 7857-999-20740 JURY REIMB. FUND- STATE 59.75 DR 7857-999-10010 66.39 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.08 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 0.76 DR 7856-999-10010 0.64 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND -STATE 0.00 DR 7502-999-10010 0.00 7998-999-20701 JUVENILE CASE MANAGER FUND 16.60 CR 7998-999-20740 TRUANCY PREV/DIV FUND - STATE 16.60 DR 7998-999-10010 33.19 CR 7403-999-22889 ELECTRONIC FILING FEE - STATE 30.00 DR 7403-999-10010 30.00 TOTAL (Distrib Req to OperAcct) $19,325.50 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISO 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT: 0.00 OUT -OF -COUNTY SERVICE FI 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 427.55 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $427.55 TOTAL COLLECTED -ALL FUNDS $19,753.06 LESS: TOTAL TREASUER'S RECEIPTS $19,753.06 REVISED 03/04/16 OVER/(SHORT) $0.00 Page 2 of 2 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 460 A 44531 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Calvin Anderle Address: Title: Justice of the Peace, Pct. 2 City: State: Zip: Phone: ACCOUNT NUMBER - DESCRIPTION - AMOUNT- 7542-999-20759-999 JP2 Monthly Collections - Distribution $19,325.50 0 2021 V# 967 TOTAL 19,325.50 Signature of Official / / Date 12-02-21;22:45 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 # 1/ 8 FAX COVER SHEET JUDGE NANCY POMYKAL "PJUMCE FOR AU -. P 0 BOX 454 PORT O' CONNOR, TX.77982 (361)983-2351 - TELEPHONE (361)9$3-2461 - FAX COUNTY OF CALHOUN JUSTICE COURT PCT. 5 DATE: DECEMBER 2. 2021 PAGES: 9 Including this cover TO: JUDGE RICHARD MEYER 8. COUNTY COMMISSIONERS ATT: MaeBelle FAX NUMBER(S) 361-553-44" SUBJECT: NOVEMBER 2021 � MONEY DISTRIBUTION REPORT NOTE: MaeBelle. I am faxing the above report for NOVEMBER 2021 Please give me a call if you have any questions., Thank you, THE CONTENTS OF THIS FAX MESSAGE ARE INTENDED SOLELY FOR THE ADDRESSEE(S) named in this message. This communication is intended to be and to remain confidential and may be subject to applicable attorney/client and/or work product privileges. If you are not the intended recipient of this message, or if this message has been addressed to you in error, please immediately alert the sender by fax and then destroy this message and its attachments. Do not deliver, distribute or copy this message and/or any attachments and if you are not the intended recipient, do not disclose the contents or take any action in reliance upon the information contained in this communication or any attachments, 12-02-21;22:45 ;From:Calhoun County Pot. 5 To:5534444 Money Diotributiola Repeat ;3619832461 # 2/ 8 377462 2021-0349-DC 11-01-2021 ME 9-00 FZLI 25.00 JPTF 5.00 Epp CAPITAL ONE BANK, (USA),N.A. 10.00 46.00 COMPanY Cheek DIERCKS, JESSICA MICHELLE . ........ .. 371466 2020-0227 11-00-202'.1 Occ 62,00 LOP 5.00 WENT 50.00 LCCC CLIFFORD, JULIE YVETTS CSRV 70.50 14.Oo FINE 104.gg 305.50 VILLA, MARTIN CA - -- 4.00 jess, 1.00 3iAy G: 90 ZDF .. .1. 2.*.go WRNT 50.00 a an A. -.n.- - -- 00 TFVF 2.00 377470 2021-0351 ... ... . 3- 'ea CCC HURLER, THOMAS DEAN FINE 146.00 62-00 SAP 5.00 SURC 50-00 LCCC 14, 273.00 29t.00 377472 2920-0292 12-09-2021 CSRV 12.00 MARRMOTOu, ANDREW 13.00 377474 2020.0277 M=Z, DAVID JOSEPH ZU.Uo LCCC 14.00 muz 10-00 uO."go FINE $9-00 CORV 60.00 "�'LCCC OMNR 10.00 TPRP 15.00 250.00 76 2021-0259 11-10.2021 CCC S2 p Z.7 WHITEN=, SEW HARRISON PWF 104-00 CSRV 65.00 Peramal Check 177478 2021-0329 1-17-2021 C--C-C-- -42.47 LAF 3.42 !':; 1 !� %Ti%: JANOTA. DANIEL EDWARD 11 WRNT 34.25 LCCC 9.59 TPRP 10.27 100.00 MUD 2021-0300 11-17-2621 CCC ... . ... 3.42 WANT 34.25 LCCC 9.5; TP;w 10.27 100.00 JANOTA, DAMSEL EDWARD 11 177402 2021-0281 11-29.2D21 CCC 62.00 7,Ap "" ' ' ' "� i� ':': , w, LANTAXxR, ALsc CLEON B-00 LCCC 24-00 OMNR 10.00 ' TPRP IS.00 FINE 99.08 "V& I - - -- -- 310.30 L2.02-2021 Vega I 12-02-21;22:51 ;From:Calhoun County Pot. 5 To:5534444 MOMeY Diatcihntion Repoxt CAIRODN ass Caeae DOPe➢dame Cedes Ameuata 377404 2021.0362 11-24-2021 CFLD 20,00 LONGORIA, BRANDON FAY 317406 2021-0355 DOLLBRY, BODY MIN Company Check 3619832461 # 1/ 1 62.00 SAY 5.00 LCCC 14.00FIN2.,..,._59..,...., 00 ..,o JANOTA, DANIEL EDWARD I1 ...... n:: i 377400 2021-0329 11-29-2021 CCC 0.40 LAF 0.69 WRNT 6.89 LCCC 1.92 TFRF 2,06 Caah Total 20.00 140.00 20.00 L2-02-2921 Page 2 12-02-21;22:45 ;From: Calhoun County Pot, 5 To:5534444 ;3619832461 Money Di,tribution Report CALEOON JPS NOVBrmER 2021 REPORT # 3/ 8 Tjyg Code Description Count -Retained Di boYeefl Money TOtalo -�- The Yellowing t0091e represent - Cash I'd Check, Collected COST CCC CONSOLIDATED COURT COSTS 7 31.04 COST CCC CONSOLIDATED COURT COSTS 0 279.37 310.41 COST CBS CCURTMOVSE SECURITY 0 0.00 0.00 D.00 COST IDF INDIGENT DEFENSE FUND 0 0.00 D.00 0.00 COST JCSB JUSTICE COURT SECURITY FUND 0.00 0.00 0.00 COST JPAY JUDGE PAY RAISE FBI 0 0.00 0,00 D,oD COST JSP JUROR SERVICE FUND 0 0.00 0.00 0.00 COST LAF SHERIFF'S FEE D 9 0.00 0.00 0100 COST LCCC LOCAL CONSOLIDATED COURT COST (EPF. 1.1. 19.99 10.00 0.00 15.9E 15.95 COST OMNC DFS OMNI VMS - COUNTY 7 0.00 COST OMND DPS OMNI FEE - UPS 0 0,10 0.00 0.10 COST OMNO DF8 OMNI FEE - ONNIBASE 0 0.00 0.00 0.00 COST OMNR OMNI REIMBURSEMENT PER (EPF. 1.1.20) 0 1 0.00 0.00 0.00 COST PWAF TEXAS PARRS & WILDLIFE 10.00 0.00 10.00 COST SAP UPS 1 3.26 9.01 4.07 COST SURD SUB TITLE C 4.00 1.00 5.00 COST IF TECHNOLOGY FOND 0 0.00 0.00 .00 COST TPC LOCH. TIP. FINE- FORMERLY TAP. 9-1-19 0 0 0,00 0.00 0.00 COST TIME TIME PAYMENT PEE 02-20 0.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 0.00 0.00 0.00 COST TPRF TIME PAYMENT REIMBURSEMENT FEE 0 0.00 0.00 0.00 COST WANT WARRANT FBI S 47,87 0.00 47.97 FEES CSRV COLLECTION SERVICES FEE a 09,60 509.60 0.00 1. VMS EPF ELECTRONIC FILING FEE 1 5.00 0.00 5E.00 55.00 FEES FILI FILING FEE 4 40.00 PRE$ IPEE INDIGENT PER 4 100.00 0.00 100.00 FEES JCMF JWENILE CASE MANAGER FEE 1.20 22.80 24.00 FEES JFTF JUDICIAL & COURT PERSONNEL TANG FEE -CV 0 0.00 0.00 0.00 FEES BPEE SERVICE FEE < 0.00 20.00 20.00 FINE ANCS DISMISSAL FINE 2 225.90 0.00 225.00 FINE FINE FINS FINE FINE 2 40.00 0.00 40.00 FINE LT(•'C LOCAL TRAFFIC FINE (EFF. 9,1.191 2 298.00 0.00 299.00 FINE PWF PARRS & WILDLIFE FINE 0 0.00 0.00 0.00 FINE STFS STATE TRAFFIC FINE (EFF. 9.1.19) 1 18.d0 B8.40 104.00 0 0.00 0.00 0.00 Money Totals 13 1,0.96.62 452.30 1,479.00 the Yollewiag toiale represent - TrAAB911e Collected :OST CCC CONSOLIDATED COURT COSTS :OST CCC CONSOLIDATED COURT COSTS 0 O.OD 0.66 0.00 :DST CHS COURTHOUSE SECURITY 0 0.00 0.00 0.00 -DST 1DF INDIGENI DEFENSE FUND 0 0.00 0.00 0.00 :UST TCSF JUSiSCE COURT SECURITY FUND 0 0.00 9.00 0.00 :DST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 :UST JSF JUROR SERVICE PUNO 0 0.00 0.00 0.00 :OST LAP SHERIFF'S FEE 0 0.00 0.00 O.OD :'CST LCCC LOCAL CONSOLIDATED COURT COST (EPF. 0 0.00 0.00 0.00 1.1. :DST OMNC DPS OMNI PER - COUNTY 0 0.00 0.00 0.00 :UST OMND UPS OMNT FEE - DP5 D 0.00 0.00 D.000 '04T OMNO DOE OMNI FEE , OMNIBASE 0.00 0.00 0.00 :OST OMNR OMNI REIMBURSEMENT FEE (EFF. 1. 1,20) 0 0.00 0.00 0.00 D 'DST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 :DST SAP UPS0 0.00 0.00 0.00 SUB :09P SUBC SUB TITLE C 0 0.00 0.00 0.00 :UST TF TECHNOLOGY FUND D 0,00 0.00 0.00 :UST TFC LOCAL TAP. FINE- FORMERLY TRP. 9.1.19 0 0 0.00 0.00 0.00 :DST TIME TIME PAYMENT FEE 02-20 0.00 0.00 0.00 :UST TPDF TRUANCY PREVENTION & DIVERSION POND 0 0.00 0.00 0.00 :DST TPRF TIME PAYMENT REIMBURSEMENT FEE 0 0.00 0.00 0.00 :DST WANT WARRANT FEE 0 0,00 0.00 0.00 ?EEO CSRV COLLRCTION SERVICES PSG 0 0.00 0.00 0.00 PEES EFF ELECTRONIC FILING FEE 0 0.00 0.00 0.00 IEEE FILI FILING FEE 0 0.00 0.00 0.00 PEES IFBE INDIGENT PRE 0 0.00 0.00 0.00 ?DES JCMP JUVENILE CASE MANAGER FEE 0 0,00 0.00 0.00 ?SEE JPTF JUDICIAL & COURT PERSONNEL TREK; FEE -CV 0 0.00 0.00 O.OD TEES EPEE SERVICE FEE 0 0.00 0.00 0.00 0 0.00 0.00 O.GD L2-02-2021 page 3 12-02-21;22:45 ;From:Calhoun County Pct. 5 To:5534444 ;3619832461 # 4/ 8 Money Distribution Report CALHOUN JPS NOVEMBER 2021 ASPORT Type Code Description Count Retained Disbursed Money -Totals PIER CPLU COMPLIANCE DISMISSAL FINE 0 0.00 0.00 0.00 FINE FINE FINE 0 0.00 0.00 0.00 FINE LTFC LOCAL TRAPFIC FINE (EFF. 9.1.19) 0 0.00 0.00 0.00 FINE PWF 4ARRS 6 WILDLIFE FINE 0 0.00 0.00 0.00 FINE STF1 STATE TRAFFIC FINE (EFF. 9.1.19) 0 0.00 0.00 0.00 Traneler Totals 0 0100 0.00 0.00 The following totals Xepresent - Jail Credit and Community Eereiea COST CCC CONSOLIDATED COURT COSTS 6 37,49 337.37 374,86 COST CCC CONSOLIDATED COURT COSTS 2 4.69 42.17 49.06 COST CHS COURTHOUSE SECURITY 2 3.51 0.00 3.51 COST IDF INDIGENT DEPEWSS FOND 2 0.23 2.11 2.34 COST JCSF JUSTICE COURT SECURITY FUND 2 1.17 0.00 COST JPAY JUDGE PAY RAISE FEE 2 0.70 6.33 1.17 7.03 COST 08F JUROR SERVICE FOND 2 0.47 4.22 4.99 COST LAF SHERIFF'S FEE 7 29.55 0.00 29.56 COST LCCC LOCAL CONSOLIDATED COURT COST (EPP. 1.1. 6 00,35 0.00 80.35 COST OMNC UPS OMNI FEE - COUNTY 2 4.99 0.00 COST ON= UPS OMNI FEE - UPS 2 0.00 23.43 4.69 23.43 COST GREG UPS OMNI FEB • OMMIHASE 2 0.06 COST OMNR OV.n REIMBURSEMENT FEE (EPP. 1,1.20) 3 30.00 7.03 0.00 7.03 COST PWAF TEXAS PARKS a WILDLIFE 0 0.00 30.00 COST SAP UPS 1 0.00 0.00 4.00 1.00 5.00 COST SUBC SOB TITLE C 0 9.00 0.00 0.00 COST TV TECHNOLOGY FUND 2 4.99 0.00 4.69 COST TFC LOCAL TAP. PINE- FORMERLY TAP, 9-1-19 0 0.00 0.00 COST TIME TIME PAYMENT FEE 02-20 1 4.29 0.00 COST TPDF TRUANCY PREVENTION A DIVERSION FUND 2 0.00 0.00 4.29 COST TPRF TIME PAYMENT REIMBURSEMENT FEE 2 2.34 2.34 COST WANT WARRANT FEE 6 26.09 0.00 29.09 PEES ('.SRV COLLECTION SERVICES FEE 30Q,57 9.00 308.57 FERS EPP ELECTRONIC FILING PEE 5 0 416.10 0.00 41G.10 FEES FILT FILING FEE 0.00 0.00 0.00 PEES IMF INDIGENT FEE 0 0 0.00 0.00 0100 FEES JCMP JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 FEES JPTF JUDICIAL A COURT PERSONNEL TANG FEE -CV 0 0.00 0.00 0.00 0.00 FEES Stan SERVICE FEE 0.00 0.00 FINE OLD COMPLIANCE DISMISSAL FINE 0 0.00 0.00 p�pp FINE FINE PINE D 0.00 0.00 0.00 FINE LTPC LOCAL TRAFFIC FINE (EFF. 9.1.19) 0 l 1,105.00 0.00 1,305.00 FINE PWF PARKS A WILDLIFE FINE 0 3.00 0.00 3.00 FINE.STPI STATE TRAFFIC FINE (art. 9.1.19) 1 0.00 0.00 0.00 2.00 48.00 50.00 Credit Totals 8 2.069.60 474.00 2,540.60 The following totals represent - Credit Card Payments COST CCC CONSOLIDATED COOAT COSTS 3 20.66 167.40 COST CCC CONSOLIDATED COURT COSTS 1 196.06 COST CBS COURTHOUSE SECURITY 1 d,00 36.00 40.00 COST IDP INDIGENT DEFNWSE FUND 1 3.00 0.20 0.00 3.00 COST JCSF JUSTICE COURT SECURITY FUME 1 1.80 2.00 COST JPAY JUDGE PAY RAISE FEE 1 1.00 0.00 1.00 COST JSF JUROR SERVICE FUND 1 0.60 5.40 9.00 COST LAP SHERIFF'S FEE 3 D.40 3.90 4.00 COST LCCC 1,601 CONSOLIDAT20 COURT COST (EFF. 1.1. 3 15.QQ 0190 55.00 COST OMNC DPS OMNI FEE - COUNTY 42.00 0.00 42.00 COST OMRD UPS OMNI FES - UPS 0 0 0.00 0.00 0.00 COST OMNO UPS OMNI FEE , OMNIBASE 0 0.00 0.00 0.00 COST OMNR OMNI REIMBURSEMENT FEB (EPP. 1. 1, 20) 2 0,00 20.00 0.00 0.00 COST PWAP TOM PARKS A WILDLIFE 0 0.00 20,00 COST SAP UPS 0.00 0.00 0.00 COST BUBC BDE TITLE C 1 4.00 1.00 5.00 COST TF TECHNOLOGY FUND 1 1 2.50 47.90 50.00 COST TPC LOCAL TAP. FINE- FORMERLY TRF. 9-1-19 1 4,0D 3.00 0.00 4.00 COST TEME TIME PAYMENT FEE 02.20 D 0.00 3.00 COST TPDF• TRUANCY PREVENTION 6 DIVERSION FUND 1 6.00 0.00 0.00 COST TPRF TIME PAYMENT REIMBURSEMENT FEE 1 0.00 2.00 2.00 COST WANT WARRANT FEE 1 15.00 0.00 15.00 60.00 0.00 $0.90 12.02-2022 Page 4 12-02-21;22:45 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 # 5/ 8 Money Diatribution Haport CALHOUN UPS NOVEMBER 2021 REPORT Type Code Description Come Retained Disbursed Mm ey-Teto30_ PEES CSRV COLLECTION SERVICES PER 4 168.50 0.00 168.5D FEES EFF ELECTRONIC FILING FEE 0 0.00 0100 0.00 FEES FILI PILING FEE 0 0.00 0.00 0.00 FEES IFEE INDIGEST FEE 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER PE2 1 5.00 0.00 5.00 FEES JPTP JUDICIAL & COURT PERSONNEL TRNG PEE -CV 0 0.00 0.00 0.00 FEES EPEE SERVICE FEE 0 0.00 0.00 0.00 FINE CPLD COMPLIANCE DISMISSAL FINE 0 0.00 0.00 0.00 PINE FINE FINE 4 SG9.00 0.00 599.00 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9. 1.19) 1 3.00 0.00 3.00 PINE PWF PARKS & WILDLIFE FINE 0 0.99 0.00 0100 FINE STF1 STATE TRAFFIC FINE (R". 9.1.19) 1 2.00 40.00 50.00 Credit Card Totals 6 930.80 312.70 1,243.50 The following totelo represent - Combined money COST CCC CONSOLIDATED COURT COSTS 10 49.64 446.77 496.41 COST CCC CONSOLIDATED COURT COSTS 1. 4.00 36.00 40.00 COST CRS COURTHOUSE SECURITY 1 3.00 also 3.00 COST IDP INDIGENT DEFENSE FUND 1 0.20 1.80 2.00 COST JCSF JVSTICS COURT SECURITY FOND 1 1.00 6.00 COST JPAY JUDGE PAY RAISE FEE 1 0.60 6.40 1.00 6.00 COST JSP JUROR SERVICE FUND 1 0.40 3.60 4.00 COST LAP SHERIFF'S FEE 8 30.95 9.99 30.95 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.1. 10 112.10 0.00 112.10 COST OMNC UPS OMNI FEE - COUNTY a 0.00 0.00 0.00 COST OMND DPS OMNI FEE - DPS 0 O.OD 0.00 0.00 COST OMNO DPS 9MN1 FEE - OMNIBASE 0 0.00 6.00 6.00 COST OMNR OMNI REIMBURSEMENT FEE (Err. 1.1.2a) 3 30.00 0.00 30.00 COST PWAF TEXAS PARKS & WILDLIFE 1 3.26 0.81 4.07 COST SAP DPS 2 0.00 2.09 10.00 COST BUM Sun TITLE C 1 2.50 47.50 $0.00 COST TF TECHNOLOGY FUND 1 4.00 0.00 4.00 COST TFC LOCAL TRF. FINS- FORMERLY TRP. 9-1-19 1 3.00 0.00 3.00 COST TIME TIME PAYMENT FSE 92-20 0 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 0.00 2.00 0.00 COST TPRF TIME PAYMENT REINBURSEMENT FEE 6 62.87 2.00 COST WRNT WARRANT FEE 5 159.60 0.00 0.00 62.87 159.69 FREE CSRV COLLECTION SERVICES FEE 5 223.50 FEES EPP ELECTRONIC PILING FSE 4 0.00 223.50 FEES PILT FILING FEE 0.00 40,00 40.00 FEES IFEE INDIGENT FEE 4 100.00 0.00 300.00 FEES JCMF JUVENILE CASE MANAGER FEE 4 1 1.20 22.80 24.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG FEE -CV 4 $.Do 0,00 0.00 6.00 FEES EPEE SERVICE FEE 2 20.00 20.00 FINE CPLD COMPLIANCE DISMISEAL FINE 2 225.00 0.90 225.00 FINE FINE FINE 40.00 0.00 40.00 FINS LTFC LOCAL TRAFFIC FINE (£FF. 9.1.19> 6 1 867.0E 3.00 0.00 897.00 FINE PWF PARKS & WILDLIFE FINE 1 15.69 0.00 3.00 FINE STPS STATE TRAFFIC FINE (EFF. 9.1.19) 1 2.00 08.40 104.00 d8.00 50.00 Money Tntalo 19 1,967.42 765.00 2,722.50 The following eetels represent - Combined Money and Credits COST CCC CONSOLIDATED COURT COSTS 19 87.23 744.14 671.27 COST CCC CONSOLIDATED COURT COSTS 3 8.99 78.27 86.86 COST CBS COURTHOUSE SECURITY 3 G.51 COST IDF INDIGENT DEFENSE FOND 3 0.43 0.00 6.51 COST JCSF JUSTICE COVRT SECURITY FUND 3 2.17 3.91 0.66 4.34 COST JPAY JUDGE PAY RAISE FEE 3 1.30 2.17 COST JSF JUROR SERVICE FUND 3 11.73 13.03 COST LAP SHERIFF'8 FEE is 0.87 60.51 7.82 8.0 COST LCCC LOCAL CDNSOUvATED COURT COST (EFF. 1.1. 16 99 60.51 COST OMNC DPS OMNI PER - COUNTY 2 192.45 0.00 192.45 COST OMND UPS OMMI FEE - DPS 2 4.69 0.00 4.69 COST OMNQ AFS ONNS FEE - OMNISASB 2 0.00 23.43 23.43 COST OMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 6 0.00 60.00 7.03 1.03 COST PWAF TEXAS PARKS & WILDLIFE 1 0.00 60.00 COST SAP DPS 3.26 0.81 4.07 3 12.00 3.00 15.00 12-02-2021 Page 5 12-02-21;22:45 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 # 6/ 8 Money DSetribuei.en Report Code DegCs1 ESOa CALHODN JpH NOVEeD3QR 2022 RHPOAT COST SVBC TITLE C CountBCE Retained Diebure4+d M0R0 +TOta10 COST TF TECHNOLOGY FUND 1 2.50 47.50 50.00 COST TFC LOCAL TRp. FINS. FORMERLY TRF. 9-1-19 1 8.60 0.00 0.69 COST TIME TIME PAYMENT PER 02-20 1 3.00 0.00 3.00 COST TPDF TRUANCY pRSVENTION 6 DIVSRSION FOMD 1 4.29 0.00 COST TPRF TIME PAYMENT REIMBURSEMENT FEE 3 0.00 4.34 4.29 4,34 COST WRNT WARRANT FEE 0 08.96 0.00 98.96 FHS6 CSRV COLLECTION SSRVICEB C2E 11 468.17 0.00 0606A.1739 FEES SFF ELECTRONIC PILING FEE 10 639.60 0.00 639.6o PEES FILI FILING FEE 4 0.00 40.00 40.00 FEES IFEE INDIGENT FEE 4 100.00 0.00 100.00 PRES SCMF JUVENILE CASE MANAGER FEE 4 1.20 22.90 FEES JPTF JUDICIAL 6 COURT PERSONNEL TRNG FEE -CV 1 5.00 0.00 24.00 5.00 FSEB SFEE SSRVIC^a FEE 4 0.00 20.00 20.00 FINE CPLD COMPLIANCE DISMISSAL FINE 2 225.00 0.00 225.00 PINE FINE FINE 2 40.00 0.00 4 FINE LTPC LOCAL TRAFFIC FINE (EPP. 9.3.10) 14 1,972.00 0.00 .00 1,972.00 FINE PWP PARRS 4 WILDLIFE FINE 2 6.00 0.00 6.00 FM STR1 STATE TPAPPIC pimc (EFp. 9.1.19) 1 15.60 88.40 104.00 2 4.00 96.00 100.00 Report Totals 27 4,024.02 1,239.08 5,263.10 L2-02-2021 Raga 6 12-02-21;22:45 ;From:Calhoun County Pot, 5 To:5534444 ;3619832461 # 7/ 8 Nosey Distribution Report Date 00-00.0000 payment a Cash & Cheeks Collected Jail Cred1CB & Comm Service Credit Cards & Transfers Total of all Collections0.00 pines 0.00 0.00 0.00 Court Cases 0.00 0.00 0.00 0.00 CALROVN JP5 NOVRNBOR Fees Dane 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2021 RRPORT Restitution 0.00 0.00 0.00 0.00 Oche! 0.00 0.00 0.00 0.00 Total 0.00.00 0,00 0.00 0.00 09.01.1992 Cash & Checks Collected Jail Credits & Comm service Credit Cards & Trana£erb Total of &11 Collections 0.00 0.00 6.00 D.00 0.00 0.00 0.00 D.00 0.00 0.00 0.00 0,00 0.00 D.qp 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 01-01-2004 Cash & Checks Collocted Jail Credits & Comm Service Credit Cards & Trane£ora Total Of all Collections 0100 323.00 95.OD 421.00 0,00 216.50 127.00 353.50 0.00 207,60 74.00 201.60 0.00 0,00 0.00 0100 0.00 0.00 0.00 0 00 0.00 0.00 0,00 0.00 .0 757.10 259. 11059.10 0 01-01-2029 Cash & Checks Collected Jail Credits & Comm Service Credit Cards & Transfers Total OE all Collecaime 442,00 633.00 524. 1, 001.00 573.00 740.00 1,634.00 464.00 206.50 772.00 0.00 0.00 0.00 0.00 0.00 0.00 0.60 0.00 0.00 0,00 0.00 O.DO 1,479.00 1,703.50 944.50 4,207.00 TOTALS Cash & Checks Collected JRil Crodits 6& COmm Service Credit Cards & Trandfara Total of all Collections 442.00 1,159.00 622.00 2,222.00 $73.00 999.50 449. 1,967.50 50 464.00 416.10 3.50 1,03053.60 0.00 0.00 0.00 0.00 0, 00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 1,475.60 1,540.5o 1,243.0 5, 2G3.10 12-02-202% Page 7 12-02-21;22:45 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 # 8/ 8 Money Distribution mepori naoari t10a CALROON Jr5 Npysi®gR 2a21 REPORT COumt CO11pCted ReOained Di sbursed State of TO%ne Quarterly Reporting Totals State Comptroller Coat and Face Report Section I: Report for offenses committed 01.01-20 Forward 01-01-94 - 12-31.19 11 546.41 52.14 494.27 09-01-91 - 12-31-03 1 40.00 4.00 36.00 Boil Bond Fen 0 0.00 0.00 O,DO DNA Testing Fee - Juvenile 0 0.00 0.00 ENS Trauma Fund (EMS) 0 0.00 0.00 0 0.00 0.00 Jwenlln Probation Diveraioq Fees 0.00 0.00 D.00 State Traffic Fine (Off. 09-01-19) 0 0.00 0.00 State Traff 1 50,00 0.00 iC Fine (prior 05-03.19) D 2.00 4a.00 Intoxicated Driver Fine 0.00 0.00 0.00 Prior Mandatory Cones (JRF,.tDF,JS) 0 0.00 0.00 0.00 Moving Violation Fees 3 12.Oc 1.20 DNA Testing Fee . Convictions 0 0.00 0.00 20,80 DNA Testing Fes Comm SUpvn 0 0.00 0.00 0.00 0.00 Truancy Prevention and Divarsion Fund a 0.00 0.00 0.00 Failure to AppgaX/Pay Faea 0 0.00 0.00 Time Payment Fees 0 0.00 0.00 0.00 Judicial Fund - Conet County Court 0 0.00 0.00 0.00 0.00 Judicial Fund - Statutory County Court 0 0.00 0.00 0.00 0 0.00 0.00 0.00 Section xx: As Applicable Peace officer Fees Motor Carrier Weight Violations 3 16•07 11.26 2.s1 Driving Record Fee 0 0.00 0.00 Report sub Total 0 0.00 0.00 19 0.00 0.00 State COmptrDlles Civil Face Report 662.48 70.60 591.80 CF: Birth Certificate Feee CF; Marriage License Face 0 0.00 0.00 CF. Declaration 0£ Informs 0 0.00 0.00 1 Marriage 0.00 0.00 0 Cs: Nondisclosure PE09 0.00 0.00 0.00 CF: Juror Donations 0 0100 0.00 CF: JUatice Court Indig Filing Fees 0 0.00 0.00 0.00 CF: Stat Pxob Court Iadig Filing Faeo 0 0.00 24.00 1.20 22.80 CF: Seat Prob Court Judie Filing Pees 0 0.00 0.00 0,00 Cr: Stat enty Court Indig Filing Pees 0 O.Oo 0.00 CF; Stat Cnty Court Judie Filin F 0 0,00 0.00 9 eCs 0.00 0.00 CF, Cns0t Caw Court Indig Filing Fees 0,00 0.00 0.00 CF; Cast Cnty Court Judie Filing Fees 0 0.00 0.00 CF: Dint Court Divorce a Family Law 0 0.00 0.00 0.00 0 0.00 CP; Diet Court Other Divorce/Family Law 0.00 0.66 0.00 CF: Dist Court xndig Legal ServlcCe 0 0,00 0.00 OF: Judicial support Fee 0 0.00 0.00 Cr: orta0.00 0,00 RepS 4 Court Fora, Training Fos 0 0.00 0.09 0.00 Report Sub Total 0 0.00 0.00 0 24, 00 1.20 22.00 0.00 Total Due Par This period 23 986.48 11,90 914.68 rRE STATS OF TEXAS Before me, the undersigned authority, this day :Ouety of Calhoun County Per00nally appeared Nancy Pomykpl, J0a410e of the Peace, ProcinCt No 5, Calhoun County, Texas, who being duly sworn, deposes and say* that the above aid foregoing report is true and correct. vlGnees my hand thisWounlaunty, Z D�Qayi peace, P 0e Ct No 5 /rT Cal Texas V #19 NOTICE OF MEETING — 12/8/2021 19. 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 16 of 17 § § § B � § 2 � � s z I z 0 § 0 d � / §§ §§§ § ■ § § § � § B� m ) § § 0m § § � Z m=_ a = f0 N O OW1 O A m m= 00000�� o m �- m FA y nO c M 9 Z = m m n 0 Z F Tm i Z tea= r T M=100X D5 C G) N �_ Nm m Z 0m -0 Tj O Z2 c�v p o-0 m m a Z a= N m �c�M El .. 3= Nam_ m C m=_ -ZZA m m m= m N i p 3° D Z a==__ 3 55 CD y m �= Z Z a m= A T Z= m C °' z n O O O N c0 <O y O z ME 3= 3�� G D 0 0 0 0 0 0 0 N O. 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Approval of bills and payroll. (RHM) MIMIC 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: 10:42 a.m. Page 17 of 17 December 8, 2021 2021 APPROVAL LIST - 2021 BUDGET COMMISSIONERS COURT MEETING OF 12/08/21 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 25 $355,117.18 AT&T MOBILITY IT DEPARTMENT -PHONE SERVICE A/P $ 122.77 GBRA RB1 - WATER - MAGNOLIA BEACH VFD, S PROMENADE ST, PARK SITE A A/P $ 378.33 QUILL JP2/MUSEUM OFFICE SUPPLIES A/P $ 327.70 SPARKLIGHT IT DEPARTMENT-INTERNET SERVICES A/P $ 119.49 PAYROLL FOR 12-10-21 TOTAL VENDOR DISBURSEMENTS: $ 356,065.47 TOTAL PAYROLL AMOUNT: TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: CALHOUN COUNTY OPERATING ACCOUNT - TRANSFER FUNDS FOR HIGHER INTEREST RATE TO MONEY MKT P/R $ 354,391.43 $ 354,391.43 TOTAL AMOUNT FOR APPROVAL: $ 710,456.90 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---December 08, 2021 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL: PAYA9LES,PAYROLLLAND-40P-TRQNIC'BANKPAYMENTS $ C016,;420.7$` `TOTALTRANSFERS BETWE¢N FUNDS $ 794iV7 ,2* 'TOTALNURSINO - QKE, UPL ExPENSEo 41 ,668 9 � TOTAL''INT9W ,0UERNMENTTRANBFERS $ GRAND -TOTAL p188URSEMENTS APP,R016ED'D06embor 08, 20¢1 $' 2 221,564 24;' MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---December 08, 2021 PAYABLES AND PAYROLL 121212021 Weekly Payables 400,113.53 1212/2021 Memorial Medical Center Petty Cash -petty cash reimbursement 14.50 12/2/2021 Texas Mutal Insurance Co-insurance 52,177.00 121212021 Patient Refunds 176.73 1212/2021 Healthsure Insurance Services -renewal of DOLT 23,998.00 12/6/2021 McKesson-3406 Prescription Expense 8,526,35 1216/2021. Amerisource Bergen-34013 Prescription Expense 1,476.52 1216/2021 Payroll Liabilities -Payroll Taxes 91,907,49 12/6/2021 Payroll 293,198,90 Prosperity Electronic Bank Payments 12/2-1213/21 Credit Card & Lease Fees 659.51 12115/2002 TCDRS November Retirement 142,891.14 1211/2021 Cleargage-Patient Financing Service 65.25 1129-12/3/21 Pay Plus -Patient Claims Processing Fee 191,06. 121212021 Authnet Gateway Billing-3rd Party Payor Fee 24.20 aTAL,j�PYdkBLtOt P#4YRtlLL ANb EL,'RCTRONi0 BANK(OAYNitNTs $ 1117 ,-da0r 18, TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 12/2/2021 MMC Operating to Ashford -correction of NH insurance payment and QIPP 64,334,81 deposited Into MMC Operating 12/2/2021 MMC Operating. to Solera-correction of NH insurance payment and QIPP 25.150.32 deposited into MMC Operating In error 12/2/2021 MMC Operating to Fart bend -correction on NH. insurance payment and QIPP 30,359.78 deposited into MMC Operating 12/2/2021 MMC Operating: to Broadmoor-correction of NH insurance payment and QIPP 26,989.80 deposited into MMC Operating 12/2/2021 MMC Operating to Crescent-ccmection of NH Insurance payment and QIPP 23,31!10.91 deposited into MMC Operating In error 12/212021 MMC Operating to Golden Creek -correction of NH insurance payment and 123,660.65 QIPP deposited into MMC Operating in error 1212212021 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 76,115.04 deposited Into MMC Operating 12/22/2021 MMC Operating. to Tuscany Village -correction of NH insurroce.payment 91,505.92 deposited Into MMC Operating 12/27/2021 MMC Operating. to Bethany -correction of NH insurance payment: deposited 101,143.21 into MMG Operating in error ME131CARE ADVANCE PAYMENT RECOUP 12/6/2021 Broadmoor to MMC Operating -correction of Broadmoor medicare recoup 35,186,48 taken from MMC Operating 12/6/2021 Broadmoor to Bethany -correction of Broadmoor medical recoup taken from 120.13 Bethany 12/6/2021 Broadmoor to Golden Creek -correction of Broadmoor medical recoup taken 4,844.39 from Golden Creek 12/6/2021 Crescent to MMC Operating -correction of Crescent medicare recoup taken 35,186.48 from MMC Operating 12/612021 Crescent to Bethany-ccrrecllon of Crecent medicare recoup taken from 120.13 Bethany 12/6/2021 Solera to MMC Operating -correction of Solera medicare recoup taken from 35,186.48 MMG Operating 1216/2021 Solera to Golden Creek -correction ofSolera medicarerecoup taken from 4,844.39 Golden Creek 12/612021 Solera to Bethany -correction of Bolero medicare recoup taken from Bethany 120.13 12/6/2021 Tuscany to MMC Operating -correction of Tuscany medicare recoup taken 29,112.00 from MMC Operating TRANSFER OF FUNDS BETWEEN NURSING HOMES 12/6/2021 Gulf Pointe Plaza -PP -correction of MMC insurance payment deposited into 10,017,16 Gulf Pointe Plaza -PP in error 121612021 Gulf Pointe Plaza-PP-correctlonof MMC Clinic insurance payment deposited 530.99 Into Gulf Pointe Plaza -PP in error 121612021 Gulf Pointe Plaza -PP -correction of Ashford insurance payment deposited Into 2,870.00 Gulf Pointe Plaza -PP in error 12/6/2021 Gulf Pointe Plaza -PP -correction of Broadmoor insurance payment deposited into Gulf Pointe Plaza -PP in error 12/6/2021 Gulf Pointe Plaza -PP -correction of Crescent insurance payment deposited into Gulf Pointe Plaza -PP in error 12/612021 Gulf Pointe Plaza -PP -correction of Fort Bend insurance payment deposited into Gulf Pointe Plaza -PP in error 12/6/2021 Gulf Pointe Plaza -PP -correction of Sclera insurance payment deposited into Gulf Pointe Plaza -PP in error 12/6/2021 Gulf Pointe Plaza -PP -correction of Golden Creek insurance payment deposited into Gulf Pointe Plaza -PP in error 12/6/2021 Gulf Pointe Plaza -PP -correction of Tuscany insurance payment deposited into Gulf Pointe Plaza -PP in error TOTAL: TRANSFERS BOWEEN,FUN00 NURSING HOME UPL EXPENSES 12/6/2021 Nursing Home UPL-Cantex Transfer 1 V62021 Nursing Home UPL-Nekton Transfer 12/62021 Nursing Home UPL-Tuscany Transfer 12162021 Nursing Home UPL-HSL Transfer 'TOTALL4400iNG HQINE U0"' PAWIS TOTAL rINTER=GOVERNMENT TRANSFERS 11,694.50 18,870.00 2,646.00 27,880.00 3,685.25 3,073.00 185,610.18 19,474.65 55,264.90 152,319.19 $, ;70072.24', GRAND TOTAL D19BURS,EMENTS.API?ROV,80 WedGm150 08, 2027 2 221;38n:34= Page 1 of 14 %&42A 2021 MEMORIAL MEDICAL CENTER 49 0 AP Open Invoice List 0 1022 Catrtolt5Cuimly A71d'-7<c; Due Dates Through: 3 ap_open_invoice.template Vendor} Vendor Name Class Pay Code 11283 ACE HARDWARE 15521 ✓. Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 159121✓ 11/30/20 11/0V20 11/26/20. 27.98 0.00 0.00 27.98 SUPPLIES f 159145 ✓ 11/30/20 11/02/20 11/27/20 16S9 0.00 0.00 16.99 f SUPPLIES 159202 ✓ 11/30120. 11/03/20 11128/20. 79.99 0.00 0.00 79.99 SUPPLIES 159204 11/30/2011/03/2011/28/20 7.96 0,00 0.00 7.96 SUPPLIES / 159201 v 11/30/2011/03/2011/28120 44.99 0.00 0.00 44.99 SUPPLIES / 159227 11/30/201110412011/29/20 25.98 0.00 0.00 25.98 ✓ SUPPLIES / / 159298 11/30/2011105/20 11130/20. 38.99 0.00 0.00 38.99 ✓ / SUPPLIES 159350 ✓ 11/30/20. 11/08/20 12103/20.. 39.98 0.00 0.00 39.98 SUPPLIES 159561 V 11/30/40. 11/15/2012/10/20 42.96 0.00 0.00 42.96 / SUPPLIES � ✓ 159542 11/30/2011/15/2012/10/20. 9,99 0.00 0.00 9.99 / l" 1` 159602 V 11/30/2011/16/2012/11/20 8.58 0.00 0.00 8.58 SUPPLIES 159635 11130/20. 11/17/2012/12/20. 27,98 0.00 0.00 / 27.98 ✓ / SUPPLIES 159720 ,/ 11/30/2011/19/20 12/14/20. 28,77 0.00 0.00 28.77 SUPPLIES - 159777 ✓ 11/30/2011/22/2012/16/20 32.56 0.00 0.00 32.56 ✓ SUPPLIES / 159877 �/ 11/30/2011124/2012115/20 11,98 0.00 0.00 11.98 SUPPLIES Vendor TotalE Number Name Gross Discount No -Pay Net. 11283 ACE HARDWARE 15521 445.68 0.00 0.00 445,68 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 2376824y/ 11/22/20 11/16/20 12/15/20 21208.00 0.00 0.00 2,208.00 TRAVEL LAB STAFFING (.1111 ^ It 11412-1) - 51 yn OW jt, 2376907 ✓ 11/22/20 11/15/2I0 12/15120 2,705.13 0.00 0.00 2,705.13 p/ TRAVEL LAB STAFFING ( It11- 11114124 - hi,)4,4 2376676 V/ 11122120. 11/16/20 12/15/20. 2,680.00 0.00 0.00 2,680.00 V` TRAVEL LAB STAFFING L101Aq - l l l u)a'1) - sh 101111 Vendor TotalE Number Name Grass Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 7,593.13 0,00 0.00 7,593.13 Vendor# Vendor Name Class Pay Code / 14088 AZALEA HEALTH ✓ file:/!/C:/Users/eheiman/cpsilmemmed.cpsinet.com/u98547/data_5ltmp_cwSreport14439... 12/2/2021 Page 2 of 14 Invoice# Comment Tran Dt Inv Dt Due Dt Check 0, Pay Gross Discount No -Pay Net 60924Y 11129/2012/01/20. 12/01/20. 550.00 0.00 0.00 550.00 PROCESSING AND SUPPORT _ Vendor Totals Number Name Grose Discount No -Pay Net 14088 AZALEA HEALTH 550.00 0.00 0.00 $50.00 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC ✓ M Invoice#Comment Tran Ot Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 109436758✓ 11/22/20. 11/15/2012/10/20. 1,288.45 0.00 0.00 1,288.45 f SUPPLIES 1094440901/ 11/22/2011/16/2012/11/20. 93.46 0.00 0.00 93.46 ✓ J SUPPLIES 109445175 11/22/20 11/17/20 12/12/20 1,359.92 0.00 0.00 1,359.92 /SUPPLIES 109450903 K 11/22/2011/1812012/13/20. 14.90 0.00 0.00 14.90 v,> UPPLIES 109437034 11/30/2011/15/2012110120 139.34 0.00 0.00 139.34 ✓' SUPPLIES Vendor Total:Number Name Gross Discount. No -Pay Net B1220 BECKMAN COULTER INC 2,896.07 0.00 0.00 2,899.07 Vendor# Vendor Name Class Pay Code B1800 BRIGGS HEALTHCARE v/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net B374180N/ 11/16/20, 11/10/2012/10/20, 236.00 0.00 0.00 236.00✓ SUPPLIES Vendor Total Number Name Gross .Discount No -Pay Net - B1800. BRIGGS HEALTHCARE 236.00 0.00 0.00 236,00 Vendor# Vendor Name Class Pay Code D1040 OR BARD, INC Invoice# Comment Tran Ot Inv Ot Due Dt Check D, Pay Gross Discount No -Pay Net 83381745 ✓ 11/24/2011116/2012/09120. 350.78 0.00 0.00 350.76 ✓'� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net D1040 C R BARD, INC 350.78 0.00 0.00 350.78 Vendor# Vendor Name Class Pay Code C1048 CALHOUNCOUNTY y// w Invoice# Comment Tran Dt Inv Dt Due Ot Check D' Pay Gross Discount No -Pay. Net. 112421 11/30/20 11/24/20 12/15/20 22.29 0.00 0.00 22.29 GAS Vendor Totals Number Name Gross Discount No -Pay Net C1048 CALHOUN COUNTY 22.29 0.00 0.00 22.29 Vendor# Vendor Name Class Pay Code 14064 CAPITAL ONE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 102121 11/29/2010/21120. 12/14/20 104.88. 0.00 0.00 104,88 SUPPLIES 102621A 11/29/2010/26/2012/14/20 87.40 0.00 0.00 87,40 SUPPLIES - 102621 11/29/2010/26/2012/14/20 64.44 0.00 0.00 54.44 f SUPPLIES 1026218 11/29/20 10/26/20 12/14/20 16.88 0.00 0100 16.88 file:///C:/Users/Cheirnan/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report14439... 12/2/2021 Page 3 of 14 SUPPLIES 1026210 11129/20 10126/20 12/14/20, 49.88 Moo 0.00 49.88 SUPPLIES ,102621D 11129/2010/26/2012114/20 49.88 0.00 0.00 49.88 ✓ SUPPLIES 102721 1112912010127/2012114/20. -49.88 0.00 0.00 -49.88 CREDIT 102721A 11/29/20 10/27/20 12/14/20 49.88 0.00 0.00 49.88 SUPPLIES .. 110221 11/29/20.11/02/20 12/14/20 4.88 0.00 0.00 4.88 SUPPLIES 111521 11 /29/20 11/15/20 12114/20 54.42 0.00 0.00 54,42 V SUPPLIES 111821 11/29/2011/18/2012/14/20 19.32 0.00 0.00 19.32 V/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14064 CAPITALONE 441.98 0.00 0.00 441.98 Vendor# Vendor Name Class Pay Code C1325 CARDINAL HEALTH 414, INC. ✓ W invoice# Comment Trani Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 80026859031/ 11/30/20. 11/06/20 W11/20. 519.46 0.00 0.00 519.46,,-' SUPPLIES 8002691769 r/ 11/30/20. 11/1 MO 12/08/20. 631.14 0.00 0.00 631.14 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1325 CARDINAL HEALTH 414, INC. 1.150.60 0.00 0.00 1,160.60 Vendor# Vendor Name Class Pay Cade 13264 CERVEY, LLC Invoice# Comment Tran Dt. Inv Dt Due D1 Check D' Pay Grass Discount No -Pay Net 13249 v1 11/30/20 11/16/20 12/11/20 1,699.00 0.00 0.00 1,699.00 v% 340E Vendor Totals Number Name Gross Discount No -Pay Net 13264 CERVEY, LLC 1,699.00 0.00 0.00 1,699.00 Vendor# Vendor Name Class Pay Code 10786 CLINICAL PATHOLOGY ,,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 176562021100 11/30/20 10/31/20 11/25/20 17,539.09 0.00 0.00 ! 17,539.09 ✓ Vendor Totals Number Name Gross Discount No -Pay Net 10786 CLINICAL PATHOLOGY 17,639.09 0.00 0.00 17,539.09 Vendor#Vendor Name Class Pay Code C1166 COASTAL OFFICE SOLUTONS W Invoice# Comment Tran Dt Inv or Due or Check DPay Gross Discount No -Pay Net OEOT191231 v/11/29/20, 11/24/2012104/20, 132.16 0.00 0.00 132.16. ✓ SUPPLIES .. OE334301y / 11/30/20 11/30/20 12110120 165.20 0.00 0.00 165.20 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1166 COASTAL OFFICE SOLUTONS 297.36 0.00 0.00 297.36 Vendor# Vendor Name Class Pay Code C1870 COLLEGE OF AMERICAN PATHOLOGIS / W file:///C:/Users/eheiman/epsi/memtned.cpsinet.condu98547/data_5/tmp cw5report14439... 12/2/2021 Page 4 of 14 Invoice# ,Comment Tran Dt Inv Dt Due Dt Check.D Pay Gross Discount No -Pay Net 2570998 ✓/ 11/1612011/13/2012/13/20 399.96 0.00 0,00 399.96 SERVICES Vendor Totals Number Name Gross Discount No -Pay Net C1870 COLLEGE OF AMERICAN PATHOLOGIST 399.96 0.00 0.00 399.96 Vendor# Vendor Name Class Pay Code 11368 CYRACOM LLC Invoice* comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 1401032 10/31/20 10131120 12115/20, 265.97 0.00 0.00 265.97 INTERPRETATION SERVICES Vendor Tota4Number Name Gross Dlscaurrt No -Pay Net 11368 CYRACOM LLC 265.97 0.00 0.00 265.97 ' Ventlor# Vendor Name Class Pay code 10368 DEWITT POTH& SON v1 Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D`Pay Gross Discount No -Pay Net 6629040 V 11/17/20. 11/15/20 12/10/20 294.20 0.00 0.00 294.20 SUPPLIES 6629030 ✓ 11/17/20 11/15/20 12/10/20. 272.99 0.00 0.00 272.99 ✓ /SUPPLIES 6631280 ✓ 11/17/2011/15/2012M0/20 $5.35 0.00 0.00 35.35 SUPPLIES / 6631281 ✓ 11/22/2011/16/2012111120 39.85 0.00 0,0D 39,85 ✓ 9UPPLIES 6633650 1 1/22/20 11118/20 12JI 3/20 40.80 0.00 0.00 40.80 SUPPLIES 6634340./ 11/30/201.1/1812012/13120 33.99 0A0 0100 3199 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH&SON 717.18 0.00 0,00 717.18 Vendor# Vendor Name Class Pay Corte 10789 DISCOVERY MEDICAL NETWORK INC Invoice# Comment Tran Dt Inv of Due Dt Check D Pay Gross Discount No^Pay Net . / MMC111521 ✓ 11/29/2011/15/2012109/20 151,427.05 0.00 0,00 151,427.05 ✓ PRO FEES t N 9 V 1-15 7 Vendor Totals Number Name Gross Discount No -Pay Net 10789 DISCOVERY MEDICAL NETWORK INC 151,427.05 0.00 0.00 151,427.05 Vendor# Vendor Name Class Pay Code 10175 DSHS CENTRAL LAB M02004 lye hkuv (_ V(,f C(I_on ) Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Grosss Discount No -Pay Net CENON0426022021 04/27/20 03/80/90 12/15/20, 605 wo 0.00 0.00 5.80 LAB SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 10175 DSHS CENTRAL LAB MC2004 60�80 0.00 0.00 60w Vendor# Vendor Name. Class Pay Code / 10690 DYNASTHETICS v+' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 21-27054 11/24120, 09/23/2012/09120 357.90 0.00 0.00 367.90✓ SUPPLIES / 21-27097 ,/ 11130120. 09/28/20 11/30/20. 47.33 0.00 0.00 47.33 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/Users/eheiman/cpsi/memmed.cpsinet.comlu98547/data 5/tmp_cw5report14439... 12/2/2021 10690 DYNASTHETICS 405.23 0.00 Vendor# Vendor Name Class Class Pay Code C2510 EVIDENT 1/M Invoice# Co ment Tram Dt Inv Dt Due Dt Check D- Pay Gross Discount T2111151378 ✓� 11/29/20 11/15/20 12/10/20 12,048.98 0.00 BUSINESS SERVICES Vendor Totals Number Name Grass Discount C2510 EVIDENT 12,048.98 0.00 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP.,/W Invoice# CPmment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount 732121691- J 11130/2010/16/2011/10/20, 154.00 MOO FR�FIGHT 5418457306 ,/ 12/01/20:09/03/20 09/28/20 56.92 0.00 FREIGHT Vendor Totals Number Name Gross Discount F1100 FEDERAL EXPRESS CORP. 212.92 0.00 Vendor#Vendor Name Class Pay Code 10788 FIRETROLPROTECTION SYSTEMS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 100750790 11130/201110312011/13/20 536.92 0.00 FIRE ALARM REPAIR 100752321 v//11/30/2011/1.1/2011/21/20 905.00 0.00 FIRE ALARM SERVICES Vendor Totals Number Name Gross Discount 10788 FIRETROL PROTECTION SYSTEMS 1,441,92 0.00 Vendor#"Vendor Name Class Pay Code 14092 FIRST CONNECT CENTER LLC Invoice# Comment. Tram Dt Inv Dt Due Dt t Check D Pay Gross Discount 3212 11/10/20. 11/09/2012109/20 4;65�`"�''5" 0.00 TRAVEL NURSE STAFFING (,t1(14-11IIB121) 60rKruvrl Vendor Total, Number Name Gross Discount 14092 FIRST CONNECT CENTER LLC 4;666:26. 0.00 Vendor# Vendor Name Class Pay Code 14200 FIRST DATA MERCHANT SERVICES y/ Invoice# Comment Tram Dt Inv Dt Due Dt Check D, Pay Gross Discount 111521E 11129/2011/15/2011/15/20. 192.14 0.00 ANNUAL CC FEE 111521A 11/29/20. 11/15/2011/15/20, 207.62 0.00 ANNUAL CC FEE Vendor Totals Number Name Gross Discount 14200 FIRST DATA MERCHANT SERVICES. 399.76 0.00 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE ✓ M Invoice# comment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount 5564337 v// 11/24/20 ii/16/20 12/11/20 481.26 0.00 SUPPLIES 5712879 v1 11/29/20.. 11/17/20 M12/20 SUPPLIES 5816265 SUPPLIES 11 /29/2011118/20 12/13/20 100.00 0.00 1,845.31 0.00 Page 5 of 14 0.00 405.23 No -Pay Net 0.00 12.046.98 No -Pay Net 0.00 12,048.98 No -Pay Net 0.00 154.00 ✓ 0.00 58.92 ,,- No -Pay Net 0.00 212.92 No -Pay Net 0.00 / 536.92 ✓ 0.00 905.00 ri No -Pay Net 0.00 1,441.92 No -Pay Net $015.W 0.00 41656-45 No -Pay Net LN25-LO 0.00 445U5 No -Pay Net 0.00 192.14 VX 0.00 207.62 v'f No -Pay Net 0.00 399.76 No -Pay Net 0.00 481.26 ✓� 0.00 100.00 ✓� 0.00 1,845.31 file:///C:/Users/eheimankpsi/memmed.epsiinet.com/u98547/data_5/tmp_cw5report14439.., 12/2/2021 Page 6 of 14 5816255 ✓ 11/29/20. 11/18/20 12/13/20 28.20 0.00 0= 2820 SUPPLIES / 5187324 11130/2011/12120 12/07120. 53.98 0.00 0.00 53,98 SUPPLIES , / 5379594 Y 11/30/2011/15120. 12/10/20. 45.92 OAO 0.00 45.92 SUPPLIES 5379593 ✓ 11/30/2011/75/2012/10/20. 404.32 0.00 0.00 404.32 v' SUPPLIES / 5917637� 11/3012011119/2012/14120 3.30 0.00 0.00 3.30 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 2,962.29 0.00 0.00 2,962.29 Vendor# Vendor Name Class Pay Code 11183 FRONTIER Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 111921 11130/20 11/19/20 12/13/20 liq,gt7 84�1 0.00 0.00 84A1. 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LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay Net 28373571 11/30/2011116/20.12/15120 JIA4317,170d(91 0.00 0.00 1Jo* 1 4•J� PHONE SERVICES' Vendor Totals Number Name Gross Discount No -Pay Net 12636 FUSION CLOUD SERVICES, LLC 0-3i 1,1001� 0.00 0.00 1,10D.9i 1944L 31 rr Vendor# Vendor Name Class Pay Code 13960 G & S MANAGEMENT GROUP LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net C 340383693 ✓ 11/15/20 11110/20 12110/20 1.379/3 0.00 0.00 1,37V53 TRASH SERVICE Vendor Totals Number Name Gross/ Discount No -Pay Net 13960 G & S MANAGEMENT GROUP LLC 1,37V53 0.00 0.00 1,37�.55 Vendor# Vendor Name Class Pay Code 13980 GBS ADMINISTRATORS, INC v/ Invoice# Comment Tran Dt Inv Dt Cue Dt Check D Pay Gross Discount No -Pay Net 4810060oi6v 11/29/20. 11/01/20 11101120. 6,761.32 0.00 0.00 6,761.32 NOVEMBEF1 481006006C 11/29120 12/01/20 12/01/20 5,056.16 0.00 0.00 5,056A61% "ECEMBER 48100602 PEG 12/02/2012/01/2012/15120 1.792.73 0.00 0.00 1,792.73 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net 13980 GBS ADMINISTRATORS, INC 13,610.21 0.00 0.00 13,610.21 Vendor# Vendor Name Class Pay Code 11149 GBS ADMINISTRATORS, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 100121A 1112912010/01/2012/09/20 8,010.39 0100 0A0 8,010.39 ✓ DENTAL file:///C:/Users/eheiman/cpsi/memmed.cpsinet.corn/u98547/data_51tmp_cw5report14439... 12/2/2021 Page 7 of 14 110121 11/29/2011101/2012/09120. 91582.53 0.00 0.00 9,582.63 DENTAL 120121 11/29/20 12/01/20 12/09/20 9,481.14 0.00 0.00 9,481.14 VZ DENTAL Vendor Totals Number Name Gross Discount No -Pay Net 11149 GBS ADMINISTRATORS, INC 27,074.06 0.00 0.00 27,074.06 Vendor# Vendor Name Class Pay Code 10642 GLAXOSMITHKLINE PHARMACUETICALV/ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 091321. 09/30/2009113/2012/13/20. 10,374.85 0.00 0.00 10,374.85✓ INVENTORY Vendor Totals Number Name Gross Discount No -Pay Net 10642 GLAXOSMITHKLINE PHARMACUETICAL 10,374.85 0.00 0.00 10,374.85 Vendor# Vendor Name Class Pay Code / G0401 GULF COAST DELIVERY v` Invoke# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 113021 11130/20. 11/30/20 12/15/20 125.00 0.00 0.00 125.00 DELIVERY Vendor Totals Number Name Gross Discount No -Pay Net G0401 GULF COAST DELIVERY 125.00 0.00 0.00 125.00 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY „/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2138449 �// 11/15/20 11/10/20 12/10/20 797.58 0.00 0.00 797.58,/ SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 797.58 0.00 0.00 797.58 Vendor# Vendor Name Class Pay Code 12380 HEALTH SOLUTIONS DIETETICS ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D'Pay Gross Discount No -Pay Net NOV 2021 11/30/20 11130120 11/30/20 3,000.00 0.00 0,00 3,000,00 DIETICIAN Vendor Totals Number Name Gross Discount No -Pay Net 12380 HEALTH SOLUTIONS DIETETICS 3,000.00 0.00 0.00 3,000.00 Vendor# Vendor Name Class Pay Code / 12868 HOLT CAT ✓ Invoice# Comment Tran Dt Inv Dt Due Dt. Check D Pay Gross Discount No -Pay Net WIEZ0030527 y 11/30/20 11/12120.11/30/20 3,497.24 0.00 OAO 3,497.24 1% GENERATOR TEST Vendor Totals Number Name Gross Discount No -Pay Net 12868 HOLT CAT 3,497.24 0.00 0.00 3,497.24 Vendor#Vendor Name Class Pay Code 14108 K2 SCIENTIFIC✓ tnvoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0008043INA 11/30/20 09/07/20 10/07/20 450.00 0.00 0.00 / 450.00 ✓ FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net 14108 K2SCIENTIFIC 450.00 0.00 0.00 450.00 Vendor# Vendor Name Class Pay Code / 14204 KAYLIN EASLEY ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp cw5report14439... 12/2/2021 Page 8 of 14 091521 11/30/20.09/15/2011130/20 11 f311-0-0.00 0.00 11/3 11.42- MILEAGE 100921 11/30/20 10/09120 11130/20 5r3 6•04 0.00 0.00 5.� 6illq TRAVEL Vendor Totals Number Name Gras Discount No -Pay Net 14204 KAYLIN EASLEY 16.8p2 W44 0.00 0.00 16:J6 Vendor# Vendor Name Class Pay Code M2178 MCKESSON MEDICAL SURGICAL INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net 18785873 ✓ 11129/20,11122120 12/07/20 211.92 0.00 0.00 211.92 �✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 211.92 0.00 0.00 211.92 Vendor# Vendor Name Class Pay Code 11203 MEDI-DOSE, INC v/' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0830216 / 11/22/20 11/10/20 12110/20 346.75 0.00 0.00 346.75 SUPPLIES Vendor Total:Number Name Gross Discount No -Pay Net 11203 MEDI-DOSE, INC 346.75 0.00 0.00 346.75 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. ✓� A/P Invoice# Comment Tram Ot Inv Ot Due Dt Check D-Pay Gross Discount No -Pay Net 113021 11/30/20 11/30/20 11/30/20, 31.01 0.00 0.00 31.01 v% INDIGENT Vendor Totals Number Name Gross Discount No -Pay Net 10613 MEDIMPACT HEALTHCARE SYS, INC. 31.01 0.00 0,00 31,01 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC of M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1974304972 ✓ 11/24/2011/12J2012/09/20 272.02 0.00 0,00 272.02 SUPPLIES 1974586344v/ 11/24/2D 11/16/2012/11/20 52.81 0.00 0.00 52.81 v/ SUPPLIES 1974666346 W/ 11/24/20. 11/1612012111/20. 74.44 0.00 0.00 74.44 SUPPLIES 1974693863 11/24/20 11/16/20 12111/20 184.53 0.00 0.00 184.53 SUPPLIES 1974586343 ✓/ 11/24/20 11/16/2012/11120 183.11 0.00 0.00 183.11 .SUPPLIES , 1974828863 ✓ 11/24/2011/17/2012/l2/20 432.87 0.00 0.00 432.87✓ SUPPLIES 1974922945 11129/20 11/18/20 12113/20 60.11 0.00 0.00 60.11 ✓ SUPPLIES 1974922946v/ 11/29/20. 11/18/2012113/20 83.75 0.00 0.00 83.75 d` SUPPLIES 1974922944 ✓ 11/29/20. 1111812012/13120. 14.12 0.00 0.00 14.12 SUPPLIES 1974922942 ✓ 11/29120. 11/18/2012/13/20, 1,622.21 0.00 0.00 1,622.21 ✓ SUPPLIES 1975374935✓ 11/29/20 11/20/20 12/15/20 23.19 0.00 0.00 23.19 file:///C:/Users/eheiman/cpsUmemnied.cpsinet.com/u98547/data 5/tmp_ew5report14439... 12/2/2021 Page 9 of 14 SUPPLIES 1964917833✓ 11130120. 09102/2009/27/20 3,110.15 0.00 0.00 3,110.15 �S/UPPLIES 1965205246 V 11/3012Q 09/04/2009/29/20 1,128.30 0.00 0.00 1,128.30 SUPPLIES 1971985671 ✓ 11/30/2010/27/2011/21120 1a.74 0.00 0.00 18.74 vs SU PLIES 19738581927 11/30/20. 11/10/2012/05/20 140.90 0.00 0.00 / 140.90 SUPPLIES 1973858171 11/30/20.11/10/2012/05/20, 89.52 0.00 0.00 89.52 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 7,490.77 0.00 0.00 7,490.77 Vendor# Vendor Name i Class Pay Code 10536 MORRIS & DICKSON CO, LLC ✓f Invoice# Comment Tran Dt Inv Dt Due. Dt Check D Pay Gross Discount No -Pay Net 7541610 f 11/30/20. 11/14/2011/24/20 38.29 0.00 0.00 38.29 ✓ INVENTORY 18981/ 11/30/2011/23/2012103/20. -5.00 0.00 0.00 -5.00 �REDIT 7678693 11/30/2011/23/2012/03/20 700.71 0.00 0.00 700.71 INVENTORY 7577283 11130/90 11123/20 12103/20 2,93121 0.00 0.00 2.93121 /INVENTORY 7578692 11/30/2011/23/2012103/20. 342.07 0.00 0.00 342.07 INVENTORY / 2005 ✓ 11130/20 11/23/20 12/03/20. -6.09 0.00 0.00 -6.09 -1,58 yI�(CREDIT 11/30/20.11/28/2012/08/20 166.43 0.00 0.00 106,43 INVENTORY 7588517 f 11/30/2011/28/2012/08/20 36,57 0.00 0.00 / 36.57 INVENTORY 2539 ✓ 12/0112011/24/2012/04/20 -0.98 0.00 0.00 -0.98 ✓� INVENTORY 7589938 12/01120 11/29/20 12/09/20 19.69 0.00. 0.00 19.69 INVENTORY 7592501 ,/ 12/01/20 11/29/20 12/09/20 321.48 0.00 0.00 321.48 /INVENTORY 7589939✓ 12/01/20. 11/29/2012/09120. 177.17 0.00 0.00 177.17 ✓ INVENTORY 3182 ✓/ 12/01/20. 11/29/20 12/09/20 -10.06 0.00 0.00 -10.06 .% /INVENTORY 7592502v 12/01/2011/29/20 12/09120. 243.98 0.00 0.00 243.98 INVENTORY 7589940,,/ 12/0112011/30/2012/10/20 77.92 0.00 0.00 77.92 e% INVENTORY 7594534✓/ 12/01/20 11/30/20 12/10/20 13,150.20 0.00 0.00. 13,150,20 INVENTORY SC8876 f 12/01/20 11/30/20 12/10/20 23.94 0.00 0.00 23.94 L,/ %INVENTORY � SC8875 V 12/0l/20 11/30/20 12/i0/20 35.40 0.00 0.00 35.40 / file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report14439... 12/2/2021 Page 10 of 14 INVENTORY 7594532'/ 12/01/2011/30/2012110/20 169.88 0.00 0.00 169.88 v✓ JNVENTORY 7597360 v/ 12/01/2011/30/2012/10/20. 57.74 0.00 0100 ,s 57.74 ✓ INVENTORY 7598451 ✓ 12/01/20 11/30/20 12/10/20 1,307,67 0.00 0.00 1,307,67, -� INVENTORV SC8874 12/01/2011/301201 iWo a9.48 0.00 0.00 69.48� INVENTORY Vendor Totals Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 19,847.70 0.00 0.00 19,847.70 Vendor# Vendor Name Class Pay Cade M2659 MXR IMAGING, INC ✓� M Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 880831914/ 11/22/2011/11/2012/11/20, 532.87 0.00 0.00 532.87 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2659 MXR IMAGING, INC 532:87 0.00 0.00 532.87 Vendor#Vendor Name / Class Pay Code 13548 NACOGDOCHES TRANSCRIPTION "' Invoice# m Comment. Train Dt Inv. Dt Due Dt Check D, Pay Gross Discount No -Pay Net 7542 ,// 11/30/20. 11124/2011/30120. 708.82 0.00 0.00 708.82 TRANSCRIPTION SERVICES (Is 1•3s - i flaJt1) Vendor Totals Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 708.82 0.00 0.00 708.82 Vendor# Vendor Name Class Pay Code 14196 NATIONAL ASSOCIATION OF RURAL Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / MEM115234 ,/ 11/22/20. 11/11/20 12M V20 450.00 0.00 0.00 450.00 MEMBERSHIP y/ , Vendor Totals Number Name Gross Discount No -Pay Net 14196 NATIONAL ASSOCIATION OF RURAL 450.00 0100 0.00 450.00 Vendor# Vendor Name Class Pay Code / 01500 OLYMPUS AMERICA INC ✓ M Invoice# Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net /Comment 31813204 r/ 11/24/20.11/16/2012111/20 197,92 OAO 0.00 197.92 SUPPLIES . Vendor Totals Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 197.92 0.00 0.00 197.92 Vendor# Vendor Name Class Pay Code 12544 PATRICK OCHOA y/ Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount No -Pay Net 120121E 11130/20,12101/20 200.00. 0.00 0,00 200.00 ✓' REHAB LAWN SERVICE 120121 11/30/2012/01/2012/01120 380.00 0.00 0.00 380.00 ✓ CLINIC LAWN SERVICES 120121A 11/30/2012/01/2012/01/20, 520.00 0.00 0.00 520.00 HOSPITAL LAWN SERVICE Vendor Totals Number Name. Gross Discount No -Pay Not 12544 PATRICK OCHOA 1,100.00 0.00 0.00 1,100.00 Vendor# Vendor Name Class Pay Code file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5reporti 443 9... 12/2/2021 Page 11 of 14 13988 PAYCHEX, ADVANCE F60 ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 007832 y/ 11/29/20 11/24/20 11/24/20 . 3,726.00 0.00 0.00 3,725,00 t� TRAVEL NURSE STAFFING t I t 1 I2- II 1111z1) - Shc a La.f Vendor Totals Number Name Gross Discount No -Pay Net 13988 PAYCHEX, ADVANCE FBO 3,725.00 0.00 0.00 3,725.00 Vendor# Vendor Name C�I as Pay Code P1725 PREMIER SLEEP DISORDERS CENTER ✓M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 113021 11/30/2012101/2012/15/20. 7.900.00 0.00 0.00 7,900.00 ✓ / SLEEP STUDY Vendor Totals Number Name Gross Discount No -Pay Net P1725 PREMIER SLEEP DISORDERS CENTER 7,900.00 0.00 0.00 7.900.00 Vendor# Vendor Name Class Pay Code 11080 RAOSOURCE of Invoice# Comment Tran or Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net SC62991 ✓ 11130120,11/16/20 12/11/20. 1,625.00 0.00 0,00 1,625.00 ✓ MAINTENANCE CONTRACT , Vendor Totals Number Name Gross Discount No -.Pay Net 11080 RADSOURCE 1,625.00 0.00 0.00 11625.00 Vendor# Vendor Name Class Pay Code 13460 RELIANT, DEPT 0954 f� Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 3060009383549 ,i 11/30/2011/1712012/15/20 24,959.14 0.00 0.00 24.959.14 ELECTRICITY Vendor Totals Number Name Gross Discount No -Pay Net 13460 RELIANT, DEPT 0954 24,959.14- 0.00 0.00 24,959.14 Vendor* Vendor Name Class Pay Code 11476 SAMS CLUB V Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 007978 11/29/20 10/20/20 12/08/20 68.70 0.00 0.00 68.70 SUPPLIES 000114 11/29/2010/24/2012/08120. 27.96 0.00 0.00 27.96✓ SUPPLIES 006144 11129/20. 10/31/20 12/08/20. 16.96 0.00 0.00 16.96 ✓ SUPPLIES 001503 11/29120. 10/31/20 12/08/20. 48.62 0.00 0.00 48.62 SUPPLIES 000080 11/29/20-11/02120 12/08/20 10.58 0.00 0.00 10.58 SUPPLIES 006524 11/29/20 11/07/20 12/09/20 185.94 0.00 0.00 185.94 ✓� SUPPLIES 002323 11/29/20 11/14/20 12/08/20 119.94 0.00 0.00 / 119.94 y' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11476 SAMS CLUB 478.70 0.00 0.00 478.70 Vendor# Vendor Name Class Pay Code 81800 SHERWIN WILLIAMS ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5255-5 ✓ 11/30/2011/11/2011/26/20. $7.64 0.00 0.00 87.64� SUPPLIES Yile:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp_cw5report14439... 12/2/2021 Page 12 of 14 1237-3yr 11/30120,11122/2012/07/20 290.85 0.00 0.00 290.85 df SUPPLIES Vendor Total, Number Name Gross Discount No -Pay Net S1800 SHERWIN WILLIAMS 378.49 0.00 0.00 378.49 Vendor#'Vendor Name Class Pay Code Saw SIEMENS MEDICAL SOLUTIONS INC V M Invoice# Comment Tran Dt Inv Dt Due Dt Check D-PayGrass Discount No -Pay Net 116136738 F 11/30/2011/16/2012/11/20 2,193.83 0.00 0.00 2,193.83�/' MAINTENANCE Vendor Totals Number Name Gross Discount No -Pay Net S2001 SIEMENS MEDICAL SOLUTIONS ING 2,193.83 0.00 0.00 2.193.83 Vendor# Vendor Name ,/ Class Pay Code 11296 SOUTH TEXAS BLOOD& TISSUE CEN r Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net / CM5805 l/ 11/22/20 11/15/20 12/10/20 •2,844.00 0.00 0.00 -2,844.00 CREDIT _ " 10701861oy 11/22/20. 11/15/201PJ10120. 5,395.00 0.00 0.00 5,395.00 SUPPLIES Vendor TotalE Number Name Grass Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 2,551 d10 0.00 0.00 2,551.00 Vendor# Vendor Name Class Pay Code 12476 SUN LIFE FINANCIAL y% Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 100121 11/30/2010/01/2011/10120 7,832.57 0.00 0.00 7,832.57 PAYROLLDEDUCTS �k � i:P9 l%SuAktt. 110121 11/30/20 11/01/20 1PJ10/20. 8,212.05 0.00 0.00 8,212.05 PAYROLLDEDUCT tr It . Vendor TotalE Number Name Grass Discount No -Pay Net 12476 SUN LIFE FINANCIAL 16,044.62 0.00 0.00 16,044.62 Vendor# Vendor Name Class Pay Code 10239 T&R MECHANICAL / ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Or Pay Gross Discount No -Pay Net G2100402 ✓ 71/30/20.07/19/2008/18/20 1,581,25 0.00 0.00 1,581.25 f CHILLER QUARTERLY MAINTE Vendor Totals Number Name Gross Discount No -Pay Net 10239 T&R MECHANICAL 1,581.25 0.00 0.00 1,681.25 Vendor# Vendor Name Class Pay Code 13880 TEXAS SELECT STAFFING. ✓i Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 001862451079IN ✓ 11/29/2011/24/2011/24/20 3,996.30 0.00 0.00 3,996.30 TRAVEL NURSE STAFFING (1II13- ItI IS Jet) -,,W jCL - VendorTolalENumber Name Gross Discount No -Pay Net 13880 TEXAS SELECT STAFFING 3.996.30 0.00 0,00 3.996.30 Vendor# Vendor Name Class Pay Code / 1/ 11908 TMS SOUTH Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV31509 11115/20, 11/11/201211 V20.. 205.26 0.00 0.00 205.26 FILTERS Vendor TotalENumber Name Gross Discount No -Pay Net 11908 TMS SOUTH 2O5.26 0.00 0.00 205.26 Vendor# Vendor Name Class Pay Code file://lC:Nsers/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5reportl4439... 12/2/2021 Page 13 of 14 T3130 TRI-ANIM HEALTH SERVICES INC '1 M Invoice# Tran Dt Inv Dt Due Dt Check D Pay Grose Discount No -Pay Net /Cpmment 64818277 ✓ 11/29/20 1111912012/14/20 287.46 0.00 0.00 287.46 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net T3130 TRI-ANIM HEALTH SERVICES INC 287.46 0.00 0.00 287A6 Vendor# Vendor Name Class Pay Code / T3334 TRINITY PHYSICS CONSULTING LLC �/ W Invoice#Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net 09-76 V/ 11130120. 11/15/20 12/15120. 330.00 0.00 0.00 $30.00 MAINTENANCE Vendor Totals Number Name Gross Discount No -Pay Net T3334 TRINITY PHYSICS CONSULTING LLC 330.00 0.00 0.00 330.00 Vendor# Vendor Name Class Pay Code / 13616 TRIOSE, INC v" Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net TRIO95743Z 11/30/20 11111/20 11/26/20 482.15 0.00 0.00 482.15 FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net 13510 TRIOSE, INC 482.15 0.00 0.00 482.15 Vendont Vendor Name Class Pay Code 14208 TRUSTED HEALTH, INC Invoice# /Comment Tran 01 Inv Dt Due Dt CheckD, Pay Gross Discount No -Pay Net INV6745 ✓ 11/30/20 11/06/20 11/06/20 4,715.00 0.00 0.00 4,715.00 TRAVEL NURSE STAFFIN(Lu I L - it lg) wlllkal� . INV6746 ✓ 11/30/2011113/2011/13120 4,521.25 TRAVEL NURSE STAFFING C LL i t ^ 11)101) Wi i tt tli� S 0.00 0.00 4,521.25 . INV674711180120,11120/2011/20/20. 4,558.75 0.00 0.00 4,658.75 TRAVEL NURSE STAFFING (lt�I,t-11.1i'i)) W tNtkj INV6748 „/ 11/30/2011/27/2011/27/20 51312.50 0.00 0.00 5,312.50 NURSE STAFFING 61I.2-5- 11 ls'4S) -1Ji litr�Rq /TRAVEL INV6744 11/30/20 11/30/20 11/$0/20. 6,738.13 ✓ 0.00 0.00 6,738.131,/ TRAVEL NURSE STAFFING (t0/22-101X" tji jjj4,;,41 Vendor Totals Number Name Gross Discount No -Pay Net 14208 TRUSTED HEALTH, INC 25,845.63 0.00 0.00 25,845.63 Vendor# Vendor Name Class Pay Code 01064 UNIFIRST HOLDINGS INC /' Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 8400381369 ✓ /11/15/2011115/2012/10/20 47.80 0.00 0.00 47.80 f LAUNDRY 8400381$94 �/ 11115/2011/1512012/10/20. 2,450.64 0.00 0.00 2,450.641/ LAUNDRY 8400381368 of 11/15/20. 11/15/20 12/10/20 45.15 0.00 0.00 45.15 LAUNDRY 8400381714. ✓ 11/2212011/18/2012/13120. 170.59 0.00 0.00 170.59 LAUI�IDRY , 8400381733 ✓` 71/22/2011/18/2012/13/20 1,499.64 0.00 0,00 1,499.64 LAUNDRY 8400381713 U% 11/22120. 11/18/2012/13/20 196.29 0.00 0.00 196.29 LA NDRY 8400381712 y/ 11/22@0. 11/18/2012113/20 137.13 0.00 0.00 137.13 ✓"� file:?//C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5reportl4439... 12/2/2021 Page 14 of 14 LAUNDRY 8400381728 11/22120,11/18120 12/13/20 79.43 0.00 0.00 79,43 LAUNDRY / 8400381711 V/ 11122120. 11/18/2012I3120 42.72 0.00 0.00 42.72 L4/�INDRY 8400381715 ✓ 1112PJ20. 11118/20 12/13120. 199.32 0.00 0.00 199.32 V/ LAUNDRY 8400381747 1/ 11/22/2011/18/2012/13120 128.50 0.00 0.00 128.60 ✓ LAUNDRY Vendor Totals Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 4,997.21 0.00 0.00 4.997.21 Vendor# Vendor Name Class / Pay Code 12208 WAGEWORKS ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV3182275 ✓ 11116/20. 11/15/2012/15120. 580.25 0.00 0.00 580.25 V ADMIN COMPLIANCE FEE VendorTotals Number Name Gross Discount No -Pay Net 12208 WAGEWORKS 580.25 0.00 0.00 580.25 Vendor# Vendor Name Class Pay Code W1040 WATERMARK GRAPHICS INC ✓ M Invoice# / Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net 134464 ./ 11/30/2011108/201=8/20 1,098.15 0.00 0.00 1,098.15 ✓ UNIFORMS Vendor Tot ale Number Name Gross Discount W1040 WATERMARK GRAPHICS INC 1,098.15 0.00 Vendor# Vendor Name Class Pay Code 11580 WILLIAM CROWLEY III, DO ,/ Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross 112421 11/29/20. 11/24/20 11/24/20 359.38 COVERED SCHULTZ 11/15/21 Vendor Totals Number Name Gross 11580 WILLAM CROWLEY III, DO 359.38 Report Summary No -Pay Net 0.00 1.098.15 Discount No -Pay Net 0.00 0.00 359.38 Discount No•Pay Net 0.00 0.00 359.38 Grand Totals: Gross Discount No -Pay Net 400,827.09 0.00 0.00 400,827.09 h@P�74T1 DEC O 2 2021 oolftwa~odt 5 5 (�YPcc1 i Nl 4 414 �4 . aG } �� 4 vunrex-{-rYv�� < 84•g17 * 45.46 C< 11100•gl 9 cvr<uitlVl 1 1j 41F'> <16 t 14.0 P!) 4 wvadiwt 4�s.ea g11o,113.y3 file:///C:/Usersleheiman/cpsi/memmed.cpsinet.com/u98547/data 5/tmp_ew5report14439... 12/2/2021 MEMORIAL MEDICAL CENTER 12/02=21 AP Open Invoice List 14:15 Dates Through: 1211512021 Vendork Vandor Name Class Pay Code 12248 MEMORIAL MEDICAL CENTER Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Grass 111821 11/30/201 V30120 12/15/20 14.50 PETTY CASH VendorTolals Number Name Gross 12245 MEMORIAL MEDICAL CENTER 14.50 Report Summary Grand Totals: Gross Discount 14.50 U0 APPAW7tw aw DEC 0 2 20Z1 G"4w cant l *e = ✓ . Page I of 1 D ap_open_invoice.template Discount No -Pay Net 0.00. 0.00 14.50 Discount No -Pay Net 0.00 0.00 14.50 No -Pay Net 0.00 14.50 file:///C:1Usersleheimanlcpsilmemmed.cpsinet.com/u98547/data_5/tmp_cw5roport4O464... 12/212021 Page I of t MEMORIAL MEDICAL CENTER 12/04 2021 AP Open Invoice. List 14:1ap_opan_Invoipe,lemplate Dates Through: 12/15/2027 Vendor# Vendor Name Class Pay Code T2204 TEXAS MUTUAL INSURANCE CO W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4483882 11/30120 11/09/20 12/02/20 52.177.00 0.00 0.00 52,177.00 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Not T2204 TEXAS MUTUAL INSURANCE CO 52;177!00 0,00 0.00 52.177.00 Report Summary Grand Totals: Grass Discount No -Pay Net 52.177.00 0.00 0.00 52,177.00 I3CU22w *tXWA0W0kR file:IlIC:IlJsersleheimanlopsilmemmed.cpsinet.com/u98547/data_5/tmp_ow5report59982... 12/2/2021 RUN DATE• }}2 Q2/';1 r; 14EMORIAL MEDICAL CENTER PAGE 1 T MEl73b.26"h L021 EDIT LIST FOR PATIENT REFUNDS ARID-0001 APCDEDIT PATI'EI1�-01eaa. C-u!�;cty PAY PAT NUMBER PAYEE NAME DATE AZ-0OUNT CODE TYPE DESCRIPTION GL NUR ----------------------------------------_--.__----------------------------------------•----------...._.....__.................. ✓--112921 176.73../ 2 REFUND FOR ARID-0001 TOTAL 176.73 ______________________________________________________________________________________________________________________ TOTAL 176.73 sw; DEC 0 2 2021 VMW n Page I of 1 MEMORIAL MEDICAL CENTER 12/02/2021 0 AP Open Invoice List 14:15 ap_open_invoice.template Dates Through: 12/15/2021 Vendor# Vendor Name Class Pay Code H1227 HEALTHSURE INSURANCE SERVICES Invoice# Comment Tran Dt Inv On Due Dt Check D Pay Gross Discount No -Pay Net 2523 11/30/20 12/02/20 12/14/20 23,998.00 0.00 0.00 23,998.00 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net H1227 HEALTHSURE INSURANCE SERVICES 23,993.00 0.00 0.00 23,998.00 Report Summary Grand Totals: Gross Discount No -Pay Net 23.998.00 0.00 0.00 23,998.00 DEC a 2 2021 @A " file:!//C:/Users/eheiman/cpsilmemmed.cpsinet.com/u98547/data_5/tmp^cw5reportl6630... 12/2/2021 MSKESSONSTATEMENT As of: 12/03/2021 Page: 002 To enure proper credit to your amount, detech last not. this nNv: eono and, with your mu ittaram OC: 8115 As of: 12/03/2021 Page: 002 MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBIT Territory: Mall 1. CaanP: 8000 AP Statement for information only AMT DUE REMITTED VIA ACH DEBIT 816 N VIRGINIA STRBET Cu2536 Statement for information only PORE LAVACA TX 77979 Date:te, 121 12/04/4/2021 Cult: 632536 PLEASE CHECK ANY Data: 12/04/2021 ITEMS NOT PAID (w) YIIIng Due )ale Dale uu ReeeNable'aHonal Amount Sagpli Number Reference Cash Description Discount Amount P alms) F Amount P Resaleable (naN F Number aP cdumn legend: P = Pap Due Item, F a Rdum Due Item, blank = Current Due Item 'OTAL' National Acet 632536 MEMORIAL MEDICAL CENTER SuMr#als: 6.700.36 USD It Paid By 12/0712021, hg Due. 0.00 Pay This Amount: 8,526.35 USD am Payment 2.451.97 It Paid After 1210712021, 18/07/2017 Pay this Amount: 8,700.36 USD Due II Paid On Time: USD 8,626.36 Dim log it paid isle: 174.01 Due If Pald Late: USD 8,700.36 APFTiO'� G 2021 1N;".r"�vT.CW W KRr'L ma* :^,;cl aus�iaw, av:nn For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT a Pmv:.000 HERB PHCY 0434/MEM MED FHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for Information only VICKY KALISEK 815 N VIRGINIA ST PORE LAVACA T% 77979 As of: 1210312021 Page: 001 TO ensure Proper credit to your scwmt, detach ant M. this stub with your remMmtea OC: B115 As Of: 1210312021 Page: 001 Mal to: Cane: 8000 Territory: 400 AMT DUE REI4no3) VIA ACH DEBIT Customer: 190813 Statement for information only Date: 12/04/2021 Cast: 190813 PLEBE CHECK ANY Date: 12/04/2021 IT@0S NOT PAID (4) K0In9 Due Peeetvabl�ationel Account 8 Cash Amount P Amount P Receivable )ale Dale Number Reference Deeariptlon Discount (games) F (net) F Number ,Uatomer Number 190813 HER PHCY 0434/MEM MED PHS 1/29/2021 12/07/2021 7308730098 2017039607 1151nvolce 2.72 136.04 133.32 J 7308730098 2/03/2021 12/07/2021 7309932081 2017040011 1151nvalce 4.59 229.67 225.08 ✓ >309932081 B rF column legend: P = Net Duo hem, F = Put. Due Item, blank = Current Due used 'OTAL• Customer Number 180813 HES PHCY 0434/MI38 M® PHS Subtaals: 366.71 USD -uhas Due: 0.00 Due It Pal! On Time: ✓ It Pad By 12/0712021, USE, 358.40 let on. 0.00 Pay This Amount: 358.40 USD Duo lost If paid late: 7.31 am Payment 2.911.93 If Paid After 1210712021, Due If Pant late: 1/29/2021 Pay this Amount: 366.71 USD USD 365.71 / n Iv �j J�;Pk. ,d4T90YII11 NEW DECO 4 &P c-r- 50uz53 For AR Inquiries please contact 800-867-0333 MSKESSON company: 0000 WAIMART 1098/MEM M® MCKYNAL SaK C6vRFA 615 N AVAC Ip ST 815 N KIRGINI PORT LAVACA 7X ]7979 STATEMENT pHs AMT DUE AEMITTED VIA ACH DEBIT Statement for inlormatlon only As of: 12/03/2021 DC: 8115 Territory: 400 Customer: 256342 Date: 12/04/2021 Page: 001 To e1P1m proper mMM to your am6rhlt, detach and return this stub with your Arlattr Ca As of: 12103/202/ Page: 001 Mall to: Carp: Boon pMT DUE RE7e ITT® VIA ACH 0®IT Slatemmt for inlmmallon only Oust: 256342 PLEASE CHECK ANY Cents 12/04/2021 ITEMS NOT PAID (1) 911„g late Due pale Mlonal Amount e N� ��77 NuumbermberblHanson. Description Cash Cash Amount P (gross) F Amount P (net) F Aresaheme Number .ustamar Number 256342 WALMARr 1098/MEM MED 1/292021 12/07/2021 7308766634 1/20/2021 12/07/2021 7308766035 1/292021 QW/2021 7308766636 1/29/2021 12/07/2021 7308766637 1/29/2021 12/07/2021 730117664138 1/202021 12/07/2021 7308766639 1/29/2021 121OW2021 7JO8766640 1/29/2021 12/07/2021 7308766642 1/30/2021 12/07/2021 7309136929 1/30/2021 12707/2021 7309136930 1/30/2021 12/072021 7309265126 1/30/2021 12/07/2021 7309285127 2/01/2021 12/07/2021 7309443921 2/012021 12/07/2021 7309443924 2/01/2021 12/07/2021 7309594562 21OW2021 12/07/2021 7309696806 2/02/2021 12/07/2021 7309696807 2/02/2021 12/07/2021 7309690808 2/02MO21 12/07/2021 7309696809 2/02/2021 12/07/2021 7309849338 2/03/2021 12107MO21 7309962054 2/03/2021 12/07/2021 7309962056 2/03/2021 12/07/2021 7309902056 2/032021 12/07/2021 7309962057 2/03/2021 IW072021 7310OBS847 PJ0312021 12/07/2021 73100881140 MS 19911964 19924815 19924815 19958834 19997196 20022486 20044609 20067789 20173020 20173820 1129210730 1129211016 20221966 20265784 1130210916 20295512 20295512 20341068 20352n09 1201211020 20370760 20370760 20417275 20417275 1202210737 1202210905 1151nvoice 115Inv01ce 115lnvoice 1151nvoice 1151moics 1151nvoice 1151nvoice 1151nvoice 1151nvaice 115lnvoice 1951nvolce /151nvoice 1151nvolce 1151nvolce 1161nvalce 1151nvalce 1151nvoice 1151nvoice 1151nvoice 1151nvoice 1161nvoloa 1151nvolce 1151moice 1151nvoice 195lnvoice 1151nvolce 5.62 16,14 17.37 2.64 0.63 5se 0.02 0.18 10.06 0.03 10.43 2.30 0.02 11.66 0.02 0.01 0,02 5.38 0.02 5.30 0.01 1.69 $3.90 290.88 606.94 868.44 131.90 31.36 268.84 0.95 9.10 502.80 1.27 521.70 114,92 0.91 0.16 577.99 0.16 0.95 0.16 0.49 0.95 268.98 1.06 268.98 0.63 84.57 1,694.91 285.06✓ 790.80 ✓ 851.07 ✓ 129,26 ✓ 30.73 / 263.46 ✓ 0.93✓ 6.92 ✓ 492.74 ✓ 1.24 ✓ 511.27./ 112.62 ✓ 0.89 0.16 566.43 ✓ 0.16 ✓ 0.93 ✓ 0.16 ✓ OAS / 0.93 ✓ 263.60 / 1.04 / 263.60 / 0,62 / 82.68/ 1,061.01 / 7308766634 7308766635 7308766636 7308766637 7308766638 7300766639 7308766840 730876GB42 7309136929 7309136930 7309285126 7309285127 7309443921 7309443924 7309594562 7309696806 7309696807 7309696808 7309696809 7309849338 7309962054 7309962055 7309962056 7309962067 7310088847 7310008848 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT co,r eeno WALMART 1098/MEN MED PHS AMT DUE RBNITTED VIA ACH D®IT MEMORIAL MEDICAL CENTER Statement for information only VICKY KALISEt 815 N VIRGINIA ST PORT LAVACA TX 77979 filling Due Hit. Date As of., 1210312021 Page: 002 To ensure proper aedh to year account, detach and Mum this dub With your mmMame DC: 6115 As m: 12/03/2021 Pages 002 Mall to: Camp: 8000 Territory.- 400 AMT DUE REMITTED VIA ACH DEBIT Customer. 266342 Statement for information only Date: 12/04/2021 Cum: 256342 PLEASE CHECK ANY Data: 12/04/2021 ITEaS NOT PAID (w) MastodonDlxeawunt Amount P Amount P Resolvable (gross) F (net) F Number W column Island: P = Pam Due Item, F = Mum Due Nam, blank = Current Due Item OTAL• Customer Number 256342 WALMART 1098/111E4 MED PHS Subtmals 6,450.00 USD 'Mum Due: 0.00 If Paid By 1210712021, Mst Due 0.00 Pay This Amount: 6,3M99 USD ast Payment 2,211.93 H Paw After 1210712021, 1/29/2021 Pay this Amount: 6,450.00 USD DECO 6 tint S. u>rn>F.1•x psi eae,¢y<.r.�tna For AR Inquiries please contact 800-867-0333 Due K And On note: use 6.320.99 Dix lost It paid late: 129.01 Due D Paw Late: USD 6,450.00 MSKESSON STATEMENT campmr: eeoo HEB MY PC 4901MEM MC PHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for intonation only VICKY KAUSEK 816 N VIRGINIA ST PORT LAVACA TX 77979 As of: 1210312021 Pogo: 001 To ramum Excle. credit to your account, detach eM return this club with your remiftance Be: 8115 As of: 12/03/2021 Page: 001 Mall tm ComP: 6000 Teoitary: 400 AMT DUE REMITTED VIA ACH DEBIT Cuslgner. 464450 Statement for Information only Date: 12/04/2021 Cust: 464450 PLEASE CHECK ANY Date: 12/04/2021 nEMS NOT PAID (A) filling Due Recewablratloual Account W&36 Cash Amount P Amount P Racewable late Dale Number Reference Description Discount (grass) F (net) F Number :ustomer Number 464450 HED MY FC 490/MEd MC PHS 1/30/2021 12/07/2021 7309187181 55x754266 1151nvolce 23.25 1,162.64 2/02/2021 12/07/2021 7309682045 55x756696 1151moice 9.19 459.73 2/03/2021 12/07/2021 7309934337 55x761279 1151nv01ce 1.32 65.95 W column legend: P = Poet Due Item, F = Mum Due Item, blank = Current Due Item 'OTAL Cue4amer Number 48946o HIMMY PC 490/MEM MC PHS Subtotals: 1,688.32 USD 'utum Due: 0.00 11 Pant By 1210712021, 'act Dw 0.00 Pay This Amount: 1,654.56 USD Ast Payment 2.211.93 If Paid After 1210712021, 1/29/2021 Pay this Amount: 1,658.32 USO AI't`ra9*0 elf DEt; if 5 2021 O111T* ^ ' WIIINIM For AR Inquiries please contact 800-867-0333 1,139.39,✓ ]309187181 450.54 ✓ 7309882045 64.83 ✓ ]30993433] Due If NU On Time: USD 1.654.56 ✓� Dim fuel if paN late: 33.76 Due If Paid We: USD 1,688.32 k Vv" MWESSON STATEMENT As d: 12/03/2021 page: 001 Toenmreotach nd to your TO ensureyour ount, EPop and relao m this M.P..i,: none stub with your remmanae OC: 8115 As of: 1210312021 Page: 001 CVS PHCY 7475/MEM Me PHS DUE REMITTED VIA ACH DEBIT Tannery: 400 Mall to: Comp: 8000 MBAOAMT AL CBJTFA Statement 10, information only AMT DUE R@AITTED VIA ACH DEBIT VICKY I(ALISIX SBK Cudomw: 835438 Statement for Information only N 815 N IA BT Date: 12/0412021 PO AVACVIRGI PORT IAVA(:A T% ]]979 Cult: 835438 PLEASE CHECK ANY Date: 12/04/2021 ITWS NOT PAID (+) )alto Due Flooshebl atonal Amount 8 9 Caen Amount P Amount P RmeNable Jere Pete Number Reference Demrlptien Dimouni Refere (gore) F (net) F Numfwr ludemer Number 835438 CVS PHCY 74751MEM MC PHS 2/02/2021 12/07/2021 7309867632 1469368 1151moice 3.93 196.33 192.40 ,✓ 7309867632 O w column "and: P = Pad Due Item, F c Future Due Item, blank a Curren Ous Item 'OTAL• Customer Number 835438 CVS PHCY 7475/Mn111 MC PHS Sumatde: 196.33 USD Mum Due: 0.00 Due If Paid On Time: If Paid By 12/0712021, USD 192.40✓ +ad Due: 0.00 Pay This Amount: 192.40 USD Dim kuA If Paid late: 3.93 ad payment 2,211.93 If Paid After 12107/2021, Due If Pod Late: 1/29/2021 Pay this Amount: 196.33 UBD USD 196.33 APy9i9� C'. 0 F 2021 ecsr-Nr gltt,6 en For AR Inquiries please contact 800-867-0333 STATEMENT statement Number. 62106357 AmerlsourceBergem Date: 12-03-2021 tort AMERISOURCEBERGEN DRUG CORP SENOERRA RX PHY MOB 501 PATRIOT PARKWAY MEMORIAL MEDICAL CENTER 10028BO781037983771 ROANOKE TX 76202-6336 O RD E 101 1301111RO ONH75087 ,II Sat-Frl Duein7days DEA: RA0316958 866- 51-9655 AMERISOURCESERGEN P.O. Box 978740 Yet Duo: .00 DALLAS TX 75397-8740 CuffentNot 95.00 Past Oue: Pastou 0.00 Total Due: 55.00 Account Solon.: 55.00 ACCOum ACtiVlty Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 11474021 12-10.2021 34330519 Inmice SSAO 0.00 55.00 Current 1 1-15 Days 16-30 Days 31-60 Days 61-90 Days 91-120 Days Over 120 Days 55.00 0.00 r 0.00 0.00 0.00 0.00 0.00 Reminders Due Date Amount 12-10-2021 56.00 Total Due: ' 55:00. .. (a0+ysavr.>r Inn DEC 0 6 2U21 aa+lw>:cI AMWIl�l; � ' I AM STATEMENT statement Number. 62106064 wisourceBergen- Date: 12-03-2021 AMERISOURCESERGEN 0 501 PATRIOT PARKWAY ROANOKE TX 76262.6336 DEA: RAD316958 866451-9655 US BIOSERVICES CARROLLTON 390E 6025 PLANO PARKWAY SUITE 10D CARROLLTON TX 75010 AMERISOURCESERGEN P.O. Box 978740 DALLAS TX 75397-8740 1 or 1002706911018628707 Sal- Fri Due In days Not Yet Due: 0.00 Current 55A0 Peat Due: 0.00 Total Due: 55.00 Account Balance: 55.00 M"wullL NGLIVRy Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 11-274021 12-10-2021 U3353515 Invoice 55.00 0.00 56.00 Current 1-15 Days 16-30 Days 31-60 Days 61.90 Days 91420 Days Over 120 Days 55.00 0.00 1 0.00 0.00 0.00 cm I0.00 APeFrJ7P, DEC 6 6 2021 6kr03%jrr=py�ldSR e13i1*+�' !4 f1390.'1N,r, Rot;A9 Reminders Due Date Amount 12-10-2021 55.00 Total Due: 55.00 I\A V STATEMENT statement Number. 62092021 AmensourceBergen` Date: 12-03-2021 1 otl AMERISOURCEBERGEN DRUG CORP 12727 W. AIRPORT BLVD. WALGREENS e12494 340E MEMORIAL MEDICAL CENTER 1001352841037028180 SUGAR LAND TX 77478E101 1302 N VIRGINIA ST PORT LAVACA TX 77979-2509 Sat-Fn Due in 7 days DEA: RA0289276 866-451-9655 AMERISOURCEBERGEN P.O. Box 905223 Not Yet Due: 0.00 CHARLOTTE NC 28290-5223 Current: 1,366.52 Pail Due: 0.00 Total Due: 1.366.52 Account Solonce: 1,366.52 ' Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 11-29-2021 12-10-2021 3075092944 163736 Invoice 854.28 0.00 654.28 11-29.2021 12-10.2021 3076692845 163738 Invoice 3.51 0.00 3.51 11-29-2021 12-10-2021 307592846 163739 Invoice 10.80 0.00 10.80 1/49-2021 12A0.2021 3075131852 163786 Invoice 101.13 0.00 101A3 11-30-2021 12-10.2021 3075257974 163794 Invoice 69.54 OLD 69.54 12.02-Ml 12-10-2021 307VA6830 163809 Invoice 297.54 0.00 297.64 1242-2021 12-10-2021 3075546MI 163810 Invoice 29.72 0.00 29.72 Current 1.15 Days 16.30 Days 31.60 Days 61.90 Days 91-120 Days Over 120 Days 1,366.52 0.00. 0.00 0.00 0.00 OAO 0.00 Thank You for Your Payment Reminders Date Amount Due Date Amount 12-03.2021 1658.92) - 12-10.2021 1,366.52 Total Due: 1,4%.52' t DEC D 6 2021 41e ftwd clstarrux e.u�atAn tia>,1vx*t,1mD,+.a TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1.800-572-8683) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" F—j"MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" F-TIF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" El "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" F_T6-DIGIT SETTLEMENT DATE" "l TO CONFIRM" ACKNOWLEDGEMENT NUMBER #11## ENTER: Ell C 0 $ 91,907.49 1 $ 47,067.34 $ 11,563.14 $ 33,277.01 CHECK 7 CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F:1AP-Payroll FileslPayroll Taxea12021W25 R1 MMC TAX DEPOSIT WORKSHEET 12,02.21 R1.x1s 1216l2021 Run Date: 12/06/21 MEMORIAL MEDICAL CENTER pane 110 Time: 16:27 Payroll Register ( Bi-Weekly I P2REG Pay Period 11/19/21 - 12/02/21 Ran% 1 Final Summary •-- P a y C o d e 5 u m m a r y --------------------------------------- D e d a C C i 0 a a 5 u m m a r Pay"d Description Hrs OTISHIWEIHOIC01 Grass I Cade Amount -------------------------------------- -.................................... '---------------- ___ ------- ..................... � 1 REGULAR PAY-S1 9141.50 N N 11 16503D.1C A/R 554,22 A/R2 25.00 AIRS 1 REGULAR PAY -S1 169E.00 N N N N 69366:96 ADVAIIC AWARDS BOOTS i REGULAR PAY-S1 167,75 N N Y 4736.91 CAFE H CA-vE-1 CAFE-2 1 REGULAR PAY-51 150.75 Y N N 3885.ei CAFE-3 CAFE-4 CAFE-5 2 REGULAR PAY-S2 1971.25 N 0 11 46302.75 CAFE-0 CAMD 1763,27 CAFE-F 2 REGULAR PAY-52 94.00 N N T 3129.62 CAFE-9 19139.56 CAFE -I CAFE-L 2 REGULAR PAY-S2 71.00 Y N 11 1940.74 CAFE-P CANUR CHILD 720.41 3 REGULAR PAY-S3 1139.75 N N N 31671.66 CLINIC 14S,00 COMES 400.80 CAEDON 3 REGULAR PAY•S3 70.75 N N Y 2630.76 GO ADV DENIAL DEP-LF 3 REGULAR PAY-S3 32.00 Y N N 985.29 DIS-LF EAT EATCSH CALL PAY 2510,00 N 1 N N 5020.00 FEDTAX 33,77.01 FICA-H 5781.57 FICA-0 23533.61 ➢ DOUBLE TIMID 7.15 N l N N 534.75 FIRST" FLEX.S 3282.29 FIX FE D DOUBLE TIME 20.25 N 2 N N 1475.39 FORT D FOTA GIFT S 349.80 0 DOUBLE TIRE 33.25 N 3 N H 2344.44 GRAVY GRP-IN OIL D DOUBLE TIME 3.75 Y 2 N N 424.69 HOSP-1 ID TFT LEAF D DOUBLE TIME 14.75 Y 3 N N 1714.69 LEGAL 280.29 MASH 869.50 MEALS 201.40 E EXTRA WAGES N N N 11 32.50 HEMS 893.11 MISC MISC,f E EXTRA WAGES N 1 N N N 643.25 WHOSE MAIM1753.01 OTHER F FUNERAL LEAVE 8,00 N 1 N N 444.24 PHI PHI*++ PR FIN I INSERVICE MOD N I N N 745.60 RELAY REPAY SAMS K EXTHNDED-ILLNESS-RANK 332,00 N 1 N N 8412.20 SCRUBS SIMON ST-TX P PAID -TIME -OFF 315.10 N N N 11 5010.86 STDNDF 640.06 STONE STONE2 P PAI➢-TIME-OFF 2432,07 N 1 N N 62023.52 STUDER SUNACC a02.47 $@TILL 744.04 X CALL PAT 2 80.00 N 1 N N 160.00 SURIND 695.63 SUNLIT 735.07 SO157D 1229.98 Z CALL PAY 3 40.00 N 1 N N 144,00 SUNVIS 3.57 SURCRG 450.00 TSA-1 p PAID TIME OFF - PROBATION 4M0 N 1 N N 053.44 TSA-2 TSA-C TSA-P t PHONE 6 DATA N N N 14 135S,00 TSA-R 29528.79 IUTION UNIFOR 567.8E v COVID-FFCEA 44.00 N 1 N N 875.16 UW/NOS -------------------- Grand Totals: 19522.67------- I Grose: 422165.94 Deductions: 128967.2E Checks Count:- FT 195 PT 10 Other 35 Female 218 Yale 21 Credit OverAnt 6 ZeroN:t ...................................................................................................... Net: 193198 69 1 Term 1 Total: 239 .......................� �a�l Ij r~ hl. �. l a • to a-i U•(I MEMORIAL MEDICAL CENTER 11 IA'l PICAS PROSPERITY BANK 4 1 • b'.- ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT- November29, 2021-December S,2021 C Dabs Bank Description MMC Notes Amount `l^w".0 17,-. � 12/3/2021 PAY PLUS ACHTRANS 452579291101000697926066 - 3rd Parry Payar Fee $ 5'T GC.(IC6 12/3/2021 MERCHANT BANKCO INTERCHNG 97116091388791000 - Credit Card Processing fee $ 049 12/312021 MERCHANT BANKCD FEE 97116091088391000012D34 - Credit Card Processing Fee $ 9.95' IUB•4Y - 12/3/2021 MERCHANT BANKCO FEE 97116091388791000012934 - Credit Card Processing Fee $ 154.8E 12/3/2021 MERCHANT OANKCO DISCOUNT 971160913887919000 - Credit Card Processing Fee $ 195.85 154-B8 12/3/2021 MERCHANT BANKCO DISCOUNT 971160910883910000 - Credit Card Processing Fee $ 19.95' 12/3/2021 AMERISOURCE BERG PAYMENTS 01000077692100002 -340H Drug Program Expense $ 658.92'k 12/2/2021 TSYS/TRANSPIRSTCHARGEBACK3930098254361661 -Credit Card Processing Fee $ 170.39: 19. y,. 12/2/2021 AUTHNETGATEWAY BILLING 1204170511040000142 - 3rd Party Payor Fee $ 12/1/2021 PAY PLUS ACHTRAN5452579291101000695440111 - 3rd Party Payar Fee $ 9 $ 12/1/2021 CLEARGAGESV9T8002363206 2420717508717492 - Patient Financing Service $ baV I n 11/30/2D21 MCKESS0N DRUG AUT0 ACH ACH04821363910000113 - 340B Drug Program Expense $ 11/29/2021 PAY PLUS ACHTRANS 4525792911010ODS93355264 - 3rd Party Payer Fee $ 86;'S 'IRH P^A 11/24/2021 CM Wire Domestic - Credit Card Processing Fee $ 1,44 ]ley 24. 21) ' 5,251.58 December 6, 2021 Anthony Richardson, CFO QfplWn.i sa'o111 ' Memorial Medical Center it Go PROSPERITYBANK A II. 12.Ds cc. 91u6 - ELECTRONICTRANSFERS FOR OPERATING ACCOUNT --ESTIMATED ACHS GS9 Date Description MMC Notes Amount 2 11/30/2021 RR/ettiyrem�ent� $ 142,892,14' 6i' 2 ' 142,891.14 December 6, 2021 Anthony Richard on, CFO Memorial Medical Center o - 7:�11 94U"Vi , 94u y� Date/Time 12-01-2021 / 09:42 AM Submitted By --' Pay Date 11-30.2021 Employee Deposits $62,475.92 Employer Contributions $80,415.22 Group Term Life Premiums $0.00 Total f !'``',.9" Comments Payroll File November 2021 Retirement Upload.xlsx �-C;6 Y-c M-C,nfi 12I 151202-1 j12A ...... Page 1 of 1 `��1'LOP72027�� t@1.c,.:r6fPP MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 06:26 ap_open_invcice.template Due Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 11816 ASHFORD GARDENS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 120121 12/02/20.12101/20 12116/20. 447.14 0.00 0.00 447.14 1/ TRANSFER NN �r+on of &JeP 120121A 12/02/20. 12101/2012116/20 63,887.67 0.00 0.00 63,887.67 TRANSFER ri 11 Vendor Totals Number Name Gross Discount No -Pay Net 11816 ASHFORO GARDENS 64,334.81 0.00 0.00 64,334.81 Report Summary Grand Totals: Gross Discount No -Pay Net 64,334.81 0.00 0.00 64,334.81 .13EA1:FP9�bti t95: DEC 5 2 2021 mot; .s'1RF81rl4Ti, dAxxt4m.,mckrd!7iw, xr.A.r file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report24901... 12/2/2021 Page 1 of 1 12/02/2021 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 08:28 ap_open_invoice.tamplate Due Dates Through: 12/16l2021 Vendor# Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 120121A 12/02/2012/0112012116/20, 133.80 0.00 0.00 133.80 tZ TRANSFER tv jV VOV41UVL of MVP lk*1J WJ- OpLW-"1-V�.i 120121 12/02/2012l01/2012/16/20 25,016.52 0.00 (a 0.00 25,016.52 ✓ TRANSFER 11 I' Vendor Totals Number Name Gross Discount No -Pay Net 11828 SOLERA WEST HOUSTON 25,150.32 0.00 0.00 25,150.32 Report Summary Grand Totals: Gross Discount No -Pay Net 25,160.32 0.00 0.00 25,150.32 Ea v$:Lp`F'T 49i DEC 0 2 2021 "J."Mur.i<t+T01Y:LAIC 0A2'_?\;�P..'•E?k.+lk{Y��, "�91.#_'Pe7�i file:///C:lUsers/eheimail/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report76952... 12/2/2021 Page 1 of I MEMORIAL MEDICAL CENTER 1210212021 0 AP Open Invoice List 08:27 ap_open_invoice.template Due Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 11820 FORTBEND HEALTHCARE CENTER Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 120121 12102/20. 12101/2012116120 165.60 0.00 0.00 155.60✓ TRANSFER u a?OritX of alV9 1'bV�A_f dtpbDj Ftb- ( A K IkWV- ;)Put_� 120121A 12102/20 12101120 12116/20 30,204.18 0.00 0.00C/ 30,204.18 TRANSFER tt 1t Vendor Total: Number Name Gross Discount No -Pay Net 11820 FORTBEND HEALTHCARE CENTER 30,359.78 0.00 0.00 30.359.78 Report Summary Grand Totals: Gross Discount No -Pay Net 30,359.78 0.00 0.00 30.359.78 .IViYAt��t✓� DEC D 2 2021 �w�+A3AitdtN#11R file:///C:/Users/eheiman/cpsi/memmed.cpsinet.corn/u98547/data_5/ttnp_cw5report91305... 12/2/2021 Page I of I 12/02/2021 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 08:26 ap_open_Invoice.template Due Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 120121 12/02/20 12/01/20 12116/20 197.85 0.00 0.00 197.85 TRANSFER NA p*on of 0dVpdg0r;j l in t Kwu. rpetw 120121A 12102120 12/01/20 12/16/20 26,791.95 0.00� 0.00 26,791.95,,,/ TRANSFER It A Vendor Totals Number Name Gross Discount No -Pay Net 11832 BROADMOOR ATCREEKSIDE PARK 26,989.80 0.00 0.00 26,989.80 Report Summary Grand Totals: Gross Discount No -Pay, Net 26,989.80 0.00 0.00 26,989.80 DEC 0 f 2021 CAL �+:,us,ai; snlne+aVn, file:!//C:/Users/eheiman/cpsi/memmed.epsinet.com/u98547/data_5/tmp_cw5report35030... 12/2/2021 Page 1 of 1 MEMORIAL MEDICAL CENTER 12/02/2021 0 AP Open Invoice List 08:28 ap_open_invaice.template Due Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 11824 THE CRESCENT Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 111521 11/29/20. 11115/2012/16120. 9,120.00 0.00 0.00 9,120.00 v'' TRANSFER NJ - jq&UVky& p�'i kWfrt� e L i r j1 MV 0Ve, 120121A 12/02/2012/01/201 18/20``'^`" 14,149,36 0.00 00 14,149.36 11 TRANSFER N6 fdy�-t'jM OF k1pr A.t11o"Iek IX-6kJKL- Or''" , — 120121 12/02/20 12/01/20 12116/20 111.55 0.00 0. 0 111.55 ✓ TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 11824 THE CRESCENT 23,380.91 0.00 0.00 23,380.91 Report Summary Grand Totals: Gross Discount No -Pay Net 23,380.91 0.00 0.00 23,380.91 r3r-M.10°ric?a 4V DrEc 0 2 2021 SS,c'�d'ii►' 01!M11C414_a. file:///C:/Users/eheiman/cpsi/memmed.cpsinet.comlu98547/data_5/tmp_cw5report76427... 12/2/2021 Page 1 of 1 MEMORIAL MEDICAL CENTER 12/02/2021 0 AP Open Invoice List 08:27 ap_openJnvolce.template Due Dates Through: 12J1612021 Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 111021 11/29/2011110/2012116/20 1,858.32 0.00 0.00 1,858.32 ✓ TRANSFER NO IP15uwtitle, pyxf- dcpore,F_ 1 K-ft M �F L 0p��.'''��.��yyy��=��''' / . ✓ 111021B 11/29/20 11/10/20 12/16/20 42,181.83 0.00 Yo.00 42,181.83 TRANSFER 4 1r 111521E 11129/20.11/1512012116/20. 0.06 0.00 0.00 0.06✓ TRANSFER I� II . 111521A 11/29/2011115/2012/16/20 1,420.92 0.00 0.00 1,420.92 TRANSFER It II 111621A 11129/20 11/16/20 12/16/20 23,543.62 0.00 0.00 23,543.62✓ TRANSFER 1% II 111621 11/29/20 11/16120 12116/20 2,157.54 0.00 0.00 / 2,157.54 ✓ TRANSFER tt II . 120121A 12/02/20, 12101/2012116/20 52,375.74 0.00 0.00 52,375.74✓ TRANSFER NI} 4 ''d^ of QjFp cl¢(Prskerj- jK4, U-W(- 120121 12102/20. 12/01/2012/16120, 122.52 0.00 0.00 122.52 ✓ TRANSFER It it Vendor Totals Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 123,660.55 0.00 0.00 123,660.55 Report Summary Grand Totals: Gross Discount No -Pay Net 123,660.55 0.00 0.00 123,660.55 609i115�YiF-�i1NJ1Yf'6<1,', file:///C:/Users/eheiman/cpsi/memmed.cpsinet.corn/u98547/data_5/tmp_pw5report45790... 12/2/2021 Page 1 of I MEMORIAL MEDICAL CENTER 12102J2021 0 AP Open Invoice List 10:14 ap_open_invpice.template Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check.D'Pay Gmss Discount No -Pay Net 111021E 11/29/20 11/10/20 12/16/20 185.50 0.00 0.00 185.50 TRANSFER NN 1YISUN LIL_?6Wk- Gig06jjeL 16th KMdt_ 0ptau.+l- 111021 11/29/20 11/10/20 12/16/20 2,968.00 0.00 00 2,968.00 TRANSFER It II 111021A 11/2912011110/2012/16/20, 7,392.00 0.00 0.00 7,392.00 ✓ TRANSFER It tI 111621A 11129120. 11/16/20 12/16/20 11,939.04 0.00 0.00 11.939.04 TRANSFER It II . 111621 11/29/20. 11/16/20 12/16/20 11,860.57 0.00 0.00 11.860.57 I/ TRANSFER It r% 111621E 11/29/20 11/16/20 12116/20 1,316.40 0.00 0.00 / 1.316.401/ TRANSFER It It 111921 11/29/20 11/19/20 12/16/20 1,424.93 0.00 0.00 1,424.93 TRANSFER V If 111521 11/30/20.11/15/2012/l6/20 7,752.00 0.00 0.00 7,752.00 y' TRANSFER It II 120121A 2101/2012116120. 30,948.04 0.00 0.00 30,948.04 '1r2/02/20,1 TRANSFER N H D JP12 fb(+!I1 Qt{]OrM'lerl- jA-Wot-. 0 p1.Y0.ki� 120121 12/02/20. 12/01/20 12/16120. 328.56 0.00 00 328.56 V% TRANSFER It r Vendor Total: Number Name Gross Discount. No -Pay Net 12696 GULF POINTE PLAZA 76,115.04 OAO 0.00 76,115.04 Report Summary Grand Totals: Gross Discount No -Pay Net 76,116.04 0.00 0.00 76,115.04 .�e?3F.7sirf :,T �1T BEC 11 2 2021 W,14wr Ain" file:///C:lUsers/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report79967... 12/2/2021 Page 1 of 1 MEMORIAL MEDICAL CENTER 12/02/2021 0 AP Open Invoice List 08:28 ap_open_invoice.template Due Dates Through: 1211612021 Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount. No -Pay Net 111021A 11/29/201111012012116/20. 61158.11 0.00 0.00 6,158.11 r% TRANSFER F VW INSUVVVttL 9,%t Clp,190(ri�red. ,&,h PtiML DVU\LJ'1 . 111021 11/29/20.11/10/20 12/16/20 3.764.52 0.00 0.60 3,764.62 ✓ TRANSFER 111221 11/29/20 11/12/20 12MR120 439.00 0.00 0.00 / 439.00 t/ TRANSFER 111621B 11/29/2011/16/2012/16/20 995.92 0.00 0.00 995,9211-1 TRANSFER 111621A 11/29/2011/16/2012116120 4.342.80 0.00 0.00 4,342.80V/ TRANSFER 111621D 11/29/20. 11/16/2012/16/20 2,040,50 0.00 0.00 2,040.50 ✓ TRANSFER 111621 11/29/20. 11116/2012/16/20. 1,136.26 0.00 0.00 / 1,136.26✓ TRANSFER 111621C 11129/20. 11/16/20 12/16/20. 5.370.15 0.00 0.00 5,370.15 TRANSFER 111721 11/29/20. 11/17/20 12/16/20. 9.973.53 0.00 0.00 9,973.53 ✓ TRANSFER 111921A 11/29/20.11119/2012/16/20 800.94 0.00 0.00 800.94 V/ TRANSFER 1115 py 111921 11/29/20 11/19/20 12/16/20 1,1 1.00 0.00 0.00 1,118.00 f111g•Oh TRANSFER 112221 11/2912011/22/2012/16/20 1,546.79 0.00 0.00 1,546.79�.- TRANSFER 112321 11/29/2011123/2012/16120 9,227.68 0.00 0.00 9,227.68 TRANSFER 120121 11/29/20. 12/01/2012/16/20. 26,456.40 0,00 0.00 25,456.40� MEDICARE REIMBURSEMENT 120121A 12/02/20. 12101/2012116120 19,135.23 0,00 0.00 19,135.23 TRANSFER Vendor Total: Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 91,505.83 0.00 0.00 91,505.83 Report Summary Grand Totals: Gross Discount No -Pay Net 91,505.83 0100 0.00 91,505.1 IS; -h 11 18. ah DEC U 2 2421 91�yny.qa- Inrwtrrsihlm;. file:///C:/Usersteheiman/cpsi/memmed.cpsinet.com/u985471data_51tmp_cw5report41224... 12/2/2021 r� Page 1 of 1 12/02/2021 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 08:26 ap_apen_Invoice.template Due Dates Through: 12/16/2021 Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoicelt Comment Trap Dt Inv Dt Due Dt Check D Pay Gross Discount 111021A 11/29/2011/10/2012/16/20 18,920.28 0.00 TRANSFER uH'IVWVyg,(i P�Mt&fgrltdot. in,40 MHIL 111021 11/29/20 11110/20 12116/20 34.301.70 0.00'D TRANSFER A U 111621 11129/20.11116/20 12116120 1,801.22 0.00 TRANSFER 11 11 111721 11/29/20 11/17/20 12/16/20. 1,429.92 0.00 TRANSFER t't 11 112221 11/29/20 11/22/20 12I6120. 7,679.66 0.00 TRANSFER It II 112321 11/29/20. 11123/2012116120 9.685.66 0.00 TRANSFER tt It 120121 11129/2012/01/2012/16/20 3,556.95 0.00 MEDICARE REIMBURSEMENT 112321A 11130/2011/23/2012116/20. 23,767.82 0.00 MEDICARE REPAYMENT Vendor Totals Number Name Gross Discount 12792 BETHANY SENIOR LIVING 101,143.21 0.00 Report Summary Grand Totals: Gross Discount No -Pay 101,143.21 0.00 0.00 �t7 DEC a 1 2021 Erg•+?:x 1+-kw%P.'s'LrtiLzi' No -Pay Net 0.00 18,920.28 ✓ 0.00 34,301.70 ✓ 0.00 0.00 0.00 0.00 0.00 0.00 No -Pay 0.00 1,801.22 ✓ 1,429.92 7,679.66 ✓ 9,685.66 3,556.95 t� 23,767.82 61/ Net 101,143.21 Net 101,143.21 file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547/data_5/tmp_cw5report93280... 12/2/2021 Facility ID Facility Name Total UHC Deposits 4811 Ashford 127,775.33 105818 Broadmoor 53,583.91 105314 Crescent 28,298.71 4628 Fort Bend 60,408.37 105006 Solera 50,033.04 102540 Golden Creek 104,751.49 100806 Gulf Pointe 61,896.07 103462 Tuscany 38,270.46 Bethany - Total UHC Desosit 525,017.37 MMC PORTION QIPP/COmP1 QIPP/ComP2 QIPP/ComP3 QIPP/Comp4& Lapse QIPP TI NH PORTION 39,171.07 88,604.26 63,887.67 63,887.67 24,048.64 29,535.27 26,791.96 26,791.95 503.40 27,795.31 14,149.36 14,149.36 23/142.76 36,965.61 30,204.19 30,204.18 15,354.66 34,678.38 25,016.52 25,016.52 40,746.83 64,004.65 52,375.741 52,375.74 24,105.891 37,790.18 30,948.04 30,948.04 11,942.72 26,327.74 19,135.23 19,135.23 179,315.97 1 345,701.40 262,508.69 262,508.67 FUNDS DEPOSITEDUNTQ MMC'ORERATING. NEEDT0ISSUEPAYMENTS,TOINURSING'HOME MAKE CHECK REQUESTS FOR EACWNURSING HOME FOR111GWLIGyTED.YELL�OililAMOUNTS 127,775.33 53,583.90 28,298.71 60,408.36 50,033.04 104,751.48 61,896.07 38,270.46 525,017.35 Facility ID Facility Name Total UHC Deposits 4811 Ashford 1,703.04 105818 Broadmaor 587.00 105314 Crescent 461.22 4628 Fort Bend 641.16 105006 Solera 553.40 102540 Golden Creek 433.73 100806 Gulf Pointe 1,324.86 103462 Tuscany Bethany - Total UHC Desosit 5,804.31 MMC PORTION QIPP/ComP1 QIPP/Comp2 QIPP/Comp3 QIPP/Comp4& Lapse QIPP TI NH PORTION 808.771 128.46 289.29 476.52 1,255.91 447.14 291.29 46.72 102.01 246.98 489.15 197.85 238.02 35.85 85.51 101.74 349.57 111.35 329.97 51.63 118.37 141.19 485.57 155.60 285.80 43.21 102.75 121.64 419.60 133.80 188.69 28.48 68.50 148,07 311.21 122.52 667.75 100.46 293.721 322.93 995.321 328.56 2,810.28 434.61 1 11000.35 1 1,559.07 4,307.30 1,497.00 0.02 FUNDS DEFPOSITEDIINTO MM,C OPERATING, NEED,TO ISSUE PAYMENTS RO NURSING HOME, MAKE CHEBK'REQ,UE5T3 FOR EAOWNURSING HOMEFOR HIGHLIGHTED YEBLOriV`AjOUry{S 1,703.04 686.99 461.12 641.16 553.40 433.72 1,324.86 5,804.29' Request for Transfer of Funds nummen:ruwe W3onmi rage. MmR.0 R6Ruen¢tlbr. .X omwe flenRen m+n 1¢q¢5aa@,M:r.n �nh. eereM1 PMn¢ um nXwbn number 361-snbzz6 an ... ..Q., Gh¢Yn fae4X4 Wrrmna1M¢d1o16Mler be re¢IYry LaLg l�ol� I6/SBl]031 r9pW Wrm tl: L RNNRanrtlyda9e ¢rµe. gFq{I.I e�rfWerlal 19yg1B,�9ID EFT(5].M ERS136607 fiVYWOMbbbm 51.11 BRWpMCOP 16h9/IOEI EFT PIL")EFlfi13BW9 NMROLM26B69 511.]9 BflWOMWP 1 u2m Ut I065.611 EFl6139491 NORP036O26K9 1I65.K 6PWOM. "mb2] ER JPAII EMU. Npg0.p%OEK69 3]1F] mumbnElml M. " $ ll..3p1 IFTnIQ1h1 Npg 'emm5 163.3p BRYS6XOOP I.A. ur, $ (1.177.S11 EFM143353 NWRp]WSK49 I.211M . ll/5/3h31 EF) S I5I1S61(M.113 NOMWW36B69 51);6 BROABMbpP SIMIMI1 EFT $ Il.. B6 Ffi6Mol CVOgPblJpi69V1 1 35.86 BPO ... 11M/]O11 E" $ M.")EFT61e)160 NWPL0' .. B559p BROPDMwm 13/1012021 EFT $ 1y139.11 E5M118918 rypM6M5E6B69 1,119 r n...R 11/]M.1 FIT $ II.fi91.W EFr6150332 NORP.6609 Ib91.09 BbeAbMNR 11/I1/$011 Efr $ IIB.I WS9 EF16152356 NMPIXN26B69 1 1b51 6PWW MOM 11/16/ M EFl NOgO26869 982 bR.M 11/112M1 EF] 16211 en. mr..M 11/IB/3051 FR $ 11OI.BEI 1 Ef16lS6M0- NOgPMM26%9 MOM bRMOMM 1 19 1h21 EIT EFML50R8 NMPGLfO24B69 I59.3] BPOgOMWR 21 li SO31 EFi 1fR616O102 NOgPO ul. .1.13 ....MO. EF16141033 BPW➢MOM 1] 21AM EFI 1 FiT6163EW NOMMM26B69 mm4l BRMOMOM 11/31=1 EFl =12.31C71 EFl61668K WORRDOCOUN9 2.314.)610/26/1011 FFT Ff16139361 NOMWMSK69 mo.e 31.159M robeflllNa,beu[h Memalal Metllol LsnMr: p¢R Pe¢ 3 I16I1 ONOolXanaln: w'YP PPI XL Fwm9aellro ..'euent, Tetz gm.unb Mlea(banil¢r�reu I �'�� Emm R6111n: .."by gmoun DEC 0 6 'ZUZ1 al-l"W OMMM x Request for Transfer of Funds I..s Ie B: -771 Dab Requertea 1?1E1202t papr Requlned by: lkManne 51.z Requel email Rtyuesbh ph.ne number Md. ermunry KINGy MNtIOW, alevrn o9ay.r, ra —'m Ine:timmlpw Iavxplwn WNlnlNaneD.Yn4e RED p OF E IREO RlklcbM Twepaemnnl of Ischawn fpypyp[ !F CMIy BOlm nleL 01M (pJFi SlAniunJaNl ^ WA N)A IV%j20E1 EFT 13C.91 EFT615J139 NDARMWE8969 >AB BROPDMOORATCREEMIOE NA WA 11/2412021 EFT 5,Wt83 EF3 M913 NOARCC0316869 338.13 BROAOMOOR AT CUMME N/A WA wal2w1 EF! ;506165 M610986 CVDARW]20M 163.22 BROAOMOOR AT CREEBSIDE N/A A 11/2W2021 EFT 3,B1J 3fi EF36165015 CVDAR0O(k2m9 120.96 BROAOMOOR AT CREEBSIDE N/A N/A ll/EWE021 EFT 5 COW E96165983 (ALMA OMB69 E95.52 BROADMOORATCREEK51DE N/A NA ll/2I= ER s 1.09093 EF76163667 NMROWOi6869 ALO6 BROAOMOORATCREEKSIOE N/A NA 11292021 EFT 6 931b2 EFT6107639 NOPROWD26869 28.38 BKOAOMOORATCREEBSIDE IOTAL ESwil I,DE3.A4 !a It, nwd Ou! by M! modal Metllu I hMeK Pole RexM : ]2 2 Pppmve6by: C evmRer OaleallraMer. 1] B 202 ^ I �5 From 1.11": Brga911Ia61 / \oEI ISTA/ \\v—�./"/'— T untM MMClmic. 11nmm1: T9 a=. hPFBW® �95 t+e C+`.t.E9�fet aq,irlca,E Request for Transfer of Funds rnmrnm OaM Requested 132/IDE1 p mAltarR: P." MEDICARE ft.w." and EOB Requested by MUM GORDON - WANESS OFFICE MANAGER MnweYti Wns(Ynpen wnpaymentmre[wpmNl.pWwpmvWa lOB W weryaMtlYm RequesWhema l I �ttlorl@he xany Irv,w wtlentxsme,bMelfervlwaeOAmwat W Pa]mrM Ever Rmaitu—MOO mu".. Requesmfsptana number 361551L3M pnd ReMIW •AdNwb: Erlfw}Py¢r�xmm 0h41RorfmntY Calhwn neaMmm Htlliry 8elhanY3emor NNng me Mum UiNnrEENtt MUM OIP hxefPament A t p Hu tla1m NY be Menneatla6pM !K EUM[HI IofOYRaemu N EboMnnn NM N/A 11262@t ER ER6166191 CVOAROOW34969 90.11 MEBROADMOPFCAFER6mEAU Y.ILURY AWANCEPMi N/A N/P 1U3020E1 EFT EFi6169ie] CUOAROOOOB6g49 2$03 THE ORf CRFERSMFAURRIAflY POVANCF ANCEE PMr 10TAL 130.13 To he ECetlamb Memorial Metlbil C<nler. Dale Reee ]l1 O3E THU Fttl..fI [ere l oate orbm mrv. �EI Emmpaaop. namwr Ta raenlry:„eemanr Pnrounk ]aiT.] ��szvr,;rr DEC 0 6 2021 Request for Transfer of Funds Trin3llre: WhRepulslM IyE/EYE1 Payer Novibi NWPOLV'024949 Requested br [mMlRoocer RlWe3Wlslmal Ll:ow:nf Mrlm.ITI.Thr un Rlpueent's Pnone number 903-3E24412 olmaormunry memonal meJkal Center 1.01dr Golden t,.k Petknexeme u 0IMUM01 oeteelttn RRMAUMIRlFM1ormm Tteud.f vment r�ygy9 09{_ ne,myny mlmxu WmnWN.en ur te0111 hole x: .. 11 29/2IG EFT616A69 514S9B.311 EFTRM69 NOPRCCOOM69 5 1.29R.31 Due to Golden Lreak bald The amiamwr U olo, 11/19/2@1 EFT61MIl 5 13546.1 EFT6167269 NRARDOW26969 5 3,54608 Due to Golden Uc,6 Dome The Noadmoor beets .At 5 @,Raq.39 5 <&IM To be 011ed ool by me menial medical Dentlr. D h Ree [ 1-nax000er Approoedh,, maNaman.. n Dalep9mm: (er. z 1 Dom21ft 15 Dm Rr - Tewaury: x ExCli E' Amoum: ;a:Rala9._ OaNi.......... x1 I •�� ts nwen '": .ter: Flloy. fC217NT'I.ri Ta Fadllry: Anwum DEC 0 0 2021 'LPSa21Pt3L9�.�`CiGsttl.'gF<, F+elai; Request for Transfer of Funds mmrer R. pace Requasmd 12/2/2021 r,nr Requehe6 b, Ad,.—NpNm RequeAols emeN fleq.=11 OlpAe num pls6. erfaun, F,Gliry MMCGnI[ RIMNinu AtivlYb: rcleaen¢er®mm[mNlawtd mm ",m„Is2�mmmsx+i9x9sa�„ ndenex,mn mh,rsemle wMol rwe..+wv,Mm mwMa r6mwe cl¢I pNonnMM�Mh, M,milar.mmaT nruVc,[[uum N/A N/A 31/e6/y.2 fFT 334.91 EFT61WM 001955> ).p6 N/A MIA 11/24I=EF] EFi6163933 cvam C.AM x%5) 330.13 NE(RESENr ME[RESENT N/A MIA 31 < 202] EFT "%071487WAS ),506.65 FFi6163806 CVpgPCC9pI955] I67.13 iNF CPFSENi N/A NIA 11/2 2021 EF] IM1636 EET616601s CVOMC 1%57 FM 96 111ECPESFNT N/A N/A I1/36Q021 Ffr 5 6A2987 ER6165937 CVOAPCCU019557 295.31 NE (WENT N/A N A I1/29/2M EFr s USM93 EM107667 NPAROC ISSS] 1006 TIIE CRESENT N/A N/A I1/29/ID21 EFT $ 931.6x EFr616)669 CWARp 19557 28.1E THE(RESFNT Li ss,anp.n t.pn.0 m be rWed out by Memutl,I Medi lCmWr.. All-0 ve : 1 2 2px1 A.t..Ft br every,'m F..F IW. 3 ipit A-nb llty: r(lescent.. To ie[IIIM MM Iml[ Amount: 1,pZ7d6' mlilzrilws avi DECO 6 2021 J 4Mll1'.A/F1fva!eve ..� Request for Transfer of Funds mmi.n: xm RtgXmN unN]ou P+Y++ MMh+r+ pe9uepN hy: Le rcn Gmw3 ptgtlmM/+email Itecn[nle:3m m_:wrlyvar a[am Pag9nlwY pPone numh+[ 3tl�551-0]M Nltlrl[lw GunlY GAnun h [Illry mwl+I Meart+l Lenlw C9Et9gbRe_ FD eJf9yS$mkt 9 MnMxmm I E pemM+nm Abhe P xIRFx N: hXu MNumhX M1W1AI.w.rini3153. IW Eft Eii61l6W)r M-1995] W n IWS9 Nil EF! 611.]91 EF]E1IBN9 611.19 CRES[CNt ll/1931 Eft x.165.W1 E139690 CV0491A91955] ].166.W [REYfXt ll/]/lxtl fri 13I19 ]) EFMFMIe0N3 NWRttM195H 311J1 M9C(xf 1]/1/ID11 Efl $ fFt6)+]191 CVOARR91955] a5&H 11/i/3911 ER f ],i]1.5i ffi6M3353 NOMUFAI9HI yE]).53 U:RC[XI 31/3/SMI ffi $ 511.E9 fii61W))3 tt6x1955] 31)36 11/0M11 ER f 1,OH1 N161f6131 NWpcCORl95E1 1.03i.H dFYFNt !1/9/5911 S 1956.9J1 iR61t]69R N9APW191955i BSS.M (pFSCWt 11/611611 E" f II.iS9.31 EFT61i691B NOAPWM1956] ].iH.31 cmXwi II, !IAIM/ Eft 5 11,691.W Ert415o3]S 5] ].. CMSCW! 11 ISk931 l irl $ I16RI EFI6151356 NOPflYw]I955] DARMW I&iW.56 Ni 13/IWS.S Ffi $ 1W. Eft61MOS6 N9Ag99[O195H C.S 11/I]/5931 Efl 5 136.]31 ER615c996 NNAP9N91955] 36.33 I..INt Ix/SOSI f I]W.WI Fi5615Wn3 CVOARMU19551 ]W,W CREXENt [gEXFNt 11 19 IDSI LFl 5 11H.1) ff1fi196336 CVMIIKW195H 25937CpFT 11/11/M31 FFi S II H.33 I61MI91 pngm{OH331 .Mgf9CMi WE3/103t fR $ ER6I6fB3i N90.YM' 61955> 613.9] GEYFXt 11/WMW1N]NMM31 Eii 5 i6I it6]M]9B 9Wb3 fPESCEXI $ 5.316]N EFi61fia966 I 31 I " Fi 5 1.5834 FfI61X361 ...19SS] ..CEX] Mi4 b6AH.911 N.159.W So he NIIN w10 Mtmo:Y1 Me11[tlfen m RtUN I/1011 HI V ap9tmee pf: MArM nMq xEz 1 /5 ✓ N91t91 Z. nmXr: cgfuixfl m r.nury: MM<. Am 9VnC Ni159.W xmmN)nnM mr++/: f+om f+tlllryv' esofiyary ix i![Illry: L� DEC 0 6 2U21 Request for Transfer of Funds Trani RN: Oe4 Nequestw Pryer Requene6 by MTUM GORWO- BUSINESS OFPCE MANAGER Reque316 IywEnri 9LlxJl�any � om spWnl RBqueR plronC numb 363-553OSBB mmo.N .u" Uheun EadiiN Belh.,Sen ,UwIn6 Petlenl Neme �je ple eyRl P Tvue MParme raE�Eul N19bnMl tln x m AN^^ma6e0. ialu knda +a rwaa Ns mrWA.me:, WA WA 11/lyi@1 EFI ER6156191 WOAR=195A 9h.L TNECR66ENTAUMBIARYA0VANCEPMT N/A N/A l SW2031 EET EET6169187 CVOARWGO1935) 22,03 TNECRESENT- AMIVARYAWANCEPMT TOTAL RO.11 To be NRM outb Memorial MCElR1 [ennr; AppA M R 1 3031 Oan olennilee ILf/1B31 nl- meed 6y [G ener V v FrwniRillay: C IIy. T. Amuum &.. ray... 133 maun !�l'$vg4eg DEC 0 6 2021 dWla )W 4JVW,, M'a.T:'CYg?'"f'.etdtT,fi, 3Ms16 Request for Transfer of Funds Tmnskr p: Oa¢Req otd Payer xCNt. N0ARIX0019557 xequeftetl by: Canna xomn Requeem/semll La000mldNnwmrlLallbm," MqueerOYs phone numker 9U3-372-8412 bUtrletorco,o, Memarlal W&.11 Cenur F.11110 God. Geek yalueansrtrplFinao[aramapmmpple�repm"IGa Foegwerpaltl Wlm E9tleMMamr UI O pate ol4rv4e E UIREO oEPa Typeol Parma 9PUD9AS. CNu rMAKE aaxm nwdN�mkr gnJal.Iw Funm Mt 29/2021 ER616T6 514398.91 EFT6267269 0ARCOb1955) $ 1,298M la Godn CrM from@eCreent 1111913O31 ER6159811 $ 3.546p9 FFi6167369 NRR000619557 5 SMEAR Due to GOldenhttkfmm TheGment TOTAL S 4BCd]91 5 99CM139 T. be filled outb Memorial Medtrala., ah ett CalrinaM oE, opored hY: M Mary ee " kasleet �6riR2 flpm Bdlelllry: -.CRESCENT, `- Te He11Hp OO 0FN C0.F- AmOum:5 q Wlanfemu dlrmaln Dare N: bnylRc FOmFadliry; TO HOIM/ Amour2 �fi DEC 6 G 2021 aayrnr s+.�rtar. Request for Transfer of Funds lxn u. onf NRw.ue p+rer negemmhr: Nre. omw3 newen.%.xwll Lew„Ixrr_p,mFzwmv+.x<w. negenwe. phwv numLn 61-35]LlM plNla orfounry 4Moun F.r1113Y Mem.:ia M.LInI Rnrer [IjILCIMLm( Ore N 5en IBep w 1 .Ynwn(W O.nrmnhavnw BNn a hx Mlw ns� Nx N�Ea3tf9A@LH Ip Ipl3uzp3l En In.)z mm3AA cvppAppmm3o sxax A¢. INNIQ1 111.]9 CVMMM]lBl]O SI L]p SOIEM Ul EF] 11.165.E MIU1413 NORRANIBIN I.165.G IMP... IMP.. EFT 3f1.<i .119 EFTB3(p96B LVppRIXW1R310 311.4] SOLE" sp 11L1o}1 En $ 1<p3.3p1 EFi414}A1 NpM0.MIBIM (W.3p so 11/(I2021 En $ 1.3P53 Fn4M3313 NpMACp18110 1.})).53 1pU. 11/S/3pxl Ff3 5 EF16fY))3 NMRALSIBIA Sn.}6 SOtEM II FiT $ I1.03386 A]p1R1lp n.11 11/9/IDSt FF 5 BSS.A 11.1.1. IYW LvppP(pAlBnp SIXfM 3l/IN}011 EEl $ 11.33931 Fn61(4918 EVOPPA}]IB I]p I.ISAM31 SIXFM 13/IVINI El 5 IL591.w1 NOpp 11/IS/]@1 Efl $ IA.E w146BB31 Fi1515 ]356 Ml. NppRAM181]p 1P.Ifip.E I.. SOIEM 11/1U3pn FR $ FFl61539W EVORRWU1811V <NU ALE. I1/W.3 EFL 5 ]4191 EF16ISiB5fi CVppRP}y1B1)O 36.1E SpIEM i unal.a, s uwa NopeA[a1E ]o ]E.0 SaLl. IS/S1Mx1 13 En 5 1359.9) [43415E }B Np�PpGJ }593] SOIEM 11/3IISOi1 EF] 5 E];3 EnIM 03 Ml. NOpPATIYI]p SOLE. llh9/SOEI EF3 $ fi13.93 LR6143BE3 NpMMMIB I]p .1];1 419.9E U. It/N/1p31 Ff 9 -, .1 90M3 5%FM Il/S6 A]I FFl $ 1:.3E.i4 EF]61E36 NpnPoaWl4no y31i,J4 SIXFM L03.(t 134359.d1 3g359.W Lohe MemorhllMLlw1(E nlr. el,,eke FI.14 B, n11 ...I Ono W iren]kn a io31 pp9rweL hy: MPYPp .R IU/^\\v/3,`'//— Frem Hallry: SpMPM^ LO F. rlllty; MMC- Rm.lmt frmm Etlllry: � N Nalllp pm.unl: UCi. U U LULI S•JCLFYI$r d9hLi0Ii r,F2 9.8L:3"•Lki @:v_ipipal; 3e_iZJS Request for Transfer of Funds Tr9nne..: -. RIn...E t2/e/2ort Fryer Al.uNd by: Ptlafanm SlraFoe Peques)Nsemell ReRYotasvlmne numbM ...dota.Ceumy FadIA, .01.1e aeveneerm nn ar 5�99!lins 9i m ram. I�.vaa� memo-mlm TYveern.m. q!N n O .1, nutlY-Four t IN/A lUl6/Ml ER 139.91 E"510913 NOAROM0191)O SOURAWEST HOUSTON N/A 11/29/2021 SP2lA] EM6163913 CVOARCWIBi]0 A13 16M, 50LEM HOUSMN N/A 11/P/2021 M SW ;SO6.66 CVOMCWJ191]o 16L11 MST SOLERAMS]HOUSTON NA 11/26/2021 ET ]A1936 EP61WA15 C961MDIS ]2161ID 195.32 SOLEMWESTHOUSTON N/A Il/x6AIDx1 EFT 9A)98] EU6167067 UttAtu EVOARMI01]0 295.32 SOLERAWESTHOUSTON N/A N/A EFL $ $ EF)016]66] 1R]0 )0.06 SOLEMWESTHOUSTOM H/A NA 12129MZI 11/29k@I Fi5 431.62 $ 931.61 EFT6I6]499 UDARO'Ytl. CVOgRMPo181)0 TBAB 501EM WE5T HOUSION it Nigt 15990.)1 1.027A9 11 TObe1111M ut Memofial Me6lnlfinten ff." P 21 APR-Fmm Vie. mmennnde= 3i2Nxon Fmm FA010: Soem MM IP Amount: PmounC 1017A4. �LTiD9Id! DEC C 6 2021 PmVSto F, Anntr a ),Marne: Request for Transfer of Funds Oace Ml..Nd 3y2/2wl NOPRWWIBI)0 Ppr odGl Mpu<FteJ b9: Utlm Noppn Mpue tohemll IEpppp�Mryexiomlleal:nrom Pe .. on PT... number 903d72d 12 OOtrle[orCouny Memorial Mediral[ennr Fannn Golden a.n mtaM< Ade1RBM EGO mer bu4neyMrtMw 1.1 n,e[wpmen41Wu pmlde Wl d—,mld d.W Un.m Wmd. and Pmnmprl<Anenl4wn RenPlhn[egdvbmun a.WM nnpuen mrm Mmitunm MHmro: Aleu nrlamn rnenUram.mm IpmpSnnam nnurva r tk AUIRED F IREO 0etenE4nn qE GaledPmAnt Twed Pmnm ((93/f©_ gpympy, P pinYNum fLl ,3mdnnteam. rmm ne,L nMma n tBYWPat<m 11/29/2021 EFI6167269 $ L298.33 FFl4161269 NOPfl0."COIB1)0 S ;39q.11 Ouata Golden CreeN (ram Sclera Wen xounon SI/19/2921 Efi4150817 513.596.081 EFl6147249 NOPflW0018D0 $ 3.N403 Go Golden GeeM A.. S01Ai M. N-,,on TOTAL 51<.BN.39 $ J,81439 T-Wf0edouth Me�mdx M<ti[al Cemen Gale Reee Ca✓ml Wper PpprWpd Y3a Maera iGamnn Onedmnsrer. n.,W39 /F id P[Nly: FEN PFFN rlmoum: a.Baad9.. PMunr I— tr P�etlt OaM dlmniral. From F.riliry: TO wlat.. iffr:Ir�43,r gmnunC DE 6 b 2021 Request for Transfer of Funds Wanner P: Dare Re.neneJ vayer Re9uesleE by: tPTUM GONOUN-. J51N In OFFICE MPNPGER uef Seaine—mall 15nrtlonNbulli.�n�livine,(ypl Rag..Nohpin— numbs, J61-SS1-0$W Ol ektarCwnry plhoun F.011, batbany RnYr UNng RemhNlr[e MVlwb: alwenearpmmconrlLwarx[am PoNent Name RE UIR paleb5ervlre pE UIRER L�J } bPaumene ¢ate¢. XumheE [YIm Nu MtlbnneeXtl�FnYr ba.mer Eon bmSS N/A LA11/26/2023 EFT E"61W191 W.W0`VAgl70 98.11 Salem West Nauflan-AUXILIARY ADVANCE PST N/A N/A 11/3012021 EFT EFTG1691g1 CVOMRMW18120 22.0E 5.11m WMt110ufIan PUMIIIARYPOVPNEE PMT TOTPL 120.13 mm9LeL1 PEareOlErebyRer I]4Ie ID21 IDTAOoaaTeoenbell balWos:leE: IeaunM`y FMMPlaultY Sva V\— PmnMAI � V DEC 0 b 2021 6L.- r W tum�tmm AAC:P3S`'IrPTMn?R', F[f;a4R )„mien: Request for Transfer of Funds pn. Pevumrm nNax9x1 Pryn meeio xgeeAed er: F.reA nmoer R.wmRn •mw oPA.nmrmm.Nem...., nm Xeve.merr 9n.ee number )s455IS}x6 pif}ri[Iw Counry [aµaun fa [IIIF/ wielMMinl [enlw WSpVil9L P @Fi9.p(F6YIp. by el n.rnrm 5gwnl el Nrm en p IS).]S ER6Il6W) CVp4RW[W199$ ML6e sm6� $).}S NSWIY VIW.cE Sa3aSOE1 EFI IOhW.} fri sll.]9 rt6116W1 NOAX60)OJ)fBs xYVIL 4l I1/Ill.n E LI65.W F]51396H CVUARW .16£6e M" )U IPGE TUS 11110}l ER 13]IA] EF10...0 M5 311.m 19IM, ER $ <09d0 Eilc lcil0l CVOAXKIXW9X5 mA]O — net"9 11AP.] Frt $ 14}>).51 [rt619x955 NUPRIXC L}]).5} NsuXY VIA[ l 1 ER 5 I51].}6 F{i61.9]]i [VpA6[NW)Hs MS 51).}6 NSCANYVSCYs Il/0/.n 6F1 $ 91.E6 [F16196151 LVOAP[(EW)905 I.955.90 3USCANYVXW E ]1/9 ER 5 I85£WI Fi)61<)9N NOP6WMN]9r5 95l.9p lY 02i Ert f 11139.11 Lfi61969Y CVOPXOCCOOHBs LOOM PM IWOE SM2,1031 u/NIDn 1 S p331 oAN.0 4691.11 ]UNAxv vnNp9 VU 11/I1p}] FR 5 11&IW.59 EFi615)354 .5 pApW'pEp)9B5 1&160.Se NSCCJIY VIUA4E Il/1fi13011 [R 5 I]69.16 ER615)3M NOPXOW. COA6i 369 i61U3UNY V111ME la}6IM}1 EFl 5 II.56341 fR61 Y361 [VpANO]Ta995 L56}.96 VSGNY VINAGF YUYA9 1}9.I ILW A.II S.OU ]o Oc 0"'deul7--d mm nvll.9r )e nnun: A.:ev:rl SRI �11f DECO 6 2021 9: ,_.r,�r 9iwUrOB. t1p:, 75., ASP GULF POINTE PLAZA CHECK REQUEST PAYEE MEMORIAL MEDICAL CENTER _12106/21 DK t 6 2021 AMOUNT $10,017.16 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED GULF POINTE PLAZA CHECK REQUEST PAYEE MM CLINIC 12/06/21 as; DEC 0 6 2021 QF2!�'#!iYy✓ fkF1FIP:'4RF>. AMOUNT $530.99 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE ASHFORD 12/06/21 aw DEC 0 6 2021 AMOUNT $2,870.00 EXPLANATION: ECHO PAYMENTS OWED FROM GPP G/L NUMBER:' REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE BROADMOOR AMOUNT $11,694.50 EXPLANATION: ECHO PAYMENTS OWED FROM GPP G/L NUMBER: REQUESTED BY: Mayra Martinez AUTHORIZED BY: 12/06/21 1097m—a 4w DEC D 6 2011 GULF POINTE PLAZA CHECK REQUEST PAYEE CRESCENT DATE: 1 2/06/21 A,Prx*ru% 4w DEC 0 6 2021 AMOUNT $18,870.00 EXPLANATION: ECHO PAYMENTS OWED FROM GPP G/L NUMBER: REQUESTED BY: Mayra Martinez AUTHORIZED BY: GULF POINTE PLAZA CHECK REQUEST PAYEE FORT BEND AMOUNT $2,646.00 EXPLANATION: ECHO PAYMENTS OWED FROM GPP G/L NUMBER: REQUESTED BY: Mayra Martinez AUTHORIZED DATE: 12/06/21 au; Dc' 0 6 2021 GULF POINTE PLAZA CHECK REQUEST PAYEE SOLERA AMOUNT $27,880.00 EXPLANATION: ECHO PAYMENTS OWED FROM GPP G/L NUMBER: REQUESTED BY: Matra Martinez AUTHORIZED 12/06/21 QE . 0 v 2021 u�:�t�ar.c+nnrtnx GULF POINTE PLAZA CHECK REQUEST YEE GOLDEN CREEK 12/06/21 ?i-1::w*,Yrz* R8i DEC 0 6 2021 AMOUNT $3,685.25 G/L NUMBER: EXPLANATION: ECHO PAYMENTS OWED FROM GPP REQUESTED BY: Mayra Martinez AUTHORIZED BY; GULF POINTE PLAZA CHECK REQUEST PAYEE TUSCANY AMOUNT $3,073.00 EXPLANATION: ECHO PAYMENTS OWED FROM GPP GIL NUMBER: REQUESTED BY: Mavra Martinez AUTHORIZED BY: 12/06/21 of 0 C092021 C%,TCVR YFV 41IT&Wgo, Memorial Medical Center Nursing Home UPL Weekly Centex Transfer Prosperity Accounts 12/6/2021 m.Y.. r.e.y. hreunt NLlnnlnE Id 0.nflna &(InNA( nmeumla YTnnnnNYXurYn( Nwl Mariu YYw }nnrrnrypl Tnnpfrrvin G e O.Ynw Xem. na,35g0 R3.131.0] 1n1.111.66 � Im.19019 361,89.b] YnkRWnu 101,39019 9� VlrYn[< Law.In R.hnu Idm ORIMIFRF3T I6R3 /�� NOVIMfRFST 19.vpJ nFLIH]FRE9i ✓ Aa3P1E wlwartnnnarAm. ml,)at6> N.13).)1✓HA3E.19 IW,Id.R f06.910A3 � 6a.611,93 r] Banq 9Yan[e IW,916.09 ✓ Varima lerveln 4Ynan Im.m / MFOIGgE RCaAYM[MTO BCTNANY 310.1]y/ MEYIGgCREVAYMEMTOMMC 34139.*` MCOIGREREPAYMEMTOMMOINIC 1.01)d.� =,19 ✓ MEDICARE UPAVAADO To MOONGEE[ ORIMERE6T I✓/ ' NOVIMFRF3T el. 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MEOIGRCAGAYMEMT060LOCN GCC. 4.GA31 �. eR IMERE9T IaA✓//L 33C"i'rN]i.Al{l.4lPl!Yid14,q. ..VIMow Ir"i orCdRAE9r pairs B.LneetrnmNrgmL flAd.ml / TmALTRLNIFER9 IE6,610.1R APpravttl: AAlhvnyglrllRrtlsM, CPO 11/by10E1 I NHW0[11VTH9IMXl9enl 0evnme6 Wag0u0valaeMmM1MNH Rant DowMee[ IIa9.E1mw 12.05-21 Nn N,I IMMINENT TpDI(IL'9�MI aPP/KmPl aPP/41np2 aPP/[omN WT[ aP/11 MNIORNON UNCCOMMUMry ILN[[WMIMI )[itlN11191WM AILN 1,[SL95 I12ZNl1 lll)9/1ai UMC PI NCCWMIM]"..I, A.T11.93 [S.E)IW AS.SM.6o ONAMUMIY VHC[NMMNMWwX[CW I. I. 9,8319B 9J]Lg8 PIATHW6M[OU tINVaO31 llll!/1023 XUMAMAfNA0U0 MCCY&IM[3wB60[]fRtlt]O6 $,B65M � 5,69W - If.9i1/ 11(l0(]al RmelyipuP]RSCNCCYIMPM]]If[]w9ip 133W2 24. 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[[XI[R III 41.N[ 11 wNM]l YnllMHeiANumMCMMPMt]46P3411116324 low IV VMIl UHC COMMUNINAL HCCGIMPMTN ONTIE S LaP I7/1/MIT MMPSMPPEo—UMCCGIMPMT]IWICI1 w43N IJILL0 260M 2.265.51 311150 Y,Y6J]J/ 11.1NJI l� 113wA • ....III . ., ,_- MC MPORTION avr/nmN MI9NUF1 Ldr Hftm HaGTMPMl11CTMNI1 w43N '" V' ' FL9Rl r�nU�enlM an/Gmpi an/bmpx alp/Compl sYpee arlT HH POFnDN Y ilr4�v �� Wi' "' / 1]e110a 11/3aIDw•I LM_ .•,.e`IM .. YmMNpNhun X[IMM1ili6a3[If R9N tV30/i0x1 UNMOHGITNGP[Ntt1ATMIM[]4FWFII1 w11N 3'NbP 3.66ya 1100/29II MARMIRRI e-HATWMPMT]46MI111133N 6wB 46NI w/VIOw 111%% J.IMYMO - i,iwso 13/VIOw CRVIP uA2Aio IVVlal THP0M1 12/42011 AMC OUiGMfXNGLMGR[[FMTW III 11'aM.M Ilatb011 VMTMMAIth eKKMIMPMT 71.1.111MIM [1.1M1A0 - ILa9M0 111312011 HUWMCHAOMOKKMTMPMr39Mw41aw11a L83RTO / J30 A LIMON 9 1 OA lB1arIJ1 wsanaT ] 121612021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Account Type Add Group v Search All (DDA Data reported as of Dec 6, 202 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $9,760,723.76 $9,972,030.92 $9,760,723.76 $9;642,940.E '4551 CAL CO INDIGENT 56,040.82 $6.040,82 $6.040.82 S6,040.E HEALTHCARE '4454 MEMORIAL MEDICAL I NH GOLDEN CREEK $1959847 $28,794.67 S19,598.47 $19,598.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $535.99 S535.99 S535.99 S535.9 2014 '4357 MEMORIAL MEDICAL S8,002,933.52 $8,082.709.49 S8,002,933.52 $7.969.196.2 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $43t.51 S431.51 S431.51 S431.9 WAIVER CLEARING •4381 MEMORIAL MEDICAL $101,390.89 f S116.543.10 $101,390.89 $101,390F CENTER / NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH / $106,916.05 / $180,712.67 $106,916.05 $62,886.9 BROADMOOR '4411 MEMORIAL MEDICAL $46.735.92 .! $57,265.42 546,735.92 $45,735.: CENTER / NH CRESCENT '4446 MEMORIAL MEDICAL $11.351.27/ $11,351.27 $11.351.27 $11.351.4 CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL CENTER / SOLERA AT $39.240.29 .f S42.688.50 $39,240.29 $35,640.2 WEST HOUSTON '2998 MMC-MONEY MARKET $1,109,095.73 S1,109.095.73 $1.109.095.73 $11109109547 FUND '5506 'MMC-NH BETHANY $152A66.13 S152.466.13 $152,466.13 $121.718.2 SENIOR LIVING '5441 MIMIC -NH GULF POINTE PLAZA- $11172 $111.72 $111.72 Sill.?MEDICAREIMEDICAID •5433 MMC -NH GULF POINTE $79.393.55 $98,907.00 S79,398.55 $73,730.0 PLAZA -PRIVATE PAY '3407 MMC-NH TUSCANY $84.476.90 $84,476.90 $84,476.90 584,476.E VILLAGE w 1 httpsA/prosperity.olbanking.comionlineMessenger lit Memorial Medical Center Nursing Home ❑PL Weekly Nevion Transfer Prosperity Accounts 12/6/2021 Previow Amount eeilnnln3 Pttuff, Too.,% Beilnning Amount W Bt Tnnrt¢rted to Numini N" Ham¢ Numh¢r &lent¢ nns/er-Out Tnnafern ,Oe aaiN 6a1an[e Nome a. „.[..rfl` 80,591.9E 60,480.4] 19,t6496 ✓ 19,59BA7 / 19a474.6$ 8,M Mtn. 1A595.0 ✓ Vanan[e Leave In BtWo. iBO.OB oaflMBEST 11.51 [/ NOVINTEBEST 11.31 OECIta1EflER Note Od baloom o)over 9$,m9 willbe ftn* red totha nurtlnD home. Notelt Eo[h u[munthaso bwe bolonceo/5100 that MMOdepmMd to opon o¢ounr. Ab4YI�*?V.* Apl DEC 0 0 2021 Aelutt Bebnm/TranaferAm! 19474:65' AnProved' Ny I V AnlhonY Aid rda¢n, CPO 11/61ma 1:\NH W-u, TrtmLrs\NN UPI Tramler Summary\3021\0t..b r\NH NPLTnmtet Summary 13.05AS.dv MMCPDNODH "\a11/Cempl6l NH 11 RipliEf_'QS )y.aL�. p aw/ccnwy aP1/fwnpi aDP/ramP9 ..v ann PONDON i9AWf,DjLNJPp'pTgp�gv 'uAm L I2/2/20 1 HOVOKSOW➢DHNCCWMPGOME"C 9RUAllb 19,9)46S 8,.1)d 65 I]R/30t1 WIPF DUI NFMIDN HEAL)N44DLDMCPEFK BD.CdD.O , bA0A1 e,N6Af 9B V69f 12/612021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number I Name Groups Add Group Account Type IDDA Data reported as of Dec 6 202 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $9,760,723.76 $9,972,030.92 $9,760,723.76 89,642,940.E '4551 CAL CO INDIGENT $6,040.82 $6.040.82 $6,040S2 $6,040.E HEALTHCARE '4454 MEMORIALMEDICAL/ NH GOLDENLDENCREEK C / $19,598,47 J $28,794.67 519,598A7 $19,598.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $535.99 $535.99 $535.99 S535.S 2014 -4357 MEMORIAL MEDICAL. $8.002,933.52 58,082,709.49 58,002,933.52 57,969,196.5 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER- PRIVATE $431.51 $431.51 $431.51 $431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $101,390,89 $116.543.10 S101.390.89 S101,390.E CENTER INH ASHFORD '4403 MEMORIAL MEDICAL CENTER! NH 5106,916.05 5180,712.67 5106,916.05 562,886.E BROADMOOR '4411 MEMORIAL MEDICAL $46.735.92 $67,265A2 $46,735,92 $46.735.E CENTER INH CRESCENT '4446 MEJNORIAL MEDICAL $11.351.27 $11.351.27 $11,35L27 $11,351.F CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT 539.240.29 $42,588.50 $39,240.29 335.640.2 WEST HOUSTON '2998 MIMIC -MONEY MARKET 51,109,095.73 S1J09,095Y3 51,109,095.73 51,109,095.7 FUND 'S506 MIMIC -NH BETHANY $152.466.13 5152,466.13 S152,466.13 $121,718,2 SENIOR LIVING '5441 MIMIC -NH GULF POINTS PLAZA- $111.72 $111.72 $111.72 $111.7 MEDICAREIMEDICAID '5433 MIMIC -NH GULF POINTE $79,398.55 598,907.00 $79.398,55 $73,730X PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $84,476.90 $84.476.90 $84.476.90 584,476 c VILLAGE https:llprosperity.olbanking.comlonlineMessenger 1t1 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity ACCOunts 12/6/2021 rmmeY AnwPmtOw axeune wdnxn6 vin rhluLlnwro xuN Moms NumMa Bilhw T .....Ou1 T nalerin ULCkved w b Tod! !w n wLnn Xw Nome 1 6tA}3.}B 4),t3.1) 6L79154- wnkwYpn )9,39BSS hna Leavlin wYnu 100.04 GNIOFNtIFIFDFWOFAYMFHUINO[NEO(WILL R[WRRiLN iOR1NRANOVNi YFIk 30p9.L / ECXOPAYMFH}TOMMC 10,W}.IBI FCts 3,0}3. 'CutsIAMVWCT.MIIfUNY M. FCXOMEW70 T06 ;Y9.R6.� EC .R Ik,... COOFAMWTOOMOON }71"60 CC OVAMYMFMTOspEN LCHOPAYMExiTO I,M6.RR ECHO CRECEXO NETTOGTOUF6CENT ECNOIFYMNFTLOGOIOFH [flfFR 3,616.35 away OCMI"Rw 016 New NMW 1351 OLCINTGL9r MIVx6allnu/InMerAml II}.YIJ6) P[Mnuo M1h A[wunt w Pmdlnt vmvdlo Thn[t—dW NOR— Numw[ U.— Wanu T91.671 J 6rvin Cs Oelhd w b ntla tBe In Hunl None 91,16fA1 9].4]9.18 � SA9 � lli)} 1IL72 wnkwlan[e 111A2 f Vadanve OAO NOf<: PVP601an<N PfnM$$,IXO WIHhI L/MItfM/ldMLlllnVIINPM1ImI. Note }:Fxhemvnl Nor P6medNanhP15100 Mel MMCdepYilNry 9pm v[vwmf. WE rjfr-- b 1 2021 leavein aalan[e IMOD OCTPVTEREFT NO:mftw SA9 .CCNTEREST PdSurtwhnh/Lrxulvr Mnt 19A01 IOTLL TNNNiF[RF XLYLJ61 MIM1P YRldaadooryCN p/6/kill s:VlxweeNln.mLlnV.x v91)rannxsumm.rylxmslwwmhnlnnwLrnnaersumm.ry s1.or.n.. W 12/6/2021 Quick View Select quick View Accounts Account Number! Name Account Type r Searrh All DDA Account Number Current Balance Number of Accounts: 15 $9,760,723.76 '4551 CAL CO INDIGENT $6,040.82 HEALTHCARE '4454 MEMORIAL MEDICAL I $19.598.47 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL $535.99 CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL S8,002,933.52 CENTER .OPERATING •4373 MEMORIAL MEDICAL $431.51 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL $101,390.89 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL S106.916.05 CENTER/NH BROADMOOR '"It MEMORIAL MEDICAL $46.735.92 CENTER/NH CRESCENT •4446 MEMORIAL MEDICAL Sit.351.27 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL $39,24029 CENTER I SOLERA AT WEST HOUSTON '2996 MMC -MONEY MARKET $1,109,095.73 FUND '5506 MMC-NH BETHANY $152,466,13 SENIOR LIVING '5441 MMC -NH GULF POINTE $111 72 PLAZA- MEDICAREIMEDICAIO '5433 NIMC -NH GULF POINTE $79,398.55 PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $84,476.90 VILLAGE https:Jfprosperity.olbanking.com/onlineMessonger Treasury Center Select Group Groups Add Group Data reported as of Doc 6, 202 Available Balance Collected Balance Prior Day Balarlc $9,972,030.92 $9,760,723.76 $9,642,940.E $6,040.82 $6,040.82 $6,040.E $28,794.67 $19,598A7 $19,598.4 $535.99 S535.99 S535.E 58,082,709.49 $8,002,933.52 S7.969,196.E 5431.51 S431.51 S431 c $116,543.10 S101,390.89 $101,390.E S180,712,67 S106,916.05 $62,886S $57.265.42 S46,735.92 S45,735.: $11,351.27 $11.351.27 $11,351.2 $42.588.50 S39.240.29 $35,640.5 S1,109,095.73 SI,109.095.73 $1.109.095.7 S152,46613 S152,466,13 $121.718.2 $111.72 $111.72 $111.7 S98.907.00 $79.398.55 S73,730.0 $84,476.90 $84.476.90 $84,476.E 1/1 Memorial Medical Center Nursing Home OPL Weekly Tuscany Transfer Prosperity Accounts 12/6/2021 Ptwbm ATOW110 Be q[eounl 4E4+.M Nadia, TnnY<ma]o Xeu Ll — E.Im[e ra.nab[.Wrt rm".s n.Cleana —I. o. lu Tod..e. mn x xame t iE9.555.{B 389..95.1 9y3]69G - - 47CM M,06.94 /55,164.90 &n R9,476.90 ✓ Vana...an[e n.. N BalaM. Imm MEYIVWEREMMENTna MMC 29.1]$.00 ✓/ WIu.19al.n[e(1�EET��\\Mergmt Note: MH4alon[a oJor[[SS.000 MI)6[4vmin[eClo Nenunin0]Ioln4 Aoe[ovee: 61-11— 6' VV I /6h Notr2. EGO ata—I has u6me 6olon—IS)M that MMCammnHm[un o[mun[. Ard"nM4F.[ son.00 a4R1!TAI��I AFa C U 2U21 11/29/2021 NOVOASSOLOTION HCCUIMPMT676201410000296 IV30/2021 Added to Account 12/1/2021 Deposit 12/l/2021 Deposit 1212/2021 WIRE OUT UNBAR ENTERPRISES, LM 12/2/2021 Molina He om HCCIAIMPMT PM12757178944200 MMCPORTION QIPP/Campo TfdM18r-0ut TransfOr•In QIPP/Camp! QIPP/Comp2 QIPP/Cpmp3 &lapse QIPP TI NH PORTION 30,071.57 30.071.57 13.27 - 13.27 30,184.60 - 39,104M 10,253.76 10,258.76 209,455.1E - - - - 5,848.70 - 5.840.70 209,455.3E 84.376.90 B4 3]690 12/612021 Quick View Select Quick View Accounts Account Number/Name Account Type Account Number NH GOLDEN Currant Balance Number of Accounts: 15 $9,760,723.76 '4551 CAL CO INDIGENT 56,040.82 HEALTHCARE '4454 MEMORIAL MEDICAL / CE $19 $9847 R EK HEALTHCARE '43 5 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER / NH ASHFORD •4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL CENTER ! NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC -MONEY MARKET FUND 'S506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA. MEDICARE/MEDICAID '6433 MMC -NH GULF POINTE PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE hops://prosperity.clbanking.comfonllneMessenger $535.99 58,002,933.52 $431.51 $101.390.89 5106.916.05 $46,735.92 511,351.27 $39,240.29 51,109,095.73 $152.466.13 5111,72 $79.398.55 $84,476.90 Treasury Center Select Group Grou s Adtl Grnup Available Balance $9,972,030.92 56,040.82 $28.794.67 $535.99 58,082,709.49 $431.51 $116.543,10 5180.712.67 $57,265.42 $11.351.27 $42.588.60 51.109.095.73 5152.466.13 5111.72 $98,907.00 $84.476.90 Collected Balance $9,760.723.76 $6,040.82 $19,598.47 $535.99 $8,002,933.52 5431,51 5101,390.89 5106,916.05 $46,735.92 $11,351.27 939,240.29 $1,109.095.73 5152,466.13 SI11.72 $79,398.55 $84,476.90 orled as of Dec 6, 202 Prior Day Balanc $9,642,940.6 $6,040,E $19,598.4 S535.E 57,969,196,2 5431.E 5101.390:E 562,Sft, 346,735.E 511,351 2 535,640.i 51,109,095.7 5121,718.2 $111.7 $73,730.0 $84,476.£ 111 Memorial Medical Center Nursing Home UPL Weekly HSLTtansfer Prosperity mount; 1?✓6/3021 Prarlom Pmtlly Pmaunl to 0. 4raaunt Sum.l., Mrtllun Total emd to Xumbq Nunn Lim4nevl dnndrnln Cho —ad R.a...t TaLJ rLLnly Bdt_ Nonlnd Nome I5],3[09a Bank Us— 153.46113 Vsiin[e .1. at WWI,, loam a[TINT[A[ST 21,39 ✓ NOYINna[[T BECImfP[ST / Noe.n[nohow[5£WOatlolAenwainA,s,o.1v9i Note }: EOM eovn(has P ease bahms,#o/$IWthat MM[I[onmodtoopen a.mwG pUPnY.PI.I[MA e/iI[wl`oC1 lCln0il[/6f]a13 ,R7Awf & Aiw 2021 fyr+'.i'S+k36iY" 6AM.1131?�aY, 1U. WMh T--shin. Ulk Tnminlummrryf303t1h[emMrgN UIL innrtn Summary 1165]ssft. 93,673.58 r 7ronsfer•Out 11/29/2031 Deposit 11/20/2021 DoWslt 11/29/2021 Oepwit 12/29/2021 NOVITASSOLUTION NCCMMPMW0 T6T64B1420196 11/30/2021 Depwlt XV112021 Depwlt 12/1/2021 Depwlt 12/1/ID21 NOVRAS SOLUTION HCCLAIMPMT 62649142D000102 12/2/2021 WIRE OUT BEfHANY SENIOR LMRS, LTD 12/2/30210epwit - 6,929.90 - 6,92150 12/3/2021 Deposit $074793 RD "1..1 95,673.58 152340.74 152M 94 MMC PORTION DMICOmP4 TtanS/eMn OIPP/Cwppl QIPP/COmP3 QIPP/Cemp3 III glppq NH PORTION 50,149AS - 50,149.65 33,236.60 - 13,226.M 11929,03 - 2,929 A3 1.471.56 1.471.55 1.514.30 - 3.514.3. S,335,36 - 5,535.39 12,594.87 - 12,594,112 330.36 330,38 1216/2021 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Add Group Account Type Search F All IDDA Data reported as of Dec 6. 202 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $9,760,723.76 $9,972,030.92 $9,760,723.76 59,642,940.E '4551 CAL CO INDIGENT S6,040,82 $6.040.82 $6,040,82 $6,040,E HEALTHCARE -4454 MEMORIAL MEDICAL 1 NH GOLDEN CREEK $19,598.47 $28.794,67 S19,598.47 $19,598.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES S535.99 $535.99 $535.99 S535.E 2014 *4357 MEMORIAL MEDICAL S8,002,933.52 $8.082,709A!) $8,002,933.52 57,969,196.2 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.51 5431.51 $431.51 S431.: WAIVER CLEARING •4381 MEMORIAL MEDICAL S101,390.89 $116,543.10 $101,390.89 5101,390.E CENTER INH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $106.916.06 S180,712,67 S106,916.05 $62,886.< BROADMOOR '4411 MEMORIAL MEDICAL $46,735.92 $57.265.42 $46,735.92 $46,735.; CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL 511.351.27 $11,351.27 $11,351.27 S11,35Li CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $39,240.29 $42,588.50 $39,240,29 $35,640.2 WEST HOUSTON '2998 MMC-MONEY MARKET $1,109,095.73 S1,109,095.73 S1,109,095.73 S1,109,095.i FUND '5506 MMC-NH BETHANY $152,466.13 S152,466.13 S152,466.13 $121.718.2 SENIOR LIVING '5441 MMC-NH GULF POINTE PLAZA - 511172 $111.72 511L72 $111.7 MEDICAREIMEDICAI❑ -6433 MMC -NH GULF POINTE S79,398.55 $98,907.00 $79.398,55 $73,730,C PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $84,476.90 $84,476.90 S84.476.90 $84,476.E VILLAGE https://prosperity.olbanking.com/ontinaMessenger 111 a 5 0 00 00 jc -Zi a� a3 fir. 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