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2022-02-16 Final PacketC .� iii 16l .ACal All Agenda Items Properly Numbered i/Contracts Completed and Signed -k, --/bll 1295's Flagged for Acceptance (number of 1295's 6 1 _4z/AII Documents for Clerk Signature Flagged On this I$ day of2022 a complete and accurate packet for i� of 2022 Commissioners Court Regular Session Day Month was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoun County Judge/Assistant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA NOl It E- 0( �vl[ Ll IN6 2/16/ 02) Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Cary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, February 16, 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 — https://txcourts.zoom.us/j/2130882273 AGENDA The subject matter of such meeting is as follows: 5 FILED � A � O'CLOCK M `�f�Call meeting to order. FEB 11 2022 `Z. Invocation. wur M GOOD IA ca eeua o TY17 3. Pledges of Allegiance. General Discussion of Public Matters and Public Participation. tr Hear report from Calhoun 911 regarding NG 9-1-1 grant program. Consider and take necessary action to approve a lease agreement between Calhoun County and 301 S. LLC, Coastal Building for Human Resources office space, and authorize the County Judge to sign the contract. (DH) 17/Consider and take necessary action to authorize Commissioner Lyssy to sign a proposal for G & W Engineering Services for Seakist Lane Drainage Improvements to be paid out of GOMESA funds. (VL) 8. Consider and take necessary action to approve the Preliminary Plat of Pelicans Landing Resubdivision No. 1. (GR) Page 1 of 3 NOTICE OF MEETING — 2/16/2022 45. Consider and take necessary action to approve the Specifications and Contract Documents for Rebid - Lane Road Drainage Improvements for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1 and to authorize G & W Engineers, Inc. and the County Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 am, Thursday, March 10, 2021 in the Commissioners' Courtroom. Sealed Bids will be due before 2:00:00 pm, Thursday, March 31, 2021. (GR) 10. Consider and take necessary action to authorize Commissioner Reese to sign a rental agreement with Texas First Rentals — Victoria for a 2021 CAT Model 259D3 Serial No. CW913087. (GR) q-1 Consider and take necessary action to approve working with the City of Port Lavaca on a concept for a Community Solid Waste/Brush/Recycle Center to be located at the �County's property on Landfill Road. (RHM) 'i2. Consider and take action on Calhoun County joining in on a Regional Economic Development Strategic Group spearheaded by the Victoria Sales Tax Development Corporation, which has engaged Newmark Knight Frank to develop an Economic Development Strategic Plan and Target Industry Study. The EDC will include Victoria County — City of Victoria, Gonzales County, Dewitt County — City of Cuero, Jackson County — City of Edna, Lavaca County — City of Yoakum and Calhoun County — City of Port Lavaca. The City of Port Lavaca will work together with Calhoun County and split the $5,000.00 cost of the study. It should be noted that we will interact with Newmark together as a single group representing the entities of Calhoun County, not individually as the City or just the County. The Cities of Seadrift and Point Comfort will be able to join in the group interaction with Newmark as well. (RHM) 3�1 Consider and take necessary action to approve the Specifications and the Invitation to Bid Packet for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement and authorize the County Auditor to advertise for the bids. Bids will be due before 2:00:00 PM, Tuesday, March 15, 2022. (RHM) / r4. Consider and take necessary action to declare as Surplus/Salvage and removed from Precinct 4 Road & Bridge inventory a Case Backhoe, Asset # 24-0479 to be used as a trade-in on new equipment. (GR) 15 oC nsider and take necessary action to extend Interlocal Agreements with the following agencies and authorize the County Judge to sign the contracts and purchase orders. (RHM) Calhoun County Senior Citizen's Association, Inc. $35,000.00 The Harbor Children's Alliance & Victim Center $28,500.00 ps4 3) Calhoun County Crime Stoppers $ 1,000.00 /�,,,0(•4) Calhoun County Soil and Water Conservation District No. 345 $ 7,750.00 f&.4%V l� 0 Gulf Bend Center $26,000.00 Page 2 of 3 NUIUC—OFMILIIN-I 2/16/2022 16. Accept Monthly Reports from the following County Offices: i. Extension Office — January 2022 Coastal and Marine 2 4-H and Youth Development 3. Family and Community Health ii.Justice of the Peace, Precinct 1— January 2022 TC Justice of the Peace, Precinct 2 — January 2022 s 'iir Justice of the Peace, Precinct 5 — January 2022 17Consider and take necessary action on any necessary budget adjustments. (RHM) Tg.C. Approval of bills and payroll. (RHM) Richard H. Meyer, County Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the counts website at www.calhouncotx.org under "Commissioners' Court Agenda" for any official court postings. Page 3 of 3 NOTICE 01- MEETING — 2/16/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct l Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 ][caddie Smith, Deputy Clerk The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, February 16, 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/213O882273 AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. by Judge Richard Meyer. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. GLO was present to speak on vessel program. Page 1 of 6 I NOTICE OF MFFTING — 2/16/2022 5. Hear report from Calhoun 911 regarding NG 9-1-1 grant program. Rachel Morales gave the report. 6. Consider and take necessary action to approve a lease agreement between Calhoun County and 301 S. LLC, Coastal Building for Human Resources office space, and authorize the County Judge to sign the contract. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to authorize Commissioner Lyssy to sign a proposal for G & W Engineering Services for Seakist Lane Drainage Improvements to be paid out of GOMESA funds. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the Preliminary Plat of Pelicans Landing Resubdivision No. 1. (GR) Terry Ruddick explained the Preliminary Plat. RESULT: APPROVED [UNANIMOUS]', MOVER: Gary Reese, Commissioner Pct 4 SECONDER: ` Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve the Specifications and Contract Documents for Rebid - Lane Road Drainage Improvements for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1 and to authorize G & W Engineers, Inc. and the County Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 am, Thursday, March 10, 2021 in the Commissioners' Courtroom. Sealed Bids will be due before 2:00:00 pm, Thursday, March 31, 2021. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens,' Reese Page 2 of 6 NO-IICE OE MEE1ING--2/1.6/2022 10. Consider and take necessary action to authorize Commissioner Reese to sign a rental agreement with Texas First Rentals — Victoria for a 2021 CAT Model 259D3 Serial No. CW913087. (GR) 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 approve working with the City of Port Lavaca on a concept for a Community Solid Waste/Brush/Recycle Center to be located at the County's property on Landfill Road. (RHM) Jody Weaver explained reason for wanting to work with the county. RESULT: APPROVED [UNANIMOUS]' MOVER:,' David Hall,, Commissioner Pct'1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take action on Calhoun County joining in on a Regional Economic Development Strategic Group spearheaded by the Victoria Sales Tax Development Corporation, which has engaged Newmark Knight Frank to develop an Economic Development Strategic Plan and Target Industry Study. The EDC will include Victoria County — City of Victoria, Gonzales County, Dewitt County — City of Cuero, Jackson County — City of Edna, Lavaca County — City of Yoakum and Calhoun County — City of Port Lavaca. The City of Port Lavaca will work together with Calhoun County and split the $5,000.00 cost of the study. It should be noted that we will interact with Newmark together as a single group representing the entities of Calhoun County, not individually as the City or just the County. The Cities of Seadrift and Point Comfort will be able to join in the group interaction with Newmark as well. (RHM) Jody Weaver Explained the Study. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 6 ' NO-] ICE OF MEETING — 2/1.6/2022 13. Consider and take necessary action to approve the Specifications and the Invitation to Bid Packet for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement and authorize the County Auditor to advertise for the bids. Bids will be due before 2:00:00 PM, Tuesday, March 15, 2022. (RHM) Everettexplained reason for needingreplacement. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER. Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action to declare as Surplus/Salvage and removed from Precinct 4 Road & Bridge inventory a Case Backhoe, Asset # 24-0479 to be used as a trade-in on new equipment. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct i SECONDER:' Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy; Behrens 15. Consider and take necessary action to extend Interlocal Agreements with the following agencies and authorize the County Judge to sign the contracts and purchase orders. (RHM) (1) Calhoun County Senior Citizen's Association, Inc. $35,000.00 (2) The Harbor Children's Alliance & Victim Center $28,500.00 (3) Galheam Getty C-Fime StepperS $ 1,99-9.90 (5) Gulf Bend Center $26,000.00 Numbers 1, 2 and 5 are approved. Numbers 3 and 4 are not approved. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy; Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 6 ' NOTICE OF MEETING — 2/16%2022 16. Accept Monthly Reports from the following County Offices: i. Extension Office — January 2022 1. Coastal and Marine 2. 4-H and Youth Development 3. Family and Community Health ii. Justice of the Peace, Precinct 1 — January 2022 iii. Justice of the Peace, Precinct 2 —January 2022 iv. Justice of the Peace, Precinct 5 — January 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 1 SECONDER:: Joel Behrens, Commissioner Pct,3' AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, 17. Consider and take necessary action on any necessary budget adjustments. (RHM) 2022: RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese ' Page 5 of 6 NOTICE OF MEETING — 2/16/2022 18. ADDroval of bills and oavroll. (RHM) MIMIC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: i Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall; Lyssyi Behrens Indigent Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall,Commissioner Pct 1 SECONDER:, Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens 2021 Bills` RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER:' Vern Lyssy Commissioner Pct 2 AYES: Judge Meyer, Commissioner` Hall, Lyssy, Behrens 2022 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct SECONDER:' Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Adjourned 10:35 a.m. Page 6 of 6 sPi-Cant_ [W-1 i IN6 - 2/lbl)0)2 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 SPECIAL MEETING The Commissioners' Court of Calhoun County, 'Texas will meet on Wednesday, February 16, 2022 at 10:30 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. bran Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA Discussion will be on policy and procedure goals for Commissioner's Court. In addition, a presentation of Tyler's TMM Commissioner's Court program will be presented by a GoToMeeting session. Richard H. Meyer, Co nt )Judge Calhoun County, Tex A copy of this Notice has been placed on the outside bulletin board ofthe 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. II,,,, FILED A'JO'CLOCK W M FEB 11 2022 ANNAM. GOODdAN to L K lH0 NFOIN ,T aY: Page 1 of 1 #5 NOTICE OF MEETING — 2/16/2022 5. Hear report from Calhoun 911 regarding NG 9-1-1 grant program. Rachel Morales gave the report. Page 2 of 15 Mae Belle Cassel From: e911@calhouncotx.org (e911) <e911@calhouncotx.org> Sent: Tuesday, February 8, 2022 2:53 PM To: Mae Belle Cassel Subject: Agenda Item Attachments: 20220128.Calhoun E911 ECD Final Lol, Attach C.pdf Mae Belle, I would like to give Comm Court a report on Letter of Intent to Participate in NG9-1-1 Fund Grant Program. Please place Calhoun E911 on the next agenda. Thank You, 1zct,guRV MOYWWd' 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 1pft�, 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 It .calhouncotx.org 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 N09-1-1 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 ESInet) $ 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 Plarming $ 40,000.00 Other S 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 N09-1-1 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 E911 ECD Funds Requested Project/item Descri tion Conservative Potential Total Notes Routing & Location Fiber $25,000.06 Routing & ALI Total $25,000,00 ISIS (imagery, Z-axis). Eagleview 125,000 X 2 flyovers, 3D Schools & Hospital, Courthouse $275,000.00 Two Aerial Fly _ ESRI, 1,500 X 2 $5,568.53 Geo Back Office 1,301 X 2 $2,602.00 Total —year $283,170.53 --_--- NGCS 911 DataMaster-21,2461st +4,375 2nd year maintenace $25,621.00 _ Text 2 911- 13,200 X 2 $26,400.00 Total --- _ $S2,021.00 Network / ESINet Installation of ESinet Installation of MRC ESinet 6,997 X 24 _$31,000.00 $167,928.00 _ ESINet MRC CI DataEenter— Total $198,928.00 PSAP Call System & Apps _ CAD - CCSO Maintenance 7,796 X 2 years $15,592.00 AT&T, CAD CC Maint, Edispat CAD- PLPD Installation 106,000 + 7,796 2n year maintenance $107,796.00 CAD to CAD CCSO 1,850 X 3 $5,550.00 NICE/ Recording 3,763 X 2 $7,526.00 _ Automatic Vehicle Location 515 X 2 Wireless Messaging.757 X 2 _ $1,514.00 Edispatches _ Electrical Work -Site $12,000,00 MDS 3,216 X 2 $6,432.00 MDIS 6,905 X2 Total _ $156,410.00 Security Cyber Security Intrusion Date _ Intrusion Detection System Software $26,000.00 IDS Monitoring 1,079 X 24 Total $26,000.00 Operations IT, IP, Grant, Admin Salaries X 24 $295,896.00 IT, IP, Grant, A Net Motion 4,400 X 2 Total $295,896.00 Operational Planning $40,000.00 Operational PI Total $40,000.00 -.Other Travel $17,000.00 _ Travel Scats $3,000.00 Ecats Total 20 000.00 :GRAND TOTAL S1,097,42S.S31 $0.00 $1097 425 53 Attachment C: Next Generation 9-1-1 Eligible Expenses by The following categories of NG9-1-1 Fund eligible expenses is taken from the Federal Communications Commission's (FCC) Task Force on Optimal Public Safety Answering Point (TFOPA) Working Group 2 Supplemental Report; and were used by the Commission et. al., in providing an estimate of costs -by -category to the Governor, the Legislature, and the Legislative Budget Board. Please indicate below your 9-1-1 Entity's estimated NG9-1-1 expenses for the period November 8, 2021, through December 31, 2024. ECD NAM E::Cal houn County E91 1 ECD ❑ Network (NG9-1-1 ESlnet): Internet Protocol -based, digital networking is the backbone required to support NG9-1-1 service. Also known as an NG9-1-1 Emergency Services Internet Protocol Network. NG9-1-1 ESlnet connects next generation core services (NGCS, see below) to the 567 public safety answering points (PSAPs) in Texas's 254 counties." ESTIMATED EXPENSES: $198,929.00 ❑ 9-1 -1 Call Routing & Location: May be provisioned within or separately from NGCS (see below); varies by NG9-1-1 solution provider. Includes Software, GIS databases, IP switches, and services required to route 9-1-1 calls to the correct PSAP for assistance and dispatch of emergency response. ESTIMATED EXPENSES: $ 25.000.00 ❑ Geographic Information System (GIS): Mapping data is required to validate a caller's location and route the call to the correct PSAP. Displays location of caller on dispatch map; provides X, Y and Z location coordinates to guide emergency response. ESTIMATED EXPENSES: S 283.170.53 ❑ Next Generation 9-1-1 Core Services (NGCS): The base set of services needed to receive and process a 9-1-1 call on an ESlnet. Receives call from originating service provider, processes data received with call and data provisioned into the system (GIS/call routing); determines and routes call to correct PSAP with embedded location information that can be displayed on a map at the PSAP for dispatch of emergency response. ESTIMATED EXPENSES: 5 52.021.00 ❑ PSAP 9-1-1 Call Handling Systems and Applications: Call handling equipment hardware and/or software that simultaneously receives voice calls and related location data from NGCS at the PSAP and displays the caller's location and other data on a map along with other contextual data that informs dispatch such as the available first responder agencies for each particular location, i.e., Fire, Law, EMS. Mission critical hardware and software requires planned maintenance and upgrades, and reconfiguration for text to 9-1-1. May also include computer aided dispatch equipment and site electrical work. ESTIMATED EXPENSES: $ 156,410.00 ❑ Security: NG9-1-1 is a connected IP-based system. Dedicated resources are required to Implement, maintain and monitor the security of the NG9-1-1 system to protect critical infrastructure and sensitive data. Costs include administration and governance of security policies; services to maintain and monitor NG9-1-1 systems; and services to conduct cybersecurity assessments and remediate/mitigate risks on a planned and continual basis. ESTIMATED EXPENSES: $ 26,000.00 ❑ Operations: 9-1-1 Entities require staffing to support IT and IP-based systems and may include engineering and specially trained subject matter experts; and administration and/or grant management expertise for financial oversight and reporting. ESTIMATED EXPENSES: $ 295,896.00 ❑ Operational Planning: Local, regional, and statewide planning required to design and implement the new NG9-1-1 services across the state by 2025; and to ensure that the systems are fully interconnected, interoperable, and can support alternate call routing, answering, and dispatch in cases of natural or manmade disasters. ESTIMATED EXPENSES: $ 40,000.00 ❑ Other: E.g., emergency call tracking system (ECaTS); travel. ESTIMATED EXPENSES: $ 20,000.00 . Please provide a list of estimated Other expenses below: TOTAL ALLOTMENT (combined total of above Estimated Expenses): _ SUPPLEMENTARY ALLOTMENT ESTIMATE: S 1,097,425.53 _ (Additional amount Emergency Communication District could spend by December 31, 2024, if previously allocated NG9-1-1 funds become available. Please describe below how the supplementary allotment will be used utilizing the above Eligible Expenses by Category.) #6 NOTICE OF MEETING — 2/16/2022 6. Consider and take necessary action to approve a lease agreement between Calhoun County and 301 S. LLC, Coastal Building for Human Resources office space, and authorize the County Judge to sign the contract. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 15 David E. Hall Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for February 16th, 2022. • Consider and take necessary action on approval of Lease Agreement between Calhoun County and 301 S. LLC, Coastal Buliding for Human Resources office space, and authorize County Judge to sign contract. Sincer , Da E. Hall DEH/apt COMMERCIAL LEASE AGREEMENT This Lease Agreement agreed on January 20, 2022 is between: The Lessor is a business entity known as 301 S. LLC with a mailing address of 4444 State Highway 111 N., Edna, Texas 77957, hereinafter referred to as the "Lessor". AND The Lessee is a business entity known as CALHOUN COUNTY, TEXAS with a mailing address of the Property's Address, hereinafter referred to as the "Lessee". The Lessor and Lessee hereby agree as follows: DESCRIPTION OF LEASED PREMISES. The Lessor agrees to lease to the Lessee the following described office space located at 131 - A N. Virginia Street, Suite G, Port Lavaca, Texas, 77979. Additional Description: Suite G. Hereinafter referred to as the "Premises". USE OF LEASED PREMISES. The Lessor is leasing the Premises to the Lessee and the Lessee is hereby agreeing to lease the Premises for administrative and office purposes for the Calhoun County, Texas Human Resources department. Any change in use or purpose of the Premises other than as described above shall be upon prior written consent of Lessor only otherwise the Lessee will be considered in default of this Lease Agreement. EXCLUSIVE USE. The Lessee shall not hold exclusive rights on the Premises. The Lessor shall hold the rights to lease other areas of the Property to any same or like use as the Lessee. TERM OF LEASE. This Lease shall commence on January 1, 2022 and expire at Midnight on December 31, 2023. ("Initial Term"). RENT AMOUNT. Payment shall be made by the Lessee to the Lessor in the amount of $400.0" for the Initial Term of this Lease Agreement hereinafter referred to as the "Rent". RENT PAYMENT. The Rent shall be paid under the following instructions: Rent shall be paid by the Lessee to the Lessor on a per month basis with payment due no later than the 5 h day of every one (1) month period. Rent shall be paid by the Lessee to the Lessor's aforementioned mailing address. RETURNED CHECKS (NSF). If the Lessee attempts to pay Rent with a check that is not deemed valid by a financial institution due to non -sufficient funds, or any other reason for it to be returned, the Lessee will be subject to a fee of $35.00 in addition to any late fee. LATE FEE. The Lessor shall charge a late payment fee if rent is not paid on time in the following amount: The Lessee shall be charged a late fee in the amount of 5% of the monthly rent amount daily until it is fully satisfied, including any late payment fees, if the rent is not paid after the 1 Oth day after it is due. OPTION TO RENEW. The Lessee shall have the right to renew this Lease Agreement. RENEWAL PERIODS The first (1st) renewal period shall begin on January 1, 2024 and end on December 1, 2024 with the Rent to be paid regularly according to the lease. EXPENSES. In accordance with a Gross Lease the responsibility of the expenses shall be attributed to the following: It is the intention of the Parties, and they hereby agree, that the above mentioned Rent is the entirety of the payment due per quarter and expenses payable by Lessee to Lessor and Lessee is not obligated to pay any additional expenses including real estate taxes, insurance (other than on the Lessee's personal property) liens, charges or expenses of any nature whatsoever in connection with the ownership and operation of the Premises. The Lessor shall be obligated to maintain the general exterior structure of the Premises and, in addition, shall maintain all major systems such as the heating, plumbing and electrical, and shall maintain the parking area and shall also provide snow removal and ground maintenance of the grounds and lands surrounding the Premises, except as hereinafter set forth. The Lessee will maintain, at their expense, casualty insurance insuring the leased Premises against loss by fire and negligence. The Lessee shall provide and maintain personal liability and property damage insurance as a lessee and will designate the Lessor as an "also named insured". The Lessee shall provide the Lessor with a copy of such insurance certification or policy prior to the effective date of this Lease, at least to the limits of $1,000,000.00. UTILITIES. The Lessor shall be responsible for the following utilities on the Premises: electricity, water, sewer, trash removal SECURITY DEPOSIT. A security deposit shall not be required in advance upon the signing of this Lease. FURNISHINGS. Tenant to provide furnishings. PARKING. Parking shall be provided to the Lessee in a shared manner provided on the Premises. There is no set number of parking spaces provided to the Lessee. There shall be no fee charged to the Lessee for the use of the Parking Space(s) LEASEHOLD IMPROVEMENTS. The Lessee agrees that no leasehold improvements, alterations or changes of any nature, (except for those listed on any attached addenda) shall be made to the leasehold Premises or the exterior of the building without first obtaining the consent of the Lessor in writing, which consent shall not be unreasonably withheld, and thereafter, any and all leasehold improvements made to the Premises which become affixed or attached to the leasehold Premises shall remain the property of the Lessor at the expiration or termination of this Lease Agreement. Furthermore, any leasehold improvements shall be made only in accordance with applicable federal, state or local codes, ordinances or regulations, having due regard for the type of construction of the building housing the subject leasehold Premises. If the Lessee makes any improvements to the Premises the Lessee shall be responsible payment. Nothing in the Lease shall be construed to authorize the Lessee or any other person acting for the Lessee to encumber the rents of the Premises or the interest of the Lessee in the Premises or any person under and through whom the Lessee has acquired its interest in the Premises with a mechanic's lien or any other type of encumbrance. Under no circumstance shall the Lessee be construed to be the agent, employee or representative of Lessor. In the event a lien is placed against the Premises, through actions of the Lessee, Lessee will promptly pay the same or bond against the same and take steps immediately to have such lien removed. If the Lessee fails to have the Lien removed, the Lessor shall take steps to remove the lien and the Lessee shall pay Lessor for all expenses related to the Lien and removal thereof and shall be in default of this Lease. LICENSES AND PERMITS. A copy of any and all local, state or federal permits acquired by the Lessee which are required for the use of the Premises shall be kept on site at all times and shall be readily accessible and produced to the Lessor and/or their agents or any local, state, or federal officials upon demand. MAINTENANCE. The Lessor shall be responsible for all repairs and maintenance due to normal wear and tear on the Premises. Particularly items which need immediate attention including but not limited to, the replacement of light bulbs, as well as the normal repair and cleaning of windows, cleaning of bathrooms, clearing of toilets, etc. The Lessor shall properly maintain the premises in a good, safe and clean condition and shall properly and promptly remove all rubbish and hazardous wastes and see that the same are properly disposed of according to all local, state or federal laws, rules regulations or ordinances. In the event the building housing the leased premises is damaged as a result of any neglect or negligence of Lessee, his employees, agents, business invitees, or any independent contractors serving the Lessee or in any way as a result of Lessee's use and occupancy of the premises, then the Lessee shall be primarily responsible for seeing that the proper claims are placed with the Lessee's insurance company, or the damaging party's insurance company, and shall furthermore be responsible for seeing that the building is safeguarded with respect to said damage and that all proper notices with respect to said damage, are made in a timely fashion, including notice to the Lessor, and the party or parties causing said damage. SALE OF PROPERTY. Lessee shall, in the event of the sale or assignment of Lessor's interest in the building of which the premises form a part, or in the event of any proceedings brought for the foreclosure of, or in the event of exercise of the power of sale under any mortgage made by Lessor covering the premises, attom to the purchaser and recognize such purchaser as Lessor under this Lease. HVAC MAINTENANCE. Lessor will provide or engage a reputable and experienced firm for the purpose of periodically inspecting and maintaining the heating ventilating, and air conditioning equipment located on the Premises, hereinafter referred to as the "HVAC System". In addition, the Lessor shall be responsible for all costs associated to the everyday upkeep and maintenance of said HVAC System. COMMON AREAS. The Lessor shall be responsible for any costs related to the maintenance and upkeep of the common areas which is defined as space used by more than one (1) of the Lessees on the Property. Common areas include but are not limited to, entry -ways, bathrooms, meeting rooms, and any other space on the Property that is shared by the Lessees or Co -Tenants. INSURANCE. In the event Lessee shall fail to obtain insurance required hereunder and fails to maintain the same in force continuously during the term, Lessor may, but shall not be required to, obtain the same and charge the Lessee for same as additional rent. Furthermore, Lessee agrees not to keep upon the premises any articles or goods which may be prohibited by the standard form of fire insurance policy, and in the event the insurance rates applicable to fire and extended coverage covering the premises shall be increased by reason of any use of the premises made by Lessee, then Lessee shall pay to Lessor, upon demand, such increase in insurance premium as shall be caused by said use or Lessee's proportionate share of any such increase. SUBLET/ASSIGNMENT. The Lessee may not transfer or assign this Lease, or any right or interest hereunder or sublet said leased premises or any part thereof without first obtaining the prior written consent and approval of the Lessor. DAMAGE TO LEASED PREMISES. In the event the building housing the leased premises shall be destroyed or damaged as a result of any fire or other casualty which is not the result of the intentional acts or neglect of Lessee and which precludes or adversely affects the Lessee's occupancy of the leased premises, then in every such cause, the rent herein set forth shall be abated or adjusted according to the extent to which the Premises have been rendered unfit for use and occupation by the Lessee and until the demised premises have been put in a condition at the expense of the Lessor, at least to the extent of the value and as nearly as possible to the condition of the premises existing immediately prior to such damage. It is understood, however, in the event of total or substantial destruction to the Premises that in no event shall the Lessor's obligation to restore, replace or rebuild exceed an amount equal to the sum of the insurance proceeds available for reconstruction with respect to said damage. The Lessee shall, during the term of this Lease, and in the renewal thereof, at its sole expense, keep the interior of the leased premises in as good a condition and repair as it is at the date of this Lease, reasonable wear and use excepted. This obligation would include the obligation to replace any plate glass damaged as a result of the neglect or acts of Lessee or her guests or invitees. Furthermore, the Lessee shall not knowingly commit nor permit to be committed any act or thing contrary to the rules and regulations prescribed from time to time by any federal, state or local authorities and shall expressly not be allowed to keep or maintain any hazardous waste materials or contaminates on the premises. Lessee shall also be responsible for the cost, if any, which would be incurred to bring her contemplated operation and business activity into compliance with any law or regulation of a federal, state or local authority. HAZARDOUS MATERIALS LAWS. Shall mean any and all federal, state, or local laws, ordinances, rules, decrees, orders, regulations, or court decisions relating to hazardous substances, hazardous materials, hazardous waste, toxic substances, environmental conditions on, under, or about the Premises, the Building, or the Property, or soil and ground water conditions, including, but not limited to, the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA), the Resource Conservation and Recovery Act (RCRA), the Hazardous Materials Transportation Act, any other law or legal requirement concerning hazardous or toxic substances, and any amendments to the foregoing. LESSEE'S DEFAULT AND POSSESSION. In the event that the Lessee shall fail to pay said rent and expenses as set forth herein, or any part thereof, when the same are due and payable, or shall otherwise be in default of any other terms of said Lease for a period of more than 15 days, after receiving notice of said default, then the parties hereto expressly agree and covenant that the Lessor may declare the Lease terminated and may immediately re-enter said premises and take possession of the same together with any of Lessee's personal property, equipment or fixtures left on the premises which items may be held by the Lessor as security for the Lessee's eventual payment and/or satisfaction of rental defaults or other defaults of Lessee under the Lease. It is further agreed, that if the Lessee is in default, that the Lessor shall be entitled to take any and all action to protect its interest in the personal property and equipment, to prevent the unauthorized removal of said property or equipment which threatened action would be deemed to constitute irreparable harm and injury to the Lessor in violation of its security interest in said items of personal property. Furthermore, in the event of default, the Lessor may expressly undertake all reasonable preparations and efforts to release the Premises including, but not limited to, the removal of all inventory, equipment or leasehold improvements of the Lessee's, at the Lessee's expense, without the need to first procure an order of any court to do so, although obligated in the interim to undertake reasonable steps and procedures to safeguard the value of Lessee's property, including the storage of the same, under reasonable terms and conditions at Lessee's expense, and, in addition, it is understood that the Lessor may sue the Lessee for any damages or past rents due and owing and may undertake all and additional legal remedies then available. LESSOR'S DEFAULT. The Lessee may send written notice to the Lessor stating duties or obligations that have not been fulfilled under the full performance of this Lease Agreement. If said duties or obligations have not been cured within 30 days from receiving such notice, unless the Lessor needs to more time to cure or remedy such issue in accordance with standard industry protocol, then the Lessor shall be in default of this Lease Agreement. If the Lessor should be in default the Lessee shall have the option to terminate this Lease Agreement and be held harmless against any of its terms or obligations. DISPUTES. If any dispute should arise in relation to this Lease Agreement the Lessor and Lessee shall first negotiate amongst themselves in "good faith". Afterwards, if the dispute is not resolved then the Lessor and Lessee shall seek mediation in accordance with the laws in the State of Texas. If the Lessor and Lessee fail to resolve the dispute through mediation then the American Arbitration Association shall be used in accordance with their rules. Lessor and Lessee agree to the binding effect of any ruling or judgment made by the American Arbitration Association. INDEMNIFICATION. The Lessee hereby covenants and agrees to indemnify, defend and hold the Lessor harmless from any and all claims or liabilities which may arise from any cause whatsoever as a result of Lessee's use and occupancy of the premises, and further shall indemnify the Lessor for any losses which the Lessor may suffer in connection with the Lessee's use and occupancy or care, custody and control of the premises. The Lessee also hereby covenants and agrees to indemnify and hold harmless the Lessor from any and all claims or liabilities which may arise from any latent defects in the subject premises that the Lessor is not aware of at the signing of the lease or at any time during the lease term. BANKRUPTCY - INSOLVENCY. The Lessee agrees that in the event all or a substantial portion of the Lessee's assets are placed in the hands of a receiver or a Trustee, and such status continues for a period of 30 days, or should the Lessee make an assignment for the benefit of creditors or be adjudicated bankrupt, or should the Lessee institute any proceedings under the bankruptcy act or any amendment thereto, then such Lease or interest in and to the leased premises shall not become an asset in any such proceedings and, in such event, and in addition to any and all other remedies of the Lessor hereunder or by law provided, it shall be lawful for the Lessor to declare the term hereof ended and to re-enter the leased land and take possession thereof and all improvements thereon and to remove all persons therefrom and the Lessee shall have no further claim thereon. SUBORDINATION AND ATTORNMENT. Upon request of the Lessor, Lessee will subordinate its rights hereunder to the lien of any mortgage now or hereafter in force against the property or any portion thereof, and to all advances made or hereafter to be made upon the security thereof, and to any ground or underlying lease of the property provided, however, that in such case the holder of such mortgage, or the Lessor under such Lease shall agree that this Lease shall not be divested or in any way affected by foreclosure, or other default proceedings under said mortgage, obligation secured thereby, or Lease, so long as the Lessee shall not be in default under the terms of this Lease. Lessee agrees that this Lease shall remain in full force and effect notwithstanding any such default proceedings under said mortgage or obligation secured thereby. Lessee shall, in the event of the sale or assignment of Lessor's interest in the building of which the Premises form a part, or in the event of any proceedings brought for the foreclosure of, or in the event of exercise of the power of sale under any mortgage made by Lessor covering the Premises, attorn to the purchaser and recognize such purchaser as Lessor under this Lease. USAGE BY LESSEE. Lessee shall comply with all rules, regulations and laws of any governmental authority with respect to use and occupancy. Lessee shall not conduct or permit to be conducted upon the premises any business or permit any act which is contrary to or in violation of any law, rules or regulations and requirements that may be imposed by any authority or any insurance company with which the premises is insured, nor will the Lessee allow the premises to be used in any way which will invalidate or be in conflict with any insurance policies applicable to the building. In no event shall explosives or extra hazardous materials be taken onto or retained on the premises. Furthermore, Lessee shall not install or use any equipment that will cause undue interference with the peaceable and quiet enjoyment of the premises by other Lessees of the building. SIGNAGE. Lessee shall not place on any exterior door, wall or window of the premises any sign or advertising matter without Lessor's prior written consent and the approval of the local municipality. Thereafter, Lessee agrees to maintain such sign or advertising matter as first approved by Lessor in good condition and repair. Furthermore, Lessee shall conform to any uniform reasonable sign plan or policy that the Lessor may introduce with respect to the building. Upon vacating the premises, Lessee agrees to remove all signs and to repair all damages caused or resulting from such removal. PETS. No pets shall be allowed on the premises without the prior written permission of Lessor unless said pet is required for reasons of disability under the Americans with Disability Act. CONDITION OF PREMISESANSPECTION BY LESSEE. The Lessee acknowledges they have had the opportunity to inspect the Premises and acknowledges with its signature on this Lease that the Premises are in good condition and comply in all respects with the requirements of this Lease. The Lessor makes no representation or warranty with respect to the condition of the premises or its fitness or availability for any particular use, and the Lessor shall not be liable for any latent or patent defect therein. The Lessee represents that Lessee has inspected the premises and is leasing and will take possession of the premises with all current fixtures present in their "as is" condition as of the date hereof. AMERICANS WITH DISABILITY ACT. Per 42 U.S. Code § 12183 if the Lessee is using the Premises as a public accommodation (e.g. restaurants, shopping centers, office buildings) or there are more than 15 employees the Premises must provide accommodations and access to persons with disabilities that is equal or similar to that available to the general vublic. Owners, operators, lessors, and lessees of commercial properties are all responsible for ADA compliance. If the Premises is not in compliance with the Americans with Disability Act any modifications or construction will be the responsibility of the Lessor. RIGHT OF ENTRY. It is agreed and understood that the Lessor and its agents shall have the complete and unencumbered right of entry to the Premises at any time or times for purposes of inspecting or showing the Premises and for the purpose of making any necessary repairs to the building or equipment as may be required of the Lessor under the terms of this Lease or as may be deemed necessary with respect to the inspection, maintenance or repair of the building. In accordance with State and local laws, the Lessor shall have the right to enter the Premises without the consent of the Lessee in the event of an emergency. ESTOPPEL CERTIFICATE. Lessee at any time and from time to time, upon at least ten (10) days prior notice by Lessor, shall execute, acknowledge and deliver to Lessor, and/or to any other person, firm or corporation specified by Lessor, a statement certifying that the Lease is unmodified and in full force and effect, or if the Lease has been modified, then that the same is in full force and effect except as modified and stating the modifications, stating the dates to which the fixed rent and additional rent have been paid, and stating whether or not there exists any default by Lessor under this Lease and, if so, specifying each such default. HOLDOVER PERIOD. Should the Lessee remain in possession of the Premises after the cancellation, expiration or sooner termination of the Lease, or any renewal thereof, without the execution of a new Lease or addendum, such holding over in the absence of a written agreement to the contrary shall be deemed to have created and be construed to be a tenancy from month to month with the Rent to be due and payable in the same amount as the previous month, terminable upon 30 days' notice by either party. WAIVER. Waiver by Lessor of a default under this Lease shall not constitute a waiver of a subsequent default of any nature. GOVERNING LAW. This Lease shall be governed by the laws of the State of Texas. NOTICES. Notices shall be addressed to the following: Lessor 301 S. LLC 4444 State Highway 111 N, Edna, Texas 77957 Lessee the Property's Address CALHOUN COUNTY, TEXAS 131 - A N. Virginia Street, Suite G, Port Lavaca, Texas, 77979 AMENDMENT(S). No amendment of this Lease shall be effective unless reduced to writing and subscribed by the parties with all the formality of the original. Lessor 301 S. LLC 4444 State Highway 111 N, Edna, Texas 77957 Lessee the Property's Address CALHOUN COUNTY, TEXAS 131 - AN. Virginia Street, Suite G, Port Lavaca, Texas, 77979 AMENDMENT(S). No amendment of this Lease shall be effective unless reduced to writing and subscribed by the parties with all the formality of the original. SEVERABILITY. If any term or provision of this Lease Agreement is illegal, invalid or unenforceable, such term shall be limited to the extent necessary to make it legal and enforceable, and, if necessary, severed from this Lease. All other terms and provisions of this Lease Agreement shall remain in full force and effect. BINDING EFFECT. This Lease and any amendments thereto shall be binding upon the Lessor and the Lessees and/or their respective successors, heirs, assigns, executors and administrators. LESSOR: 301 S. LLC Signature Um kQ.Q,I_kk9 Date V— �—")-0a Ceanne Webb LESSEE: CALHOUN COUNTY TEXAS r Signature 1' - Date z - & — -2- -2— Printed Name:_ &A 4 rJ u , M ,0 y2 r Title: :T;J Page 8 CERTIFICATE OF INTERESTED PARTIES FORM 1295 l oil Complete Nos.1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2022-849433 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 301 South, LLC Edna, TX. United States Date Filed: 02/10/2022 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 Identify the contract, and provide a .description of the services, goods, or other property to be provided under the contract. 21322 Commercial Lease Agreement for offices Located at 131 N Virginia Street, Port Lavaca, Texas beginning January 1, 2022 at $400.00/month 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 Parry. X 6 UNSWORN DECLARATION YID My name is L`Pa'`[V 2' and my date o My address is old (city) I declare unde - and correct. Executed in County. State of �ix' , on the day of 20 . (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.t cus Version V1.1.191b5cdc NOTICE OF MEETING — 2/16/2022 Consider and take necessary action to authorize Commissioner Lyssy to sign a proposal for G & W Engineering Services for Seakist Lane Drainage Improvements to be paid out of GOMESA funds. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 15 Vern L Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 February 4, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda • Consider and take necessary action and allow Vern Lyssy to sign proposal for G&W Engineering Services for Seakist Lane Drainage Improvements and be paid out of the Go Mesa Funds. d 4-2�� Vern Lyssy Commissioner, Pct. 2 VL/Ij G&WENGINEERS, INC. 205 W. Live Oak Port Lavaca, TX 77979 • p: (361)552-4509 • f: (361)552-4987 Texas Firm Registration No. F04188 February 2,2022 Calhoun County Precinct # 2 Commissioner Vern Lyssy 5812 FM 1090 Port Lavaca, TX 77979 RE: PROPOSAL — Professional Engineering Services — Sealdst Lane Drainage Improvements Calhoun County, Texas Dear Commissioner Lyssy, G&W Engineers, Inc. understands that you are considering engaging a professional engineering consulting firm to analyze the existing storm sewer infrastructure near Seakist Lane is Calhoun County, Texas. We also understand that in recent rain events that flooding occurred at Seakist Lane, covering Seakist Lane, as well as, private road(s) and property in the vicinity. The existing drainage channels downstream of the existing culvert crossing at Seakist Lane, pass through private property ownership. Additionally, there are at least two (2) other road crossings with culverts, as well as two (2) intercepting private ponds before the runoff reaches Lavaca Bay. The subject drainage channels, some culverts and ponds are not maintained by Calhoun County Precinct # 2, or the Calhoun County Drainage District Number 11. Per our conversations, G&W offers the following recommendation in order to move forward with this project: G&W is recommending that the existing drainage channels, culverts, and intercepting ponds be analyzed to determine exactly how insufficient they are in terms of flow and determine if they should be upsized and/or modified. A key element to the design will be determining elevations for relief structures at or near the existing ponds to ensure that the safety for the neighboring residents, with regards to drainage, is maintained Alignments of proposed pipes, structures, easements, etc. will need to be determined. G&W will conduct hydrology and hydraulic modeling to determine system component sizing. Based up the above recommendation, G&W understands our Scope of Work for Professional Engineering Services will consist of the following: 1. Perform Topographic Survey of site to gather necessary information for the drainage project. 2. Perform site visit with professional engineer to finiher investigate and discuss as required. 3. Prepare signed and sealed drainage modeling, plans & construction estimates for options. 4. Perform final site survey for four (4) drainage easements, including applicable plats, descriptions and staking comers. 5. Coordinate project bidding, review bids, recommend award. 6. Provide construction observations and review pay request. Engineering Consulting Planning Surveying G& W ENGINEERS. INC. P.2of2 G&W Engineers, Inc. proposes to perform the referenced Scope of Work for this project on a Time & Material Basis with a fee Not -To -Exceed based upon the following values: Topography: NTE $4,500.00 Drainage Design, Modeling and Plans: NTE $25,000.00 Survey of Drainage Easements: NTE $3,000.00 Bidding Phase: NTE $3,000.00 Construction Phase: NTE $6,500.00 TOTAL FEES: NTE $42,000.00 Clarifications: 1. The professional services estimated fee provided above is based upon preliminary discussions as well as information provided by the Calhoun County and any additions or alterations to this will increase man hour requirements. These additions or alterations from the original scope of work will be charged based on the G&W Engineers, Inc. Rate Schedule and is subject to increases. 2. Any fees (if any) incurred by public entities are not included within the scope of this project. 3. Drawings shall be made available to G&W in either AutoCAD or PDF format. Exclusions: 1. Geotechnical investigation is not included within this Scope of Work. 2. Environmental assessments and/or permitting is not included within this Scope of Work. 3. Any permits are not included within the Scope of Work (if required). If this proposal meets with your approval, please sign and return one copy to my attention or return to me via scan/email ( smason ,gwengineers.com ) as acknowledgement to proceed with this engineering effort. We appreciate the opportunity to work with you on this project. Sincerely, �y >?E Scott P. Mason, P.E. Lead Project Engineer Vern Lyssy Commissioner Pct. 2 Cr ," `9 Printed Name Title Signa re Date File: job # 9317.049 CERTIFICATE OF INTERESTED PARTIES FORM 1295 J. of 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. 2022-847511 G&W Engineers, Inc. Port Lavaca, TX United States Date Filed: 02/07/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Precinct # 2, Calhoun County, Texas Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. G&W Project # 9317.050 Seakist Lane Drainage Improvements - Technical Services 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Novian, Brian Port Lavaca, TX United States X Sappington, Michial Port Lavaca, TX United States X Danysh, Henry Port Lavaca, TX United States X Gohlke, Anthony Port Lavaca, TX United States X Tuch, Elton Part Lavaca, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is and my date of birth is vie4rla Ti , 7790y USA (street) (city) (state) (zip code) (country) I declare under penalty,ofthat the foregoing is true and correct. ,perjury .�-./ �` a,//�u/1 ,(/ Executed in _ County, State of , f` on the day of r`f" , 20 7 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us Version V1.1.191b5cdc NOTICE OF MEETING — 2/16/2022 8. Consider and take necessary action to approve the Preliminary Plat of Pelicans Landing Resubdivision No. 1. (GR) Terry Ruddick explained the Preliminary Plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 15 Mae Belle Cassel From: april.townsend@calhouncotx.org (April Townsend)<april.townsend@calhouncotx.org> Sent: Wednesday, February 9, 2022 7:33 AM To: MaeBelle.Cassel@calhouncotx.org; richard.meyer@calhouncotx.org Cc: truddick@urbansurveying.com Subject: Agenda Request Attachments: 2022-02-16 Agenda Request.pdf; 524792_PLT-102821-PP.PDF Importance: High Please see attached agenda request for February 16, 2022. Thanks, April Calhoun County Texas Gary D. Reese County Commissioner County of Calhoun Precinct 4 February 8, 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 16, 2022. Consider and take necessary action to approve the Preliminary Plat of Pelicans Landing Resubdivision No. 1. Sincerely, F� \1�, Gary D. Reese GDR/at P.O. Box 177 — Seadrift. Texas 77983 email: earv.rceserPucalhouncoN.ore — (361) 785-3141 — Fax (361) 785-5602 IN z�n Mg9� W ai�3 ]'� 30 p9p RM lm A < F < p uga 'gy 5['€ m Yag r pgyq m m M. f€8 as m a £ 9-H nny,A" &t�4€�=5,m nil m Fno@@25 '3'n° � oio ism m a Eq o m z j o N RON #9 NOTICE OF MEETING — 2/16/2022 9. Consider and take necessary action to approve the Specifications and Contract Documents for Rebid - Lane Road Drainage Improvements for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1 and to authorize G & W Engineers, Inc. and the County Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 am, Thursday, March 10, 2021 in the Commissioners' Courtroom. Sealed Bids will be due before 2:00:00 pm, Thursday, March 31, 2021. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 15 Mae Belle Cassel From: april.townsend@calhouncotx.org (April Townsend) <april.townsend@calhouncotx.org> Sent: Wednesday, February 9, 2022 9:01 PM To: Mae Cassel; richard.meyer@calhouncotx.org; Peggy Hall; smason@gwengineers.com Subject: Fwd: Rebid - Lane Road Agenda Item Please place the following on the agenda for February 16, 2022. Sent from my iPhone Begin forwarded message: From: smason@gwengineers.com Date: February 9, 2022 at 6:32:23 PM CST To: Gary Reese <Gary.Reese@calhouncotx.org> Cc: gking@gwengineers.com, Katy Sellers <katy@ksbr-Ilc.com>, Cindy Mueller <cindy.mueller@calhouncotx.org>, april.townsend@calhouncotx.org, peggy hall <peggy.hall@calhouncotx.org> Subject: RE: Rebid - Lane Road Agenda Item CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Gary, Please place the following for court action: RE: Agenda Item for Court February 161h Lane Road Drainage Improvements Here is wording forthe agenda item to approve the specifications and contract documents for Lane Road Drainage Improvements -- Change where needed Please confirm with Mae Belle that court room will be available for the pre -bid meeting date before sending the agenda item request to Mae Belle. • Consider and take necessary action to approve the Specifications and Contract Documents for Rebid - Lane Road Drainage Improvements for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1 and to authorize G & W Engineers, Inc. and the County Auditor to advertise forbids. A pre -bid meeting shall be held at 10:00 am, Thursday, March 10, 2021 in the Commissioners' Courtroom. Sealed Bids will be due before 2:00:00 pm, Thursday, March 31, 2021. Thank you, 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 From: peggy hall <peggy.hall@calhouncotx.org> Sent: Wednesday, October 20, 20218:53 AM To: David.Hall@calhouncotx.org Cc: Angela Torres <Angela.Torres@calhouncotx.org>; Scott Mason <smason@gwengineers.com>; gking@gwengineers.com; Katy Sellers <katy@ksbr-Ilc.com>; Cindy Mueller <cindy.mueller@calhouncotx.org>; april.townsend@calhouncotx.org; Gary Reese <ga ry. reese @ ca I h o u ncotx. o rg> Subject: RE: Lane Road Agenda Item David, Thanks! And sorry about that! My brain is not working. Peggy From: David.Hall@calhouncotx.org (David Hall)[mailto:David. Hall@calhouncotx.org] Sent: Wednesday, October 20, 20218:52 AM To: peggv.hall@calhouncotx.org Cc: Angela Torres<Angela.Torres@calhouncotx.org>; Scott Mason <smason@gwengineers.com>; gking@gwengineers.com; Katy Sellers <katy@ksbr-Ilc.com>; Cindy Mueller <cindv.mueller@calhouncotx.org>; april.townsend@calhouncotx.org; Gary Reese <ga rv. re e s e@ ca I h o u n c of x. o rg> Subject: Re: Lane Road Agenda Item This is going to be Commissioner Reese's. I'm forwarding to him Sent from David's iPhone On Oct 20, 2021, at 8:43 AM, peggv.hall@calhouncotx.org wrote: David, RE: Agenda Item for Court October 271^ Lane Road Drainage Improvements Here is wording for the agenda item to approve the specifications and contract documents for Lane Road Drainage Improvements -- Change where needed I noticed the pre -bid meeting was in the Commissioners' Courtroom. I called Mae Belle and luckily it was available and she reserved it for this meeting. Anytime you will be having something in Commissioners' Courtroom, please make sure it is available by calling Mae Belle to reserve it for the date and time needed. Please send your agenda item to Mae Belle by 4 pm, tomorrow, Thursday, October 21". • Consider and take necessary action to approve the Specifications and Contract Documents for Lane Road Drainage Improvements for Calhoun County, Texas — Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-1 and to authorize G & W Engineers, Inc. and the County Auditor to advertise forbids. A pre -bid meeting shall be held at 10:00 am, Thursday, November 18, 2021 in the Commissioners' Courtroom. Sealed Bids will be due before 2:00:00 pm, Thursday, December 9, 2021. Peggy -9Va9 Assistant Auditor Calhoun County 202 S. Ann St., Ste B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Calhoun County Texas Calhoun County Texas Calhoun County Texas Calhoun County Texas INVITATION TO BID Notice is hereby given that the Commissioners Court of Calhoun County, Texas will receive bids for: REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065-064-C182 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORK ORDER NO. B-1. This project is funded by the Texas General Land Office of the State of Texas, to provide for disaster recovery and restoration of infrastructure for communities impacted by Hurricane Harvey. The funds have been allocated by the United States Department of Housing and Urban Development through the Community Development Block Disaster Relief Grant Program. Bids shall be for the furnishing of all labor, materials, equipment, plant and superintendence, for performing the Work for the installation of approximately 24,953 LF of drainage channel ditches, 1782, LF of storm sewer pipe, 350 CY of rock rip -rap, and reconstruction of gravel roads all in accordance with the Plans and Specifications. Specified Work is set out in Document No. 00300 of these Contract Documents. Bid documents may be examined at Calhoun County Auditor's Office, Courthouse Annex II, 202 S. Ann St, Suite B, Port Lavaca, TX or G&W Engineers, Inc, at 205 W. Live Oak, Port Lavaca, TX and obtained from www.CivcastUSA.com. There is no charge to view or download the documents. Addendums and other announcements will be distributed via CivCastUSA to all plan holders. A Pre -Bid Meeting shall be held at 10:00 am, Thursday, March 10, 2022 at the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Texas. All plan holders and/or potential Bidders are STRONGLY urged to attend. Social distancing and masks will be required. SEALED BIDS ARE DUE BEFORE 2:00:00 PM, THURSDAY, MARCH 31, 2022. At that time, all bids will be publicly opened and read aloud at the County Judge's office in the Calhoun County Courthouse at 211 South Ann Street, Yd Floor, Suite, 301, Port Lavaca, Texas. All bids must be delivered (one original unbound bid and three unbound copies) to the Office of the Calhoun County Judge in a sealed 9x12 or larger envelope and clearly marked REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065-064-082 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORK ORDER NO. B-1. Calhoun County does not accept faxed or emailed bids. Any bids received after the due date and time will be returned unopened. Sealed bids may be hand delivered or mailed to: Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 South Ann Street, Yd Floor, Suite 301 Port Lavaca, TX 77979 00020-1 CERTIFICATE OF INTERESTED PARTIES, FORM 1295 Form 1295 must be filled out online, printed, signed and returned. The copy included is a Sample Copy Only. See Calhoun County, Texas — Policy of Compliance (behind the sample copy of the form) TO FILL OUT FORM 1295, VENDORS MUST: Go to: https://www.ethics.state.tx.us/File 1. If you have an account, log in and proceed with the process or if you do not have an account, follow the instructions to set up an account and then proceed with the process. 2. Submit and print a copy of the form which will contain a unique certification number and date submitted in the upper right hand box that is marked "Office Use Only". 3. The Respondent or an authorized agent of the Respondent must sign the printed copy of the form. 4. The completed Form 1295 must be included with your bid when it is submitted to Calhoun County. For help in filling out the form: #1 Name of Business Entity filing the form, and the City, State and Country of the Entity's place of business #2 Calhoun County, Texas #3 REBID - Lane Road Drainage Improvements - TX GLO Contract No. 20-065-064- C182 On #4 and #5, complete only the one that applies to you #4 Fill in the correct information if this applies OR #5 Mark an X in the Box if this applies #6 Fill in the correct information, submit and print After printing, the respondent or an authorized agent of the respondent must sign When you print you should see a Certificate Number and Date in the upper right hand box that is marked "Office Use Only". # Zo NOTICE OF MEETING — 2/16/2022 10. Consider and take necessary action to authorize Commissioner Reese to sign a rental agreement with Texas First Rentals — Victoria for a 2021 CAT Model 259D3 Serial No. CW913087. (GR) 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 Mae Belle Cassel From: Richard. Meyer@calhouncotx.org (Richard Meyer) <Richard.Meyer@calhouncotx.org> Sent: Friday, February 11, 2022 8:40 AM To: Mae Belle Cassel Subject: FW: Texas First Rentals- Victoria From: Gary.Reese@calhouncotx.org (Gary Reese) <Gary.Reese@calhouncotx.org> Sent: Friday, February 11, 2022 8:38 AM To: Richard Meyer <Richard.Meyer@calhouncotx.org> Subject: Fwd: Texas First Rentals- Victoria Sent from myiPhone Begin forwarded message: From: Jacob.Johnson@texasfirstrentals.com Date: February 11, 2022 at 8:23:15 AM CST To: Gary Reese <Garv.Reese@calhouncotx.org> Subject: Texas First Rentals- Victoria 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. Gary, Please see CAT 259 info below. When you have a chance Monday, please send me your tax certification as well. Thank you. Year-2021 Make -CAT Model-259D3 Serial-CW913087 Replacement Value-$82,000 Jake Johnson Outside Sales Rep 203 Holt Road Victoria, TX 77905 Cell: 361-433-6327 Office: 361-881-4677 Toll Free: 844-TxFirst (844-893-4778) Jacob. Joh nson(o)TexasFirstRentals. com www.texasfirstrentals.com A ##MT'COMPANV ,Aerial, Dirt, Power& Whatever It Fakes, Calhoun County Texas Calhoun County Texas or I QUOTE Contract #.. 206997 TexasCiFirstContract dt. 2/14/22 Date out.... 2/22/22 8:00 AM Est return.. 3/22/22 8:00 AM 203 HOLT ROAD 7:OOAM TO 5:o0PM Job LOC..... CPU, SEADRIFT VICTORIA, TX 77905 Job No...... 3 - CALHOUN COUNTY P 361-881-4677 FX:000-o00-000O texasfirstrentals.com Written by.. JACOB JOHNSON Customer: 1009972 Job Site: CALHOUN COUNTY PCT 4 CALHOUN COUNTY PCT 4 PO BOX 177 CPU SEADRIFT, TX 77983 GARY-361-746-1019 SEADRIFT, TX 77983 COPY Page: 1 C#: 361-785-3141 J#: 361-785-3141 Ordered By: Purchase Order Number: Cust Job Ref No. Terms: GARY, Due Upon Receipt RPP Policy Expiration Date: Texas First Rentals Sales Rep: Time Printed: Delivery Driver Initials: JACOB JOHNSON 2/14/22 3:23 Qty Equipment # Cat -Class Min Day 1 4103800 410-3800 425.00 2900-3000 LB SKID STEER TRACK Cab unit 9252800 925-2800 72-74" SMOOTH SKID STEER BUCKET 425.00 SALES ITEMS: Qty Item number Description 1 HEIT HEAVY EQUIPMENT INVENTORY TAX Week 4 Week Amount 1260.00 3175.00 3175.00 N/C Unit Price EA 6.350 6.35 RPP: 476.25 AND OBTAIN A PICK UP NUMBER 40HR WEEK, 160 HRS 4-WEEK, OT WILL APPLY DAMAI The Loss Damage Waiver ("LDW") now called the Rental Protection Plan or "RPP" is not available for all rental transactions. Texas First Rentals may refuse to offer the RPP in its sole discretion. The RPP charge is 15 % of the Base Rental installment per month. Rental Protection Plan: Customer Accepts initials Customer Declines initials Statement of Total Charge: for the Optional Rental Protection Plan: If the customer elects to purchase the optiona�P the total estimated charge to the customer under this agreement shall be $ 0 3657.60 Remit To: Texas First Rentals LLC P.O. BOX 650869 DALLAS, TX 75265-0869 844-893-4778 Phone/Fax nwvcva CONDITIONS OF RENTAL, READ FRONT & REVERSE SIDE CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f 1 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. 2022-850516 TEXAS FIRST RENTALS LLC San Antonio, TX United States Date Filed: 02/14/2022 2 Name of governmental entity or state agency that is a party tot the contract for which the form is being filed. CALHOUN COUNTY PCT 4 Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Res #206549 2021 CAT 259D3 S/N CW913087 (Rep Value $82,000) 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary JOHNSON, JACOB Victoria, TX United States X HOLT, PETER J San Antonio, TX United States X HOLT RICHTER, CORINNA San Antonio, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is Michael PUryear and my date of birth is My address is (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. ,r� Executed in Bexar County, State of Texas on the I! day of FEB , 20 22 (month) (year) �i S e. slgnature of author zed agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc #11 NOTICE OF MEETING — 2/16/2022 11. Consider and take necessary action to approve working with the City of Port Lavaca on a concept for a Community Solid Waste/Brush/Recycle Center to be located at the County's property on Landfill Road. (RHM) Jody Weaver explained reason for wanting to work with the county. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 15 Mae Belle Cassel From: Richard.Meyer@calhouncotx.org (Richard Meyer) <Richard.Meyer@calhouncotx.org> Sent: Thursday, February 10, 2022 2:20 PM To: Mae Belle Cassel Subject: FW: agenda Importance: High This will go on 2-16-22 agenda. From: jweaver@portlavaca.org (Jody Weaver) <jweaver@portlavaca.org> Sent: Thursday, February 10, 2022 9:46 AM To: 'Richard Meyer' <Richard.Meyer@calhouncotx.org> Cc: vern.lyssy@calhouncotx.org Subject: RE: agenda Importance: High 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. Richard — How is this wording for the agenda item ?? I'm finishing up a memo that can go along as back up and will have that to you here shortly. Consider and take any necessary action regarding working with the City of Port Lavaca on a concept for a Community Solid Waste/brush/recycle center to be located at the County's property on Landfill Road. From: Richard Meyer<Richard.Mever@calhouncotx.org> Sent: Thursday, February 10, 2022 8:44 AM To: iweaverC@portlavaca.ore Subject: agenda Good morning. We can put together an agenda item with what you sent. Just go ahead and send what you can on the other item. Thanks, Judge Meyer Calhoun County Texas Calhoun County Texas #12 NOTICE OF MEETING — 2/16/2022 12. Consider and take action on Calhoun County joining in on a Regional Economic Development Strategic Group spearheaded by the Victoria Sales Tax Development Corporation, which has engaged Newmark Knight Frank to develop an Economic Development Strategic Plan and Target Industry Study. The EDC will include Victoria County — City of Victoria, Gonzales County, Dewitt County — City of Cuero, Jackson County — City of Edna, Lavaca County — City of Yoakum and Calhoun County — City of Port Lavaca. The City of Port Lavaca will work together with Calhoun County and split the $5,000.00 cost of the study. It should be noted that we will interact with Newmark together as a single group representing the entities of Calhoun County, not individually as the City or just the County. The Cities of Seadrift and Point Comfort will be able to join in the group interaction with Newmark as well. (RHM) Jody Weaver Explained the Study. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 15 Mae Belle Cassel From: Karen.Rinasz@calhouncotx.org (Karen Rinasz) <Karen.Rinasz@calhouncotx.org> Sent: Thursday, February 10, 2022 9:54 AM To: MaeBelle.Cassel@calhouncotx.org; Richard Meyer Subject: Agenda Item from Judge Meyer for February 16th The Judge would like the following put on the February 16th Agenda Consider and take action on Calhoun County joining in on a Regional Economic Development Strategic Group spearheaded by the Victoria Sales Tax Development Corporation, which has engaged Newmark Knight Frank to develop an Economic Development Strategic Plan and Target Industry Study. The EDC will include Victoria County — City of Victoria, Gonzales County, Dewitt County — City of Cuero, Jackson County — City of Edna, Lavaca County —City of Yoakum and Calhoun County — City of Port Lavaca. The City of Port Lavaca will work together with Calhoun County and split the $5,000.00 cost of the study. It should be noted that we will interact with Newmark together as a single group representing the entities of Calhoun County, not individually as the City or just the County. The Cities of Seadrift and Point Comfort will be able to join in the group interaction with Newmark as well. Xaren Rinasz Emergency Management Floodplain Administration 211 S. Ann St., Suite 301 Port Lavaca, TX 77979 361-553-4400 Emerg. Mgmt. 361-553-4455 Floodplain 361-553-4444 Fax https://www.calhouncotx.org/flood-plain-administration/ Calhoun County Texas #13 NOTICE OF MEETING — 2/16/2022 13. Consider and take necessary action to approve the Specifications and the Invitation to Bid Packet for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement and authorize the County Auditor to advertise for the bids. Bids will be due before 2:00:00 PM, Tuesday, March 15, 2022. (RHM) Everett explained reason for needing replacement. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 15 Mae Belle Cassel From: peggy.hall@calhouncotx.org (peggy hall) <peggy.hall@calhouncotx.org> Sent: Wednesday, February 9, 2022 3:11 PM To: MaeBelle.Cassel@calhouncotx.org; Richard H Meyer Cc: Everett Wood; Cindy Mueller Subject: Agenda Item for February 16, 2022 Attachments: Agenda - Approval of Specs and Invitation to Bid Packet for Annex AC.docx Mae Belle, Please put the attached on the agenda for Wednesday, February 16, 2022. Backup info will follow. Thanks! Peggy -Aaff Assistant Auditor Calhoun County 202 S. Ann St., Ste B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Calhoun County Texas February 9, 2022 To: Judge Meyer From: The office of the County Auditor For Everett Wood, Building Maintenance Please place the following item on the Commissioners Court Agenda for Wednesday, February 16, 2022: • Consider and take necessary action to approve the Specifications and the Invitation to Bid Packet for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement and authorize the County Auditor to advertise for the bids. Bids will be due before 2:00:00 PM, Tuesday, March 15, 2022. CALHOUN COUNTY, TEXAS INVITATION TO BID CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT Bid Number: 2022.05 SEALED BIDS ARE DUE: TUESDAY, MARCH 15, 2022 BEFORE 2:00:00 PM SUBMIT SEALED BIDS TO: HONORABLE RICHARD H. MEYER COUNTYJUDGE CALHOUN COUNTY COURTHOUSE 211 SOUTH ANN STREET 3Ro FLOOR, SUITE 301 PORT LAVACA, TX 77979 PUBLIC BID OPENING will be conducted at 2:00 PM, Tuesday, March 15, 2022 in the County Judge's office, Calhoun County Courthouse, 211 South Ann Street, 31d Floor, Suite 301, Port Lavaca, Texas 77979. Bids will be considered for award Wednesday, March 23, 2022 during Calhoun County Commissioners Court. Award information will be sent to all bidders that submitted a bid and will also be posted on the County's website (www.calhouncotx.org) under Bid Notices and Results, Results 2022 as soon as time permits. CONTENTS • Invitation to Bid • Return Instructions General Conditions • Specifications for Complete Purchase and Install • Additional Required Forms o Bidder Information Form o Affidavit o Certificate of Interested Parties Form 1295 o Conflict of Interest Questionnaire Form CIQ o Certification Regarding Lobbying o House Bill 89 Verification INVITATION TO BID Notice is hereby given that the Commissioners Court of Calhoun County, Texas, will receive SEALED BIDS for the following: CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT, BID NUMBER 2022.05 The bid shall be for the complete purchase and installation of a rooftop heating/cooling unit. The bid must include all permits, if any are required, all equipment and material required to complete the specifications, removal and disposal of existing unit, installation of new package unit, including consideration of equipment weight and mounting footprint as compared to the existing unit and TDI Windstorm field inspection(s) and required certificates(s). Bids shall include all requirements of the Invitation to Bid Packet for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05. The complete Invitation to Bid Packet can be downloaded from the County's website, www.calhouncotx.org (under Bid Notices and Results, Bid Notices 2022) or by contacting Peggy Hall, Assistant Auditor, at peggy.hall@calhouncotx.org or 361-553-4610. INSPECTION OF SITE FOR THE AIR CONDITIONER REPACEMENT: Inspection of the site for the rooftop heating/cooling unit may be done by appointment only by contacting Everett Wood, Building Maintenance Superintendent, at 361-553-4499. The inspection is "VIEW ONLY". No questions may be asked at this time. No comments may be made at this time. County employees may not answer any questions or make any comments to anyone inspecting the site. No questions may be answered once the Bid Specifications and Invitation to Bid Packet are approved by Commissioners Court unless in the form of an Addendum that is approved by Commissioners Court and sent to all bidders that received an Invitation to Bid Packet. All Addendums, if any, will be posted on the County's website under Bid Notices and Results, Bid Notices 2022. SEALED BIDS ARE DUE: Date: Tuesday, March 15, 2022 Time: BEFORE 2:00:00 PM Location: County Judge's Office Calhoun County Courthouse 211 South Ann Street 3rd Floor, Suite 301 Port Lavaca, Texas 77979 At this time, all bids will be publicly opened and read aloud. Bids will be considered for award Wednesday, March 23, 2022 during Calhoun County Commissioners Court. Page 1 of 2 All bids (one original) must be delivered to the office of the Calhoun County Judge in a SEALED 9 x 12 or larger envelope and CLEAREY MARKED on the outside of the envelope: SEALED BID: CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT, BID NUMBER 2022.05. Calhoun County does not accept faxed or emailed bids. The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative will be the official clock that shall be used in determining the time the bid is received and the time the bids received will be opened. Bids received after the deadline will be returned unopened. SEALED BIDS MAY BE HAND DELIVERED OR MAILED TO: Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 South Ann Street, 3rd Floor, Suite 301 Port Lavaca, TX 77979 Calhoun County is not responsible for the delivery of your bid to the office of the County Judge or delivery to the wrong office. If you choose to send your bid by postal delivery, it is recommended that you call the County Judge's office at 361-553-4600 to verify receipt of your bid prior to the bid due date and time. Calhoun County accepts no financial responsibility for any cost incurred by the bidder in the course of responding to this bid. Calhoun County reserves the right to waive any technicalities or irregularity, accept or reject any and/or all bids, to accept the bid deemed most advantageous to and in the best interest of Calhoun County. The award of a bid shall be made to the responsible bidder whose bid is determined to be the most beneficial to Calhoun County, taking into consideration the relative importance of price and other factors set forth in the Invitation to Bid Packet. Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and Labor Surplus Area Firms are encouraged to submit bids. Cindy Mueller County Auditor Calhoun County, Texas Page 2 of 2 RETURN INSTRUCTIONS For Submitting a Bid for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement Return the following BEFORE 2:00:00 PM, TUESDAY, MARCH 15, 2022 Return One (1) Original of the following: Bid with Submittal Requirements Bidder Information Form Affidavit Certificate of Interested Parties, Form 1295 Conflict of Interest Questionnaire, Form CIQ Certification Regarding Lobbying House Bill 89 Verification Do Not Fold any of the above information. Bid must be returned in a sealed 9 x 12 or larger envelope clearly marked: SEALED BID: CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT, BID NUMBER 2022.05 If you send your bid by UPS, Fed Ex or other delivery service, the outside of this sealed envelope must be clearly marked: SEALED BID: CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT, BID NUMBER 2022.05 Submit Sealed Bid to: Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 S. Ann St., 3rd Floor, Suite 301 Port Lavaca, TX 77979 CALHOUN COUNTY, TEXAS GENERAL CONDITIONS General Conditions apply to all advertised Invitations to Bid (hereinafter called Bid), Request for Proposals (hereinafter called RFP), Request for Qualifications (hereinafter called RFQ), Contracts/Agreements/Leases (hereinafter called Contract); however these may be superseded in whole or in part by the scope, special requirements, specifications or special sections of Texas Government Code and/or Texas Local Government Code. Governing Law• Bidder/Vendor is advised that the Bid, RFP, RFQ and/or Contract shall be fully governed by the laws of the State of Texas and that Calhoun County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney concerning any portion of the Bid, RFP, RFC, and/or Contract. All parties agree that the venue for any litigation arising from this Bid, RFP, RFQ, and/or Contract shall be held in Port Lavaca, Calhoun County, Texas. Completion of Bid, RFP, RFQ, and/or Contract Forms: Once the Bid, RFP, RFQ, and/or Contract is released for bidding, Calhoun County will not answer any questions except through an addendum that has been approved by Calhoun County Commissioners Court or at a mandatory pre -bid meeting. Complete, sign, and return to the Calhoun County Judge's Office the required number of Bid forms, RFP forms, RFQ forms, and/or Contracts, and any other required information by the day and time the Bid, RFP, RFQ, and/or Contract is due. The Bid, RFP, RFQ, and/or Contract must be signed and dated by an officer, employee or agent who is duly authorized to execute this Bid, RFP, RFQ, and/or Contract, and affirms that this company, corporation, firm, partnership or individual has not prepared this Bid, RFP, RFQ, and/or Contract in collusion with anyother bidder/vendor or any official or employee of Calhoun County, and that the contents of this Bid, RFP, RFQ, and/or Contract as to prices, terms or conditions of said Bid, RFP, RFQ, and/or Contract have not been communicated by the individual signing nor by any employee or agent to any other person engaged in this type of business or to any official or employee of Calhoun County prior to the official opening of this Bid, RFP, RFQ, and/or Contract. The use of liquid paper or white out is not acceptable and may result in the disqualification of the bidder's/vendor's Bid, RFP, RFQ and/or Contract. If an error is made, the bidder/vendor must draw a line through the error and initial each change. All responses typed or handwritten in ink must be clear and legible. Page 1 of 13 Submission of Sealed Bid, RFP, RFQ and/or Contract: All Bids, RFPs, RFQs, and/or Contracts must be delivered to the Countyludge's Office in a SEALED envelope. When submitting a SEALED Bid, RFP, RFQ and/or Contract the envelope must be taped and/or glued closed in order for it to be accepted as a SEALED Bid, RFP, RFQ, and/or Contract. The bidder/vendor must submit the original and required number of copies of their completed Bid, RFP, RFQ, and/or Contract and any additional required information/forms in a SEALED envelope to the Calhoun County Judge's Office, Calhoun County Courthouse, 211 South Ann Street, 3rd Floor, Suite 301, Port Lavaca, Texas. The Bid, RFP, RFQ, and/or Contract will specify the date and time due. The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative is the official clock that will be used in determining the time the Bid, RFP, RFQ, and/or Contract is received and the time the Bid, RFP, RFQ, and/or Contract will be opened. A late delivery with an early postmark or delivery of the Bid, RFP, RFQ, and/or Contract to the wrong office will not suffice. The door to the County Judge's office will be closed once the due date and time has been reached and no other bids will be accepted. Calhoun County will not be responsible for the delivery of your Bid, RFP, RFQ and/or Contract to the office of the Calhoun County Judge. Calhoun County is not responsible for late deliveries due to postal mail or other mail delivery services delays. Calhoun County is not responsible for the delivery of the Bid, RFP, RFQ, and/or Contract to the wrong office. Calhoun County does not accept faxed or emailed Bids, RFPs, RFQs, and/or Contracts. If the bidder/vendor would like to confirm the delivery of their Bid, RFP, RFQ, and/or Contract, the bidder/vendor may call the Calhoun County Judge's office at 361-553-4600. Late Bids, RFPs, RFQs, and/or Contracts will not be accepted. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be opened and shall be considered void and unacceptable. Bids, RFPs, RFQs, and/or Contracts must be submitted in a SEALED 9 x 12 or larger envelope, addressed as follows: Richard H. Meyer, County Judge, Calhoun County Courthouse, 211 S. Ann St., Suite 301, Port Lavaca, TX 77979. The outside of the SEALED envelope must be clearly marked: SEALED BID (RFP, RFQ, or Contract) and the name of the Bid, RFP, RFQ, or Contract. If the Bid, RFP, RFQ, and/or Contract is sent by UPS, FedEx or other delivery service, the outside of this envelope must be clearly marked: SEALED Bid (RFP, RFQ, or Contract) and the name of the Bid, RFP, RFQ, or Contract. Withdrawal of Bid, RFP, RFQ, and/or Contract: A bidder/vendor may withdraw their Bid, RFP, RFQ, and/or Contract before Calhoun County's acceptance of the Bid, RFP, RFQ and/or Contract without prejudice to the bidder/vendor, by submitting a written request for its withdrawal to the Calhoun County Judge and mail or hand deliver to the address the Bid, RFP, RFQ, and/or Contract was submitted to. A Bid, RFP, RFQ and/or Contract that was opened are not subject to amendment, alteration, or change for the purpose of correcting an error in the Bid, RFP, RFQ and/or Contract price. Bids, Page 2 of 13 RFPs, RFQs, and/or Contracts containing an error may be offered "as is" or withdrawn by the bidder/vendor in accordance with applicable State Laws. Opening and Award of Bid, RFP, RFQ, and/or Contract: Bidders/vendors are invited to be present at the opening and awarding of the Bid, RFP, RFQ, and/or Contract. Governing Forms: In the event of any conflict between the terms and provisions of these conditions, the Bid, RFP or RFQ specifications or contract, if applicable, shall govern. In the event of any conflict of interpretation of any part of this overall document, Calhoun County's interpretation shall govern. Addendums: When specifications are revised, the Calhoun County Auditor's Office will send each bidder/vendor that received a Bid, RFP, RFQ and/or Contract packet the addendum once it has been approved by Calhoun County Commissioners Court. No addendum can be sent out until Calhoun County Commissioners Court has approved the addendum. Indemnification/Hold Harmless: The successful bidder/vendor shall defend, indemnify and hold Calhoun County and its officials, agents, and employees harmless from all suits, actions, or for personal injury, death and/or property damage arising from any cause whatsoever, resulting directly or indirectly from bidder's/vendor's performance. Bidder/vendor shall procure and maintain, with respect to the subject matter of this Bid, RFP, RFQ, and/or Contract, appropriate insurance coverage including, as a minimum, general liability and property damage, workers' compensation, employer's liability and auto insurance with adequate limits to cover bidder's/vendor's liability as may arise directly or indirectly from work performed under terms of this Bid, RFP, RFQ, and/or Contract. Certification of such coverage shall name, by policy endorsement, Calhoun County as an additional insured and be provided to Calhoun County upon request. Waiver of Subrogation: Bidder/vendor and bidder's/vendor's insurance carrier shall waive any and all rights whatsoever with regard to subrogation against Calhoun County and its respective officials, employees, and insurers as an indirect party to any suit arising out of personal or property damages resulting from bidder's/vendor's performance under this Bid, RFP, RFQ and/or Contract. Insurers and all policies of insurance provided shall contain a provision and/or endorsement stating that the insurance carriers and underwriters waive all rights of subrogation in favor of Calhoun County and its respective officials, employees, and insurers. Bonds: If the Bid, or RFP, requires submission of bid or proposal guarantee and performance bond, there will be a separate page explaining those requirements. Bids or RFPs submitted without the required bid bond or cashier's checks are not acceptable. Taxes: Calhoun County is exempt from all sales tax (state, city and county sales tax) and federal excise taxes. Tax exempt forms will be furnished upon request to the Calhoun County Auditor's Office. Page 3 of 13 Pricing: Prices for all products/goods, services, and/or contracts shall be firm for the duration of the Bid, RFP, and/or Contract and shall be stated on the Bid, RFP, and/or Contract form. Prices shall be all inclusive. All prices must be written in ink or typewritten and must be legible. Pricing on all transportation, freight, and other charges are to be prepaid by the bidder/vendor and included in the Bid, RFP, and/or Contract prices. If there are any additional charges of any kind, other than those mentioned above, specified or unspecified, bidder/vendor must indicate the items required and their costs or forfeit the right to payment for such items. Additional charges added to the Bid, RFP, and/or Contract prices may void the Bid, RFP, and/or Contract. Where unit pricing and extended pricing differ, unit pricing prevails. Inspections: Calhoun County reserves the right to inspect any products/goods or service location for compliance with specifications and requirements and needs of the using department before accepting them. When applicable, Calhoun County reserves the right to enter upon any County leased premises at any time to inspect said premises. Testing: Calhoun County reserves the right to test equipment, supplies, materials, and products/goods bid, proposed, and/or agreed upon for quality, compliance with specifications and ability to meet the needs of the user. Should the equipment, supplies, materials, products/goods and/or services fail to meet requirements and/or be unavailable for evaluation, the Bid, RFP, and/or Contract is subject to rejection. Material Safety Data Sheets: Under the "Hazardous Communications Act", commonly known as the "Texas Right To Know Act", a bidder/vendor must provide to Calhoun County with each delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the bidder/vendorto furnish this documentation will because to reject any Bid, RFP, and/or Contract applying thereto. Awards: Calhoun County reserves the right to award this Bid, RFP, RFC, and/or Contract on the basis of lowest and/or best Bid, RFP, RFQ and/or Contract that met specifications in accordance with the laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one bidder/vendor, to reject any or all Bids, RFPs, RFQs, and/or Contracts and to be the sole judge in determining which Bid, RFP, RFC, and/or Contract will be most advantageous to Calhoun County. Calhoun County will evaluate and may award a Bid, RFP, RFQ, and/or Contract based on lowest and/or best Bid, RFP, RFQ, and/or Contract meeting specifications. "Lowest and/or best Bid, RFP, RFC, and/or Contract" means a bid or offer providing the best value considering associated direct Page 4 of 13 and indirect costs, including transport, maintenance, reliability, life cycle, warranties, the county's past experience with the bidder/vendor and customer service after a sale. Calhoun County reserves the right to accept and/or reject any/all of the options Bid, any/all of the RFPs, any/all of the RFQs, and/or any/all of the Contracts as it deems to be in the best interest of the County. An award is final only upon formal execution by Calhoun County Commissioners Court. Per Local Government Code, Sec. 262.027, Calhoun County reserves the right to reject all Bids, RFPs, RFQs, and/or Contracts and to go out for new Bids, RFPs, RFQs, and/or Contracts. In the event of tie Bids, RFPs, RFQs, and/or Contracts, the winning Bid, RFP, RFQ and/or Contract is determined per the Texas Local Governmental Code 262.027(b). Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit Bids, RFPs, RFQs, and/or Contracts. Assignment: The successful bidder/vendor may not assign, sell, sublease or otherwise transfer the Bid, RFP, RFQ, and/or Contract without first obtaining the written approval of Calhoun County Commissioners Court. A change in ownership or management shall cancel the Bid, RFP, RFQ, and/or Contract unless a mutual agreement is reached with the new owner or manager to continue the Bid, RFP, RFQ, and/or Contract under the awarded provisions and approved by Calhoun County Commissioners Court. Term of the Bid, RFP, RFQ, and/or Contract: If the Bid, RFP, RFQ and/or Contract is intended to cover a specific time period, said time will be given in the specifications, instructions, and/or contracts. Obligation of the Bid, RFP, RFQ, and/or Contract: Bids, RFPs, RFQs, and/or Contracts are awarded only upon formal execution by Calhoun County Commissioners Court. If a contract is required, the Calhoun County Judge or other person authorized by Calhoun County Commissioners Court must sign the contract before it becomes binding on Calhoun County. No person is authorized to sign contracts until authorized by Calhoun County Commissioners Court. Calhoun County is not responsible for any contract signed without Commissioners Court approval. Delivery: All items shall be shipped F.O.B. inside (or site location) delivery unless otherwise stated in the specifications. Default in promised delivery (without accepted reasons) or failure to meet Page 5 of 13 specifications, authorizes Calhoun County to purchase supplies from the next lowest bidder/vendor that met specifications. Resections: Articles not in accordance with samples and specifications must be removed by the bidder/vendor at the bidder's/vendor's expense. All disputes concerning quality of equipment, supplies, materials, products/goods, and/or services delivered under this Bid, RFP, RFQ and/or contract will be determined by Calhoun County Commissioners Court or their designated representative. Termination: Calhoun County reserves the right to terminate the Bid, RFP, RFQ and/or Contract for default if the bidder/vendor breaches any of the terms therein, including warranties of bidder/vendor or if the bidder/vendor becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper products/goods and/or services within the proper amount of time, and/or to properly perform any and all services required to Calhoun County's satisfaction and/or to meet all other obligations and requirements. Bids, RFPs, RFQs, and/or Contracts may be terminated without cause upon thirty (30) days written notice to either party unless otherwise specified. The bidder/vendor or Calhoun County must state therein the reasons for such cancellation. Calhoun County reserves the right to award cancelled Bid, RFP, RFQ, and/or Contract to the next lowest and best bidder/vendor that met specifications and is deemed to be in the best interest of Calhoun County. Delinquent Property Taxes: Calhoun County reserves the right to reject any Bid, RFP, RFQ, and/or Contract submitted by a bidder/vendor owing delinquent property taxes to Calhoun County, Texas. If the bidder/vendor subsequently becomes delinquent in the payment of Calhoun County taxes this may be grounds for cancellation of the Bid, RFP, RFQ and/or Contract. Despite anything to the contrary, if the bidder/vendor is delinquent in payment of Calhoun County taxes at the time of invoicing, bidder/vendor assigns any payments to be made under this Bid, RFP, RFQ and/or Contract to the Calhoun County Tax Assessor Collector for the payment of delinquent taxes. Certificate of Interested Parties — Form 1295 Section 2252.908 was added to the Government Code by the 80 Texas Legislature through adoption of House Bill 1295. Senate Bill 255 adopted by the 85t" Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018, Page 6 of 13 Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal: https://www.ethics.state.tx.us/whatsnew/elf_ info_form1295.htm. The law states that a County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) has been completed and provided to the County at the time the contract is considered for action by Commissioners Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract' includes amendment, extension or renewal of an existing contract (Bids, RFPs, and/or RFQs also require Form 1295). The law does not apply to a Bid, RFP, RFQ, and/or Contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within thirty (30) days of approving a contract, and/or awarding a Bid, RFP, RFQ, and/or Contract with a business entity. Governmental transparency is the objective of the law. A business entity must generate Form 1295 online. A business entity must use the application at the Texas Ethics Commission website to enter the required information on Form 1295 and print a copy of the completed form, which will include a certification of filing that will contain a unique certification number and date filed in the box marked "Office Use Only" located at the top right hand corner of the form. An authorized agent of the business entity must sign and complete the bottom portion of the printed copy of the form affirming under the penalty of perjury that the completed form is true and correct. Calhoun County Commissioners Court will not consider for action any Bid, RFP, RFQ and/or Contract with a business entity unless it is accompanied by a completed and signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than thirty (30) days after Calhoun County Commissioners Court approves a contract, or awards a Bid, RFP, and/or RFQ with a business entity, the Calhoun County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. The Texas Ethics Commission will post the completed Form 1295 to its website within seven (7) business days after Calhoun County acknowledges receipt of the form. Page 7 of 13 Debarment: Bidder/vendor certifies that at the time of submission of its (their) Bid, RFP, RFO, and/or Contract, the bidder/vendor, as well as the bidder's/vendor's principals, are not on the federal government's list of suspended, ineligible or debarred bidders/vendors and that the bidder/vendor and its (their) principals have not been placed on this list between the time of the Bid, RFP, RFO;, and/or Contract submission and the time of execution of the Bid, RFP, RFO, and/or Contract. A print out of the search results, including principals, if any, from the System for Award Management (www.SAM.gov) that includes the record date must be included with the bidder's/vendor's Bid, RFP, RFO, and/or Contract. If bidder/vendor or its (their) principals are placed on this list during the term of the Bid, RFP, RFO, and/or Contract, the bidder/vendor shall notify the Calhoun County Auditor. False certification or failure to notify may result in termination of the Bid, RFP, RFQ, and/or Contract for default. Invoices and Payments: All invoices are subject to approval by the Calhoun County Auditor's Office. Invoices shall be billed to Calhoun County to the attention of the County Department that the invoice pertains to and, if applicable, have all necessary backup information needed. Invoices shall be itemized (detailed) and free of sales tax (state, city and county sales tax) and federal excise taxes, if applicable. Invoices that are not billed to Calhoun County to the attention of the County Department that the invoice pertains to, not itemized (detailed) and/or free of sales tax (state, city and county sales tax) and federal excise taxes, if applicable, may be returned to the bidder/vendor for corrections. Calhoun County will not incur any fees and/or charges for this request and/or delay in payment of the invoice(s) that was originally submitted incorrectly. Approval of payment of all invoices will be made once the purchase order and invoice(s) are properly and timely submitted to the Calhoun County Treasurer's Office by the appropriate County department. Each County department is responsible for submitting their purchase orders for payment to the Calhoun County Treasurer's Office by the deadline time and date set forth by the Treasurer's office. No payment can be made or mailed out until approved by Calhoun County Commissioners Court. Purchase order due dates/times and Commissioners Court dates/times are subject to change. Calhoun County's obligation is payable only and solely from funds available for the purpose of this purchase. Lack of funds shall render the order null and void to the extent funds are not available and any delivered but unpaid goods will be returned to the seller by the county. Page 8 of 13 Gratuities: Calhoun County may, by written notice to the bidder/vendor, cancel any order and/or service without liability, if it is determined by Calhoun County that gratuities, in the form of entertainment, gifts, or otherwise were offered or given by the bidder/vendor, or any agent or representative of the bidder/vendor to any official, employee, or agent of Calhoun County with a view toward securing a Bid, RFP, RFQ Contract, order, and/or service. In the event a Bid, RFP, RFQ, Contract, order, and/or service is canceled by Calhoun County pursuant to this provision, the County shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by bidder/vendor in providing such gratuities. Warranty Product: Bidder/vendor warrants that products/goods sold to and/or services provided to Calhoun County shall conform to the highest commercial and/or professional standards in the industry and laws established by the U.S. Department of Labor, U.S. Department of Homeland Security, Occupational Safety and Health Administration and OSHA Act of 1970. In the event products/goods sold and/or services provided do not conform to OSHA Standards, where applicable, Calhoun County shall return the product/item for correction or replacement at the bidder's/vendor's expense. In the event that services do not conform to OSHA Standards, Calhoun County may immediately stop the services and seek reimbursement for said services at the bidder's/vendor's expense. In the event the bidder/vendor fails to make the appropriate correction within a reasonable time, correction made by Calhoun County shall be at the bidder's/vendor's expense. Bidder/vendor shall not limit or exclude any implied warranties and any attempt to do so shall render this Bid, RFP, RFQ, and/or Contract voidable at the option of Calhoun County. Bidder/vendor warrants that the products/goods and/or services furnished and/or performed will conform to the specifications, scope of work, general conditions, drawings, and/or descriptions listed in the Bid, RFP, RFQ and/or Contract and to the sample(s) furnished by bidder/vendor, if any. In the event of a conflict between the specifications, scope of work, general conditions, drawings, and/or descriptions, the specifications shall govern. All products/goods must be new, in first class condition, unless otherwise specified. The design, strength and quality of materials must conform to the highest standards of manufacturing practice. Products/goods, and/or services supplied and/or performed under this Bid, RFP, RFQ, and/or Contract shall be subject to Calhoun County's approval. Successful bidder/vendor shall warrant that all products/goods and/or services shall conform to the proposed specifications and/or all warranties as stated in the Uniform Commercial Code and Page 9 of 13 be free from all defects in material, workmanship and title. Any products/goods and are services found defective or not meeting specifications shall be picked up and promptly replaced or corrected to Calhoun County's satisfaction by the successful bidder/vendor at no expense to Calhoun County. Cancellation: Calhoun County shall have the right to cancel for default all or any part ofthe undelivered portion of an order and/or services if bidder/vendor breaches any of the terms hereof including warranties of bidder/vendor, or if the bidder/vendor becomes insolvent or files for protection under the bankruptcy laws. Such rights of cancellation are in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Calhoun County shall not incur any fees and/or charges related to the cancellation. The bidder/vendor shall be responsible for any fees and/or charges that are related to the cancellation. Force Maieure: Force Majeure means a delay encountered by a party in the performance of its obligations under this Bid, RFP, RFC, and/or Contract, which is caused by an event beyond the reasonable control of that party. Without limiting the generality of the foregoing, "Force Majeure" shall include but not be restricted to the following types of events: acts of God or public enemy; acts of governmental or regulatory authorities; fires, floods, epidemics or serious accidents; unusually severe weather conditions; strikes, lockouts, or other labor disputes; and defaults by subcontractors. In the event of a Force Majeure, the affected party shall not be deemed to have violated its obligations under this Bid, RFP, RFQ, and/or Contract, and the time for performance of any obligations of that party shall be extended by a period of time necessary to overcome the effects of the Force Majeure, provided that the foregoing shall not prevent this Bid, RFP, RFQ, and/or Contract from terminating in accordance with the termination provisions. If any event constituting a Force Majeure occurs, the affected party shall notify the other parties in writing, within twenty-four (24) hours, and disclose the estimated length of delay, and cause of the delay. Waiver: No claim or right arising out of a breach of any Bid, RFP, RFC, and/or Contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. Applicable Law: To the extent it is applicable, this Bid, RFP, RFC, and/or Contract shall be governed bythe Uniform Commercial Code. Whenever the term "Uniform Commercial Code" is used it shall be construed as meaning the "Uniform Commercial Code" as adopted in the State of Texas as effective and in force on the date of this Bid, RFP, RFQ, and/or Contract. Otherwise, Texas state and federal law shall apply. Page 10 of 13 Prohibition against Personal Interest in Bids, RFPs, RFQs, and/or Contracts: No official, employee, or agent of Calhoun County shall have financial interest, direct or indirect, in any Bid, RFP, RFQ, and/or Contract with Calhoun County, or shall be financially interested, directly or indirectly, in the sale/lease to Calhoun County of any land, materials, supplies, or service, except on behalf of Calhoun County as an official, employee, or agent. Any willful violation of this section shall constitute malfeasance in office, and any official, employee, or agent guilty thereof shall be subject to disciplinary action under applicable laws, statutes and codes of the State of Texas. Any violation of this section, with the knowledge, expressed or implied of the company, corporation, firm, partnership, or individual contracting with Calhoun County shall render the Bid, RFP, RFQ, and/or Contract involved voidable by the Calhoun County Commissioners Court. Insurance: Proof (copy of bidder's/vendor's current insurance) of the below listed insurance may be required to be returned with the Bid, RFP, RFQ, and/or Contract. As additional security for Calhoun County and as separate obligations of bidder/vendor not in conjunction with any other provisions of the Bid, RFP, RFQ, and/or Contract, bidder/vendor agrees to carry and maintain during the term of the Bid, RFP, RFQ, and/or Contract the minimum insurance coverages stated below. Before commencing work, the successful bidder/vendor shall be required, at his own expense, to furnish the Calhoun County Auditor within ten (10) days of notification of award with a certificate(s) of liability insurance (Form ACORD 25 or equivalent) showing, at least, the following minimum insurance coverage to be in force throughout the term of the Bid, RFP, RFQ and/or Contract. Higher rates and/or additional coverage may apply depending upon type of Bid, RFP, RFQ and/or Contract. General Liability ($100,000/$300,000 or greater) Workers' Compensation (at Statutory Limits) Employer's Liability ($1,000,000 or greater) Auto Insurance ($100,000 BIPP/$300,000 BIPO/$100,000 PD or greater) Professional Liability Insurance (if applicable) Farm Liability Insurance (if applicable) Coverages shall apply on an occurrence basis. The certificate(s) must reflect, by policy endorsement, that Calhoun County, Texas is an additional insured on all required policies. Each certificate of liability insurance (Form ACORD 25 or equivalent) to be furnished by successful bidder's/vendor's insurance agent shall include, by endorsement to the policy, a statement that a notice shall be given to the Calhoun County Auditor by certified mail thirty (30) days prior to cancellation, material change, or non -renewal in coverage. Calhoun County's receipt of or failure to object to any insurance certificates or policies submitted by the bidder/vendor does not release or diminish in any manner the liability or obligations of Page 11 of 13 the bidder/vendor or constitute a waiver of any of the insurance requirements for the Bid, RFP, RFQ and/or Contract. Replacement certificate(s) of liability insurance (Form ACORD 25 or equivalent) evidencing continuation of such coverage and naming, by policy endorsement, Calhoun County as an additional insured, shall be furnished to the Calhoun County Auditor's office prior to the expiration of the current policies. Should bidder/vendor at any time neglect, refuse to provide, or cancel the insurance required, Calhoun County shall have the right to terminate the Bid, RFP, RFQ, and/or Contract or pursue any remedy available by law. The insurance coverage requirements in the Bid, RFP, RFQ, and/or contract will in no way be construed as limiting the scope of indemnification. OSHA Requirements: Bidder/vendor must meet all Federal and State OSHA requirements. The bidder/vendor hereby guarantees to Calhoun County that all materials, supplies, equipment and/or services listed on the Bid, RFP, RFC, Contract, Purchase Order or Invoice shall conform to the requirements, specifications and standards promulgated by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970, as amended and in force at the date hereof. Protest Procedures: All protests and disputes will be held in Port Lavaca, Calhoun County, Texas. Any actual or prospective bidder/vendor who believes they are aggrieved in connection with or pertaining to a Bid, RFP, RFC, and/or Contract may file a protest. The protest must be delivered in writing to the Calhoun County Auditor's Office, in person or by certified mail return receipt requested prior to award. The written protest must include: Name, mailing address and business phone number of the protesting party; Appropriate identification of the Bid, RFP, RFC, and/or Contract being protested; A precise statement of the reasons for the protest; and Any documentation or other evidence supporting the protest and any alleged claims. The Calhoun County Auditor's Office will attempt to resolve the protest, including at the County Auditor's option, meeting with the protesting party. If the protest is successfully resolved by mutual agreement, written verification of the resolution, with specifics on each point addressed in the protest, will be forwarded to Calhoun County Commissioners Court. If the Calhoun County Auditor's Office is not successful in resolving the protest, the protesting party may request in writing that the protest be considered by Calhoun County Commissioners Court. Applicable documentation and other information applying to the protest will be forwarded to Calhoun County Commissioners Court, who will promptly review such documentation and information. Page 12 of 13 If additional information is required, Calhoun County Commissioners Court will notify the protesting party to provide such information. The decision of Calhoun County Commissioners Court will be final. Public Information Act: All governmental information is presumed to be available to the public. Certain exceptions may apply to the disclosure of the information. Bidder/Vendor waives any obligation to the release to the public of any documents submitted in accordance with the Bid, RFP, RFQ, and/or Contract. Governmental bodies shall promptly release requested information that is not confidential by law, either constitutional, statutory, or by judicial decision, or information for which an exception to disclosure has not been sought. CALHOUN COUNTY AUDITOR To request information from Calhoun County, please contact: Cindy Mueller Calhoun County Auditor Calhoun County Courthouse Annex II 202 S Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Email: cindy.mueller@calhouncotx.org To request a Bid, RFP, and/or RFQ packet from Calhoun County, or information on how to obtain a packet, please contact: Peggy Hall Assistant Auditor Calhoun County Courthouse Annex II 202 5 Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Email: peggy.hall@calhouncotx.org Bids, RFPs, and/or RFQs may also be viewed on Calhoun County's website, www.calhouncotx.org, under Bid Notices and Results. Page 13 of 13 SPECIFICATIONS FOR COMPLETE PURCHASE AND INSTALL Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement SPECIFICATION FOR COMPLETE PURCHASE AND INSTALL Project Title: Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement Project Location: Calhoun County Courthouse Annex, 201 W Austin St, Port Lavaca, TX 77979 Document No.: 5310.015 Annex AC Doc. Date/Revision: February 4, 2022 / 1 Summary of Existing Conditions The existing air conditioning unit selected for replacement is a packaged outdoor rooftop air conditioning unit. The unit is a "Carrier" Model 50AJ-030-NF61 IEE. See Exhibit A for reference photos. Description Contractor shall provide one (1) each complete packaged rooftop heating/cooling unit of equal capacity with the existing unit mentioned above. Package unit shall include comparable controls, remote panel and roof mounting frame. Complete package unit materials and installation shall meet the requirements of the Texas Department of Insurance (TDI) Windstorm Inspections Division, for Calhoun County, Texas. This packaged rooftop heating/cooling unit shall be "Carrier Part Number 50A213030-NT641ER" or equivalent, and shall have the following minimum parameters: • Configuration: • Heat Options • Unit Size : • Motor Options • Coil Options: • Volts -Phase -Hertz: CV Vertical 36/27 kW Low Electric Heat 030 (30 Tons) 10 HP E-Coated Al/Cu Cond, Al/Cu Evap 460-3-60 • Non -Fused Disconnect • 115v Convenience Outlet: Factory Wired • Stainless Steel Drain Pan Reference Documentation I. Exhibit A — Photos (Existing Conditions) Equipment/Material to Be Furnished by Contractor 1. All equipment/material required to complete this specification. Eguipment/Material to Be Furnished by Others 1. None Page 1 of G&W Engineers, Inc. Submittal Requirements 1. Product data and schematic layouts showing condensing unit, cooling coils, refrigerant piping and accessories required for complete system. Include rated capacities, dimensions, weights, accessories, required clearances, electrical requirements, wiring diagrams and location and size of field connections. Provide footprint adaptation documentation including roof mounting frame and base. Include TDI Windstorm compliance documentation with regards to structural mounting with manufacturer recommended supports and weather tight curbing. 2. Product data including manufacturer's installation instructions, descriptive literature, operation and maintenance manual (O&M Manual), and repair data. 3. Manufacturer warranty information Delivery The complete packaged rooftop heating/cooling unit shall be delivered according to owner's instructions. Other Work Included Within This Specification 1. Removal and disposal of existing unit. 2. Installation of new package unit, including consideration of equipment weight and mounting footprint as compared to existing unit. 3. TDI Windstorm field inspection(s) and required certification(s). End of Document Page 2 of 2 G&W Engineers, Inc. Exhibit A — Photos (Existing Conditions) Page I of 4 G&W Engineers, Inc. Page 2 of 4 G&W Engineers, Inc. End of Document Page 4 of 4 G&W Engineers, Inc. ADDITIONAL REQUIRED FORMS Bidder must return one (1) original of the following forms with their Bid: • Bidder Information Form • Affidavit • Certificate of Interested Parties Form 1295 • Conflict of Interest Questionnaire Form CIQ • Certification Regarding Lobbying • House Bill 89 Verification BIDDER INFORMATION Please Type. If handwritten, must be in ink and legible Bidder's Name: Address: Remittance Address: Telephone: Fax: Email: Signature of Authorized Representative: Printed name of Authorized Rep: Contact Name & Title: Contact Telephone: Contact Fax: Contact Email: CONTACT INFORMATION INVOICES — CONTACT INFORMATION For Invoice Inquiries: Contact Name & Title: Contact Telephone: _ Contact Fax: Contact Email: STATE OF {} AFFIDAVIT COUNTY OF {} BEFORE ME, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bid to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies, materials, or equipment bid on, or to influence any person to Bid or not to bid thereon. I affirm that I am duly authorized to execute this Bid, that this company, corporation, firm, partnership or individual has not prepared this Bid in collusion with any other Bidder. I affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to any official, employee or agent of Calhoun County in connection with the submitted Bid. The contents of this Bid as to price, terms or conditions of said Bid have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business or to any official, employee or agent of Calhoun County prior to the official opening of this Bid. I affirm that the bid price(s) contained in this bid have been carefully checked and is submitted as correct and final and if bid is accepted, agrees to furnish any and/or all items upon which prices are offered, at the price(s) and upon the conditions contained in the Specifications and General Conditions, Affiant Printed Name and Title of Affiant Name of Bidder (Company) Address Phone Number Fax Number Email Address SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this day of 120. Notary Public, State of My Commission Expires Stamp/Seal CERTIFICATE OF INTERESTED PARTIES, FORM 1295 Form 1295 must be filled out online, printed, and returned with bidder's bid. The copy included is a Sample Copy Only. See Calhoun County, Texas — Policy of Compliance (behind the sample copy of the form) TO FILL OUT FORM 1295, VENDORS MUST: Go to: https://www.ethics.state.tx.us/File 1. If you have an account, log in and proceed with the process or if you do not have an account, follow the instructions to set up an account and then proceed with the process. 2. Submit and print a copy of the form which will contain a unique certification number and date submitted in the upper right hand box that is marked "Office Use Only". 3. The Respondent or an authorized agent of the Respondent must sign the printed copy of the form. 4. The completed Form 1295 must be included with your solicitation when it is submitted to Calhoun County. For help in filling out the form: #1 Bidder's Name, City, State and Country #2 Calhoun County, Texas #3 Bid Number 2022.05 (this can be used as the Contract Number) Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement On #4 and #5, complete only the one that applies to you #4 Fill in the correct information if this applies OR #5 Mark an X in the Box if this applies #6 Fill in the correct information, submit and print After printing, the respondent or an authorized agent of the respondent must sign When you print you should see a Certificate Number and Date in the upper right hand box that is marked "Office Use Only". CERTIFICATE OF INTERESTED PARTIES FORM 1295 OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. ♦`� ` 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. � 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. ♦ 4foldentify 3 Provide the identification number used by the governmental entity or state agency to tJ+ the contract, and provide a description of the services, goods, or other property to be provided L* t}e contract. V 4 City, State, Country ature of Interest (check applicable) Name of Interested Party (place of business) � ♦ ♦ Controlling Intermediary 5 Check only if the I terestedParty. ❑ 6 UNSWORNDEe N My name is V , and my date of birth is My addre:c� , A-�`J' (street) (city) (state) (zip code) (country) 1`c1�Gnder penalty of perjury that the foregoing is true and correct. Executed in County, State of , on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) ADD ADDITIONAL PAGES AS NECESSARY Form provided by Texas Ethics Commission vnvev.ethics.state.tx.us Revised 12/22/2017 Calhoun County, Texas POLICY OF COMPLIANCE SECTION 2252.908 TEXAS GOVERNMENT CODE Approved by Commissioners Court January 28, 2016 Amended by Commissioners Court January 31, 2018 BACKGROUND Section 2252.908 was added to the Government Code by the 84" Texas Legislature through the adoption of House Bill 1295. The law states that the County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) is provided to the county at the time the contract is considered for action by Commissioner's Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract. The law does not apply to a contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within 30 days of approving a contract with a business entity. Governmental transparency is the objective of the law. Senate Bill 255 adopted by the 851h Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal httus://www.etilics.St,qte.tX.Lis/whatsnew/elf info form1295.htm. A business entity will generate Form 1295 online. Calhoun County will acknowledge online the receipt of Form 1295 after a contract is executed. Within seven business days, Form 1295 will be available for public viewing on the Commission's website. COMPLAINCE Calhoun County Commissioners Court will not consider for action any contract or bid with a business entity unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than 30 days after Commissioner's Court approves a contract or awards a bid with a non-exempt business entity, the County Clerk will file acknowledgement of receipt of the Form 1295 with the Ethics Commission. CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO For vendor doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. 1J Name of vendor who has a business relationship with local governmental entity. 2 Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. Name of Officer 4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIO as necessary. A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor? Yes F7No B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? Yes FlNo 5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more. 8 ❑Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1). 7 Signature of vendor doing business with the governmental entity Date Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 CONFLICT OF INTEREST QUESTIONNAIRE For vendor doing business with local governmental entity A complete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.legis.state.tx. us/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form. Local Government Code S 176.0010-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on: (A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity; (B) a transaction conducted at a price and subject to terms available to the public; or (C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency. Local Government Code 4176.003(a)(2)(A) and (B): (a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if: (2) the vendor: (A) has an employment or other business relationship with the local government officer ora family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor; (B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that: (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor. Local Government Code 4176.006(a) and (a-1) (a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and: (1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A); (2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1); or (3) has a family relationship with a local government officer of that local governmental entity. (a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of: (1) the date that the vendor: (A) begins discussions or negotiations to enter into a contract with the local governmental entity; or (B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or (2) the date the vendor becomes aware: (A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a); (B) that the vendor has given one or more gifts described by Subsection (a); or (C) of a family relationship with a local government officer. Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 Certification Regarding Lobbying (To be submitted with each bid or offer exceeding $100,000) The undersigned certifies, to the best of his or her knowledge and belief, that (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (c) The undersigned shall require that the language paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official Printed Name and Title of Contractor's Authorized Official Date HOUSE BILL 89 VERIFICATION FORM Certification Required by Texas Government Code Section 2270.001 The 85`h Texas Legislature approved new legislation, effective September 1, 2017, which amends Texas Local Government Code Section 1, Subtitle F, Title 10, Government Code by adding Chapter 2270 which states that a government entity may not enter into a contract (which includes contracts formed through purchase orders) with a company for goods or services unless the contract contains a written verification from the company that it: 1) Does not boycott Israel; and 2) Will not boycott Israel during the term of the contract Pursuant to Section 2270.001, Texas Government Code: 1. `Boycott Israel' means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli - controlled territory, but does not include an action made for ordinary business purposes; and 2. "Company' means a for profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or any limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of those entities or business associations that exist to make a profit. I, (authorized official) , do hereby verify the truthfulness and accuracy of the contents of the statements submitted on this certification under the provisions of Subtitle F, Title 10, Government Code Chapter 2270 and that the company named below: 1) Does not boycott Israel currently; 2) Will not boycott Israel during the term of the contract; and 3) Is not currently listed on the State of Texas Comptroller's Companies that Boycott Israel List located at https://comptroller.texas.gov/purchasing/publications/divestment.php Company Name Signature of Authorized Official Printed Name of Authorized Official Title of Authorized Official Date #14 NOTICE OF MEETING — 2/16/2022 14. Consider and take necessary action to declare as Surplus/Salvage and removed from Precinct 4 Road & Bridge inventory a Case Backhoe, Asset # 24-0479 to be used as a trade-in on new equipment. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct I SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Page 11 of 15 Mae Belle Cassel From: april.townsend@calhouncotx.org (April Townsend)<april.townsend@calhouncotx.org> Sent: Thursday, February 10, 2022 2:00 PM To: Mae Cassel; richard.meyer@calhouncotx.org Cc: Gary Reese; Candice Villarreal Subject: Agenda Request Please place on the agenda for February 16, 2022. 1 will send the surplus salvage for Monday Consider and take necessary action to declare surplus salvage and remove from Precinct 4 Road & Bridge inventory, asset # 24-0479 Case Backhoe, to be used for trade in on new equipment. Sent from my Whone Calhoun County Texas Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: 570 — Pct 4 R&B Requested By: Commissioner Gary Reese Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration 24-0479 580SN, T4F 4WD NGC732237 TO BE USED FOR TRADE-IN BACKHOE FOR NEW EQUIPMENT #15 NOTICE OF MEETING — 2/16/2022 15. Consider and take necessary action to extend Interlocal Agreements with the following agencies and authorize the County Judge to sign the contracts and purchase orders. (RHM) (1) Calhoun County Senior Citizen's Association, Inc. $35,000.00 (2) The Harbor Children's Alliance & Victim Center $28,500.00 (5) Gulf Bend Center . 111 11 Numbers 1, 2 and 5 are approved. Numbers 3 and 4 are not approved. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 15 CALHOUN COUNTY 202 S. ANN STE. A PORT LAVACA, TX 77979 CHECK REQUISITION/ PURCHASE ORDER DATE: 2/4/2022 DEPT#:' 360 VENDOR INFORMATION NAME: Gulf Bend ADDRESS: 6602 Nursery Drive, Suite 100 CITY: Victoria STATE: TX ZIP: 77904 PHONE: VENDORM 2638 PURCHASE ORDER NO. 2022-0011 DEPARTMENT INFORMATION NAME: Indigent Health Care ; '..ADDRESS: CITY: ;��. STATE: ':ZIP: `-IPHONE: ACCOUNT NO. '_ FUND DEPT GL INVOICE DATE INVOICE NO. DESCRIPTION (TO BE ENTERED INTO MIP TOTAL 1000 360 60644 Care of Indigents at Gulf Bend $ 26,000.00 Agreement approved, in Commissioners' Court on Februa , 2022 THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THE OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR TOTAL $ SERVICES WERE RECEIVED BY ME IN GOOD CONDITON AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION. COUNTYAUDITOR APPROVAL ONLY APPROYALIDEPARTMENT HEAD DEPARTMENTHEAD DATE BY DATE 26,000.00 CONTRACT between CALHOUN COUNTY and GULF BEND CENTER STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Having found the above elements fully satisfied, COUNTY may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county finds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, GULF BEND CENTER, hereinafter referred to as GULF BEND CENTER is engaged in providing services to persons with chronic and persistent mental illness and mental retardation, including crisis response and stabilization services, outpatient mental health services, and renders support to the county and district courts in the determination of competency and case disposition involving persons with mental illness and mental retardation who are involved in the criminal justice system, as well as multiple community support services for persons with mental retardation. GULF BEND CENTER is thereby providing for the betterment of Calhoun County, and desires to enter into such a contract for the provision of certain services for the COUNTY; said services being considered by both parties to this contract as fair consideration from GULF BF,ND CENTER to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: In consideration that the services described below to the residents of COUNTY, GULF BEND CENTER shall be entitled to a sum not to exceed $26,000.00 per annum. Such amount shall be disbursed by COUNTY to GULF BEND CENTF,R after January 1, 2022, upon written request for GULF BF,ND CENTER. 2. Insurance: The County will require documentation of General Liability insurance coverage, with adequate limits to be determined individually, depending on exposure. 3. Services: GULF BEND CENTER, hereinafter referred to as GULF BEND CENTER is engaged in providing services to persons with chronic and persistent mental illness and mental retardation, including crisis response and stabilization services, outpatient mental health services, and renders support to the county and district courts in the determination of competency and case disposition involving persons with mental illness and mental retardation who are involved in the criminal justice system, as well as multiple community support services for persons with mental retardation. 4. Term: The Term of this contract is to begin on January 1, 2022 and end on December 31, 2022, unless earlier terminated by either party on thirty days written notice. 5. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 6. Relationship: The parties hereby agree that this is a contract for the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of GULF BEND CENTER, and GULF BEND CENTER shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to GULF BEND CENTER by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 7. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and GULF BEND CENTER, except as herein otherwise provided. CALHOU OU/JNTY By:d/ Date: z-Aa- Z-z, NOTICES COUNTY: Richard H. Meyer Calhoun County Judge 211 S. Ann Street, Suite 301 Port Lavaca, Texas 77979 GULF BEND CENTER By. Date: 7 2 GULF BEND CENTER Jeffrey Tunnel] Executive Director 6502 Nursery Drive Victoria TX 77901 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above n •a ct was accepted and agreed to by the Commissioners' Court of Calhoun County on 2022. By: w Deputy Clerk ,1 Date:�,I 1, I I X PTCDEC05 TCDEC21 TEXAS COUNCIL RISK MANAGEMENT FUND TCRMF DECLARATIONS OF COVERAGE Member Name: Gulf Bend Center Contract Number: 00009 Declarations Effective Date: 09/01/21 12:01 AM Fund Year: 2021 - 2022 Declarations of Coverage Number: 1:21-22 A. WORKERS' COMPENSATION Coverage Basis Statutory Volunteers Yes Elected / Appointed Officials Yes Piece -Rate Client Workers No Wage -Earning Client Workers (less than minimum wage) No Annual Contributions (Estimated) $ 24,398 Per Claim Deductible N/A Annual Aggregate Deductible N/A Effective Date 09/01/21 12:01 AM Expiration Date 09/01/22 12:01 AM Original Inception Date 11/01/88 12:01 AM B. LIABILITY COVERAGES ------------------------- Automobile Liability Coverage Per Occurrence Limit of Liability $ 1,000,000 Annual Aggregate N/A Deductible $ 1,000 Annual Contribution $ 7,308 Effective Date 09/01/21 12:01 AM Expiration Date 09/01/22 12:01 AM Original Inception Date 10/01/88 12:01 AM Additional Per Occurrence and Annual Aggregate Limit of Liability $ 1,000,000 in Excess of $1,000,000 $ 80 Additional Contribution Excess Layer(s) Effective Date Expiration Date Notes $1 M xs $1 M 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/16 Original Eff Date ENDORSEMENTS (END-1) Non -Owned AL Endorsement See Endorsement Worksheet Uninsured/Underinsured Motorists - New Rates Eff 12/31/01 See Endorsement Worksheet Pagel of 6 58861 Fund Year 21-22 - Renewal B. LIABILITY COVERAGES (continued) Gulf Bend Center 00009 General Liability Coverage Per Occurrence Limit of Liability $ 1,000,000 Annual Aggregate $ 1,000,000 iLB-1) Deductible $ 1,000 Annual Contribution $ 603 Effective Date 09/01/21 12:01 AM Expiration Date 09/01/22 12:01 AM Original Inception Date 10/01/88 12:01 AM Additional Per Occurrence and Annual Aggregate Limit of Liability $ 1,000,000 in Excess of $1,000,000 Additional Contribution $ 73 Excess Layer(s) Effective Date Expiration Date Notes $1M xs $1M 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/16 Original Eff Date pictle052 ENDORSEMENTS (END-1) ------------------------------------------------------------------------------ Professional Liability Coverage -------------------------------------------------------------- Per Claim Limit of Liability Annual Aggregate (Increased Annual Aggregate Effective 09/01/01) Deductible Annual Contribution Retro Active Date Effective Date Expiration Date Original Inception Date Additional Per Claim and Annual Aggregate Limit of Liability in Excess of $1,000,000 Additional Contribution $ 1,000,000 $ 3,000,000 $ 1,000 $ 3,273 09/01/1991 12:01 AM 09/01/21 12:01 AM 09/01/22 12:01 AM 10/01/88 12:01 AM $ 1,000,000 $ 96 Excess Layer(s) Effective Date Expiration Date Notes $1M xs $1M 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/16 Original Eff Date ENDORSEMENTS (END-1) Sexual Misconduct Endorsement See Endorsement Worksheet Expanded Professional Liability Professional Defense Endorse See Endorsement Worksheet ptc e052 TCDEC22 Page 2 of 6 58861 Fund Year 21-22 - Renewal Gulf Bend Center B. LIABILITY COVERAGES (continued) 00009 --------------------------------- Errors and Omissions Liability Coverage Per Claim Limit of Liability $ 1,000,000 Annual Aggregate $ 1,000,000 Deductible $ 2,500 Annual Contribution $ 10,780 Retro Active Date 10/01/198812:01 AM Effective Date 09/01/21 12:01 AM Expiration Date 09/01/22 12:01 AM Original Inception Date 10/01/88 12:01 AM Additional Per Claim and Annual Aggregate Limit of Liability in Excess of $1,000,000 Additional Contribution Expiration Date $ 167 Excess Layer(s) Effective Date Expiration Date Notes $1M xs $1M 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/16 Original Eff Date ENDORSEMENTS (END-1) Expanded Employment Practices C. PROPERTY COVERAGES See Endorsement Worksheet Coverage Basis All Risk (PR"1) Valuation Method for Loss Adjustment Real and Personal Property Replacement Cost (PR-2) Mobile Equipment & Automobile Physical Damage Catastrophe Coverage Actual Cash Value Blanket Limit Each Occurrence Blanket Per Occurrence Deductible Annual Contribution Effective Date Expiration Date Original Inception Date ENDORSEMENTS (END-1) Boiler & Machinery Endorsement $ 16.767,267 $ 5,000 (PH-1) $ 89,447 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/88 12:01 AM Not Elected p'ctle053 TCDEC23 Page 3 of 6 58861 Fund Year 21-22 - Renewal D. AUTOMOBILE PHYSICAL DAMAGE COVERAGES Gulf Bend Center 00009 Valuation Method Property Coverage Collision Deductible per Vehicle Comprehensive Deductible per Vehicle Specified Causes Deductible per Vehicle Rental Reimbursement Coverage Annual Contribution Effective Date Expiration Date Original Inception Date E. CRIME Per Occurrence Limit of Liability Deductible Annual Contribution Effective Date Expiration Date Original Inception Date ENDORSEMENTS Actual Cash Value As Scheduled Varies by vehicle (APD 1) Varies by vehicle (APD 1) N/A (APD-1) No (APD-1) $ 25,223 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/89 12:01 AM See Attachment (CR-1) See Attachment (CR-1) $ 0 09/01/21 12:01 AM 09/01/22 12:01 AM 09/01/15 12:01 AM ptcdeo54 58861 Fund Year 21-22 - Renewal TCDEC24 Page 4 of 6 Footnotes Gulf Bend Center 00009 END-1 Reference individual endorsement worksheet for additional information. LB-1 GL Annual Aggregate Applicable to Products, Completed Operations, Contractual and Personal Injury Coverages. PR-1 Windstorm Coverage — Named Storm Wind: 1. Tier 1 Windstorm: Windstorm coverage is excess of the maximum amount of coverage available from the Texas Windstorm Insurance Association (TWA) in the 14 eligible counties designated as Tier 1, subject to a $4,424,000 minimum deductible per occurrence per Location (Total TIV at location). 2. Harris County and Fort Bend County Windstorm: 5% per occurrence per Location (Total TIV at location) deductible, subject to a $100,000 minimum deductible per Location (Total TIV at location) shall apply for all locations in Harris County and Fort Bend County. 3. Location shall mean all properties, regardless as to the number scheduled with the Fund, at the same physical address. Total insured values (TIV) at the location shall mean the sum of all replacement cost values for buildings, contents and property in the yard without regard to the sublimit, at the location. 4 For properties not located in Tier 1 or in Harris County or in Fort Bend County, the Wind/Hail Coverage Deductible — Other than Named Storm Wind would apply. 5. Named Storm Wind is defined as the direct action of wind, including wind driven rain, when associated with or occurring in conjunction with a storm or weather disturbance that has been declared and named by the National Weather Bureau, National Hurricane Center, National Weather Service or any other recognized meteorological authority to be a Hurricane, Typhoon, Tropical Cyclone, Tropical Storm, or Tropical Depression whether or not such storm or weather disturbance is named prior to the loss or damage. Wind/Hail Coverage Deductible — Other than Named Storm Wind: The deductible for wind or hail losses from weather events other than Named Storm Wind as defined above is 10% of the building TIV, subject to a $25,000 per building maximum and $50,000 aggregate maximum per occurrence. Flood Coverage: 1. Flood Coverage is excluded for property located in the 100 year flood zone A, zone V and zones prefixed A or V as shown in the most recent documentation published by the Federal Emergency Management Agency (FEMA), or other qualified and recognized authority in the absence of FEMA. 2. For property at locations other than the 100 year flood zones, the member's standard deductible will apply for flood coverage. 3. The aggregate limit for loss by flood in any single Fund Year shall not exceed $5,000,000 at all locations not situated within the 100 year flood zone A, zone V, and zones prefixed A or V as shown in the most recent documentation published by the Federal Emergency Management Agency (FEMA), or other qualified and recognized authority in the absence of FEMA. PR-2 Coverage for buildings is provided on a replacement cost basis unless otherwise noted on the building and contents schedule. PR-3 Coverage for mobile equipment is provided on an actual cash value basis unless otherwise noted on the mobile equipment schedule. ptcde055 TCDEC25 Page 5 of 6 58861 Fund Year 21-22 - Renewal Footnotes Gulf Bend Center 00009 PR-4 The following types of property must be scheduled to be covered: Fences, Gates, Retaining Walls, Flag Poles, Radio or Television Antennas and their lead in wiring, Masts or Towers, Signs, Swimming Pools, Bulkheads, Piers, Wharves or Docks, Sidewalks, Driveways, Curbs, Patios, Parking Lots and other paved surfaces and free standing Lights and Light Poles. APD-1 Coverages and deductibles may vary by vehicle. The automobile physical damage vehicle schedule should be referenced to determine specific coverages and deductibles on a particular vehicle. APD-2 The Limit per vehicle for Hired Auto APD Coverage is $35,000. The deductible for comprehensive and collision coverage under Hired Auto APD coverage is $500. CR-1 Refer to the Crime Coverage Contribution Worksheet for specific coverages, limits and deductibles. ptcde056 TCDEC26 Page 6 of 6 58861 Fund Year 21-22 - Renewal 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 6if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2022-848120 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Gulf Bend Center Victoria, TX United States Date Filed: 02/08/2022 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: 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. 2022 Mental Health and IDID Services from Gulf Bend Center - Local Funds Provided by Calhoun County 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is Jeffrey Turlrlell and my date of birth is My address is _ TX 77904 USA . (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Victoria codnty, State of Texas , on the 8th day of February 26 22 . j (month) (year) i Signat a of authorized agent of contracting business entity (Declarant) Forms provided by 1 exas Etnlcs commission www.ethics.state.tx.us Version V1.1.19lb5cdc CALHOUN COUNTY 202 S. ANN STE. A PORT LAVACA, TX 77979 CHECK REQUISITION/ PURCHASE ORDER DATE: 2/4/2022 DEPT#: 770 VENDORsINFORMATION NAME: Calhoun County Senior Citizens ADDRESS: 2104 West Austin Street CITY; Port Lavaca STATE: TX - ZIP: 77979 PHONE: VENDOR #: 845 PURCHASE ORDER NO. 2022-0009 DEPARTMENT INFORMATION 'i NAME: Aid to Aging b:'' ADDRESS: arv: ":j:'. STATE: ZIP: !-: PHONE: ACCOUNT NO. FUND DEPT GL INVOICE DATE = INVOICE NO. DESCRIPTION O BE ENTERED INTO MIP TOTAL 1000 770 61280 Contribution to Expense $ 35,000.00 Agreement approved in Commissioners' Court on Februa 022 THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THE OBLIGATION. ICERTIFV THAT THE ABOVE ITEMS OR TOTAL SERVICES WERE RECEIVED BY ME IN GOOD CONDITON AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION. COUNTYAUDITOR APPROVAL ONLY APPR - DEPARTMENT HEAD I DEPARTMENTHEAD BY $ 35,000.00 DATE DATE CONTRACT Between CALHOUN COUNTY and THE CALHOUN COUNTY SENIOR CITIZENS ASSOCIATION, INC. STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further deternned that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, /. ifia. Having found the above elements fully satisfied, COUNTI' may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, The Calhoun County Senior Cithzens Association, Inc., a Texas nonprofit corporation, hereinafter referred to as SENIOR CITIZENS, is engaged in restoring and providing an economic development area for the betterment of Calhoun County, and desires to enter into such a contract for the provision of certain services for the COUNTY; said services being considered by both parties to this contract as fair consideration from SENIOR CITIZENS to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: In consideration that the services described below to the residents of COUNTY, SENIOR CITIZENS shall be entitled to a sum not to exceed $35,000.00 per annum. Such amount shall be disbursed by COUNTY to SENIOR CITIZENS on or after January 1, 2022, upon written request by SENIOR CTI77ENS. 2. Insurance: The County will require documentation of General Liability insurance coverage with adequate Iimits to be determined individually, depending on exposure. 3. Services: SENIOR CITIZENS shall provide services at the Heritage Center and two satellite centers in the County a network for individualized assistance including meals, meal delivery for shut-ins, transportation, minor home repairs, life -line telephones when funding allows, preparing application forms, counseling, advocacy, check writing and various other needs. 4. IRS Classification: SENIOR CIITZENS' Internal Revenue Service, non-profit classification is 501(c)(3) andits IRS 1 IN is 74-192-1482. 5. Most Recent Financial and Performance Reports: SENIOR CITIZENS shall submit to COUNTY Auditor and COUNTY Judge each a copy of ,SENIOR CITIZENS' most current independent financial audit or end -of -year financial report of all expenditures and income for the period of SENIOR CIITZENS fiscal year ending in calendar year 2014, within 60 days of the approval of this contract. SENIOR CITIZENS shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which SENIOR CITIZENS gives details of services provided and clients served for the previous COUNTY fiscal year ending on December 31, 2021, on or before March 1, 2022. 6. Prospective Financial and Performance Reports: SENIOR CIITZENS shall submit to COUNTY Auditor and COUNTI' Judge each a copy of SENIOR CITIZENS' independent financial audit or end -of -year financial report of all expenditures and income for the period of SENIOR CITIZENS' fiscal year ending in calendar year 2018, within thin, days following its receipt by SENIOR CITIZENS. SENIOR CIITZENS shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which SENIOR CITIZENS gives details of services provided and clients served for SENIOR CITIZENS' fiscal year ending in calendar year 2021, by March 1, 2022. 7. Term: The Term of this contract is to begin on January 1, 2022 and end on December 31, 2022, unless earlier terminated by either party on thirty days written notice. 8, Books and Records: All books and records of SENIOR CITIZENS shall be open for inspection during normal business hours to any member of the public, the Calhoun County Auditor, and such persons as may be given that authority, in writing, by the Commissioners' Court, provided, however that this clause shall in no way be construed to override the provision of the Federal Privacy Act or other state or federal law or regulation concerting the disclosure of confidential or privacy matters. 9. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 10. Non -Discrimination: SENIOR CIITZENS agrees to operation under a policy of non-discrimination with regard to the provision of said services, Such policy shall prohibit discrimination on the basis of race, sex, age, religion, color, handicap, disability, national origin, language, political affiliation or belief or other non -merit factor. Any act of discrimination shall constitute a material breach of this contract. 11. Sexual Harassment Prohibited: SENIOR CITIZENS agrees to adopt and maintain a policy that prohibits sexual harassment. Any act of sexual harassment constitutes a material breach of this contract. 12. Applicable Laws: SENIOR CIITZENS agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or workers compensation. This clause places a duty to meet the requitements of such laws only if the law itself places such a duty on SENIOR CITIZENS. Any act in violation of any of those laws or ordinances shall constitute a material breach of this contract. 13. Default: a. In the event either party shall fail to keep, observe or perform any covenant, contract, term or provision of this contract to be kept, observed of performed by such party, respectively, and such default shall continue for a period of ten days after notice thereof by the non -defaulting party to the other, then in any such event the non -defaulting party shall be entitled to terminate this contract. b, No delay on the part of either party in exercising any right, power or privilege shall operate as a waiver thereof, nor shall ally single or partial exercise of any right, power or privilege constitute such a waiver nor exhaust the same, which shall be continuing. No notice to or demand on either party in any case shall entitle such party to any other or further notice or demand in similar or other circumstances, or constitute a waiver of the rights of either party to any other of further action in any circumstances without notice or demand. 14. Successors and Assigns: This contract shall inure to the benefit of, and be binding upon, the parties hereto and their respective heirs, legal representatives, successors and assigns; provided that SF,NIOR CITIZFNS may not assign this contract without CO1111�1'x prior written consent. 15. Governing Law: This contract shall be governed by and construed and interpreted in accordance with the laws of the State of Texas and shall be enforceable in, and venue shall be in, Calhoun County, Texas. 16. Notices: Any notice or communication hereunder must be in writing, and may be given by registered or certified mail; if given by registered or certified mail, same shall be deemed to have been given and received when a registered or certified letter containing such notice, properly addressed, with postage prepaid, is deposited in the United States mail; and if given otherwise than by registered mail, it shall be deemed by haven been given when delivered to and received by the party to whom it is addressed. Such notices or communications shall be given to the parties hereto at the addresses set forth below. Any party hereto may at any time by giving ten days written notice to the other party hereto designate any other address in substitution of the foregoing address to which such notice or communication shall be given. 17. Sevetability: If any term, covenant or condition of this contract or the application thereof to any person or circumstance shall, to any extent, be invalid of unenforceable, the remainder of this contract or the application of such term, covenant or condition to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term, covenant or condition of this contract shall be valid and shall be enforced to the fullest extent permitted by law, 18, Relationship: The parties hereby agree that this is a contract fot the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of SENIOR CITIZENS, and SENIOR CITIZF1\13' shall have no authority to bind COUA77Y to any contract, matter or obligation. No duties of COUNTY arc delegated to SENIOR CITIZENS by this contract and any provision wlucli is or inay be held to be such a delegation shall be of no force or effect. 19. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and SENIOR CITIZENS, except as herein otherwise provided. 20. Total Agreement: This contract is a total and complete integration of any slid all undertakings existing between the parties hereto and supersedes any prior oral or written agreements, promises or representation between them. The headings of the various paragraphs of this contract are for convenience only, and shall not define, interpret, affect or prescribed the meaning and interpretation of the provisions of this contract, CALHOUN COUNTY r/ By: Date: CALHOUN COUNTY SENIOR CITIZENS ASSOCIATION, INC. By: Dat NOTICES COUNTY: SENIOR CITIZENS: Calhoun County Judge Chairman of the Board Richard H. Meyer P.O. Box 128 211 S. Ann Street, Suite 301 2104 W. Austin Street Port Lavaca, Texas 77979 Port Lavaca, Texas 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above n tract wac as ce ted and agreed to by the Commissioners' Court of Calhoun County on �ua�u �; Imo. B3-: `)& � j �q Deputy Clerks / Date: 1 l�� q 11 i February 7, 2022 Honorable Richard H. Meyer Calhoun County Judge and Calhoun County Commissioners 211 South Ann Street Port Lavaca, TX 77979 Dear Judge Meyer and Commissioners Court Members, The Board of Directors and I would like to thank you for the support you have given to the Calhoun County Senior Citizens Association, Inc. this past year. The Center was again a busy place. In 2021 we have provided approximately 24,438 congregate and home delivered meals - this number includes those served at our satellite location of Port O'Connor, as well as our primary location in Port Lavaca, Additionally, our Transportation Department has provided 4591 trips to our residents within our region. The usage of our facility and services by Calhoun County seniors and other community residents, has been gratifying to all of us who continue to strive to provide a venue for the residents of our county, particularly senior citizens and disabled, to maintain their independence for as long as possible. As we continue to serve Calhoun County seniors and the community, we are grateful for the financial support of the Commissioners Court. The support we receive from you allows us to continue to provide for the seniors and citizens of our county. I respectfully ask the Commissioner's Court to consider the Calhoun County Senior Citizens at their next meeting and grant us the funds set aside for the Center for 2021. Thank you for your time Sincerel Rebecca Jer 'gan � Executive Director CERTIFICATE OF INTERESTED PARTIES FORM 1295 Soft Complete Nos. 1.4 and 6 if there are interested parties. OFFICE USE ONLY complete Nos.1, 2, 3, 5, and 61f 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, 2022.847713 Calhoun County Senior Citizens Association, Inc. Port Lavaca, TX United states Date Filed: 02/0712022 2 Name of governmental entity or state agency that Is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or Identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2022 Congregate and Meals on Wheels, Transportation for elderly 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 . ♦ 12, 1y My name Is _,� �„= '�, , and my date of birth Is _ My address f— r (street) - ,_„„ ,_,p code) (country) I declare under penalty of that the foregoing is true and correct. perjury Executed in t--..I kzs LL1t. County, State of '('.. ("'� ", on the —`% day of r-e--6 .20 \) f (month) (year) Si Stu a of aufined ag t of contracting business entity IDeclar nt) Forms provided by Texas Ethics Commission www.ethics,statexc.us Version V1.1.191b5cdc A� O® CERTIFICATE OF LIABILITY INSURANCE MIDDn'YY1) 02/02//02/2022 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 pollcy(tes) 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 endorsements , PRODUCER Herman Novak Insurance Agency- Branch of Epiphany 1219 NVirginia St, Port Lavaca, TX 77979 NAMEACT Herman Novak P�oNE '- 930 FAX Na, 36 AT41- A RIEae: hermannovakinsagenc�2021(cDamall .com INSURERS AFFORDING COVERAGE NAICe INSURERA: Scottsdale 41697 INSURED INSURERS; Texas Mutual 22945 INSURERO: Calhoun County Senior Citizens Association vV 2104t Austin St. Port Lavaca, TX 77979 INSURERD; INSURER E: INSURER F t COVERAGES CERTIFICATE NUMBER: 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 Limit TYPE OF INSURANCE POLICYNUMBSR POLICYEFF MMDO POLICY P MMDD LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y Y CPS7520227 02/02/2022 02/02/2023 EACH OCCURRENCE $1,000.000 X E SES E onnu ence $1,000,000 MED EXP one amen) $5,000 A PERSONALSADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 GEN'L X POLICY JECT DLee PRODUCTS-COMP/OPAGG $2,000,000 $ OTHER: AUTOMDMLELIABILITY COMBIN DSINGLE LIMIT $ ANYAUTO BODILY INJURY (Per person) $ OWNED SCHEDULEb AUTOS ONLY AUTOS BODILYINJURar accidentV P ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPE DAMAGE trident $ UMBRRLLALIAN OCGUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEB I I RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORrPARTNER/EXECUTIVE OFFICERIMEMBEREXCLII (Mandatory In NH) NIA 0002025502 12/28/2021 12128/2022 I PER OTH STATUTE ER ' E.L. EACH ACCIDENT $1,000_000 E.L. DISEASE -EA EMPLOYEE $1,000,000 Il yyes doscdbe under DESCRIPTION OF OPERATIONShelow EL. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached If more space Is required) Add onal Insured& WeNerol Subragagon Medical Transportation Management, Inc. 18 Hawk Rldgo Drive Lake St. Louis, Mo. 03387 Notice of Csncelallon Required HHSC 4800 Lamer Blvd. Austin, TX 78761 ' Nodce of Concelallan Required CERTIFICATE HOLDER CANCELLATION Medical Transportation Management, Inc, 16 Hawk Ridge Drive SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lake St. Louis, Mo,63367 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2016 ACORD CORPORATION, All rights reserved, ACORD 25 (2010103) The ACORD name and logo are registered marks of ACORD ACORDs provided by Forms Boas, www.FormsBoss.com; (o) Impressive Publishing 800-208-1977 CALHOUN COUNTY 202 S. ANN STE. A PORT LAVACA, TX 77979 CHECK REQUISITION/ PURCHASE ORDER DATE: 2/4/2022 DEPT#: 230 VENDOR INFORMATION NAME: The Harbor Children's Alliance ADDRESS: P O. BOX 1300 CITY: Port Lavaca STATE: TX ZIP: 77979 PHONE: VENDOR#: 3089 PURCHASE ORDER NO. 2022-0012 DEPARTMENT INFORMATION '.`'.NAME: Commissioners' Court -:!ADDRESS: CITY: '. STATE: '. .ZIP: I iPHONE: ACCOUNT NO. FUND DEPT GL INVOICE DATE INVOICE NO. DESCRIPTION O BE ENTERED INTO MIP) TOTAL 1000 230 61281 Contribution to Expense $ 25,000.00 1000 230 61288 Hotline & Child Welfare $ 3,500.00 Agreement approveidjn Commissioners' Court on Februa 2022 THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THE OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD CONDITON AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION. COUNTYAUDITOR APPROVAL ONLY APPROVAUDEPARTMENT HEAD r DEJF91A EN EAD BY TOTAL $ 28,500.00 DATE DATE CONTRACT between CALHOUN COUNTY and THE HARBOR CHILDREN'S ALLIANCE AND VICTIM CENTER STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Raving found the above elements fully satisfied, COUNTY may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, COUNTY, a political subdivision of the State of Texas, has the authority and duty to conduct necessary investigations, enforce the laws and under legislative mandate, through its district attorney, assist all victims of crime, and further, pursuant to ' 264.402, Texas 7aviiyCod6, the authority to establish children's advocacy centers, which centers shall provide certain services to and support of the children of COUNTYwho are victims of child abuse and neglect, and FURI"HER, that COUNTY has determined such activities serve valuable public purposes and constitutes county business, and WHEREAS, COUNTY, pursuant to ' ' 264.403 and 264.406, Texas Fancily Code, has the authority to develop, maintain and support, through the children's advocacy center, an environment that emphasizes the best interests of abused and neglected children and that provides investigatory and rehabilitative services, and further, to enter into contracts to provide certain services to and support of the children of COUNTY who are the victims of child abuse and neglect, and FURTHER, that COUNTYhas determined such activities serve valuable public purposes, and constitute county business, and WHEREAS, The harbor Child-ten's Alliance and Victim Center, a Texas nonprofit corporation, hereinafter referred to as T7-IE HARBOR, is engaged in providing investigations of child abuse and assisting the child victims of abuse and neglect, along with their families, and desires to enter into such a contract for the provision of certain services to and support of the children and adults of COUNTY who are victims of physical/sexual abuse and neglect; said services being considered by both parties to this contract as fair consideration from THE HARBOR to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT, 1. Payment by County: In consideration that the services described below to the residents of COUNTY, THE HARBOR shall be entitled to a sum not to exceed $¢28,500.00 per annum. Such amount shall be disbursed by COUNTY to THE HARBOR after January 1, 2022, upon written request for THE HARBOR. 2. Insurance: The County will require documentation of General Liability insurance coverage, with adequate limits to be determined individually, depending on exposure. 3. Services: THE .L-IARBOR shall provide services to the residents of COUNTYas follows: a. To provide the children and adults residing in COUNTY and surrounding counties with a facility where children and adults who are the victims of sexual and/or physical abuse and their non -offending family members can go for evaluation, intervention and counseling. b. To provide the agencies and professionals of CO UNTY and surrounding counties who work with abused children with a forum where they can gather and work together in assisting victims and their families. c. To provide a resource center for training and education in the area of child abuse, domestic violence and victimization. d. To provide a warm, non-tiv:eatening environment in which the victims of physical/sexual abuse and victimization and their families can work with law enforcement or protection services in pteparation for their court appearances. e. To provide a location where local and area law enforcement agencies and those assisting them may obtain evidence to be used to investigate and prosecute those accused of child abuse, domestic violence, family violence and neglect. 4. IRS Classification: THE HARBOR's Internal Revenue Service, non-profit classification is 501(c)(3) and its IRS EIN is 74-2578679 5. Most Recent Financial and Performance Reports: THE HARBOR shall submit to COUNTYAuditor and COUNTYJudge each a copy of THE HARBOR's most current independent financial audit or end -of -year financial report of all expenditures and income for the period of THE HARBOR's fiscal year ending in calendar year 2018, within 60 days of the approval of this contract. THE HARBOR shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which THE HARBOR gives details of services provided and clients served for the previous COUNTY fiscal year ending on December 31, 2018, on or before March 1, 2022. 6. Prospective Financial and Performance Reports: THE HARBOR shall submit to COUNTY Auditor and COUNTY Judge each a copy of THE HARBOR's independent financial audit or end -of -year financial report of all expenditures and income for the period of THE HARBOR's fiscal year ending in calendar year 2018, within thirty days following its receipt by THE HARBOR. THE HARBOR shall provide to COUNTY Auditor. and COUNTY Judge each a performance review by which THE HARBOR gives details of services provided and clients served for THE HARBOR's fiscal year ending in calendar year 2018, by March 1, 2022. 7. Term: The Term of this contract is to begin on January 1, 2022 and end on December 31, 2022, unless earlier terminated by either patty on thitty days written notice. S. Use of Funds: No moneys paid to THE HARBOR shall be expended for any purpose other than for the provision of certain services to and support of the victims of COUNTY who are victims of physical/sexual abuse and neglect; provides, however, that no exception of the person who shall conduct all of the child interviews and provide training to volunteers. 9. Books and Records: All books and records of 7I3E HARBOR shall be open for inspection during normal business hours to any member of the public, the Calhoun County Auditor, and such persons as may be given that authority, in writing, by the Commissioners' Court, provided, however that this clause shall in no way be construed to override the provision of the Federal Privacy Act or other state or federal law or regulation concerning the disclosure of confidential or privacy matters. 10. Non -Exclusion: This contract is not exclusive and COUNTYreserves the right to contract with additional parties for the provision of certain services to and support of the victims of COUNTY who are victims of physical/sexual abuse and neglect in the area covered by this contract. 11. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 12. Non -Discrimination: THE HARBOR agrees to operation under a policy of non-discrimination with regard to the provision of said services. Such policy shall prohibit discrimination on the basis of race, sex, age, religion, color, handicap, disability, national origin, language, political affiliation or belief or other non -merit factor. Any act of discrimination shall constitute a material breach of this contract. 13. Sexual Harassment Prohibited: a policy that prohibits sexual harassment. material breach of this contract. THE HARBOR agrees to adopt and maintain Any act of sexual harassment constitutes a 14. Applicable Laws: THE HARBOR agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or workers compensation. This clause places a duty to meet the requirements of such laws only if the law itself places such a duty on THE HARBOR. Any act in violation of any of those laws or ordinances shall constitute a material breach of this contract. 15. Default: a. In the event either party shall fail to keep, observe or perform any covenant, contract, term or provision of this contract to be kept, observed or performed by such party, respectively, and such default shall continue for a period of ten days after notice thereof by the non -defaulting party to the other, then in any such event the non -defaulting party shall be entitled to terminate this contract. b. No delay on the part of either party in exercising any right, power or privilege shall operate as a waiver thereof, nor shall any single or partial exercise of any right, power or privilege constitute such a waiver nor exhaust the same, which shall be continuing. No notice to or demand on either party in any case shall entitle such party to any other or further notice or demand in similar or other circumstances, or constitute a waiver of the rights of either party to any other or further action in any circumstances without notice of demand. 16. Successors and Assigns: This contract shall inure to the benefit of, and be binding upon, the parties hereto and their respective heirs, legal representatives, successors and assigns; provided that TT-.IE HARBOR may not assign this contract without CO UNTY's prior written consent. 17. Governing Law. This contract shall be governed by and construed and interpreted in accordance with the laws of the State of Texas and shall be enforceable in, and venue shall be in, Calhoun County, Texas. 18. Notices: Any notice or communication hereunder must be in writing, and may be given by registered or certified mail; if given by registered or certified mail, same shall be deemed to have been given and received when a registered or certified letter containing such notice, properly addressed, with postage prepaid, is deposited in the United States mail; and if given otherwise than by registered mail, it shall be deemed by haven been given when delivered to and received by the party to whom it is addressed. Such notices or communications shall be given to the parties hereto at the addresses set forth below. Any party hereto may at any time by giving ten days written notice to the other party hereto designate any other address in substitution of the foregoing address to which such notice or connnunication shall be given. 19. Severability: If any term, covenant or condition of this contract or the application thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, the remainder of this contract or the application of such term, covenant or condition to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term, covenant or condition of this contract shall be valid and shall be enforced to the fullest extent permitted by Iaw. 20. Relationship: The parties hereby agree that this is a contract for the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of THE HARBOR, and THE FIARBOR shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to THE HARBOR by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 21. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and THE HARBOF, except as herein otherwise provided. 22. Total Agreement: This contract is a total and complete integration of any and all undertakings existing between the patties hereto and supersedes any prior oral or written agreements, promises or representation between them. The headings of the various paragraphs of this contract are for convenience only, and shall not define, interpret, affect or prescribed the meaning and interpretation of the provisions of this contract. CALHOUN COUNTY 9&4�� By: 61-11 Date: /i ` Z S— COUNTY: Calhoun County Judge 211 S. Ann Street, Suite 301 Port Lavaca, Texas 77979 THE HARBOR CHILDREN'S ALLIANCE AND VICTIM CENTER By: _ Gi/i ts.. � 'j'�w. Date: C p 6, 1 , ,'0 1 d-" NOTICES THE HARBOR: President of the Board P.O. Box 1300 Port Lavaca, Texas 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above cp tract was accepted and agreed to by the Commissioners' Court of Calhoun County on ,w w 2022. By: qaa � /�/Deepu Deputy Clerk Date: I V �IJ�(%�� 1 Vl t III w q� 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. 2022-836405 The Harbor Chlildren's Alliance & Victim Center Port Lavaca, TX United States Date Filed: 01/04/2022 2 Name of governmental entity or state agency that is a party to the contract for whic the orm is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2022 Contribution The Harbor provides services to victims of crime and their non -offending family members as well as a place for them to got to for assistance. 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Children's Alliance & Victim Center, The Harbor Port Lavaca, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN{DECLARATION , ` 1� My name is( ' /t C'r �' W P— h and my date of lath is _ y ((J� L b r My address is _ `J f ` pJ0.C-er � rig 1-3 �S (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of , on the _day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc TEXAS FARM BUREAU UNDERWRITERS 7420 Fish Pond Road, Waco, TX 76710 COMMERCIAL PROPERTY DECLARATION MEMBERSHIP NUMBER:4CGJ 14AMtU 1NZ)UKtzU ANU MAILINU AUUHtb5 CHILD WELFARE ALLIANCE OF CALHOUN COUNTY DBA THE HARBOR PO BOX 1300 PORT LAVACA, TX 77979 POLICY NO: 02-CP-081874920-0 11 AGENCY AND MAILING ADDRESS 29 CALHOUN COUNTY, PORT LAVACA MAIN OFFICE 1601 W AUSTIN ST PORT LAVACA, TX 77979 POLICY PERIOD: FROM 08/28/2021 TO 08/28/2022 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. COMMERCIAL PROPERTY COVERAGE IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LOCATION: i BUILDING: 1 DESCRIPTION OF PREMISES ADDRESS: 215 W RAILROAD ST, PORT LAVACA, TX 77979 BUILDING DESCRIPTION: OFFICE PROTECTION CLASS: 2 CONSTRUCTION: FRAME COVERAGES PROVIDED INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN COVERED CAUSE LIMIT OF COVERAGE OF LOSS DEDUCTIBLE COINSURANCE INSURANCE Building Broad $500 80% $300,000 Actual Cash Value Business Personal Property Special $500 80% $30,000 Including Theft Actual Cash Value Business Personal Property Special $500 80% $7,000 Including Theft Actual Cash Value TF5 CP DEC 01 19 08-02-21 Page 1 of 2 TEXAS FARM BUREAU UNDERWRITERS COMMERCIAL GENERAL LIABILITY DECLARATION POLICY NO: 02-CP-081874920-0 EFFECTIVE DATE: 08/28/2021 INSURED: CHILD WELFARE ALLIANCE OF CALHOUN AGENT: CALHOUN COUNTY, PORT LAVACA MAIN COUNTY OFFICE LOC. NO. CLASSIFICATION CODE NO. PREMIUM BASE EXPOSURE PREM/OPS RATE PROD/COMP OPS RATE OTHER RATE 1 Buildings or 61226 Square 3,000 21.856 Premises - Feet office - Not Otherwise Classified (For - Profit) TERRORISM RISK INSURANCE ACT CHARGE IS WAIVED TOTAL COMMERCIAL GENERAL LIABILITY PREMIUM 1 $ 134 FORMS AND ENDORSEMENTS APPLYING TO COMMERCIAL GENERAL LIABILITY AND MADE PART OF THIS POLICY AT TIME OF ISSUE: See Forms Schedule THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND ENDORSEMENT(S), AND SUPPLEMENTAL FORM DECLARATION(S), IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. TFB CG DEC 01 19 08-02-21 B. Page 2 of 2 The Harbor Chifdren's Affiance & Victim Center January 4, 2022 Judge Richard Meyer 211 S. Ann Street Port Lavaca, TX 77979 Judge Meyer, I Thank you for allowing me to submit this requestforsupport for The Harbor Children's Alliance & Victim Center. Our request is for $ 28,500 to support the operation of the center to enable us to provide services for victims of child abuse, sexual assault and domestic violence. I have enclosed the proof of insurance and will send the financial report and performance review as soon as the reports are completed. f Abuse touches all of us. It can occur among people of all ages, genders, races, educational C background and, socioeconomic groups. The crimes of child abuse, sexual assault, and family violence do not,just affect those to whom. the violence is directed, but affect all of society as well. We strive to be a non-profit victim center that meets the needs of the community. We see our task as offering services to victims who have been abused, and also facilitating an environment ' of awareness, prevention and safety. Assessment of our community has led us to revise our program by; expanding our services, education and`outreach'to the underserved members of our community. As.a small rural center with a staff of eight, we are cross trained to allow each member to provide services to anyone who seeks assistance whether it is for child abuse, domestic violence, sexual abuse and any other need. We sincerely appreciate the county leaders assisting us in providing services to citizens in Calhoun County. Thank you again for your support_ Sincerely, ria T. Walton Executive Director 215 W. Railroad Port Lavaca, Texas 77979 Bus. Office 361 /552-1982 Fax 361 /552-4309 Hotline 361 /552-4357 ( cactx O.bcn.a.e oa�a�' a, centers f to.. NATIONAL , .CHILDREN'S ALLIANCE #16 NOTICE OF MEETING — 2/16/2022 16. Accept Monthly Reports from the following County Offices: i. Extension Office —January 2022 1. Coastal and Marine 2. 4-H and Youth Development 3. Family and Community Health ii. Justice of the Peace, Precinct 1 — January 2022 III. Justice of the Peace, Precinct 2 — January 2022 iv. Justice of the Peace, Precinct 5 — January 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Page 13 of 15 4-H and Youth Development EXTENSION ACTIVITY REPORT TO COUNTY CON January 2022 Miles traveled: County Vehicle 0; Personal Vehicle 0 Selected major activities since last report January 4 — District Food Show/Food Challenge Wrap Up Meeting 4-H Videography Project Meeting January 7 — District Livestock Judging Committee Meeting January 10 — Virtual D 11 4-H Specialist Interviews January 11 — Assisted 4-H member with Public Speaking Speech January 12 — Attended Calhoun Marine Committee Meeting January 14 — Calhoun 4-H Photo Contest Entries Due January 17 — Assisted Karen with Strong People, Strong Bodies class January 18 — Virtual Food Challenge Committee Meeting 4-H Videography Project Meeting January 19 — Assisted RJ with CPR Training in Port O'Connor January 21 — Coastal Bend 4-H Sportfishing Day Planning Meeting January 29 — Assisted 4-11 member with 4-H Leadership Camp January 31 — Calhoun 4-H Council Meeting COURT Direct Contacts by: Office: 53 E-mail: 229 Facebook Posts/Followers: 18 posts/514 followers Site: 1 Newsletters: 1 Instagram Posts/Followers: 5 posts/188 followers Phone/Texts: 43 4-H Enrollment: 179 youth; 23 adult volunteers Maier events for next month— February 2022 February 1 — CCISD Wetlands Field Trip Planning Meeting Corpus Christi with RJ to purchase items for Sportfishing Club February 3 — Rotary Meeting Presentation CCF Livestock Board Meeting February 6 — CDM Practice February 7 — Livestock Judging Practice February 8 — 4-H Videography Project Meeting February 9 — Performance Appraisal February 13 — CDM Practice February 15 — Livestock Judging Practice February 18-24 — San Antonio Livestock Show and Rodeo February 26 — Boater Safety February 27 — San Antonio Livestock Judging Contest February 28 — Calhoun 4-H Council Meeting Emilee S. DeForest CEA — 4-H and Youth Development Texas A&M AgriLife Extension Ualhoun Janugly 2022 The Texas A&M Un' r ' System • College Station, Texas Z / G, Coastal and Marine EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT January 2022 Miles traveled: County Vehicle 169 Personal Vehicle 36 Selected maior activities since last report 1/6 — TPWD Oyster Meeting in Rockport 1/10 — Meet with CCISD CHS Ag. teacher about FFA contest 1/11 — LEPC Meeting at Commissioners Court 1/12 — Marine Advisory Committee Meeting 1/13 — TPWD Trout Regulation Seeping Meeting at Ag. Building 1115 — Presentation for 185 Matagorda Bay Cooperative Fishing Project Fisherman on Oyster Regulations 1/17 — F1atsWorthy Meeting 1/18 — TXGLO Coastal Habitat Meeting for TAC Members 1/19 — CPR/First Aid/AED Program for Fishing Guides at POC Community Center 1/21 — 4-H Sportfishing Planning Meeting 1/25 — Texas Seaside Chat — Careers in Marine Extension 1/28 — Texas Sea Grant Annual Meeting 1/19 — Volunteer Program for Texas Master Naturalists Mid -Coast Chapter Direct Contacts by: Office: 16 E-mail/Letters: 153 Instagram Posts/Followers: 3/255 Site:6 Newsletters: 0 Phone/Texts:141 Volunteers:0 Major events for next month — January 2022 2/3 — Presentation to Rotary 2/8 — Texas Sea Grant Fisheries and Aquaculture Meeting 2/9 — Extension Performance Review 2/18-2/25 — Crab Trap Cleanup 2/22 — F1atsWorthy Meeting 2/26 — Boater Education Program at Calhoun Fairgrounds KI Shelly Calhoun Name County Coastal and Marine Agent January 2022 Title Date (Month -Year) Texas A&M AgriLife Extension The Texas A& niversity System • College Station, Texas //7// -� Family and Community Health ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT January 2022 Miles traveled: 50 County Vehicle Personal Vehicle Selected maior activities since last report ➢ Jan 3 Planning Meeting with Methodist Church Group for Strong People Strong Bodies ➢ Jan 4 Texas Extension Educators Association Meeting ➢ Jan 5 Meeting and Interpretation to Quilt Guild ➢ Jan 6 Meeting with Deputy Hamilton to discuss and supply Car Seats ➢ Jan 6 Calhoun County Fair Meeting ➢ Jan 11 Diabetes meeting at Memorial Medical Center ➢ Jan 12 Planning Meeting with Library for Better Living for Texans Program — Get the Facts ➢ Jan 12 Meeting on applying for Awards ➢ Jan 13, 18 & 20 Monthly meetings with Our Lady of the Gulf, United Way and Senior Citizen's Center ➢ Jan 14, 17, 19-21, 24, 26-28& 31 StrongPeople Strong Bodies (SPSB) Strength Training Classes for Beginners - two sets of classes - Evening classes M/Th at the Extension Office - Morning classes W/F at First United Methodist in PL ➢ Jan 24, 25 and 31-Blood Work for Participants of SPSB ➢ Jan 25 Taught the Statewide Early Childhood Educator Class ➢ Jan 26 Statewide Volunteer Steering Committee Meeting ➢ Jan 26 Food Challenge Meeting and Practice Direct Contacts by: Office:30 E-mail/Letters:623 Facebook Page Post 45 Site:5 Newsletters: 0 Followers 536 Phone/Texts: 150 Volunteers: 8 Facebook profile 968 friends Major events for next month — February 2022 ➢ Meetings on 1, 4, 10, 15, 17 & 18 with Texas Extension Educators, Healthy South Texas Focus Group Feedback, OLG School Advisory Council, United Way, Senior Citizen's & Volunteer Steering Committee ➢ Feb 2 & 16 Food Challenge Practice ➢ Feb 2-4,7, 9-11, 14, 16-18, 21, 23-25 & 28 — Strong People Strong Bodies Classes 24-week series ➢ Feb 1, 8, 15 Better Living for Texans Program — Get the Facts 4-week series ➢ Feb 8 Food Handler Class at the Calhoun County Library in Port Lavaca ➢ Feb 9 Extension Office Performance Review with Donnie Montemayor DEA ➢ Feb 21- 24 VG Young Institute Training in College Station ➢ Feb 26 Boater Safetv Program assisting Marine Agent RJ Shelly Karen P. Lyssy Calhoun Name County Y CEA — Family and Community Health January 2022 Title Date (Month -Year) Texas A&M AgriLife Extension - Texas A&M University System - College Station, Texas n to A �,--. .... ... �... � .. n- ,� ..• � ILI z'p O'O OO O'O O tj O j0 N:N N NiN N N N N O N',N O OHO' A N IJ N N NIt) N N--. N. r O Ky w r•1 � ' p P1 y77 ' �' - A� F N A. i+ o „O„� S O r1 .� O CGC CpC G:' f1 G.i p p. C F av'n �. n. ' O 5;. C O, N �yS rn ivo cr o ono 0 0 0 d°onroaroaro bcbo v ro IV m ao luo ao i� a°o < r CIL IV °Jr. � � '•17 � '�y hf '•rJ C7 ny '�3 C '�� x,xxxo e. ZC !D'oAlH po k ro 3 moo• K � '70 � F, �' A "' .17 to". In u, U O ' `J N a+• 5 m mr T NAME: JUSTICE OF PEACE NO. 1 OFREPORT JANUARY FREPORT CASH B( ADMINISTRATION FEE-. - BREATH ALCOHOL TESTING CONSOLIDATED COURT COSTS STATE CONSOLIDATED COURT COST LOCAL CONSOLIDATED COURT COST COURTHOUSE SECURITY CHILD -SAFE_' CHILD SEATBELT FEE-. CRIME VICTIMS COMPENSATION DPSC/FAILURE TO APPEAR OMNI-'I ADMINISTRATION FEE FTAIFTP;(aka .OMNI) ELECTRONIC FILING FEE :. FUGITIVE APPREHENSIOI GENERAL REVENUE CRIM:- IND LEGAL SVCS SUPPORI JUVENILE CRIME & DELINQUENCY JUVENILE. CASEMANAGER FUND.-: JUSTICE COURT PERSONNEL TRAINING JUROR SERVICE FEE LOCAL ARREST FEES PARKS & WILDLIFE ARREST FEES -F STATE ARREST FEES.. SCHOOL CROSSINGICHILD SAFETY FEE SUBTITLE C STATE TRAFFIC FINES -EST 9.1.19 TABC.ARREST FEES TECHNOLOGY FUN[ TRAFFIC. LOCAL TRAFFIC FINE- . TIME CA•VMFNT- COLLECTION SERVI DEFENSIVE OF DRIVING STATE:CONSOUD, LOCAL CONSOLID4 .FILING FEE:: COPIES/C INDIGE JUDGEF ='.OUT-OF-C ELECTRON,( EXPUI EXPIF ..ABSTRACT, ALI .'LICENSE E PARKS:&'V 'OVERPAYMEI• 'OVERPAYMENT($:. PARKS & WILDLIFE WATEF MARINE SAFETY PAR TOTAL ACTW TYPE, TOTAL WARRANT FEES ENTER LOCAL WARRANT FEESI STATE WARRANT FEES_ IF TO OTHFRS:. - ouY w YIOe OD iv Gases :STITUTION FUND VERPAYMENTS ITY SERVICE FEE AMOUNT 0.00 REVISED.02A)Z2022 20.00 0.00 36.82 4,939.23 1,103.12 3.68 0.00 0.02 0.00 0.00 0.00 0.00 0.00 7.32 31.63 0.00 0.00 0.00 1.84 0.00 10.24 0.00 3.68 290.82 0.00 0.00 0.00 0.00 9.60 107.76 0.00 8.78 2,083.24 0.00 3.68 0.88 125.51 46.18 223.99' 1.75 270.46 406.05 89.10 1,842.66 0.00 0.00. 147.00 231.00 0.00 0.00 0.00 0.00 11.24 300.00 0.00 0.00 0.00 0.00 0.00 0.00 365.00 5,334.60 0.00 3,118.00 0.00 0.00 0.00 0.00 0.00 239.00 0.00 AMOUNT: 27OA6 241.45 RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWAR"O. REPORT $29.01 ", RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO REPORT 4MOUNT BAO PLEA&EINCLUC£ D.R. REQUESTING OIGRURSEMENi 6.60 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT -0.00PIE45E INCLUDE DR REQUESTING DISBURSEMENT 0.00: PIEASEINCLUDE ORREQUEG➢NGDI&BURSEMENT CASH BONDS O.00 PI SEINCLUOEDRREQUESTINODISBURSEMENTQFREQUIRED) TOTAL DUE TO OTHERS 0.00` TREASURERS RECEIPTS FOR MONTH AMOUNT- MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 6,203.15 CR 1000-001-44190 SHERIFF'S FEES 649.37 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 89.10 CHILD SAFETY 0.00 TRAFFIC 126.39 ADMINISTRATIVE FEES 1,894.48 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 2,109.97 CR 1000-001-44010 CONSTABLE FEES -SERVICE 300.00 CR 1000-001-44061 JP FILING FEES 0.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-00144322 TIME PAYMENT REIMBURSEMENT FEE 223.99 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 406.05 TOTAL FINES, ADMIN. FEES & DUE TO STATE $9,892.53 CR ?r670-001-44061 COURTHOUSE SECURITY FUND $388.85 CR 2720-001-44061 JUSTICE COURT SECURITY FUND $0.92 CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $318.86 CR 2699-001-44061 JUVENILE CASE MANAGER FUND $10.24 CR 2730-00144061 LOCAL TRUANCY PREVENTION & DIVERSION FUND $393.97 CR 2669-00144061 COUNTY JURY FUND $7.88 CR 2728-001-446M JUSTICE COURT SUPPORT FUND $175.00 I CR 2677-00144061 COUNTY DISPUTE RESOLUTION FUND $35.00 LR 2725-001-44061 LANGUAGE ACCESS FUND $21.00 STATE ARREST FEES DPS FEES 27.35 P&W FEES 1.92 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 29.27 CR 7070-999-20610 CCC-GENERAL FUND 3.68 CR 7070-999-20740 CCC-STATE 33.14 DR 7070-999-10010 36.82 CR 7072-999-20610 STATE CCC- GENERAL FUND 493.92 CR 7072-999-20740 STATE CCC- STATE 4,445.31 DR 7072-999-10010 4,939.23 CR 7860-999-20610 STF/SUBC-GENERAL FUND 0.44 CR 7660-999-20740 STF/SUBC-STATE 8.32 DR 7860-999-10010 8.76 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 83.33 CR 7860-999-20740 STF- EST 9/1/2019- STATE 1,999.91 DR 7860-999-10010 2,083.24 Page 1 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 COURT NAME: JUSTICE OF PEACE NO. 7 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 CR 7950-999-20610 TP-GENERAL FUND 23.09 CR 7950-999-20740 TP-STATE 23.09 DR 7950-999-10010 46.18 Page 2 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 COURT NAME: JUSTICE OF PEACE NO.1 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 0.18 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 1.66 DR 7865-999-10010 1.84 CR 7970-999-20610 TUFTA-GENERAL FUND 2.44 CR 7970-999-20740 TL/FTA-STATE 4.88 DR 7970-999-10010 7.32 CR 7505-999-20610 JPAY- GENERAL FUND 1.12 CR 7505-999-20740 JPAY-STATE 10.12 DR 7505-999-10010 11.24 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 0.37 CR 7857-999-20740 JURY REIMB: FUND- STATE 3.31 DR 7857-999-10010 3.68 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS: GEN FUND 0.00 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.02 DR 7856-999-10010 0.02 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 0.88 7998-999-20701 JUVENILE CASE MANAGER FUND 0.88 DR 7998-999-10010 1.75 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 147.00 147.00 TOTAL (Distrib Req to Oper Acco $18,560.60 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT; 0.00 OUT -OF -COUNTY SERVICE FI 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 2,650.30 WATER SAFETY FINES 203.15 TOTAL DUE TO OTHERS $2,853.45 TOTAL COLLECTED -ALL FUNDS $21,414.05 LESS: TOTAL TREASUER'S RECEIPTS $21,414.05 REVISED 02/02/2022 OVER/(SHORT) $0.00 Page 3 of 3 gtpTE otc T CALHOUN DISTRIBUTION f REQUEST i )COUNTY � ¢' \\arc 201 West Austin DR# 450 A 44599 PAYEE PAYOR Name: Calhoun County Opera Acct. Official: Hope Kurtz Address: Title: Justice of the Peace, Pct. 1 _. City: - State: Zip: Phone: ACCOUNT NUMBER. - DESCRIPTION. _...AMOUNT.. 7541-999-20759-999 JP1 Monthly Collections - Distribution $18,560.60 0 0 V# 967 TOTAL 18,560.60 Signa ure of Official Date 0 ENTER COURT NAME ` JUSTICEOFPEACENO.2 ENTER MONTH OF REPORT q(.upns� ENTER YEAR OF REPORT 7, CODE. AMOUNT: 'CASHSONDS 0.00- REVISED 02/02/2022 ADMINISTRATION FEE-ADMF 20.00 BREATH ALCOHOL TESTING :BAT 0.00 CONSOLIDATED COURT COSTS-CCC 410.34 STATE CONSOLIDATED COURT COST-2020 935.28 LOCAL CONSOLIDATED COURT COST- 2D20 205.10 COURTHOUSE SECURITY -CHS 41.03 CLIP 0.00' ' ' CIVIL JUSTICE DATA REPOSITORY FEE -CJDR 0.45 CORRECTIONAL MANAGEMENT INSTITUTE -.CMI 0.00 CR 0.00 CHILDSAFETY-CS 0.00 CHILD SEATBELT FEE CSBF 0.00 - CRIME :VICTIMS COMPENSATION -CVC ODD DPSC/FAILURE TO APPEAR -OMNI-DPSC 201.70 '. ADMINISTRATION FEE FTAFIP"(aka OMNO 2020 43.55 i ELECTRONIC FILING FEE -EEF 0.00 -: FUGITIVE APPREHENSION -"FA 0.00 ' GENERALREVENUE-GR 0.00 GRIM IND LEGAL SVCS SUPPORT --IDF 20.52 JUVENILE CRIME & DELINQUENCY -JCD 0.00 JUVENILECASE MANAGER FUND -JCMF 46.06- JUSTICE COURT PERSONNEL TRAINING -:JCPT ODD r JUROR SERVICE FEE -JSF 41.03 LOCAL ARREST FEES - LAF 102.20 LEMI 0.00 ' LEDA 0.00 LEOO 0.00 h OCL 0.00 :. PARKS & WILDLIFE ARREST FEES -PWAF 0.00 STATE ARREST FEES -SAF 5.10 SCHOOL CROSSING/CHILD.SAFETY FEE -SCF 0.00 .SUBTITLE C-SUBC 76.05 STATE TRAFFIC FINES -EST 9.1.19-::STF 469.42 TABC ARREST FEES -TAF 0.00 TECHNOLOGY FUND.- TF. 41.03 ..:TRAFFIC-. TFC 7.61 LOCAL TRAFFIC FINE-2020 28.94 I' TIME PAYMENT- TIME 81.87 TIME PAYMENT REIMBURSEMENT FEE-2020 137.33 TRUANCY PREVENTIONIDIVERSION FUND..: TPDF 13.76 LOCAL &.STATE WARRANT FEES -WRNT 928.40 '. COLLECTION SERVICE FEE-MVBA CSRV 1,782.14 DEFENSIVE DRIVING COURSE-DDC 0.00 DEFERRED FEE OFF 463.05 DRIVING EXAM FEE- PROV.DL 0.00 FILING FEE -FFEE 0.00 :. STATE CONSOLIDATED CIVIL FEE-: 2022 59.88 LOCAL CONSOLIDATED CIVIL FEE -2022 94.12' FILING FEE SMALL.CLAIMS -FFSC 0.00 JURY FEE -JF 0.00 < COPIESICERTIFED COPIES - CC 0.00 'INDIGENT FEE -:CIFF or INDF 0.00 'JUDGE PAY RAISE FEE -JPAY 61.55 SERVICE FEE SFEF 150.00 OUTOF-COUNTYSERVICE FEE 0.00 - - ELECTRONIC FILING .FEE EEF CV OAKI ' `.' EXPUNGEMENTFEE-EXPG 0.00 EXPIRED RENEWAL-EXPR ODD. - ABSTRACT OF JUDGEMENT -AOJ 0.00 - ALL WRITS WOP / WOE 0.00 CPS FTA FINE -DPSF 15.14 - LOCAL FINES -FINE 4,917.55 LICENSE & WEIGHT FEES '-LWF 0.00 PARKS & WILDLIFE FINES -PWF 0.00 SEATBELTAINRESTRAINED CHILD FINE. -:SEAT 0.00 .`. -JUDICIAL& COURT. PERSONNEL TRAINING-JCPT 0.00 OVERPAYMENT (OVER $10)'-OVER 0.00 " OVERPAYMENT($10 AND LESS) --OVER 0.00 '. RESTITUTION -REST 0.00 PARKS & WILDLIFE -WATER SAFETY FINES-WSFj 0.00 MARINE SAFETY PARKS & WILDLIFE -.M50 0.00 TOTAL ACTUAL MONEY RECEIVED $11,401.10- TYPE: AMOUNT TOTAL WARRANT FEES - - 928.40. C ENTER LOCAL. WARRANT FEES 750.00 RECORD ON TOTAL PAGE OF HILL COUNT" 80FTWAREMO. REPOIR . STATE WARRANT FEES $178.40' RECORDONTOTALPAGE OF HILL COUNTRY SOFTWARE MD REPORT. DUE TO OTHERS: AMOUNT DUE TO.CCISD-:50% of Fine on JV cases 0.00 PLFASEINCLUDE DR.REMESTINGDISBURSENOIT DUE TO DA RESTITUTION FUND :' .-___ .: 0.00 PiFasElxcwDE OR. REouesnrvc OlsauSeEuexr REFUND OF OVERPAYMENTS 0.00 PIEASEINCUNM DR.RECUE8TNGDISBIRffNENT OUT -OF -COUNTY SERVICE FEE , 0.00 PVMA INCLUDEDRMOUESTINGDISUNWEMENT- CASHBONDS 0.00 PLEASE INCLUDE OR NEDUEUINGUMINNSEMEM(IFNECUIRED) TOTAL DUE TO OTHERS $0.00 - - TREASURERS RECEIPTS.FOR MONTH AMOUNT CASH, CHECKS, M.O.a&CREDIT CARDS 1 $11401.10 lCalculato from ACTUAL TreasureYS Receipts TOTAL TRFak RFr FIPT3 SN AATAn MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 ACCOUNTNUMBER CR 1000-001-45011 CR 1000-001-44190 CR 1000-001-44361 CR 1000-001-44010 CR 1000-001-44061 CR 1000-001-44090 CR 1000-001-49110 CR 1000-001-44322 CR 1000-001-44145 CR 1000-999-20741 CR 1000-999-20744 CR 1000-999-20745 CR 1000-999-20746 CR 1000-999-20770 CR 2670-001-44061 CR 2720-00144061 CR 2719-001-44061 CR 2699-001-44061 CR 2730-00144061 CR 2669-001-44061 CR 2728-001-44061 CR 2677-001-44061 CR 2725-001-44061 _ CR 7020-999-20740 CR 7070-999-20610 CR 7070-999-20740 CR 7072-999-20610 CR 7072-999-20740 CR 7860-999-20610 CR 7860-999-20740 CR 7860-999-20610 CR 7860-999-20740 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 0 ADMINISTRATIVE FEES: DEFENSIVE DRIVING CHILD SAFETY TRAFFIC ADMINISTRATIVE FEES EXPUNGEMENTFEES MISCELLANEOUS STATE ARREST FEES DPS FEES P&W FEES TABC FEES DR 7072-999-10010 DR 7860-999-10010 DR 7860-999-10010 ACCOUNTNAME FINES SHERIFF'S FEES AMOUNT 4,932.69 999.00 0.00 0.00 36.55 526.60 0.00 0.00 TOTAL ADMINISTRATIVE FEES 563.15 CONSTABLE FEES -SERVICE 150.00 JP FILING FEES 0.00 COPIES / CERTIFIED COPIES 0.00 OVERPAYMENTS (LESS THAN $10) 0.00 TIME PAYMENT REIMBURSEMENT FEE 137.33 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 DUE TO STATE -DRIVING EXAM FEE 0.00 DUE TO STATE-SEATBELT FINES 0.00 DUE TO STATE -CHILD SEATBELT FEE 0.00 DUE TO STATE -OVERWEIGHT FINES 0.00 DUE TO JP COLLECTIONS ATTORNEY 1,782.14 TOTAL FINES, ADMIN. FEES & DUE TO STATE $8,564.31 COURTHOUSE SECURITY FUND JUSTICE COURT SECURITY FUND JUSTICE COURT TECHNOLOGY FUND JUVENILE CASE MANAGER FUND LOCAL TRUANCY PREVENTION & DIVERSION FUND COUNTYJURYFUND $102.56 $10.26 $99.63 $46.96 $73.25 JUSTICE COURT SUPPORT FUND $71.30 COUNTY DISPUTE RESOLUTION FUND $14.26 LANGUAGE ACCESS FUND $8.56 36.70 0.00 0.00 TOTAL STATE ARREST FEES 36.70 CCC-GENERAL FUND 41.03 CCC-STATE 369.31 410.34 STATE CCC- GENERAL FUND 93.53 STATE CCC- STATE 841.75 935.28 STF/SUBC-GENERAL FUND 3.80 STF/SUBC-STATE 72.25 76.05 STF- EST 9/1/2019- GENERAL FUND 18.78 STF- EST 9/1/2019- STATE 450.64 469.42 Page 1 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 0 CR 7950-999-20610 TP-GENERAL FUND 40.94 CR 7950-999-20740 TP-STATE 40.93 DR 7950-999-10010 81.87 Page 2 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/8/2022 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 0 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 2.05 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 18.47 DR 7865-999-10010 20.52 CR 7970-999-20610 TUFTA-GENERAL FUND 67.23 CR 7970-999-20740 TUFTA-STATE 134.47 DR 7970-999-10010 201.70 CR 7505-999-20610 JPAY-GENERAL FUND 6.16 CR 7505-999-20740 JPAY - STATE 55.39 DR 7505-999-10010 61.55 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 4.10 CR 7857-999-20740 JURY REIMB. FUND- STATE 36.93 DR 7857-999-10010 41.03 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS: GEN FUND 0.04 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.41 DR 7856-999-10010 0.45 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 6.88 7998-999-20701 JUVENILE CASE MANAGER FUND 6.88 DR 7998-999-10010 13.76 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 59.88 59.88 TOTAL (Distrib Req to OperAcct) $11,401.10 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT: 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 0.00 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $0.00 TOTAL COLLECTED -ALL FUNDS $11,401.10 LESS: TOTAL TREASUER'S RECEIPTS $11,401.10 REVISED 02/02/2022 OVER/(SHORT) $0.00 Page 3 of 3 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 44600 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Address: - Title: City: State: Zip: Phone: Hope Kurtz Justice of the Peace, Pct. 1 - ACCOUNT NUMBER- - - - DESCRIPTIONS - - AMOUNT - 7541-999-20759-999 JP1 Monthly Collections- Distribution $11,401.10 0 0 V# 967 f Signature of Official Date TOTAL 11,401.10 02-03-22;22:40 ;From:Calhoun County Pct. 5 To:13615534444 ;3619832461 # 1/ 7 ANp.1WWr,wRA" FAX COVER SHEET JUDGE NANCY POMYKAL P 0 BOX 454 PORT O' CONNOR, TX.77982 (361)983-2351 - TELEPHONE (361)983-2461 - FAX COUNTY OF CALHOUN JUSTICE COURT PCT. 5 DATE: FEBRUARY 3 2022 PAGES:-8 Including this cover TO: JUDGE RICHARD MEYER & COUNTY COMMISSIONERS ATT: MaeBelle FAX NUMBER(S) 361-663-4444 SUBJECT: JANUARY 2022 � MONEY DISTRIBUTION REPORT NOTE: MaeBelle I am faxing the above report for JANUARY 2022 Please give me a call If you have any questions Thank you, A1#0 2 y Doomped THE CONTENTS OF THIS FAX MESSAGE ARE INTENDED SOLELY FOR THE ADDRESSEE(S) named in this message. This communication is intended to be and to remain confidential and may be subject to applicable attofney/Client and/br work product privileges. If you are not the intended recipient of this message, or if this message has been addressed to you in error, please immediately alert the sender by fax and then destroy this message and its attachments. Do not deliver, distribute or copy this message and/or any attachments and if you are not the intended recipient, do not disclose the contents or take any action in reliance upon the information contained in this communication or any attachments. 02-03-22;22;40 ;From;Calhoun County Pot, 5 To:13615534444 ;3619632461 # 2/ 7 Money Diotsibeti0A Reper6 CALHOUN COONTI PCT 5 SANGMY 2022 REPORT Receipt Cause/Defendant COdes%Ameeats Total 377527 2022-DIOO 01-05-2022 CCC 92.00 LAP 5.00 LCCC 14.00 FINE 239.00 320.00 HOWARD, DAVID COURTNEY 377529 2021-0375 01-10-2022 CCC 62.00 LAP 5.00 LCCC 14.00 LTFC 3.00 STPI 50.00 144.00 JOHNSON, COLTON SRYAN DDC 10.00 377531 2021-0390 01-10-2022 CCC 62.00 LAP 5.00 LCCC 14.00 FINE 126.00 LTFC 3.00 260.00 WALKER, DOUGLAS ALBERT JR STF1 30.00 Cash 377533 2021-D354-PED 01-1D-2022 WPFF 5.00 wear 350.00 FEDERAL NATIONAL MORTAGE ASSOC. Company Check 31753S 2022-0104 01.12-2022 CCC 62.00 LAP 5.00 LCCC 14.00 FINE 99.00 140.00 WALDEN, DARRELL GENE 377537 2021-0320 01-17-2022 PWAF 0.89- LAP 0.99 PWF 45.00 45.00 JANOTA, DANIEL EDWARD II 377539 202;-0300 01-17-2022 War 50.00 50.00 JANOTA, DANIEL EDWARD II MCCORDA'SEAN'', DAVID :: > y It i :.� : io a v d 377541 2021-0352 01-17-2022 CCC 62.00 SAF 5.00 LCCC 14.00 FINE 59.00 140.00 DZIUZYNSKI, SARAH INDEPENDENCE 377543 2021.0316 01-18-2022 CSRV 05.00 65.00 DELGADO CANPOS, JORGE DANIEL Page 1 02-03-22;22:40 ;From:Calhoun County Pct. 5 To:13615534444 ;3619832461 # 3/ 7 Money Distribution Report CALHOUN COUNTY PCT S JANUARY 2022 REPORT Type Code Description Covert Retained Dioburoed Money-Tetale The following totals represent - Cash and Checks Collected COST CCC CONSOLIDATED COURT COSTS 3 18.60 167.40 186.00 COST CCC CONSOLIDATED COURT COSTS 1 4.00 36.00 40.00 COST CHS COURTHOUSE SECURITY 1 3.00 0.00 3.00 COST IDF INDIGENT DEFENSE FUND 1 0.20 1.00 2.00 COST JCSF JUSTICE COURT SECURITY FUND 1 I.OD 0.00 1.OD COST JPAY JUDGE PAY RAISE PEE 1 O.GD 5.40 6.00 COST JSF JUROR SERVICE FUND 1 0.40 3.60 4.00 COST LAP SHERIFF'S FEE 3 15.00 0.00 15.00 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.1. 3 42.00 0.00 42.00 COST OMNC DES OMNI FEE - COUNTY 1 4.00 0.00 4.00 COST OMND UPS OMNI FEE UPS 1 0.00 20.00 20.00 COST OMNO DPS OMNI FEE - OMNIBASE 1 0.00 6.00 6.00 COST OMNR OMNI REIMBURSEMENT FEE (EFP. 1.1.20) 0 0.00 0.00 0.00 COST PWAF TEXAS PARES & WILDLIFE 1 4.00 1.00 5.00 COST SAP UPS 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 1 4.00 0.00 4.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 0.00 2.00 2.00 COST WRNT WARRANT FEE 1 50.00 0.00 50.00 PEES CSRV COLLECTION SERVICES FEE 1 75.00 0.00 75.00 FEES DOC DRIVER SAFETY COURSE - 2020 0 0.00 0.00 0.00 FEES OCMF JUVENILE CASE MANAGER FEE 1 5.00 0.00 5.00 PEES WPFF Writ of Possession Filing Fee 1 5.00 0.00 5.00 FEES WPSF Writ of Possession Service Fee 1 150.00 0.00 150.00 FINE CPL➢ COMPLIANCE DISMISSAL FINE 1 10.00 0.00 10.OD FINE _ PINE FINE 3 424.00 0100 d24.00 PINE LTPC LOCAL TRAFFIC FINE (EFF. 9.1.1g1 1 3.00 0.00 3.00 FINE PWF PARRS & WILDLIFE FINE 1 14.70 83.30 93.00 FINE STP1 STATE TRAFFIC FINE (EFF. 9.1,19) 1 2.00 48.00 5D.DO FINE WSF WATER SAFETY FINE 0 0.00 0.00 0.00 Money Totala 6 835.50 374.50 1,210.00 The following totals represent • Transfers Collected COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CCC CONSOLIDATED COURT COSTS 0 D.00 0.90 0.00 COST CHS COURTHOUSE SECURITY 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0.00 COST JCSP JUSTICE COURT SECURITY FUND 0 0.00 6.00 0.00 COST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 COST JSF JUROR SERVICE FUND 0 0.00 D.00 0.00 COST LAP SHERIFF'S FEE 0 0.00 0.00 0.00 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF, 1.1. 0 0.00 0.00 0.00 COST OMNC UPS OMNI FEE - COUNTY 0 0.00 0.00 O.DO COST OMND DPS OMNI FEE - UPS 0 0.00 0.00 0.00 COST OMNO UPS OMNI FEE - OMNIBASE 0 0.00 0.00 O.DO COST OMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 0 0.00 0.00 0.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAF UPS 0 0.00 0.00 0.00 COST IF TECHNOLOGY FUND 0 0.00 0.00 0.00 COST TPDF TRUANCY PREVENTYON & DYYERSYON FUND 0 0.00 0.00 0.00 COST WRNT WARRANT FEE 0 0.00 6.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00 FEES DOC DRIVER SAFETY COURSE - 2020 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 FEES WPFF Writ of Possession Filing Fee 0 C.00 0.00 0.00 PERS WPSF Writ of Possession Service Fee 0 0.00 0.00 0.00 FINE CPLD COMPLIANDE OttkeShL FYNE 0 0.00 0.00 0.00 FINE FINE FINE 0 0.00 0.00 0.00 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.1.29) 0 0.00 0.00 0.00 FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00 FX142 STF1 STATE TRAFFIC FINE (EFF. 9.1,29) 0 0.00 0.00 0.00 FINE WSF WATER SAFETY FINE 0 0.00 0.00 0.00 Transfer Totals 0 0.00 0.00 0.00 The following tetalo represent - Jail Credit and Community Service 02-01-2022 Page 02-03-22;22:40 ;From:Calhoun County Pct. 5 To:13615534444 ;3619832461 # 4/ 7 Money bistrdbutiea Report CALHOUN COMITY PCT 5 JANUARY 2022 REPORT Type Code Description Count Retained Disbursed Money -Total* COST CCC CONSOLIDATED COURT COSTS 3 18.90 167.40 186.00 COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CHS COURTHOUSE SECORITY 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND a O.OD 0.00 0.00 COST JCSF JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00 COST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 COST JSF JUROR SERVICE FUND 0 0.00 0.00 0.00 COST LAP SHERIFF'S FEE 1 5.00 0.00 5.D0 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.1. 3 42.00 0.00 42.00 COST OMNC CPS OMNI FEE - COUNTY 0 0.00 0.00 0.00 COST OMND CPS OMNI FEE - CPS 0 0.00 0.00 0.00 COST OMNO UPS OMNI FEE - OMNIBASE 0 0.00 0.00 0.00 COST DMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 0 0.00 0.00 0.00 COST PWAF TEXAS PARRS A WILDLIFE 0 O.DO 0.90 0.00 COST SAP UPS 2 8.00 2.00 1D.00 COST IF TECHNOLOGY FUND 0 0.00 0.00 D.00 COST TPDF TRUANCY PREVENTION A DIVERSION FUND 0 0.00 0.00 D.00 COST WRNT WARRANT FEE 0 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00 FEES DOC DRIVER SAFETY COURSE - 2020 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 PEES WPPP Writ of Pegge9gien Filing Fee 0 0.00 O.OD D.00 FEES WPSF Writ Of Possession Service Fea 0 0.00 0.00 0.00 FINE CPLO COMPLIANCE DISMISSAL FINE 0 0.00 0.00 0.00 FINE FINE FINE 3 357.00 0.00 357.00 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.1.19) 0 0.00 0.00 0.00 FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00 FINE STFI STATE TRAFFIC FINE (EFF. 9.1.19) 0 0.00 0.00 0.00 FINE WSF WATER SAFETY FINE 0 O.OD 0.00 0.00 Credit Totals 3 430.00 10.40 600.00 The 9921OWdag totals represent - Credit Card Payments COST CCC CONSOLIDATED COURT COSTS 4 22.60 203.40 226.00 COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CHS COURTHOUSE SECURITY I 3.0D 0.00 2.00 COST IDF INDIGENT DEFENSE FUND 1 0.20 1.80 2.00 COST JCSF JUSTICE COURT SECURITY FOND 1 1.00 O.OD 1.00 COST JPAY JUDGE PAY RAISE FEE 1 0.60 9.40 6.00 COST JSP JUROR SERVICE FUND 1 0.40 3.60 4.90 COST LAP SHERIFF'S FEE 5 20.89 0.00 20.89 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.1. 3 42.09 0.00 42.00 COST OMNC CPS OMNI FEE - COUNTY 0 0.00 0.00 0.00 COST OMNO DP$ OMNI FEE - DPS 0 0.00 0.00 0.00 COST OMND CPS OMNI PEE - OMNIBASE 0 0.00 0.00 0.90 COST OMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 2 20.00 0.00 20.00 COST PWAF TEXAS PARKS & WILDLIFE 1 0.71- D.18- 0.89- COST SAP CPS 0 O.CO 0.00 0.00 COST TF TECHNOLOGY FUND 1 4.00 0.00 4.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 0.00 2.00 2.00 COST WANT WARRANT FEE 2 100.0D 0.00 100.00 FEES CSRV COLLECTION SERVICES FEE 3 91.00 0.00 91.00 FEES DDC DRIVER SAFETY COURSE - 2020 2 20.0D 0.00 20.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 FEES WPFF Writ of Possession Filing Fee 0 0.00 0.00 0.00 FEES WPSF Writ of Possession Service Fee 0 0.00 0.00 0.00 FINE CPLD COMPLIANCE DISMISSAL FINE 0 0.00 0.00 0.00 FIND• FINE FINE 2 218.07 0.00 218.07 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.1.19) 4 11.71 0.00 11.71 FINE PWP PARES S WILDLIFE PINE 3 25.95 147.05 173.00 FINE STFS STATE TRAFFIC FINE (EFF. 9.1.19) 4 7.81 187.41 195.22 FINE WSF WATER SAFETY FINE 1 7.5D 42.50 50.00 Credit Card Totals 9 596.02 592.98 21189.00 The Eollowdag tousle represent - Combined Haney COST CCC CONSOLIDATED COURT COSTS 7 41.20 370.90 412.00 COST CCC CONSOLIDATED COURT COSTS 1 4.00 36.00 40.00 COST CHS COURTHOUSE SECURITY 2 6.00 0.00 6.00 02-01.2022 Page 3 02-03-22;22:40 ;From:Calhoun County Pot. 5 To:13615534444 ;3619832461 # 5/ 7 Money Distribution Report CALHOUN COUNTY PCT S JANUARY 2022 REPORT Type Code Deeeri0tion Cause Retained Disbureed Honey-Tetels COST Ybf TNDTO&NT DEFENSE FUND 2 0.40 3.60 4.00 COST OCSF JUSTICE COURT SECURITY FUND 2 2.00 0.00 2.00 COST JPAY JUDGE PAY RAISE FEE 2 1.20 10.80 12.00 COST OF JUROR SERVICE FUND 2 Oleo 7.20 8.00 COST LAP SHERIFF'S FEE 8 35.09 0.00 35.89 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.2, 6 84.00 0.00 84.00 COST OMNC DPS OMNI FEE - COUNTY I 4.00 0.00 4.DO COST WHO DPS OMNI PEE - DPS 1 O.OD 2D.00 20.00 COST OMNO DPS DMNI Fee - OMNIBASE 1 0.00 6.00 6.DO COST CMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 2 20.00 0.00 20.00 COST PWAF TEXAS PARKS & WILDLIFE 2 3.29 0.82 4.11 COST SAP DPS D 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 2 8.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 2 0.00 4,00 4.00 COST WR14T WARRANT FEE 3 150.00 0.00 150.00 FEES CSRV COLLECTION SERVICES FEE 4 196.00 0.00 16G.00 FEES DOC DRIVER SAFETY COURSE - 2020 2 20.00 0.00 2D.00 FEES 3CMF JUVENILE CASE MANAGER FEE 1 5.00 0.00 5.00 FEES WPFF Writ Of POB9ee9iOn Filing Fao 1 5.00 0.00 5.00 Fees WPSP Writ of Possession Service Fee 1 150.00 0.00 150.00 FINE CPLD COMPLIANCE DISMISSAL FINE 1 10.00 0.00 10.90 FINE FINE FINE 5 642.D7 0.00 642,07 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.I.I9) 5 14.71 0.00 14.71 FINE PWF PARKS & WILDLIFE FINE 4 40.65 230.35 271.00 FINE STF1 STATE TRAFFIC PINE (EFF. 9.1.19) 5 9.82 235.41 245.22 FIND• WSF WATER SAFETY FINE 1 7.50 42.50 SD.00 Money Totals 15 1,43I.S2 967.48 2,399.00 The following totals represent - Combined Money and Credits COST CCC CONSOLIDATED COURT COSTS 30 59.00 538.20 598.00 COST CCC CONSOLIDATED COURT COSTS 1 4.00 39.00 40.00 COST CHS COURTROUSE SECURITY 2 6.00 0.00 6.00 COST TOP INDIGENT DEFENSE FUND 2 0.40 3.60 4.00 COST JCSF JUSTICE COURT SECURITY FUND 2 2.00 Oleo 2.99 COST JPAY JUDGE PAY RAISE FEE 2 1.20 10.00 12.00 COST JSF JUROR SERVICE FUND 2 0.80 7.20 8.00 COST LAP SHERIFF'S FEE 9 40.89 0.00 40.89 COST LCCC LOCAL CONSOLIDATED COURT COST (EFF. 1.1. 9 126.00 0.00 126.00 COST OMNC CPS OMN1 PRE - COUNTY 1 4100 0.00 4.00 COST OMND DPS OMNI FEE - DPS 1 O.DD 20.00 20.00 COST OMNO DPS OMNI FEE - OMNIBASE 1 9.90 6.99 6.00 COST OMNR CMNI REIMBURSEMENT PEE (EFF, 1.1.20) 2 20.00 0.00 20.00 COST PWAP TEXAS PARKS & WILDLIFE 2 3.29 0.02 4.11 COST SAP UPS 2 8.00 2.00 10.00 COST Tr• TECHNOLOGY FUND 2 8.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 2 0.00 4.00 4.00 COST WRNT WARRANT FEE 3 150.00 0.00 150.00 FEES CSRV COLLECTION SERVICES Mr 4 199.00 0.00 166.00 FEES DOC DRIVER SAFETY COURSE - 2020 2 20.00 0.00 20.00 FEES JCMF JUVENILE CASE MANAGER FEE 1 5.00 0.00 5.00 FEES WPFF Writ of Possession Filing Fee 1 5.00 0,00 5.00 FEES WISP Writ of Possession Service Fee 1 ISO M 0.00 150.00 FINE CPLD COMPLIANCE DISMISSAL FINE 1 10.00 0.00 10.00 FINE FINE PINE 0 999.07 0.00 999.07 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.1.19) 5 14.11 0.00 14,71 FINE PWF PARKS & WILDLIFE FINE 4 40.65 230.35 271.00 FINE STFS STATE TRAFFIC FINE (EFF, P.I.1P) 5 9.81 235.41 245.22 FINE WSF WATER SAFETY FINE 1 7.50 42.50 50.00 Report Totals 18 2,862.22 1,136.08 2,999.00 02-01.2022 Page 7 02-03-22;22:40 ;From:Calhoun County Pct. 5 To:13615534444 ;3819832461 # 6/ 7 Money Aietrihution Report CALROOM COMITY PCT 5 JARMARY 2022 REPORT Date Payment Type Pines Court Costs Peea Bends Restitution Other Total 06-66.0606 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 O.DO 0.00 Credit Cards & Transfers 0.00 0.00 D.00 0.00 0.00 0.00 O.DO Total 00 all COSSOot}Rns 0.00 0.00 0.00 O.DO 0.00 O.DO 0.00 09-01-1991 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 O.DO 0.00 Jail Credits & Comm service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 0.00 D,00 0.00 0.00 0.00 0.00 CI-01.2004 Cash & Checks Collected 90.00 147.OD 80.00 0.00 0.00 0.00 325.00 Jail Credits & Comm Service 0.00 0,00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total 08 all Collections 98.00 147.00 90.00 0.00 0.00 0.00 325.00 01-01-2020 Cash & Checks Collected 407.00 243.00 155.00 0.00 0.00 0.00 885.00 Jail Credits & Comm Service 357.00 243.00 0100 0.00 0.00 0.00 600.00 Credit Cards & Transfers 648.00 430.00 111.00 0.00 0.00 0.90 1,189.00 Total of all Collections 1,492.00 916.00 266.00 0.00 0.00 0.00 2,474.00 TOTALS Cash & Checks Collected 585.OD 390.00 235.00 0.00 0.00 0.00 1,210.00 Jail Credits & Comm Service 357.00 243.00 0.00 0.00 0.00 0.00 600.00 Credit Cards & Transfers 648.00 430.00 111,00 0.00 0.00 0.00 11189.00 Total of all Collections 11590.00 1,063.00 349.00 0.00 0.00 0.00 2,999.00 02-01-2022 Page 5 02-03-22;22:40 ;From:Calhoun County Pct, 5 To:13615534444 ;3619832461 # 7/ 7 Money Diatribution Report CALHOUN CO(1 E PCT 5 JANUARY 2022 REPORT Description Count Collected Retained Dieburaea State of Texas Quarterly Reporting Tota1B State Comptroller Cost and Foes Report Section I; Report for Offenses Committed 01-01-20 Forward 7 412.00 41.2D 370,00 01.01-04 - U-31-19 1 40.00 4,0D 36.00 09-01-92 -12-31-03 0 0.00 0.00 D.00 Hail Bond No 0 0.00 0.00 0.00 DNA Testing Fee - Juvenile 0 0.00 0.00 O.DO EMS Trauma Fund (EMS) 0 0.00 0.00 0.00 Juvenile probation Diversion Feem 0 0.00 0.00 0.00 State Traffic Fine (eff. 09.01.19) 5 245.22 9.81 219.41 State Traffic Fine (prior 09-01-19) 0 0.00 0.00 D.00 Intoxicated Driver Fine 0 0.00 0.00 O.DO Prior Mandatory Costs (,7RF,IDF,JS) 6 24.00 2.40 21.60 Moving violation Fees 0 0.00 0.00 O.OD DNA Testing Fee - Convictions 0 0.00 0.00 0.00 DNA Testing Fee - Comm Supvn 0 0.00 D.DD 0.00 Truancy Prevention and Diversion Fund 0 0.00 0.00 0.00 Failure t0 Appear/Pay Fees 1 20.00 0.00 2D.00 Time Payment Fees 0 0.00 9.00 0.00 Judicial Fund - Coust County Court 0 0.00 0.00 0.00 Judicial Fund - statutory County Court 0 0.00 0.00 0.00 Section II: As Applicable Peace Orricer Fees 2 4.11 3.29 0.82 Motor Carrier Weight Violation3 0 0.00 0.00 0.00 Driving Record Fee 0 0.00 0.00 0.00 Report Sub Total 22 745.33 60.70 684.63 State Comptroller Civil Fees Report CF: Birth Certificate Fees 0 0.00 0.00 0.00 CF: Marriage License Fees 0 0.00 0.00 0.00 CF: Declaration of Informal Marriage 0 0.00 0.00 0.00 CF! Nondisclosure Fees 0 0.90 0100 0.00 CF: Juror Donations 0 0.00 0.00 D.00 CF: Justice Court Indig Filing Fees 0 0.00 0.00 0.00 Cr: Stat Prob Court Indig Filing Fees 0 0.00 0.00 0.00 CF: St4t Prob Court Judic Piling Fees 0 0.00 0.00 0.00 CF: Stat Cnty Court Indig Filing Fees 0 D.00 0.00 0.00 CF: StOt Cnty Court JUdiC Filing Fees 0 0.00 0100 0100 CF. Cost Cnty Court Indig Filing Fees 0 0.00 0.00 0.00 CF: Coat Cnty Court Judic Filing Fees 0 0.00 0.00 0.00 CF: Diet Court Divorce a Family Law 0 0.00 0.00 0.0D CF: Dist Court Other Divorce/Family Lam 0 0.00 0.00 D.OD CF; Diet Court Indig Legal Services 0 0.00 0.00 0.00 Cr, Judicial Support Fee 0 0.00 O,OD D.00 CFf Judioial a Court FdrD, Training Fee 0 0.00 0.00 0.00 Report Sub Total 0 0.90 0.00 0.00 Total Duo For This Period 22 745.33 GO.70 GOd.03 ^HE STATE OF TEXAS Before me, the undersigned authority, this day COUnty OE CalhOun COunty pCr94nA11y eppegred Nancy Pomykal, Justice of the who being duly 0sworn, deposes and Baystthatethel above ��`"�000C`E`C,,,����� a foregoing report is true and correct. ©G f/ -S�)J' Witness my hand this ez ay of 9 //`L//1_r,, : A ,�. ? •�.� J its eace, Preci Itt No 5 C r •• A elho n ounty, Texas ;'fr 4;C #17 NOTICE OF MEETING — 2/16/2022 17. Consider and take necessary action on any necessary budget adjustments. (RHM) 2022: 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 z 0 0 m D 1 m m z 1 0 a r M O co so so <o z z z z 0000 0 0 0 0 zzzz z z z z -4-4�-41 3 a 0 c z w z 0 0 z ID Z 0 n m m m r, C 0 NOTICE OF MEETING — 2/16/2022 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 Indigent Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens 2021 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens 2022 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Adjourned 10:35 a.m. Page 15 of 15 February 16, 2022 2022 APPROVAL LIST - 2021 BUDGET COMMISSIONERS COURT MEETING OF 02/16/22 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 7 $184,349.40 TOTAL VENDOR DISBURSEMENTS: $ 184,349.40 PAYROLLFOR SUPPLEMENTAL PAYROLL TOTAL PAYROLL AMOUNT: CALHOUN COUNTY INDIGENT HEALTH CARE P/R P/R TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: S TOTAL AMOUNT FOR APPROVAL: $ 184,349.40 February 16, 2022 2022 APPROVAL LIST - 2022 BUDGET COMMISSIONERS COURT MEETING OF 02/16/22 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 35 $2,128,365.68 AFLAC FEBRUARY 2022 PREMIUMS P/R $ 2,604.08 PRINCIPAL FINANCIAL GROUP FEBRUARY 2022 PREMIUMS P/R $ 1,531.28 CITIBANK DEPT CREDIT CARD CHARGES A/P $ 22,828.61 TOTAL VENDOR DISBURSEMENTS: $ 2,155,329.65 PAYROLL FOR FEBRUARY 18, 2022 TOTAL PAYROLL AMOUNT: CALHOUN COUNTY INDIGENT HEALTH CARE TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: P/R $ $ 331,669.34 / 331,669.34 ✓ 10,074.35 $ 10,074.35 ✓ I TOTAL AMOUNT FOR APPROVAL: $ 2,497,073.34 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---= February 16.2022 INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES HEB Pharmacy (Medimpact) Pharmacy Reimbursement MMCenter (in -patient $0/ Out -patient $3,292,701 ER $1,771.94) Memorial Medical Clinic Port Lavaca Clinic Associates Singleton Associates, PA Victoria Anesthesiology Assoc SUBTOTAL Memorial Medical Center (indigent Healthcare Payroll and Expenses) Co -pays adjustments for January 2022 Reimbursement from Medicaid by:DC 90.98 5,064.64 515.27 109.33 61.75 155.71 6,997.68 4,166.67 Subtotal 10,164.35 (90A0) 0.00 COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES QUANTITY 9 UNIT PRICE TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $10,074.35 approved by Commissioners Court'oni02/16/2022 1000-001-46010 Janµary 31, 2022 Interest ($0.66) $10,073.69 COUNTY AUDITOR h APPROVAL ONLY d THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD CO IT ON AND REQUEST THE COUNTY TREASURER TO PAY THE ABO I�GA.JT�InON. ` BY: 2/9/2022 ! 2r: .� CV t9b O Ga W wo DEPARTMENT HEAD DATE ©IHs Source Totals Report Issued 02/01/22 Calhoun Indigent Health Care Batch Dates 01/31/2022through 02/01/2022 For Source Group Indigent Health Care For Vendor. All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 986.00 61.75 01-2 Physician Services- Anesthesia 624.00 155.71 02 Prescription Drugs 90.98 90.98 08 Rural Health Clinics 1,082.00 624.60 14 Mmc - Hospital Outpatient 8,665.00 3,292.70 15 Mmc - Er Bills 4,663.00 1,771.94 Expenditures 16,195.42 6, 082.1 fi Reimb/Adjustments -84.44 -84.44 Grand Total 16,110.98 5,997.68 EXPENSES 4,166.67 10,164.35 COPAYS <90.00> 10,074.35 411&0� APPROVED ON FEB 0 9 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS 50240.000 01/21/22 614056 10.00 10.00 00/00/00 CAS 2 50240.000 01/18/22 614539 10.00 10.00 00/00/00 Geis 2 50240.000 01/05/22 613618 20.00 20.00 00/00/00 RAN 2 50240.000 01/05/22 613275 10.00 10.00 00/00/00 PLB 2 50240.000 01/07/22 613707 10.00 10.00 00/00/00 PLB 2 50240.000 01/07/22 613726 10.00 10.00 00/00/00 PLB 2 50240.000 01/20/22 614970 10.00 10.00 00/00/00 PLB 2 50240.000 01/26/22 615399 10.00 10.00 00100/00 PLB 2 **TOTAL** 50240.000 COMM INDIGENT COPAYS 90.00 r 1 r - Bill To: Calhoun County 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Date: 2/4/2022 Invoice # 366 For: Jan-22 DESCRIPTION IAMOUNT Funds to cover Indigent program operating expenses. $ 4,166.67 Any Richardson Interim CFO Total $ 4,166.67 APPROVED ON FEB 0 9 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS January February March April May June July August September October November December Mi6, Calhoun County Indigent Care Patient Caseload 2022 Approved Denied Removed Active Pending 1 0 0 7 5 Monthly Avg 1 December 2020 Active 6 Number of Charity patients Number of Charity patients below 50%,FPL 7 207 82 Calhoun County Pharmacy Assistance Patient Caseload 2022 January February March April May June July August September October November December 5 Approved Refills Removed Active Value 2 6 0 28 $16,676.00 YTD PATIENT SAVINGS $16,676.00 Monthly Avg 2 6 December 2021 Active 26 28 $16,676.00 0 PROSPERITY BANK 41,6 410 Statement Date Account No THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13203 1/31/2022 *`4551 Page 1 of 2 01/01/2022 Beginning Balance $5,421.53 3 Deposits/Other Credits + $5,522.04 4 Checks/Other Debits - $5,522.19 01/31/2022 Ending Balance 31 Days in Statement Period $5,421.38 Total Enclosures 6 �DEPOSITS/OTHER CREDITS Date Description Amount 01/07/202.2 Deposit $5,471.38�wIL�e mad 01/19/2022 Deposit $ l�HS 01 /31 /2022 Accr Earning Pymt Added to Account $0$.00 0.66 Check Number Date Amount Check Number Date Amount 12507 01-05 $353.78 12509 01-10 $921.08 12508 01-05 $80.66 12510 01.05 $4,166.67 D. Date Balance 01-01 $5,421.53 01-05 $820.42 Date Balance 01-07 $6,291.80 01-10 $5,370.72 r7FARNINGS SUMMARY '• Below is an itemization of the Earnings paid this period. Interest Paid This Period Interest Paid YTD $0.66 Annual Percentage Yield Earned $0.66 Days in Earnings Period Earnings Balance Date Balance 01.19 $5,420.72 01-31 $5,421.38 0.15 % 31 $5,193.81 MEMBER FDIC LEN 6R NYSE Symbol "PB" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---February 16, 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES,, PAYROLL AND ELECTRONIC;BANK PAYMENTS TOTAL TRANSFERS BETWEEN FUNDS TOTAL NURSING HOME UPL EXPENSES' $ 7618,801.1:4 $ 38,552.39'11-1� $ 912,627.97 v TOTAL INTER -GOVERNMENT TRANSFERS $ 74,244.00 GRAND TOTAL.DISBURSEMEN7S.APPROVEp Februo . 16, 2022 $ 1,705,225.60 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---February 16, 2022 PAYABLES AND PAYROLL 211012022 Weekly Payables 347,315,18 2114/2022 Citibank Credit Card -see attached 863.08 2/1412022 McKesson-3408 Prescription Expense 8,053.76 2/14/2022 Amedsource Bergen-340B Prescription Expense 917.09 2/14/2022 Payroll Liabilities -Payroll Taxes 95,295.68 2/1412022 Payroll 298,435.38 2/14/2022 Payroll Liabilities for supplemental payroll -Payroll Taxes 140.99 2/1412022 Supplemental Payroll 671.97 Prosperity Electronic Bank Payments 217-2/10122 Credit Card 8 Lease Fees 5,829.74 V2012022 Sales Tax for January 2022 1,052.20 2/10/2022 Cleargage-Patient Financing Service 111.32 2/7-2111/22 Pay Plus -Patient Claims Processing Fee 214,75 TOTAL PAYAEILES,iPAYRQLL AMMELECTRONICsBANK PAYMENTS $ 758,501.14 TRANSFER OF FUNDS BETWEEN NURSING HOMES 2/14/2022 Gulf Pointe Plaza -PP -correction of Ashford Insurance payment deposited into 17,813.07 Gulf Pointe Plaza -PP in error 2/14/2022 Golden Creek -correction of Solera insurance payment deposited into Golden 15,990.00 Creek in error 2/14/2022 Golden Creek -correction of Gulf Pointe insurance payment deposited into 5,749,32 Golden Creek in error TOTALTRANSFBRS BETWON FUNDS, $ 39 562:39;. NURSING HOME UPL EXPENSES 2/14/2022 Nursing Home UPL-Cantex Transfer 371,642.82 2/14/2022 Nursing Home UPL-Nexion Transfer 28,101.47 2/14/2022 Nursing Home UPL-HMG Transfer 66,717.28 2/14/2022 Nursing Home UPL-Tuscany Transfer 129,080.08 2/14/2022 Nursing Home UPL-HSL Transfer 237,015.05 OIPP CHECKS TO MMC 2/14/2022 Ashford 9,106.26 2/1412022 Broadmcor 3,802.31 2/14/2022 Crescent. 2,737.33 2/1412022 Fort Bend 3,852.69 2I140022 Solera 3.558.46 211412022 Golden Creek 36,273.20 2/1412022 Gulf Pointe 16,014.48 2114/2022 Tuscany 4,525.94 TO.TALNUR$1001HOMIsUPLENPENSES+ $ 912,677,.O77 INTER•GOVERNMENTTRANSFERS 2/1412022 IGT 2022 DSH Advance 3 Payment to be paid March 812022 74,244.00 TOTAL INTER, PCI , , T TRANSFERS $ 74,244i06,; CaRAND TOTAL.1)ISBURSEMPNTS,APPROVED Fehrua . 1,6-20221 $ 1,78M,226.6011 ; EIVED BY THE MEMORIAL MEDICAL CENTER 02/1 ON 0 14:54 AP Open Involce List fAUDITOR Due Dates Through: 09/02/2022 FEDn 10 2022 ap_openinvoice.tempiate Vendor# Vendor Name Class Pay Code 1 /N COUNTY TFYn� ACUTE CARE INC ✓ Involce# C4rr�ment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net INV555 r,! 01/31/2022 01/20/202P 02/28/2022 1,400.00 0.00 0.00 1,400.00 r>' RFID FEE - Vendor Totals: Number Name Gross Discount No -Pay Net 10950 ACUTE CARE INC 1,400.00 0.00 0.00 1.400.00 Vendor# Vendor Name Class Pay Code 10730 AMERICAN COLLEGE OF RADIOL(✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gress Discount No -Pay Net 200689202lv62/09/2022 01/05/2022 02/05/2022 500.00 0.00 0.00 500.00✓ DATA REGISTRY LOW DOES LUNC Vendor Totals: Number Name Gross Discount No -Pay Net 10730 AMERICAN COLLEC 500.00 0:00 0.00 500.00 Vendor# Vendor Name Class Pay Code 11632 AMERICAN CONSTRUCTION „/- Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1682. t/'� 02/10/2022 02/01/2022 02/02/2022 6,855.00 0100 0.00 6,856.00 REPLACE CEILING TILES Vendor Totals: Number Name Gross Discount No -Pay Net 11632 AMERICAN CONSTI 6,855.00 0.00 0.00 6,855.00 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC N' Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2461808 6/ 02/09/2022 01/31/2022 03/02/2022 2,726.50 0.00 0.00 2,725.50 ✓ LAB STAFFING t r lift . 1 1'/A 1 i i) S i minl A 24616671/ 02/09/2022 01/31/2022 03/02/2022 536.00 0.00 0.00 535.00 STAFFING 6") Itq 2461877%,/ 02/09/2022 01/31/2022 OW02/2D22 2.378.50 0.00 0.00 2,378.50 4/' LAB STAFFING (,1Vitt Vendor Totals: Number Name Gross Discount No -Pay Not A0400 AUREUS RADIOLO( 5,640.00 0.00 0.00 5,640.00 Vendor# Vendor Name Class Pay Code 12800 AUTHORITYRX ,i Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Grass Discount No -Pay Net 1303 yf 02/10/2022 02/02/2022 02/03/2022 1,000.00 0.00 0.00 1,000.00 ,. 3400 SVCS VendorTotals: Number Name Gross Discount No -Pay Net 12800 AUTHORITYRX 1,000.00 0.00 0.00 11000.00 Vendor# Vendor Name Class Pay Code A2600 AUTO PARTS & MACHINE CO. W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt. Pay Gross Discount No -Pay Net 977476 4% 02/09/2022 02104/2022 02/19/2022 49.12 0.00 0.00 49.12 ti WIPER BLADE Vendor Totals: Number Name Gross Discount No -Pay Net A2600 AUTO PARTS & MA, 49.12 0.00 0.00 49A2 Vendor# Vendor Name Class Pay Cade B1220 BECKMAN COULTER INC ✓ M Invoice# Cc ment Tran. Dt Inv Dt Duo Dt Check Dt Pay Gross Discount No -Pay Net 109658876 722/09/2022 01/31/2022 02/25/2022 3,874.83 0.00 0.00 3,874.83 rr LAB SVCS 7310935 02(09/2022 02/02(2022 OZ/27/2022 6,659.59 0.00 0.00 6,659.59 y // METER BILLING 109668194 002/09/2022 OPJ04/2022 03/01/2022 756.88 0.00 0.00 756.88 ✓ SUPPLIES / 5453163 y/ OPJ09/2022 02/05/2022 03/02/2022 6.249.42 0.00 0.00 6,249.42 SERVICE AND MAINT LAB Vendor Totals: Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTE 17,540.72 0.00 0.00 17,540.72 Vendor# Vendor Name Class Pay Cade 12740 BUILDING KID STEPS ,/ Invoice# Comment Tran Dt Inv Ot Due Dt Check Ot Pay Gross Discount No -Pay Not JAN2022A 02/10/2022 01/31/2022 02/15/2022 1,039.00 0.00 0.00 1,039.00 ✓ SPEECH THER JAN2022C 02/10/2022 01/31/2022 02/15/2022 1,039.00 0.00 0.00 1,039.00 ✓ SPEECH THER JAN2022B 02/10/2022 01/31/2022 02/15/2022 1,091.00 0.00 0.00 1,091.00✓ SPEECH THER JAN20220 02/10/2022 01/31/2022 02/15/2022 150.00 0.00 0.00 150.o0 ✓ SPEECH THER Vendor Totals: Number Name Gross Discount No -Pay Net 12740 BUILDING KID STEF 3,319.00 0= 0.00 31319.00 Vendor# Vendor Name Class Pay Code 14120 CALHOUN COUNTY EMS y / Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 22010001 V�2/10/2022 02/01/2022 02/28/2022 5,280.00 0.00 0.00 5,280.00 to" "VA -IU%frr Iflw,- IlAz- Vendor Totals: Number Name Gross Discount No -Pay Net 14120 CALHOUN COUNTY 5,280.00 0.00 0.00 5,280.00 Vendor# Vendor Name Cla/$s Pay Code 11295 CALHOUN COUNTY INDIGENT AC( n Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 020422 02/10/2022 02/04/2022 02/05/2022 90.00 0.00 0.00 90.00 INDIGENT CO PAYS Vendor Totals: Number Name Gross Discount No -Pay Net 11295 CALHOUN COUNTY 00.00 0.00 0.00 90.00 Vendor# Vendor Name / Class Pay Code 14064 CAPITAL ONE ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 122221 02/10/2022 12IM2021 02/13/2022 3.88 0.00 0.00 / 3.88 ✓ SUPPLIES 122921E 02/10/2022 12/29/2021 02/13/2022 11.88 0.00 0.00 11,88 ✓ SUPPLIES 122921A 02/10/2022 12/29/2021 02/13/2022 -29.16 0.00 0.00 -29.16 ✓ CREDIT PT 122921 02/10/2022 12/29/2021 02A 312022 59.84 0.00 0.00 / 59.84 rf SUPPLIES 011122A 02/10/2022 01/11/2022 02/13/2022 11.88 0.00 0.00 11.68� SUPPLIES 0111220 02/10/2022 01/11/2022 02/13/2022 49A2 0.00 0.00 49.12 1/ SUPPLIES 011122B 02/10/2022 01/11/2022 02/13/2022 53.04 0.00 0.00 53.04 ,/ SUPPLIES 011122E 02/10/2022 01/1112022 02/13/2022 49.12 0.00 0,00 49.12 SUPPLIES 011322 02/10/2022 01/11/2022 02/13/2022 -1.30 0.00 0.00 -1.30 ✓ CREDIT 011122C 02/10/2022 01/11/2022 02/13/2022 52.98 0.00 0.00 52.98 ,.� SUPPLIES 011122 02/10/2022 01/11/2022 02/13/2022 12.94 0.00 0.00 12.94 SUPPLIES 011322B 02/102022 01/13/2022 02/13/2022 63.58 0.00 0.00 53.58 ✓ SUPPLIES 011322F 02/102022 01/13/2022 02/13/2022 139.84 0.00 0.00 / 139.84 J SUPPLIES 011322G 02110/2022 01/13/2022 02/13/2022 1.30 0.00 0.00 1.30 v� SUPPLIES 011322A 02/10/2022 01/13/2022 02/13/2022 -31.62 0.00 0.00 -31.62 r,,' CREDIT FOR BROKEN SUPP 011722 02t10/2022 01/17/2022 02/13/2022 - 66.84 0.00 0.00 66.84 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 14064 CAPITAL ONE 504.16 0.00 0.00 604.16 Vendor# Vendor Name Class Pay Code 13992 CARIANT HEALTH PARTNERS ✓/ Invoice# Comment Tran Dt Inv Or Due Dt Check Dt Pay Gross Discount No -Pay Net 131923 01/31/2022 01/26/2022 02/26/2022 857.50 0.00 0.00 857.50 Vim. TRAVEL NURSE STAFFINGU IIS'Z'1) ?'tl/ W S Vendor Totals: Number Name Gross Discount No -Pay Net 13992 CARIANT HEALTH F 857.50 0.00 0.00 857.50 Vendor# Vendor Name Class Pay Code 14236 CARRIER CORPORATION r' Invoice# Comment Tran Dt Inv Dt Due rot Check Dt Pay Gross Discount No -Pay Net 90175058 ✓61/31/2022 01/24/2022 02/25/2022 12,830.00 0.00 0.00 12,830.00 LEASE U.Aku, 144tkt Vendor Totals: Number Name Gross Discount No -Pay Net 14236 CARRIER CORPOR. 12.830.00 0.00 0.00 12,830.00 Vendor# Vendor Name Class Pay Code 13028 CAVALLO ENERGY TEXAS LLC r/f Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 012122 01/31/2022 01/31/2022 02/25/2022 10.17 0.00 0.00 10.17✓ ELECTRICITY Vendor Totals: Number Name Gross Discount No -Pay Net 13028 CAVALLO ENERGY 10.17 0.00 0.00 10.17 Vendor# Vendor Name Class Pay Code C1600 CITIZENS MEDICAL CENTER ,j W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 012022 02/09/2022 01/20/2022 02/20/2022 30.00 0.00 0.00 30,00 BLS CARDS v' 012421 02/09/2022 01/24/2022 02124/2022 40.00 0.00 0.00 40.00 tr CPR CARDS Vendor Totals: Number Name Gross Discount No -Pay Net C1600 CITIZENS MEDICAL 70,00 0.00 0.00 70.00 Vendor# Vendor Name Class Pay Code 10786 CLINICAL PATHOLOGY Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1765620220'02/09/2022 01/31/2022 OV25/2022 9.671,37 0.00 0.00 0,671,37 tAS SERVICES Vendor Totals: Number Name Gross Discount No -Pay Net 10786 CLINICAL PATHOLC 9,671.37 0.00 0.00 9.671.37 Vendor* Vendor Name Class, Pay Code 13572 COMMUNITY INFUSION SOLUTION / Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net IC20220218 W!0/2022 02/03/2022 02/1312022 10,414.90 0.00 0.00 10,414.90 INFUSION SERVICES Vendor Totals: Number Name Gross Discount No -Pay Net 13572 COMMUNITY INFUS 10,414.90 0.00 0.00 10.414.90 Vendor# Vendor Name Class Pay Code 10368 DEWITr POTH & SON Invoice# Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net /Comment 6709330 r/ 02/09/2022 02/02/2022 02/27/9022 68.69 0.00 0.00 68.6&. ' SUPPLIES 6712560 ✓ 02/09/2022 02/03/2022 02/28/2022 136.73 0,00 0.00 136.73 ✓ SUPPLIES 6695842 ./ 02/09/2022 02/03/2022 02/28/2022 5.68 0.00 0.00 5.68 . ' SUPPLIES 02l09/2022 6712990✓ 02/04/2022 03/01/2022 90.14 0.00 0.00 90.14 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 10368 DEWITT POTH 8: SC 301.24 0.00 0.00 301.24 Vendor# Vendor Name Class Pay Code 12484 EL CAMPO REFRIGERATION Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 81857 V,' 01/31/2022 01/24/2022 OPJ24/2022 483.75 0.00 0.00 483.75 REPAIRS t` Vendor Totals: Number Name Gross Discount No -Pay Net 12484 ELCAMPO REFRIG 483.75 0.00 0.00. 483.75 Vendor# Vendor Name Class Pay Code 13240 ELSEVIER INC. �i Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net JAN22-23 02/10/2022 02/10/2022 02/10/2022 2,691.00 0.00 0.00 2,691.00 PHARM SUBS 1/i Vendor Totals: Number Name Gross Discount No -Pay Net 13240 ELSEVIER INC. 2,691.00 0.00 0.00 2,691.00 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIO ✓ Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 40934 �'�02109/2022 01/31/2021 02/10/2021 5,640.00 0.00 0.00 5,640.00 ER PHYSICIANS ✓- Vendor Totals: Number Name Gross Discount No -Pay Net 11284 EMERGENCY STAF 5,640.00 0.00 0,00 5,640.00 Vendor# Vendor Name Class Pay Code 14156 FUJI FILM Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net PJIN018585f 0)121/2022 01/15/2022 02/25/2022 7,908.33 0.00 0= 7,908.33 t/ SMA FEE uZ, Vendor Totals: Number Name Gross Discount No -Pay Net 14156 FUJI.FILM 7,908.33 0.00 0.00 7,908.33 Vendor# Vendor Name Class Pay Code 12404 GE PRECISION HEALTHCARE, LLC L, Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 6002041414 V1i31/2022 01/26/2022 02/26/2022 541.60 0.00 0.00 541.60 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 12404 GE PRECISION HE{ 541.60 0.00 0.00 541.60 Vendor# Vendor Name class Pay Code G1210 GULF COAST PAPER COMPANY Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2175561 01/31/2022 01/25/2022 02/24/2022 677.61 0.00 0.00 677.61 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPE 677.61 0.00 0.00 677.61 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICI r' Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 100570948 ✓01/31/2022 01/25/2022 03/01/2022 4,610.52 0.00 0.00 4,610.52 G EMISTERI LIZER/PHONE Vendor Totals: Number Name Gross Discount No -Pay Net 11552 HEALTHCAREFINA 4,610.52 0.00 0.00 4,610.52 Vendor# Vendor Name Class Pay Code H0031 HEB CREDIT RECEIVABLES DEPT: Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Not 219894 01/30/2022 01/23/2022 02/25/2022 9.75 0.00 0.00 i 9.75 ✓ SUPPLIES 570780 01/30/2022 01/24/2022 02/25/2022 46.13 0.00 0.00 46.13t�- SUPPLIES 252237 01/31/2022 01/01/2022 02/25/2022 15.66 0.00 0.00 15.66 SUPPLIES 112524 01/31/2022 01/01/2022 02/25/2022 109.34 0.00 0.00 109.34 ✓ - SUPPLIES 402610 01/31MOP2 01/03/2022 02/25/2022 18A1 0.00 0-00 18.41 v SUPPLIES 272508 01/31/2022 Ot/04/2022 02/25/2022 31.28 0.00 0.00 31.28 SUPPLIES 874633 01/31/2022 01/09/2022 02/25/2022 91.62 0.00 0.00 91.62 L' SUPPLIES 764307 01/31/2022 01/10/2022 02/25/2022 37.98 0.00 0.00 37.981' SUPPLIES 102260 01/31/2022 01/11/2022 02/25/2022 42.64 0.00 0.00 42.64 SUPPLIES 452494 01/31/2022 01/11/2022 02/25/2022 29.07 0.00 0.00 29W ✓` SUPPLIES 7.68 01/31/2022 01/13/2022 02/25/2022 7.68 0.00 0.00 7.68 // SUPPLIES 910658 01/31/2022 01/13/2022 02/2512022 9.68 0.00 0.00 9.68 rf SUPPLIES 707364 01/31/2022 01/16/2022 02/25/2022 137.57 0.00 0.00 137.57 ✓ SUPPLIES 807761 01/31/2022 01/16/2022 02/25/2022 19.80 0.00 0.00 18.aq/ SUPPLIES 495226 01/31/2022 01/17/2022 0?J25/2022 38.97 0.00 0.00 38.97,,% SUPPLIES 379672 01/31/2022 01/18/2022 02/25/2022 74.03 0.00 0.00 74.03 ✓' SUPPLIES 906454 01/31/2022 Ol/20/2022 02/25/2022 63.84 0.00 0.00 63.84 SUPPLIES 662645 01/31/2022 01/20/2022 02/25/2022 108.05 0.00 0.00 108.05 y! SUPPLIES 793291 01/31/2022 01/2W2022 02/25/2022 63.38 0.00 0.00 63.38 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net H0031 HEB CREDIT RECEI 954.88 0.00 0.00 954.88 Vendor# Vendor Name Class Pay Code H0416 HOLOGIC INC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net i0000912 ✓'01/31/2022 01/21/2022 02/25/2022 236.25 0.00 0.00 236.25 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 236.25 0.00 0.00 236.25 Vendor# Vendor Name class Class Pay Code 12868 HOLT CAT ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount - No -Pay Net _ WIEZ00316702110/2022 01/27/2022 02/11/2022 559.50 0.00 0.00 559.50✓ GEN MAINT WIEZ00316702110/2022 01/27/2022 02/11/2022 559.50 0.00 0.00 559.50 ✓' GEN MAINT Vendor Totals: Number Name Gross Discount No -Pay Net 12868 HOLT CAT 1,119.00 0.00 0.00 1,119.00 Vendor# Vendor Name Class Pay Code 10922 HUNTER PHARMACY SERVICES V' Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 4768 ,! 02/o9/2022 01/31/2022 02/20/2022 14,890.40 0.00 0.00 14,890.40y:" PHARM SRVS-ADOLPH Vendor Totals: Number Name Gross Discount No -Pay Net 10922 HUNTER PHARMAC 14,890.40 0,00 0.00 14,690.40 Vendor# Vendor Name Class Pay Code 14256 INFICARE HEALTH, INC. / Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net MMC0113 ✓ 10/2022 01/13/2022 01/28/2022 2,216.60 0.00 0.00 2,216.50 NURSE STAFFING Lt 1-1- 1143 i 2bf ✓i' Vendor Totals: Number Name Gross Discount No -Pay Net 14266 INFICARE HEALTH, 2,216.50 0.00 0.00 2,216.50 Vendor# Vendor Name Class Pay Code 11260 INTOXIMETERS INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 698776 ✓� 01/31/2022 01/26/2022 02/25/2022 480.00 0.00 0.00 480.00 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 11260 INTOXIMETERS INC 480.00 0.00 0.00 480.00 Vendor# Vendor Name Class Pay Code 11200 IRON MOUNTAIN rs' Invoice# Comment Tran Ot Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net GHMV565 /01/31/20PP 01/31/2022 03/02/2022 596.82 0.00 0= 596.82 SERVICES Vendor Totals: Number Name Gross Discount No -Pay Net 11200 IRON MOUNTAIN 596.82 0.00 0.00 596.82 Vendor# Vendor Name Class Pay Code 11264 ITA RESOURCES, INC `/' W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net MMCO220229210912022 02/07/2022 02/07/2022 27,689.46 0.00 0.00 27,689.46 RESPIRATORY SVCS Vendor Totals: Number Name Gross Discount No -Pay Net 11264 ITA RESOURCES, Ir 27,689.46 0.00 0.00 27,689.46 Vendor# Vendor Name Class Pay Code 14316 JUNXIONMED STAFFING Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net MEM0101220A0/2022 01/31/2022 02/15/2022 6,258.13 0.00 0.00 6258.13 NURSE STAFFING ICU ( 10-10-1 - 1loll J-i) MEM01082202/10/2022 01/31/2022 02/15/2022( I1-}._IItl1lj p &VA-t 3,952.50 0.00 0.00 3,952,50 ICU STAFFING Vendor Totals: Number Name Gross Discount No -Pay Net 14316 JUNXION MED STAI 10,210.63 0.00 0.00 10,210.63 Vendor# Vendor Name Class Pay Code 1_0100 LAW PUBLICATIONS �/� W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 283419 �&09/2022 01/04/2022 01/04/2022 649.00 0.00 0.00 649.00 AD ON DRUG. FREE BOOKS Vendor Totals: Number Name Gross Discount No -Pay Net L0100 LAW PUBLICATION: 649.00 0.00 0.00 649.00 Vendor# Vendor Name Class Pay Code 11600 LEGAL SHIELD / Invoice# Comment Tran Ot Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net 011522 01/31/2022 01/31/2022 02/25/2022 429.70 0,00 0.00 429.70�,-' PAYROLL DEDUCT Vendor Totals: Number Name Gross Discount No -Pay Net 11600 LEGAL SHIELD 429.70 0.00 0.00 429.70 Vendor# Vendor Name Class Pay Code M2181 MATTHEW BENDER & CO.JNC. v,W Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 013122 02/10/2022 01/31/2022 03/02/2022 75.08 0.00 0.00 75.08" CONT ED PHARM Vendor Totals: Number Name Gross Discount No -Pay Net M2181 MATTHEW SENDEF 75.08 0.00 0.00 75.08 Vendor# Vendor Name Class Pay Code 11141 MEDICAL DATA SYSTEMS, INC. i/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 167302 1% 01/31/2022 01/31/2022 02/25/2022 32.85 0.00 0.00 32.85 COLLECTION FEES 167300 01/31/2022 01/31/2022 02/25/2022 1,695.71 0.00 0.00 1,695.71 COLLECTION FEES 167301 /01/31/2022 01131/2022 02/25/2022 5,324.76 0.00 0.00 5.324.76 COLLECTIONS Vendor Totals: Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SW 7,053.32 0.00 0.00 7,053.32 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC L/ M Invoice# Comment Tran Dt Inv Or Due Dt Check Dt Pay Gross Discount No -Pay Net 1984612024,¢2109/2022 01/26/2022 02/20/2022 55.38 0.00 0.00 55.38 SUPPLIES 1984612019,02/09/2022 01/26/2022 02/20/2022 18,736.53 0.00 0.00 18,736.53 SUPPLIES 1984612020,WO9/2022 01/26/2022 02/20/2022 14.989.23 0.00 0.00 14,989.23 SUPPLIES 1984824018,*09/2022 01/27/2022 02/21/2022 479.40 0.00 0.00 479.40 SUPPLIES v- 1985789492 P12(09/2022 02/02/2022 02/27/2029 60.28 0.00 0.00 60.28 a! SUPPLIES 1985789497,02709/2022 02/02/2022 02/27/2022 23,431.21 0.00 0.00 23,431.21 Ll ' SUPPLIES 1985789495 02/09/2022 02/02/2022 02/27/2022 11,246.98 0.00 0.00 11,246.98 SUPPLIES 1985789494 W0912022 02/02/2022 02/27/2022 232.00 0.00 0.00 232.00 SUPPLIES Vander Totals: Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTR 69,231.01 0.00 0.00 69,231.01 Vendor# Vendor Name Class Pay Code 13492 MEDVANTAGE ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 40033 02/09/2022 01/04/2022 02/04/2022 1,072.49 0.00 0.00 1,072.49 ✓✓ ADHESIVE LABELS -DIETARY Vendor Totals: Number Name Gross Discount No -Pay Net 13492 MEDVANTAGE 1,072.49 0.00 0.00 1.072.49 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No�Pay Net 7829520 4/02/10/2022 02/02/2022 02/12J2022 355.60 0.00 0.00 355.60 ..'` INVENTORY PHARM 7829518 \, 02/10/2022 02/02/2022 02/12/2022 609.91 0.00 0.00 609.91 INVENTORY PHARM ✓ 7833179 v'�0211012022 02/02t2022 02/12/2022 69.80 0.00 0.00 69.80 INVENTORY PHARM 7831176 ,' 02/10/2022 02/02/2022 02/12/2022 283.96 0.00 0.00 283.96 ./ INVENTORY PHARM 7829517 v' 02/10/2022 02/02/2022 02/12/2022 46.32 0.00 0.00 46.32 INVENTORY PHARM 7829519 /021101PO22 02/02/2022 02/1212022 7.91 0.00 0.00 7.91 INVENTORY PHARM 7829522 "'02(10/2022 02/02/2022 0211212022. 376.00 0.00 0.00 376.00 INVENTORY PHARM 7829523 ' /021101202.2 02/02/2022 02/12/2022 13.85 0100 0.00 13.85 V INVENTORY PHARM Vendor Totals: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSOI 1,763.35 0.00 0.00 1,763.35 Vendor# Vendor Name class Pay Code 14124 MSH HEALTH SERVICES LLC y' Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net MMC0013 0&09/2022 10/11/2021 10/26/2021 2,340.50 0.00 0.00 2.340,50 NURSE STAFFING (w 11- du�� ,.\ �,t4.rr•. MMC0015 6/09/P022 10/11/2021 11/11/2021 2,340.50 0.00 0.00 2.340.50 NURSE STAFFING( to It- to 1-3ht� MMC0017 V609/2022 10/26/2021 11/10/2021 1 \ 4,531.25 0.00 0.00 4,531.25 , U NURSE STAFFING t `o Itg-- 10 MMC0016 A0 09/2022 10/26/2021 11/10/2021 2,325.00 0.00 0.00 2,325.00, - NURSE STAFFING (1012t-101701I)I MMC0018 02/09/2022 ii/01/2021 11/i6/2021 2,356.00 0.00 0.00 2,356.00 NURSE STAFFING (111.1 - 1113) 11, f?xkwAd-L°`-'- MMC0043 02/10/2022 01/31/2022 OPJ16/2022 4,375.00 0.00 0.00 4,375.00 ICU STAFFING ( 111,, 1 -II L4l 7 i_lgt,{�1� MMC0044 02/10/2022 01/31/2022 02m5/2022 3,852.00 0.00 0.00 3,852A0 V" NURS STAFFING Vendor Totals: Number Name Gross Discount No -Pay Net 14124 MSH HEALTH SERv 22,120.25 0.00 0.00 22,120.25 Vendor# Vendor Name Class Pay Code 14252 OLOOP TECHNOLOGY SOLUTION: V.' Invoice# Comment Tran Ot Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net INVAJONES:01/31/2022 01/26/2022 02/25/202.2 5,720.00 0.00 0.00 6,720.00 -' TRAVEL NURSE STAFFING 01 -21 - I I L� } n� IV" INVAJONESi01/31/2022 01/26/2022 02/25/2022 q 6,011,20 0,00 0.00 6,01 L20 TRAVEL NURSE STAFFING Vendor Totals: Number Name Gross Discount No -Pay Net 14252 OLOOP TECHNOLC 11,731.20 0.00 0.00 11,731.20 Vendor# Vendor Name Class Pay Code 12544 PATRICK OCHOA 1� Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 0201223 02/10/2022 02/01/2022 OPJ02/2022 200.00 0.00 0.00 200.00 LAWN SVC 020122 02/10/2022 02/01/2022 02/02/2022 380.00 0.00 0.00 380.00 v LAWN SERVICE 020122A 02/10/9022 02/01/2022 02/02/2022 520.00 0.00 0.00 520.00 LAWN SVC Vendor Totals: Number Name Gross Discount No -Pay Net 12544 PATRICK OCHOA 1.100.00 0100 0.00 11100.00 Vendor# Vendor Name Class Pay Code 12708 POO ELECTRIC, LLC t Invoice# Comment Tran Dt Inv Dt Due DI Check Ot Pay Gross Discount No -Pay Net 3474 02/09/2022 02/03/2022 02/08/2022 7,500.00 0.00 0.00 7,500.00 112 LABOR CHARGE Vim- Vendor Totals: Number Name Gross Discount No -Pay Net 12708 POO ELECTRIC, LLt 7,500.00 0.00 0.00 7,500.00 Vendor# Vendor Name Class Pay Code 11932 PRESS GANEY ASSOCIATES, INC. ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net IN0005157090031/2022 01/31/2022 03/02/2022 2,523.79 0.00 0.00 2.523.79 CONTRACT FEES Vendor Totals: Number Name Gross Discount No -Pay Net 11932 PRESS GANEY ASS 2.523.79 0A0 0.00 2,523.79 Vendor# Vendor Name Class Pay Code 13460 RELIANT, DEPT 0954 V Invoice# Comment Tran Dt Inv Ot Due Ot Check Dt Pay Gross Discount No -Pay Net 3040011844:01/31/2022 01/31/2022 02/25/2022 25,200.00 0.00 0.00 25,200.W V/ ELECTRICITY Vendor Totals: Number Name Gross Discount No -Pay Net 13460 RELIANT, DEPT 09E 25,200.00 0.00 0.00 25,200.00 Vendor# Vendor Name Class Pay Code 11252 FIX WASTE SYSTEMS LLC ✓' Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 3548 �� 0 J02/2022 OPJ01/2022 02/26/2022 60.00 0.00 0.00 60A0 _. PHARMACEUTICAL WASTE Vendor Totals: Number Name Gross Discount No -Pay Net 11252 RX WASTE SYSTEM 60.00 0.00 0.00 60.00 Vendor# Vendor Name Class Pay Cade S1405 SERVICE SUPPLY OF VICTORIA IN W ,i` Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 701124829,/01/31/2022 01/26/2022 OPJ2412022 224.10 0.00 0.00 224.10 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net $Y4b5 SERVICE SUPPLY ( 224.10 0.00 0.00 224.10 Ventlor# Vendor Name Classy Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE C ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net CM6241 \,d2/09/2022 01/31/2022 02/25/2022 -3,318.00 0.00 0.00 -3,318.00 BLOOD CREDIT 107020238 02(09/2022 01/31/2022 02/25/2022 7,541.00 0.00 0.00 7,541.00 ✓/ BLOOD Vendor Totals: Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLO 4,223.00 0.00 0.00 4.223.00 Vendor# Vendor Name Class Pay Code 14224 THE TACT CORPORATION OF NYC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 9266702317 PY31/2021 12/31/2021 03/01/2022 5,760.00 0.00 0.00 5,760.00 v' TRAVEL NURSE STAFFING Vendor Totals: Number Name Gross Discount No -Pay Net 14224 THE TACT CORPOF 5,760.00 0.00 0.00 5,760.00 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC .� Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 8400387037 a)'/31/2022 01/31/2022 02/25/2022 40.10 0.00 0.00 40.10 LAUNDRY 8400,987036 Vj31/2022 01/31/2022 02/25/2022 46.15 0.00 0.00 45.15 LAUNDRY 8400387062 q(/31/2022 01/31/2022 02/25/2022 2,200.71 0.00 0.00 2,200.71 V1. LAUNDRY Vendor Totals: Number Name Gross Discount No -Pay Net U1004 UNIFIRSTHOLDINC 2,285.96 0.00 0.00 2,285.96 Vendor# Vendor Name Class Pay Code 14312 US STARS ,/ Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 11733 V/ 02/09/2022 01/19/2022 02/18/2022 27,033.00 0.00 0.00 27,033.00 INSTALL PLANS, CALC, DRAWING: Vendor Totals: Number Name Gross Discount No -Pay Net 14312 US STARS 27,033.00 0.00 0.00 27,033.00 Grand Totals: Gross Discount No -Pay Net 347,315.18 0.00 0,00 347,315.18 ,APPROVER any FEB 10 2022 BY COUNTY AUDITOR CALHOUN COUNI'i, TEXAS Account Statement Canmedcal Card Account JASON W ANGLIN Account inquiries: Toll Free: 1.(600)•248.4553 International: •1-(904)-954-7314 Account Number: XXXX-XXXX-XXXX• ; TDDlTTY: 1-(877)-505.7276 Send Notice of Billing Errors and Customer Service Inquiries to: CITIBANK, N.A., PO BOX 6125, SIOUX FALLS SD 57117-6125 Transactions Not an invoice. For your records only. Credit Limit CLOSED Cash Advance Limit 0 Statement Closing Date 02/03/2022 Days in Billing Period 31 Post Tmns Oute Dale MCC Reference Number Description/Location Amount ""--"'""""""' NOTICE MEMO ITEM(S) LISTED BELOW -"-'"'""^'^•••' / 01/06 01/05 6968 55432862005200071724542 1 Amazon Prime Amm.com/billWA 08109 USA 19.04 CR D01-8543653.09570 yt��li "" ""^'-" TOTAL AMOUNT OF MEMO ITEM(S): S19.04 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION CITIBANK N.A. P0 Box S OUXX FALLS $D 57117-6125 JASON W ANGLIN CALHOUN COUNTY STE A 202 S ANN ST PORT LAVACA TX 77979-4204 Page 1 of 2 , Hov 1) FE„ I J M) Account Number XXXX-XXXX-XXXX Statement Closing Date February 03, 2022 Not an invoice. For your records only. 00006934502 }nfiv nl': r,(Lr ual hrJf v•ay ..rd. qr,,:.,, _<_ a. • Rupert a r.,•t or Sfolon Card Immediately our telephone humare open awry way, . Payments You may make a payment to yourinflWAINyblledeafw account Wine 24 hwuma day. C3110saOtstomer Service telephone nermterf,mciflad on the frontal trsMgCNfavfoger. Please note Imusomevitanfzahana do lmthanalhe NNISmger Ole statement to report a lost or malen ON Corporate Card, online payment feature enabled for atdholders. If paying by mail, plane shnyr 9u1(1dv'nt malting lllnC. Please write four account number on The lrontaf the leak. For 1 Caallybged alostal please be sureM Mena an company Meek MIS Slam . Cich y Cttuse Lfor: Each ASKOnc r), has an is themlCradS L(ne(aptNonel farall CI9finsar bby6rQO. lla. acter y IM0, it dl me tatted as for@Stour wardh may Ee used a Casa Advances a oAtIf is the magmer amount that the iS YMIMIS taalils by lMa p.m. Eegem Tune, it sfe he -Mae mu d r, al thatday. Cardholder it Charge de a rmny grad. The size of each and a ps Credit Lime toed Payments can also tea made by flaall the ord transfer. wfre t of MIS ACN I ant Mr Cash ny C it it Lin is determined W the Company ant is a portion of me total gmpl aebh, and ghat meWads. Call the numher on IF.a front of the statement (or Company Creak Line, d¢lags. • Company RlbdCabda: By US poymenlof any amounts cinrgod to the Acoaunl the • TO lnercasc ar @eagoeete a Company or Camlhelder Credit Line: The Company, Company: (i) ntiffhe the original Application lit the Amount arm fire aWhOPoy 11 all may request changes to credit lines by comachng Cal Cougnle Card Customer persons at the time of their simmisuch Appikallon, and! (if) rutUmbas daconlhoed Services, Our telephone lines are open say day, 24 hours a day at the telephone use of the Amount antler the tonns of The CalpomM Cmtl Agreement by all number speehMd an the front of meatalementi i onflottlers la Whom Chose are ryVnd, a Additional COMMOSd¢B: Tine Company may requnn applkadons for additional Cardtloltlere by molesting Chi Corporate CaM Sen,ke. Our lelSphone Roes are men every day, 24 hours a day at the telephone number speswad on Me front of the statement Limit one Of Caro lme Card per, CarUhgEer. • CNl421,39e01) Onlfne Taal: You can easily manage your Chl Corporate Card online using the Ctllldarmom online toot. Ohniaosgim enables you M manage business expenses Tram onywhem around the globe from your compute(of Mobae daWca, you Can New statements online as All as Star. amount balances. To regaur for Clflmarager. Please lag on to — riftmanxnermmnoa and click an Me 'Soft leglsuagon for CardholdeM link. From there, follow the prompts to establish your account in Case or Errors or Questions About )bur lull: You are responsible for Inhaling Me dispute msolupon process d your Ateoulit Statement lilts charges Mat you belle. are magmaalred, Incorrect (ar merchandise that has nor been momhoid, or for loomed merchandise, You should also Mighm tithe process 4 YourAAeodnl Statement Ineonedly time a cledd as a charge or lie credit. forwhkh you ham been issued a credal slip, M hot shown. To begin the dispute rasalwon process, WS1 chimanaanr.mmnoain IfIr to help If we are Yau will the rasp BanY. finds you w ing to till. You may wile to us an a an the front of this StSdMM lit as soon as far the error. It more intormason Me . Spetml mrorrnabon an Cash AdAaaeea: Cardhmdars may get a Cash Adwnte at o.r e60,C)0 maedons wmQdwke. • The CAMMIdeys Cash Advance Limit is a pan of Me Oulduldets Total Cradh Lino. It is not an additional line of credit, • For Cash Adwncm tram AThds, a Memento personal IdenBaEon Humber(PIN) to required for security purposes. • 0.hnquency Fee MY A Ottrt aWll be delinquent untaes the Sank eaeebes the amount shown on the billmg statement os Me balance dua, lees any deputed chalgea, by Ole payment due date. The Bank will Shaer any unpaid portion el the bean doses a past due balance an subsequentbllhrgehR neums, If any poaa of Me Pomona Munm appears on live cenaacubm bgMg sMOmenW (apploWmetely 5 days after the bll'Ilfg cycle date), t agree to pay A delinquency fee Scantly based an a percentage of the entire pa ndue, balance AM! MY paYmentts receked by the Bank, A late fee may also be imposed monthly unha payment for the pall due balance IS fecal by the Bank Page 2 of 2 In the letter to us, please easlaln in detali the delpula aal the resullsd the Memplio leSSNe it'Mthe marchanLThNahefmuMtmcludethe Snort inwwed, and Of be signed by the Indleldual Cardhorder. Wewlll notify you of the results at our efforts. If you relumed memharAhe and fecemed a credit slip Ankh has lid yet bean pasted, please ARM, a0 days tram life date ftwas issued. 111 nos not been Rasped 10 the Amount by Man, toward a copy m the credit septa us at the bII1gW dumule address sPecread on the front of the atokmenL Along Yh 0. copy of Me ardtlft gip please induda a teller (signed If Me fodwtdual Cadholder) stating Mat credit was not Imeired. If a creak Slip was not losuetl, please request one from the merchant If the merchant refuses, pease wrhe to us and ekplalo the detgis. On Mon-0kputed matters at any matter shown by the Bank not m to in error, the Bank may Charge Me Company, or COMhoider (he (as speoirwd in the Oupom(o COME Agreement for each ropy of any dcWmem the Company It Cardholder requests, such as duplicate pedadG sot minls, Imna3ction Slips, and the like, Please saw your chefgeraceipts. F w cIatI Account Statement Commerical Card Account ROSHANOASTHOMAS Account Inquiries: Toll Free: 1-(800)-246-4553 International: 1-(904}954.7314 Account Number: XXXX-XXXX-XXXX-9457 TDOIIYY: 1-(877)-505.7276 Send Notice of Billing Errors and Customer Service Inquiries to: CITIBANK, N.A., PO BOX 6125. SIOUX FALLS SD 57117.6125 Transactions casn nave.. umn S0 Statement Closing Date 02103/2022 Days in Billing Period 31 Post Date Trans Date MCC Reference Number DescriptlordLocatlon Amount "'""""'"''.""•""• NOTICE MEMO ITEM(S) LISTED BELOW """•"'"`"•'""""" 01/04 01103 9399 05134372004600038518176 1 NPDB NPDB.HRSA.O0V 800-767-6732 VA 22033 USA , '2.60 N80688460 01104 D1103 9399 (151343720046oamss1B258 2 NPDB NPOB.HRSA.GOV BOO-767-6732 VA 22033 USA .2.60 „ 1t N80599477 01110 01107 8299 75418232007133119339719 3 CC[ 868-2572B67 CO 80231 USA ,.325.00 \% LIGU14A); 01111 01110 9399 55488722011091272004573 4 TXDPS CRIME RECS 5124242936 TX 78752 USA i153163 '✓` 4l;Fi t001 01118 01117 8299 05436842017300223670871 6 FSP'EMR SAFETY B HEALT 972-235-8330 TX 75243 USA .,-24.00 -4fYj'J q 01118 01117 8299 05436842017300223670954 6 FSP'EMR SAFETY BHEALT 972.235-8330 TX 76243 USA U24.00 �' / 11 01120 01119 6968 65432862010200165971573 7 LOGMEIN'GoToMeeling logmein.com MA USA ,696.00 t.-' 4671f61i ODF6576E 889C 462 01124 01119 8062 66457372021029873900202 8 TEXAS HOSPITAL ASSOC 5124651000 TX 78701 USA y�73525 CR iJuUtDLt 01124 01119 8062 55457372OZ1029873900186 9 TEXAS HOSPITAL ASSOC 6124651000 TX 78701 USA .,916,39 OR '{oujo0 01/27 01/26 8299 65429SO2027852134536239 10 MGMA 3037991111 CO SD112 USA 9.00 .,j 1iDAgOj 13453623 la3 D128 01127 8641 55429502027852164883162 11 NARHC 8663061961 MI 49412 USA 475.00 / gGi+O'iDt 16488316 01131 0128 5734 82711152028000ODBIBI459 12 SURVEYMONK"T42102691 SANMATEO CA 94403 USA V gCS-Ktfil, Ot131 0128 9399 05134372029600035746580 13 NPDB NPDB.HRSA.GOV 800.767-6732 VA 22033 USA �334,00 �k.50 4;5011 N81237645 01131 01128 9399 05134372029600035746663 14 NPDB NPDB.HRSA.GOV 800-767.6732 VA 22033 USA s2.50 +%j 4li-) l', M81238161 01131 01129 8999 554328620292CO864745409 16 AMA"CREDE TIALING 800-621.8335 IL 60611 USA .' 44.00 "�/ 40IfAFiI _.. .... *''""""'"'""" TOTAL AMOUNT OF MEMO ITEM(S): $863.08 NOTICE: SEE REVERSE SIOE FOR IMPORTANT INFORMATION Page 1 of 2 at( 11 CITIBANK, NA Account Account Number XXXX-XXXX-XXXX-9457 C1 ta PO BOX 6125 SIOUX FALLS SO 57117-6125 Statement GIDSIDg Date February 03, 2022 ROSHANDASTHOMAS 202 S ANN ST PORT LAVACA TX 77979-4204 Not an Invoice. For your records only. 00007905040 F • Report a lest WSlofen Cald hamed/atdyc Our telephonelinesam open every day, • payments: You may make. Payment to your individually billed met account online 24 boors a day. Call the Customer Soreke telephone number specified on the front of using CHIManager. Planes note that same organheWns as not have the Cifibleager the stammentta mporta lost or stolen CHI Corporate Card. oniiUp payment feawro enabled fat eardheldws. If paying by mat, please allow sufficient making was. please was your amamt number on the front of the check. For centrally billed accounts, please be sum to send on Company check as payment • Cardholder Credit Up. Each Cardholdm has a a lndwMal Credit Line (a podknd for all Cardholder Ontario&. If we reaake your mated payment In proper form at our when may be used for Cash Advarms), which Is the mesdames amount that the processing faciMy by 6:00 p.m. Eastern TMe, It wilt be credited as of that day. Cardholder can charge at any time. The size of cash Cardholders Credit Llrre (and Payments can also be made by electronic fund bansfar, corm bansfaa ACM tmmfeq Cash Limit. d any), Is determined by the Company and Is a portion CI the Ishii dead debt, and other methods. Call the number on the front d this statement Or Company Credit Line. details. • ComWny ROUnaadon: By ice payment of any amounts charged W the Account rite • To inemaaa 01 Rodhaote a Company or Cmdhaldar Credit Line: The Company Company: (1) lamfes we odglnat Application fur the Account and the auOmlly of all may mquasl changes to Credit lines by sOntading OIL Corporate Card Customer parsons at We ffine of that, signing such Appllalbn, and(11) authadzes thflconOued Sonlcm. Our telephone Ifnm are open every day, 24 hours a day at inn lelapbonb use d the Account wader the terms of The Corporate Card Agreement at all numberspeetlled an thefowt of thestetament. Cardholders to whom Cards are Issued. • Spedol connotation an Cash Achim m: Cardholders may get a Cash Advance At • Additional COAhoiders; Tha Company may request apal.afam, far addtiond over t6DAW mmtisne worldwide. CWtHralders by mnlaflmg at Corporate Card Service. Ourtelophon,linos am open • The Cardholders Cash Advance Limit is a part of tie Cardholders Total every day, 24 hours a day at the elephane number speddktl on the front of the Credit Line. HIS notan additional line atcradn statement Unit one CHl Corpomla Card per Cardholder. . For Cash Advances from ATMs, a smaret. Personal adentalatlon Number (PIN) Is required forescudly purposes, • C®Ongne Taal: You can eaelyManage your CHI Cord online CIUailing the the an gercoo began,earou lost. enables you or manage business M .rings lances the Bank the tlalinMe sac; My Accoumark; ekpenaea from expenses gllobafrom ma glabc your camputs.rm%To device; you amount amount shoirrym,wn s ate en on the billing statement as balance due, loss any disputed b any sainted Wdemarwimrelum a. ran view ahiwmenfa onrtne es wall os confirm amount balances, To nMe'l for a y tit w charges, by the payment tlue dale The sank will ahvw any unpaid of n regManagnA ass lag an and click on Me follow to balance dueas a paetappear due any of portion of subsequentecowasbWilin r yourialf for Cardholders' Ilnk. From Were, follow the prompts to establish your Ink, From Mom, prompts , pt on two the pedalos balance appears on Opting state ant (approximately account account days agar billing eyahi tlpast 1 agree m pay a yfee monthly ), Iagree delinquency fee mammy data), basedena to y payment by eof the angrypastdue balance until myyment he Me Me Seek. late rate fee may elm he imposed monthly until payment for the pall tlue forpast due helan<fl ts received by the Bank r • In Case of Sandra or QueAons About Your $It;: You are responsible for Inflating ' In the hall Us, please explain In detail the dispute and the results of the Me dispute mealation process g yaw Amount Statement likes shergva that you holbw attempt to resolve It with the merchant The letter mud include the amount are unauthodzed. incorrect far momhandlse that has hat boon mcohmd, or for Involved, and must be attend by the Individual Cardholder. We will rotumed merchandise. You should oho bluato the process t your Amount Statement notify you of the r."he of our egad., nowroctiy, fish a cro t so a charge or U a nedlt, for whkh you have bean Issued a • If you teamed merchandise and combed a credit slip which has net yet .reds slip, He net shown. To begin Ito dispute resolution process, visit been posted, please al1mv20 dayalmm the date awes issued. it It has not .Wwwam.wanlooin been posted to Na Amount by Nen, mmurd asopy dthemedaalipPo m • You may also dbpulo a transaction by wiling In Cm. You may wvita to us on a atthobgingdhputeaddralmspeallledon glatmnlel tie shtamMLAkng whiff the eapY at the coedit slip please Include a iener (apnea by the mpania sheet at me address specified an the pe land of the armaments as soon as Individual Cardholder) setting thatcredit was net headed. If a Credhat(o poulble, Please notify us no later then 60 days sterme date of tie htion whkh Pe error or problem Net appealed. to the letter please gba us the fallowing Information: wo. net handed, please request ono from the merchant ff coo merchant • Your name and account number. For cenbdiy billed Company Account, refuses, phase vela to we and explain the details. an non.dtvputed matters or any matter shown by the Bank not to W In the Company name and IndfAdvar account number. The dollar amount ofMesexpaded anon eNo,, me Bank may charge the Company or Comholdm the fan specified Describe the war and explain the mason for the even U more Information In the Command Card Agreement for each copy of any document the Company m Cadholder requests, such as duplicate periodic shkmmis, Is needed about an lam, please desulb. itto us. transaction slips, and Ise like. • Mamhagt 019Pul4s. If to Company or Cwt hdder coos unmmaeaml in • please Saw your hung. recaiph. attempting m alva a problem wlh a merchant cenmmWg the quality of goods or services purchased with Ina Cat Comomk Card, we may he able 1. help Itwe are nolllkd in voting wthln 60 days or me date of the charge, You wlll be ropsnsble U coo are not able to woman Me dispute at lithe Bank gntls you respormbh Aar me disputed charge. Page 2 o12 MEMORIAL MEDICAL CENTER PURCHASEORDER Bill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 PHONE: (361) 552-6713 FAX: (361)552-0312. FAX: (.3�6t1)552-0312 Vendor Name: CttL&f1XL Date: Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account # .. Initiated Yomf A Y4UI Date Required Expensed Department DeliverTo Line No. Qty. Catalog Number DescTiptian Unit Cast Unit Mess.. Extended Cost t - ;L 501 -- 2 N�'�� a-50 3 S Crime, QeGS q K+if aedi W s Ut 5 a FS - ew yw �K �- P4 s; caA��, S 7 i n - 1. ee i 1641(e cc s Ij95)2e- g]1N--z:; 's-frn uy)6,, ¢ Gri 10 d J4A �- VNU C#,14c k, ttli7 cL u.) S • U✓ Est. Freight Est. Total Cost TOTAL COST TTl1TIIC- Contact: Quoted By: Buyer. Dale: E.T.A. Dept. Dir. Nursing Dir. Clinical MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 8d5 N. VIRGINIA ST. Ship To: 8IS N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 --PHONE: (361) 552-6713 FAX (361)5/52-0312. FAX: (361)352-0312 Vendor Name: ✓" I + +1 '� Date: 3V Vendor Address: P.O. # Vendor Phone #: Account # Vendor Fax #: Initiated By: Date Required Expense# Department Deliver To Form 01 # 9g Line Na. Qty- Catalog Number 2 = 5 u + 2.6+ 1 53 • 6> r Description UnCaCast Unit Mees. Extended Cost AA6M _ rv)e t b pr 7 ® 6 4 qi nib+ fVl MM Cd f n 1 C, ��Hijit" oD -, 2 2 4 • 0 0 + i.r 94 ^ U + - �1, 3 fAge ec I (��i-' A. -f q -{-TA/• wMIMI -I►�MU'i'1�1fG q r3I -' - 9,(--31 - 3 2 5• 0 + 349.ou 475•00 + 384.00 + 32.50 + e C V I1/ l� i — Ar)r) LiGt/� de to�� �, G 6 7 Npof2:)®1 J OtG�!i vl bra 3d.5'o g z• 5 o+ 4I.•00 + N P(J� - 6 ��W ovrai�-� 9 8 6 3• 0 6 T p— Idt �J 1 �� d �Ul� AMA to fCqyT M nyo- s .To %Ydd!%3'L ?r ATr1TCC- Est. Freight Est. Total Cost TOTAL COST l j< Contacc Date: Quoted By: Buyer: E.T.A. Dept. Director Din Nursing _ Dir. Clinical Services MSKESSON wmraoy: coos MEMORIAL MEDICAL CENTER AP B15 N VIRGINIA STREET PORT IAVACA TX 77979 STATEMENT ANT DUE REMITTED VIA ACH DEBIT Statement for information only As of: 02/11/2022 DC: 8115 Territory: Customer, 632536 Data: 82n2/2022 filling Due ReceivaMktatlonal Account MA,36 cash )ale Data Number -- — Rerererlce Description Discount IF column legend; P = Part nue Item, F = Future Due Item, blank = Current Due Item 'DTAL National Acot 632536 MB30PoAL MEDICAL CENTER Subtotals: 8.218.11 USD 'uture Due: 0.00 It Pald By 02115/2022. Page: 002 To enure proper coach to year account, detach and return this Mob With your remittance As of: 02/11/2022 Page: 002 Mail to. Cars, 8000 AMT DUE REMITTED VIA ACH DEBIT Statement far information only Curt: 632536 PLEASE CHECK ANY Dale: 02112/2022 ITEMS NOT PAID (+) Amount P Arno Amount P Recelvr (grow) F— F Number tat Due: 0,00 Pay This Amount: 8,053.76 USD cost Payment 2,451.97 If Paid After 0211512022, IB/07/20/7 Pay this Amoral: 8,218.11 USD 774.65 = 5,541-03 + 16.61 + I1484•&U + 232.67 8.053.76 APPROVED ON FEB 14 2022 RY COUPTTY AUDITOR n4; J;0'JN COUNTY. TEEXA,S t7W (.ls Due It Paid On Time: USD 8,053.76 DI. lort It paid [Me: 164.35 Due It Paid late: USD 8,210.11 A NV-p For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: D2/, „2D22 Page: °°' comes a your ac lach and account, detach and return this re company: e04 stub whin your remhterrce DC: 8115 As of: 02M 112022 Paga: 001 H® PHCY 0434/ME1N MED PHS AMT DUE REMITTED VIA ACH DEBIT Territory: 400 Moll tm Camp: 8000 MFMORAL MEDICAL CEVTM Statement for information only ANT DUE REMITTED VIA ACH DEBT VICKY KAUSEC CNslor: t90813 mes. m1 1 Statement for information only 615 N VIRGINIA ST pate: 20 PORT LAVACA T% 77979 Cush 190813 PLEASE CHECK ANY Dale: 02112/2022 ITEMS NOT PAID (v) - —_ .. ._... ____'ccou __ u Cash Mlirg Due Numb ebl9'atlanal Account Refine. )ate pale Number Fidlererwe Description Discount pt Amount P (gross) F Amount P Receivable (mot) F Number :ustomer Number 190813 H® PHCY 0434/MBMi MEn PHS 12/0912022 02115/2022 7323527876 2017044195 1161nvalce 15.61 780.39 764.78 `� 7323527876 12/1112022 02/15/2022 7324053234 2017044447 1151mmice 0.20 10.07 9.87 7324053234 FE 1F column le0eml: P = Not Due Item, F = Future Due Item, blank = Current Due Item 'OTAL Customer Number 190813 H® PHCY 0434I101311 M® PHS Subimale: 790.46 USD `uture Due: 0.00 Due It Paid On Time; It Paid DY 02115/2022, USD 774.65 ✓ %m Due: 0.00 Pay This Amaunl: 774.65 USD Diet last If paid Kim: 15.61 ast Payment 11,468.44 if Paid After 02/1512022, Due If Paid late: 12/07/2022 Pay this Amount: 790.46 USD USD 790.46 M i�pppovEn oN FFD 1 A)no7 ay COUN Tl AUDITOR &ALHOUN COU14T1', TEXAS For AR Inquiries please contact 800-867-0333 11W MSKESSON coinBe,v: Bono WALMAR7 1098/MEM MID PHS MEMORIAL MEDICAL CENTER VICKV KAUSEK 815 N VIRGINIA ST PORT LAVACA T% 77979 STATEMENT As of: 02/11/2022 CC: 8115 AMT DUE REMITTED VIA ACH DEBIT Territory: 400 Statement for infarmalion only Customer: 256342 Date: 02/12/2022 filing Due Natlohal ot 6 W 6 Accun )ale pate - Number Numb Reference Description :uetomer Number 256342 WAU4ARr 10981MFM MED ME 1210612022 02/15/2022 7322922329 24743045 1151nvoice 12/06/2022 02/15/2022 7322922331 24770784 11 Streetce .2106/2022 02/15/2022 7322922333 24791104 1151nvoice 12/06/2022 02/15/2022 7322922335 24812689 1151nvcice 12/07/2022 02M512022 732312HI58 0204220840 1961nveice 12/08/2022 02/16/2022 7323248868 24938767 1151nvoice 12/08/2022 02/15/2022 7323248869 24938767 1151m0ice 12/09/2022 02/15/2022 7323524142 WMMH0208 1151ramIce 32/0912022 02/IS/2022 7323524145 24985133 1t51nvolce 12/09/2022 02/15/2022 7323524147 25029664 1151nvoice -2/0912022 02/15/2022 7323524149 25029664 1151nvoice 12/09/2022 02/15/2022 7323688788 0208220632 1951nvcice 12/09/2022 02/15/2022 7323688789 D208220719 IISlwolca 12/10/2022 02/16/2022 7323792978 250602DI II51nvaiee IWIO12022 02/15/2022 7323792979 25105180 1151nvolce 12710/2022 02/16/2022 7323971166 0209220935 1151nvoice 12/1112022 02/15/2022 73240SI640 251341139 1151ovoice 12/11/2022 02/15/2022 7324224000 0210220849 1951nvolce 12/11/2022 OW15/2022 7324224001 0210220743 115Invoice W column legend: P = Pout Due Item, F = Future Due Item, blank = Current Due Item "OTAL CUNomer NumM 256342 WAlMgrir 1098IMEM NEE) PHS Subtotals *Kure Dud: 0.00 kik pee: o.OD am Payment OM 11.468.44 12/07/2022 , re¢ (! 7022 FIv ""'AVOITOR If Paid By 02/1512022, Pay This Amount: If Paid After 02/1512022, Pay this Amount: Page: 001 To asked proper credit to your amount, detach and return this Note with your remittance As of: 02/11/2022 Page: 001 Mail to: Comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for Imonnalion only Cost: 256342 PLEASE CHECK ANY Dale: 02/12/2022 REMS NOT PAID (J) Cash Amount P Amount Dl Discount (gross) F (eel) P F Nble -Numberumber 0.04 8.49 1.15 5.68 0.01 0.59 13.75 17.35 4.78 7.51 8.32 6.611 10.03 14.90 7.14 7.73 5.65B.18 USE) 5,545.03 USp 5,658.18 USD 0.16 1,91 0.09 424.39 57.26 284.03 0.63 29AB 0.16 687.26 867.62 239. t 4 375.60 416.16 284.03 501.59 745.02 356.97 386.68 For AR Inquiries please contact 800-867-0333 0.18✓ 1.071 0.09v 415.90✓ 56.11 278.35✓ 0.62 ,, 28.89 v a.I By 873.51 v 850.27 ' 234.36 ✓ 368.09,.' 407.84 ,% 278.35 ✓ 491.56 ✓ 730.12✓ 349.83 378.95 ✓ 7322922329 7322922331 7322922333 7322922335 7323128158 7323248868 732324BB69 7323524142 732352414E 7323624147 7323524149 7323688788 7323688789 7323792978 7323792979 7323971166 7324051640 7324224000 7324224001 If PafE On nme: USD 5,546.03 " 01. lost it pore lets: 113.15 Due If Paid Late: USD 5.658.10 MSKESSON STATEMENT �mveor: escs CVS PHCY 7006/MB40RIA MIS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CEJTEH &element tar information only VICKY KAUSEK 815 N ViMINIA PORT LAVACA TX 77979 As of: 0211112022 Page: 001 To ensure proper cre6K to your account, cletech and Mum this stub with your mmittanee DC: 8115 As of: 02/11/2022 Page: 001 Mall lc: Comp:8000 Temitay: 400 AMT DUE REMITTED VIA ACH DEBIT customer. Statement information for information only Date: 02M2/2022 Cull: 262252 PLEASE CHECK ANY Date: 0211212022 ITEMS NOT PAID (v) gllirrg Die Numberblrallonal Account 36 Cash late — Data Number Mfererrce Oeaeripflsn Oisouunt :m1 mer Number 262262 CVS PlICY 7006/1AEMOMA PHS 12/09/2022 02/15/2022 7323509191 1562972 115mvo1co 0.34 IF column legend: P e Past Due Item, F = Fmum Due Item, blank a Current Die Dem 'OTAL Customer Number R62262 CVS PHCY 7006IMLgAOWA PHS Subtotals 16.96 USE inure D. 0.00 It Fuld By 0211512022, Ing Due: 0.00 Pay This Amount: ast Payment 14,600.52 It Paid After 0211512022, )1/24/2022 Pay this Amami: APPROVEOON FEB 14 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Amount P (gross) P Amount Amount P Number la F Number 16.95 16.61 ✓ 7323509191 O Due It Paid On Time: USE) 16.61 ✓ 16.61 USD Disc log If paid late: 0.34 Due 1t Paid Late: 16.95 USD USD 16.95 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT oomaanr nr.o HEB MY PC 490/MEM MG PIS ANT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information only VICKY KAUS9C 815 N VIRGINIA ST PORT IAVACA TX 77979 As at: 02/11/2022 Page: 001 To ermuro Proper arotl4 to your account, delaeh and Mum this Mum with your Matthews CC: Ella As at: 02/11/2022 Page: Out Mall to: Camp: 8000 Territory: 400 ANT DUE VIA ACH DEBITCustomer, 464450 lot info® Statement tar information only Data: 02/12/2022 Coro: 464450 PLEASE CHECK ANY Date: 02/12/2022 ITEMS NOT PAID (+) filling Due NxelvabM'etlanel Account y96 )ale Date Number Rateronce Dexdptl0n ;Iwtomer Number 464450 HSH MY FC 490/MEM MC ME 12/07/2022 02/15/2022 7322920306 55x324412 1151nvolce 12/08/2022 02/15/2022 7323243766 56x327422 1151nvaica 12/08/2022 02/15/2022 7323243768 55x327441 1151nveice H: column ngend: P = Part Due Item, F -. Forum Due Item, blank = Dument Ow Item "OTAL Customer Number 464450 H® MY PC 490/MEM MC PHS SubtWelc -mum Ow: 0.00 If Paid By 02/1512022. last Due: 0.00 Pay This Amount: am Payment 11,468.44 It Mid After 0211512022. 12/07/2022 Pay this Amount: 1tPPROVED ON FEB 14 2022 RY COUNTAUDITOR - - '^ COUNTY. TEXAS Discount 5.76 23.62 0.92 1,515.10 LED Amount P Amount P Heaelsable (9.1 F (wN F Number II... 11 288.03 282.27 ✓ 7322920306 1,181.23 1,157.61 ✓ 7323243766 fj 45.84 44.92 ✓ 7323243768 Due If Pold On Time: LED 1,484.80 f 1,484.80 USO Dix lost it paid late: 30.30 Due If Paid late: 1,515.10 USO USE] 1,515.10 For AR Inquiries please contact 800-867-0333 STATEMENT ..m .: 8000 CVS PHCY 7475/MEvt Me PHS ANT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statemenl for infarmalian only VICKY KALISEK 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 02/11/2022 DC: 8115 Terdmry: 400 Customen,835438 Dale: 02/12/2022 Ailing Due N National Account bib ble )ate De[e Number Reference Description :ustomer Number 836438 CVS PHCY 7476/MBA Me PHS 12/09/2022 02/16/2022 7323720786 1563354 1151nvoice T Wumn "no. P e Pam Due Item, F = Future Due Item, blank = Current Due Item 'OTAL• LL14omer Number 896438 CVS PHCY 7476/MBA MC PHS Subtotals: :mum Due: 0.00 B Paid By 0211512022, %m Due: 0.00 Pay This Amount: Aat Payment 11,468.44 It Paid Aker 02115/2022, 12/0712022 Pay this Amount: APPROVED ON FEB 14 2022 BY COUK Il' AUDITOR CALHOUN COUNTY, T LXAN Cash Discount 4.)5 237.42 USD Page: 001 To ensum paste, cr"it to your account, &tech end mum this stub with your remittance As of: 02/11/2022 Page: 001 Mall to: Comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for Information only Cust: 835438 PLEASE CHECK ANY Dale: 02/12/2022 ITEMS NOT PAID (v) Amount P (gross) F Amount P Receivable (.1) F Number 237.42 232.67 ✓ 7323720786 O Due If Paid On Time: USD 232.67 232.8/ USD Olso lost if paid IMe: 4.75 Due It Mid tare: 237.42 USD USD 237.42 For AR Inquiries please contact 800-867-0333 on U, STATEMENT statement Number. 62491758 AmensourceBergen- Date: 02-11-2022 AMERISOURCEBERGEN DRUG CORP WALGREENS #124e4 340E 100135284 1037028186 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER SUGAR LAND TX 7747"101 1302 N VIRGINIA ST PORT LAVACA TX 77979-2509 Sat - Fri Due in 7days DEA: RA0289276 866451-9655 AMERISOURCESERGEN Not Yet Due: 0.00 P.O. Box 905223 CHARLOTTE NO 28290-5223 Current: 917.09 Past Due: 0.00 Total Due: 917,09 Account Balance: 917,09 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 02.07-2022 02-18.2022 3082563159 164618 Invoice 235.33 0.00 ✓236.33 02-07-2022 02-18.2022 3082566480 164620 Invoice 253.7E 0.00 ✓253.78 02-07-20M 02-18.2022 3082566481 164621 Invoice 0.09 O.DD ✓0.09 02-07-2022 02-18.2022 3082566482 164623 Invoice 0.29 am 429 0247-2022 02-16-2022 3062SM483 164622 Invoice 2.19 0.00 t.19 02-07-2022 02-16-2022 3082607709 164670 Invoice 23.63 0.00 123.63 02-08-2022 02A8-2022 3082738376 164676 Invoice 50.08 0.00 80.08 02-08-2022 02-10-2022 3082736377 164677 Invoice 0.93 0.00 -'6B3 02.08-2022 02A8.2022 344746636 164246 Invoice (3.53) 0.00 43.53) (IM8-2022 02-18-2022 344748637 IU246 Invoice 3.37 0.00 ✓7.37 02-09-2022 02-18-2022 3082a77649 164682 Invoice 233.21 0.00 '233.21 02-10-2022 02-18-2022 3083017741 104691 Invoice 5.55 0.00 5,55 02-11-2022 02-18-2D22 3083180708 164698 Invoice 107A4 0.00 /107.14 02.11-2022 02-18.2022 30B3180709 164699 Invoice 5.03 0,00 ✓6.03 Current 1-15 Days 16.30 Days 31-60 Days 61-90 Days 91-120 Days Over 120 Days 917.09 I 0.00 oeo I 0.00 0.00 I 0.00 I 0.00 APPnOVED ON, Thank You for Your Payment Reminders Date Amount FEB 14 2022 Vj Due Date Amount 02-11-2022 (1,033.25) BY COUK T Y AUDI (OR 02-18-2022 917.09 Total Due: 917:09. CALHOUN COUNTY, TEXAS t.X w J`llnlL 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" E"IF FEDERAL TAX DEPOSIT ENTER 1" El "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 15T QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec ❑"ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #t# ENTER: L� 941 # y 22 1,,. C $ 95,29568 1 $ 49,701.96 $ 11,623.76 $ 33,969.96 CHECK 5 CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F?AP-Payroll FileslPayroll Taxes12022W4 R1 MMC TAX DEPOSIT WORKSHEET 2.10.22.xls 211112022 Ru:n Cate: 02i11122 REN3SIAL MEDICAL CENTER Pass 1C0 Time: 15:25 Payroll Register I B= Weekly ) P2REO Fay .er'cd 0112d,22 - 02I:0,22 Rmu Final Sumary I-- P a y C o d e S a m m a r y-------------------------------------------- D e d u c t i o n s S u m m a r y -------------� Pa7Cd De9:riptian Rrs OrjvjW-jEOjCEj Gross I Code k1m, •................................... .-------------- _.._................................... .--.---------- •-............ ......... 1 REGLAR PAY-S1 9445.50 N N N 191105.35 A/R 585.00 A/R2 25.00 A/R3 1 REGULAR PAY-S1 2054.5C N N N N P6055.94 AOVANC AWAKES BCASVI 1767.41 1 REGUAR PAY-S1 449.75 Y N N 12521.63 SLOTS CA-.- r CAFE 2 REGULAR PAY-82 2407.75 H N N 54796, 17 CAF 2 CAP3-3 CAPS-4 2 REGULAR PAY-S' 789.25 N V N N 789.25 CL"-E-5 CA3-C CAFE-D 1732.33 2 REGULAR PAY-S.' 157.25 Y S N 5419.32 CAFE-F CAFE-E 25559.03 CAP _ -I 3 REGULAR PAY-93 1131,50 N N N 31913.15 CAe:-L CAFS-F CANCER 3 REGULAR PAY -Si 85.CO Y N N 3177.34 CRITD 609.70 CLINIC 320,00 CONBIN 329.85 CALF FAY 214L25 N 1 N N 4262.5E CP.?D'a'N CC AD., DENTAL D DOUBLE TIME 15.25 N 1 N N 712.18 DEP-LF DLS-LF EAT C DOUBLE TIME 39.PP N 2 N N 2600.45 RATCSF. FEXAX 33969.9E PICA-H 5811.98 D DCUELE TIME 49,50 N 2 N N 1798.27 F7C4.5 <485G.58 FIFSTC FLEE S 3532.62 D DOUBLE TIME 14,26 Y 3 N N 1363.55 FIX FE FORT D FUTA E EXTRA WAGES N N N N 6438.90 GIFT S 176,76 GRA\T GRP-IN E EXTRA WAGES N 1 N 11 N 9L2.25 G.L SOS.-: :S Ti- 3 INSERVICE 16.50 N 1 N N 516.D6 LEAF LEGA1, 217.25 NASA 824.75 S ovURY LEAVE 8.00 N 1 N N 91.12 HEALS 20C.60 HETVIS RISC X EXT-EY)ED-I:S103-SANE 222.24 N 1 N N 6_70.04 H-SG EXCERR HATFP"i 2510.75 P PAID -TIME -OFF 59.88 N N N N 1i85.88 OACR PHI PHI... P PAID -TIME -OFF KOA7 N 1 N N 18224.62 PR FIN RELAY REPAY X CAL,,-, PAY 2 144.06 N 1 N N 2d8.GC SAYS S11R7S SIGNOR Y YMCA/NAVES N N N N 30.00 ST-TX STONOF 640A6 STONE Z CALL PAY 3 48.00 N 1 N N 244.00 S:19NE2 STUDEN Su*.CC 009.18 v COVID-FFCFA 208,00 N 2 N N 4L47.94 SUNI:L 932:: ST.9IN'T 659.43 SLT.IF 85634 SUNSTD 146D.14 SUNVIS SL'ECOG 430.00 TSA-1 TSA-2 TSA-C TSA-? TSA-R 30571.59 TLTION UNIFOR Ud/ROS •-----••------------- Grand Tota's: 20269.24-----•- I Ornss: 43673E.45 ledazticu: 138301.C7 Net: 238435.18 _ Checks Coat;- FT 196 P'T 10 Other 35 FeTale 215 Male 21 Credit GrerAmc7 ZeroNet Tern Total: 240 '------------------------------------------------------------------------------ ------- .---------- -------------------------' Pay 4lali : us' 1%-IV 941 REC/TAX DEPOSIT FOR MMC PAYROLL "E PAY PERIOD: BEGIN 112412022 VQ PAY PERIOD: END 211012022 PAY DATE: 211812022 GROSS PAY: S 436.736.46 DEDUCTIONS: AIR 5 510.00 ADVANC BOOTS SUNLIFE CRITICAL ILLNESS $ 932.16 SUNLIFE ACCIDENT S 889.18 SUNLIFE VISION 5 - SUNLIFE SHORT TERM DIS $ 1,460.14 BCBS VISION S 1161.41 CAFE-D S 1,732.33 CAFE-H 5 25,559.03 S - S - CAFE•P CANCER CHILD S 609.70 CLINIC S 320.00 COMBIN S 328.85 CREDUN DENTAL S DEP-LF SUNLIFE TERM LIFE S 856.84 SUNLIFE HOSP INDEM S 689-43 FED TAX 5 33,969.96 FICA-M S 6.811.88 FICA-0 5 24.850.98 FIRST C $ - FLEX S S 3,532.62 FLX-FE 5 GIFT S S 176.76 GRP•IN GTL HOSP-I LEGAL $ 1,042.00 OTHER S 200.60 NATIONAL FARM LIFE S 1,910.76 MED SURCHARGE S 430.00 PR FIN S RELAY REPAY STONEOF 5 640.86 STONE STONE 2 STUDEN TSAR S 20,571.89 UWIHOS $ TOTAL DEDUCTIONS: S 138,301.07 $ ^ExouLe NET PAY: 2-9043a83 S TOTAL CAFE 126 PLAN: $ 35,913.73 IAXABLEPAY: $ 400.822.72 $ 400.822.72 •-CALCMLATEo" Ptom MMC Rapon Difference !ICA-MED(ER) 145r $ 5,811.93 9CA - MED (EE) ,.se $ 5,811.93 S 5.811.88 S 0.06 :ICA - SOC SEC (ER) sv, $ 24,851.01 7ICA-SOC SEC(EE) +m, 5 24,851.01 S 24A50.98 $ 0.03 ED WITHHOLDING S 33,969,96 S 33,96S96 S REVISED 3/182014 iNAL CK111 TOTALS $ 436.736,46 610.00 932.16 889,19 1.460.14 1.167.41 1,732.33 25.559.03 609.70 320,00 328.85 866.84 689.43 13,969.96 5,811,88 34,850.98 3.532.62 176.76 5 1.0.12.00 5 200.60 S 1,918,75 S 430.00 S - S 5 5 640.86 S 5 - S S 30.571.59 S 5 - 5 � 138,301.D7 Nww wren aePAen -alroxo wron RaPoer• 5 S S 298,435.38 exoulo wren At+oar -s,wuo wrcK AEPefl1- Exempt Amt: Employees over FICASS Cap: S Sharma Odonnell S - Roshanda Thomas 5 - Paycodo S - Employee Reimh.: TAX DEPOSIT: 5 95,296M 5 952950 FICA - MEDICARE :w. S 11.623.86 511,623.76 FICA -SOCIAL SECURITY ,:.:, S 49.702.02 $49.701.96 PREPARED BY: FED WITHHOLDING S 33,969.96 $33.969.96 PREPARED DATE: TOTAL TAX: $ 98,296.84 $96,295.68 $ 0.16 TOTAL: $ Caillin Clevenger 2/11/2022 "RI MMC TAX DEPOSIT WORKSHEET 210.2241s. TAX DEPOSIT WORKSHEET 21IIQD22 _![_._ r ii :ca in2ft,x eEEeZ Si2.25 @?iill! :2':nd2 52i6- .^ee; p }m:C:;Cb 1;c::.;. wa;`1; '_` _. `- ...._ SIM.;....1 _...r a::.:. —' - l ;Y RICE LEE TcI.F. 2vti.?t _„' 42-1 .._ .:a:..'.:..._..r..... .. _. __ ._ .. .. ...._ _. _._. .... ............. ...._e :'W ....... .. . -- Z .. .. .. I .. . 7W F13TEELY .4 3L:: n WIN .. 5 :.._ .._.. _r.E R _7JES,_.. __...._ -_ .- A z ;: C:i Ei: i;n :S:iiiid•SA1Ic3E2 EBL i" C.". [... 12 :2t5' E:':..? !! ' .dff 11a1.5S 2C U ..._ .31N R ...... .._ . :,."i;-.__.r... .iii.:. .: .. -.._ Ain ::!:._._ ::5::.RA ...:.. _. 50.. Toe, ::-Ill HZZHEF. iZ,131.EF. ."...M ... t Q . SATE a i Ilv a:': ..:_. _ ._ N 1:1 ;... 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M! 210 7A1iF;}: ti P.::Cc AS 22 es ULU w IKAW -EnSGi: ?s.ii « .. ..Am WHAT 3:: TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) F7"ENTER 9-DIG IT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" E-TIF FEDERAL TAX DEPOSIT ENTER 1" ❑"ENTER 2-DIGITTAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #w ENTER: ###E m 0 941 # $ 140.99 1 $ 87.84 $ 20.54 $ 32.61 CHECK: a btu L_� CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F:%P-Payroll FlleslPayroll Tazes1202244 R2 MMC TAX DEPOSIT WORK511EET 2.10.22.s1s 21412022 ... - - . 1 ... e e ---- - . - >_ _ _ .. . :.M: SO .. _.,. .. ....: !: a__ .:.:"E.'A H: :c ................................................... 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Zn Cri!it:..: _ _nre_. ;1 QV.�jcAuk,'• 1� 941 RECITAX DEPOSIT FOR MMC PAYROLL PAY PERIOD: BEGIN PAY PERIOD: END PAY DATE: GROSS PAY: DEDUCTIONS: AIR ADVANC BOOTS SUNLIFE CRITICAL ILLNESS SUNLIFE ACCIDENT SUNLIFE VISION SUNLIFE SHORT TERM OIS BCSS VISION CAFE-D CAFE-H CAFE-P CANCER CHILD CLINIC COMBIN CREDUN DENTAL DEP•LF SUNLIFE TERM LIFE SUNLIFE HOSP INDEM FED TAX FICA-41 FICA-0 FIRST C FLEX S FLX•FE GIFT S GRPAN GTL HOSP-1 LEGAL OTHER NATIONAL FARM LIFE MED SURCHARGE PR FIN RELAY REPAY STONEDF STONE STONE 2 STUDEN TSA-R UWIHOS i&SL[\7x01111049SUR NET PAY: TOTAL CAFE 125 PLAN: TAXABLE PAY: $ 706.35 $ 708.35 ••CALCULATED'• From MMC REemL DlNerence FICA -MED (ER) S 10.27 FICA - MED(EE) use S 10.27 S 10.27 S - FICA -SOC SEC (ER) S 43.92 FICA -SOO SEC(EE) nma S 43.92 S 43.92 $ - FEDWITHHuLDING 32.61 5 3231 TM DEPOSIT: S 14099 S 14099 FICA -MEDICARE 1xw $ 20.54 $20.54 FICA -SOCIAL SECURITY u.v S 87.84 $87.84 PREPARED BY: FED WITHHOLDING $ 32.61 $32.61 PREPARED DATE: TOTAL TAX: $ 140.99 $140.99 $ - REVISED 311WO14 TOTALS $ 708.35 i i i 2.61 10.27 i 43.92 i - i - S - i i - i i i i - i i - i i i i 49A8 i S 136,38 $ 671.97 Exempt Amt: Employees over FICA -SS Cap: $ Sharma Cdonnell $ Roshanda Thomas S Paycode S - Employee Raimh.: TOTAL: $ Caillin Clevenger 211412022 k4 R2 MMC TAX DEPOSIT WORKSHEET2. 1022.1, TAX DEPOSIT WORKSHEET V1412022 -age 71.y + F + + k k r + + + 4- + Z3 Q N In x crj N 00 z 00 0 7; N N CTI O\ 11< .. s N M 0 Ll CO tr\ N N 'o N 0 ao 71 N aO CO �C\ U.\ UN 'A Lf% L, %D 00 LA N V7 M 0, 10 %0 In No fri 6 �Z� 4 4 N cr� r4 z° d � I z) rz 2 2 6 'E m 45 u u Zt. = z O 0 u R gi wo mnpjmamq m m m Z. Z. Zti R R Mw w w w a am: u< OM 7 Z Z z z !2 z < X t; a d z ,�Z ;zr ;�r !Z! E < SOIiCS Z/20(2z 0 Confirmation: You Have Filed Successfully Sales and Use Tax Taxpayerl): UserlD: Reference Number: Date and Time of Filing: 02/07/2022, 04'09:15 PM PAYMENT SUMMARY Electronic Cheek State Amount: S797.12 Local Amount: $255.08 Amount to Pay: $1,052.20 Electronic Check: 81,052.20 Period Ending 01/31/2022 (2201) Taxpayer Name: MEMORIAL MEDICAL CENTER Taxpayer Address: 816 N VIRGINIA ST PORT LAVACA, TX 77979-3025 IF Address Payment Reference Number: Trace Number: CREDIT SUMMARY Credits Taken Are you taking credit to reduce taxes due on this return? Entered By: Email Address: Telephone Number: (361) 5$2-0342 Type of Bank Account: Checking Accountholder Name: Bank Routing Number: Bank Account Number: Payment Effective Date: 02/20/2022 4 Licensed Customs Broker Exported Sates Did you refund sales tax for this filing period on items exported outside the United States based on a Texas Licenced Customs Broker Export Certifications? No No LOCATION SUMMARY Total Texas Taxable Subjectto State Subject to Taxable bales Lace Sales State Tax out Loeat Tax Rate Local TaX Due Purchases Tax(Rate.0625) Local Tax 00004 12818 12818 0 12818 801.13 12818 0.02 256.36 SubTotal 12819 12818 0 12018 801.13 12918 256,36 Total Tax for Locations $1,057.49 Total Tax Due: $1,05T49 Timely Filing Discount: - S5.29 Balance Due: $1,052.20 Pending Payments: - 80.00 Total Amount Due and Payable: $1,052.20 (Stale amount due is $797.12) ( Local amount due is $255.08 ) Transaction Summary Transaction Cornnlef.e Texas Health and Human Services Commission Memorial Medical Center Operating County Page No: 7 of 1 Run Date: 2M 112022 Run Time: os:osw To: jgulihur@rchd.care;jsmith@medicalartshospital.org; diana.strupp@tenethealth.com; scarruth@obmc.org; hrichards@oceanshealthcare.com; megan@pm-hs.com Cc: HHSC PFD DSH Payments; Brown,Adam (HHSQ; Okoniewski,Amanda (HHSQ Hodges,Jandi (HHSC); Quintanilla,Sarah (HHSQ; Guzman,Kenneth (HHSQ; Regmi,Asha (HHSQ Subject: DSIOW Advance 3 Paymeht I©T Notification 3 of N' Attachments: 2022 DSH Advanced Payment 3 CalculationJRD.Asx; TexNet User Guide.pdf [WARNING -Remote attachments, VERIFY SEDERIL CAUTIQN: This email ueliWtkd from outsiite.of `the organiiat on, go not`clrck links;er openatfasFiment§ unless.yo4 recggnize_th a sender and'knpw tJie^con[ent'ife. DSH Providers: Attached is the third FFY 2022 DSH advance payment calculation that details how HHSC calculated the advance payment(IGT amounts, and related IGT Notification spreadsheets. Payment amounts/transfer amounts for state hospitals can be found in column V of the "State" tab. Payinenhtltttguttts for npn-atate hospitals can be found in column AW of the "Non-State"`tab and the corresponding IOT amounts in column AX of the same tab. To ensure that all government entities receive this notification, HHSC strongly encourages providers to send this to any government entity who is IGT'ing on their behalf. Please note that HHSC has adopted two changes to the interim hospital -specific limit (HSL) rule (1 TAC §355.8066). First, the interim HSL has been renamed "state payment cap." Second, HHSC will calculate the state payment cap with all costs and payments for individuals with both Medicaid and other insurance or Medicare. The following information pertains to 2022 Third DSH advance payment. All payment dates are calendar year 2022, I. Key Dates February 10, 2022 HHSC notifies of payment & intergovernmental transfer (IGT) amounts March 7, 2022 Last date to transfer funds into TexNet Match 8, 2022 TexNet settlement date March 18, 2022 Pay the transferring hospitals (Urban public hospital- Class one) March 14, 2022 State Owned Hospitals submit Journal Entry March 18, 2022 State Owned Hospitals paid March 30, 2022 Pay remaining DSH hospitals II. March 2022 Advance DSH payment Which hospitals will receive an advance DSH payment in March? Hospitals that received a 2021 DSH payment are eligible to receive a 2022 Advance DSH payment (subject to the availability of the non-federal share of the payment amount). Since this payment will be made before HHSC has determined qualification for 2022 DSH, a hospital may opt out of the March payment by sending a written request to DSHPayments afts.texas.gov by February 28, 2022. Hospitals should opt out of the March payment if: 1. The hospital is concerned it will not qualify for 2022 DSH; or 2. The hospital is concerned that it will be overpaid for 2022 DSH based on XTD advance payments and the costs calculated in the providers' 2022 DSH/UC Application. Does a hospital need to do anythina to receive the March oavment? All public hospitals will be required to transfer funds to HHSC in order to receive a program year 2022 DSH payment. Urban public hospitals are required to transfer 100 percent of the non-federal share of their Pass One and Pass Two 2022 DSH payments and non -urban public hospitals are required to transfer 100 percent of the non-federal share of their Pass One and Pass Two 2022 DSH payments. Urban public hospitals class one and class two (see below), (i.e„ those owned by a governmental entity that has historically funded DSH payments) do not need to do anything prior to transferring funds into TexNet. Urban public hospital - class one is a hospital that is operated by or under a lease contract with one of the following entities: the Dallas County Hospital District, the El Paso County Hospital District, the Harris County Hospital District, the Tarrant County Hospital District, or the University Health System of Bexar County. Urban public hospital - class two is a hospital that is operated by or under a lease contract with one of the following entities: the Ector County Hospital District, the Lubbock County Hospital District, and the Nueces County Hospital District. Non -urban public hospitals may need to take certain steps. A non -urban public hospital is: 1. Any hospital anywhere in the state that is owned and operated by a non -state governmental entity (other than one of the entities described above); or 2. A privately -operated hospital operating under a lease from a governmental entity in which the hospital and governmental entity are both located in the same county with 500,000 or fewer persons, based on the most recent decennial census, where the privately -operated hospital and governmental entity have both signed an attestation that they wish the hospital to be treated as a public hospital for all purposes for 2022 DSH and 2022 UC waiver payments. If you are a privately owned hospital who has submitted an attestation to be treated as a public hospital for prior DSH payments, HHSC will continue to treat your facility as a public hospital for the purpose of DSH and UC payments. Privately -operated hospitals in this category are "rural public -financed hospitals" and are eligible, along with rural public hospitals, for Pass Three DSH payments. All non -urban public hospitals should ensure that the governmental entity that owns the hospital is aware of its obligation and prepared to transfer funds for the November payment. Any governmental entity that has not previously transferred funds through the TexNet System for an HHSC Payment (i.e., Uncompensated Care, ASH, and DSRIP) must enroll with TexNet to submit funds for this payment. The TexNet Enrollment form can be accessed at https://texnet.cna.state.tx.us. Private hospitals (i.e., privately -operated hospitals that do not lease from a governmental entity and hospitals described in item (2) above that do not submit an attestation form) do not need to do anything to receive the March DSH payment. How will payment and IGT amounts be calculated? To calculate the March payment amounts and distribute 20% of the 2022 DSH funds, HHSC will use the methodology described in I Tex. Admin. Code § 355.8065 for interim DSH payments, but will use hospitals' 2022 interim hospital -specific limits, Medicaid days, and low-income days. III. Remaining 2022 DSH funds Which hospitals will receive subsequent DSH payments? HHSC is distributing 2022 DSH funds over four payments. Only hospitals that received a 2021 DSH payment and submitted a 2022 DSH/UC Application will be eligible for advance DSH payments. Due to the timing, HHSC has not verified that providers who are included in the first 2022 DSH advance payment calculation have requested a 2022 application. If a provider slated to receive a 2022 DSH advance payment knows they are not going to request a 2022 application, they should opt out of receiving this payment. All hospitals that meet the DSH qualification criteria based on data in the 2022 DSH/UC application will be eligible to receive DSH payments that occur after the applications are processed (subject to the availability of the non-federal share of the payment amount), including hospitals that did not participate in 2021 DSH. How will payment and IGT amounts be calculated? Using information from each qualifying hospital's 2022 DSH/UC application, HHSC will use the methodology described in the DSH rule to calculate a 2022 DSH payment amount. For each hospital that received one or more advance payments, HHSC will reduce the 2022 DSH payment amount by the sum of such payments. HHSC will then determine IGT obligations, If a hospital received an advance payment and later submitted a rural public -financed hospital attestation form, HHSC will increase the IGT obligation for the governmental entity that owns the hospital by an amount equal to half of the non-federal share of any 2022 advance payments. Will there be a Pass 3? Once the final 2022 DSH payment amounts are calculated, HHSC will determine if any 2022 DSH allocation funds remain to be distributed through Pass 3. If such funds are available for distribution, HHSC will work with rural public hospitals and rural public -financed hospitals that have submitted the above -referenced attestation to determine Pass 3 payments and required transfers. Pass 3 payment amounts are not calculated for advance payments. What if a hospital receives advance payments but does notqualify for 2022 DSH? HHSC will recoup the entire amount of all advance payments made to any hospital that does not qualify for 2022 DSH. What if a hospital's advance payments exceed its 2022 DSH pavment amount? HHSC will recoup the amount of any advance payments that exceed the 2022 DSH payment amount calculated using the information in the application. Any hospital concerned about potential recoupment should opt out of receiving advance payments, as described in Section II above. For additional information, please contact DSHPa_,Lm_ents_irhhs.te:cassgpy ** Note that if you have not already enrolled in TexNet Connect for HHSC Rate Analysis you will need to do so immediately. Information pertaining to enrollment can be found at: https,//texnet.cpa tate.tx.us Please ensure you select the DSH bucket in TexNet when you enter your IGT. It is imperative that you send a screen shot/PDF copy of the confirmationitrace sheet from TexNet or an email with the confirmation number and IGT amount if the TexNet is submitted over the phone, to USIIPevmerts t/'hhs texas, um. Please include two contacts with their phone numbers and email addresses, should HHSC have any questions regarding the TexNet received. HHSC will not confirm receipt of emails Please set Your email -settings to request a delivery receipt. if a confirmation is needed. Please let us know if you have any questions. Thank you, HHSC Provider Finance Payments (Formerly Rate Analysis) Texas Health and Human Services Commission P.O. Box 149030, Mail Code 1344 Winters Building 701 W 51st Street Austin, TX 78751 TEXAS! %V; Health and Human Services HIM IGT TOWIs $5]z.81 928.9] $190,01%266.64 Check Hons Check $575,812,930.30 $190,018.266.56 IGTCHECK Me".. t$1420M $0.0]990 Difference Culck"Ptiva '9DT Check $DW OK Proposed Method for State -Owned Hospitals Urban Public 5 Hospital Class 1 3 Non -State Owned 157 Non -State Owned Texas Health and Human Services Commission April 27, 2015 351,410 983,267 834.825 1,186,235 1,166,235 71,405 400.143 132,831 204,236 204,236 - 1,584,342 7,738,690 2,018,623 3,602,965 3,671,912 Texas Health and Human Services Commission April 27, 2015 70,969,146 70.969,148 1,856,053,277 490,386,887 1,284,100,626 1,856,053,277 12,218,858 12,218,858 240.286,813 53,079,519 167,948,223 - 240,286,813 219,680.310 219,680,310 2,789,181,304 534,850,144 892,967,263 69,543,620 2,719,637,684 Texas Health and Human Services Commission April 27, 2015 70,969,146 - 1,785,084,131 2.336,179 73,307,325 36.106,593 12,218,858 - 228.067,954 298,733 12,517,592 6,165,381 213.761,094 51919,216 2.505,876,590 3,282.304 217,043,398 8,179,710 Texas Health and Human Services Commission April 27, 2015 IMD CHECK $9,064.489 98.722.263 208,136.181 208,136,181 - 1,647,917,096 131,982 208,268.163 - - 18,682.973 18,682,973 - 221.603,840 17,748 18,700,721 - 225,223,108 224.873,570 349,538 2.494,764,114 199,807 225,073,377 (115,347) 98,722,263 462,042,261 461,692,724 349,538 4,364,285,051 349,538 452,042,261 (115,347) gal { (I5 I Y $224,804 $0 $2,212,822 $177 $224,981 t� tom. i ,$0 $224,804 $0 Texas Health and Human Services Commission April 27, 2015 43,554 60.455 134,932,864 1,647,785,114 73,335,299 5,857 - 6,171,238 221,586,092 12,529,483 5,482 - 8,069,844 2,494,864,307 217,003,533 54,893 60,455 149.173.946 4.363.935.513 302.868.315 . 2022 YTO OSH 2O22 Advance 05H Payinunts Payments IGTs Texas Health and Human Services Commission April 27, 2015 1.02. .. 208.268,163 134,932,864 18,700,721 6,171,238 225,073,377 8.069,844 Texas Health and Human Services Commission April 27, 2015 YEE ASHFORD AMOUNT $17,813.07 GULF POINTE TRANSFER REQUEST DATE REQUESTED: 2/14/22 APPROVED Onc FEB 14 2022 BY COUh7y AUDITOR G/L NUMBER-: LHOUN OOUN-ry, TEXAS EXPLANATION: ECHO PAYMENTS DEPOSITED INTO GULF POINTE THAT BELONG TO ASHFORD REQUESTED BY: Mayra Martinez AUTHORIZED BY: PAYEE SOLERA AMOUNT $15,990 GOLDEN CREEK TRANSFER REQUEST DATE: 2/14/22 APPROVED Oh FEB 14 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS G/L NUMBER: EXPLANATION: ECHO PAYEMNTS DEPOSITED INTO GOLDEN CREEK THAT BELONG TO SOLERA REQUESTED BY: Mayra Martinez AUTHORIZED BY: 1-T / GOLDEN CREEK TRANSFER REOUEST YEE SQtER-A Ciul} PUadc- DATE REQUESTED: 2/14/22 APPROVED ON FEB 14 2022 BY COUNTY AUDITOR CALHOUN COUNTY, 10AS, AMOUNT $5,749.32 G/L NUMBER: EXPLANATION: ECHO PAYMENTS DEPOSITED INTO GOLDEN CREEK THAT BELONG TO GULF POINTE REQUESTED BY: Mayra Martinez AUTHORIZED BY: Memorial Medical Center Nursing Home UPL Weekly Centex Transfer Prosperity Accounts 2/14/2022 Pnian. Mwum ae.....I aO1 XUNnIXIT! yllnle /in.1sIJ1u1 .innnelJn AiN(o1d;Ger4eN- 69,i65.88' 69b51.36 I30b65.48 emadmoor 73.268534/73d)6.e) ✓59.203AS V/ Crescent 21684M11 38,169.90�30.OSfi.S) 56,3335> ,i Fortilend 216/44446 261366.36Y 28.259.Is /a.,821.21 +^/ 50lala etWN0Y11100 21MM38 58j51m..58,642,34 a/123,91616 J u iii335o.,2z + 14 55,401=14 + 53,596a24 + 31,06A•5:i , 120,417.7U + xnn: onnfimnnrerann.ssaa -3 7 i: 8 4 2 n 8 I xme:: cam Pcmn,R n.. a care a 14NHVhaUvTw;,I..ANH UPL Tnn0.15umnary\1Gn\,.6n.NjNH u.uranesvmm.rr01as,12aI.. .day. Basmina 4r,-Ar1.a.Ta.V-4 P, N..Ir, bl.nae Momr 110,59kIR 331.359.12 Bank BaNn,Y 130511O.10 Vabnm Lear.].e.bnn Imse AMERIGROYPYR4A011 9,106.26,/ IAN INTERMT 14.63 .% rER INTEREST MARINTEREET a41en Balanc n—Afer A. 411,399.22 Y/a 59,315 82 55,401.14 eank0alanca 59.31581 Vaeanee leave in R.I.ce 300.00 AMERI GROUP YR 4 A0l I 3,BB1.31 MEOIEARE WAYMENTTO NAME )AN INTER957 1246 PEB INTEREST MARINTEPEST A4lun elNnle/rranafMAnl OSAOL24 56,446.90 ✓ 0,596.24 Bank Bala.. 5AA46.9a Variance le.Aaln Oal.x. Imm AMERISOURCErR4A011 2,737.33 MEDICARE REPAYMENT TO MME IAN INTEREST am ✓ In INTEREST MARINIEPFST A41un Balance/Tnnek, Amt 53,Ewa, 35,023.44 ✓ 31,068.52 Bank Babnee 35AN1.44 Vaiance Lave In B.l.nn 100.00 AM ERI000RCE YP UOl l 3.652A9 I/ 112NINTERBST 1.211�' PFBINTEREST MMIXlERFST APryn Balann/TOMer A,M 3E.063.51 124,093.62 170,417.70 BMkealmn 114,09382 Variance APPROVED 01kg Leave In lekn4e 100.Oo AMMSODUV44AOJI 3,S584G 1/ FEB 142022 MF01[AIIEPMAYMFNTTOIUMc 1ANINTEREM PyCOUNYAUQITOR 1Tb 'V PEBINTEREST i'AL7 0uIx, I'—TXA! MARIXTENF51 Arena se.c./T.W.,R" ✓// u0,41T.ro AMONY 217nnpE2AP12 U xcLOMMUNmPIall"NCfWMPMr]+6WHUHRCY 21M011 YXC CCMMMX FLHCCWMPMCN0m141191WW yen03] VXC<OMMUNmpIMC(WMPMrbNUN119(gD] LMa] W S-(CHO CWI MN(MW(gNRRIfl SAMM, IIXB [CNON<LGIMPMI]IfWHII tIWW19p111 )AW2012 0.Mu1 2/lyla} MoGm N[a1T%N[tNIMIMi PN193NICHHim 1/IOnW] MOH.NCa1T6NfMIMIMrIN13IN161N41W 2/lama Nn(YmupR9CMf[dIMPMOnnlIN1111Wi xnulY2 mle] 2ll$W] Mehn.N[e1d X[[WMPMSIMR2YYN19gim MaMI] VHCOQ MONCMIMPM]M9WN111YYL1]HIS ]/ll/lOI} YNCmMMVMm PIM(CWMIMT]IWg1t119IW W +/111W} UMC(gMMUMm PINQWMPMi Mbylt119t0.N }/I1f101] wC[MMMYNMPINCCWMIMi>IMO14119tCWl E/lll2m} nPu]xxu6uxsvcxawMPMr v.6mauupgs$ ViL2W;:lvnwOXNIPfuPa L}AYMSMPISI)Y9lliilo96. ]ng0y UHCCOMMUxm P(NCIINMIMi i6S W yyMOMXWNASSgIIMONNCCWMPMrbiYS]NMMMtlIW WPM VIAMI NYM6NyXSw NC QLVW T?s mMWA561N6 MoIN2MMPNppMnmY xC(WMrMr]1(O]]Nl H6)Y ]Anal] WWOYiCWI[CMNm1 WRECFHRFf III al.11.1 10p.xEUMNYMMIN[N((WMPMi I]L[W1411]pLl ]nmlm]Me.YIIN[ef1XN[t]AMPMipN1669iW6LQW ]MCYne N AM022[efRX[[GWPMLpMIN9)Ehl]]Nm 2nlnon lnH En1mnMIMIC eRW xxe-PmoneaANNrmrummuMlW Wyeas ]/l1n011 WCwMMYNIiLPIMfCWMPMttbwl)N)9140]q )/ll/]0x) NYMNMINb CONi(INMIMrl909ilyll]alSTabpy y91n999 uMWMNCYiq LPAVMIM¢f;f0119i`iiiL99 �/1011 UNCfOMMYNm PIN[[]NMPMrlINM11119fmm ]nnW] 44HAN((GPIPM91N9tN(]59RgpyNilH ]/LnOEa MNNe X(e1RHW/AMPMlIN166HW(19YW yylm; MN6'[CNO xC[WMPM(SLamIgsM0.W]iNsl i/y10E1 NVMµRM(m M[[W M9MrIW6NYt®Msu6 SAnW] WIRFOV]WUSANEAIMGR([FH1N9111 ]An4n M9PMNCaIMNCCWMPM}PXI66(([tl164;m IAn01] VNCLOMMUNm 1(NCpyM9MTMNgHll9lmm IAnW; g41MNCMWPM919691L01I591pS41aa911 yfq/]0 V(paM yly1W1 NNe-[LNOMCq.VMPMfMMVM131W W1t916N y112 ani 2n1M/24I1 dnl lnyl0uxcwRlMuxmvLxKWM9MrHY09H111W W 711111012 wmaYXC(OMMVxmmIXLpNMMI]]IW191191Rm IN91;M1fAk911lMCM9C�Fi4YM6PiflW1N)H I;IG4 �fi]/gy]mE Ma4w N[elRxCaMMPMi'Ixl]IOSMf0I1;W ]fenq]1 NFASMryVMeNmxttLSMVMr3lIFpN11]%OLx ]/dnW$ MM1VmNIMMINIXWMPM1166W)Nll]41E1 ]AnOli WIRrON WIIGNfMT9GRELFMIEREIN .Vama UNCmMMVXm PLMC(NIMIMI']1lNHI1 P10001 ]/Iquoz} ,kl?2 y;uloll ant }/ly]Oli UNCmMMVNRfh MCWIMPMT]IµW11191W1 x%ly5ori. AunuLM W a mlyo LIArN3;rtnAxP09)Walap xnnllt'.1»s1YMuY9e 02 ylnm9 zn/]n2 }nnat ;/y]W2 ya/9M1 2n/W1; Illnm; annmz n1Wn IVIW2 ""I ]/9/]01] lnnml yw;aa null ]ninon anv 1/nnal UNCCOMMVMNY9l HC HJIMrMYW1119. ];W]a; UNCmMMO00CI MIMTMrrIMM)611990XM ;nln9n MUMMAMA HCH'.PM JH=.I ]m1992 2AW612 NUMMIEg1.9gU5HCLMIMpMr19mfi2NmJg1692 :y1yiY;'AMEppiPNlP OOyOLMNMSMR51]alnilloiO .TA m $m Oot.lnI QPP/9nmpl gPyf&mpl qPl/bmH mw 19pPn I H.,Omog ' 3USIs l,msa) ' 9,fmLas 5,34tAf - ),x16,59 1.116,i5 u,ys.az li • 6,]5}66 6151.56 ' a.91LI R,nla1 ' 156.1t et6.n I,be 9p I,b6A9 ss.xlsdt ]/ , 4Ym gY,ox 44.I0,1 ' S9f.10 391.10 i.Rn999,ML b I0.6p Ilo.m9 l 91.119;1t. fJfLY 1YYu •f9 901W5 N.YLi6✓ llgµs.0 l FI99A1 1.Y9.15 lH>.W YfLO 6106,Ei HL159.11 i MMCIMOgN GPp/ nmM lgMas'h qM0/Cgrvpi gpyCnmpl tl01/bmp LbM GPPp ...now pON - ;459 - 9}1695 - 4wf.m - eon.M 39.566d3✓ 61.30 - - 6;,i0 - lA9f]a 3.IN.tf 5,1911$ 9.19)dE 6.9gL05 <J.63 1,361.616 A36i.6i n.ae4.n j • 1.9912 4H9A1 9,955i6 1. Sd1061 9,106E10M s,u5d. YYd31 A... ynJ. n.nu] ✓ Hamds / LNaH •u.n IASLW Is6dt soLv ./ u ]s4er MMCPpmx-N gpP/b g Tn.Men� n rypp/bmpi 0/P/0m11 qln/fnmp9 iMW CPPII xNppS 3,IEi.W 1,1aa1111q SSISO ' ]A16S0 .20 ONw ;p - - 41M"160. 11.1E131 4,11 IiLLID x(� W1.91 I2,il3.31 ' LN9,4 67j?.% ' I.. 2AMW 10.117I0✓r M 4]61.M Il.11l41 7a0.96 1Mp.Pp WaI Av9]m sm4l uxs 1.I+LM 11]v 7": !] H.a6n ✓ 5511151 "II fS1AI inml MMCMn. g P/mmM Rf!pM1l_ Tn hf(y gM/YomPl WPp/[empl p111/bmpl t4M gHtl MX Pgq]IgN • :.aLls 1.al.0 - ' 19.i6 Is" 21. 1.74 NA j ' I.MI.1q f,Nl.lp lsnao aaLlo ]1,19Y03 � . 1LHOAS npiss iri{9.9[ Yty6 1)p320. I.Hf.N 3,S9LY ]AiYY t3mos NSA9 Ip1Y]0 v MMS PO9IION NPP/b M m 11@b�'�+R 19y1Y1q NM/Lnmpi m9y(.mpl LYPPIbMpI W PT MI PORgOX ' IT5610 p .6f - USIA - lUllA IIlI.69 s,.q" - 1.SW.4Y N,NO.Ie 5,610.91 I;S.]6 uA2s.81 I;y.w 3.M u]ese 1u41su ly,u 410.56 xe.xM,n j 'M llamas 6,IW]5 10.m50 GAMIS Milan iUO.4es.ss.N 11,N 1.9Y ' Avons " M.'sY - IS.NI S a,IwM S,fl).S] 15.799M I6bA' W - Sl:: L:10.N 6)S.Itl •YJI til .aS.H9W 1 Y Y•Sp � ]Y0.t1l.N l nfi6.6) m1A%dI m910.m LM.L 45 I.In36 NAS].m ])LNI.m 2/14/2022 Quick View Select Quick View Accounts Account Number I Name Account Type v Search All DDA Account Number Currant Balance Number of Accounts: 15 $7,068,353.62 '4551 CAL CO INDIGENT $5,746.47 HEALTHCARE '4454 MEMORIAL MEDICAL I $100,878.34 NH GOLDEN CREEK HEALTHCARE :A= MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.13 2014 '4357 MEMORIAL MEDICAL $4.976.119.53 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.61 WAIVER CLEARING '4381 MEMORIAL MEDICAL $120,580AV CENTER / NH ASHFORD `4403 MEMORIAL MEDICAL CENTER/NH $59,315.81' BROADMOOR '4411 MEMORIAL MEDICAL $56,446.90✓" CENTER INH CRESCENT '4446 MEMORIAL MEDICAL $35.028.44 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL $124,093.62 ✓ CENTER /SOLERA AT WEST HOUSTON '2998 MMC -MONEY MARKET 51. 109,566.76 FUND '5506 MMC -NH BETHANY $237.140,74 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- 566,823.70 MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $41,938,85 PLAZA - PRIVATE PAY '34D7 MMC -NH TUSCANY $133.706,62 VILLAGE httpa://prosperity.olbanki ng.comlonlineMessenger Treasury Center Select Group Groups Add Grcup Data reported as of Feb 14, 202: Available Balance Collected Balance Prior Day Balanc $7,164,335.10 $7,068,353.62 $6,785,535.5 $5,746.47 $5,746.47 $5,823.E 5100,878.34 $100,878.34 $99,356,7 5536.13 S536.13 5536.1 55,017,827.23 $4.976,119.53 $4,694,417.E 5431.61 $431.61 5431.E 5126,394.42 S120,580.10 5701,451.P $79,563.98 $59,315.81 $73,855.E $63,610.51 556.446.90 $70,306.2 $35,233.43 $35.028,44 $38,659.1 5143,043.99 5724,093,62 5100,870.E $1.109.566.76 $1,109,566,76 51,109,566.7 5237,140.74 $237.140.74 5224,742.3 $68.716,02 566,823.70 $66.823.7 $41,938.85 $41,938.85 541,877.` 5133,706.62 S133,706.62 $156,915.8 1/1 Memorial Medical Center Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 2/14/2022 vram4ua AfeOun[ Btglnning PenGlnj Todey'f Baglnnmg Amoumw9e Tnndened to NueNng Nursrna llame Number Balance Trander-0ut �Tranebbin OeaddO Balance H GoldePOMk SB,35g.t8 58,38).14 ✓ 300,767.30 ✓ 10 ,678.34 28,101.47 Bank Selene 100,871I34✓ v.d.n e leave In Balance IM.M SUPEMORDEUMBEROIPP 36,373,30./ WTHHOIAOIPPPAYMENT 14.653.31' VADPAYMEATTOSOEERA 1s'saa.m✓ ECHO PAYMENT TO GULF POINTS 5J4s.a3 �/ IANIMEREST 11A41// FEBINTMEST Nov: 0n1vbownvaof.—sS,a0ae16rrmnaf rwdw roe nunFU; home. Now B: Each aa4unrhma ban babnnaf$300 1h4rMMCdr➢wihd w oam xmunr. APPROVED ON FEB 14 2022 CAALHOOUN UNT COUNTY'7F " MMINTEREST AdiuRmlanre/Tnnder Aml 28,ID16 A...d: // V / ANTHONYRImMD50N,CF0 1/14/303) InNHYwW,Tanaleas\NH UPI Tnmrn Summaq\lOR\FabmrMNH UPE Taman wmmrryoxn.:x tlax ENG10 nie4. m/m23 D.onm Nn@i f1YBRMNSfIMTBN[OSiIMi H]6MB69tl69 V 9 In/S022 HEALTH XO HUMAN MM111660961JYW)JIRAGII S/J/3035 HEALTH HUMAN SVC NCCNIMPMJ IMDWA11301 S I/t/2012 WIRE 1412022 TS"/TOUT NFgHNF3TNAT60LB2NCB66N WAM RIM, MNS6IRT.(C[VCMT4RS64331146I SN/SOt2.CNII.. MmNEunr CCD/CF COET6M]f51/S1SK0 l/9/1013 CMLLnefMn166MCCqA[li,awJ6Ni]Sui11OD' 2na3mz D.onH1 1/li/SDS] NNN-ECHO NC[IAIMPMIJ<6W36SJ liQTA' 11B11f MMCIORTION qWP/Fmg6L NH 7S ,IMI,EUL T]... N n 011,11 11 NPP/LAIR DIPP/fnm A. ylPil PORTION Z187,49 - ]p1)A9 ;9]6.OD - 1:9]6.M ]13.fl - 211i1 Z%2.11 - aW2.11 .1.62 M5,12 5R26J.F - J99 ]f ]9f.)f • pZ]O.M l;A9.J6 ].C94Y IgSTBID 1,941,F 16:gf]a1 6.607.33 51A6LI9 l[a,]aYdO ]ylW.76 ),694A6 36AN.t0�96�0 2/1412022 Quick View Select Quick View Accounts Account Number/Name Account Type Account Number Current Balance Number of Accounts: 15 $7,068,363.62 '4551 CAL CO INDIGENT $5.745.47 HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK 5100,878.34 V' HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.13 2014 '4357 MEMORIAL MEDICAL S4,976,119.53 CENTER• OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $g31.61 WAIVER CLEARING '4381 MEMORIAL MEDICAL $120.580.10 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER7NH 559,315.81 BROADMOOR '4411 MEMORIAL MEDICAL $56.446.90 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S35.028.44 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $124,093.82 WEST HOUSTON '2998 MMC -MONEY MARKET $1,109,566.76 FUND '5506 MMC-NH BETHANY 8237,140.74 SENIOR LIVING 'S441 MMC •NH GULF POINTE PLAZA- $66,823,70 MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE $41,938.85 PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $133.706.62 VILLAGE hltps:llprosperity.olbanking,comlonlineMessenger Treasury Center Select Group Groups Add Group Available Balance Collected Balance $7,164,335.10 $7,068,353.62 $5,746.47 $5,746,47 S100.878.34 S100,878.34 S536.13 $5.017,827.23 S431.61 S126,394.42 $79.563.98 $63,610.51 S35.233.43 S143,043.99 $1,109,566.76 9237,140,74 S68,716.02 $41.936.85 S133,706.62 $536.13 S4,976,119.53 S431.61 S120,580.10 $59,315.81 $56,446.90 $35,028.44 $124.093.62 $1.109,566.76 S237,140.74 $66,823.70 $41.938.85 S133.706.62 as of Feb 14, 202: Prior Day Balanc 86,785,535.E S5,823.E $99.356.7 $536.1 54,694,417.E S431.E S101,451.` $73,855.5 S70,306.2 $38,559.1 5100,870.E S 1,109,566.7 S224,742.3 S66,823.7 $41,877,E 5156,915.E 1/1 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 2/24/2022 IFIaV, Amounted,! .Yeoum 4llnryni vlxdln! Tnm)eendw Numker ,N a e+neler-0V1 TemdeMn [ketleend elb Tnde nnln 93A w Atrin ., 1.561.P0 !0,))13) 41,93i,5 AOIRANIF sank lIn'. nu q,9316' W&nee Loveln pebnw IWW UXI,FXpFl,O F410 vP)MFIIRINOCNFCN WILL,f WRIREN )IIRYHIl YMOUNT]FTl 117.11 SUP)RIORKC01PP Id,,llM ✓ ECHOWNO TO APP]M) ed14.63+ PAYMENTS i0A9XF00.p 1]Al]A)A/ JAN INTPPF9) AM Ffa INTERFSF "INTERIM Adlmt xNnlAtI.W rANA IsiPs)1,� rwvrom Ain d,ne td Re Nnnunl NtlnM,t ImdiTnnelenMw NunL,lMmme "'-' Ghm! .TnndervOut /fnneler-In tliitlnnd on 1. I4 iede aCe Inn 44me Xuttl Xane 6YNPdIRIR IItiY•MbICn/Mklk,d e),112.n 83.1p6.35 �/ leallAp t6.)1T.13 ✓ Blnk3ahnw Catl).m/ VIAMNA Nww G.Iv v11n. dv-ld. v1A IS.W.O mN kn Inn]pned n ]Ne ndnm9 Nnnw Nv]e3:fvMWnadwedvMnofSlEdflvtMMCd[pvlrtldrovpm vnvun(. APPROVED 0Iq FEB 14 ?.022 SY COUNTY AUDITOR CAU-,CtIN C;(,L)NTv, TE-XAs .-0 MINA. MN INITAW CAl,% iEa1HRRFSr MMN1T[RpT /. AdIdN&Mw(rrmelerAme 6a)1)31 A, TWALTRAN)FER) W ..a P nred: Pr3T10XYPl sOry,tlO 3)N13,11 cwxwFSlr rmmmNNArs N.m]msvmm.M],nueen.ntxx wsu..m s.mm.nozsaial,. L W3Pn3mi kk6 Pdo w Piir. W12022 HMO- ECHO HcMIMPMr7460034114400W2794l] 2/M3022 HMO -ECHO NCCWMPMf ]46W341144 W W116151 2/0/1021 HMO -ECHO HCCWMPMT1460O341I N0000226251 2/9/1022 NDCSWEEPPRCH261 21000020233325 SWEEP PR 2012022 Cen14n4 MgMW. CCO/COI 00E165453514'111000 7/912OU HOMANACNADISBHCCLAIMPMT624932420000167 VW2O22 bnt4n6M.AssaM000/CTR00126S33351611/000 V1012022 HNB-MRONCCUIMPW14SW3411440000296659 2/11/2022 HMO -ECHO HCCWMPMT746W3411440000228245 GurcpnMb PliIYM!'AUtpIM411ei1d 2/1/2912 HNO-ECHONCC4IMPMT]46N3411 "1100D239411 2/i/0022 HEALTH HUMAN SVC HCCLAMPM] 374600341130132 I(8/N122 HNO-ECNOHCCUIMPMT]46CM141I44WW226251 2/9/2022 SVIRE OOrNMG SEANCES, LLC 2/9(20I3 MERCHANTUNRCDDEPOSIT496426S169999300W1 2/9/2022 HAS- ECHOHCCLAIMPMT 24600341144000020188 2/10/2022 Deposit MMCPORTION I aPp/COmpIL NH Tra.dwt ut m0ie". CUPPICOMPI aPP/COmp2 aPP/CPmp3 Upl6 aPP 11 PORTION - 225.21 - 215 1 - 308.14 %B l4 - 419.09 419,09 - 10,66A.90 12,663.90 • 32,05>.lE 14A7/A}. 3,41115.21 lot," 3,742,64 11%46—.... UPA6 - 1,410.62 8.410.62 ' -.36I1-0 - 351,10 61.33 - 61.33 40.322.23 V 16.2>i.34 3A65.T8 16014 41 /24361 29 MMCPORTION OIPP/Cnmp46 NH Tr9niler-Out T@Mferin ayP(CPmo1 ayP/Cpmo2 aPP/canp3 up..OIPPTI PORTION 4,54S.21 - 4.545.21 • 147.66 143.68 - 1.03 1.03 - 2,604.10 2,604.m - 56,33130 56,630.30 43,10635 I6,21T.n 16717.29 $3.106.35 102094.55 2A.223A4 3AR6.211 160A.4p 91.080.07 2/14/2022 Quick View Select Quick View Accounts Account Number 1 Name Account Type Treasury Center Select Group Groups Add Grcup Account Number Current Balance Available Balance Collected Balance Prior Day Selene Number of Accounts: 15 $7,068,353.62 $7,164,335.10 $7,068,353.62 $6,785,535.5 '4551 CAL CO INDIGENT $5,746.47 $5,746.47 $5,746.47 $5,623.E HEALTHCARE `4454 MEMORIAL / NH GOLDENN CREEK $100,878.34 5100.878.34 5100,878,34 $99,356.7 HEALTHCARE •4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES 5536.13 5536.13 $536.13 5536.1 2014 '4357 MEMORIAL MEDICAL CENTER - OPERATING $4,976.119.53 $5.017.827.23 $4,976.119.53 $4,694,417.E '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.61 5431.61 5431.61 S431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER INH ASHFORD $120,580.10 $126.394.42 $120.580.10 $101,451.2 '4403 MEMORIAL MEDICAL CENTER / NH $59,315.81 $79,563.98 $59.315.81 c 573,855.- BROADMOOR '4411 MEMORIAL MEDICAL CENTER INH CRESCENT $66,446.90 $63,010.51 $56.446,90 $70,306.2 '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND 535,028.44 $35,233.43 $35,028.44 $38,559.1 '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $124 093 62 5143,043.99 5124.093.62 5100,870,E WEST HOUSTON '2998 MMC-MONEYMARKET FUND 51,109,566.76 $1,109,566.76 $1,109.566.76 $1.109.566.7 'S506 MMC-NH BETHANY SENIOR LIVING 5237.140.74 5237,140.74 5237,140.74 S224,742.P '5441 MMC -NH GULF POINTE PLAZA- $66,823.70 $68,716.02 $66,823.70 $66,823.7 MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE PLAZA -PRIVATE PAY $41,93B.85 ✓ 541.938.85 $41,938.85 $41,877,E '3407 MMC-NH TUSCANY VILLAGE $133.706.62 $133.706.62 S133,706.62 5156.915.E htlpsalprosperily.oibanking.comlonlineMessenger 111 Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 2/14/2022 rre9mm ae<aum agmnms Hunln<Nmm< "'—w LI<nee TY WIIyVNYN-:. 6f.595.55 Nwe:.1, bolonva of are[ $;KO wd16u[anfjtllq ro IM1e nw4ng M1hme. Naf<1: fvN o[<ountM1vohmeholnn[eof$IG]eM1VI MMCd<pan(Nta apVlat[aLn[. APPROVED ON FEB 14 2022 BY COUNTY AUDITOR CA.LHOUN COUP"V, TEXAS vena�M 1<v<N11 .-.11<aY hmtl<md le Rank6alan[< Vadina Yrv<In RJanN R ITUGRWI YR4MJI "MI6: n Ste, 1MAIa,Y 16 NE3 IVA PII.NRNY I[1 $GNP G TuseinertAllan 2/7/2022 Deposit 2/7/2022 HN8-ECHO HCCIAIMPMT746W3411440000279897 2/7/2022 HNS-ECHO HCCIAIMPMT 7460034114a0000280141 218/21222 NOVITAS SOLUTION HCCLAIMPMT 676202420000160 2/9/2022 WIRE OUT UNRAR ENTERPRISES, LIE 2/10/2022 04pom 2/11/2022 ckl091 2/31/21122 KS PIAN ADMINIST HCCIAIMPMT 179111000029538 2/11/2022 AMERIGROUP CORPOE-PAVMENT EE52309319111000 MMC PORTION pIPP/Cump9 Tran5fer-0ut Traniferdn pIPP/C4mp1 plpP/COmp2 0IPP/COmp3 &lapse 11 NH PORTION - 26,597.47 - 26,597.47 - 2,151,32 - 2,151.32 - 1,818.09 - 1,828.09 - 10,205.6e 10,205.64 33,933.40 - - - 86,481.16 - 86.481.16 29.562.15 - 755.70 - / 755.70 5597.24 3 454.64 496.83. 561.79 1,083.98 4,525.94 1,071.30 63,995.55 ./ 133,606.62 ,/3,454.64 496.83 86179 1,083,98 4.525.94 129,080.68 2/1412022 Quick View Select Quick View Accounts Account Number I Name Account Type Search All DDA Account Number Current Balance Number of Accounts: 15 $7,068,353.62 '4551 CAL CO INDIGENT 55.746,47 HEALTHCARE *4454 MEMORIAL MEDICAL / NH GOLDEN CREEK 5100.878.34 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.13 2014 '4357 MEMORIAL MEDICAL $4.976,119.53 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.61 WAIVER CLEARING '4381 MEMORIAL MEDICAL $120.580.10 CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $59.315.81 BROADMOOR '4411 MEMORIAL MEDICAL 556.446.90 CENTER INH CRESCENT '4446 MEMORIAL MEDICAL $35.028.44 CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $124.093.82 WEST HOUSTON '2998 MMC-MONEY MARKET 51,109,566.76 FUND 'S506 MMC -NH BETHANY $237.140.74 SENIOR LIVING 41 MMC -NH GULF POINTE PLAZA- $66,823.70 MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE $41.938.85 PLAZA - PRIVATE PAY '3407 / MMC-NH TUSCANY $133,706,62 VILLAGE https:/Iprosperity.oibanking.com/oniineMessenger Treasury Center Select Group Groups Add Group Data reported as of Feb 14 202: Available Balance Collected Balance Prior Day Balanc $7,164,335.10 $7,068.363.62 $6,785,535.: 55,746.47 $5,746.47 55,823 c $100,878.34 5100,878,34 $99.356.7 $536.13 8536.13 $536A $5,017,827.23 54,976,119.53 54,694,417.E 5431.61 $431.61 5431.E $126,394,42 5120.580.10 5101,451.E $79,563.98 $59,315.81 $73,855.5 S63.610.51 $56,446.90 $70,306.2 $35,233.43 $35,028.44 $38,559.1 $143,043.90 $124,093.62 S100,870.E 51,109,566.76 $1,109,566.76 $1,109,566.7 $237,140.74 8237,140.74 $224,742.: $68,716.02 $66,823.70 $66,823.7 541.938.85 $41,938.85 $41,877.E 5133,706.62. 5133,706.62 3156,915.E r ili Memorial Medical [enter Nursing Home UPL Weekly HSLTransfer Prosperity Accounts 2/14/2022 M1eNwa v.MW A..M as 9e Aemunl aeiinnb9 _ _ _ Medken i entlened ae Smk eal9nn 339,Re.9e vlan[< Ieaveln Bahn[e IeaW 3AH INIFe35T 35.69 ✓ 3]a iUMT MM a 9T / Adluiese..e "ff. 11 ]T.OIS xS y Non:Mlrbaramne ofwer$S,IXO ealke Vom(ened b Me nun,hd *. 4 nved: Nole 3: lorhmcounrNmo Maebolonna/$IP]MotMM[de$nfiled MepM otMwt, 6NTHQNYN Nr S/19/SV33 APPROvrD obF FEB 14 2022 6Y COUN—j YRUf)ITOEI CALHr: Irl,f:C�OUKtrc, rE,.W 3Wx wwaNnmdapxx w.*nmkrsemmen\mn6ee�wrvWHuvsumalnwmm+rvd9a9.]].n,. @tlhamSeBlsiHLlvlHi 2/7/2022 Deposit 2/7/2022 Deposit 2/7/2022 HEALTH HUMAN SVC HCCLAIMPMT 174WO341130162 2/B/2022 Deposit 1/9/2022 WIRE OUT BETHANY SENIOR LIVING, LTD 2/9/2022 Deposit 2/9/2022 HEALTH HUMAN SVC HCCLAIMPMT 174NO341130162 2/10/2012 Deposit 2/10/2022 DANISH 2/10/2022 HEALTH HUMAN SVC HCCLAIMPMT 17460094113016 2 2/21/2021 Deposit 2/11/2022 Deposit 2/11/2022 HOSPICE OF SOUTH Payments NF 1131226MOISS38 1/11/2022 HEALTH HUMAN SVC HCCLAIMPMT 1746WS41130162 MMCPORTION gIPP/Comps TronsPer•Out Tronsfenln OIPP/Comp! gIPP/Comp; QIPP/ComD3 &Lapse gIPPTI NH PORTION 14.552.50 - 14.552.50 33,909.29 - 93,904.20 9,125.76 S,27S.76 492.00 - 492.00 270,380.33 - - - • 61060,00 - 61040.00 - %42483 - 3.422.88 - 147.353.40 - 147,353.40 - 97.50 - 97.50 - L2.754.30 - 12,754.50 - 6,531.72 8,531.1E - 3,070.91 - 31070.02 - 8E4.09 - 874.09 i L921.81 / 1.91L61 229580.33 z3T,D1s.Os ✓ 23)A35.03 2/14/2022 Quick View Select OUlck View Accounts Account Number / Name Account Type - Search All DDA Account Number Current Balance Number of Accounts: 15 $7,068,353.62 '4551 CAL CO INDIGENT 55,746.47 HEALTHCARE •4454 MEMORIAL MEDICAL NH GOLDEN CREEK $10087634 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.13 2014 '4357 MEMORIAL MEDICAL $4.976.119.53 CENTER - OPERATING -4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.61 WAIVER CLEARING '4381 MEMORIAL MEDICAL $120.580.10 CENTER/NH ASHFORD •4403 MEMORIAL MEDICAL CENTER/NH 559,315.81 BROADMOOR '4411 MEMORIAL MEDICAL - $56.446.90 CENTER) NH CRESCENT '4446 MEMORIAL MEDICAL $35.028.44 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $124,093.62 WEST HOUSTON '2998 MMC-MONEY MARKET $1,109.566.76 FUND 'S506 MMC-NH BETHANY $237.140.74 SENIOR LIVING `5441 MMC -NH GULF POINTE PLAZA- $66,823.70 MEDICAREIMEDICAID 'S433 MMC -NH GULF POINTE $41,938.85 PLAZA -PRIVATE PAY '3407 MMC-NH TUSCANY $133.706.62 VILLAGE https:liprosperity,olbanking.com/onlinaMessenger Treasury Center Select Group Groups Adn Group Data reported as of Feb 14, 202: Available Balance Collected Balance Prior Day Balanc $7,164,335.10 $7,068,353.62 $6,7851535: $5,746.47 $5,746.47 $5,823 c 5100,878.34 $100,878.34 $99.356.7 5536.13 5536.13 $536.1 55,017,827.23 54,976,119.53 S4,694,417,E $431.61 5431.61 $431.6 5126,394.42 5120,580.10 $101,451.' $79.563.98 $69,315.81 573,855.E 563,610.51 $56,446.90 $70,306.2 $35,233.43 $35.028.44 $38,559.1 $143,043.99 $124,093.62 5100,870,E 51,109,566.76 $1.109,566-76 51,109,566.7 $237.140.74 $237,140.74 $224,742.2 $68.716.02 $66,823.70 $65,823.7 S41,938.85 541,938.85 $41,877.E $133.706,62 5133,706.62 5156,915.E V7 A ... r-, LUi A L C!" NVI MEMORIAL MEDICAL CENTER DFAC. 2/14/22 FOR ACC!, USE ONLY APPROVED ON jhnprect ca% ------------ ❑A� P t'heljk FEB 14 2022 to Vendor ... ..... Return Check Lo Depi: ........ . 3yCoUNjy.AUbjTOR CALHGON COUNTY, TEXAS 10255040 AMERIGROUP YR 4 ADJ 1 QIPP ....... . .. Mayra Martinez ---- --------- IMIEDICAL ("FINTF, P r tj 1 MEMORIAL MEDICAL CENTER -),ni=.Kequnsl(:d: 2/14/22 ........ ... . . A PORACCT. USE O,.,'[,Y APPnOVEDON11 17A/P Che& [I MIJI Ch,--eck to Vendor FCB 14 2022 Pr�cuja. chtclk Lo Pepi BY COUN7 Y AUDITOR CALNGL"N CCUNTV TEXAS 10255040 ....... . .. 1 X D AMERIGROUP YR 4 ADJ I QIPP - - - ------------------- Mayra Martinez DIP' AV - Ur ij,'S-i MEMORIAL MEDICAL CENTER Dar 2/14/22 FOR."kCrT. USE ON t.Y APPROVED ONR I lilrylp. est C-ash FEB 14 2R2 PAiP 1 11 Mail Check to Vendor CoUt,'TY AUDITOR, Recul"i" Ch(-.d; is Depl, GAS pcm, 1 6cuffy- . - --- 10255040 0'r 1: AMERIGROUP YR 4 ADJ I Qjpp Mayra Martinez L"Y1 ---------- - ------ MEMORIAL MEDICAL CENTER 2/14/22 PACCT. USE ()�Jty APPROVED (A lIn. j r h s t C. a s 0— A/P Chec% FEB 14 2022 j M!Il Check to Vendor BYCOUNWAUDITOR RLtm vi Ch(4i:jc to J)epj, c ALNOUN COLIK-i), TOMS AMOUNT $3 .69 G-A NUfAF!FQ,- 10255040 — --------- ---- — -------- ,r.xP! ANA, ;ON: AMERIGROUP YR 4 ADJ 1 QIPP 1. Mayra Martinez 17F7 uyl P A ---- - ------- m 'EY11C) RX I A 1" ! df F D CA 1- C Fr: NF!' - E R RF" IJEST % MEMO R IA L M ED ]CAL CENTER Date4 2/14/22 FOR ACCT. USE ON'Pt APPROVED ON El lrlprest ca,sll -----FFB 14 2022 L❑17 1-lMail Chink iQ'Ve1-ldi)r By COUNTY AUDITOR c I a Dept CALHOLIN COUN-rr, TEXAS, I riewtul i ,"mMOUNIT --$_3L5511.46 10255040 Pk. NAI'ktl N; AMERIGROUP YR 4 ADJ 1 QIPP 1 J ; M ayr a Martinez t; C L --------- — ----- ......... MEMORIAL MEDICAL CENTER O.Ac. Requested: 2/14/22 r0RACC7. LfSE (im.Y m APPROVED ON FEB 14 2022 ----.13YCOW,--t(YAUDITOR CAU11GLIN COUNTY.. TFaAs A.M.-OLIN'T _.$361271?0 10255040 FAptA'W,',,"!0N.: SUPERIOR DEC QIPP Marra Martinez FHC wnprLst casi,. 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