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2022-02-02 Final Packet
III 2 il!" 1 C (� \II��I(11\I:I"�' �1 a) 11 Agenda Items Properly Numbered _ Contracts Completed and Signed ##1 , Wo 1 r �Z ,Z'AII 1295's Flagged for Acceptance (number of 1295's 3 ) ✓AII Documents for Clerk Signature Flagged On this 14qz day of 2022 a complete and accurate packet for 2&k of 2022 Commissioners Court Regular Session Day Month was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. O&I'L Calhoun County Judge/Assistant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOTICE Ol- MEETING -- 2/2/2022 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 of Calhoun County, Texas will meet on Wednesday, February 2, 2022 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. The public may participate in the meeting through the following video conference link or toll free number: PC with camera and microphone capabilities — ]hops://txcourts.zoom.us/i/2130882273 AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Gary Reese Texas Flag- Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Hear report from Calhoun 911 regarding NG 9-1-1 grant program. PASS Page 1 of 4 I N011CF OF MEETING - 2/2/2022 6. Approve the minutes of the January 191h, 2022 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action and allow Vern Lyssy to sign Lease & Rental Agreement with Anderson Machinery Company for a 2014 Bomag BW190ADO-5 roller. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action on Contract Agreement with Matagorda Bay Mitigation Trust for Contract No. 024: Hog Bayou Park Improvements; contract period from March 1, 2022 until June 30, 2024; and authorize Judge Meyer to sign all documentation. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to allow Commissioner Behrens to sign the 2022 maintenance contract with Hurt's Wastewater Management for Precinct 3 septic system. (JB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: David Hall, Commissioner Pct AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to acknowledge and accept the Resolution for Operation Stone Garden Grant for 2021 and allow Judge Meyer to sign. (RHM) RESULT: APPROVED [UNANIMOUS], MOVER: David Hall, Commissioner Pct-1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to authorize loan in amount of $117,000 from general fund to Magnolia/Indianola Beach Pavilion's capital project fund. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NOTICE OF MEETING — 2/2/2022 12. Consider and take necessary action to execute the construction contract for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 and authorize the County Judge to sign. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Lvssv, Behrens, Reese 13. Consider and take necessary action to accept check from Calhoun County Fair Association in the amount of $1,208.63 for 1/2 damages to Precinct 1 Caterpillar Backhoe 21-0293 and deposit into account 63530. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Lvssv, Behrens, Reese 14. Consider and take necessary action to accept the Continuing Education Transcript from the District Clerk. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Consider and take necessary action to accept Emergency Connectivity Fund Commitment Decision Letter for the Library in the amount of $21,430. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall; Commissioner Pct SECONDER:'` Gary Reese, Commissioner Pct 4 AYES: Judqe Mever, Commissioner Hall, Lvssv, Behrens, Reese 16. Accept Monthly Reports from the following County Offices: i. County Treasurer — November 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Lvssv, Behrens, Reese 17. 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 3 of 4 NOTICE 01: MEE I ING — 2/2/2022 18. 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 County 2021 RESULT: APPROVED[UNANIMOUS]1- MOVER: David Hall, Commissioner Pct 1 SECONDER:` Vern Lyssy, Commissioner Pct2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens' County 2022 RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct`1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner` Hall, Lyssy, Behrens` Adjourned: 10:13 a.m. Page 4 of 4 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, February 2, 2022 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. The public may participate in the meeting through the following video conference flint; or toll free number: PC with camera and microphone capabilities — hitps://Ixcourts.zoom.us/i/2130882273 AGENDA The subject matter of such meeting is as follows: aT�'Q�o•c OCK Qv M `Call meeting to order. JAN 2 8 2022 AN h G000! Invocation. Gou�� N 0 N Y,T S rr WPledges of Allegiance. 14/. General Discussion of Public Matters and Public Participation. Q&9d__Hear report from Calhoun 911 regarding NG 9-1-1 grant program. ;7A -prove the minutes of the January 19th, 2022 meeting. Consider and take necessary action and allow Vern Lyssy to sign Lease & Rental Agreement with Anderson Machinery Company for a 2014 Bomag BW190ADO-5 roller. (VL) Consider and take necessary action on Contract Agreement with Matagorda Bay Mitigation Trust for Contract No. 024: Hog Bayou Park Improvements; contract period from March 1, 2022 until June 30, 2024; and authorize Judge Meyer to sign all 6/documentation. (GR) consider and take necessary action to allow Commissioner Behrens to sign the 2022 maintenance contract with Hurt's Wastewater Management for Precinct 3 septic system, (JB) Page 1 of 2 i"1iJ111I ()1 IVII 1.I I6 /1)tq)o . f0. Consider and take necessary action to acknowledge and accept the Resolution for �Operation Stone Garden Grant for 2021 and allow Judge Meyer to sign. (RHM) I1�. Consider and take necessary action to authorize loan in amount of $117,000 from general fund to Magnolia/Indianola Beach Pavilion's capital project fund. (RHM) 'i2. Consider and take necessary action to execute the construction contract for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 and authorize the County Judge to sign. (DH) 13 Consider and take necessary action to accept check from Calhoun County Fair Association in the amount of $1,208.63 for 1/2 damages to Precinct 1 Caterpillar Backhoe �21-0293 and deposit into account 63530. (DH) 4-4. Consider and take necessary action to accept the Continuing Education Transcript from the District Clerk. (RHM) 15. Consider and take necessary action to accept Emergency Connectivity Fund Commitment Decision Letter for the Library in the amount of $21,430. (RHM) i6. Accept Monthly Reports from the following County Offices: �� Cnty Treasurer— November 2021 i7. Consider and take necessary action on any necessary budget adjustments. (RHM) 18. Approval of bills and payroll. (RHM) Richard H. Meyer, Coun Ju ge 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 2 of 2 #5 NOTICE OF MEETING — 2/2/2022 5. Hear report from Calhoun 911 regarding NG 9-1-1 grant program. PASS Page 2 of 15 Mae Belle Cassel From: e911@calhouncotx.org (e911) <e911@calhouncotx.org> Sent: Wednesday, January 26, 2022 4:08 PM To: Mae Belle Cassel Subject: Agenda Item Attachments: 20220126.Calhoun 911 District Letter of Intent to CSEC.pdf Mae Belle, Please add this item to the next agenda. Calhoun 911 would like to give a report on NG9-1-1 Grant Program. Thank You, 2a.que1,Mcra k Raquel Morales, Executive Director Calhoun County 911 Emergency Communication District 361-552-5455 Office 361-552-9691 Fax e9ll@calhouncotx.org Calhoun County Texas CALHOUN COUNTY E9-1-1 EMERGENCY COMMUNICATIONS DISTRICT 426 West Main Street, Suite B / P.O. Box 1093 * Port Lavaca, Texas 77979 Office: (361) 552-5455 * Pax: (361) 552-9691 E-Mail: e91 II(C�.calhouncotx.ora January 28, 2022 Commission on State Emergency Communications Attention: Kelli Merriweather, Executive Director 333 Guadalupe Street, Suite 2-212 Austin, Texas 78701 RE: Letter of Intent to Participate in NG9-1-1 Fund Grant Program Dear Ms. Merriweather: Calhoun County E911 ECD (9-1-1 Entity) provides this Letter of Intent (LOI) to notify the Commission of 9-1-1 Entity's intent and ability to participate in the NG9-1-1 Fund Grant Program. 9-1-1 Entity anticipates requesting grant funds in the amount of $ 1,097,425.53 ; broken down by Cost Category as follows: Network (NG9-1-1 ESlnet) $ 198,928.00 9-1-1 Call Routing & Location $ 25,000.00 Geographic Information System (GIS) $283,170.53 Next Generation 9-1-1 Core Services (NGCS) $ 52,021.00 PSAP 9-1-1 Call Handling Systems and Applications $ 156,410.00 Security $ 26,000.00 Operations $ 295,896.00 Operational Planning $ 40,000.00 Other $ 20.000.00 By signing this LOI, the undersigned represents that he/she has the authority to officially act on behalf of the named 9-1-1 Entity. By submitting this LOI, 9-1-1 Entity attests to its ability to timely procure and timely expend awarded NG9-1-1 Fund grant funds in accordance with applicable requirements including federal and state laws and regulations and Commission requirements. Raquel Mor les—� , Executive Director Calhoun County E91 I ECD 0 4 mod o v z cG $ nn (l UI N O O p q X ry O c. N O l0 < X N V N t O m � O N IAJI � N s 3 O� N N 1+ V U1 V N V 1p� Ol lI1 N UI U1 N T O N O A Ot O T N W O O N N W O O 6 O 0 0 G G O O O O O O w O O O O O.O O O 0.0 O ol O oa c m u #6 NOTICE OF MEETING — 2/2/2022 6. Approve the minutes of the January 19th, 2022 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 15 Richard ]H . Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, January 19, 2022, at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. ichard H. Meyer, Coi64 Judge Calhoun County, Texas Anna Goodman, County Clerk 6eputy Clerk Page 1 of 1 NOTICE OF MEETING—1/19/2022 (ABSENT) Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 9 Kaddie South, Deputy Cleric NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, January 19, 2022 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. by Commissioner Gary Reese. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Gary Reese Texas Flag- Vern Lyssy 4. General Discussion of Public Matters and Public Participation. David Hall explains Commissioners' Court will continue to meet publicly. Sherriff Bobby Vickery warns the public of the ice storm that may strike the coast later this week. 5. Approve the minutes of the January 12, 2022 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Commissioner Hall, Lyssy, Behrens, Reese Page 1 of NOTICE OF MEETING — 1/19/2022 6. Proclaim January 23 — 29, 2022 as School Choice Week in Calhoun County, Texas. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to create a full-time clerk position for the Sheriff's Office. (RHM) Sherrill Bobby Vickery spoke on important key points. No action taken. B. Consider and take necessary action to increase the credit limit to $20,000 on the County Credit Card for Ron Reger, IT Coordinator. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to extend the interlocal agreement between Calhoun County and Guadalupe -Blanco River Authority for Mitigation Project Work for the County for the Green Lake Control Structure in accordance with the County's and the Matagorda Bay Mitigation Trust's Green Lake Breach Repair contract. (RHM) RESULT: APPROVED [UNANIMOUS] . MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action on the FY 2022 Interlocal Agreement with the City of Port Lavaca for Fire Protection and authorize the payment of a purchase order in the amount of $220,349.14 and authorize the County Judge to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action on the FY 2022 Interlocal Agreement with the City of Port Lavaca for Animal Control and authorize the payment of a purchase order in the amount of $65,000.00 and authorize the County Judge to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER, Joel Behrens, Commissioner Pct 3 AYES: Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 3 NOTICE OF MEETING— 1/19/2022 12. Accept Monthly Report from the following County Office: I. Sheriffs Office — December 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Commissioner Hall, Lyssy, Behrens, Reese 13. Consider and take necessary action on any necessary budget adjustments. (RHM) 2021 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens, Reese 2022 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens, Reese 14. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens Indigent Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens 2021 Bills RESULT, APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens . 2022 Bills RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Commissioner Hall, Lyssy, Behrens Adjourned 10:22 a.m. Page 3 of 3 #7 NOTICE OF MEETING — 2/2/2022 7. Consider and take necessary action and allow Vern Lyssy to sign Lease & Rental Agreement with Anderson Machinery Company for a 2014 Bomag BW190ADO-5 roller. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 15 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 January 24, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge: 9 (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda • Consider and take necessary action and allow Vern Lyssy to sign Lease &Rental Agreement with Anderson Machinery Company for a 2014 Bomag BW190ADO-5 roller. Vern Lyssy Commissioner, Pct. 2 VL/Ij NDERS rn N t MACHINERY COMP NY fy LEASE & RENTAL AGREEMENT Sales rep - 530 Lessee: Calhoun Co Pct.2 Address: 5812 FM 1090 Port Lavaca, Tx 77979 Description 2014: Bomag BW190ADO-5 roller Equipment # 4303 Serial # 101921311005 Start Date: 2-1-22 Hour Meter: 267.0 $ Equipment Value 220,000.00 Guaranteed Term: Month Purchase Order # Vern Single shift base rate per Insurance HET TERP month Subtotal 0,2022% 1,50% $ $ $ 4,050.00 Customer Provided 4,050.00 8.19 Estimated Delivery & Pickup X Lesso Lesser Charges $275 Jobsite Location Sales Tax 8.25% Port Lavaca, Tx Total due per month $ 4,058.19 Fuel : Unit will be furnished with a full tank of fuel on delivery. Lessee agrees to return the unit with a full tank or reimburse the Lessor for the cost of filling the fuel tank. Any unit that requires clef fluid will be handled the same way as fuel. Repair : Lessee agrees to pay repair cost except normal wear. Lessee also agrees to pay for high wear items like cutting edges, teeth, tires, hammer points and undercarriage (tires and undercarriage will pro -rated). Lessee agrees that the time required to complete repairs to the above described equipment after return from rental, whether necessitated by physical damage and covered by Lessee's insurance or resulting from repairs, required as a damage beyond normal wear, will be billed at 50% of the appropriate single shift base rate above and Lessee agrees to pay the charges therefor. Non -Waiver : Time is of the essence. Lessor's failure at any time to require strict performance by Lessee of any of the provisions hereof shall not waive or diminish Lessor's right thereafter to demand strict compliance therewith or with any other provision. Waiver of any default shall not waive any other default. No remedy of Lessor hereunder shall be exclusive of any other remedy herein or by law provided, but each shall be cumulative and in addition to every other remedy. Send all payments to: 6309 US Hwy 59 N • Victoria - TX - 77906 All conditions on this contract and attached "Terms and Conditions" are accepted by: Anderson Machine o »'any Lessee: alhoun' Pct.2 Cj N m ame Title: is Date: al/%a� Title: Commissioner Date' 02/02/2022 (Not valid unless signed by an officer of Anderson Machinery Company) CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1 -4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2022-842693 Anderson Machinery Company Victoria, TX United States Date Filed: 01/24/2022 2 Name of governmental entity or state agency that Is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: g 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. 1234 Rental Equipment 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Anderson, Machinery Victoria, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is SQL tl• 11�.q and my date is _ T -off�birth II My address is,_ y6: L, (street) I (city) (stale) (zip code) (country) I declare under penalty perjury that the foregoing is true and correct. /af Executed in V i 4ADr`. 4. County, State of on the day of 21 o _, (month) 1 (year) C✓.1 Signature o t orized agent of nlr tin usiness entity, (Declarant) Forms provided by Texas Ethics Commission www.eth(cs.state.tx.0 Version V1.1.191b5cdc NOTICE OF MEETING — 2/2/2022 8. Consider and take necessary action on Contract Agreement with Matagorda Bay Mitigation Trust for Contract No. 024: Hog Bayou Park Improvements; contract period from March 1, 2022 until June 30, 2024; and authorize Judge Meyer to sign all documentation. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 15 Gary D. Reese County Commissioner County of Calhoun Precinct 4 January 24, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for February 2, 2022. • Consider and take necessary action on Contract Agreement with Matagorda Bay Mitigation Trust for Contract No. 024: Hog Bayou Park Improvements; contract period from March 1, 2022 until June 30, 2024; and authorize judge Meyer to sign all documentation. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift Texas 77983 — email: gam.reese rr calhouncoix org — (361) 785-3141 — Fax (361) 785-5602 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 6If there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2022•841815 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Matagorda Bay Mitigation Trust Path, TX United States Date Filed: 01f201202z 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County iDateAcknoutledged: 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. Hog Bayou Park Improvements Funding for construction of improvement to Hog Bayou Park in Calhoun County 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Wood Boykin & Wolter Corpus Christi, TX United States X Aguirre, Robert Pipe Creek, TX United States X Raabe, Steven Path, TX United States X 6 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is Steven L Reabe , and my date of birth is - My address is USA (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Wilson Texas J County, State of , on the 20lhday ofanus ry , 20 22 (month) (year) Signature of authorized agent of contracting business entity (Declaranq Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc MATAGORDA BAY MITIGATION TRUST CONTRACT COVER/SIGNATURE PAGE TITLE OF CONTRACT No. 024: 1-log Bayou Park Improvements This Contract is entered into by the Matagorda Bay Mitigation "Trust (herein referred to as "the Trust") and the following named Recipient: THE TRUST: RECIPIENT: Matagorda Bay Mitigation Trust Calhoun County P. O. Box 1269 211 S. Ann Street Poth, Texas 78147-] 269 Port Lavaca, Texas 77979 Email: Trustee@mbmtrusLcom EMAIL: richard.meyerC(i,calhomneotx.or" Contact Person: Steven J. Raabe, Trustee garv.reese a,calhouncotx.ore Contact Person: Judge Richard Meyer and Commissioner Gary Reese The Recipient ("Recipient") agrees to provide Mitigation Project Work and Services ("Mitigation Project") in compliance with this Contract ("Contract") and all applicable federal and state laws, regulations, and rules. In accordance with the General Terms & Conditions, it is understood and agreed by both parties hereto that the Trust's obligations under this Contract are contingent upon Recipient's compliance with this Contract and federal and state law regulations and rules. This Contract, which constitutes promised performances by the Recipient, consists of the following documents: Contract (Cover Sheet/Signature Page) General Terms and Conditions Statement of Mitigation Project (Attachment A) Budget (Attachment B) Invoice Format (Attachment C) The Recipient hereby acknowledges that it has read and understands this entire Contract. All oral or written agreements between the parties hereto relating to the subject matter of this Contract that were made prior to the execution of this Contract have been reduced to writing and are contained herein. The Recipient agrees to abide by all terms and conditions specified herein and certifies that the information provided to the Trust is true and correct in all respects to the best of its knowledge and belief. CONTRACT PERIOD: FROM: March 1, 2022 UNTIL: June 30, 2024 FUNDING: This Contract may not exceed $141,000.00 ("funds"). APPROVED: MATAGORDA BAY MITIGATION TRUST BY /r 1 .-- NAME: Steven_ J. Raabe TITLE: Trustee DATE: January 20, 2022 0 BY: ,TEXAS TITLE: Calhoun County Judge DATE: .Z - 2-- 1 GENERAL TERMS AND CONDITIONS I. PARTIES A. Trustee of the Matagorda Bay Mitigation Trust herein referred to as "Trustee" or "Trust" as applicable and "Recipient," have made and entered into this Contract herein referred to as "Contract." B. Recipient represents and guarantees that it possesses the legal authority to enter into this Contract, receive the funds authorized by this Contract, and to perform the work and services described on Attachment "A" comprising the Mitigation Project ("Mitigation Project"). The Recipient has obligated itself to perform under this Contract, including subsequent contract amendments or modifications. As may be applicable to Recipient, the Recipient shall comply with appropriate federal and state licensing or certification requirements. C. The persons signing this Contract on behalf of the parties hereto warrant that they are the duly authorized representatives authorized to execute this Contract and to validly bind their respective parties to all terms, conditions, performances and provisions herein set forth. II. PURPOSE This Contract sets forth the terms and conditions upon which the Trust agrees to provide funds ("funds") to the Recipient to perform the Mitigation Project. III. RECIPIENT AS INDEPENDENT CONTRACTOR A. It is understood and agreed by both parties that the Trust is contracting with Recipient as an independent contractor and that Recipient is and shall be liable to its own employees and is responsible for its own risk of loss. B. The Recipient agrees to repay the Trust for all disallowed cost or other claims which may be declared by the Trustee occurring in connection with the Mitigation Project to be performed or administered by the Recipient under this Contract. C. Employees of Recipient are not employees or agents of the Trust. Employees of Recipient are subject to the exclusive control and supervision of Recipient and Recipient is solely responsible for employee payroll and claims arising therefrom. IV. FUNDS A. Funds and Payment Disbursements 1. Trust agrees to pay Recipient in accordance with the approved budget structure set forth in Attachment B and other provisions of this Contract and such payment shall not exceed the amount specified in the Contract Cover/Signature Page. 2. Recipient agrees that it shall not utilize funds for administration or overhead expenses in an amount that exceeds fifteen percent (15%) of the approved budgeted project salaries of Recipient. Recipient shall ensure salary amounts charged to the project are reasonable and solely for the project(s) identified. 3. Funds will be disbursed to Recipient as follows: a. Mitigation Project Work Plan. The work plan for the execution of the Mitigation Project is described in Attachment A and includes the following: i. Details regarding the specific work and services to be performed; ii. A schedule of estimated time to perform each stage of the Mitigation Project; iii. A budget to perform the Mitigation Project as shown in Attachment B; and iv. Such other information requested by Trustee. b. Invoicing. Upon completion of each stage of the Mitigation Project or as otherwise agreed, the Recipient shall electronically submit an invoice to the Trust with details about the work and services performed, the date(s) performed and a list of all expenditures in the format shown on Attachment C and such other information requested by the Trust. Trustee may approve payment of the invoice or upon review request additional information the Trustee deems necessary for clarification or other purposes prior to payment. Trustee may withhold payment until satisfied that the invoice represents accurately the contents therein. Prior to, during, or subsequent to approval of payment of invoices to Recipient, the Trustee shall have the right to conduct an audit or investigation regarding such invoices or other information provided by Recipient. c. Progress Reports. Recipient shall provide Trust with a progress report with each invoice detailing the Mitigation Project activities performed to date together with a list of all expenditures with supporting documentation such as paid invoices, copies of subcontracts, reports maintained internally by Recipient, such reports to include information regarding potential issues that affect the Mitigation Project and reports submitted to Recipient's governing body and such other information requested by Trustee. 3 d. Final Report. Recipient shall provide Trust with a final report detailing the Mitigation Project as completed which shall include copies of all reports maintained internally by Recipient, such reports to include information regarding the resolution of issues that affected the Mitigation Project and reports submitted to Recipient's governing body reflecting the completion of the Mitigation Project and such other information requested by Trustee. e. Additional Reports. Recipient agrees to provide follow-up information and documentation to any report submitted to Trust as Trustee deems reasonable and necessary and such other information requested by Trustee from time to time. 4. Recipient agrees to return, refund, or repay to Trust any sum which Trustee determines represents an overpayment to Recipient or represents funds not used in accordance with the terms of this Contract. Trustee's determination of overpayment or funds not used in accordance with the terms of this Contract shall constitute an event of potential default more fully described in Section XIV hereinafter. 5. Trustee may withhold funds to Recipient if Trustee determines that Recipient has not complied with the terms of this Contract. Trustee's determination to withhold funds due to Recipient's failure to comply with the terms of the Contract shall constitute an event of potential default more fully described in Section XIV hereinafter. 6. Recipient agrees that it will not receive duplicate funds from another source for any of the items included in the budget set forth in Attachment B. 7. Following Trustee's approval of the Final Report, any portion of the funds not expended or obligated in accordance with this Contract shall be returned to the Trust by Recipient. 8. This Contract shall not be construed as creating any future financial obligation or debt of or on behalf of Trust. It is understood and agreed that funds may be provided to Recipient only from funds allocated for this Mitigation Project which shall be distributed subject to compliance with this Contract and upon such timing as deemed reasonable by the Trustee. V. RECORDS MANAGEMENT A. Recipient shall maintain all books, records, documents, papers, and other evidence related to Mitigation Project implementation, including financial records, reports maintained internally by Recipient and reports submitted to Recipient's governing body, and Mitigation Project performance information, in accordance with generally accepted business and accounting practices, consistently applied. Recipient shall also maintain the financial data used in the preparation of support for any cost (direct and indirect) information or analysis for the Contract or for any negotiated subcontract. Recipient shall also maintain a copy of any negotiated subcontract. Recipient shall also maintain a copy of any cost information or analysis submitted to Trustee. Recipient agrees to the disclosure and access of Trustee, or any authorized representative of Trustee to all such books, records, documents, papers, and other evidence for the purposes of review, inspection, audit, excerpts, transcriptions and copying during normal business hours. B. Recipient understands that acceptance of funds under this Contract acts as acceptance of the authority of the Trustee or his authorized representative, to conduct an audit or investigation in connection with those funds. Recipient further agrees to fully cooperate with the Trustee, or his authorized representative in the conduct of the audit or investigation, including providing all records requested. Recipient shall ensure that this clause concerning the audit of funds accepted under this Contract is included in any subcontract it awards. C. Recipient shall maintain such records and be subject to these audit requirements during the performance under this Contract for a period of five years after Trustee provides written approval of the Final Report. However, if Recipient is aware of any litigation, claim, negotiation, audit, cost recovery or other action, including actions concerning costs of items to which an audit exception has been taken, relating to the Mitigation Project that started before the expiration of the five-year record retention period, Recipient shall maintain all records and be subject to such audit requirements until completion of the action or resolution of all issues which arise from any litigation, claim, negotiation, audit, cost recovery or other action, or until the end of the five-year record retention period, whichever is later. The Trustee will have access to records at any reasonable time for as long as the records are maintained by Recipient. Recipient agrees to transfer records in its custody to Trustee upon his request. This paragraph survives termination of this Contract. D. Failure to comply with all records management and reporting requirements of this Contract shall constitute an event of potential default more fully described in Section XIV hereinafter. VI. FINANCIAL MANAGEMENT Recipient shall have a financial management or accounting system which accounts for costs in accordance with generally accepted accounting standards and principles. Recipient shall allow Trustee's review of the adequacy of the financial management system. Failure to maintain the financial accounting requirements shall constitute an event of potential default more fully described in Section XIV hereinafter. The accounting requirements shall include: A. Provide for the identification of costs in accordance with the approved project budget (Attachment B) and segregation of Mitigation Project costs between the budget categories; VII. B. Maintain records which adequately identify the source and application of funds provided under this Contract. Such records must contain information pertaining to awards and authorizations, obligations, unobligated balances, assets, liabilities, outlays or expenditures, and income; C. Provide internal control by maintaining effective control and accountability for all cash, real and personal property and other assets paid for under this Contract. All such property acquired with Project funds must be adequately safeguarded and used solely for authorized purposes; D. Provide budget control by comparing outlays and expenditures with budgeted amounts for the funds provided by the Trust both by category and by task as shown in Attachment C; E. Support accounting records with source documentation, including cancelled checks, paid invoices, payrolls, time and attendance records, and subcontract documents; F. Permit the tracing of funds to a level of expenditures adequate to establish that such funds have not been used in violation of this Contract or applicable statutes; and G. Permit preparation of reports required by this Contract or requested by Trustee. A. Recipient may subcontract all or any portion of the Mitigation Project for purposes of this Contract. B. Recipient shall be responsible for all acts and omissions of all subcontractors performing or furnishing any portion of the Mitigation Project under a direct or indirect contract with Recipient to the extent provided under applicable laws and regulations. Nothing in this Contract shall create for the benefit of any such subcontractor any contractual relationship between Trust and any such subcontractor, nor shall it create any obligation on the part of Trust to pay or to see to the payment of any money due to any such subcontractor. C. Recipient shall be solely responsible for scheduling and coordinating the work of subcontractors performing or furnishing any portion of the Project under a direct or indirect contract with Recipient. Recipient shall require all subcontractors performing or furnishing any portion of the Project who desire to communicate with Trustee to communicate through Recipient with Trustee. D. All work performed for Recipient by a subcontractor shall be pursuant to an appropriate written contract between Recipient and the subcontractor which is not inconsistent with the terms and conditions of this Contract. Each subcontractor shall be provided a copy of this Contract prior to initiating any portion of the Project. VIII. PUBLICATIONS. NEWS RELEASES, AND OTHER PUBLIC ANNOUNCEMENTS All public reports, news releases, other publicity, and other materials prepared for publication pursuant to or as a result of this Contract shall acknowledge the Matagorda Bay Mitigation Trust as the funding source. Public reports or other publications, news releases, and other publicity issued by Recipient about the Mitigation Project shall be provided to Trustee. IX. RIGHTS IN DATA AND OTHER MATERIALS A. Recipient and the Trust agree that any data collected as a result of this Contract shall be jointly owned by Recipient and the Trust. Recipient and Trust agree that each shall have complete and unlimited access and use to all data collected as a result of this Contract. Further, at the termination of the Trust, or at such other time deemed appropriate by Trustee, the Trustee has the right, but not the obligation to transfer any interest in the data to Recipient. B. Recipient shall act to ensure all subcontractors used for this Mitigation Project are advised of the rights in data and other materials described herein and that the subcontractors are prohibited from asserting any rights at common law or in equity or otherwise seeking to establish any claim to statutory copyright in any data, material or information developed under this Contract. C. Recipient and the Trust agree that in addition to the joint ownership by Recipient and the Trust of any data collected as a result of this Contract, that in the event any invention or intellectual property is created as a result of this Contract in which the Recipient retains title, Trust shall have a non-exclusive, nontransferable, irrevocable, paid -up license to practice or have practiced the subject invention throughout the world. Materials developed as a result of this Contract will be made available to the Trustee in written and electronic formats upon request under the non-exclusive, nontransferable, irrevocable, paid -up license. D. The Recipient has the responsibility to obtain from its subcontractors all data and rights therein necessary to fulfill the Recipient's obligations to the Trust under this Contract. If a subcontractor refuses to accept terms affording the Trust's such rights, the Recipient shall promptly bring such refusal to the attention of the Trustee. E. Recipient shall place a section in all subcontractor contracts that complies with Section IX. X. AGREEMENT TO HOLD HARMLESS AND INDEMNIFICATION A. TO THE EXTENT PERMITTED BY APPLICABLE LAW, RECIPIENT AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE TRUST, TRUSTEE AND AGENTS, EMPLOYEES, CONSULTANTS, ACCOUNTANTS, ATTORNEYS AND OTHER PROFESSIONALS AND REPRESENTATIVES ENGAGED OR EMPLOYED BY THE TRUST TO THE FULL EXTENT PERMITTED UNDER FEDERAL AND STATE LAW FROM AND AGAINST ANY AND ALL CLAIMS, DEMANDS, AND CAUSES OF ACTION TO THE EXTENT ARISING FROM THE MISCONDUCT, NEGLIGENCE, OMISSIONS, OR RECKLESS ACTS OF RECIPIENT OR ITS EMPLOYEES, OFFICERS, OFFICIALS OR AGENTS OR ITS SUBCONTRACTORS IN CONNECTION WITH THE PERFORMANCE OF SERVICES OR WORK BY RECIPIENT UNDER THIS CONTRACT. THE PROVISIONS OF THIS PARAGRAPH SHALL SURVIVE TERMINATION OF THIS CONTRACT. B. TO THE EXTENT PERMITTED BY APPLICABLE LAW, THE RECIPIENT AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE TRUST, TRUSTEE AND AGENTS, EMPLOYEES, CONSULTANTS, ACCOUNTANTS, ATTORNEYS AND OTHER PROFESSIONALS AND REPRESENTATIVES ENGAGED OR EMPLOYED BY THE TRUST TO THE FULL EXTENT PERMITTED UNDER FEDERAL AND STATE LAW FROM ANY AND ALL CLAIMS AND LOSSES ACCRUING OR RESULTING TO RECIPIENT AND TO ANY AND ALL SUBCONTRACTS, MATERIALS, PERSONS, LABORERS AND AN OTHER PERSONS, FIRMS OR CORPORATION, FURNISHING OR SUPPLYING WORK, SERVICES, MATERIALS, OR SUPPLIES IN CONNECTION WITH THE PERFORMANCE OF THIS CONTRACT. XI. CONFLICT OF INTEREST A. Recipient shall maintain an internal policy regarding conflicts of interest and shall adhere to said policy with respect to any potential or actual organizational or personal conflict of interest between Recipient and its employees or any subcontractor with respect to this Contract. Further, such internal policy shall include a prohibition that funds received by Recipient from the Trust shall not be used to pay, reimburse or otherwise give in any manner or for any purpose to the Plaintiffs and Defendants in Cause No. 6-17-CV-00047, In San Antonio Bay Estuarine Waterkeeper and S. Diane Wilson vs. Formosa Plastics Corp., Texas, and Formosa Plastics, Corp., U.S.A., in the United States District Court for the Southern District of Texas, Victoria Division. B. Recipient shall notify Trustee regarding any potential or actual organization or personal conflict of interest involving Recipient's employees or subcontractors and shall keep the Trustee informed regarding any actions taken or decisions made in connection with such employee or subcontractor. In the event that the organizational or personal conflicts of interest does not become known until after performance on the Contract begins, Recipient shall notify Trustee of the conflict and any action taken as soon as Recipient becomes aware of the conflict. C. Trustee has sole discretion to make the final determination as to whether an organizational or personal conflict of interest exits, and if the conflict of interest requires action beyond the action taken by Recipient, whatever action that may be. Trustee may request. Recipient to terminate any subcontractor in whole or in part, if Trustee deems such termination necessary to avoid an organizational or personal conflict of interest. D. If Recipient was aware of an actual organizational or personal conflict of interest prior to award or discovered an actual conflict afterward and did not disclose it or misrepresented relevant information to Trust, Trustee, at his sole discretion, may terminate this Contract for default or pursue such other remedies as may be permitted by law or this Contract. E. Recipient shall place a section in all subcontractor contracts that complies with Section XI. XH. VENUE Recipient acknowledges and agrees that this Contract is being performed in Calhoun County, Texas. Recipient agrees that any permissible cause of action involving this Contract arises solely in Calhoun County. This Contract constitutes the entire and full agreement between the Recipient and the Trust, and all previous oral or written agreements relating to the subject matter of this Contract between the Trust and Recipient have been superseded, reduced to written.form, and are incorporated herein. E7 Recipient and Trust expressly agree and understand that all future, oral agreements, representations or modifications shall not have any legal binding effect unless and until reduced to writing and executed by both Recipient and Trustee, except for amendments by operation of law as provided in Section XVII in this Contract. XIV. DEFAULT AND REMEDIES A. Recipient shall be considered in default under this Contract if any one or more of the following events occur, provided that Recipient has received written notice of such potential default from Trustee and has failed to cure the potential default within thirty days from the date of said notice. If Recipient has begun a good faith effort to cure the potential default within the thirty -day period, Recipient may be allowed additional time, if deemed reasonable by Trustee in his sole discretion, as needed to cure the potential default. B. Event of Potential Default. Trustee will, in his sole discretion, determine if an Event of Potential Default exists. Each of the following shall constitute an Event of Potential Default under this Contract: If Recipient makes an assignment for the benefit of creditors or takes any similar action for the protection or benefit of creditors. 2. If at any time Recipient knowingly, negligently, or intentionally makes any representation to Trustee which is incorrect in any material respect. 3. If Recipient knowingly, negligently, or intentionally submits any request for payment to Trust which is incorrect in any material respect. 4. If Recipient knowingly, negligently, or intentionally submits any report or certification to Trust related to the Mitigation Project which is incorrect in any material respect. 5. If Recipient utilizes funds which Trustee determines represents an overpayment to Recipient or represents funds not used in strict accordance with the terms of this Contract. 6. If Recipient fails to perform the Mitigation Project described on Attachment A in any material aspect. 7. If Recipient fails to comply with the reporting and invoicing requirements under this Contract. 8. If Recipient fails to maintain the records management requirements under this Contract. 9. If Recipient fails to maintain the financial accounting requirements under this Contract. 10 10. If Recipient fails to maintain the insurance requirements under this Contract. 11. If Recipient fails to comply with any term or provision contained in this Contract. C. Remedies. Upon the occurrence of any such Event of Potential Default and failure of Recipient to cure such potential default as provided above, Trustee may declare Recipient in default in writing and may, as Trustee determines appropriate, withhold payments to Recipient or require Recipient to return, refund or repay any payments received prior or subsequent to the event of default. In addition, Trustee may terminate this Contract and avail himself of any appropriate legal remedies, including recovery of attorney's fees and expenses incurred in enforcing any such legal remedies, if so awarded by a court of competent jurisdiction. D. No Waiver. A waiver of any Event of Potential Default shall not be considered a waiver of any other or subsequent Event of Potential Default, and any delay or omission in the exercise or enforcement of the rights and powers of Trust shall not be construed as a waiver of any rights or powers. XV. USE OF FUNDS AND LIMITATIONS ON EXPENDITURES Funds distributed or allocated to Recipient under this Contract, or any modification thereto, shall not be used to support other programs operated by the Recipient under a different contract. Nor can such funds be carried over to a new contract or amended contract without the written permission of the Trustee. XVI. LIMITATION ON LUBILITY The Recipient understands and agrees that the Trust shall not be liable for expenditures made in violation of terms of this Contract, any laws, regulations, rules, or policies, or any other laws or regulations applicable to the Mitigation Project performed under this Contract. The Recipient also agrees that the Trust shall not be liable for any cost incurred by Recipient which exceeds the funding amount provided hereinabove. The Recipient shall be liable for such funds and shall repay such funds even if the improper expenditure, if any, was made by a subcontractor of the Recipient. XVII. AMENDMENTS BY OPERATION OF LAW Any alterations, additions, or deletions to the terms of this Contract which are required by changes in Federal law, State law, by regulations, are automatically incorporated into this Contract as if set forth fully, without written amendment hereto, and shall become effective on the effective date designated by such law, regulation, or policy. 11 XVIII. COMPLIANCE WITH LAW. Recipient covenants and agrees to comply with all applicable Federal, State and local laws, and all applicable Federal and State regulations. Recipient shall also be responsible to ensure that its' subcontractors shall comply with applicable Federal, State and local laws, and all applicable Federal and State regulations. XIX.PATENT INDEMNITY The Recipient shall include a provision in all of its contracts with contractors and subcontractors that the contractor and subcontractor will indemnify the Trustee, the Trust and its consultants, agents, attorneys, and employees against liability, including costs, for infringement of any United States patent (except a patent issued upon an application that is now or may hereafter be withheld from issue pursuant to a Secrecy Order under 35 U.S.C. §181) arising out of the manufacture or delivery of supplies, the performance of services, or the construction, alteration, modification, or repair of real property under this Contract, or out of the use or disposal by or for the account of the Trust of such supplies or construction work. XX. DISCLOSURE OF INTEREST Recipient represents and warrants that the Trustee, the Trust or its' consultants, agents or attorneys have no ownership or beneficial interest of any kind in Recipient or Recipient's subcontractors. Further, Recipient shall ensure subcontractor's compliance with Section XX. XXI. SEVERABILITY If for any reason any section, paragraph, subdivision, clause, phrase, word or provision of this Contract shall be held invalid or unconstitutional by final judgment of a court of competent jurisdiction, it shall not affect any other section, paragraph, subdivision, clause, phrase, word or provision of this Contract for it is the definite intent of the parties that every section, paragraph, subdivision, clause, phrase, word or provision hereof be given full force and effect for its purpose, so long as the invalidated matter does not substantially deprive a party of the benefit of this Contract. XXII. INSURANCE Recipient shall maintain during the term of this Contract and shall provide Trustee with proof of insurance in amounts sufficient to cover the Recipient's liability subject to applicable constitutional and statutory limitations of liability. 12 1. The Trust shall not be responsible for the payment of premiums or assessments on such policies. 2. Proof of insurance showing such coverages as required herein shall be submitted to Trustee within 20 days of contract execution. 3. In the event any insurance policy as specified herein is cancelled or in the event Recipient fails to maintain the minimum insurance limits as specified herein or in the event recipient fails to provide certificates of insurance, such event shall constitute an event of potential default more fully described in Section XIV hereinabove. XXIII. ASSIGNMENT This Contract shall be binding on and inure to the benefit of the Trust and Recipient and their respective successors and permitted assigns. This Contract may not be assigned by Recipient without the prior written consent of the Trustee. XXIV. NOTICES/COMMUNICATIONS All notices, communications, and requests given to or made upon the Trust and Recipient hereto shall, except as otherwise specified herein, be in writing and shall be delivered or mailed to such party at the notice addresses specified on the Contract Cover/Signature Page. The Trust and Recipient may change their notice addresses but shall provide immediate notice to the other and shall provide such notice in writing to the other party. XXV. DISPUTES In the event a Recipient has a dispute with the Trust or in the event any Recipient seeks to file a claim or lawsuit, the Recipient's sole recourse shall be by informal dispute resolution between the Recipient and the Trust and if such informal dispute resolution is not resolved, then the Recipient may seek the alternative dispute resolution as provided herein. The alternative dispute resolution process shall consist of a Mediated Settlement Conference in Calhoun County, to be conducted with the Recipient and the Trust and their legal counsel. The mediator shall be selected by agreement of the Recipient and the Trustee. Should the parties fail to agree on a mediator, an attorney mediator shall be selected by the Director of Calhoun County Dispute Resolution Services. The decision made by a Mediator shall be binding on the Recipient and the Trust, and there shall be no further appeal but the decision shall be enforced, if necessary, by the District Court of Calhoun County. The Recipient agrees to submit to such binding alternative dispute resolution as provided herein. Further, Recipient's sole remedy under the informal dispute resolution and under the binding alternative dispute resolution shall be limited to all, none or part of the remaining balance, if any, of Funds allocated to it under the terms of this Contract with the Trust; however, the Trust may recoup any Funds distributed to the Recipient through the same alternative dispute resolution procedure described herein. Any remedy under the mediation shall be sole province of the Mediator unless the Recipient and Trustee agree otherwise. In no event shall a Recipient be entitled to any other remedy; including, but not 13 limited to, actual damages, compensatory damages, punitive damages, exemplary damages, interest, costs of court, actual expenses and attorneys' fees. These procedures shall be binding on Recipients notwithstanding any conflict with any law or regulation. XXVI. PERIOD OF CONTRACT This Contract will remain in effect until the termination of the CONTRACT PERIOD as defined above, unless extended, modified, or terminated by written agreement of the Parties or terminated as provided herein with the exception of the five-year records retention provision in Section V. This provision shall survive termination of this Contract. END OF TERMS AND CONDITIONS 14 Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT A STATEMENT OF MITIGATION PROJECT* Calhoun County, Texas ("Recipient") 211 S. Ann Street Port Lavaca, Texas 77979 1. Execute contract with MBMT— March 1, 2022 2. Issue request for bids for bulkhead work - Sept 1, 2022 3. Execute contract with bulkhead contractor - Dec 31, 2022 4. Remove dilapidated bulkhead and install new bulkhead accessible shoreline bank - September 30, 2023. S. Backfill behind the new bulkhead -September 30, 2023 6. Grade and re -gravel the vehicle area - December 31, 2023 7. Add trash cans at 3 additional locations - March 31, 2024 8. Add signage identifying the County Park and listing park rules —June 30, 2024 9. Add game cameras in 3 locations -June 30, 2024 10. Provide close-out paperwork to MBMT—July 31, 2024 15 Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT B BUDGET Calhoun County ("Recipient") 211 S. Ann Street Port Lavaca, Texas 77979 Contract Budget Direct Salaries $ 0.00 Taxes and Benefits 0.00 Administrative Overhead 0.00 Construction 141,000.00 Consultants/Contractual 0.00 Supplies/Materials 0.00 Total Contract Budget $141,000.00 Budget Justification TASK AND EXPENSE BUDGET Tasks Unit Per unit _C= MBA County Cask I Execute contract with MBMT I $ - $ _ $ $ - rask 2 Request for Bids for bulkhead 1 $ _ $ _ $ _ $ _ Cask 3 Execute contract with bulkhead contra I $ - S - $ - $ - rask 4 Remove old bulkhead 70 ft $ 100 $ 7,000 $ 7,000 $ - Install new bulkhead 300 ft $ 400 $ 120,000 $120,000 $ - rask 5 Backfill behind new bulkhead 300 ft $ 17 S 5,000 S 5,000 $ - Grade and re -gravel vehicle area-- rask 6 materials 300 tons $ 30 S 9,000 $ 9,000 $ - Labor and use of county equipment 1 $ 3,000 $ 3,000 $ - $ 3,000 Cask 7 Add trash cans 3 $ 500 $ 1,500 $ - $ 1,500 Cask 8 Add signage 3 $ 500 $ 1,500 $ - $ 1.500 cask 9 Add game cameras 3 $ 1,000 $ 3,000 $ 3,000 Cask 10 Provide close-out paperwork to MBM' 1 $ - $ $ $ $ 150.000 $141.000 S 9,000 16 RECIPIENT WILL SUBMIT INVOICES TO TRUST (mark appropriate option): GT X Monthly Quarterly 17 Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT C INVOICING INSTRUCTIONS Below are the instructions on how to complete and submit your invoice. All invoices must be submitted electronically. You do not need to submit a hard copy unless specifically requested to do so. Invoices that don't balance or that lack proper supporting documentation will be delayed, so please ensure that your invoice is in order prior to submission. The Recipient's Contract includes the budget and invoice form (Attachment Q. The Contract's budget is tracked in two ways: Budget by Contract Category and Budget by Task. Each invoice submitted for payment must track the project costs in compliance with the Recipient's Contract as outlined in Attachment C. Each field at the top and bottom of the Invoice form must be completed and the invoice must be signed and dated by the person authorize to certify that the invoice is true, correct and complete and in accordance with the Contract. Each invoice should have the amounts being billed for the current billing period ("This Invoice" columns) and the accumulated amount billed for this Contract to -date, including the current billing period ("Contract To -Date" columns). Please take special note that the two budgets — Budget by Contract Category and Budget by Task — must always equal. Supporting documentation must be attached to the invoice for each line item being billed in the sequence such items appear in the Budget by Contract Category section. Each supporting document must be clearly labeled and in the proper budget sequence in order allow our audit of the invoice and its approval for payment. Failure to properly label or sequence the supporting documentation will cause a rejection of the invoice, so this is very important. All invoices are to be submitted electronically (email) to: Trustee@mbmTrust.com. If a Recipient has any questions whatsoever about invoicing procedures, please feel free to contact the Trust office at 361-200-1456 or write to Administrator@mbmTrust.com. Effective Date: June 1, 2020 18 C O V_ CL vi a. u 'o m � o m E H � Q � Q E C U v E O O> +L C v E N > O O. ? E C Y 3 O n 0 U � O 0 O t CO O ti to `r u x � z° E E m z C v N o ' u m C o E a u m N c cr v m C v a � Y j V C C = U u a Z } 0 0 0 0 c.00 0 � � I V � m " Y a C I u h Y F m F W u C > a+ ~ C7 c a - ca m Y YI jp y ~ C 0 FO- Y C O V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0a o 00 0 on 0 0 H m CD r N in u N m Y m � O Y a GO w O u�- F a U F- u u L � Z > ~ C 0 - m o l7 a m — o 13 o m c c w t u v ° m c m (UO > C 7 -�Y W y O ` V n N > Y a ¢ u° r- S U C v v v s n m � � c m o x F m u �O > C m U J u 0 c o c a o N � N C � O C C cu Q v a V)u � u N C O H U C O v ° E a } u °' m 0 O E E c Z FLm m v w V #9 NOTICE OF MEETING — 2/2/2022 9. Consider and take necessary action to allow Commissioner Behrens to sign the 2022 maintenance contract with Hurt's Wastewater Management for Precinct 3 septic system. (JB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 15 Joel Behrens Calhoun County Commissioner, Precinct 3 24627State Hwy. 172—Olivia, Fort Lavaca, Texas 77979 —Office (361) 893-5346 —Fax (361) 893-5309 Email: ioel.behrens@calhouncotx.org Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for February 2, 2022. Please Consider and Take Necessary Action to allow Commissioner Behrens to sign the 2022 maintenance contract with Hurt's Wastewater Management for Precinct 3 septic system. Sincerely, � ( artn � a %�v`, Joel Behrens Commissioner Pct. 3 Hurts Wastewater Management, Ltd. P.O. Box 662 / 321 Hwy 172 Ganado, TX 77962 Date: 1/13/2022 To: Calhoun County PCT. 3 24627 St. Hwy 172 Port Lavaca, TX 77979 Phone: (800) 841-3447 Fax: (361) 771-3452 www.hurtsN eetewater.com Phone: Subdivision: Site: 24627 St. Hwy 172, Pon Lavaca. TX 77979 County: Calhoun Installer. Colin Marshall Agency: Victoria County Health Dept. - Environmental Wgf--mnd:-No:weco 960-500 SVP-900345KV Contract Period Start Date: 2/12/2022 End Date: 2/12/2023 Warranty Expired: 6/4=10 Permit -1: 2008-173 No Email on File _ ID: 2632 installed: 614=01i 3 visits peryear- one every4 months Hurrs Wastewater Management Ltd. Terms of Maintenance Contract 1.) Three (3) inspections per year (at least one every 4 Months). Inspections include adjustme t and servicing of the mechanical• electrical and other applicable components to ensure proper function. This includes inspecting the control panel, aerators and filters. ReplacemenUrepair costs will be charged direly to the homeowner. A Hurts Wastewater Management Ltd. employee will visit the site within 48 hours of a problem being reported. Inspections may be performed anytime during the momh they are due, with a two week grace period before and after' he month the inspections are due. 2.) The homeowner is responsible for maintaining a chlorine residual of st least 1.0 mg/L in the treatment system. This can be accomplished by using chlorine (calcium hypochlorite) tablets for systems designed with a tablet chlorinator. Swimming pool tablets must, not be used in the aerobic system designed for chlorine tablets because they cause corrosion of the components of the system. At the time of a service inspection, the service representative will inform the homeowner if the chlorinator does not contain sufficient tablets or liquid chlorine (whichever is applicable) to effectively disinfect the wastewater. 3.) The required routine reporting of system operation and function to the local authority, as required by OSSF regulation. will be covered by the policy. Any additional visits• inspections or sample oolleQions required by specific County Agencies, TCEQ or any other regulatory agency in your jurisdiction will not be covered by the policy. 4.) The cont may be voided if NON -BIODEGRADABLE MATERIALS are used inthe system. '.) All Commercial systems will have a BOO and TSS test performed annually. Additional charges will he charged to owner for 800 and TSS testing. Tms warranty is strictly limited to the above terms and does not include the cost of replacement components• chlorine or pumping or sludge build-up. The maintenancepolicy includes labor charges only for normal routine inspections and maintenance. Additional .service calls are riot covered by the policy. Service detemired to be caused by abuse or neglectis not covered by the policy. Failure to pay for service call, labor, and/or replacement components not covered under warranty will void contract. VtOLATiONS include shutting off the electric current to the system for more than 24 hours, disconnecting the alarm system• restricting ventilation to the aerator, overloading the system above its rated capacity. introducing excessive amounts of harmful matter into the system, or any otherform of unusuaiabuse. -'-'- -- " The homeowner agrees to provide Hurt's Wastewater Management Ltd. with all gate combinations, keys, eta necessarytogain access to the system for the purpose of conducting routine inspections or service calls priorto the start date of this contract and notify Hurr s Wastewater Management Immediately with any changes and provide the new combinations or keys. By signing this form, both rnaimtenance provider and homeowner agree to the terms ofthis policy. THIS POLICY DOES NOT INCLUDE PUMPING SLUDGE FROM UNIT IF NECESSARY. Please check your contract preference: 5300.00 Service contract only; no chlorine (homeowner must install own chorine) r Home Owner. M Date: Hun's Wastewater Management Ltd.: fn` Date• il¢`I?1 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft 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. 2022-M269 Hutt's Wastewater Management,. LTD Ganado, TX United States Date Filed: 01/25/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, Texas Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2008-173 Septic System Maintenance 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 n My name is jam' 1'CT.(L/-t5K , and my date of birth is My address is , (street) (City) (state) (ZIP cede) .(country) I declare under penalty of perjury that the foregoing is true and correct Executed in J A G(2So,J County, State or %�-X/a'S , on the �YdayOf-JA-L� , 20 Z=. (mon (year) re of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc #10 NOTICE OF MEETING — 2/2/2022 10. Consider and take necessary action to acknowledge and accept the Resolution for Operation Stone Garden Grant for 2021 and allow Judge Meyer to sign. (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 7 of 15 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: RESOLUTION FOR OPERATION STONE GARDEN GRANT 2021 DATE: FEBRUARY 2, 2022 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR FEBRUARY 2, 2022 * To acknowledge and accept the Resolution for Operation Stone Garden Grant for 2021 and allow Judge Meyer to sign. ----Sincerely, ... _...._.— _.. e BoPbieickery Calhoun County Sheriff CALHOUN COUNTY RESOLUTION WHEREAS,CALHOUN COUNTY, finds it in the best interest of the citizens of CALHOUN COUNTY, that the 2021 OPERATION STONE GARDEN GRANT be operated for the 2022 GRANT YEAR; and WHEREAS, CALHOUN COUNTY agrees that in the event of loss or misuse of the Office of the Governor funds, CALHOUN COUNTY assures that the funds will be returned to the Office of the Governor in full. WHEREAS, CALHOUN COUNTY designates COUNTY JUDGE Richard Meyer as the grantee's authorized official. The authorized official is given the power to apply for, accept, reject, alter or terminate the grant on behalf of the applicant agency. NOW THEREFOR IT RESOLVED that CALHOUN COUNTY approves submission of the grant application for the 0 1 OSG FROM 09/01120-08/31/23 to the Office of the Governor. Signed by: COUNTY J E, Richard Meyer Anna Goodman, Clerk of the Court Calhoun County, Texas K. Passed and Approved this Z1A�(Day) of -J onth),20Z�Year) Grant Numbed: 3192807. 000 Sample Resolution page f of 1 #11 NOTICE OF MEETING — 2/2/2022 11. Consider and take necessary action to authorize loan in amount of $117,000 from general fund to Magnolia/Indianola Beach Pavilion's capital project fund. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 15 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Tuesday, January 25, 2022 4:33 PM To: Mae Belle Cassel Cc: Richard Meyer Subject: Agenda Item Request Please place the following item on the agenda for February 2, 2022: Consider and take necessary action to authorize loan in amount of $117,000 from general fund to Magnolia Indianola Beach Pavilions capital project fund. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindv.mueller@calhouncotx.ore Calhoun County Texas #12 NOTICE OF MEETING — 2/2/2022 12. Consider and take necessary action to execute the construction contract for the Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 and authorize the County Judge to sign. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Lvssv, Behrens, Reese Page 9 of 15 Mae Belle Cassel From: David.Hall@calhouncotx.org (David Hall) <David.Hal l@calhouncotx.org> Sent: Thursday, January 27, 2022 9:25 AM To: Mae Belle Cassel; Richard Meyer Subject: Fwd: Agenda Item for Little Chocolate Bayou Boat Ramp Sent from David's iPhone Begin forwarded message: From: smason@gwengineers.com Date: January 27, 2022 at 9:17:56 AM CST To: David Hall <david.hall@calhouncotx.org> Cc: angela.torres@calhouncotx.org, Glynis King <gking@gwengineers.com> Subject: Agenda Item for Little Chocolate Bayou Boat Ramp CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. David, We need to place an agenda item today for next week's court. Consider and take necessary action to execute the construction contract forthe Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038. Thanks, Scott P. Mason, P.E. Lead Project Engineer G&W Engineers, Inc. 205 W. Live Oak Port Lavaca, Texas 77979 P: (361) 552-4509 F: (361) 552-4987 smason@gwengineers.com Calhoun County Texas DOCUMENT NO.00510 ATTORNEY'S REVIEW CERTIFICATION Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 I, the undersigned, %V6 V V 1. ` ( the duly authorized and acting legal representative of CALHOUN COUNTY, do hereby certify as follows: I have examined the attached contract(s) and surety bonds and am of the opinion that each of the agreements may be duly executed by the proper parties, acting through their duly authorized representatives; that said representatives have full power and authority to execute said agreements on behalf of the representative parties; and that the agreements shall constitute valid and legally binding obligations upon conditions and provisions tthe�re/oyf. Attorney's signature: 0 � r the parties executing the same in accordance with terms, Zot-- Print Attorney's name: 5uY-Ct IM . R c-Ao NW (A Texas State Bar Number: / "G V 50 { r END OF DOCUMENT 00510-1 DOCUMENT NO.00500 AGREEMENT BETWEEN OWNER AND CONTRACTOR THIS AGREEMENT is dated as of the 8th day of December in the year 2021, by and between CALHOUN COUNTY (hereinafter called OWNER) and DERRICK CONSTRUCTION COMPANY INC. (hereinafter called CONTRACTOR). OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: .01 .02 .03 1�1�'dL1] 7;f1 CONTRACTOR shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as follows: Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 ENGINEER: The Project has been designe Lavaca, Texas, 77979, who is duties and responsibilities and in the Contract Documents in with the Contract Documents. CONTRACT TIMES: a. Calendar Days d by G & W Engineers, Inc., 205 West Live Oak, Port hereinafter called ENGINEER and who will assume all will have the rights and authority assigned to ENGINEER connection with completion of the Work in accordance The Work shall be complete and ready for final payment in accordance with Paragraph 14.07 of the General Conditions within 120 Calendar Days after the date when the Contract Times commence to run. b. Rain Days CONTRACTOR may be allowed an adjustment to the CONTRACT Times for "rain days", which are defined as follows. Any day(s) in which rainfall occurs prior to 12:00 p.m. (noon), of such quantity that, in the opinion of OWNER's representative, would prevent a safe working environment for CONTRACTOR at the construction site. 00500-1 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Bout Ramp — Texas Parks and Wildlife Ramp Project No, BA-2020 — Calhoun County-00038 (File No. 9115 025) 2. Any day(s) following the above described "rain day(s)" in which the condition of the construction site, in the opinion of OWNER's representative, is not conducive to providing CONTRACTOR with a safe working environment at the site. OWNER shall only consider an adjustment in Contract Times if CONTRACTOR submits a written request for "rain days" to OWNER's representative for review, by 10:00 a.m. on the Monday following the week in which the day(s) occurred. Failure to submit such a written request shall be a representation by CONTRACTOR that additional days are not warranted. OWNER's representative shall review all requests when submitted and will have final on site determination for "rain days". Disagreements between CONTRACTOR and OWNER's representative shall be submitted to OWNER. C. Liquidated Damages OWNER and CONTRACTOR recognize that time is of the essence in this Agreement and that OWNER will suffer financial loss if the Work is not substantially complete within the time specified in paragraph .03.a above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the delays, expense and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not substantially complete on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that, as liquidated damages for delay (but not as a penalty), CONTRACTOR shall pay OWNER THREE HUNDRED DOLLARS ($300.00) for each day that expires after the time specified in paragraph .03.a. CONTRACTOR hereby agrees that said sum per day is a fair estimate of the pecuniary damages which will be sustained by OWNER in the event that the Work is not complete within the agreed time, or within extensions of time properly granted in accordance with the Contract Documents. Said sum shall be considered as liquidated damages only and not a penalty, said damage being caused by loss of timely use of the Work other injury difficult to quantify. For purposes of applying this liquidated damages clause, the CONTRACTOR agrees to waive as against the OWNER any defense to enforcement of said clause based on any of the following claims: (1) that the clause is a penalty; (2) that the daily amount stated in the clause is not a reasonable estimate and approximation as of the time of contracting of OWNER's actual damages; (3) that the damages caused to OWNER by reason of delay were not difficult to estimate at the time of contracting. 00500-2 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Project No, BA-2020 — Calhoun County— 00038 (File No. 9115,025) .04 CONTRACT PRICE: OWNER shall pay CONTRACTOR for performance of the Work in accordance with the Contract Documents in current funds as per CONTRACTOR's bid which forms a part of this contract. In no event shall the amounts payable pursuant to this Contract exceed $207,075.00, being the Total Base Bid Amount, plus the amount of any duly authorized change orders or contract amendments executed by OWNER. .05 PAYMENT PROCEDURE: CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions unless otherwise amended by the Contract Documents. Applications for Payment shall also include all required documentation indicated in Division 1 - General Requirements, Section 01025 of these Specifications. ENGINEER shall process Applications as provided in the General Conditions. a. Progress Payments OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Applications for Payment as recommended by ENGINEER and as provided below. All progress payments will be on the basis of the progress of the Work measured by the schedule of values provided for in Article 2 of the General Conditions. Progress payments will be in an amount equal to the percentage indicated below, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold in accordance with Paragraph 14.02.13.5 of the General Conditions. A. 90% of the Work completed (with the balance being retainage) B. 90% (with the balance being retainage) of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentation satisfactory to OWNER as provided in Paragraph 14.02.A.I of the General Conditions). 2. Request for Payments All requests for payments shall be divided into materials costs and labor/equipment costs. All requests for material payment shall be accompanied by CONTRACTOR's paid invoice for the material in accordance with Article 14.02.A.1 of the General Conditions. 00500-3 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Project No, BA-2020 — Calhoun County —00038 (File No. 9115.025) b. Final Payment Upon final completion and acceptance of the Work in accordance with Paragraph 14.07 of the General Conditions, OWNER shall pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph. .06 CONTRACTOR's REPRESENTATIONS: In order to induce OWNER to enter into this Agreement, CONTRACTOR makes the following representations: a. CONTRACTOR has examined and carefully studied the Contract Documents (including the Addenda listed in paragraph 7 herein) and the other related data identified in the Bidding Documents including "technical data." b. CONTRACTOR has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost, progress, performance or furnishing of the Work. C. CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. d. CONTRACTOR has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR accepts the determination set forth in the Supplementary Conditions to the extent of the "technical data" contained in such reports and drawings upon which CONTRACTOR is entitled to rely as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR acknowledges that such reports and drawings are not Contract Documents and may not be complete for CONTRACTORts purposes. CONTRACTOR acknowledges that OWNER and ENGINEER do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Contract Documents with respect to Underground Facilities at or contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes responsibility for having done so) all such additional supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface, subsurface and underground facilities) at or contiguous to the site or otherwise which may affect cost, progress, performance or furnishing of the Work or which relate to any aspect of the means, methods, techniques, sequences and procedures of construction to be employed by CONTRACTOR and safety precautions and programs incident thereto. CONTRACTOR does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the performance and furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents. 00500-4 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boat Ramp - Texas Parks and Wildlife Ramp Project No. BA-2020- Calhoun County - 00038 (File No. 9115.025) e. CONTRACTOR is aware of the general nature of the Work to be performed by OWNER and others at the site that relates to the Work as indicated in the Contract Documents. f. CONTRACTOR has correlated the information known to CONTRACTOR, information and observations obtained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. g. CONTRACTOR has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that CONTRACTOR has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing of the Work. .07 CONTRACT DOCUMENTS: The Contract Documents which comprise the entire Agreement between OWNER and CONTRACTOR are attached to this Agreement, made a part hereof and consists of the following: a. This Agreement. b. Exhibits to this Agreement. C. Required Contract Requirements. d. CONTRACTOR's Bid. e. Performance, Payment and other Bonds. f. Notice of Award. g. Notice to Proceed. h. General Conditions. i. Calhoun County, Texas General Conditions. j. Supplementary Conditions. k. Technical Specifications. 00500-5 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Projecl No. BA-2020— Calhoun County — 0003 8 (File No. 9115.025) Drawings numbered & titled for the different areas of work as indicated below: Chocolate Bayou Boat Ramp — Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 SHEET NO. DATE DESCRIPTION Cl. 06/03/20 COVER SHEET C2 06/03/20 GENERAL NOTES & TOPOGRAPHY C3 06/03/20 OVERALL SITE LAYOUT C4 06/03/20 BOAT RAMP PLAN AND PROFILE DETAILS C5 06/03/20 CUT/FILL PLAN & SECTIONS in. Addendum numbers One (1) to One (1) inclusive n. The following of which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto: All Written Amendments and other documents amending, modifying or supplementing the Contract Documents pursuant to Paragraph 3.04 of the General Conditions. There are no Contract Documents other than those listed above in this Article 7. The Contract Documents may only be altered, amended or repealed in accordance with the appropriate provisions of Article 3 of the General Conditions. .08 MISCELLANEOUS: a. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. b. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such consent(except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. C. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, agreements and obligations contained in the Contract Documents. d. Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. 00500-6 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boar Ramp — Texas Parke and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 (File No. 9115.025) IN WITNESS WHEREOF, the parties hereto have signed this Agreement in triplicate. One counterpart each has been delivered to OWNER, CONTRACTOR and ENGINEER. All portions of the Contract Documents have been signed or identified by OWNER and CONTRACTOR or by ENGINEER on their behalf. OWNER: CALHOUN COUNTY BY: Richard H. Meyer, my Judge ATTEST: ADDRESS: 211 S. Ann, Suite 301 Port Lavaca, Texas 77979 CONTRACTOR: DERRICK CONSTRUCTION COMPANY C;`,„p I I,,,,,, Roy Johns , V' e Press v'•. 5: :�d••�:FXP ��; ATTEST: , its Q • `� .` ADDRESS: 250 S Cove Harbor Rockport, Texas 78382 PHONE: (361) 553-4600 PHONE: (361) 729-2423 FAX: (361) 553-4444 FAX: (361) 729-1218 EMAIL: serenity@derrickconstruction.net END OF DOCUMENT 00500-7 AGREEMENT BETWEEN OWNER AND CONTRACTOR Chocolate Bayou Boat Ramp— Texas Parks and Wildlife Ramp Project No. BA-2020 —Calhoun County — 00038 (File No 9115.025) DOCUMENT NO.00300 HID Derrick Construction Company Inc. , hereinafter called "BIDDER", (Legal Firm Noma) is submitting this Bid for Furnishing and Performing the Work specified herein as the Chocolate Bayou Boat Ramp - Texas Parks and Wildlife Ramp Project No. BA-2020 - Calhoun County - 00038. This BID is Submitted to CALHOUN COUNTY, hereinafter called "OWNER". Terms used in this BID are defined in the General Conditions or Document No. 00120 - Instructions to Bidders and shall have the meanings indicated in the General Conditions or Instructions. 2. BIDDER proposes and agrees, if this BID is accepted, to enter into an Agreement with OWNER in the form included in the Contract Documents to furnish and perform all Work as specified or indicated in the Contract Documents for the Bid Price and within the Bid Times indicated in this BID and in accordance with the other terms and conditions of the Contract Documents, 3. BIDDER accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid Security. This BID will remain subject to acceptance for Sixty (60) Calendar Days after the Bid Opening. BIDDER shall sign and deliver the required number of counterparts of the Agreement, including all required documents indicated by the Bidding Requirements, within Fifteen (15) Calendar Days after the date of OWNER's Notice of Awaid. 4. In submitting this BID, BIDDER represents, as more frilly set forth in the Agreement, that: a, BIDDER has examined and carefully studied the Bidding Documents and the following Addenda, receipt of all which is hereby acknowledged: (List Addenda by Addendum Number and Date): Addendum No: ADDENDUMNO.1 Date Received: 10r12121 b. BIDDER has visited the site and is familiar and satisfied with the general, local and site conditions that may affect cost, progress, and furnishing and performing the 00300-1 C. BIDDER is familiar and satisfied with all federal, state and local Laws and Regulations that may affect cost, progress, and furnishing and performing the Work. d. BIDDER is aware of the general nature of work, if any, to be performed by OWNER (or others) at the site in relation to the Work for which this BID is submitted. e. BIDDER has correlated the information known to BIDDER, information and observations obtained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. f. BIDDER has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents, and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing the Work for which this BID is submitted. g. This BID is GENUINE and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or Hiles of any group, association, organization or corporation. BIDDER has not directly or indirectly induced or solicited any other BIDDER to submit a false or sham BID. BIDDER has not solicited or induced any person, firm or corporation to refrain from bidding. BIDDER has not sought by collusion to obtain for itself any advantage over any other BIDDER or over OWNER. 5. BIDDER agrees to complete the Work in accordance with the Contract Documents. a. BIDDER acknowledges that the amounts are to be shown in both words and figures, and in case of discrepancy, the amount in words shalt govern. b. BIDDER acknowledges that the quantities are not guaranteed and final payment will be based on the actual quantities determined as provided in the Contract Documents, C. BIDDER acknowledges that, at OWNER's option and/or at OWNER's request, any of the quantities may be deleted, reduced, or increased based upon the respective Unit Prices. d. BIDDER acknowledges that Unit and Lump Sum Prices have been computed in accordance with paragraph 11.03.13 of the General Conditions. a. BIDDER agrees to furnish all necessary labor, superintendence, plant, machinery, equipment, tools, materials, insurance, services and all other requirements deemed necessary to complete the items of Work indicated on the following pages for the specific dollar amounts stated. 00300-2 BASE BID BID BID DESCRIPTION OF ITEM WITH UNIT PRICE ITEM QTY. UNIT WRITTEN 1N WORDS AMOUNT I. I LS Furnishing Mobilization and Insurance as per plans and specifications. Seven Thousand Two Hundred Dollars and Zero Cents. $ 7,200.00 2. 1 LS Furnishing materials, equipment and labor for the construction and removal of a temporary coffer dam to allow the installation of a new concrete ramp with side walls as per plans and specifications for a hump sum price of Four Thoursand Eight Hundred Dollars and Zero Cents. $ 4,800.00 3. 1 LS Furnishing equipment and labor for the demolition and disposal of the existing concrete ramp including side walls as per plans and specifications for a lump sum price of Seven Thousand Two Hundred Dollars and Zero Cents. $ 7,200.00 4. 1 LS Furnishing materials, equipment and labor for the installation of the concrete ramp (approx. 20 x 50) as per plans and specifications for a lump sum price of Eighteen Thousound Dollars and Zero Cents. $ 18,000.00 5. 1 LS Furnishing materials, equipment and labor for the installation of approximately 280 linear feet of vinyl sheet bulkhead including the timber cap, conorete/rod deadman and sand backfill as per plans and specifications for a lump sum price of one hundred fifty-four thousand sixty-five Dollars and Zero Cents. $154,065.00 00300-3 BID BID DESCRIPTION OF ITEM WITH UNIT PRICE ITEM OTY. UNIT WRITTEN IN WORDS AMOUNT 6. 1 LS Furnishing materials, equipment and labor for the installation of drainage inlet and drain pipe as per plans and specifications for a lump sum price of two thousand eight hundred eighty Dollars and Zero Cents. $ 2,880.00 7. 1 LS Furnishing materials, equipment and labor for installation of 25 ea. (6" die.) and 4 ca. (8" die.) guard posts as per plans and specification for a lump sum price of Five Thousand Two Hundred And Fifty Dollars and Zero Cents. $5,250.00 8. 1 LS Furnishing equipment, labor and fill as required and reshaping site for proper drainage as per plans and specifications for a lump sum price of SevenThousand Six Hundred And Eighty Dollars and Zero Cents. $7.6130.00 TOTAL BASE BID AMOUNT, being Items 1 thru 8 above, is: two hundred seven thousand seventy-five DOLLARS Zero CENTS. $ 207 075.00 ++++++++++++++++++++++++++..++++++++++++++++++++++++++++++++++++++++++.t..++++ OWNER'S OPTION BID BID DESCRIPTION OF ITEM WITH UNIT PRICE ITEM OTY. UNIT WRITTEN IN WORDS AMOUNT 0.1. 1 LS For adding to the Project Cost for furnishing materials, equipment and labor for the construction of a concrete bulkhead cap in lieu of the timber cap for the total length of vinyl bulkhead wall as per plans and specifications for the lump sum price of two hundred eleven thousand five hundred seventy-five Dollars and Zero Cents per each. $ 211, 575.00 00300-4 ++++++-F++++++++++-++++++++-F+++++-1.a..1•.F.I..I-.I..I•-F+i•+++-I-F-F+-I-i-++i+++++++.1.+++++-F++++++++ 6. BIDDER agrees that the Work shall be complete and ready for final payment in accordance with Paragraph 14.07 of the General Conditions within O CALENDAR DAYS after the date when the Contract Timos commences to run. BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work within the times specified in the Agreement. 7. 7. The following documents are attached to and made a condition of this BID: DOCUMENT NO. 00411- REQUIRED BID SUBMITTAL INSTRUCTIONS 8. Communications about this BID shall be directed to BIDDERS address indicated below. - ,11. SUBMITTED this 18 day of Authorized Signature:/` 7 ;; 1990 Name: Roy Johnson ���rnnnr Title: Vice President Attesting Signamte: _ Name: Serenity Allen Title: Chief Financial Officer I Controller Legal Firm Name: Derrick Construction Company Inc. Business Address: 250 S Cove Harbor Rockport, Texas 78382 Phone Number: 361-729-2423 Facsimile Number: 361-729-1218 E-Mail Address (optional) serenity .derrickconstruction.net State of incorporation, if applicable: Texas State Contractor License No.: Charter No. 1146525 END OF DOCUMENT 00300-5 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that: Derrick Construction Company Inc (Name of Contractor or Company) 250 S. Cove Harbor, Rockport, TX 78382 (Address) Bond No. C3264304 a Corporation hereinafter called Principal, and The Cincinnati Casualty Company (Name of Surety Company) 6200 South Gilmore Road Fairfield Ohio 45014-5441 (Address) hereinafter called Surety, are held and firmly bound unto of Grant R Port Lava Recipient's hereinafter called OWNER, In the penal SUM Of $ Two Hundred Seven Thousand Seventy Five & 00/100 Dollars ($ 207,075.00 ) in lawful money of the United States, for the payment of which sum well and truly to be made we bind ourselves, successors, and assigns, jointly and severally, firmly in these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER dated the 8th day of December, 2022 , a copy of which is hereto attached and made a part hereof for the construction of: 00610-1 NOW THEREFORE, if the Principal shall well, truly and faithfully perform its duties in all the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the OWNER, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the OWNER from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may incur in making good any default, then this obligation shall be void, otherwise to remain in full force and effect. PROVIDED FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the Principal shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in 3 counterparts, each one of which shall be deemed an original, this the 11th day of January. 2022 ATTEST: Derrick Construction Company Inc _t (Principal) -t BY (s) v (Principal Secretary) Roy Johnson, VP6 President (7SE!4' 250 S. Cove Harbor I ness as to Principal) (Address) 250 S. Cove Harbor Rockport, TX 78382 (Address) Rockport, TX 78382 ATTEST: (Witness as to Surety) i pant .'� 9 i cmlctwrvAre, OHIO Tric,a Balol ng ��•• `CJ 500 N Shoreline Blvd. 1200, Corpus Christi, TX 78401 6200 South Gilmore Road, Fairfield, Ohio 45014-544 (Address) (Address) NOTE: Date of BOND must not be prior to date of Contract. If PRINCIPAUCONTRACTOR is Partnership, all partners should execute BOND. "Power -of attorney for person signing for Surety Company must be attached to bond 00610-2 Bond No. C3264304 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that: Derrick Construction Company Inc (Name of Contractor or Company) 250 S. Cove Harbor RockportTX 78382 (Address) a Cnrnnrnfinn , hereinafter called Principal, (Corporation! Partnership) and The Cincinnati Casualty Company (Name of Surety Company) 6200 South Gilmore Road Fairfield Ohio 45014-5441 - (Address) hereinafter called Surety, are held and firmly bound unto hereinafter called OWNER, in the penal sum of $ Two Hundred Seven Thousand Seventy Five & 00/100 Dollars, $ 207,075.00 in lawful money of the United States, for this payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. THE CONFIDENTIALITY OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER, dated the 8th day of December. 2022 a copy of which is hereto attached and made a part hereof for the construction of: 4 fa'HT,-i 9di:Qs:l i[• R111I r ,r rlt: GCrI 1 r01 J(•1laM■\NJ�-1:v1rl4ro (Project Name) NOW, THEREFORE, if the Principal shall promptly make payment to all persons, firms, SUB- CONTRACTORS, and corporations furnishing materials for or performing labor in the prosecution of the WORK provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and coke, repairs on machinery, equipment and tools; consumed or used in connection with the construction of such WORK, and all insurance premiums on said WORK, and for all labor, performed in such WORK whether by SUB -CONTRACTOR or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. 00620-1 PROVIDED, FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in on of which shall be deemed an original, this the 11th ATTEST: (Principal Secretary) (SEAL) as to 250 S. Cove Harbor Rockport, TX 78382 (Address) ATTEST: (Number) day of January, 2022 counter -parts, each Derrick Construction Comoanv Inc (Principa By F (s) Roy Johnsoj Vice resident 250 S. Cove Herb( (Address) Rockport, TX 78382 The Cincinnati CLt.rnl`.t.�, By (Witness as to Surety 500 N Shoreline Blvd. 1200, Corpus Christi, TX 78401 (Address) 6200 South Gilmore Road, Fairfield, OF (Address) r. a. . CINCINNATI, {c' NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. 'Power -of attorney for person signing for Surety Company must be attached to bond 00620-2 CIHNCINNATI INSURANCE COMPANIES SURETY BOND SEAL ADDENDUM The CINCINNATI CASUALTY COMPANY Due to logistical issues associated with the use of traditional seals during the COVID-19 pandemic, The Cincinnati Casualty Company ("Cincinnati") has authorized its Attorneys -in -Fact to affix Cincinnati's corporate seal to any bond executed on behalf of Cincinnati by any such Attorney -in -Fact by attaching this Addendum to said bond. To the extent this Addendum is attached to a bond that is executed on behalf of Cincinnati by its Attorney -in -Fact, Cincinnati hereby agrees that the seal below shall be deemed affixed to said bond to the same extent as if its raised corporate seal was physically affixed to the face of the bond. Dated this 24th day of March, 2020. The Cincinnati Casualty Company `\rnati Cds . CINCINNATI, : o N OHIO 'a By: Stephen A. Ventre, Senior Vice President THE CINCINNATI INSURANCE COMPANY THE CINCINNATI CASUALTY COMPANY Fairfield, Ohio POWER OF ATTORNEY KNOWALL MEN BY THESE PRESENTS: That THE CINCINNATI INSURANCE COMPANY and THE CINCINNATI CASUALTY COMPANY, corporations organized under the laws of the State of Ohio, and having their principal offices in the City of Fairfield, Ohio (herein collectively called the "Companies"), do hereby constitute and appoint William Blanchard; James R. Reid; William Mitchell Jennings; Aaron Endris; Tricia Balolong; Payton Blanchard; Lindsay Senior Gingras; Jessica Turner and/or Allison Cantu of Fort Worth, Texas their true and legal Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and deliver on behalf of the Companies as Surety, any and all bonds, policies, undertakings or other like instruments, as follows: Any such obligations in the United States, up to Fifty Million Dollars and No/100 ($50,000,000.00). This appointment is made under and by authority of the following resolutions adopted by the Boards of Directors of The Cincinnati Insurance Company and The Cincinnati Casualty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the President or any Senior Vice President be hereby authorized, and empowered to appoint Attorneys -in -Fact of the Company to execute any and all bonds, policies, undertakings, or other like instruments on behalf of the Corporation, and may authorize any officer or any such Attorney -in -Fact to affix the corporate seal; and may with or without cause modify or revoke any such appointment or authority. Any such writings so executed by such Attorneys -in -Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. RESOLVED, that the signature of the President or any Senior Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary or Assistant Vice -President and the Seal of the Company may be affixed by facsimile to any certificate of any such power and any such power of certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS WHEREOF, the Companies have caused these presents to be sealed with their corporate seals, duly attested by their President or any Senior Vice President this 16th day of March, 2021. „pe � ,a•,a„y CORPORATE t �,COAPORAiE SEAL' SEAL` oRio oxia STATE OF OHIO )SS: COUNTY OF BUTLER 1 THE CINCINNATI INSURANCE COMPANY THE CINCINNATI CASUALTY COMPANY On this 16th day of March, 2021 before me came the above -named President or Senior Vice President of The Cincinnati Insurance Company and The. Cincinnati Casualty Company, to me personally known to be the officer described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of said Companies and the corporate seals and the signature of the officer were duly affixed and subscribed to said instrument by the authority and direction of said corporations. Keith C�tt, Attorney at Law Notary Public State of Ohio My commission has no expiration date. Section 147.03 O.R.C. I, the undersigned Secretary or Assistant Vice -President of The Cincinnati Insurance Company and The Cincinnati Casualty Company, hereby certify that the above is the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Power of Attorney is still in full force and effect. Given under my hand and seal of said Companies at Fairfield, Ohio, this 11th day of January 2022 :LCORPOAAlE �`COAPORAiE' �SEAL� 'SEAL' 0 AL BN-1457 (3/21) TEXAS IMPORTANT NOTICE To obtain information or make a complaint: You may call our toll -free telephone number for information or to make a complaint at: 1-800-635-7521 You may also write to us at: The Cincinnati Insurance Companies or The Cincinnati Insurance Companies 6200 South Gilmore Road P.O. Box 145496 Fairfield, Ohio 45014 - 5141 Cincinnati, Ohio 45250-5496 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance P.O. Box 149104 Austin, TX 78714-9104 FAX# (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. IA 4332 TX 11 09 `A� " CERTIFICATE OF LIABILITY INSURANCE oATE(MMmorvvvl 1/13/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Renee Terrell Higginbotham Insurance Agency, Inc. PHONE FAX PO Box 870 IAIC No E, 1. 361-561-4237 WC No:361-844-0101 noorsIEss: rterrell hi inbotham.nel Corpus Christi TX 78403-0870 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Starr Indemnity & Liability Company 38318 INSURED DERRCON-01 INSURER B : Texas Mutual Insurance Company 22945 Derrick Construction Co., Inc. PO Box 1046 INSURERC: State Auto Property & Casualty Insurance Company 25127 INSURER D : Continental Casualty Company 20443 Rockport TX 78381-1046 INSURER E : Lloyd's 15792 INSURER F : COVERAGES CERTIFICATE NUMBER: 973603158 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD - INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR 1NSn WVQ POLICYNUMBER POLICYEFF MMIDD/YYYY) POLICY EXP flMM1DDIYNYYI LIMITS D X COMMERCIAL GENERAL LIABILITY ML9780461 12/31/2021 12/31/2022 EACH OCCURRENCE $1,000,000 CLAIMS -MADE lxl OCCUR PREM SES Ea occur ante $ 50,000 MED EXP(Any oneperson) $5,000 PERSONAL &AOV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY FAX7 PRO- JECT D LOC PRODUCTS - COMP/OP AGG $1,000,000 $ OTHER: C AUTOMOBILE LIABILITY BAP248007702 12/31/2021 12/31/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Par person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ IX X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLALIAB X OCCUR MASILH00087321 12/31/2021 12/31/2022 EACH OCCURRENCE $10,000.000 I AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED I X I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE N OFFICERIMEMBER EXCLUDE W NIA 0001145792 12/31/2021 12/31/2022 X STATUTE OTRH- E.L. EACH ACCIDENT $1,000,000 (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 Iryes, describe under DESCRIPTION OFOPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 E Protection & Indemnity TRM411991 1/13/2022 12/31/2022 P&I Limit $1,000,000 Mediums Employers Liability MEL Limit $1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached if more space is required) See Attached... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Calhoun County 211 South Ann Street, 3rd Floor, Suite 301 Port Lavaca TX 77979 reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: DERRCON-01 LOC #: ACC)OR o ADDITIONAL REMARKS SCHEDULE Page 1 of 1' AGENCY Higginbotham Insurance Agency, Inc. NAMED INSURED Derrick Construction Co., Inc. PO Box 1046 Rockport TX 78381-1046 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ne General Liability policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract teen the insured and certificate holder that requires it. (Manuscript Form). ne General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only . i there is a written contract between the insured and certificate holder that required such status. (Manuscript Form). ne General Liability policy includes a primary & non-contributory provision only when there is a written contract between the insured and certificate holder - requires such provision. (Manuscript Form), General Liability policy includes In Rem and Action Over Indemnity Buyback - Manuscript form. General Liability policy includes Pollution Limitation Endorsement (Sudden & Accidental Basis) - Pollution Buy Back - Manuscript form. policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the insured certificate holder that requires it. (Texas Business Auto Policy Plus Endorsement - Form SA 30 02 06/08). a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a Ban the insured and certificate holder that required such status. (Texas Business Auto Policy Plus Endorsement - Form SA 30 02 06/08). a provision that provides Primary Auto Liability Coverage for any liability assumed under an insured contract. (Business Auto Coverage — Excess Liability ("Bumbershoot") policy includes a blanket automatic waiver of subrogation and blanket automatic additional insured endorsement that s this feature only when there is a written contract between the insured and certificate holder that requires it. (Additional Insured / Waiver of Subrogation of Cancellation - Standard "Bumbershoot" Wording). Excess Liability ("Bumbershoot") policy follows form of the underlying Commercial Marine Liability, Auto Liability, Employers Liability, Vessel Pollution rtection & Indemnity policies - Bumbershoot Liabilities. - s' Compensation policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract n the insured and certificate holder that requires it. (Texas Waiver of Our Right to Recover from Others - Form WC 42 03 04B). policy includes Longshore and Harbor Workers' Compensation Act Coverage Endorsement (Form TM-LHW-2001) and Outer Act Coverage Endorsement (Form TM-OCS-2001). Protection & Indemnity policy covers master & crew members. (Protection & Indemnity Clauses-SP 23). Indemnity policy includes Jones Act, Death on the High Seas, In -Rem and Transportation, Wages, Maintenance & Cure. (Protection & Indemnity 23). Protection & Indemnity policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the insured and certificate holder that requires it. (Protection & Indemnity Clauses-SP 23). Protection & Indemnity policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the insured and certificate holder that required such status. (Protection & Indemnity Clauses-SP 23). Protection & Indemnity policy includes Collision Liability - Tower's Liability. Hull & Machinery: Company - Continental Insurance Company Coverage $2,986,429 Scheduled Vessels, Policy# H0877477, Policy Period 01/13/2022-12/31/22 Marine Vessel Pollution: Company -Water Quality Insurance Syndicate Coverage $5,000,000 Per Occurrence, Policy# 56-83445, Policy Period 12/31/21-22 ce Company Any One Project Limit, Policy #UM000821 1 9MA21A, Policy Period 12131121-22 Chocolate Bayou Boat Ramp - Texas Parks and Wildlife Ramp Project No.: BA-2020-Calhoun County-00038. Calhoun County, Texas ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DOCUMENT NO.00417 IRENCH SAFETY SYSTEMS INDEMNITY AGREEMENT OWNER: CONTRACTOR: ENGINEER: Calhoun County Derrick Construction Company Inc. (company name) G & W Engineers, Inc., Port Lavaca, Calhoun County' Texas PROJECT: Chocolate Bayou Boat Ramp —Texas Parks and Wildlife Ramp Project No. BA-2020 — Calhoun County — 00038 CONTRACTOR has entered into a contract with OWNER for the constriction of the Project. ENGINEER has designed the Project on behalf of OWNER, but has not designed any trench safety systems for the Project that may be required by applicable federal, state and/or local laws. CONTRACTOR, in its contract with OWNER, has agreed to prepare, and to conform all trenching work to plaits for trench safety systems meeting the standards of applicable laws. CONTRACTOR, as part of its consideration to OWNER for the contract for the construction of the Project, agrees that it will be solely responsible for compliance with its trench safety plans and with all applicable standards of federal, state and/or local laws relating to trench safety. CONTRACTOR further agrees to hold harmless, indemnify, and defend OWNER and ENGINEER, and all officers, agents and employees of either OWNER or ENGINEER, from and against any and all claims, demands or causes of action of any nature, character or description in connection with the presence, or in any way arising out of, the use or construction of trenches or trench safety systems as part of the Project. EXECUTED, this 18 day of CONT TOR , By: � � %l_ Officer's at e: Roy Johnson Title of Officer: Vice President (Contractor's Seal) er ,20 21 OWNE / By: Officer's Name: Richard Mever Title of Officer: Calhoun Countv Judge ENGINEER By: Engineer's Name: Scott P. Mason, P.E. Title of Engineer: Sr. Proiect Engineer END 0# DOCUMENT 00417-1 #13 NOTICE OF MEETING — 2/2/2022 13. Consider and take necessary action to accept check from Calhoun County Fair Association in the amount of $1,208.63 for damages to Precinct 1 Caterpillar Backhoe 21-0293 and deposit into account 63530. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judqe Mever, Commissioner Hall, Lvssv, Behrens, Reese Page 10 of 15 David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for February 2nd, 2022. • Consider and take necessary action to accept check from Calhoun County Fair Association in the amount of $1,208.63 for 1/2 damages to Precinct 1 Caterpillar Backhoe 21-0293 and deposit into account 63530. Sincer L Da E. Hall DEH/apt ��RVI�E INu+©lwyE "Mir . ® P.o.BOX zo791e San Antonio, TX 78220.7916 Bill To: 80 1 SP 0.530 E008OX 10110 08296316960 S2 P8629386 0001:0003 I'IIIIIIIIIIIIIIIIII111rldllul'1111111111Plllllilllllllllllirl CALHOUN COUNTY PCT 1 202 S ANN ST PORT LAVACA TX 77979-4204 Ship To: INVOICE NUMBER: Invoice Date: WIMV0047181 11/01/21 Due Date Payment Terms Belofn Make AP Model 430F C4EX Serial # "CAT0430FAHWE01043' Machine # Machine ID HCT010645 Meter Reading 956,C Work Order # VA4724e • • • • hftps:fl ltcat.bilitrust.com • Use Invoice Number PLEASE REMIT TO: HOLT.CAT P.O. BOX 660345 DALLAS, TX 75265.0346 SEG DESCRIPTION PARTS LABOR MISC FIR ALL ADJ TOTAL 01 TROUBLESHOOT HYDRAULIC LEAK 1461.38 984.00 492.00- 1943.38 99 TRAVEL TO & FROM MACHINE 320.00 85.00 405.00 TOTAL 1451.38 1304.00-407.00 0.00 0.00 2348.38 CALHOUN COUNTY FAIR ASSOCIATION PO BOX 42 PORT LAVACA TX 77979 to the 1473 88-2316/1131 111C O�-7 W�� 01 Date F. H%W .:.ECK ..,..�: ,. i $ tangy �% U rk f �1 a4 LUQ Gam` TWO In y *1- 2u J(5'noilars 10 pso: F FimNATioNALBANx In Part Lever. BP.O. Drnwn17, Port Lavern, Texas 77970 www.inbprrllevace.com For i 'URNABLE de legendary customer service. Itcat.com. ,f, this invoice shall otherwise be due and 1e equipment; Rentals due and payable upon 0001:0003 Page 1 of 3 #14 NOTICE OF MEETING — 2/2/2022 14. Consider and take necessary action to accept the Continuing Education Transcript from the District Clerk. (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 15 m05 rD a m _ a 0 C r+ 0 r+ n� C+ rD Aj 0, -nC) 00 C� CD ,:3 5. n a (D a = -' O O 00 O 7 W N Q N N d N N O O m 0 �o �v m � m CD 7 N 0 N CD �0 nW my 2 = 06 �D n] CD :3 fin C1 0v v m � �CD 2 fl1 N #15 NOTICE OF MEETING — 2/2/2022 15. Consider and take necessary action to accept Emergency Connectivity Fund Commitment Decision Letter for the Library in the amount of $21,430. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Lvssv, Behrens, Reese Page 12 of 15 Mae Belle Cassel From: ncruz@cclibrary.org (Noemi Cruz) <ncruz@cclibrary.org> Sent: Thursday, January 27, 2022 10:58 AM To: MaeBelle.Cassel@calhouncotx.org Subject: Agenda Item Attachments: CCLBScan.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Good morning MaeBelle, Please add the attached to the next Commissioners' Court agenda. 1) To accept Emergency Connectivity Fund Commitment Decision Letter in the amount of $21,430. Calhoun County Texas ® IE Universal Service Administrative Co. January 10, 2022 ECF Funding Commitment Decision Letter 2021 Contact Information: Noemi Cruz CALHOUN COUNTY LIBRARY 200 W MAHAN ST PORT LAVACA TX 77979 - 3327 ncruz cclibraryqrc Totals ECF FCC Form 471: ECF222116626 BEN: 141452 Obligation File: 7 Application Nickname: Hotspots for CC Total Committed 1 $21,430.00 What is in this letter? Thank you for submitting your Emergency Connectivity Fund (ECF) funding application. Attached to this letter, you will find the funding statuses for the ECF FCC Form(s) 471, Services Ordered and Certification Form, referenced above. The Universal Service Administrative Company (USAC) is sending letters to both the associated applicant and the service provider(s) so that you can work together to complete the funding process. Next Steps Submit Requests for Reimbursement to the Emergency Connectivity Fund (ECF) Portal.' The Commission in the Emergency Connectivity Fund Report and Order provided two ways for applicants to be able to invoice for eligible equipment and services through the Emergency Connectivity Fund Program? Applicants and service providers, who agree to invoice on behalf of the applicant(s), are allowed to submit ECF Program requests for reimbursement. 'The Emergency Connectivity Fund Report and Order directed USAC to make the invoicing system available 15 days after the Issuance of the first wave of commitments for the Emergency Connectivity Fund Program. Establishing the Emergency Connectivily Fund to Close the Homework Gap, WC Docket No. 21-93, Report and Order, FCC 21-68, pars. 98 (rel. May 11. 2021) (Emergency Connectivity Fund Report and Order) If your funding commitment was released as part of the first wave, you may need to wail 15 days prior to submitting your request for reimbursement. USAC will announce when the invoicing system is available and requests for reimbursement can be submitted. 2 Emergency Connectivity Fund Report and Order, at para.93. BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 BEN:141452 Obligation File: 7 If you (the applicant) are invoicing: After receiving the ECF-supported eligible equipment and/or services, you will file the ECF FCC Farm 472, the Billed Entity Applicant Reimbursement (BEAR) Form to Invoice for reimbursement of the ECF-supported eligible equipment and/or services. If you request reimbursement prior to paying your service provider(s), you will be required to provide verification that you paid your service provider(s) within 30 days of receipt of funds. • If your service provider(s) Is Invoicing: The service providers) must provide the ECF-supported eligible equipment and/or services and then file the ECrm44,7the Service Provider Invoice (SPI) form, to invoice for reimbursement for the ECF-supported eligible equipment and/or services provided. Applicants and service providers, who agree to invoice on behalf of the applicant(s), must provide Invoices detailing the Items purchased, along with the requests for reimbursement. In general, any request for reimbursement submitted without the necessary information will be rejected with an explanation as to the deficiency, and the funding recipient will need to timely resubmit its invoice submission in order to receive reimbursement. Notice on Rules and Requirements The applicants' receipt of funding commitments is contingent on their compliance with all federal, statutory, regulatory, and procedural requirements of the ECF Program and the FCC's rules. This also includes the certifications under penalty of perjury contained in their funding application(s). Funding recipients are subject to audits and other reviews that the Commission and other appropriate authorities may undertake periodically to ensure that committed funds are being used in accordance with such requirements and for their intended purpose. Please see paragraphs 116.134 of the Commission's Emergency Connectivity Fund Report and Orderfor more information regarding the Program's documentation, certification, and audit requirements. As referenced in paragraph 101 of the Emergency Connectivity Fund Report and Order, attached to this letter is the full text of Appendix A to 2 CFR Part 170, which provides additional information about the reporting requirements for reporting executive compensation (through httI25,i1wwwsam,g0v) and subaward activity (through htto;/r .. ,, gov) under the Federal Funding Accountability and Transparency Act of 2006 as amended by the Digital Accountability and Transparency Act of 2014 (collectively the Transparency Act or FFATA/DATA Act) for award and subaward payments that equal or exceed $30,000. On behalf of the FCC, USAC may be required to reduce or cancel funding commitments that were not issued in accordance with these requirements, whether due to action or inaction of USAC, the applicant, or the service provider. The Commission and other appropriate authorities may pursue enforcement actions and other means of recourse to collect improperly disbursed funds. How to Appeal or Request a Waiver of a Decision You can appeal or request a waiver of a decision in this letter within 30 calendar days of the date of this letter. Failure to meet this deadline will result in an automatic dismissal of your appeal or waiver request. Please note that this is shorter than the deadline for appeals In the E-Rate Program. January 10,2022 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: F-CF222118626 BEN: 141452 Obligation File: 7 Note: The Federal Communications Commission (FCC) will not accept appeals of ECF Program decisions that have not first been submitted and addressed in the Emergency Connectivity Fund (ECF) Portal. However, if you are seeking a waiver of ECF Program rules, you must submit your request directly to the FCC and not in the ECF Portal. Waivers of the ECF Program rules cannot be addressed within the ECF Portal • To submit an appeal that Is not a waiver, visit the Appeals section in the Emergency L'annectivity Fund (ECF) Pogi it and provide the required information. USAC will reply to your appeal submissions to confine receipt. Visit the ECF Program's W@051te for additional information on submitting an appeal, Including step-by-step instructions. • To request a waiver of the FCC's rules, please submit your request to the FCC in proceeding number WC Docket No. 21-93 using the ElectronicCQm ian Fiiing 5y-,Stgm (ECFS). Include your contact information, a statement that your filing is a waiver request, identifying information, the FCC rule(s) for which you are seeking a waiver, a full description of the relevant facts that you believe support your waiver request and any related relief, and any supporting documentation. For all appeals and waivers, be sure to keep a copy of your entire appeal or waiver document, including any correspondence and documentation, and provide a copy to the affected service provider(s). January 10, 2022 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 BEN: 141452 Obligation File: 7 FundingECF • „_ _ • Overview 2021 Funding Commitment Decision Overview Funding Request Number(FRN) Service Provider Name Amount Requested Amount Committed Status ECF2190026960 T-Mobile USA, Inc. $17,430.00 $17,430.00 Funded ECF2190028741 Dell Marketing LP $10,690.20 $4,000.00 Funded January 10, 2022 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 BEN: 141452 Obligation File: 7 FRN Service Type Status ECF2190026960 Services Funded Dollars Committed Monthly Cost Months of Service 12 Total Eligible Recurring Charges [ $17A30.00 Dates Service Start, Date Service End Date Service Delivery Date Invoice Deadline Date Consultant Information Consultant Name Consultants Employer CRN one4ime Cost Total Eligible One Time Charges 1 $0.00 Total Charges 1 $17,430.00 Committed Amount $17,430.00 Service Provider Informa tion 7/1/2021 Service Provider T-Mobile USA, Inc. 8i30/2022 s SPIN (4981D) 143026181 6/30/2022 8/29/2022 Funding Commitment Decislon Comments Approved as submitted. January 10,2022 6 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 SBI® BEN: 141452 Obligation File:7 FRN ECF2190028741 Dollars Committed Monthly Cost Service Type Status Equipment Funded One4ime Cost Months of Service 112 Total Eligible Recurring Charges $0.00 Total Eligible One Time Charges $4,000.00 .M. Total Charges $10,690.20 Committed Amount $4,000.00 Dates Service Stan Date Service End Date Service Delivery Date Invoice Deadline Date Consultant Information Consultant Name Consultants Employer CRN Service Provider Information 4 7/112021 6130/2022 6/3012022 Service Provider Dell Marketing LP G SPIN (4981D) 143004340 1 8/29/2022 Furl Commitment Decision Comments T The funding request amount for Connected Device was reduced from $1.069.02 per connected device to $400.00 per connected device to remove the amount that exceeds the cap amount. January 10, 2022 6 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 BEN:141452 Obligation File: 7 Appendix A to Part 170—Award Term 1. Reporting Subawards and Executive Compensation a. Reporting of first -tier subawards. Applicability. Unless you are exempt as provided in paragraph d. of this award term, you must report each action that equals or exceeds $30,000 in Federal funds for a subaward to a non -Federal entity or Federal agency (see definitions in paragraph e, of this award term). 2. Where and when to report 1. The non -Federal entity or Federal agency must report each obligating action described in paragraph a.1. of this award term to hUR',/Iyr"_Jsrs,gQv. II. For subaward Information, report no later than the end of the month following the month in which the obligation was made. (For example, if the obligation was made on November 7, 2010, the obligation must be reported by no later than December 31, 2010.) 3. What to report. You must report the information about each obligating action that the submission instructions posted at httpMAvww.fsrs.gov specify. b. Reporting total compensation of recipient executives for non -Federal entities. 1. Applicability and what to report. You must report total compensation for each of your five most highly compensated executives for the preceding completed fiscal year, if- 1. The total Federal funding authorized to date under this Federal award equals or exceeds $30,000 as defined in 2 CFR § 170.320; ii. in the preceding fiscal year, you received — (A) 80 percent or more of your annual gross revenues from Federal procurement contracts (and subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 2 CFR § 170.320 (and subawards), and (B) $25,000,000 or more in annual gross revenues from Federal procurement contracts (and subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 2 CFR § 170.320 (and subawards); and, III. The public does not have access to information about the compensation of the executives through periodic reports filed under sections 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. §§ 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has access to the compensation information, see the U.S. Security and Exchange Commission total compensation filings at http://www.sec,aov/answers/execomp.htm.) 2. Where and when to report. You must report executive total compensation described in paragraph b.1. of this award term: 1. As part of your registration profile at https'l/www.sam.gov IL By the end of the month following the month in which this award is made, and annually thereafter. c. Reporting of Total Compensation of Subrecipient Executives, 1. Applicability and what to report. Unless you are exempt as provided In paragraph d. of this award term, for each first -tier non -Federal entity subrecipient under this award, you shall report the names and total compensation of each of the subrecipient's five most highly compensated executives for the subrecipient's preceding completed fiscal year, if— s, in the subreclpients preceding fiscal year, the subrecipient received — (A) 80 percent or more of its annual gross revenues from Federal procurement contracts (and subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 2 CFR § 170.320 (and subawards) and, January 10, 2022 BEN Name: CALHOUN COUNTY LIBRARY ECF FCC Form 471: ECF222116626 BEN: 141452 Obligation File: 7 (B) $25,000,000 or more in annual gross revenues from Federal procurement contracts (and subcontracts), and Federal financial assistance subject to the Transparency Act (and subawards); and IL The public does not have access to information about the compensation of the executives through periodic reports filed under sections 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.§§ 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has access to the compensation information, see the U.S. Security and Exchange Commission total compensation filings at http:flwww.seg.ggvla,nswers(exeeorpo htm.) 2. Where and when to report. You must report subrecipient executive total compensation described in paragraph c.1. of this award term: 1. To the recipient. It. By the end of the month following the month during which you make the subaward. For example, If a subaward is obligated on any date during the month of October of a given year (i.e., between October 1 and 31), you must report any required compensation information of the subrecipient by November 30 of that year. d. Exemptions. If, in the previous tax year, you had gross income, from all sources, under $300,000, you are exempt from the requirements to report: L Subawards, and ii. The total compensation of the five most highly compensated executives of any subrecipient. e. Definitions. For purposes of this award term: 1. Federal Agency means a Federal agency as defined at 5 U.S.C. § 551(1) and further clarified by 5 U.S.C. 552(f). 2. Non -Federal entity means all of the following, as defined in 2 CFR part 25: 1. A Governmental organization, which is a State, local government, or Indian tribe; ii. A foreign public entity; III. A domestic or foreign nonprofit organization; and Iv. A domestic or foreign for -profit organization 3. Executive means officers, managing partners, or any other employees in management positions. 4. Subaward: 1. This term means a legal instrument to provide support for the performance of any portion of the substantive project or program for which you received this award and that you as the recipient award to an eligible subrecipient. li. The term does not include your procurement of property and services needed to carry out the project or program (for further explanation, see 2 CFR § 200.331). iii. A subaward may be provided through any legal agreement, Including an agreement that you or a subrecipient considers a contract. 5. Subreclpfent means a non -Federal entity or Federal agency that: I. Receives a subaward from you (the recipient) under this award; and ii. Is accountable to you for the use of the Federal funds provided by the subaward. 6. Total compensation means the cash and noncash dollar value earned by the executive during the recipient's or subreciplenYs preceding fiscal year and Includes the following (for more Information see 17 CFR § 229.402(c)(2)). [2 CFR Part 170; 85 FR 49526, Aug. 13, 2020] January 10, 2022 #16 NOTICE OF MEETING — 2/2/2022 16. Accept Monthly Reports from the following County Offices: I. County Treasurer — November 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judqe Mever, Commissioner Hall, Lvssy, Behrens, Reese Page 13 of 15 01124/2022 14:41 CALHOUN CO AUDITREAS Q:A1g3615534614 P.O0110O3 CALHOUN COUNTY, TEXAS COUNTY TREASURER'S REPORT MONTHOP: N0VEMBER2021 BEGINNING ENDING FUND FUNDRA41NCE RECEIPTS DISBURSEMENTS FUNDRALANCE OPERATING 1 GENERAL 3 25,508.327,79 $ 9.789,093.21 S 11.234.506.96 $ 24,062,914.04 AIRPORT MAINTENANCE 50.542,31 13,780.63 5.307.45 69.015.49 APPELLATE JUDICIAL SYSTEM 1,403.97 155.44 - 1.559.41 COASTAL PROTECTION FUND 2.274.644.46 720.23 L275,364,69 COUNTY AND DIST COURT TECH FUND 7.949.36 111,16 8.060.52 COUNTY CHILD ABUSE PREVENTION FUND 734" 0.54 - 734.98 COUNTY CHILD WELFARE BOARD FUND 244.21 104.17 - 948.48 COUNTYIURYFUND 454.93 42,45 - 4973B COURTHOUSE SECURITY 269.023.17 1.929,08 - 271,932.25 COURT INITIATED GUARDIANSHIP FUND 12,640.4.1 124.07 - 12,96432 DIST CLK RECORD PRESERVATION FUND 39.915.42 352.64 - 40,279.06 COURT REPORTERS SERVICE FUND 307.32 45.22 - $52.74 CO CLK RECORDS ARCHIVE FUND 317D25.07 4.550.38 - 321.585-45 COUNTY SPECIALTY COURT FUND 3.974.10 444.18 4.418.28 DONATIONS 107,567.50 4.419.42 165.51 111.369.31 DRUOMWI COURT PROGRAM FUND -LOCAL 25.979.57 121.50 25,100.07 JUVENILE CASE MANAGER FUND 17.619.02 204.37 405.92 17.357.47 FAMILY PROTECTION FUND 14,259.16 94.51 14.35167 JUVFNU-E DELINQUENCY PREVENTION FUND 91258.86 2.93 9.261.79 GRANTS 484,471.88 8.12 20.430.20 464,029.30 JUSTICE C0URTTFCHN0L0GY 93.961.65 995.60 94,847.25 JUSTICE COURT BUILDING SECURITY FUND 6,701.82 49.95 6,751.77 LATERAL R0AD PRECINCT 81 4.336.10 1.37 - 4,337.47 LATERAL ROAD PRECINCT 82 4,336.10 1.37 - 4,337.47 LATERAL ROAD PRECINCT 83 4,336,10 1.37 - 4.331.47 LATERAL R0AD PRECINCT 04 4,336.10 1.37 - 4.337.47 JUROR DONATIONS . HUMANE SOCIETY 843.91 112.27 956.18 JUROR DONATIONS - HUMANE SOCIETY 8.00 104.00 112.00 PRETRIAL SERVICES FUND $5,812.40 127.17 - $5.939.57 LOCAL TRUANCY PREVENTIONIDIVERSION FUND 13.354.29 633.65 - 14.187.94 LAW LIBRARY 213,910.72 1.117.70 - 214,928.42 LAW ENF OFFICERS STD, EDUC. (LBOSM 29.415.55 9.32 29.434.97 POC COMMUNITY CENTER 16.058.03 5.037.63 3.538.67 17.556.99 RECORDS MANAGEMGNT-DISTRICT CLERK 9.575.18 214,06 - 9.789.24 RECORDS MANAGEMFNT•COUNTY CLERK 212,356.65 4.65229 2,550.00 214.428,94 RECORDS MOMT & PRESERVATION 38,235.61 784.77 39,020.31 ROAD & BRIDGE GENERAL 1,682,230.66 42.779.03 1.725.009.69 6ME.E PIERIB0AT RAMP INSURAMAINT 35.714.53 11.31 - 35.725.04 CAPITAL PRO)- BOGGY BAYOU NATURE PARK 193.733.10 - 198.733.00 CAPITAL PRO) AMERICAN RESCUE PLAN ACT OF 202 2,013,314.56 - 36,840.53 1.976.474.03 CAPITAL PRO) KING FISHER PARK 501000,00 - - 60.m.00 CAPITAL PRO]• CDBO OR INFRASTRUCTURE 32,487.75 - 32,487.75 CAPITAL PRO] CHOCOLATE BAYOU BOAT RAMP 176.050.01 - 176,050.01 CAPITAL PRO]. ELECTION MACHINES 0.21 - 0.21 CAPITAL PRO; -RB INFRASTRUCTURE 775.477.22 - 139.964.95 635.512.27 CAPITAL PR0J ENER0YTRZ91 171,830.01 1.441.60 170,388.41 CAPITAL PRO) AIRPORT RUNWAY IMPROVEMENTS 14,972.13 - - 14,972.13 CAPITAL PROD MAGNOLIA BEACH EROSION CONT 179,000.00 - - 175.000.00 CAPITAL PROI EVENT CENTER 125.927.09 - - 125,927.09 CAPITAL PROS FIRE TRUCKS & SAFETY EQUIP 0A49.68 - - 6,448.68 CAPITAL PROD -GREEN LAKE PARK 7,160.74 - 7,160.74 CAPITAL PROI HATERIUS PARKIBOAT RAMP 20.U2.36 - 6,9%.97 IL245A9 CAPITAL PRO] PORT ALTO PUBLIC BEACH 1,494.78 - I484.78 CAPITAL PROI HURRICANE HARVEY FEMA 54.914.63 - - 54.014.40 CAPITAL PROI IMPROVEMENTS PROJECTS 344,369.10 - 344,369.10 CAPITAL PRO) HOSPITAL IMPROVEMENTS 2,94402.66 - 2,944 02,66 CAPITAL PRO)-MMC LOANS 4.000.60D.O0 - 4,000.000.00 ARRESTFEES 1,061.12 201.05 667.34 594.89 BAIL B0ND FEES (HE 19401 1.000.00 645.00 1,593.00 832.00 CONSOLIDATED COURT COSTS (NEW) 5,304.14 2.667.34 4.746.71 3.224.77 CONSOLIDATED C0URT COSTS 2020 32A67,17 14,010.28 29.220.45 17,257.00 DNATESTINOFUND 30,02 0.93 89.11 260.84 DRUG COURT PROGRAM FUND- STATE 031 113.25113,561 6UBT0TALS S 72 823.25 Page 1 of 01124/2022 14:41 CALHOUN CO AUDITREAS (FA1)3615534614 P.0021003 COUNTY TREASURER'S REPORT MONTH OF: NOVEMBER 202I BEGINNING ENDING FUND FUND BALANCE RS B!PVISBURSUMENTE FUND BAL9NCH OPER nN FUN •BALAN BFORWARD S 42,777,673.19 5 9.890,725.43 S 11.499.575.37 S 41,179. 3 ELECTION SERVICES CONTRACT 81.055.00 6,456.33 - 97.511.33 ELECTRONIC PUMO FEE FUND 0.00 IA02.10 1A02.10 EMS TRAUMA FUND 1.602.72 880.93 1.329.53 1.153.12 FINES AND COURT COSTS HOLDING FUND 7,147.31 7,847.31 INDIGENT CIVIL. LEGAL SERVICE 021.50 29L00 170.20 343.30 JUDICIAL FUND (ST. COURT COSTS) 10.2E 30.23 10.26 30.28 JUDICIAL A COURT PERSONNEL YN&wjNO FUND 734.15 240.00 719.69 2SC49 JUDICIAL SALARIES FUND 5,OIOAO 11751.61 4.945.93 1,816.0E JUROR DONATION•TX CRIME VICTIMS FUND 416.00 - 36,00 360.00 JUVENILE PROBATION RESTITUTION 57.37 - - 62.37 LIBRARY OIFTANb MEMORIAL 40.367.22 112.79 40,490.00 MISCELLANEOUS CLEARING 9,745.15 49,756.77 48,843A4 10,656.49 REFUNDABLE DEPOSITS 21000,00 2.000.00 STATE CIVIL PEE FUND 6,732.61 2.277.60 6.731.61 Z270.60 CIVIL JUSTICE DATA REPOSITORY FUND 4.98 2.51 4.48 3.01 WRY REIMBURSEMENT FEE 435.30 218A3 391.77 261,95 3UB77TLECF0D 14,770.27 5,048,52 14,029.66 5.799.13 SUPP OFCRIM INDIGENT DEFENSE 213.29 117.09 191.95 138,43 TIMEPAYMENTS 922.10 39845 461.03 859.71 TRAFFIC LAW FAILURE TO APPEAR 1,664.7E 576.03 1.109.84 1,130.94 UNCLAIMED PROPERTY 12,773.78 0.33 IL774.11 TRUANCY PREVENTION AND DIVERSION FUND 193.71 86.71 ROAD 191.92 BOOTCAMPJJJAEP I47A3 - 147.43 JUVENILE PROBATION 2 215.292.40 SUBTOTALS S 43.196.1M.07 9.995,525.90 5 11,619.352.04 S 41,572,609.33 TAXES IN ESCROW 1 "4.11 11231473.67 O.OD 11,247,307,73 TOTAL OPERAnNG MINDS 71 1 OTHER FUNDS D A FORFEITED PROFBRTY FUND 13.294.45 1.64 13,2%.09 SH ERI" NARCOTIC FORFEITURES 17.477.36 2.16 483.24 16.996.28 CERT OF OB-CRTHSE REF SERIES 2010 35.377.71 272.072,11 - 307,449.82 CERT OF OB-CRTHOUSE IDS SERIES 2012 49.761.6E 351.750.82 401,512A8 CAL. CO. FEES A FINES 169 376.54 MEMORIAL MEDICAL CENTER OPERATING 5.229.894.11 5.863.140.19 3.664.678.21 $ 7,429.256.09 MONEY MARKET 1,108,867.88 227.85 $ 1,109.095.73 INDIOENTHEALTHCARE 5.019.26 12,199.55 12.190.59 SAO= PRIVATE WAIVER CLEARING FUND 431.46 0.05 451,51 CLINIC CONSTRICTION SERIES 201E 935.92 0.07 535.99 NH ASPORD NHBROADMOOR 221,309.19 141S9S.02 473.704.99 291.519.42 546.676.46 337.191.09 1454138.11 96,223.35 NH CRESCENT NH PORT BEND 63.514,03 34.220.00 349.837.14 14504.73 320,975.29 IZ9,3Z6.16 9Z,375,88 49,999.57 NH SOLERA 163981.81 437,888.05 517.061.01 84,808.85 NN OOLDEN CREEK 75,699.68 388,142.45 363.763.19 100.079.94 NH SOLBRA DACA 0.00 - - 0.00 NHASHFORDDACA 0.00 - - 0.00 NH BROADMOOR DACA 0.00 - 0.00 NH GULF POLITE -PRIVATE PAY 191AW.44 323.910.30 407,222.76 110,29110 NH GULF POINT PLAZA MEDICARE IMEDICAID 36,OD6.45 171.240.14 115,453.69 91.790.90 NHBETHANYSENIORLIVINO 86,299.16 995.069.93 791,804.44 190,153.65 NH TUSCANY VILLAGE 193677.15 476 17. 1 352.554.94 TOTAL MEMORIAL MEDICAL CENTER FUNDS S. s $ 9,030A01.97 7 DRAINAGE DISTRICTS NO.6 NO.6 28.918.45 133,762.60 S 1,997.57 9,262.60 S 279.47 2,733.65 S 30536.59 140419135 NO, 10•MAIN77NANCE 201.690.54 IZ090.46 599.79 213,191.22 NO. 17-MAINTENANCFJOPERA71NG 75.956,45 127.594.77 9.VA.23 194,306.99 NO. II -RESERVE 225 76.14 27.81 225604.63 TOTAL DRAINAGE DISTRICT FUNDS 665804.91 CALHOUN COUNTY WCm11 OPERATING ACCOUNT $ 223,019.51 36.007A3 40.807.59 $ 212.138.35 PAYROLLTAX 1 1.127.77 TOTAL WCID FUNDS CALHOUN COUNTY PORT AUPHORITY MAINTENANCE AND OPERATING 62246.79 CALHOUN COUNTY FROST BANK 20t5.97 5.00 2010.87 S IM6,907,09 1230 3432 S 1,618AU,93 10 ITAB TOTAL MMC, DR. DIST.. NAV. DIST, WCDJ B FROST S 52,009ACL03 S 32,002,SUA0 $ 19,314,080.53 S 64,696,86630 TOTAL ALL FUNDS Page 2 of 3 01124/2022 14:41 CALHOUN CO AUDITREAS (FA*615534614 P.003/003 COUNTY TREASURER'S REPORT I MONTHOF: NOVEMBER 2021 BANKRECONCILIATION IBSS: CERT,0FDEPI FUND OUTSTNOO DER/ PLUS. CHECKS SANK FUND BALANCE OTHERITEMS OUTSTANDING BALANCE OPERATING • 5 52519,917.61 $ 151.761.62 $ 16907.11 $ 32,936,563.10 OTHER D A FORFEITED PROPERTY FUND 13.296.09 13.296.09 SHERIFF NARC017C FORFEITURES 16.996.23 50B.Z4 17,504.52 CERT OF OB•CRTHSE REP SERFS 2010 307.449.62 3.302.42 300.087A0 CERT OF OB-CRTHOUSE IRS SERIES 20IZ 401,512.43 Q47,80 397.164.68 CAL. CO FEES R FINES 169,376.54 12,684.90 11.453.83 168.155.57 MEMORIAL MEDICAL CENTER OPERATING S 7.428.356.09 - 49L882.86 7.921.239.95 MONEY MARKET 1.109.095.73 1.109.095.93 INDIOENT HEALTHCARE 5.019.22 12,179.74 12.752A6 5.592494 PRIVATE WAIVER CLEARING FUND 431.11 43L51 CLINIC CONSTRUCTION SERIES 2014 535.99 535,99 NH ASHFORD 148.338,11 148.338.11 NH BROADMOOR 95,223.35 - - 96.223.35 NH CRESCENT 92,375.83 - - 92.375.88 NHFORTBEND 4%898.57 - - 49,898.57 NH SOLERA 84,808.8E - - 84,808.85 NHGOLDSNCRSSK IOD,078.94 - - 100,079.94 NH SOLERA DACA 0.00 - - 0.00 NH ASHFORD DACA 0.00 - - 0.00 NR BROADMOOR DACA 0.00 0.00 NH GULF POINT PRIVATE PAY 110.292.16 110.292.18 NH GULF POINTS PLAZA MEDICARE/MEDICAID 9).790.90 91,79D.90 NH BETHANY SENIOR LIVING 190.153.65 1".153.65 NH TUSCANY VILLAGE 319.640.02 319,640.OZ DRAINAGE DISTRICT: NO.a 30,536.55 75A6 11.60 30,47L5Z NO, 8 140,291.55 3.20 - 140,288.35 NO. lO MAINTENANCE 213,191.22 999.10 212.18LI2 NO. 11 MAINTENANCEIOPERATING 194.306,99 3,520.18 3.718.52 199.505.33 NO. 11 RESERVE 225.604.65 - - 225,6K65 CALHOUN COUNTY WCm 61 OPERATING ACCOUNT 212.138.35 - - 212.138.35 PAYROLLTAX 961.49 - - 961.49 CALHOUN COUNTY PORT AUTHORITY MAINTENANCE/OPERATINO •••• 62,246,79 62.246.79 CALHOUN COUNTY PROSTBANK 7.010.87 2D10.87 ••*• THE DEPOSITORY FOR CALHOUN COUNTY WCD IS INTERNATIONAL BANK OF COMMERCE • PORT LAVACA THE DEPOSITORY FOR CALHOUN CO. NAVIGATION DISTRICT IS FMST NATIONAL BANK -PORT LAVACA THE DEPOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK - AUSTIN, TEXAS THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS PR ORT LAVACA Court costs and fees collected and reported may not be current d up-to-date a to on -car ce y o er county offices. I hereby certify that the current balances are correct to all monies that hav bee cei ed by nt esurer of the dale of this report. ,j / . n1i4i S.KOKENA TREASURER Page 3 of 3 #17 NOTICE OF MEETING — 2/2/2022 17. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 14 of 15 a m 'a i 3 m z z O �I N N N N W O W O a m m m z z z o b o� m m a c A On goon e o 0 O O O e o O o pp 'Ci'I T O o e O o a O a m N w O T o O o N M O N N T N T l G Z O � WW N N T S G O O 0 O O O a m 3 m z �1 z O H N p1 S N N N O1 A N O O y m y N c [ m z m z �a N h z o co m OR c A N 9 m 0 0 � m N m m a a z z H o z m a b (G b 10 N fD N b b b b on O O O O ea cAyz� 0 0 0 y z z z 0000� O o O O T O O O O T O O O O O O T O O ± N yy O o O o �Tn e y T q pN A N M [I1 b i o O O O T T b o o m O O O O S �I O 2t z z z 0 m b b 100 b Z O z z W 0 0 �0 00�yy z z oRpmME O O T O O T O 'a C 9 3 p o z D m ;u y O m z m W m z z oZ N 0 m 9 m r T cc:r Z O 0 O c z Q O m m_ C a� O a T re O O O O 0 m 9 3 p m m = m 1 z 2 O O Z Q m� oa p O < C z0 O m i e m i w m 6 AO AO z z 0 m a mm' I Z O m N T p « O F. 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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 County 2021 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens County 2022 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Adjourned: 10:13 a.m. Page 15 of 15 Zr n0 3 >�ma 7m� vm z� =a a a z z 0 0 r r O O O y x A Cz Cn -� y � m r y m y S a a y O O O O O O O O O N N p A y.� nn 3a o « <g <3 �x o-1> 0 0� o> o� o� On .jr ym x� m zz zz Z0 z Zz zz m0 m0 ..t0 ,..t0 -7O y0 yZ n00 t)y r Fa Aa F a Fa �a r r m m Oa N m m m m m < y c a n n cai n r) n z y x x x x x a a m � w w N u u u u u O\ W A d O O O O O N N O ry O O n 9g 3 �3 3 Oa> xz3 ya3 moA3 any yvyy y a a ra a kMa Oma Cma mM> Oma nC3 nc3 �2 pz 33n o3n �3n �3n 33n zmm zzc W mww D m w M w nto to ZC w_ rn m m a m x m crn n0 nOr y myyyx mAx ^'OS OS �m2 ymm yi°m R C D .�-a Ctr'� mz3 ZxZm33 yw On On y z NzID A�� tA mto r M W z Cz M. 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S o 8000 Q <z0 �A> n- X O X 8 mnae nma Co vFi N N N N z n ?O m N m � s N Oon N O D aw0 �p0 m a,� m�D <zcn] nn� m O J p � ryC7 O = O = y n � w O O m O r r rn In y rn y s 0z m m n m N 0 n O con ya D zw0 A - za= e m�a <zn nn� m A O r z OO 3 � f 3 �i P lJ - N N O O J R 6 ^ O O O O S O 0 N 0 P 3 ma O C) zp z 3 3 a m ^ g tsn m O O m n a0 mz �m m ,i c m y N z o z .° a y -mC 9 O z w r � a m n H < n O Z m y n 3D �y 3D 3D >y 3D nS m3 �c^2 m3 R m3 m3 m3 mS' no 3 O"' < xn m Ovp Gi mvv� ezno0 DPr>FhA l—�2" r o t-A C)m r In Oyu> m{ 'O n Z O z zm zm zm zm zm m Z v z v v m m m m m y A A A w N N N N N N O oo to U VI N V1 U lA N N lA lA N W (A 1NJ1 T P Q J a Q q Q T p Q C O n O ^ , bw m m mom ? mOu ON pn ° yaD O:a "oq a oH_ >W0 ZOpr =a'DNym aa° A sG 0a _0 0 —0 OOAo� paa ° Or Or Or Or Or Or -raw r' O cmi nm m (mn� m fm] mry F p o yNa < o o aOm r z Z Z Z 2 Z Z mOa 3pn o r a m m m m m m 3 V O Oo A q A N JA w O � q tVi� tAi� N O N O O O O O d ° T b w N twit O C 1.8 c O c z „cro z r0- n r z o o N N N N N N N N N O O O O O N O O O p r a>�ac TO SO 3D cyy02 T 02 r"nn n ° �x D SOn° rn n0 rny 0 ,On0 n -3 D > ti o v O T m M Z Z En a i 3m<a 0w o<� "n aSyO� a a a° Wrnn aO° x m d n Oy n n OO �a my 3 _n _n _n P P P � J X X A A P q aq P N N J C O O OO •'p F m y X m Cw O�n .N- Nz O Ap= yNO O z > s 3s an m3 a z a� a° -" z° a n'O w0 moN C A " �m�� OT m rn P � to 3 Y CC Ohm T a ai 7o 3 A m y a a a r N U N A P J N N Di A A O J W ao ao 0g 00 Ana ma m 0 n � N � N O U O O z a r A 3 y z z z y y o �{ y gym, ° ti r z y m O C m w w w w w w w w w b O b b N b b lI N N N tbi N N O O O O rn n� zCc: cc xn arC- xn °- nr nH 3AA-ai nH x m �w °n n �O �O �O �O z0 yz O �' A>y F>y Ay Cm :CM -a-] 2r m 'a r r r r Za y Za p z y � n n n n n m n m ca- n W A O O O O W w W A b b o A N A a a eo W o w b ymW W am Nam m oNAN mN �>w Ky Ox�2oN �.Nb.. °z. 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N y N N O O N O N N O O O O O O O 0 0 O O rn Cn M to rppo rn -3 n0-3 mz mz mz m nx'�1 m^n rn 0y 54 n C (S -zi r) r x� x� �cm Cm Cm 2ES mC� rail vim+ vy oa oa a oa oa >ro>E yyE roF.;n mr "n 'o n O "n "n ZO z0 z0 m my c37y aw z� yzy {< {< O O 9 a O O :gym Km -gym zC'7 z� Z o a n y r rtm -rim a a ro Z a b b M "t �' n O G 'o O m { o O �> n n> m m m z C 0 2 Y m T m m m a a a n �'n O 0 z° zo o b b U A b b J J J N U U A N N N N n N w O N U CO J J < < a a O.-n pa a a na a a roa a a -a na na na n a Fa m A [rw m w Om �m Cm rm rm m rm rw nA nA mA mW mA A mA mA a 0. o O J m 0 m w b m 0 m o o C C mq= as y rn aro rn 0 aro aro ti aro aro Z Z mw9 ,mc ,Co ,CD a i r ,aro sZ mm a a 9 a a O O C rO n y r y r C. y m tm» y ti ,ror_, y a m y m Czi m y y n' y n n n < a < < < < 5 m X � m m m m -ai m a 0 Q w J A A N W N N W A �D VNi U A A w oo N N tY W CO O CO 'W V A LA U IJ IJ 'O w1 Q� �O W W N O V J N b CO b b b O O O b U C E O P O N x AO p b maY ^ w0 m n n A � O y W n J O m /m r O n z z zm Z m < i { m m C m a n 9 y A N P A O O O w J a n r N J w O w O w O to O O O p N n iz <m n 0 <m �p n >Oz G) a m m az m0 m a 'a nm a a rm jz m o < a no n o m x 0 O m n O a O W U J W lA W p� w O A A A 9 O O N to O < z p 3 W � R p w n y ti 0 w O w x w m0 F H ;3 n0 p0 00 mop z zm z `D m Ca 'n ,SOz m W yY a t° asn A e oy c m m0x n Z m z t7 _c .c N �e O N N �O M oo Co O W A N U O O O O O O O O O O O yg N^ Y rn y 8 f0 -�7 H 3 3 9 m m a z z H H 0 ir 9 0 R P N 6 O 0 0 S ro ro 3 3 m m 3 Z Z e o � 9 n N n O P p ro 0 9 o Z O aR ny oy y y z r yy n z G a_ y Y o yN 0 X 0 J A N O A T W - N J w A n Q O O O a R a g z O z O v v 3 0 m n c H n n n m R o � N c 3 Z m b O m G m OCf r Zn� o _ a q C OO N IJ O !f N ' N rog`c min x D v ;o a uO ^ S A N a 3 W v N J m O N O A n 6 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---February 02,202 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL P.AYABLES PAYROLL AND E CTRQNIC.BgNK PAYMENTS $'r 985;377 9.Q, TOTgLTRANSFERS BETWEEN FUNDS_ $_ 27,7,20095 TOTAI iNS1RSlNG HOME OWL ' XPENSES';_ $ '1,079;894.05,' TOTAL!fNT,EWGO,VERNMENT TRANSFERS $ GRAMD'TOTAL DISBURSEMENTS APPROVED Februa 02, 1022 $ -$ 282'289 901 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---February 02 2022 PAYABLES AND PAYROLL 112712022 Weekly Payables 1/2712022. Patient Refunds 1/31/2022 McKesson-340B Prescription Expense 1/31/2022 Amerisource Bergen-34013 Prescription Expense 1/31/2022Payroll Liabilities -Payroll Taxes 1/31/2022 Payroll Electronic Bank Payments TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 1/27/2022 MMC Operating to Broadmoor-correction of NH insurance payment deposited into MMC Operating 1/27/2022 MMC Operating to Golden Creek-correctlon of NH insurance payment deposited Into MMC Operating in error 1/27/2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment deposited into MMC Operating 1/27/2022 MMC Operating to Tuscany Village-correctlon of NH insurance payment deposited into MMC Operating 112712022 MMC Operating to Bethany -correction of NH insurance payment deposited into MMC Operating in error MEDICARE ADVANCE PAYMENT RECOUP 569,102.89 3,341.27 16,953.36 2,116.62 94, 327.63 299,162.87 373.26 9135,3779Q 4,436.81 52,122.68 32,653.96 6,326.54 83,551.39 1/31/2022 Broadmoor to Bethany -correction of Broadmoor medical recoup taken from 12,703,19 Bethany 1/31/2022 Crescent to Bethany -correction of Crecent medicare recoup taken from 12,703.19 Bethany 1/3V2022 Solera.to Bethany -correction. of Solera medicare recoup taken from Bethany 12,703,19 TOT,TRANS E12$�E,hWEN;tYL1N17S'. $'_._ 2d7r20095;: NURSING HOME UPL EXPENSES 1/31/2022 Nursing Home UPL-Cantex Transfer 518,162,34 1/31/2022 Nursing Home LPL -Neuron Transfer 64,471.53 1/31/2022 Nursing Home UPL-HMG Transfer 85,458.84 1/31/2022 Nursing Home LIPL-Tuscany Transfer 182,970A6 1/31/2022 Nursing Home UPL-HSL Transfer. 228,627.88 hTORSING^.H'OIVt) :00L1=XPENSE3 $ '1,P29; AC115' ITOT�VL.IfflTERG�VE,RNMENT`TRANSF6RS _ $; f�1i/lN[??"fOT�A�.of9�2URS�IVI�N'fSiAPPROY�D'��ti�ira OQ;�p22 _ 2,2§22fi9s9jf} Page 1 of 15 RECHVEP 13Y THE TORON Ot(a'0� ZUZZ MEMORIAL MEDICAL. CENTER AP Open Invoice List 0 11:29 ap_opan_invoice.templata Due Dates Through:02/16/2022 �UNCOUNTME" or# Vendor Name Class Pay Code A1111 A&JLANDSCAPING f Invoice# Comment TranDt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 011722 ✓ 01/25120 01/17/20 01117/20 450.00 0.00 0.00 450,00 /. LANDSCAPING 011822 ✓ 01/26/20 01 /18120 01/18/20 880.00 0.00 0.00 880.00 LANDSCAPE SERVICES , Vendor Totals Number Name Gross Discount No -Pay Net A1111 A & J LANDSCAPING 1,330.00 0.00 0.00 1.,330.00 Vendor# Vendor Name Class Pay Code R1200 ADT COMMERCIAL ✓' Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Not 143569788 ✓/ 01/25/20.01/05/2001/30/20. 49.18 0.00 0.00 49.18 4,f FIRE MONITORING VendorTotals Number Name Gross Discount No -Pay Net R1200 AOT COMMERCIAL 49.18 0.00 0.00 49.18 Vendor# Vendor Name Class Pay Code O A1715 ALCSALES&SERVICE CO ��. M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net j 28717191N%/ 04/25/20-01/17/2002/04/20 224.00 0.00 0.00 ,r 224.00 .f SUPPLISE Vendor Totals Number Name Gross Discount No -Pay Net A1715 ALCO SALES & SERVICE CO 224.00 0.00 0.00 224.00 Vendor# Vendor Name Class Pay Code / 14028 AMAZON CAPITAL SERVICES ✓ Invoice# Comment Tran Dt Inv Ot Due Dt Check 0 Pay Gross Discount No -Pay Net 16CNNY7DFMKM 11/ 01126/2001/17/Po 02/16120. 178.79 0.00 0.00 178.79 s/'f SUPPLIES CpVjq�,i�hMc, Vendor Totals Number Name Gross Discount No -Pay Net 14028 AMAZON CAPITAL. SERVICES 178.79 0.00 0.00 178.79 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC .✓ Invoice# Comment Tran. Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2444723 01/21/20. 01/17/2002116/20 2,814.00 0.00 0.00 2,814.00 TRAVEL LAB STAFFING 11 j-I811 o-1-I14 WJq III ,r 2444512 ✓ 01/21/20 01/17/20 02116120 3,182.50 0.00 0.00 3,182.50 ✓ TRAVEL LAB STAFFING (1a12I I a-1- 11 dX3-) r.+7 66q 2444681/ 01/21/2001/17/2002/16/20 2,760.00 0.00 0.00 2,760.00 TRAVEL LAB STAFFING 1 I -131 1a-I- A L �7-7-) Si M it{1it,1v Vendor Totals Number Name Gross Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 8,756.50 0.00 0.00 8,756.50 Vendor#Vendor Name Class Pay Code B1220 BECKMAN COULTER INC M Invoice# Comment Tran Dt Inv Dt Due Ot Check Pay Gross Discount No -Pay Net 109576632 01/05/20. 01/04/2002M 1120. 136.86 0.00 0.00 136.86 ✓ SUPPLIES 109622474 / 01/25/20. 01/19/20 02/13/20 39.12 0.00 0.00 39,12 ✓ SUPPLIES file:///C:/Users/eheimar,/cpsi/memmed.cpsinct.com/u98547a/data_5/tmp_cwSreport33 53... 1 /27/2022 Page 2 of 15 ✓ 109628745 01/26/20 01/20/20 02/14/20 75.60 0,00 0.00 75:60 L SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 251.5E 0.00 0.00 251.58 Vendor# Vendor Name Class Pay Code 12740 BUILDING KID STEPS v'f Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net ✓ NOV2021A 01/26/20.01/26/2001/26/20. 1,052.00 0.00 0.00 1.052.00 PEDI SPEECH SPEECH THERAPYS , NOV 2021./ 01126/20. 01/2612001/26/20 1,052.00 0.00 0.00 1.052.00 PEDI SPEECH THERAPY / DEC2021C 01/26120 01126/20 01/26/20 U60'(D 600.00 0.00 0.00 U00.l}i)500,40 ! P EDI SPEECH THERAPY DEC20218v`' 01/26/2001/2612001/26/20. 1,026.00 0.00 0.00 1,026.00 PFFDI SPEECH THERAPY NOV20218 ,/ 01126/20 01126/20 01/26/20. 1,213.00 0.00 0.00 1,213.00✓ PEDI SPEECH THERAPY , DEC2021A, 01/26/20. 01/2612001126/20 1,026.00 0.00 0.00 1,026.00 PED11OCCUPATIONAL THERAI NOV2021C ,/ 01126/2001126/2001/26/20, 450.00 0.00 0.00 450.00 PEDI SPEECH THERAPY Vendor Totals Number Name Gross Discount No -Pay Net 12740 BUILDING KID STEPS Uglq.00 6,3/9.00 0,00 0.00 6,31/00 Vendor#Vendor Name Class Pay Code A1825 CARDINAL HEALTH 414,LLC „% M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8002724149 V/01/21/20 01/10120 01/29/20 232.41 0.00 0100 232,41 f� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1825 CARDINAL HEALTH 414,LLC 232.41 0.00 0.00 232.41 Vendor# Vendor Name Class Pay Code 14200 CAREFUSION SOLUTIONS, LLG ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 10119256 r/ 01117/20,1210312002111120. 266,013.00 0.00 0.00 266,01300 PYXIS EQUIPMENT ,. Vendor Totals Number Name Gross Discount No -Pay Net 14260 CAREFUSION SOLUTIONS, LLC 266,013.00 0.00 0.00 266,013.00 Vendor# Vendor Name Class Pay Code 13992 CARIANT HEALTH PARTNERS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 129141 ✓ 01/11/2010/27/2002/11/20 11000.00 0.00 0.00 1,000.00 � TRAVEL NURSE STAFFING ( 0 11? 1 L7) 6"tlu- 131689 ,i 01/24/20.. 01119/2002116/20 1,680.00 0.00 0.00 1,680.00 ✓' TRAVEL NURSE. STAFFING t011V%.) T7-- 011 a1�22):�*6.y / 1278498/ 01/25/20.09/08/2010108/20 5,140.00 OAO 0.00 5,140.00 TRAVEL NURSE STAFFING ( $ I3110-1-1,412O 6y 6tkL_ 128362A ✓/01/25/20 09/30/20 10130/20. 1,020.00 0.00 0.00 1,020.00 TRAVEL NURSE STAFFING (41HIS1) bV1A U_ . Vendor Total: Number Name Gross Discount No -Pay Net 13992. CARIANT HEALTH PARTNERS 8,840.00 0.00 0.00 8,840.00 Vendor# Vendor Name Class Pay Code file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 3 of 15 C1992 COW GOVERNMENT, INC. M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Q584737 ✓,/ 01/21/20. 01/07/2002108/20. 281.42 SUPPLIES aarsw1 ✓f 01/25/20 01/14/20 02/13/20. 20.55 /SUPPLIES Q873129 01/25/2001/14/2002113120 214.58 SUPPLIES Discount No -Pay 0.00 0.00 0.00 0.00 0.00 Q929684 01/25/20. 011171PO 02/16/20 1,207.52 0.00 SUPPLIES Vendor Totals Number Name Gross Discount C1992 CDW GOVERNMENT, INC. 1,724,07 0.00 Vendor# Vendor Name Class Pay Code C1730 CITY OF PORT LAVACA v/'� W Invoice# Comment Tran Dt Inv.Dt Dus Dt Check D Pay Gross 02722A 01/25/2001/19/20 02/07/20 27.04 WATER SERVICE HOSP JAN 2 020722B 01/25/20,01/1912002/07/20 62.29 WATER SERVICE CLINIC JAN, 0.00 0.00 No -Pay 0.00 Discount No -Pay 0.00 0.00 0.00 0.00 020722 01/25/20. 01/19/2002/07120 65.49 0.00 0.00 WATER SERVICE PT JAN 22 020722C 01/27/20 01/14/20 02/07/20 1,941.78 0100 0.00 WATER SERVICE HOSP JAN 2 Vendor Totals Number Name Gross Discount No -Pay C1730. CITY OF PORT LAVACA - 2.096.60 0.00 0.00 Vendor# Vendor Name Class. Pay Code C1160 COASTAL OFFICE SOLUTONS ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay OEOT194732 v/ 01/25/20 01/19/20 01/29/20 666.50 0.00 0.00 SUPPLIES OEOT194731 / 01125/20 01/21/20 01/3112Q 150.00 0.00 0.00 SUPPLIES OEQT193912 �/ 01125/2001/2112001/31/20 118.24 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay 01166 COASTAL OFFICE SOLUTONS 934.74 0.00 0.00 Vendor# Vendor Name Class Pay Code 13336 COCA COLA SOUTHWEST BEVERAGES ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 24165200481 �'� 01/12/2001/12/2002/12/20. 814.99 0.00 0.00 DRINKS Vendor Totale Number Name Gross Discount No -Pay 13336 COCA COLA SOUTHWEST BEVERAGES 814.99 0.00 0.00 Vendor# Vendor Name Class Pay Code % 11368 CYRACOM LLC J Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 1445486 1PJ31/20. 12/31/2002/14/20 572.67 0.00 0.00 INTERPRETATION SERVICES Vendor Totals Number Name Gross Discount No -Pay 11368 CYRACOM.LLC 572.67 0.00 0.00 Vendor# Vendor Name Class Pay Code Net 281.42,,, 20.55 214.58 ✓ 1,207.52 Net 1,724.07 Net 27.04 y� 62.29 65.49 1,941.78 t Z Net 2,096.60 Net 666-,50 y,r' Isom LZ 118.24 Net 934.74 Net 814.99 ✓ Net 814.99 Net 572.67 Net 572.67 file:/(/C:/Users/eheiman/cpsi/memmed.epsinet.com/u98547a/data 5/tmp_cw5report3353... 1/27/2022 Page 4 of 15 14292 DEARBORN LIFE INSURANCE COMPAN Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net JAN 2022 01/24/20 01/20/20 01/20/20 3,732.00 0.00 0.00 3,732.00 LZ� PAYROLLDEDUCTS Vendor Totals Number Name Grass Discount No -Pay Net 14292 DEARBORN LIFE INSURANCE COMPAN 3,732.00 0.00 0.00 3,732.00 Vendor# Vendor Name Class Pay Code 10368 DEWITT.POTH & SON JJ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6692070 / 01119120, 01/17/20 02/11/20. 366.42 0.00 0.00 366.42. ✓' SUPPLIES 6692040 ✓ 01/19/20.01/17/20 02/11/20 174.74 0.00 0.00 174.74 a/f /SUPPLIES 6692060 ✓ 01/19/20 01/17/20 02/11/20. 105,61 0.00 0.00 105.61 y% SUPPLIES 6692140� 01/1912001117/2002/11/20. 64.18. 0.00 0.00 / 64.18 V SUPPLIES 6692970 y'� 01/21/20.01/18/2002/12/20 43.41 0.00 0.00 43.41 SUPPLIES 6692990,1' 01/21120 01/18/20 02/12120 182.54 0.00 0.00 182.54 ✓ SUPPLIES 6694050 V 01/24/20. 01/19/20 02/13/20 165.31 0.00 0.00 165.31 ✓"' SUPPLIES 6695840V 01/24120, 01/19/2002/13120. 651.79 0.00 0.00 651.79 ✓ SUPPLIES 6694110 VI/ 01/24/20 01/19/20 02/13/20 237.50 0.00 0.00 237.50 v' SUPPLIES 66941201,./ 01/24/20.01/19/2002113/20, 295.82 0.00 0.00 295.82 ai ,SUPPLIES , 6684480✓ 01/25/2001/10/2002104/20 683.58 0.00 0100 683.58 SUPPLIES 6692141 �,% 01125/20 01 /18/20 02112/20. 23.90 0.00 0.00 23.90 SUPPLIES 6695841 ,�'01/25/20 01/20/20 02/14/20 161.25. 0.00 0.00 161.25 SUPPLIES 6671280 ✓ 01/27/20, 01/07/20 02101/20. 17A8 0.00 0.00 17.18 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH&SON 3,173.23 0.00 0.00 3,173.23 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS ✓/ Invoice# Comment Tran. Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay Net 40911 ,f 01/26/20. 01/31/20 02/10/20 40.062.50 0.00 0.00 40,062.50 LI PHYSICIAN STAFFING (14-ebv"� _ Vendor Totals Number Name Gross Discount No -Pay Net 11284 EMERGENCY STAFFING SOLUTIONS 40,062.50 0.00 0.00 40,062.50 Vendor# Vendor Name Class Pay Code C2510 EVIDENT ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross. Discount No.Pay Net A2201051738 v-' 01/2412001/0612001/30/20 17,516.00 0.00 0.00 17,515.00 HARDWAREITECH :SUPPORT file:///C:/Users/eheimaniepsi/memmed,cpsinet.com/u98547afdata_5/tmp ew5report3353... 1/27/2022 Page 5 of 15 994122 ,/ 01/24/20. 01/10/2002/04/20 260.00 0.00 0.00 260.00 END OF YEAR FORMS , Vendor Totals Number Name Gross Discount No -Pay Net C2510 EVIDENT 17,775.00 0.00 0.00 17,775.00 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP. �,! w Invoice# Comment Tran Dt Inv Dt Due Ot Check D, Pay Gross Discount No -Pay Net 763506199 1/ 01/25/20 01/20/20 02114/20 97.56 0.00 am 97,56 FREIGHT Vendor Totals Number Name Gross Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 97.56 0.00 0.00 97.66 Vendor# Vendor Name Class Pay Code 14092 FIRST CONNECT CENTER LLC invoice# Comment Tran Dt InvOt Due Dt Check D, Pay Gross Discount No -Pay Net 3690 01/11120.01/10/2002/10/20 4,593.75 0.00 0.00 4,593.75 V TRAVEL NURSE STAFFING GI2,1U"IA-cWIxl)fbuvixj yA . , 3689 r,.� 01/11/20,01/1012002110120. 4,687.50 0.00 0.00 4,687.50 TRAVEL NURSE STAFFING [ I2I I'll ` I2-111 k Z11 61w ," wk 3691 ✓� 01/11/20. 01/10/2002/10/20, 4,687.50 0.00 0.00 4,687.50 V TRAVEL NURSE STAFFING I lZi 3 1 - � I ZI rz) 13unKh0_VA Vendor Totals Number Name Gross Discount No -Pay Net 14092 FIRST CONNECT CENTER LLC 13,9W75 0.00 0.00 13,968.75 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE �% M Invoice# Comment Tran Dt Inv Dt. Due Dt Check Pay Gross Discount No -Pay Net 7841099 t// 01/21/20 01/06120 01/31/20, 157.15 0.00 OAO 157.15 p1� ,SUPPLIES _ 8048383 ✓ 01/21/20. 01/11/2002105/20. 1,895.40 0.00 0.00 1,895.40 ✓ SUPPLIES 8322657 ,/01/25/20,01/17/2002/11/20 120.46 0.00 0.00 120A6 SUPPLIES 851BP73 v// 01/25/20. 01120/2002/14/20 237.97 0.00 0.00 237.97 / SUPPLIES 7071736A, 01/26/20 12/15120 01109/20 -154.08 0.00 0.00 -154,08 .i CREDIT 8387746 v/ 01/26/20 01/18/20 02/12/20. 1,041.96 0.00 0.00 1,041.96 SUPPLIES 8387748v 01126/20. 01/18/2002112/20 141.20 0.00 0.00 141.20 y/ SUPPLIES j. 8197799✓ 01127120 01/13120 02107/20 9,416.30 0.00 0.00 9,416.30 SUPPLIES VenddrTotal.Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 12,856.36 0.00 0.00 12,856.36 Vendor# Vendor Name Class Pay Code 14156 FUJI FILM ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net PJIN0172765 01/21/2G05/15/2006/25/20. 7,908.33 0.00 0.00 7,908.33 SMA FEE PJIN0176033 r% 01/21/20 07/15/20 08/25/20. 7.908.33 0.00 0.00 7,908.33 SMA FEE PJIN017T709✓ 01/21/2008/1612009/25120. 7,908.33 0.00 0.00 7.908.33 ✓ file:///C:/Users/eheimanlepsi/memmed.cpsinct.com//u98547a/data 5/tmp ew5report3353... 1/27/2022 Page 6 of 15 SMA FEE Vendor Totals Number Name Gross Discount No -Pay Net 14156 FUJI FILM 23,724.99 0.00 0.00 23,724.99 Vendor# Vendor Name Class Pay Code W1300 GRAINGER ✓ M Invoice# Comment Tran Dt Inv or Due Dt Check a Pay Gross Discount No -Pay Net 9175702233 ✓ 01/25/20 01/12/20 02/06/20 222.60 0.00 0.00 222.60 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net W1300 GRAINGER 222.60 0.00 0.00 222,60 Vendor# Vendor Name Class Pay Cade s G1210 GULF COAST PAPER COMPANY ,% M Invoice# Comment Tran Dt Inv Dt Due Dt Check.D Pay Gross Discount No -Pay Net 2170871 ✓01/21l2001/17/2002/16/20. 54:70 0.00 0.00 i 54.70 SUPPLIES 2167607 ,// 01/25120 01/11/20 02110120 32.53 0:00 0100 im. 32.53 11 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 8723 0.00 0.00 87.23 Vendor# Vendor Name Class Pay Code 10804 HEALTHCARE CODING & CONSULTING ,/ / Invoice# Comment Tran Dt Inv Dt DueDt Check D' Pay Gross Discount No -Pay Net 11852 ✓ 01/25120. 12/31/2001/30/20. 571.25 0.00 0.00 571.25 L,,'' CODING SERVICES , Vendor Totals Number Name Gross Discount No -Pay Net 10804 HEALTHCARE CODING&CONSULTING 571.25 0.00 0.00 571.25 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES ✓l Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Not 100564896/ 01/21/20.01/07/2002/01/20 7,154.17 0.00 0.00 7,154,17V' LEASE 100564825r% 01/21/2001/07/2002/01/20. 4,919.41 0.00 0.00 4,919.41✓ LEASE Vendor Totals Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 12,073.56 0.00 0.00 12,073.58 Vendor# Vendor Name Class Pay Code 11182 ✓/ Invoice# Comment Tran Dt. Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 012022 01/26/20.01/20/2001/20/20- 200.00 0.00 0.00 200.00 REFUND Vendor Totals Number Name Gross Discount No -Pay Net 11182 200,00 0.00 am 200,00 Vendor# Vendor Name Class Pay Code 14256 INFICARE HEALTH, INC. y/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMC1230.V 01/12120: 12/30/2002/11120 2,325.00 0.00 0.00 2,325.00 TRAVEL NURSE STAFFING i I1JaV-10-�3tlI=-IJ NL4IOIla.� MMC0106 01124/2001/06/2002/06/20. 2,673.75 0.00 0.00 2,673.75 TRAVELNURSE STAFFING (12-151- JI4.1za) N61.1PTj , Vendor Totals Number Name Gross Discount No -Pay Net 14250 INFICARE. HEALTH, INC. 4,998.75 0.00 0.00 4.998.75 file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547a/data_5/tmp cw5report3353... 1/27/2022 Page 7 of 15 Vendor# Vendor Name Class Pay Code / L1001 LANDAUER INC ✓ W Invoice# Comment Tran Dt Inv Dt DueDt Check D Pay Gross Discount No -Pay 100956132 V/01/25/20.11/18/2011/18/20 849.65 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay L1001 LANDAUER INC 849.65 0.00 0.00 Vendor# Vendor Name Class Pay Cade 10972 M G TRUST ,// Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay 011422 01/24/20 01/14/20 01114/20. 640.86 0.00 0.00 PAYROLL DEDUCTS Vendor Total: Number Name Gross Discount No -Pay 1.0972 M G TRUST 640.86 0:00 0.00 Vendor# Vendor Name Class Pay Code M2181 MATTHEW BENDER & CO.,INC.. ,% W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 29765781 / 01/24/20.01/10/2002110/20 75.08 0.00 0.00 CONTINUING EDUCATION Vendor TotaN Number Name Gross- Discount No -Pay M2181 MATTHEW BENDER & CO.,INC. 75.08 0.00 0.00 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 11972236 01/1712011/30/2002111120, 243.10 0.00 0.00 FINANCE CHARGES 11972235 �/ 01/17/20. 11/30/20 02111120, 8.78 0.00 0.00 FINANCE CHARGE 12017167,/ 01/1712012/31/2002111/20. 8.78 0.00 0.00 FINANCE CHARGE 12017168y/ 01/17/20. 1213112002/11/20. 251.79 0.00 0.00 FINANCE CHARGE 18923000 / 01/17/2001/0412002115/20. 69.01 0.00 0.00 SUPPLIES 1524760 f 01/18/2008/0712002J11/20: -510.59 0.00 0.00 CREDIT CM1818305/ 01118120 05/12120 02111120 -500.62 0.00 0.00 CREDIT CM18930128 r/, 01118120. 01/05/2002/11/20 -223.24 0.00 0.00 CREDIT 18947586✓ 01/18/2001/11/2002111/20 4,936.43 0.00 SUPPLIES / 18968888 ✓ 01/25/20, 01117/2002111/20 473.85 0.00 SUPPLIES 18969137 ✓ 01125/2001/17/2002/11/20; 588.09 SUPPLIES 18979274 01/25/20. 01/20/2002J11/20 51.39 SUPPLIES 18930128 / 01/26/20. 01/05/2002111/20. -223.24 CREDIT Vendor Totals Number Name Gross 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Discount No -Pay Net 849,65 V/ Net 849.65 Net 640,86 Net 640.86 Net 75A8 u Net 75.08 Net / 243.10 a/ 8,78 8.78 j 251.79 69.01 ✓' -510.59 ✓ -560.62 -223.24 4,936.43 ✓'r 473.85 r/ 588.09 51.39 -223.24 Net file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 M2178 MCKESSON MEDICAL SURGICAL INC 5,113.53 0.00 0.00 Vendor# Vendor Name Class Pay Code 12588. MEDICAL TECHNOLOGY ASSOCIATES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay INV193865,/ 01/26/20. 12/08/2001/02120,. 2,700.00 0.00 0.00 DRYER WORK Vendor Total: Number Name Gross Discount No -Pay 12588 MEDICAL TECHNOLOGY ASSOCIATES 2,700.00 0.00 0.00 Vendor#Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. i// A/P Invoice# Comment Tran Dt. Inv Dt Due Dt Check D, Pay Gross 012422 01/26/20 01/25/20 01/25/20 69.20 INDIGENT Vendor Total: Number Name Gross 10613 MEDIMPACT HEALTHCARE SYS, INC. 69.20 Vendor# Vendor Name Class Pay Code M2827 MEDIVATORS M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 91191204 ✓ 01/14/20. 01/10/20 02/11/20 400.00 SUPPLIES Vendor Total: Number Name Gross. M2827 MEDIVATORS 400.00 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D'Pay Grass 1982022095 01/25/2001/11/2002/05/20 142.76 SUPPLIES 1982184475 ✓/01/25/20.01/12/2002/06/20 18.98 SUPPLIES 1982184478 V/' ai/25/2o ot/12/2o 02/O6/20. 51.54 SUPPLIES 1982184477 t// 01/25/20, 01/12/20 02106/20.. 54.90 SUPPLIES i Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1982144049 ✓ 01/25/20 01112/20 02/06/20 2.495.70 0.00 0.00 0.00 Page 8 of 15 5.113.53 Net 2,700.00 V'l Net 2,700.00 Net 69.20 Net 69.20 Nei 400.00 Net 400:00 Net 142.76 18.98 51.54 ,...' 54.90 L,l 2,495.70 v' SUPPLIES 1982184476 y7 01/25/2001H2/2002/06/20 5.38 0.00 0.00 5.38 SUPPLIES 1982144046 ✓ 01/25/20 01/12/20 0006/20 16.15 0.00 0.00 16.15 ./ SUPPLIES 1982184479✓ 01/25/2U01/12/2002/06/20 35.49 0.00 0.00 35.495.- SUPPLIES 1982184482✓ 01/251200111PJ2002/06120 201.16 0.00 0.00 201,16 ,f SUPPLIES 1982184490 ✓/ 01/25/20. 01/12/20 02/06/20 123.00 0.00 0.00 123.00 SUPPLIES 1982184474 ' 01/25/2001/12/200=6/20 44.14 0.00 0.00 44.14 SUPPLIES _ 1982184469✓'` 01/2512001/12/2002106/20 308.37 0.00 0.00 308.37 SUPPLIES 1982184487 �/ 01/25/2007/12/2002/06/20 3,333.61 0.00 0.00 3,333.61 SUPPLIES file:///C:/Users/eheiman/cpsi/memmed.cpsinet.coni/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 9 of 15 1982144051, / 01125/20 01/12/20 02/06120 1.168.76 0.00 0.00 1,168.76 SUPPLIES 1982184473 ✓ 01/2512001/12/2002106120. 11.34 0.00 0.00 11.34 f SUPPLIES 1982144052 `/ 01/25/2001/12/2002/06/20 114.56 0.00 0.00 114.56 SUPPLIES 1982144048✓ 01/25/20. 01/12/2002106/20. 1,602.83 0,00 0.00 1.602.83 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 9,728A7 0.00 0.00 9,728.67 Vendor# Vendor Name Class Pay Code 10963 MEMORIAL MEDICAL CLINIC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Grosse Discount No -Pay Net 011422 01/24/20 01/14/20 01114/20. 493.00 0.00 0.00 493.00 PAYROLLDEDUCTS P"l Vendor Totals Number Name Gross Discount No -Pay Net 10963 MEMORIAL MEDICAL CLINIC 493.00 0.00 0.00 493.00 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC Invoice#/ Comment. Tran Dt Inv Dt Due Dt Check 6 Pay Gross Discount No -Pay Net 5640 ✓ 01/24/20 01/17/20 01127/20 39.12 0.00 0.00 -39.121/� CREDIT 7773875 ✓ 01/24/20.01/18/20 01/28/20. 115.09 0.00 0.00 115.09 ✓� .INVENTORY , 7772811 v ` 01124120.01/1812001/28/20 0,97 0.00 0.00 0.97 'NVENTORY 7773876 ./ 01/24/20 01/18/20 01/28/20, 1,422.09 0.00 0.00 1,422.09 ,INVENTORY , 7775854 „/ 01/24/20.01/19/2001/29/20. 27.21 0,00 0.00 27.21 INVENTORY t 7779282/ 01/24/2001/19/2001/29/20 550.42 0.00 0.00 550.42111 )NVENTORY . 7775863 ,% 01/24/20, 01/19/20 01/29/20. 15.83 0.00 0.00 15.83 JNVENTORY , 7779283 ,�/ 01/24/20 01/19/20 01/29/20 641.43 0.00 0.00 641.43 INVENTORY , 7775852 ,/ 01/24/2001119/2001/29/20. 18.67 0.00 0.00 18.67 INVENTORY , 7782573 ✓,- 01/24/20, 01/20/2001/30/20. 17.94 0.00 0.00 17.94 ✓- INVENTORY 7782574 01/24/20 01/20/20 01130/20. 486.04 0.00 0.00 486.04 ✓'� /.INVENTORY 7782162,7 01/24/20:01/20/2001/30/20 59.06 0.00 0.00 59m INVENTORY , 7782163f 01/24/20. 01W/2001/30/20 29.92 0.00 0.00 29.92 ✓" INVENTORY , 7782575 4� 01124120.01/20/2001/30120 231.26 0.00 0.00 231.26 .: INVENTORY 6553 ,/ 01/24/20 01/20/20 01/30/20 -2.75 0.00 0.00 -2.75 CREDIT 7789758 , 01/25/20. 01/23/2002/02120 1,945.77 0.00 0.00 1,945.77,/' file:///C:/Users/eheiman/cpsi/rnemmed.cpsinet.com/u98547a/data 5/tmp ew5report3353... 1/27/2022 Page 10 of 15 /INVENTORY � 7789769 ✓ 01/25/20. 01/23/2002/02J20. 560.40 0.00 0.00 560.40 INVENTORY , 7792137 01/25/20. 011/24/2002103120 290.29 0.00 0,00 290.29 INVENTORY 7795121 / 01/25/20 01/24/20 02t03/20 184.51 0.00 0.00 184.51 ✓`� INVENTORY 7792139 ✓ f 01/25/20 01 /24/20 02/03/20 318.05 0.00 0.00 31 B.os ✓ INVENTORY 7792136 01/25/20 01124/2002/03/20. 28.28 0.00 0.00 26.28 /INVENTORY 7795120 +/ 01125/20. 01/24/2002/03120 66.08 0.00 0.00 06.08 ✓- JNVENTORY 7792138 ,' 01/25/20. 01/2412002/03/2(t 289.89 0.00 0.00 289.89 y% ,INVENTORY 7800691 01/26/20. 01/25/20 02104/20. 7,042.03 0.00 0,00 7,042.03 V INVENTORY 7797376 ,/ 01/26/20, 01/25/20 02/04/20 3.97 0.00 0.00 3.97 ✓ INVENTORY 7800690 01/26/20.01/25/2002/04/20. 726.49 0.00 0.00 726.49 ✓" INVENTORY 7797377 ✓ 01/2612001/25/2002/04120- 30.69 0.00 0.00 30.69 ✓' INVENTORY / CM13403A ✓ 01/27120 01/21/20 01/31/20. -503.10 0.00 0.00 -503.10 CREDIT Vendor Total: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 14,557.41 0.00 0.00 14,557.41 Vendor# Vendor Name Class Pay Code 14124 MSH HEALTH SERVICES LLC V1 Invoice# Comment Tram Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net MMC0038 ✓ 01/17/20 01/10/20 02/11120, 4,676.25 0.00 0.00 4,67625 TRAVEL NURSE STAFFING (I14- 11k 1�,2) vu UY1tFjl6tr. MMC0039 1/ /01/24/20 01/17/20 01/17/20 6,927,50 0.00 0.00 6,927.50 ✓ TRAVELNURSE STAFFINGI_O W - 111391 7-"r-) MMC0040 y/ 01/24/20. 01/18/2002116/20.++ 2,741.04 0.00 0.00 2,741.04 ✓ yy TRAVEL NURSE STAFFING L 1 I '-� I L 47 Zz) JUY1 aAA-' Vendor Total- Number Name Gross Discount No -Pay Net 14124 MSH HEALTH SERVICES LLC 14,344.79 0.00 0.00 14,344.79 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC �i� M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8800852847 ✓ 01/25/2001/1012002109/20_ 386.27 0.00 0.00 386.27 yJ� SUPPLIES 8800844794 / 01/26/2012117/2001/16120 716.06 0.00 0.00 716.05✓ SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2659 MXR IMAGING, INC 1,102.32 0.00 0.00 1.102.32 Vendor# Vendor Name Class Pay Code / 12388 NATIONAL FARM LIFE INSURANCE ✓ Invoice# Cgomment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3607213 01/26/20 01/17/20 02/01/20 3,837.36 0.00 0.00 3,837.36 file://YC:/Users/eheiman/cpsi/memrned.cpsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 11 of 15 PAYROLL DEDUCT Vendor Totals Number Name Gross Discount No -Pay Net 12388 NATIONAL FARM LIFE INSURANCE 3,837.36 0.00 0.00 3,837.35 Vendor# Vendor Name Class Pay Code i 73624 NEXION HEALTH AT NAVASOTA INC I/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Grass Discount No -Pay Net TM20220102 �% 01125/2001/09/2001/09/20. 1,000.00 0.00 0.00 1,000.00 ' TELEMED REIMBURSMENT DI Vendor Totals Number Name Gross Discount No -Pay Net 13624 NEXION HEALTH AT NAVASOTA INC 1,000.00 0.00 0.00 1,000.00 Vendor# Vendor Name Class Pay Code 14262 OLOOP TECHNOLOGY SOLUTIONS V Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INVAJONES0011 01118/20. 01/1212002111/20 5,960.00 0.00 0.00 5,960.00 r% TRAVEL NURSE STAFFING tIJ-1-B)13)$2�� ,5 INVAJONES0010 01/18/20.01/12/2002/11/20. 5,979.20 0.00 0.00 5,979.20 y' TRAVEL NURSE STAFFING ((y)aiJ11-1?4I�-y�-10+ 1. Vendor Totals Number Name Gross Discount No -Pay Net 14252 OLOOP TECHNOLOGY SOLUTIONS 11,939.20 0,00 0.00 11,939.20 Vendor# Vendor Name Class Pay Code 01500 OLYMPUS AMERICA INC ✓. M Involce# Comment Tran Dt Inv Dt Due Dt Check D.Pay Gross Discount No -Pay Net 32048506 ✓� 01/21/2001107/2002/01/20. 1,137.51 0.00 0.00 1,137.51 S7RVICE CONTRACT 32042795 s/ 01125/20, 01/07/2002J01/20 194.03 0.00 0.00 194.03 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 1,331.54 0.00 0.00 1,331.54 Vendor# Vendor Name Class Pay Code 10032 PHILIPS HEALTHCARE v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 947297642 r/'J 01/26/20 07/30/20 08/24/20 995.00 0.00 0.00 995.00 947788926 ,J 01/26/2010106/2010/31120. 247.50 0.00 0.00 247.50 t,/ SUPPLIES 947862019,/� 01/2612010/15/2011/09/20, 167.25 0.00 0.00 167.25 ✓` SUPPLIES 947917687 ✓ 01/26/2010/24/20 11/18/20 437.25 0.00 0.00 437.25 SUPPLIES 947956588 y� 01/26/2010/28/2011/22/20. 192.00 0.00 0.00 192.00 SUPPLIES 947956587 / 01/26/2010/2812011/22/20. 133,50 0.00 0.00 133.50 �UPPLIES . 947968313 01/26/20. 10/2912011123120 207.00 0.00 0.00 207.00 SUPPLIES 947968311 ✓ 01/26/20 10/29120 11/23/20 621.00 0.00 0.00 621.00 SUPPLIES. _ 947968315,/' 01/26/2010/29/2011/23/20 1,242.00 0.00 0.00 1,242.00 948170263 ✓� 01/26/2011/25/2012/20/20 120.00 0,00 0,00 120.00 j SUPPLIES. file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547a/data 5/tmp cw5report3353.., 1/27/2022 Page 12 of 15 948170270 y/ 01/2612011125/2012/20120, 315.00 0.00 0.00 315.00 SUPPLIES 948294347 % 01/26/20. 12/09/20 01/03/20 609.10 0.0 0.00 609.10 f gUPPLIES 948316926,/ 01/2612012/1212001/06/20. 51.75 0.00 0.00 51,75,/� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10032 PHILIPS HEALTHCARE 6,338.35 0.00 0.00 5,338.35 Vendor# Vendor Name Class Pay Code P1590 PHYSICIAN'S RECORD COMPANY �/� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 0231397IN 01/25/20 12/31/20 01/30/20 302.07 0.00 0.00 302.07 PACU LOG Vendor Totals Number .Name Gross Discount No -Pay Net P1590 PHYSICIAN'S RECORD COMPANY 302.07 0.00 0.00 302.07 Vendor# Vendor Name Class Pay Code 11080 RADSOURCE Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /Comment PO-26931 r/ 01121120, 01/16/2002/10/20 11625.00 0.00 0.00 1,625.00 SERVICE CONTRACT SC136549✓ 01/21/2001/19/2002/13/20 1,708.33 0100 0.00 1,708.33 AGREEMENT /gERVICE SC136550 v' 01/21120 01/19/20 02/13120, 1,791.67 0.00 0.00 1,791.67„i CONTRACT /SERVICE SC136543 y 01/21120. 01/19/20 02/13/20. 1,708.33 0.00 0.00 1,708.33 f' SERVICE AGREEMENT Vendor Tolals Number Name Gross Discount No -Pay Net 11080 RADSOURCE 6,833.33 0.00 0.00 6,833.33 Vendor# Vendor Name Class Pay Code 10927 ROSHANDA THOMAS „/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 012422 01125/20. 01/24/2001/24/20; 34-16 0.00 0.00 34.16 TRAVEL (I lq I S L - tyl-t4ia' W ( el C1'e LE f , Vendor Totals Number Name Gross Discount No -Pay Net 10927 ROSHANDA THOMAS 34.16 0.00 0.00 34.16 Vendor# Vendor Name �. Class Pay Code 10699 SIGN AD, LTD. ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 270387 ✓,/ 01/26/20 01/16/20 01/26/20 400.00 0.00 0.00 400.00 j BILLBOARD AD w . Vendor Totals Number Name Gross Discount No -Pay Net 10699 SIGN AD, LTD. 400.00 0.00 0.00 400.00 Vendor# Vendor Name Class Pay Code 14240 SMILEMAKERS ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Nei 9093471 ✓ 01/24/20 01/19/20 01/30/20 59.92 0.00 0.00 59.92 STICKERS Vendor Total: Number Name Gross Discount No -Pay Net 14240 SMILE MAKERS 59.92 0.00 0.00 59.92 Vendor# Vendor NameClass Pay Cade 11296 SOUTH TEXAS BLOOD & TISSUE CEN file:///C:/Users/eheiman/cpsi/memmed.cpsinct.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 13 of 15 Invoice# lromment Tran Dt Inv Dt Due Dt Check D'Pay Gross Discount No -Pay Net CM6176 V'� 01118120. 01/16/2002/14/20-1,659.00 0.00 0.00 -1,659.00 V•. CREDIT 107019919 V 01118/20.01115120 02/14/20. 7,065.00 0.00 0.00 7,065.00 ; BLOOD PRODUCTS Vendor Totals Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 5,406.00 0.00 0.00 5,406.00 Vendor# Vendor Name Class Pay Code 01010 SPARKLIGHT V w Invoice# Comment Tran Ot Inv Dt Due. Dt Check D' Pay Gross Discount No -Pay Net 011622 01/24/20 01/16/20 01/30/20 95.40 0.0o 0.00 95AO INTERNET CLINIC JAN22 013022 01/24/2001/1612001/30/20 2,252.00 0.00 0.00 2,262.00 s/l TELEPHONE 011622A 01/24120 01/16/20 01/30120 1,675.15 0.00 0.00 1,675.15 INTERNET HOSP JAN 22 , Vendor Totals Number Name Gross Discount No -Pay Net 01010 SPARKLIGHT 4,022.65 0.00 0.00 4,022.55 Vendor# Vendor Name Class Pay Code 10735 STRYKER SUSTAINABILITY ✓ Invoice# Comment Tran Dt Inv Dt Duo Dt Check DPay Gross Discount No -Pay Net 4350183 ✓/ 01/25/20 01/17/20 02/16/20 95.71 0.00 0.00 95.71 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABILITY 95.71 0.00 0.00 95.71 Vendor# Vendor Name / Class Pay Code TP639 T-SYSTEM, INC o/ w Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 60452 ✓� 01/2512011130/2012/30/20. 5,699.00 0.00 0.00 5,699.00 EV PHYSICIAN/NURSEITRACK . Vendor Totals Number Name Gross Discount No -Pay Net T2539 T-SYSTEM, INC 5,699.00 0.00 0.00 5,699.00 Vendor# Vendor Name Class Pay Code 11944 TALX CORPORATION �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check DvPayGross Discount No -Pay Net 1002624835 �,/ 01/25/20 04/08120 05/08/20 10.99 0.00 0.00 10,99 �/- ACCOUNT SERVICES 1002725210 ✓ 01/25120. 05/08/20 06/07/20 10.99 0.00 0.00 10.99.1,/• AC/COUNT SERVICES 1002826971 i/ 01/25/20 06/08/20 07/08/20. 10.99 0.00 0.00 10.99 vl/ ACCOUNT SERVICES 1002931630 f yr 01/25/20 07/08I20 08l07/20. 10.99 0.00 0.00 '! 10.99 ✓"� ACCOUNT SERVICES 1003028314 1/ 01/25/20 08/00/20 09/07/20, 10,99 0.00 0.00 10.99 t/'! ACCOUNTSERVICES 1003092387�/' 01 /25/2009108/2010/08/20, 10.99 0.00 0.00 10.991,/"� ACCOUNT SERVICES 1003155215 V 01/2612010/08/2011/07/20 10.99 0.00 0.00 10.99 ACCOUNT SERVICES . 2050988379 • / 01/25/2011/15/20 12/15/20 10.99 0.00 0.00 10.99 ACCOUNTSERVICES file:///C:/Users/eheiman/cpsi/memmed.cpsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 14 of 15 2051025931 01/2512012/OB12001107120, 10.99 0.00 0.00 10.99 4% ACCOUNT SERVICES , Vendor Totals Number Name Grass Discount No -Pay Net 11944 TALX CORPORATION 98.91 0.00 0.00 98.91 Vendor# Vendor Name Class Pay Code 10758 TEXAS SELECT STAFFING, LLC Invoice# Comment Trap Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net 001894351079IN w% a 1/21/2001/0612001106/20. 4.320.80 0.00 0.00 4,320.80 ✓� TRAVEL NURSE STAFFING 0019047510791N 01/24/2001/20/2001/20/20. 4,021.60 0.00 0100 4,021.604,;r TRAVEL NURSE STAFFING ,c&LhKA- Vendor Totals Number Name Gross Discount No -Pay Net 10758 TEXAS SELECT STAFFING, LLC 8,342.40 0.00 0.00 8,342.40 Vendor# Vendor Name Class Pay Code / 11039 THEBRATTON FIRM t/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 012022 01/21/20. 01/20/2001/20/20. 1,250.00 0.00 0.00 1,250.00 .SERVICES +% Vendor Totals Number Name Gross Discount No -Pay Net 11039 THE BRATTON FIRM 11250.00 0.00 0.00 1,250.00 Vendor# Vendor Name Class Pay Code / 14224 THE TACT CORPORATION OF NYC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 928670202, 12J31/20. 12/17/20021115/20 5,760.00 0.00 0,00 5,760.00 TRAVEL NURSE STAFFING { i11 S- B z11112,1) " [a , Vendor Totals Number Name Gross Discount No -Pay Net 14224 THE TACT CORPORATION OF NYC 5,760.00 0.00 0.00 5,760.00 Vendor# Vendor Name Class. Pay code 13224 TORCH f Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net / 2225565 ✓ 01/27/20.10/1812010/18/20. 10,250.00 0.00 0.00 10,250.00 CEO CANDIDATE REVIEW Vendor Total: Number Name Gross Discount No -Pay Net 13224 TORCH 10,250.00 0.00 0.00 10,250.00 Vendor# Vendor Name Class Pay Code 14208 TRUSTED HEALTH, INC v,/ Invoice# Comment Trap Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net INV7765 01124120 01/16/20 01/15/20 I 4l!623.75 0.00 0.00 4,623,75 t,r' TRAVEL NURSE STAFFING ( 1)-7-IJA1Zz) �tfIIUWS Vendor Totals Number Name - Gross Discount No -Pay Not 14208 TRUSTED HEALTH, INC 4,623.75 0.00 0.00 4,623.75 Vendor# Vendor Name Class Pay Code U1064 UNI FIRST HOLDINGS INC Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay Net 8400386024 / 01/18120, 01/17/2002/11/20, 40.10 M00 0.00 40.10 LAUNDRY 8400386023J 01/18/20,01/17/2002/11/20. 45-15 0.00 0.00 45AS LAUNDRY $400386050 / 01/18/20 01/17/20 02/11/20 2,338.61 0.00 0.00 2,338.61../ LAUNDRY 8400386389✓/ 0 1/24120 01/20120 02/14120 94.34 0.00 0.00 94.34 file:///C:/tJsers/eheiman/cpsi/memmed.opsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 Page 15 of 15 LAUNDRY 8400386354 ✓ 01/24/2001/20/2002/14120 173.89 0.00 0.00 LAUNDRY . 8400386352 V' 01 /25/20 01 /20/20 02/14/20 34.90 0.00 0.00 LAUNDRY 8400386355 d 01 /25/20 01/20/20 02/14/20 198.99 0.00 0.00 LAUNDRY 8400386356✓ 01/25/2001/20/2002/14/2o 199,32 0.00 0.00 LAUNDRY 8400386368 V 01/25/20 01/20/20 02/14120. 79.43 0.00 0.00 LAUNDRY 8400386374 / 01,25,20. 01,20/2002114/20. ,/LAUNDRY 1,706.06 0.00 0.00 Vendor Totals Number Name Gross Discount No -Pay U1064 UNIFIRST HOLDINGS INC 4,908,79 0.00 0.00 Vendor# Vendor Name Class Pay Cade 12208 WAGEWORKS ✓� Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay INV3337365 f 01/21/20, 01/18/20 02/16120. 580.25 0.00 0.00 MONTHLY ADMIN/COMPLIANC 011422 01/24/20,01114/2001/14/20 3,537.29 0.00 0.00 FLEXIBLE SPENDING Vendor Total, Number Name Gross Discount No -Pay 12208 WAGEWORKS 4,117.54 0.00 0.00 Vendor# Vendor Name / Class Pay Code ✓ 11110 WERFEN USA LLC involce# Comment Tran Dt Inv Dt Due Dt Check Pay Gross 9111096997E 01/25/20 01/12/20 02/O6/20, 160.11 SUPPLIES 9111101900 ,/ 01 /25/20 01/19/20 02113/20 1,236.36 SUPPLIES Vendor Totals Number Name Gross. 11110 WERFEN USA LLC 1,396.47 Report Summary Grand Totals: Gross Discount 509,002.89 0.00 0•C 50u�tju 600.OU T _569„102.89 APPROVED ON JAN 2 7 2022 BY COUR1r? AUD(TOA CALHOUN COUtM, TEXAS 173.89 j 34.90 196.99 ✓ 199.32 ✓"' 79.43 v 1,706.06 Net 4.908.79 Net 580.25 ,� V 3,537.29 Net 4,117.64 Discount No -Pay Net 0.00 0.00 160.11 0.00 0.00 1,236.36 �- Discount No -Pay Net 0.00 0.00 1.396.47 No -Pay Net 0.00 569,002.89 m a WrtAii/A <,"O. u> $�,uu, file:///C:/tJsers/eheiman/cpsYmemmed.cpsinet.com/u98547a/data 5/tmp cw5report3353... 1/27/2022 RUN DATE: 01/27/22 MEMORIAL MEDICAL CENTER TIME:4&,ll�rnn 9,.I.NE EDIT LIST FOR PATIENT REFUNDS ARID-0001 Cn .%ATORON PATIENT PAY PAT NUMBER J�ApgEd 14PE2022 DATE AMOUNT CODE TYPE DESCRIPTION ------------------------- -...----------------- -------------•----------------------------------- 012122 10.00 2 REFUND FOR 1 012122 150.00 ✓! 2 REFUND FOR ' 012522 1964.56 ✓ 3 REFUND FOR 012522 124.80 2 REFUND FOR 012522 150.00 „/ 2 REFUND FOR 012122 40.00 ✓ 2 REFUND FOR 012122 477.59 ,/ 2 REFUND FOR ; 012122 50.00 ✓ 2 REFUND FOR I 012122 21.002 REFUND FOR 012122 278.32 5 REFUND FOR '-'-------------------------------- ---........................................................ 012122 75.00 % 2 REFUND FOR ARID=0001 TOTAL ................................. --------------------- ................... 3341.27 -------------------- TOTAL 3341.27 JAN 2 7 2022 BY COUNTY AUDITOR CAL40UN COUNTY, TEXAS PAGE 1 APCDEDIT GL NUM ME-KESSON STATEMENT As of: 01/28/2022 Page: 002 Tor acct Company: 8000 Stub DC: 8115 As of: MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBIT Territory: Mall to'. AP Statement for information only AMT 815 N VIRGINIA STREET Customer. 632536 State PORT LAVACA TX 77979 Date: 01/29/2022 Cust: Date: 0 3111ing Due Receivable ational Account 3rdi?6 Cash Amount P Amoun )ate Date Number Reference Description Discount (gross) F (net) IF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item -OTAL- National Acct 632536 MEMORIAL MEDICAL CENTER Subtotats: 17,301.29 USD vture Due: 0.00 Di It Paid By 02101/2022, U: >ast Due: 95.80- Pay This Amount: 16,953.36 USD DI ast Payment 2,451.97 If Paid After 02/0112022, Di IS/07/2017 Pay this Amount: 17,301.29 USD U: `4 15°491°13 + 9 1 1 ° 6 9 + 2.86-D6 + 1°24 r 16,955`)r APPROVEri aN JAN 31 2022 13Y CON TyUDrwR CALHOUN C UNTY, TEDf1$ e, ort'�� For AR Inquiries please contact 800-867-0333 MSKESSON Company; 6000 HIB PHCY 0434/MEM MED PHS ME OF31AL MIEDICAL CENTER VICKY KAUSE( 815 N VIRGINIA ST PORT LAVACA TX 77979 STATEMENT AMT DUE REMITTED VIA ACH DEBIT Statement for information only As of: 01/28/2022 DC: 8116 Territory: 400 Customer: 190813 Date: 01 /29/2022 Page: 001 To, soon stut As of: Mail to AMT State Cost: Date: tilling Due Receivableational Account 83Refe2sa6r Cash Amount P Amour )ate Date Number Reference Description Discount (gross) P (net) :ustomer Number 190813 HEB PHCY 0434/MEM MED PHIS 11/26/2022 02/01/2022 7320673106 2017043191 1151nvoice 0.63 31.60 3 0/28/2022 02/01/2022 7321220163 2017043379 1151nvoice 4.74 237.01 23 IF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item "OTAL Customer Number 190813 HED PHCY 0434/MEUI MED PHIS Subtotals: 268.61 USD 'uture Due: 0.00 0 If Paid By 02101/2022, U past Due: 0.00 Pay This Amount: 263,24 USD D ast Payment 14,606.52 If Paid After 02/01/2022, D 01124/2022 Pay this Amount: 268,61 USD U APPA011€0'EyA JAN 31 2022 BY COUNTY 99VIV-0, CALHOUN cove v, VA < > For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: Oi/28/2022 Page: 001 To aril Company: 0000 slut DC: 8115 As of: WALMARr 1098/MEM MED RHS AMT DUE PEMITT® VIA AGN DEBIT Territory: 400 Mail to MEMORIAL MEDICAL CENTER Statement for information only AMT VICKY KAUSEK State 815 N VIRGINIA ST Customer., 256342 FORT LAVACA TX 77979 Date: 01/2912022. Cust: Date: 3ilte Due ational Account a32sa6 Receivable Refer' Casa Amount P )ate Date Number Reference Description Discount (gross) F (net) (not) )ustomer Number 256342 WALMARf 1098/Ml]N M® PHS 11/22/2022 02/01/2022 7320074328 0121220819 1151nvoice 0.04 2.21 11/24/2022 02/01/2022 7319992163 23803543 1151nvoice 0.10 11/24/2022 02/01/2022 7319992154 23829559 1151nvoice 0.03 1.27 11/24/2022 02/01/2022 7319992156 23829559 1151nvoice 8.06 403.16 39 11/24/2022 02/01/2022 7319992156 23877992 1151nvoice 8.06 403.16 39 11/24/2022 02/O1/2022 7319992157 23881406 1151nvoice 2.21 110,28 10 11/2412022 02101/2022 7319992158 23930343 1151nvoice 0.03 1.27 11/24/2022 02/01/2D22 7319992159 23952647 1151nvoice 9.73 486,65 47 11/24/2022 02/01/2022 7320165932 0121220740 1951nvofce 3.22 161.08 15 11/26/2022 02/01/2022 7320346878 23976674 1151nvoice 1.93 96,57 9 11/25/2022 02/01/2022 7320355971 24030783 115Invoice 1,22 60.84 5 11/25/2022 02/01/2022 7320531197 0124221031 1151nvoice 0.64 32.08 3 11/26/2022 02/01/2022 7320657359 WMMM01252 1151nvoice 1.61 80.50 7 11/26/2022 02/01/2022 7320657361 24120049 1151nvoice 32.08 1,603.99 1,57 N 126/2022 02/01/2022 7320657362 24/20049 1151nvoice 2.91 145.68 14 11/26/2022. 02/01/2022 7320815337 0125220802 1951nvoice 76.49 3,824,49 3,74 11/26/2022 02/01/2022 7320815338. 01.25220734 1151nvoice 35,28 1,764.10 1,72 11/27/2022 02/O1/2022 7320922130 24150925 1151nvoice 5.68 284.11 27 11/27/2022 02/0112022 7320922131 24200062 1151nvoice 0.06 11/27/2022 02/01/2022 7320922133 24203711 1151nvoice 6.62 330.93 32 I1/27/2022 02/01/2022 7321085183 0120R20925 1151nvoice 02.03 3,101.52 3,03 11/28/2022 02/01/2022 7321212289 24211.902 1151nvoice 0,12 11/26/2022 02/O1/2022 7321212290 24227987 1151nvoice. 20.34 1,416,79 1,38 11/28/2022 02/01/2022 7321212291 24227987 1151nvoice 0.01 0.63 11/28/2022 02/01/2022 7321212292 24269529 1151nvoice 13,75 687.35 67, 11/28/2022 02/01/2022 7321212293 24269529 1151nvoice. 11.95. 597.65 581 11/28/2022 02101/2022 7321344751 0127220910 1151nvoice 0153 26.57 21 11128/2022 02/01/2022 7321344752 0127220749 1951nvoice 3.68 184.10 181 e> For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT As of: 01/28/2022 co -paw 8000 DC: 8115 WALMAITT 1098/MBA MED PHS AMT DUE REMITTED VIA ACH DEBIT TevRory: 400 MEMORIAL MEDICAL CENTER Statement for information only VICKY KALISEK Customer: 256342 815 N VIRGINIA ST Date: 01/29/2022 PORT IAVACA TX 77979 Page: 002 TO f accc stub As of: Mail to: AMT State Cust: Date: 0 ational Account 6 )filling Due NumbRecelabl Cash (grow) P (Amoun not) )ate Date Number Reference Description Discount (gross) F (net) fF cofumn legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item "OTAL• Customer Number 256342 WALMART 1098/MEM MED PHS Subtotals: suture Due: 0.00 It Paid By 02/01/2022, fast Due: 0.00 Pay This Amount: Ast Payment 14,606.52 If Paid After 02/01/2022, 11124/2022 Pay this Amount: APPROVED ON JAN 31 W2 BY COUNTY AUDITOR CALHOUN COUWY, MAS 15,807.26 USD Di U: 15,491-73 USD Di D1 15,807,26 USD Uc (4 vt/L--� < > For AR Inquiries please contact 800-867-0333 MSKESSON O mpeny 8000 HED PHY FC 490/MEd MC PHS MEMORIAL MEDICAL CENTER VICKY KAUSEK 815 N VIRGINIA ST PORT LAVACA. TX 77979 STATEMENT AMT DUE REMITTED VIA ACH DEBIT Statement for information Only As of: 01/28/2022 DC: 8115 Territory: 400 Customer: 464450 Dale: 01 /29/2022 Page: 001 To f a= stub As of: Mail lo; AMT Slate Cust: Date: 0 3111ing Due Receivablj4ational Account bM45f36 Cash Amount P Amoun' )ate Date Number Reference Description Discount (gross) F (net) :ustomer Number 464450 H® PHY PC 490/ME M MC PHS T 11/24/2022 01/24/2022 7320340115 MFC PR CORR CR Pricing Cor 53.26- P 51, 11/24/2022 02/01/2022 7320340116 MFC PR CORR IN Pricing Cor 0.21 10.55 11 11/25/2022 02/01/2022 7320339195 55x301301 1151nvoice 0.05 2.32 )1/28/2022 02/01/2022 7321187022 55008897 1151nvoice 14.06 702.85 681 11/28/2022 02/01/2022 7321187024 55x309067 IISInvolce 5,38 268,93 2& IF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due item -OTAL• Customer Number 464460 HEB PHY PC 490/MEM MC PHS Subtotals: 931.39 USD �uture Due: 0.00 DI It Paid By 02/01/2022, U7 last Due: 53.26- Pay This Amount: 911.69 USD Di asl Payment 14,606.52 It Paid After 02101/2022, DI 1112412022 Pay this Amount: 931.39 USD Ui APPR M ON JAN 3 1 2022 vvu/ 13Y COUN T YAUDHOR CALHOUN COUNTY, MAS c > For AR Inquiries please contact 800-867-0333 MSKESSON comnonv+ 8000 CVS PHCY 7475/MEM MC PHS MEMORIAL. MEDICAL CENTER VICKY KALISEK 815 N VIRGINIA ST PORT LAVACA TX 77979 STATEMENT AMT DUE REMITTED VIA ACH DEBIT Statement for information only As of: 01/28/2022 DC: 8115 Territory: 400 Customer. 835438 Date: 01 /29/2022 3IIIfng Due ReceivabOational Account b9Y6 )ate Date Number Reference Description :ustomer Number 835438 CVS PHCY 7475/MEM MC PHIS 11/24/2022 01/24/2022 7320334616 MFC PR CORR CR Pricing Cor 11/24/2022 02/01/2022 7320334617 MFC PR CORR IN Pricing Cor 11/27/2022 02/01/2022 7321120107 1548718 1151nvoice )F column fagend: P c Past Due Item, F n Future Due Item, blank = Current Due Item 'OTAU Customer Number 835438 CVS PHCY 7475/M901 MC PHIS Subtotals: 'vture Due: 0.00 It Paid By 02101/2022, )eat Due: 42.54- Pay This Amount: ast Payment 14,606.52 It Paid After 02/01/2022, 11/24/2022 Pay this Amount: APPROVED ON JAN 31 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Page: 001 To e 8= stub As of: Mail to: AMT States Cust: Date: 0 Discount (gross)Amount F (net) 42.54- P 4, 0.16 8.08 6.64 327.22 32, 292.76 USD Di U: 286.06 USD Di 01 292.76 USD U: 4 7 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT Company: DODO WALMART 5315/MBd RL MC PHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information only A/P 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 01/28/2022 DC: 8195 Territory: 99 Customer. 945479 Date: 01/29/2022 lilting Due RecalvabtPatlonal Account 931?6 )ate Date Number Reference Description )ustomer Number 945479 WALMART 5315/MEMRL MC PHS it/24/2022 02/01/2022 7320118194 MHO1212022 1951nvolce 11/2712022 02/01/2022 7321000546 MHO1262022 195lnvoice IF column legend: P = Past Due Item, F 6 Future Due Item, blank = Current Due Item Page: 001 TO f acoc stub As of: Mall to; AMT State Cusu Date: 0 Cash Amount P Amoun Discount (grass) F (not) 0.01 0.32 0.02 0.95 'OTAL• Customer Number 945479 WALMART 6315/MEMRL MC PHS Subtotals: 1.27 USD 'uture Due: 0.00 D If Paid 13y 02/0112022, U last Due: 0.00 Pay This Amount: 1.24 USD D ast Payment 14,606.52 If Paid After 02/01/2022, D 11/24/2022 Pay this Amount: 1.27 USD U ,APPROVED ON JAN 31 2022 i BY COUNTY AUDITOR CALHOUN COUNTY. TEXAS For AR Inquiries please contact 800-867-0333 AmensourceBergen- STATEMENT Statement Number: 62392696 Date: 01.28-2022 AMERISOURCEBERGEN DRUG CORP 12727 W. AIRPORT BLVD. SUGAR LAND TX 77478-6101 DEA: RA0289276 866-451-9655 WALGREENS #12494 340E MEMORIAL MEDICAL CENTER 1302 N VIRGINIA ST ;Sat PORT LAVACA TX 77979-2509 AMERISOURCEBERGEN P.O. Box 905223 Not Yet CHARLOTTE NC. 2829M223 Current Past Dt Total D Acccun Account Activity Document Due Date Date Reference Number Purchase Order Number Document Type Original Last Receipt Amount 01-24-2022 02-04-2022 3081063868 164440 Invoice 31A7 01-24-2022 02-04.2022 3081063869 164441 Invoice 55.36 01.24-2022 02-04-2022 3081100225 164488 Invoice 111.36 01-24-2022 02-04-2022 3081100226 164489 Invoice 0.09 01-25-2022 02-04-2022 3081231298 164498 Invoice 1,665,81 01.25-2022 02-04-2022 3081231299 164499 Invoice 2.19 01-26-2022 02-04.2022 3081385108 164506 Invoice 0.11 01-27-2022 02-04-2022 3081523862 164516 Invoice 133.59 01-27-2022 02-04-2022 3081523863 164517 Invoice 6,64 Current 1-16 Days 16-30 Days 31-60 Days 61-90 Days 91-11 2.006.62 0.00 0.00 0.00 0.00 Thank You for Your Payment Date Amount 01-28-2022 (675.51) APPROVED OM JAN 31 2022 13Y COUNTY AUDITOR CALHOUN COUNTY, TEXAS Reminders Due Date a-V-111 02-04-2022 'M STATEMENT Statement Number: 62406576 AmensourceBergen- Date: 01-28-2022 AMERISOURCEBERGEN DRUG CORP US BIOSERVICES CARROLLTON 340E 501 PATRIOT PARKWAY 5025 PLANO PARKWAY SUITE 100 � ROANOKE TX 76262-6336 CARROLLTON TX 75010 DEA: RA0316958 866-451-9655 AMERISOURCEBERGEN P.O. Box 978740 DALLAS TX 75397.8740 10027C I Sal -F Not Yel Curren) Past Di Total ❑ Acooun Account Activity Document Due Reference Purchase Order Document Original Last Receipt Date Date Number Number Type Amount 1711.2R-2022 02-04-2022 344600718 Invoice 55.00 Current I 1-15 Days 16-30 Days 31-60 Days 61-90 Days 91-11 55.00 0.00 0.00 0.00 0.00 Reminders Due Date 02-04.2022 APPROVED ON JAN 31 2022 BY COUN T Y AUDITOR CALHOUN COUNTY, TEXAS �) STATEMENT Statement Number: 62406859 AmensourceBergen• Date: 01-28-2022 AMERISOURCEBERGEN DRUG CORP SENDERRA RX PHY 340E ' 501 PATRIOT PARKWAY MEMORIAL MEDICAL CENTER 10028E ROANOKE TX 76262.6336 1301 E ARAPAHO RD STE 101 RICHARDSON TX 75081 Sat - Fi DEA: RA0316958 866-451-9655 AMERISOURCEBERGEN P.O. Box 978740 Not Ye' DALLAS TX 75397-8740 Curren! Past Dt Total D Accour Account Activity Document Due Reference Purchase Order Document Original Last Receipt Date Date Number Number Type Amount 01-28-2022 02-04-2022 344600735 Invoice 55.00 Current 1-15 Days 16-30 Days 31-60 Days 61-90 Days 91-1: 55.00 0.00 0.00 0.00 0.00 Reminders Due Date oz-o4-zozz APPROVED ohU JAN 3 J 2022 13Y COUNTY AUDITOR CALHOUN COUNTY, TEXAS TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" F"IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" El "6-DIG IT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #### ENTER: ###�� I:.f 0 0 $ 94,327.63. 1 $ 49,648.56 $ 11,611.42 $ 33,067.65 CHECK J CALLED IN BY: CALLED IN DATE: CALLED IN TIME: RAP -Payroll FilesSPayroll Taxesk20221#3 R1 MMC TAX DEPOSIT WORKSHEET 127.22AS 1131I2022 Fie .lC •-- F a V: 0 6 a S '1 Z I a r y _. — _". _._—-- .................. ............ C? a 7 .. e 0 f 5 6 u T T. a r; .____". ___-- --------------- ........................................ ..."..............r.._..__..._.._....................................... AF, .__... .. F.. _.._. .1, F. EEU Liii N641 :,165.:5 G !I 1i „7??.6? ii".4rr niinF,L'E SSW: L"G05.?. .. . NZ-.1 ... _ H. wttna FeY-.G [S]i.:-0 i� n 11 40edb.:] CAFE-< _..E-t :are-; .__.-l.'. W."-SG' .. .. !! 6,e? .... . CAFE-: '.rFE•8 "1.... xlt L,;I N r 1� ILL JD rn, JEITT•nt E01aU TINE iE.00 !! ? !! 1! L77?.Ic E&TSH' HUM 330RE F:n,.S•1! EHEA E EMU MRS N '. N N N U.00 FL% FE FCRT ➢ FL??. 1115EE:1L"c s.H 1: !, a 56.6; GIL '."Sp-: 1L T.. E "XI E ZE.--11,120S-EAIF. NEFLS _i5.....Ci �:s N:_. C Fn:ll• N.•JF: .x ,._ .• . _:.<4.1G ;: ACY. .... ..._ ., s..,_ No. .. .��: .� S .. .. .:?... ?.....; ELL+:! _.... . FOE 'x Caen 4:.. uC _ 13 57I!1.r 511.... LIv!k 51010 65C.75 s21E:_ .'D'is SPY?: _ -C-., _...,. TSy.1 7Sn.i. TL�.� 3i4HE. '0 ,...0 i!7VEC_ ---- Grana Inal.: e122e r, 43"75.a: ea ee on4 _t .87 r..._.-..'--""----__ ........................................... u�'Q� %?- 941 REC/TAX DEPOSIT FOR MMC PAYROLL -e PAY PERIOD: BEGIN -111412022. Y9 PAY PERIOD; END 11274022. PAY DATE; 2144022' GROSS PAY; S 437.089.55 DEDUCTIONS: AIR 5 576.12 ADVANC BOOTS SUNLIFE CRITICAL ILLNESS S 918.66 SUNLIFE ACCIDENT $ 903,99 SUNLIFE VISION $ - SUNLIFE SHORT TERM DIS S 1,603.86 BCSS VISION S 1,206.79 CAFE-O 5 1,770,26 CAFE-H S 26.133.57 S - S CAFE•P CANCER CHILD 5 609.70 CLINIC S 170.00 COMBIN 5 328.85 CREDUN DENTAL S - DEP-LF SUNLIFE TERM LIFE 5 748.$S SUNLIFE HOSP INDEM S 650.76 FED TAX S 32,067.66 FICA-M S 5,805.71 FICA-0 S 24.824,28 FIRST C S FLEX S 5 3.620.62 FLX-FE S - GIFT S $ 249.03 GRP-IN GTL HOSP-1 LEGAL S 1,042.66 OTHER S 115.26 NATIONAL FARM LIFE $ 1,918.75 MED SURCHARGE S 525.00 PR FIN 5 - RELAY REPAY STONEDF 5 640,86 STONE STONE 2 STUDEN TSA-R 5 30.586,46 UWIHOS S - TOTAL DEDUCTIONS: S 137,916.68 S -s..ouw vattn RERORr •aKcu� NET PAY: $ 299 172.37 1 $ 'BHOUII -*.UWWTCNReFM" Tu'I AL CAFE 125 PLAN: 5 36.697.60 Lc S S - S TAXABLE PAY: $ 400,391.95 $ 400.391.95 "CALCULATED" From MMC Reeort Difference FICA - MED (ER) m. S 5,805.68 FICA - MED (EE) +.. S SA05.68 S 5,805.71 S (0,03) FICA - SOC SEC (ER) s s.: 5 24,824.30 FICA -SOC SEC(EE) sajn S 24.824.30 $ 24.824.26 S 0.02 FEC WITHHOLDINr S 33.067.65 S 33,067,65 TAX DEPOSIT: S 94.327 61 5 94,32763 FICA -MEDICARE vsx $ 11,611.36 $11.611.42 FICA - SOCIAL SECURITY ,:.,r, S 49,648.60 $49,648.56 PREPARED BY: FED WITHHOLDING 5 33,067.66 $33,067.65 PREPARED DATE: TOTAL TAX: $ 94,327.61 $94,327.63 $ (0.02) REVISED 311WO14 NAL.CK HI TOTALS S 437,089.56 S 676.12 6 - 5 - S 1.205-79 S 1.770 26 S 26.133.57 S 5 6 5 - $ 60%70 5 170.00 S 328.85 S - S S S 743.95 S 6SO.76 S 33,067.65 5 6.805,71 S 24.824.28 S 5 3,620 62 S S 349.03 S - S - S S 1,042.56 S 116.26 S 1.918.75 S 625.00 S 5 - S S 640.86 S S - S S 30.586.46 S S - 5 137,916.68 'BHCWLY A4iGIRfiRORI•• 5 -j $ 299,172.87 Exempt Amt Employees over FICA•SS Cap: S Shanna Odonnetl S Roshanda Thomas S Psycode S -Employee RelmO.: TOTAL: $ Caitlin Clevenger 1131/2022 R3 RI MMC TAX DEPOSIT WORKSHEET 1 27 22 xis TAX DEPOSIT WORKSHEET V312022 ......an-. __. __ :_ kF5'3.._-� !'E._.a_ .:�?==_-iiE_._. 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PL,F.IA l F?RIAS 1023.7.4 DD 9C355 EMBIE DIME BIL&51' 745.93 OD 0214/22 OU34 ROSS N WKWK ¢112.39 DD Q:Wi ,...- A ;eiiLE11... .. .._ ._ .. • �1 91l:: J:�� F_AURTIlf:r RGIr1GAS 1411,4 ED VVNILL 020LL 5E?e_. OS^91t?A-SA1iCt.EZ 334.i3 DD n2ln� •2 ,riL O<G54 MPN: LAi'BA GAECIA 24I.:3 CC 62104/12 ..:£'r T:.... m SEEFCIE 993.51 CG C2144. -Exi.s .._.. C''C 52I412 O2193 TIK::'ERG' R 395..55 DC Oi/P4 i22 TitrE11116 3545.05 DC .24'4i22 ..... ..._.. _. .___ _ :..:Es .. N 4 9 GP . i21G412c ..... r.:.c 3 _L2r- :916.Lr DE WA. 0231E NINA !d GEBElf 1"5,3; ED 02�C4/22 :L415 .-REL.- KCIT 21 ..40 BE U..NA: :a P2D?STF ?a., c_:-.. 51i14122--U!2"22 F—m: i ?2=111 MGDALVJA SEPULVEDA 211,23 DD C2104122 .:_._ SAME M. _„_IZ NEE __ . ;4(2: f2534 SEAUNE !!4GU 221119 A Gh'04 e: ONS WES A G:F DISS 310 _. 514 . 0270i RGA^cA "K.MLL". MINI M9.7. N G21 4r'2' 075 DNO n `4CCL _.A M 113 A __ .... S Y'[< 02?;S 75n'EY L WIGGS 145U.06 GD 02/04!L _ _ TIN W . 1P_LEF 10',3. a. _. 4:'1041iL .2s2' MiCFAEL I GAZ'luc 3007,0P _= 0Zi 04 i22 C27 .}`iE G A ETBBC" 045.. BE U 141; 03864 JACQL'ELIHE R 3E pan.. 1I16,63 ED 0144/22 .L.. REW A MAETMEZ = 1.44 __ ,2IC4A q5(W XNE ; IIUM 13115 __ OKA: . ... •:i r.:T KLDEF 013A BE 12140, 1, 02. 62 N K)N/22 1:11i :ll-: _..-. BE W141: _:_- :::.._om A Emu i0 IR DD WZ: 114:2 .!'.TO`U LY,':i::Q:tE1.' 225.32 ED q;1L M._... _ :MS 1:1:5 LESA J EIAOJCSA 93i.46 EE 02%C4f'22 .._,. M KA E :NUM 1413 BE .i.'CME ..-.- .: La : DIME_ L ._.-. :1 -21t 1: 1513i SARIDIM HAOLEv I401.56 ED 02/0,/22 _.235 dniD: 1(Pli95; 2653.65 BE02iO4ii2 154i_" Mr; :9 IXED 056M DE 0:01 , 202C" Ssn% G W27L ?931.30' BE O104. _ ED _�. Cry^FP Ij ME"!; 41503 ED C: rG 11, 204@: En?d1Rin S PASSKR5 161.90 DE 02104/22 2015 NOR J!MEAEZ SIL22 DE 0214122 2CS3' OA._i M.=)R1v-.L iC 8.9i 20" .4E.Mll - TECCH.. 1433 AP E1 02141: F2EIi:. 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C'C O2UM 2991K X Page P2CIE r MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT--- January 24, 2022 - January 30, 2022 Date Bank Description 1/28/2022 PAY PLUS ACHTRANS 452579291101000693724126 1/28/2022 AMERISOURCE BERG PAYMENTS 0100007768 2100002 1/27/2022 PAY PLUS ACHTRANS 452579291101000692889496 1/26/2022 PAY PLUS ACHTRANS 452579291101000692038405 1/25/2022 PAY PLUS ACHTRANS 452579291 101000691205862 1/25/2022 MCKESSON DRUG AUTO ACH ACH04887338 910000133 1/24/2022 PAY PLUS ACHTRANS 452579291101000690301164 1/26/2022 WIRE OUT CBNA INCOMING SETTLEMENT ACCOUNT 1/26/2022 WIRE OUT CBNA INCOMING SETTLEMENT ACCOUNT Anthony Richardson Memorial Medical Center Date PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT-- ESTIMATED ACHS MMC Notes - 3rd Party Payor Fee -3408 Drug Program Expense -3rd Party Payor Fee - 3rd Party Payor Fee - 3rd Party Payor Fee -3408 Drug Program Expense - 3rd Party Payor Fee -CltiBank Corporate Card Payment -CitiBank Corporate Card Payment Description " �-F1�ppr/Wr0l 01•a4aacc. 31, 2022 I" 7Iy January 31, 2022 Anthony Richardson Memorial Medical Center MMC Notes Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON AM 2022 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 08O ap_open_invoice.template �1,HOUN COUNTY, TEXAS Due Dates Through: 02/17/2022 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 011022 01/21/2001/10/2002/17120. 4,436.81 0.00 0.00 TRANSFER � H 1'l1SUol.VtlL Pt�MI'i t'�1.�701ni 4[ a Ilt�N IW%L (Y(1(.N„}1 ,i Vendor Total. Number Name Gross Discount 11u_\o\-Pay 11832 BROADMOOR AT CREEKSIDE PARK 4,436.81 0.00 010 Report Summary Grand Totals: Gross Discount No -Pay 4,436.81 0.00 0.00 APPROVED ON' JAN 2 7 ZOZZ BY COUNTY AUDITOR CALHOUN (,0t1NV, TEXAS Net 4,436.81 Net 4.436.81 Net 4,436.81 file:///C:/Users/eheimari/cDsi/memmed.cDsinct.com/u98547a/data 5/tmn ew5renort2272... 1/27/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON JA0/�20;27 2022 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List �����gg��nn55�� l;At.ttUUN COUNTY, TEXAS ap_open_invoica.template Due Dates Through:. 02117/2 022 Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check n Pay Grass. Discount No -Pay Net 011122 01/tt2,��1/20. 01111/2002117/20 3,501.65 0.00 3.501.65 TRANSFER N11 1PtSJNKGL N4,j � �lt'P W KL. ,i�0.00 11ntwl" 011122A 01/21/20. 01/11/2002117/20 33,738.98 0.00 1Q.00 33,738.98 y/ TRANSFER it 011222 01/21/20 01/12120 02117/20 1,438.05 0.00 0.00 1,438,05 / t/ TRANSFER V it 012122 01/25/20. 01121/2002117/20. 13,444.00 0.00 0.00 13,444.00 75% OF PHASE 4 BASE PYMT Vendor Totals Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 52,122.68 0.00 0.00 52,122.68 Report Summary Grand Totals: Gross Discount No -Pay Net 52,122.68 0,00 0,00 52,122.68 A"OVED 01W BAN 2 7 2o22 CA HOUN C UC NN ,, TEXAS file:///C:[Users/eheiman/CDsi/memmed.ensinet.com/u98547a/data 5/tmn cw5renort4167... 1/27/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON J aN ZZ 022 MEMORIAL MEDICAL CENTER 7/2 0 AP Open Invoice List 11g �,AU1uG1�7C0UN1Y,7EXAS ap_open_invoice.template Due Dates Through: 02/17/2022 Vendor# Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 011122 01121/2001/11/2002/17/200 11,769.99 0.00 0.00 11,769.99 TRANSFER �[11--1hWr qQ_ �fll'1 G�,Dvh��r j_ 16 IV _ 011122A 01/21/20 01/11/20 02(17/20 20,883.97 0.00 0 20,883.97 t% TRANSFER li rA Vendor Totals Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 32,653.96 0.00 0.00 32,653.96 Report Summary Grand Totals: Gross Discount No -Pay Net 32,653.96 0.00 0.00 32,653.96 APPROVED ON JAN 2 7 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/eheiman/ensi/memmed.cl)sinet.com/u98547a/data 5/tmn cw5reoort8858... 1/27/2022 Page 1 of 1 RECEIVED BY THE BOUNTY AUDITOR ON JANJ274,022 MEMORIAL MEDICAL CENTER u 0 AP Open Invoice List 08:07 ap_open_involce.template CALHOUN COUNTY, TEXAS Due Date$ Through: 02117/2022 Vendor# Vendor Name Class Pay Cade 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011122 0112u1/20. 01/1112002/17/20. 3,914.22 0.00 0.00 3,914.22 TRANSFER N ti jMijW (j I1Vj �"'I/� It � 1 �k� nn Hk�1L r 012422 01/24/2001/24/2002/17 0 2,412.32 0.00 2,412.32 ✓ MEDICARE REPAYMENT . Vendor Totals Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 6,326.64 0.00 0.00 6,326.54 Report Summary Grand Totals: Gross Discount No -Pay Net 6,326.54 0.00 0.00 6,326.54 APPROW0 W JAN 2 7 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/eheiman/cnsi/memmed.cnsinet.com/U98547a/data 5/tmn cw5renort8256... 1/27/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON JAN 2 7 2022 MEMORIAL MEDICAL CENTER 01/27/2022 AP Open Invoice List CA81@9UN COUNTY, TEXAS Due Dates Through: 02/17/2022 Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING r / Invoice# Comment Tran of Inv Dt Due of Check D Pay Gross 011022 0I1121120. 01/10/20 02117/20, 1,855.010 TRANSFER t IJ VI VtSojgk 11I1! fe (,�A'. 0t'liiij- Ike 011122A 01/21/20.01/11/2002/1 20 26,441.92 TRANSFER It 011122 01/21/20. 01/1112002/17/20, 40,319.04 TRANSFER tt 011222 01/21/20 01/12120 02/17/20 255.43 TRANSFER Il 012122 01/25120 01/21/20 02117/20, 14,680.00 75% FO PAHSE 4 BASE PYMT Vendor Total: Number Name Gross 12792 BETHANY SENIOR LIVING 83,661.39 Report Summary Grand Totals: Gross Discount 83,551.39 0.00 JAN 2 7 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS a ap_open_Invoice.template Discount No -Pay Net 0.00 0.00 1,855.00 14lfYLL opt Fi 0.00 O.Oo 26,441.92 ✓ rI 0.00 0.00 40,319.04 y/ 0.00 If 0.00 t1 255.43 0.00 0.00 14,680.00 ,,- Discount No -Pay Net 0.00 0.00 83,551.39 No -Pay Net 0.00 83,551.39 file:///C:/Users/eheiman/cDsi/memmed.cnsinet.com/u98547a/data 5/tmn cw5renort2091... 1/2712022 Date Requested Payer Requested by: Requestat'semall Requeslais phone number District or County Faclllty TATUM GORDON -BUSINESS OFFICE MANAGER IBoetlon @VethanvdWina.com 361.551-0500 Bethany senior Uying for Transfer of Funds EOB m ovemaymmtor remupmen4 Pleese Pre C00YODRgC@O MHag lavaca.co mmaUine248mmromllavaca co Patient Name RE RED Date of Sonsire E UIRED to of ent Type of Payment Amoo.tof Payment shown on QKANumber 90i Nu e Aron needed Enter Notes fundsl.lar Fumb N1 Y 0. —J N/A N/A 11412022 EFT EFT 6203438 CVDAROOM26869 38.99 THE SRO. ADVANCI N/A N/A 1/21/2022 EFT EFT 622007S CVDARDOOD26869 12,092.30 TIE DRO, ADVANCI N/A N/A. 1/24/2022 EFT ER 62218U CVDAR000026869 22.74 THE BRIT ADVANCI NIA N/A 1/25/2022 EFT EFT 6223522 CVDAR000026869 40.37 THE SRO ADVANCI N/A N/A 1126/2022 EFT EFT6225272 CVDAROGN26869 503.89 THE SRO. ADVANCI N/A N/A 2/27/2022 EFT EFT 6226824 CVDAROON26869 4.91 THEBRO. ADVANCI JBIJBI TOTAL 12J03.19 no FadlitV: fadIhV.- Ye9MDanslergalee2: for Transfer of Funds Date Requested IJ2712022 Payer MEDICARE Requested by. TATUM GORDON m BUSINESS OFFICE MANAGER RequestOesemall I einon LCltmy;Ly! .want Requeswsphone ' number 361.551-0500 D19IHft er County Calhoun FaNGIy 9¢Ihany Senior ❑Wn8 ttleven¢er(mmmmonhvaa r4 m nPnlnel VN nmfPor110VbCn CC Padent Name MEqWffQL_D Dateof5erWce aeof ent TvOeof Payment E Amounts pavessent hovmon Q! &Mu bel 1 Number ARlonra"dREEESt, hlMsbl or Fuads Nl Notes t4y0URmfmne N/A N/A 1/4/2022 M EFT 6203439 CVDAROOM19557 39.98 THECRE! N/A N/A 1/21/2022 EFT EFT 622007S CVDAR000019557 12.09230 THECRE! N/A N/A 1/24/2022 EFT EFT 6221834 CVDARDOD019557 22.74 THECRE. N/A N/A 1/25/2022 EFT EFT 622352E CVDAR00WI9557 40.17 THECRE! N/A N/A 1 261202E EFT EFF 6225272 UDAROOM19557 S03.89 THECRE! N/A N/A 1/27/2022 EFT M6226924 UDAROOM19557 4.91 THECRE: TOTAL 12 703.19 SMISM CAt for Transfer of Funds Date Requested 1(27/2022 Payer MEDICARE Requested by: TA7UM 60ROON- BUSINESS OFFICE MANAGER Requestafsemx0 920-0 L@IeIhanv4V rc mm Requester's phone number 361-551-0500 Distrittor County Calhoun Facility Bethany Senior Living EGO cde..mr,ldmmcooNlavaca c. mmaninel®mr1RPArttay.ea.re Pa0edt Name E Dateof mor UIREO R"SgQjXqEqqA Tyaeof Payment j(1E9dif§Msho.nq. Amount. Pawsprem CheckNumbor Q lm Nu AetlnnneedeA-fnrer foods 4 or Foods 1.1 moon"Pig. N/A NA 1/4/2022 EFT EFT 6203438 CVDAROOOOIB170 38.98 Salem K PMT N/A N/A 1/21/2022 EFT EFF6220075 CVDAROWDIS170 12,092.30 Soles K PMT N/A N/A 1/24/2022 EFT EFTW218M CVDAR000018170 22.74 Soler. K PMT N/A N/A 1/15/2027 EFT EFT 6223522 EVDAROODQIS170 40.37 Solna K PMT N/A N/A 1 26 2022 EFT EU6225272 CVDAR000018170 503.89 Soler. K PMT N/A N/A 1/27/2022 EFr EFT 622682 CVDAROOOD18170 4.91 Sol... K PMT TOTAL 12,703J9 afteansfer•. Facility: ea: i Q Memorial Medical Center Nursing Home 11PL Weekly CanteN Transfer Prosperity Accounts 1/31/2022 ReMaur TatlayY Aeenunt BgiAd PM MalnnlN A—,m to BV Tnm4mtl4NunIN Nunl Neme ••�"— 4T brce T�hn0u1 lm nnln I4 A.1. nahNe Nomv A9)f. pPd iT_.pE'rj'.'¢ 35,105.91 35,005.91 6T,959.19h✓ 167,655.Is WORabntt 167,655.15 ✓ Vamnce M..1n SRI.. 100.00 MN INTEREST FEBINTF1165T MARINTEREST Adjurt Salancerrmnsfer Aml 167,555.15 ✓ V93,4(u.% YfgCa�01g0l; ,... 114,753.54 FU4 653.54 1/ 93,501.ss H0,699.77 B4nk0alanre 93,501.% >/ Vamnce leLve In B.M. 100" MEDICARE REPAYMETNTO BEiNANY 22.703,194/ IAN INTEREST FEB INTEREST MAR2NTERCST Adjurt BRbn[e/7nmfn Ami 80,698.7] y '"i' / 129.328.04 ✓119,228.04 ✓ 93,929:66 / 73,429.66 , ✓� 50,626.47 Bankaalance 73,420.66 V4r4Me W..1n B.N. loom MEDICARE REPAYMENT TO BETHANY 12,703.19 Y IAN INTBRMT FEB INTEREST MAR INTEREST Adjuva 0alann/rmnrlerRml 60.626.4] v �/ 45,234.24 S/4%134.14 B5.018.25 ✓ 05318.26 % / 35,018,26 BanL 841ann 85,118.26 Vnianre 4ave In BalanR 100.00 IAN INTEREST FEBINIEREST MARINTEREST Atllml Balanve7rmmfer Amt 85,038.26 S/ ay3��yg� �� 159.063,75 V// 8,%3,75 V136,966.68 aj 137,066.89 124,263.69 Bank Balance 137,066.88 Vamnn - taave In ea Bna 100.00 APPROVED ON MEDICANEREPAYMENT108MANY 12,703.19 JAN 3 12022 1671555.15 + 801698.7Y 1 60,626.41 851018n26 + 124,263.69 + rc44: owvpwanm Nl4m3s.w 518, 1 6 2. 3 4 * NoN2: FvrA x<eun[AnF4Mll1 IANINTERFST BYCOUNTY AUDITOR FEBINTEREST CALHOUN COUNTY, fUA9 MAAINTEREST Adjurt a alancelTmWarAml IZV63.69 TOTALTRANSFEII _ SN,Z6t31 Approved: ja ANTHONY RICRXRDSON,CFO 1/31/2022 1:\NM WeakN Tramlen\NN NIt 7nmfer5ummary\20Z2W.Yary\NN 4PLT-1., Summary Ol.lL2lrNs qv� s.P{'� ]'}LAP, •i l �-� 4l+nWf UnXNNe+gM�rt NKWMWAT]IW1111fiMJ 1nin0}l YHCCOMMUNT'PI NCCGVAPLR IILW)lp 5}RW 1ncn0ll MGInI MYMMI fVCMCCWMIMT{MEWS{I1)Wfi IRS/3px} gMeXL++YPT15[XCLGIMIMI31YIXf]d3111OA LSFnB}i YXCCOMMUMry1l N[CWMIMi ]16Wi1t191WN t/ISn02i UHCCOMMYNIM1PL N[CWMPMilIF(ON1191WW InfnWl XXVrtK5a1Ta+N1R.UMIMf6Tf1M 1IRCOMi InC/l0}S WIPFOVTKNPOW NGl1NUMCEN3Gl10 In6n0il A"cImmUNMKMMaMPMTNa1T]]111W0 In5nW3 VM[[OMMVNIc'+PI HCLWMPMT ]+XWI]{91WA in6/laEl NGLMXUMgNSVLN[MIMPMT IM6W11115a1Si 1R]n011 VnM+6HrvMoce NCCWMPMT]IFDJII1l1}aN 1129AMZ UNCWMMUNXYPLI1M"PMTT+6W]IIl9IKW 1/ienW3 VNC[OMMUM{I9 PLIILCIAIMIMTTIFW1lIt91aD] vunal2 GIIO 1/2{12012 MWgGGNON"17IeMMPMM tUel{I al """ UGMMWVNI-H0WiAMPM31{XW{3191WA In{nW; XO9NK SaMInCNN[CIAIMPMi6]WS]dxWU139 N{nWl NVMRX.9UIgOW XCUMMPMi39%il{iW WIWs In3nWl XNB� IOIV N[f WM9MY)KOlMllb{aDJ119M0 I/lSn Vl; V1RI.UT VIINYW NCMWMY]{PIIW{Sl9IWA InBnO]2 WIX6oWMGPYMGRGNfCFNIFASNI 1/]6nW2 NHCtdMMMCDVlIHC MMM1{II=4II]N]I InBpWi UX[[OMMVNgYPINCtlrUMPMi]{6W1{1191Vi"A MIAW2 UNIMNnhNMRNCCINMPMTM6101I131N3M wwail 3nNON3KBOLUMW NCaKMPMT6Jb]S]{SW[OIS] 1/3Wx i.1 .III OM M/2A 2MgNMlf/J0M431]IO MNf MIMCWO1lOW]N19131 - NSW elfin ]/31WUN[[OMMYMM1IINKWMIMf ];6MINI391WW Ip]SW p]Ppp In3n0ll UNC COMMVNNPPS NCUNMPMT]{.11MWW MBRX}2 VIIC iOMMUNMPIN]11NMPMff{EW3Nl91a%O sAM.le 13{,NI9{ 1 f9;WL96 / - N,N1.9f / bgnfW War/c mN TJ1rMnOu+ ]24yNx10 WPP/CPMPI WPI/wmpt WII/QmN BMw WPBT MNPoRneX JJ'yr$I( ]apNMdp �W/I/wmPl aPpjCompl VIII/tbmN WP+ a/PT � HN pORTON - 1,6Waa 1.N000 - AllS.l9 J.dISJ9 - 193YB.fJ 19,EOS.iJ - lriNl.f£ 1.2N,55 - 1.111.11 Ld11.m - n.MJA6 - ti;pil.{b - I.Lf;99 - I.WL99 15,aYi.91 - - 19fN6.L - 19A16J1 t - I6 - M asiam 6,Sb 0,,9.S m 6YA0 10,77193 35.9W9e /•iq.%s,M J Lq S551S Y gyp, Uf "]41 "4"`^ A n3'fY'tl k ]'. uaf4^�'htiP awn 1/2{nW2 W W In{nWl VN[COMMIINNY6LNCLMMPM4]LEWL1191mN InIn613 N4nJKSMLVNON11LdNMPM16]63M {faMa119 I/ESn@t HN6-FCNa NCMM]Mf]INLM11N0.10]INm In9/f0lf UNf COMMUNgY6l NCCINMIMfmYa3U19ICWB N6/2Wt MWAGI MEINWTH fMfCEMf0.918 ln6/Wtf MNNNGGNONFil21t MNSlMM 3146{t In6n0fl NON]KSbtYnONNCWl11MPMI6]NtlIxKW1l6 not 22 WXMNL+ML+RHCCWMIMI]{6WMI1ll13N ln4]Bx2 Mwil ID 1na11B11 UHC( 1nfn011 UHClOg1MUN11Y/INKWMPMT MfWI1l191WW 1n1/181] NOVIIKIOlUS10XNCCGIMPM]616RIN0%MISE fi11 NMI pkl. x Y:15it ^'1 In{I]W3 MgHAOF1N8NETl)MMNSPMMOW9WOAY0{lN{A InL/]O11 UXC[OMMUNIIY IINLpNM]MT ]I6W111191CaW UxLn013 NOVRNSIIIU]IONN[CWMPM]6)S%SNOWp119 UlTnW1 VNCCOMMUNII9VLNCCWMPMT]LEWNI191WY] Ins/]ail ]romp WlanoNNEWMM/MiN%el d30000Mx l/16/M31 WIRfOMGNIFINFMTN GRFKNRPSUI W6/fW ] UNC COMMUNgYpLXLCWM]MT]ICWJL1191W W I/xf/iWl HOMK]OIUTONNCLWMTMi61fW9G0'Ibll! 1UN<COMMYNIIYTI NLCWM]MT]IWMt19108W InenW] UMC[aMMUNIIYPLXCCVIM]MIMWJIL1191aM PWMI .:. Inlnml "vm 1nPnW3 MgXgGE9NOXFTI)I3MNl IMMMYaIG• VBE4111 1/13nW3 gmMCreuPttKNC[WMMIi)IM]N9l6lItOb InlnOli UNC WMMUXII9MM(CWMPMTMKOfIl191WW InC/IW3 NOVOK SWUnOXNKWMINn6]N10{lW W119 UI{nWx NVMNNgpg01S6NCCWMPMTIIWNUW W1PJ9 1n1n021 Mg1MOFgNONFTI111 MH9PMM[OLDWW00MN d! 1/3fnW3 NNl•fCNONCCWMIMT]16Wl4IMLW]2{N20 1nln-UNCOOMMMONLK IM]MCW3N312N;1 n0-VNCCOM)LUV PLNCCWMPMTSI1W4200001411 WW 1121/2 1/2f/lW3 xOWTKSOLUnON NLIWMIMTNNl01]OOWIIl Inln011 WmOUlWfl INGI2HMEMTEOSIN lllP/3Wl MMJAOFNIONfTI]I3 MN9 PMMCDkWWOWi{N {i ]/]In011 ""Supp1mem+HKWMPMP{W]MI11243N I12WO22 MgN9GEgNONETI]12 MNTIMMWOW WbOWMIl CI ❑31n0]] VOWMSQUa1QRCCWMPMfTG70%04AgIN U1]nWl NOW)Af 104000NNCLWMPM)6]611013R'WI]3 menml "Ilia U11/2021 "Ilia 0NVXNCl-C[OWMMNYNNRWPPLNPMCCTW]MfOPnMiCM1{OYAMJMUlIG91} W61222 III"oI UNECOMMUWPM1910)(W UnmUNCUPmi COMMNMtH=MVWUMA%l9]400 TOW MMCPoRIIbN aPP/Comp1 TR.+n�-aw T=mrp�p arv/wmPx aPorwmpx a9P�wRN WPR aPnn Hx Papnoll s]V3.95 - - l,Y9Y.H IAA.f9 - losm.a - 1as15.w ]0,61ip1 146PJ6 69s.1] - 61SI1 ns1a.W I;NCtt. Ipsu191 - e,Wzn fiWTAx b,fiWW - e.fiWW - Y,WLJt J.ioLJJ 2,N1:3! - t,)SS.SI 1.}53.31 - 9.Itl.t9 Slil.19 110A16A1 - - S,WLtI - 3,WLIf - 1,69.93 3,+69.9f %Lsy - - 343N.SJ 9G5{ 1.SN.91 1H.134,N M934A6 ✓ nN9M MMCPXRTOX Wn/GMM y r9+" qIF/wmpl aPPJfomPi WIP/SaInN W9R WPPT NNPORgOX - 3.9SW - 3.5£0,$I - 1 - "A.""A"A.""- 16,N Qui 1.]1 - 3{,vLG xesnAl - 7,661.07 1,66101 {s,GI.M • Ifi.93 M.9] 6,gSG - B,136.K - T.St1.ffi - i.S13.56 Y.IM]1 6S,W936 95019.]6 MMCPWITOM am/wmw jnn r.yB WPp/wmN Wpp/Gmp3 Wpp/wnpi iMpu Wppn ryN lgpnON LIM.W - LIb UI - m,ISI.19 - ll.lSp.19 - 6,Ml.iV - 6.6G.1p - 1,110Fa ' ].U2.43gW ]35 1.911.25 5.1WW ];115.]a 6,901.93 I{9.19L13 - , - 2.410.91 - 2{]0.9p 141.00 ]u.W 119.58 - IM.w • low ]6.W - 1122.85 - 1,421.45 - 5.9Se.9£ f,9fL91 - esys.0 e.lMae l.Wl,n a,Wl.a 1£IAef.1f 116.1Fi.te - GB9K.M 4LNf.4 156.]IIAI SN x)Lfe 1/31/2022 Treasury Center IF Search All DDA Account Number Current Balance Available Balance Number of Accounts; 15 $8,526,085.63 S8,688,805.09 '4551 CAL CO INDIGENT S5,420.72 $5,420.72 HEALTHCARE •4454 MEMORIAL MEDICAL 1 $64,571.53 $64,571.53 NH GOLDEN CREEK HEALTHCARE *4365 MEMORIAL MEDICAL $536.06 S536.06 CENTER - CLINIC SERIES 2014 `4357 MEMORIAL MEDICAL S6,291,447.84 S6,407.394.15 CENTER -OPERATING •4373 MEMORIAL MEDICAL $431.56 S431.56 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL $167,655.15 J S167,945.90 CENTER/NH ASHFORD •4403 MEMORIAL MEDICAL $93.501.96 1 5102,971:87 CENTER/NH BROADMOOR *4411 MEMORIAL MEDICAL $73,429.66 ,% $79,481.0fi CENTER/NH CRESCENT .4446 MEMORIAL MEDICAL $85,118.26 $85, 118.20 CENTER/NH FORT BEND �, *4438 MEMORIAL MEDICAL S137,066.88 S145,600.94 CENTER /SOLERA AT ,/ WEST HOUSTON `2998 MMC -MONEY MARKET $1,109,331.22 S1,109,331.22 FUND *5506 MMC-NHBETHANY $228,727.88 S228,727.88 SENIOR LIVING '5441 MMC -NH GULF POINTS $75,079.21 $75,079.21 PLAZA- MEDICAREIMEDICAID `5433 MMC-NH GULF POINTE $10,697.24 $10,969.70 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $183,070A6 S205,225.03 VILLAGE Copyright 2022 Prosperity Bank, https:llprosperity.albanking.com/onlineMessenger Data i Collected Balance $8,526,085,63 $5,420.72 S64,571.53 as of Jan 31, 202: Prior Day Balane $8,070,762.9 $5,420.7 $64,417.: S536.06 S536.0 $6,291,447.84 $5.899.079 c $431.56 $431,E $167,655.15 $149,4772 $93,601.96 S85,770.E $73,429.66 $73,045.2 $85,11816 $81,260.' $137,066.88 S118,2502 S1,109,331.22 S1,109.331.2 $228,727.88 $218.663.4 $75,079.21 $74,929.4 $10.697.24 $10,697,2 $183.070.46 S179,451 c ' indicate: Page generated on 0113112022 i Memorial Medical [enter Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 1/31/2022 PRNOW B.&Mnp 6,663,16 / 64,471.53 Net.; ON, bokacm ofow1SIM.111 be eramllned to the nursing home. Note 2: Eaeh....thata bme bofanc. of$100 fAatMMC de0..feM M oelo..ant. APPROVED ON JAN 31 202? W COUNTY AUDITOR CALHOUN COUNTY,TCXAS Bank B41a,He Variance Leave In B.Iae. 3AN INTEREST FESINTEREST MARINTEREST Taday'a BoAI.nine Amount to Be Transferred to Kurt], 64S)1.53 64,5)153 ✓ 100.00 Adimt Balance/Trantler Ann 64Ari.53 V Aoomuad: �/� a' V ANTHONY RICHARDSON, CM 1� 1PIP022 JANNW.51,Tnmfen\HH UFS Wnl(R Sunlma112032klanvary\NH UPL tnMler Summary 01.31,11.A r �AS y", ^, u.� rs f �3 ,ors �- mmcooanox NH ..i4���S.lin�4w Transfer -In yPP/LemPl yPP/CamN NPP/[mmP3 �qP yPPT PO0.n011 V31/3G11 TlY54TILOU 1WT PRO SNIT 543S"SS56769119 2Kgp NCO)1/3<pW3 NGVIi/S fOlG110N NCCUIMPM3616M14iMNll9 63�9m.g2 63.90.11 V16APE3 WIREOU MENONHFAITHRTG9WENMI!K 6.663A6 - , Vl6/lOR GOIOFNLRF[MNFGIT MF0.[O[P R3G39691GGN]UI wo.6G - SKIN 1/3PpOEE NOUJH HUMAN SW HCCUIMPMI 174=141130112 n4 S1 PP.53 NOVITAS SOLUTION HRUI APMT 671074200N152 15).N 155.94 NA7143 1/31/2022 Treasury Center Search All DDA Data reported as of Jan 31, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $8,526,OB5.63 $8,688,806.09 $8,526,085.63 $8;070,762,9 '4551 CAL CO INDIGENT $5,420.72 $5,420.72 $5,420.72 S5,420.7 HEALTHCARE •4454 MEMORIAL MEDICAL/ NH GOLDEN CREEK $64.571.53 �$64.571.53 $64.571.53 $64,417.: HEALTHCARE '4365 MEMORIAL MEDICAL $536.06 S536.06 $536.06 $536.c CENTER - CLINIC SERIES 2014 •4357 MEMORIAL MEDICAL S6,291,447.84 $6,407,394.15 $6,291,447.84 $5,899.079.£ CENTER - OPERATING '4373 MEMORIAL MEDICAL S431.56 $431.56 S431.56 S431.E CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL $167.655.15 S167,945.90 $167,655.15 $149,477.; CENTER INH ASHFORD '4403 MEMORIAL MEDICAL CENTER! NH $93,501.96 $102,971.87 $93,501.96 $85,7701 BROADMOOR "4411 MEMORIAL MEDICAL $73,429.66 $79,481.06 $73.429.66 $73,045.2 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S85,116.26 $85,118.26 S85,118.26 $81,260.! CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $137,066.88 $145,600.94 S137,065.88 $118,250.2 WEST HOUSTON •2998 MMC-MONEY MARKET $1,109,33112 S1,109,331.22 S1,109,331.22 51,109,331.2 FUND •5506 MMC -NH BETHANY $228,727.88 $228,727.88 S228,727.88 $218,663.4 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- $75,079.21 $75.079.21 $75,079.21 $74,929.4 MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $10,597.24 $10,969.70 $10,697.24 $10,697.2 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $183,070.46 $205,225.03 $183,070.46 $179,451 c VILLAGE indicate; Page generated on 01131/2022 ; Copyright 2022 Prosperity Bank. t https://prosperity.olbanking.comlonlineMessenger try Memorial Medical [enter Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 1/31/2022 IrevlAm Acwum B Fula... XunlnM1 Han w.....1... 3J3tl.90 IIA tl01FTNNfe'Wr"7Y�apP-,rryrr .� �N I 1 t[itd�+laar""So Fnuluw AauUnt 9glnn' ' Babnn / hrnv 6,03953 n9,939.91 NAIe: Only Bobn[vpfavmSS,pM wlllEanon[/M/edM IhenuninDM1wne. NattYfvth attaunl da[ u GuaeLubnn uJ$1COrho[MMCd�ailNToOrnn a[rounl. APPROVED oN JAN 31 2022 CAALHO N GOU MWE � a.4n.• ✓ 8an4 Gbnm Vari ledue in U.— UNIDENDFIEDEMOPAYMEMS4XUCHECKWILEDEWRR NFORTNISAMOUNYYEn 4m0unuP6e Tnmlemdm 10.07.24 IOd9].td Iwo ]6E61 IANINTFBGT FEB INTEREST MAR INTEREST j Adluq Balan[e(r[anAR INTEREST )D,OB.63 ArR.W.B. F,.A, Tnndcnedlo )SAJ9.J1 Ban4 Hlann 76,0>4II VaNanw L..We Babn[e FODOR IAN INTEREST FEBINTEREST MAR INTEREST / Ad1uN& an[e/LnnAnrAml 71.W9.21 ✓ TOTAL71BN9FERS REBER.td ApprwvL AxTHavrua sOx;uD Y��b y13y�2i I:WN WMN Tnmlen\NN UPLT.W.rIUmma U.'VanuamNN UPI Tram3v Summan01.11.21.0m MMC PORTION g _ � /` '� t t x :4Yzt ; , P. Il,�, '16F'? 1 ✓''` }y,@PP/ComWB a a i;A�a'q NH MnshrAut TrandPr-In gIPP/MmP1 OIPP/CampE gIPP/[emP3 lepu OIPP TI PORTION 1/E41E011 HNB-ECHO HUMUMPMTINI 0M114,10000200242 363.62 63.6E 1/2411022 HUMANACH CIAMPMTfi392430W105 1,311.40 1.331A0 31361292WIRE Off HMGSERVICES, TC 31,124.39 , 113713022 NNE -ECHO HMUIMPMT ]4fi034I140000213480 - 23E.36 , 2. 1/27/ID22 NUMANp<Np O168 NCCIAIMPMi6169B3i200001U5 - 6,56235 - 6,S6L25EB 3Z124,29 V ID,a29.63 V 100963 MMC PORTION .i"il^�" �'PrS& l.•ry C +V k'.�}'Irg 4Y"�ti,`</V~ "^4 U I Aa k 7@'<I gIPP/CPmPW NH . :: / TranvierAUL Trander-In g11P/Camp1 gIPP/Cemp3 OIPv/Comp3 uPK gIPP TI PORTION 1/24/2022 NORIDIANI3AHCCIAIMPMT62999242000D1261214 - 41,VO.36 - 41,270.36 1/912022 HIS -ECHO HCCWMPM77460034114400W246720 I'SO5.84 - 1,505.84 1/25/2022 WPS-TDEPIC CONTR HCCWMPMT 222426108221000 1.03.40 - 1,003.40 11251262E NORIOIANI3AHCCUIMPM762589142 0 1340S10 - 20,552,60 - W,55768 1/20/2022 WIRE OUT HMG SERVICES. NC 51939,51 1/16/2022 HMLTNHUMANSVCHCCIAIMPMTI746W341130132 203,2E 20322 11271202E NORIDIANI3AHCCWIMPMT0569241MD1465327 - 10.288.91 10,288,91 1/38/1022 PNOECHO NCCIAINIPMT 74MI411410001256GS957 149.0 / 149,80 5.939.51/ 74,9n.21 )49)921 33,063.80 95,458,84 95458.84 1/31/2022 Treasury Center Search All DDA Data reported as of Jan 31, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $8,526,085.63 $8,688,805.09 $8,526,085.63 $8,070,762.9 '4551 CAL CO INDIGENT S5,420.72 $5,420,72 $5,420,72 $5,420.i HEALTHCARE •4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $64,571.53 $64,571.53 $64,571.53 $64,417.: HEALTHCARE "4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.06 S536.06 S536.06 S536.0 2014 '4357 MEMORIAL MEDICAL $6.291.447.84 $6,407,394.15 $6,291,447.84 S5,899,079 c CENTER - OPERATING •4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.56 S431.56 S431.56 8431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $167.655.15 S167,945.90 $167,665.15 $149,477.: CENTER / NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $93,501.96 S102,971.87 $93,501.96 S85,770.E BROADMOOR *4411 MEMORIAL MEDICAL $73,429.66 $79,481.06 $73,429.66 $73,045.2 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S85,118.26 $85.118.26 SB5,118.26 SB1,260.'. CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL CENTER / SOLERA AT $137,066.88 S145,600.94 S137,066.88 $118,250:3 WEST HOUSTON 2998 MMC-MONEYMARKET S1.109,331.22 $1,10%331.22 $1,109,331.22 $1,109,331.2 FUND '5506 MMC -NH BETHANY $228,727.88 S228,727.88 S228,727.88 S218,663.4 SENIOR LIVING '5441 PLMMMAC_ NH GULF POINTE $75,079.21 ,� $75.079.21 S75,079.21 $74.929.4 MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE S10.697.24 $10.969,70 $10.697.24 $10,697.2 PLAZA -PRIVATE PAY v/ '3407 MMC-NH TUSCANY $183,070.46 $205,225.03 $183,070.46 $179,451.9 VILLAGE ' indicate: Page generates on 01/3112022 ; Copyright 2022 Prosperity Bank_ t https://prosperity,olbanking.comfonlineMessenger 111 Memorial Medical Center Nursing Nome UPL Weekly Tuscany Transfer Prosperity Accounts 1/32/2022 hwlw. Aawnt aeRlnnhR NUNn Nmm� ""—` 41aM. NMe:OC"db ... f—Skm.0 henwr/ertN10 M,,. [urehane. N.C. 2: EaNu[[pvat has a baft ho nm Rlssm thatmmcdeaantNMOpenac[ounf. JAN 31 Z022 BY COUN iY AUDITOR CALHOUN COUNTY, TEXAS R.ndbE Rmannua ae Tnnfhnetl In 4n1, 44n1e Iq,oto 96 VuWh . leweln Behnn M.w WERIGRoup Nowcapp 1PN INTEREST EEh OM161sr MMINRRFSi Ad(uttRalma Nrlun\ Iei.9]0.96 oveE: _ 113V2021 MRINOHTRICHMRRiON�C MMC PORTION �3 gIPP/Camp9 [Owfc.--pa µ 1�+4, Transfer -Out Transfer -In OIPP/Camp2 QIPP/Camp3 &lapse Qlpp Tl NH pORT10N 1/24/2022 Depost - 15,911.B5 - 15,911.85 1/2412022 Molina HCof TX HCCIAIMPMTPN12757178944200 - 7,301.27 - 7,301.27 1/24/2022 NOVITAS SOLUTION HCCLAIMPMT 6762014200DO119 - 9,277.46 9,277,46 1/26/2022 WIRE OUT LINEAR ENTERPRISES, LLC 59,80311 - - - 1126/2022 NOVITAS SOLUTION HCCIAIMPMT 67620142U000146 753,98 - 753.98 1/27/2022 NOVTAS SOLUTION HCCUAIMPMT 676201420000123 - 146,307.42 146.107.42 1/28/2022 Deposit / 3,618A8 3.618.98 _59,80331, 183,9T0.46 / 18297046 1/31/2022 Treasury Center r Search All DA Data reported as of Jan 31, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $8,526,085.63 $8,688,805.09 $8,526,085,63. $8,070,762.9 -4551 CAL CO INDIGENT S5,420.72 $5,420,72 $5,420.72 $5.420.7 HEALTHCARE •4454 MEMORIAL MEDICAL 1 NH GOLDEN CREEK $64,571.53 $64,571.53 S64 571.53 r $64,417.5 HEALTHCARE •4� MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.06 S536.06 S536.06 S536.0 2014 '4357 MEMORIAL MEDICAL S6,291.447.64 $6,407,394.15 S6,291,447.34 S5,899,079.f CENTER - OPERATING *4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.56 $431.56 $431.56 S431.5 WAIVER CLEARING '4361 MEMORIAL MEDICAL $167,655.15 $167,945.90 S167,655.15 S149,4773 CENTER /NHASHFORD •4403 MEMORIAL MEDICAL CENTER/NH $93,501.96 $102,971A7 593,501.96 S85,7701 BROADMOOR *4411 MEMORIAL MEDICAL $73,429.66 $79,481,06 $73,429.66 $73,045.2 CENTER/NH CRESCENT -4446 MEMORIAL MEDICAL S85,118.26 $85,118.26 $85,118.26 $81,260.1 CENTER/NH FORT BEND -4438 MEMORIAL MEDICAL CENTER /SOLERA AT $137,066.88 $145,600.94 S137,066.88 $118.250.1 WEST HOUSTON `2998 MMC-MONEY MARKET S1,109,331.22 $1.109,331.22 S1,109,331.22 S1,109,331.e FUND 15506 MMC-NH BETHANY $228,727.88 S226,727.88 S228,727.88 S218,563.4 SENIOR LIVING '5441 MMC -NH GULF POINTS PLAZA- $75,079.21 $75,079.21 $75,079.21 $74,929.4 MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $10,697.24 $10,969.70 $10,697.24 $10,697.2 PLAZA - PRIVATE PAY -3407 MMC -NH TUSCANY $183,070.46 ✓ S205,225.03 $183.070.46 $179,451 c VILLAGE ' indicate: Page generated on 0113112022; Copyright 2022 Prosperity Bank. t https:tlprosperity.olbanking.com/onlinuMessenger 1/1 Memorial Medical Center Nursing Home UPL Weekly HSLTranster Prosperity Accounts 1/31/2022 vrnlo:n Rvndift pmeummee xmuns 0e[imm�F MWim! Tmmt.mdlo NUMn Nom Xambvr Bann<e Trimin•eN /TnnfleMn .ntl Rea !nl Toda fB! nMn Bahnn Nunln Nome _.. „,_ +, a BB,OB.B1 F/ aFABS] ✓ 228,6E]BR 220,II7.88 BenF Balance 228,1).p8 � {29,62)88 Y vulanu lnvemeamm 10000 IdNINTIAM INTEREST MA,IKINTERT Btllmzmriuc nnu lj NMerfMlvhalln[60/ote<$S,IXtl will bnnvn[lmfdeo tAenunmglrome �e 1!,]la.— Nare 2. Fad a[eamebm n bvehalpq<!!)$IWIAm MMPdepmXedla V# m< , ANWONYBI[X se OSOH,6 �i/ i/2l/SOR JAN 3 12022 BY COUNTY AUDITOR CAUiOUN COUNTY, TEXAS LWN WnFN T.W.W. uovran[Iae2vmm.M)a XV.... q1NH wunndnsummanOL)s.zadf. 1/24/2022 Deposit 1/24/2022 NOVITAS SOLUTION HCCUIMPMT 676481420000119 3/25/2022 Deposit 1/25/2022 NOVITAS SOLUTION HCCUIMPMT 67648142000131 1/25/2022 HEALTH HUMAN 6VC NCCtAIMPMT 174GW341130162 1/16/2022 WIRE OUT SETHANy SENIOR LIVING, LTD V2612022 NOVITAS SOLUTION HCCUIMPMT 67USI 420000146 1/27/2022 Deposit 1/27/2022 NOVITAS SOLUTION HCCUIMPMT 676481420000123 1/28/2022 Oepolit 2/28/2022 Deposit 1/38/2022 NOVITAS SOLUTION HCCUIMPMT 67618142000D152 1/28/2022 HOSPICE OF SOUTH P4ymentT NF 213122650019304 MMCPORTION QIPP/C4mp4 Tmnsfee.OutTransfer-In QIPP/Comp1 QIPP/Comp2 QIPP/CamP3 &Lapse QIPPTI NHPORTION 18,960.96 - 18,960.96 181,394.50 34,181,588.50 74 S88.70 . - 341.09 - 941.009 3,647.09 - 3,64].09 85,7]8.51 _ - 605.S1 - 605.51 - 5,477.13 5,477.13 7.550.38 .0 - 3.855.50 - 3,B95.50 31895 5.413.40 5,473.40 - ]3,69 681.89 681.89 .09 85.T]8.51 228,627.86/ ne 6D 88 1131/2022 Search Ail DDA IF Treasury Center Data reported as or Jan 31, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts; 15 $8,526,085.63 $8,688,805.09 $8,526,085.63 $8,070,762.e '4551 CAL CO INDIGENT S5,420.72 $5.420.72 $5,420.72 $5,420.7 HEALTHCARE '4454 MEMORIAL MEDICAL 1 NH GOLDEN CREEK $64.571.53 $64,571.53 $64,671.53 e $64,417... HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES S536.06 S536.06 S536.06 S536.0 2014 '4357 MEMORIAL MEDICAL $6,291,447,84 S6,407.394.15 S6;291,447.84 S51899.079 c CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.56 S431.56 $431.56 S431.'_ WAIVER CLEARING '4381 MEMORIAL MEDICAL S167,655.15 $167,945.90 S167,655.15 S149,477.; CENTER/NH ASHFORD •4403 MEMORIAL MEDICAL CENTER / NH $93.501.96 S102,971.87 $93,501.96 $85,770.E BROADMOOR '4411 MEMORIAL MEDICAL $73,429.66 $79,481.06 $73,429.66 $73,045.2 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S85,118.26 $85,118.26 $85,118.26 $81,260.' CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /50LERA AT $137,066,88 5145,600.94 S137,066.88 S118,250,2 WEST HOUSTON •2998 MMC-MONEY MARKET S1.109,331.22 S1,109,331.22 S1,109,331.22 S1,109,331.2 FUND '5506 'MMC -NH BETHANY $228.727,88 $228,727.88 $228.727.88 S218,663.4 SENIOR LIVING -5441 MIMIC -NH GULF POINTE PLAZA- $75,079.21 $75.079.21 $75,079.21 $74.929.4 MEDICAREIMEDICAID -5433 MMC-NH GULF POINTE $10,697,24 $10,96970 $10,697.24 $10,697.2 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $183,070.46 S205,225.03 S183,070.46 S179,451.£ VILLAGE ' indicate: Page generated On 01/3112022 ; Copyright 2022 Prosperity Bank. 1 https://prosperity.olbanking,comfonlinaMessenger Vi