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2022-03-02 Final PacketAll Agenda Items Properly Numbered Contracts Completed and Signed *1'0, $t11 / ,L All 1295's Flagged for Acceptance (number of 1295's Z ) 41-1 All Documents for Clerk Signature Flagged On this 4 day of 2022 a complete and accurate packet for n,A of f-k 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 NOTICE OF MEETING — 3/2/2022 Richard H. Meyer County judge David Hail, Commissioner, Precinct 1 (ABSENT)Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Kaddie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners'Court of Calhoun County, Texas will meet on Wednesday, March 2, 2022 at 10:00 a.m. in the Commnissioners' Courtrooms in the County Courthouse at 211 S. Ann Street, Smite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Joel Behrens 4. General Discussion of Public Matters and Public Participation. N/A 5. Hear a report from MMC. Roshanda Thomas gave the report. Page 1 of 5 NOTICE OF MEETING — 3/2/2022 6. Consider and take necessary action to approve a grant management proposal between Kathy Smart and Calhoun County to manage CMP grant paperwork for the Magnolia Beach and Indianola Pavilions and authorize all appropriate signatures. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Mever, Commissioner Hall, Behrens, Reese Consider and take necessary action to approve utilizing the Calhoun County Recycling Center for a cooperative program with the Texas General Land Office and Calhoun County partnership for the TXGLO VTIP (Vessel Turn In Program). (DH) GLO spoke in regard to the VTIP. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese S. Consider and take necessary action to approve the Preliminary Plat of the Replat of Lots 4 & 5 in Block 5 of the Tilke and Crocker First Addition to Magnolia Beach. (DH) Henry Danysh spoke on the prelim plat. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 9. Consider and take necessary action to remove a 2014 Ford Explorer, VIN 1FM5K8AR3EGB90852 from the Sheriffs Office fleet due to being totaled in an accident. CoPart has been assigned to pick up the vehicle/title after all equipment has been removed. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 10. Consider and take necessary action to approve a lease agreement with Quadient Leasing for a iX-3 postage meter and authorize the County Clerk to sign the agreement. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 2 of 5 NOTICE OF MEETING — 3/2/2022 11. Consider and take necessary action to approve a contract with Certified Payments, new credit card processing provider for the County Clerk's Office and authorize the County Judge to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 12. Consider and take necessary action to approve Addendum Number 1 to the Invitation to Bid and Specifications for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05. (RHM) Everett explained Addendum No. 1 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 13. Consider and take necessary action to continue participation in TAC HEBP ARTS Program and authorize the County Judge to sign the agreement. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 14. Consider and take necessary action to approve a Blanket Access Easement Agreement between Calhoun County and the Calhoun County Independent School District as described in the attached document and authorize the County Judge to sign all relevant documents. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 15. Consider and take necessary action on the Special Road Use Indemnity Agreement and Permit from Tres Bahias Solar Power, LLC., and authorize the County Judge and Commissioner Behrens to sign all relevant documents. (JB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 3 of 5 NOTICE OF MEETING — 3/2/2022 16. Consider and take necessary action regarding the expiration of the MMC Underground Storage Tank Policy on March 13, 2021 which is no longer renewable. (RHM) Roshanda Thomas explained the situation. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 17. Consider and take necessary action to extend the Interlocal Agreement with the following agency and authorize the County Judge to sign the contract and purchase order. (RHM) Calhoun County Soil and Water Conservation District No. 345 $ 7,750.00 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 18. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $7,969.71 for damages incurred during the Winter Storm the week of February 15, 2021. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 19. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $2,095.70 for damages from a windstorm to the Port O'Connor Community Center Pavilion roll up doors on January 31, 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 20. Accept Monthly Reports from the following County Offices: i. District Clerk — January 2022 ii. Justice of the Peace, Precinct 3 — January 2022 iii. Justice of the Peace, Precinct 4 — January 2022 iv. Tax Assessor -Collector — January 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 4 of 5 NOTICE OF MEETING —3/2/2022 21. Consider and take necessary action on any necessary budget adjustments. (RHM) 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2022: RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 22. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2021 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2022 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Adjourned: 10:38 a.m. Page 5 of 5 Richard IH . Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Cary Reese, Commissioner, Precinct 4 NOTICE OF MEETING ING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, March 2, 2022 at 10:00 a.m. in the Commissioners' Courtroom In the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA P �'��j FILED The subject matter of such meeting is as follows: AT 'CLOCK iy M 'Call meeting to order. FEB 2 5 2022 COlJNBP ANNNAGM Go UNry, Invocation. ar: Pledges of Allegiance. General Discussion of Public Matters and Public Participation. `'Sear a report from MMC. 5, Consider and take necessary action to approve a grant management proposal between Kathy Smart and Calhoun County to manage CMP grant paperwork for the Magnolia /Beach and Indianola Pavilions and authorize all appropriate signatures. (DH) 7. Consider and take necessary action to approve utilizing the Calhoun County Recycling Center for a cooperative program with the Texas General Land Office and Calhoun County partnership for the TXGLO VTIP (Vessel Turn In Program). (DH) / ffi, Consider and take necessary action to approve the Preliminary Plat of the Replat of Lots 4 & 5 in Block 5 of the Tilke and Eimer First Addition to Magnolia Beach. (DH) 19/. Consider and take necessary action to remove a 2014 Ford Explorer, VIN 1FM5K8AR3EGB90852 from the Sheriff's Office fleet due to being totaled in an accident. CoPart has been assigned to pick up the vehicle/title after all equipment has been removed. (RHM) Page 1 of 3 I0. Consider and take necessary action to approve a lease agreement with Quadient Leasing for a V-3 postage meter and authorize the County Clerk to sign the agreement. (RHM) 71. Consider and take necessary action to approve a contract with Certified Payments, a new credit card processing provider for the County Clerk's Office and authorize the County Judge to sign. (RHM) 12. Consider and take necessary action to approve Addendum Number 1 to the Invitation to Bid and Specifications for the Calhoun County Courthouse Annex Rooftop Air Conditioner /Replacement, Bid Number 2022.05. (RHM) � Consider and take necessary action to continue participation in TAC HEBP ARTS Program and authorize the County Judge to sign the agreement. (RHM) �<Consider and take necessary action to approve a Blanket Access Easement Agreement between Calhoun County and the Calhoun County Independent School District as described in the attached document and authorize the County Judge to sign all relevant documents. (RHM) 615. Consider and take necessary action on the Special Road Use Indemnity Agreement and Permit from Tres Bahias Solar Power, LLC., and authorize the County Judge and Commissioner Behrens to sign all relevant documents. (JB) rAovmd Consider and take necessary action regarding the expiration of the MMC Underground / Storage Tank Policy on March 13, 2021 which is no longer renewable. (RHM) `17. Consider and take necessary action to extend the Interlocal Agreement with the following agency and authorize the County Judge to sign the contract and purchase order. (RHM) Calhoun County Soil and Water Conservation District No. 345 $ 7,750.00 I8. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $7,969.71 for damages incurred during the Winter Storm the week of February 15, 2021. (RHM) 39. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $2,095.70 for damages from a windstorm to the Port O'Connor /Community Center Pavilion roll up doors on January 31, 2022. (RHM) 20. Accept Monthly Reports from the following County Offices: `ice District Clerk — January 2022 ii Justice of the Peace, Precinct 3 — January 2022 i(. Justice of the Peace, Precinct 4 — January 2022 Tax Assessor -Collector — January 2022 Page 2 of 3 Oik n II',i; ,/-/-U) :; `i'cjnsider and take necessary action on any necessary budget adjustments. (RHM) 22. Approval of bills and payroll. (RHM) L,17Z�— Richard H. Meyer, County dg Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda' for any official court postings. Page 3 of 3 #5 NOTICE OF MEETING — 3/2/2022 5. Hear a report from MMC. Roshanda Thomas gave the report. Page 2 of 19 #6 NOTICE OF MEETING — 3/2/2022 6. Consider and take necessary action to approve a grant management proposal between Kathy Smart and Calhoun County to manage CMP grant paperwork for the Magnolia Beach and Indianola Pavilions and authorize all appropriate signatures. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judqe Mever, Commissioner Hall, Behrens, Reese Page 3 of 19 David E. Hall Calhoun County Commissioner, Precinct 91 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for March 2nd, 2022. • Consider and take necessary action on approval of grant management proposal between Kathy nSmart and Calhoun County to manage CMP grant paperwork for Magnolia Beach and Indianola Pavilions and authorize all appropriate signatures. Sincer , Da E. Hall DEH/apt SMARTT GRANTS 3801 Menchaca Road, Apt. 7 Austin, TX 78704 (512) 800-4740 February 11, 2022 David Hall, County Commissioner Precinct #1 305 Henry Barber Way Port Lavaca, TX. 77979 Re: Project Management Services for Magnolia & Indianola Beach Pavilions Commissioner Hall, I offer my project management services to oversee and manage the CMP Cycle 25 grant for Magnolia & Indianola Beach Pavilions. My services will include, but not be limited to: 1. Act as the liaison between the General Land Office (GLO) and the County. 2. Provide guidance to the County on any problems/concerns that might arise concerning the project. 3. Ensure that all Special Award Conditions are met. 4. Work with appropriate vendors to obtain necessary project services, including review of proposals. 5. Ensure that all contracted services are completed on time and on budget. 6. Work with the County Auditor on financial documentation. 7. Prepare and submit all required reports to the GLO, including monthly progress reports, monthly financial reports, and the final report. 8. Review all vendor documents, including reports, deliverables, and invoices. 9. Visit the site during construction. 10. Assist in the preparation of any revisions to the County-GLO contract, including contract amendments and changes to the Work Plan. 11. Work with the Calhoun County Museum and Texas Parks & Wildlife Department to design educational stand-alone signage/kiosks. 12. Submit conceptual designs and draft layout text of signage to the GLO prior to installation. 13. Ensure that correct funding acknowledgement is stated on temporary signage. 14. Stay in constant contact with the County. 15. Provide other requested services as needed. I will provide these services at $500 per calendar quarter until all project work is completed. I will invoice for my services at the end of each calendar quarter. Thank you for this consideration. Kathy Smartt NOTICE OF MEETING — 3/2/2022 7. Consider and take necessary action to approve utilizing the Calhoun County Recycling Center for a cooperative program with the Texas General Land Office and Calhoun County partnership for the TXGLO VTIP (Vessel Turn In Program). (DH) GILD spoke in regard to the VTIP. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 4of19 David E. Hall Calhoun County Commissioner, Precinct 91 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for March 2nd, 2022. • Consider and take necessary action on approval utlizing the Calhoun County Recycling Center for a cooperative program with the Texas General Land Office and Calhoun County partnership for the TXGLO VTIP (Vessel Turn In Program). Since' , Da E. Hall DEH/apt TEXAS GENERAL LAND OFFICE GEORGE P. BUSH, COMMISSIONER Texas General Land Office Oil Spill Prevention and Response Vessel Turn In Program The General Land Office Oil Spill program leads the successful Vessel Turn -In Program (VTIP). Establishing partnerships with coastal counties, cities, state agencies including Texas Parks and Wildlife and other public/private entities, VTIP creates opportunities for boat owners to voluntarily relinquish derelict vessels at no cost to the owner. Owners must provide transportation for their vessels. The program is a proactive approach to preventing unwanted vessels and boats from entering coastal waters where they create water pollution and unsightly safety hazards for humans and wildlife. Since VTIP's inception in March of 2015, the TGLO has coordinated 23 events (currently one is ongoing in Orange County) in Galveston, Calhoun, Aransas, Brazoria and Matagorda Counties as well as the Cities of Corpus Christi, Port Isabel and Galveston; To date: ➢ VTIP partnerships have resulted in relinquishment and salvage of 1,045 boats and 86 trailers; ➢ VTIP events have facilitated the disposal of 1,676 gallons of fuel, including five 55- gallon drums of hydrocarbon waste. ➢ VTIP events represent the removal of 17,373.20 linear vessel feet and a projected cost savings of $8.6 million* for state and local governments. The Oil Spill program's goal is to conduct an annual VTIP event in each of the program's 18 jurisdictional coastal counties. Upcoming VTIPs are scheduled for Corpus Christi and Harris County. *Cost savings based on an average contractor removal price of $500 per linear foot. Removal costs vary from vessel type, size, condition and location. 31112022 1700 North Congress Avenue, Austin, Texas 78701-1495 P.O. Box 12873, Austin, Texas 78711-2873 512-463-5001 glo.texas.gov Orange County is partnering with the Texas General land Office (GLO) and Texas Parks & Wildlife Department (TPWD) to offer Orange County residents a FREE opportunity to remove inoperable and derelict vessels through the Vessel Turn -In Program'(VTIP) Designed to provide owners with a voluntary method of disposal, TPWD will verify ownership and ensure each vessel (boat) qualifies for disposal. The GLO will remove all oil, fuel, batteries and pollutants. Orange County will dispose of the vessels. You are encouraged to participate if you own a vessel under 26 feet long in need of disposal or know a neighbor who may need assistance. Boats must be clear of waste and debris. All boats must be brought to the drop off location. March 1, 3, 5, 8,10,and 12, 2022 7:00 AM — 6:00 PM Orange Drop-off Location: Orange County Collection Station 11265 FM 1442 Orange, TX 77630 REMEMBER - THIS IS A SIX -.DAY EVENT.. March1, 3, 5, 8,10, and 12, 2022 0 NOTICE OF MEETING — 3/2/2022 8. Consider and take necessary action to approve the Preliminary Plat of the Replat of Lots 4 & 5 in Block 5 of the Tilke and Crocker First Addition to Magnolia Beach. (DH) Henry Danysh spoke on the prelim plat. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 5 of 19 Mae Belle Cassel From: David.Hall@calhouncotx.org (David Hall) <David.Hall@calhouncotx.org> Sent: Tuesday, February 15, 2022 3:36 PM To: hdanysh@gwengineers.com; Mae Belle Cassel Subject: Re: Replat of Lot 4 and Lot 5 in Block 5 Tilke and Crocker Subdivision Attachments: 10288-001 PRELIMINARY SUBDIVISION PLAT.pdf The next court date will be on March 2nd. I'll send to the judges office to be placed on the agenda for that court Sent from David's Whone On Feb 15, 2022, at 3:25 PM, hdanysh@gwengineers.com wrote: 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. Commissioner Hall, Please place the following item on the agenda for February 23, 2022: 1) Consider and take necessary action to Approve the Preliminary Plat of the Replat of Lots 4 & 5 in Block 5 of the Tilke and Crocker First Addition to Magnolia Beach Thank you HENRY A. DANYSH Registered Professional Land Surveyor State of Texas No. 5088 G & W ENGINEERS, INC 205 W. Liveoak Street Port Lavaca, Texas 77979 Office: 361-552-4509 Cell: 361-920-4524 Calhoun County Texas LOT 10 LOT 9 LOT 8 LOT 7 LOT 6 [10' ALLEY] yy / v 4 p 92.6 N5J9---- - - P V s O , j,•?tye sz 1-3 a k. ! CD !€s o o t c O p2 a - I � U J , VV I I 11 C$ b s�y --------------------�� zLTJO r 9E ,LB' 3.9Z.5S.LS6 N ICI y ----3nN3AV-- --— W NVNllO-------lj-----� �\ n pd„ d R 6 � RF ;@ X R p f€E§� €R Imo+ U1 tl eG _ 5 s I F 1U-0 @ £ a 5 3I a 9 ill P � gill m Al. qv 0 �t� EP{RRR O FA C�i �y ygyg d $z 7. Cx5y"r1 O �£ A �'I �a� egggg$ 6 v@ eN G O C�7 xi e F E€ P pPit a a p acn �� • 3� Y^4q � lJ R� �• � F@�� .spy $9• �4 g�3 � p$ Nq® A 77 p n yy S 5 s 9 6 8q�• oio �m8 � q �8�"� �� 3 gg F R a� flu •�� y�49 %� @ �o @ 6 y a o`'a'di asp o c 9 � a —e— '•' G & W ENGINEERS, INC. T ° m o • ENGINEERING • SURVEYING • PLANNING • m v ��'no ~ o O o p 205 W. UW OAK STREET, PORT LAVACA, TEXAS A9J9 v m O O O :. O ;, ' • iBPLS ARM NO.: 1002z100 PRELIMINARY PLAT (asU ssz-Asoe: PORT LARM N IOD2 m-noo: am ciT, #9 NOTICE OF MEETING — 3/2/2022 9. Consider and take necessary action to remove a 2014 Ford Explorer, VIN IFM5K8AR3EGB90852 from the Sheriffs Office fleet due to being totaled in an accident. CoPart has been assigned to pick up the vehicle/title after all equipment has been removed. (RHM) RESULT: APPROVED [UNANIMOUS] ---] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 6 of 19 CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361).553-4646 FAX NUMBER (361) 553-4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: REMOVE VEHICLE FROM INVENTORY DATE: MARCH 2, 2022 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR MARCH 2, 2022 * Consider and take necessary action to remove 2014 Ford Explorer, VIN lf1m5k8ar3egb90852 from the Sheriff s Office fleet due to being totaled in an accident. CoPart has been assigned to pick up vehiclehitle after all equipment has been removed. Sincerely, Bobbie Vickery Calhoun County Sheriff #10 NOTICE OF MEETING — 3/2/2022 10. Consider and take necessary action to approve a lease agreement with Quadient Leasing for a iX-3 postage meter and authorize the County Clerk to sign the agreement. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 7 of 19 Mae Belle Cassel From: Anna.Goodman@calhouncotx.org (Anna Goodman) Sent: <Anna.Goodman@calhouncotx.org> Wednesday, February 23, 2022 8:19 AM To: MaeBelle.Cassel@calhouncotx.org Cc: Sara. Rodriguez@calhouncotx.org Subject: 2022 QUADIANT CONTRACT AND FORM 1295 Attachments: 2022 QUADIANT CONTRACT AND FORM 1295.pdf Good morning again, Will you please add this contact to the agenda to allow me to sign the lease for the postage meter? Thanks! z 1 raw /ff �OavXalr Calhoun County Clerk 361-553-4416 OBI can ehanee my life No one can do it for me Carol Burnett CONFIDENTIALITY NOTICE: The information contained in this transmission may be strictly confidential. If you are not the intended recipient of this message, you are notified that you may not disclose, print, copy or disseminate this information. If you have received this transmission in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail may be a violation of criminal law. Calhoun County Texas Quadient Proposal for CALHOUN COUNTY Prepared for: Anna Goodman anno.goodman@colhouncotx.org CALHOUN COUNTY CLERK CLERK Prepared by: Michele Tessier m.tessier@quadient.com 203-301-3724 Ext. Quodient, Inc. q u a d i e n t 478 Wheelers Farms Road Milford, CT 06461 Because connections matter. 203.301.3400 Overview Dear Anna Goodman, This exclusive offer includes the new iX-3 postage meter with a 51b scale, maintenance, and rate change protection for only $55.99 per month. The new IX-3 Mailing System features: • User friendly navigation and shortcut keys that simplify rate selection and ensure postage accuracy every time. • Rate chaining that automatically switches items weighing over 13 oz to Priority rates An integrated scale, sealer, and large display • Space saving, built-in weighing platform with Smart Start technology • Convenient ATM -style postage downloads with High speed internet connection or iMeter'. PC Link • Up to 5,300 impressions per ink cartridge with Low Ink E-mail Alerts for efficient planning • Convenient access to postal and department usage on Myquadient for reporting at your fingertips • Automated USPS ® Rate Change updates Click here to learn more about the iX•3 Mailing System today! We appreciate your business! Sincerely, Michele Tessler m.tessler@quadlent.com 203-301-3724 Ext. -* Please Note: This meter connects through a high-speed digital connection for postage downloads and rate change and software updates. Any changes, addition, or modifications to the agreement must be accompanied by the signers initials. If the address or company name on the form needs to be adjusted, please contact me before you sign and I will send you an updated copy. — Statement of Confidentiality This proposal and supporting materials contain confidential and proprietary business information of Quadient, Inc. These materials may be printed or photocopied for use in evaluating the proposed project, but are not to be shared with other parties. 0 quadient Leasing Product: Quadient IX-3 Products: 51b Scale Product Lease Agreement Billing Frequency: Quarterly Service Products: Depot Maintenance, Rate Change Protection, Installation Monthly Payment: $55.99 (Plus applicable taxes) Company Name: CALHOUN COUNTY CLERK DBA: Address: 211 S Ann St Ste 102 PORT LAVACA, TX77979 Contact: Anna Goodman Email: anna.goodman@calhouncotx.org Phone: (361) 553-4411 Fax: Office: 2290 - Austin Main Post Office / Mail Drop: Post Office ZIP Code: Purchase Order #: Tax Exempt: ❑ ACH Payments (Lease Payment Only): Previous Lease th Replaces Meter S/N: 10270542 Company Name: CALHOUN COUNTY CLERK Address: 211 S Ann St Ste 102 PORT LAVACA, TX77979 Contact: Anna Goodman Email: anna.goodman@calhouncotx.org Phone: (361) 553-4411 Fax: Office#: 2290 - Austin Main Post Office / Mail Drop Off: m3a �i { Va r u Use my POC/TMS Account #: R My POC/TMS Account#: 8032508 Date Sent: 2/2/2022 Offer Valid Until: Existing customers who currently fund the Postage account by ACH Debit will not be converted to a Postage Funding Account unless initialed here: Approval & Terms Guided by Quadlent, Inc s Sustainable Design and Responsible Manufacturing Policy, our Products may contain reused components. For more Information visit https: ww.,quodient.com/about-us/sustainable-design-and-manufacturing. This document consists of a Product Lease Agreement with Quadient Leasing USA, Inc.; and a Postage Meter Rental Agreement, Maintenance Agreement and an Online Services and Software Agreement with Quadlent, Inc; and a Postage Funding Account Agreement with Quadlent Finance USA, Inc. Your signature constitutes an offer to enter Into such agreements, and acknowledges that you have received, read, and agree to all applicable terms and conditions (version Commercial-Equipment-Lease- Terms-USPS-Direct-V9-2020), which are also available at www uadientmm/Commercial-Equipment-Lease-Terms-USPS-Direct-V9-2020. and that you are authorized to sign the agreements on behalf of the customer Identified above. The agreements will become binding on the companies identified above only after an authorized Individual accepts your offer by signing below, or when the equipment is shipped to you. Name: Title: Authorized Signature: Date: Michele Tessier m.tessier@quadient.com PH: 203-301-3724 Ext. FAX: (203) 301-2805 Quadient Leasing USA Inc. 478 Wheelers Farms Road, Milford, CT 06461 iX-3 Series with Neoship and Neostats PRACTICAL MAILING SOLUTIONS FOR SMALL BUSINESSES Compact. Cost -Effective. Effortless. 1 Becauacd"le n t iX-3 Series with Neoship and Neostats Powerful Performance with a Compact Design The iX-3 Series offers small offices the most pragmatic choice for delivering effortless mailing and shipping operations. Don't let this compact design fool you — the iX-3 is extremely powerful. Coupled with Neoship ADVANCED and Neostats, this complete suite offers a one -stop approach to processing, tracking, reporting and reconciling postage expenses for mail and parcels. 6. USPS® Approved IMI Meter 1. Weighing Platform Ensure compliance with on Intelligent Standard 5 lb. integrated scale handles postcards, Mail® Indlcia (IMI). These new meters envelopes and small packages with ease. meet the latest USPS requirements Optional 10, 30, and 70 lb. platforms available. for data and security management. l s. 2. Catch Tray ®I From postcards to 10' x 13" envelopes, the catch tray k. holds a variety of items. M1a 3'n` u � i I' 3. Shortcut Keys Save time and eliminate keystrokes with the iX-3 shortcut keys. 4. Moistener Automatic sealing with an easy -access reservoir ensures a perfect envelope seal. 5. Hand Feeder Smooth powerfeed provides fast batch processing. MANAGE, CONTROL AND TRACK POSTAGE EXPENSES WITH NEOSTATS This robust application provides tools to reconcile postage dollars down to 1/10 of a cent in minutes! • Analyze postage expense data in summary or detailed formats • Tighten postage forecasting and budgets by understanding postage usage trends on a daily, weekly, or monthly basis This flexible solution supports predefined and user -defined reporting parameters based on Mail Class, Account/Department, Weight Break, Presort and Operator details. Neostats Enhanced supports a single mailing system. Upgrade to Neostats Consolidated to centralize postage expense data for multiple mailing systems at one location or across many. • Optimize potential cost savings by reviewing use of USPS Mail Classes and Weight Break detail Create spreadsheets and eye-catching colorful graphs Export and share data for additional analysis N-3 Series with Neoship and Neostats SPECIFICATIONS LISPS. approved IMI meter Standard Processing speed Up to 45 Ipm Weighing platform (integrated). 5 lb. Standard On -screen DIM rating Standard Accounts/departments 50 Standard Envelope minimum 3.5' X 5' Envelope maximum 10" X 13" Envelope thickness Up to 3/8" Envelope orientation Landscape or portrait Connectivity LAN Standard Rate shortcut keys 5 Job imprint memories 9 Neoslogan Standard Incoming mail date stamp Standard Default rate settings Standard Postage meter tapes Standard 4-digit PIN code Standard Automatic postal rates download Standard Low -ink alerts Standard Neostats Basic postage expense Standard reporting OPTIONS Differential weighing Available External weighing platform Available 10, 30 or 70 lb. Accounts/departments upgrade 100 or 300 Barcode scanner Available E-Services with Electronic Return RecelptTM Available Neostats Enhanced Postage expense reporting Available Neostats Consolidated postage Available expense reporting Neoship PLUS online shipping - software(USPSonly) Available Neoship ADVANCED multi -carrier online shipping software Available WIFI adapter Available IPV6 Available SYSTEM DIMENSIONS iX-3 with integrated 5 lb. scale 10" X 17" X 10.5' iX-3 with Integrated feeder and 28.5' X 17" X 10.5" catch tray Ink Supply Management Simplified -q` Your postage meter is smarter than you think. It can even order ink cartridges for you at exactly the right time. As a result, there's no need to: • Closely monitor the ink level in your mailing system • Ensure orders are placed early enough to avoid running out of ink and disrupting your mail flow • Take time out of your schedule to call or go online to order ink • Communicate with company purchasing staff to request an ink order It's actually as simple as it sounds. Just leave your meter connected to your local area network. When the ink level reaches 20%, your meter alerts Quadient that you'll need a replacement cartridge soon. Quadient will promptly ship you a new ink cartridge -so that it arrives before your system runs out of ink. NO You'll also get notification emails when each ink order is created and when each replacement cartridge ships. Best of all, your ink orders are charged to your Postage Funding account; so you'll get MR a single bill for both the postage you I download and the ink cartridges you buy. There's no fees of any kind, and you can opt out whenever you want. CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl 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. 2022-851228 Quadient, Inc. Milford, CT United States Date Piled: 02/16/2022 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. 985L1-1970 We offer mailing, shipping solutions, software and parcel lockers. 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Shankle, Kirk Milford , CT United States X Assous , Fabrice Milford , CT United States X Fairise, Alain Milford, CT United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is John Tartaro and my date of birth is xx/x/1967 My address is 478 Wheelers Farms Road Milford CT 06461 USA (street) (city) (state) (zip ccde) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in New Haven County, Slate of CT , on the 16 day of Feb , 20 22 (month) (year) Signature of a&horized 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 — 3/2/2022 11. Consider and take necessary action to approve a contract with Certified Payments, new credit card processing provider for the County Clerk's Office and authorize the County Judge to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 8 of 19 Mae Belle Cassel From: Anna.Goodman@calhouncotx.org (Anna Goodman) <An na.Goodman@ calhou ncotx.org> Sent: Wednesday, February 23, 2022 8:14 AM To: MaeBelle.Cassel@calhouncotx.org Cc: Sara.Rodriguez@calhouncotx.org; Richard Meyer Subject: Certified Payments Contract with Form 1295 Attachments: Certified Payments Contract with Form 1295.pdf Good morning, Will you please add this to the agenda to allow judge to sign the contract with certified payments, which is a new credit card processing provider? Thanks! **Sara, please let us know if there is anything wrong with contract.** 74t<rla W �ooilxall Calhoun County Clerk 361-553-4416 Only I can change my life. No one can do it for me. Carol Burnett CONFIDENTIALITY NOTICE: The information contained in this transmission may be strictly confidential. If you are not the intended recipient of this message, you are notified that you may not disclose, print, copy or disseminate this information. If you have received this transmission in error, please reply and notify the sender (only) and delete the message. Unauthorized interception of this e-mail may be a violation of criminal law. Calhoun County Texas CERTIFIED by deluxe SERVICE PROVIDER AGREEMENT CREDIT CARD PROCESSING THIS SERVICE PROVIDER AGREEMENT ("Agreement") is made and entered into by and between Certified Payments, a division of Accelerated Card Company, LLC, with offices a1100 Throckmorton Street, Suite 200. Fort Worth, TX 76102 ("Certified") and Calhoun County, Texas 211 South Ann Street Port Lavaca. Texas RECITALS WHEREAS, Agency desires to accept payments from individuals or entities ("Customers") by Credit Card, pin -less Debit Card, and pin -entry Debit Card (if Agency is utilizing debit -capable equipment) ("Agency Payments"). WHEREAS, Certified is a third party service provider that performs such Services on behalf of Agency ("Services"). WHEREAS, Agency desires to engage Certified to act on behalf of Agency in providing the Services and Certified desires to provide the Services subject to the terms and conditions set forth in this Agreement. NOW THEREFORE, in consideration of the foregoing, and the mutual promises set forth below, the parties hereto agree as follows: DEFINITIONS. As used herein, the following terms have the meanings set forth below: "Agency Bank" is the Depository Financial Institution where the Agency Bank Account is maintained and receives deposits from Agency's Customers or credits from the Federal Reserve Bank on behalf of the Agency. "Agency Bank Account" is the account Agency has established with Agency Bank for credit card and debit card deposits from Agency's Customers as provided under the terms of this agreement, and identified on Page 3 of the Bureau Credit Card Account Setup Form, Bureau Banking Information, which is attached hereto. "Bureau Code" is the unique seven (7) digit Agency identifier assigned to Agency by Certified. "Card Issuing Bank" is a financial institution that issues cards and contracts with its cardholders for billing and payment of transactions. "Card Brands" are membership corporations of financial Institutions that issue cards for payments of goods and services, provide card products and establish the rules and regulations governing member participation in card programs. "Card Holder" is an authorized user of a payment card issued by a Card Issuing Bank, "Chargeback" is a transaction whereby the Card Issuing Bank reverses the Agency's Payment. "Service Fee" means the fee charged by Certified to Customers for the convenience of using the Services in making an Agency Payment. "Credit Card" refers to a pin -less debit card or credit card issued to a Customer for payment of goods and services. "Customer" means both consumer and corporate, individual or company that purchases or uses the Services. 'Debit Card' refers to a pin -entry debit card issued to a customer for payment of goods and services. "Front -End Processor' Is an authorization service through which Card Issuing Banks can approve or decline individual card transactions. "IVR" means Integrated Voice Response system. "Processing Facility' refers to the appropriate credit or debit network to which Certified transmits transactions, 2. CERTIFIED'S OBLIGATIONS. Certified shall provide the Services as follows: A, Certified will provide Customers with the opportunity to make Agency Payments by Credit Card, pin -less debit card, and pin -entry debit card (if Agency Is utilizing debit -capable. equipment). These Agency Payments may be made through Certified's websile, the Agency's website, through an IVR system; by con- tacting the Agency directly by telephone, or by other methods that may be offered by Certified from time to time. B. Certified shall begin providing the Services to Customers on a date mutually agreed upon by Certified and Agency. C. Certified shall collect and transmit Agency Payments from Customers using MasterCard, Visa, Discover, American Express, and the Debit Card Networks D. Certified may charge each Customer a Service Fee for each Agency Payment processed. The Service Fee will be collected in addition to the correspond. ing Agency Payment. Exhibit A attached hereto details the Schedule of Service Fees that Certified may charge to Agency's Customers. Certified, in its sole discretion may charge Customers a minimum Service Fee for each payment and may change the amount of the Service Fee upon thirty (30) days' advance written notice to Agency. Certified will cause all net funds resulting from Agency Payments to be transmitted to Agency's Bank Account; Certified shall retain all Service Fees collected by It hereunder. E. Except for the fees outlined in Exhibit A, Certified shall not charge Agency a fee in consideration for Certified's provision of the Services to Customers as provided for in this Agreement; any fees payable by Agency in connection therewith will be mutually agreed upon by Certified and Agency. F. Certified will notify each Customer of the dollar amount of the payment and the corresponding Service Fee to be charged to the Customer and obtain Customers approval (electronically or otherwise) of such charges prior to initiating any charges to the Customer's Credit Card or Debit Card. G. Certified will provide each Customer with electronic confirmation of the Agency Payment and the corresponding Service Fee. H. Certified will electronically collect and transmit all payment information to the appropriate Processing Facility in the most time critical manner that each facility can accept. 1. Certified will provide Agency with online access to Agency payment data and reports summarizing the use of the Services by Agency's Customers. Agency will have the ability to import such payment data utilizing Microsoft Excel, Microsoft Access, a comma -delimited file ("CSV') or XML file. Access to Agency payment data and reports will be available 24/7. J. Certified will retain all logs and data for such period of time as required by applicable law and the regulations of the Card Brands and Debit Card Networks. K. Prior to initiating any refunds to a Customers Credit Card or Debit Card, Certified will attempt to obtain permission, either orally or in writing, from the Agency's authorized representative. Unless Agency receives written authorization from Certified to the contrary, Agency may not Issue refunds to the Customer by check. Certified will process such refunds In the form of a credit to the Customers Credit Card or Debit Card that was initially charged and, In Certified's sole discretion, may refund the corresponding Service Fee payment. Certified or Its authorized agent will debit the Agency's Bank Account for the amount of the Agency Payment refund. L. Under the rules of the Card Brands, Customers Card Issuing Bank gives Certified a limited amount of time to dispute a Chargeback or issue a refund. In the Page 1 Servlce Provider Agreement, continued event a refund must be issued, Certified will contact Agency and Agency will immediately Issue a memo authorizing Certifed to refund the transaction, however, Certified and Card Issuing Bank reserve the right to debit the Agency Bank Account for the amount of the Agency Payment at any time during the Chargeback process. In the event a Service Fee is disputed by the cardholder, both the. Agency payment and the service fee payment will be refunded to the cardholder. In no case shall a Service Fee be charged back to Certified without the related Charge also being charged back to the Agency. M. Agency will reimburse Certified for all chargeback actions or refunds of any kind, including but not limited to those resulting from overpayments, duplicate or misapplied payments or unauthorized charges. In the case of either a refund or Chargeback, where Certified is unable to collect amounts owed by Agency to Certified, Agency agrees to make amounts owed available to Certified in immediately available funds. N. Certified shall implement policies and procedures to maintain the security of cardholder data that Certified possesses, stores, processes or transmits on behalf of Agency, or to the extent that Certified could Impact the security of Agency's cardholder data environment, in accordance with applicable payment card industry security standard (PCI-DSS) requirements, 3. AGENCY'S OBLIGATIONS. A. In addition to this Agreement, Agency hereby agrees to the Merchant Processing Terms & Conditions found at www.CertifiedPayments.net/tc, as they may be revised from time to time, and further agrees to enter into any and all applicable agreements that are required to perform the Services hereunder, including without limitation any agreements required by Visa, MasterCard, Discover, American Express. the Debit Card Networks, or the applicable sponsor bank. Such Agreements may include but are not limited to documents required by MasterCard, Visa, Discover, American Express, and the Debit Card Networks. Agency agrees to fully comply with the rules, regulations and operating procedures of the various Card Brands, including without limitation with respect to the use of specific Card logos and marks. B. Prior to Certified's commencement of the Services. Agency will complete in full and sign all necessary paperwork that Certified puts forth. C. Certified is required to fully adhere to and operate according to the rules, regulations and operating procedures of the Card Brands, the Debit Card Networks, the Bank and any rules and regulations provided by American Express and Discover. Agency agrees to immediately comply with any requests by Certified regarding any Agency conduct that is outside said rules and regulations. Agency's failure to comply with such request by Certified will be grounds for immodi- ate termination of this Agreement. D. Certified will provide customer support to Agency's customers. In order to provide said support services Agency will include on any statements or materials provided to Agency's customers, Certified information such as Web Address; IVR Telephone Number (if applicable), assigned Bureau Code, Customer Service Phone Number or ether information. E. Agency will not require, as a condition to making an Agency Payment, that a Cardholder agrees in any way to waive such Cardholder's right to dispute the transaction with the Card Issuing Bank for legitimate reasons. F. Agency agrees that Certified will be the exclusive provider of fee -based electronic payment services and that Agency may not procure similar services from any other parry during the Term of this Agreement. 4. ADDITIONAL MATTERS A. Confidentiality, Agency will not disclose to any third party or use for any purpose Inconsistent with this Agreement, any confidential or proprietary, non-public information it obtains during the term of this Agreement regarding Certified's business, operations, financial condition, technology, systems, know-how, products, services, suppliers, customers, marketing data, plans and models and personnel. Certified will not disclose to any third party or use for any purpose incon- sistent with this Agreement any confidential Customer information it receives In connection with its performance of the Services, except that Certified may use personal information provided by Customers to establish and maintain individual user accounts requested to be established by such Customers with Certified. B. Relationship of Parties.The performance by Certified of its duties and obligations under this Agreement shall be that of an independent contractor and nothing contained in this Agreement shall be deemed to constitute a joint venture or partnership between Certified and Agency. C. Capacity to Contract. Each parry hereby certifies that the person executing this Agreement on its behalf is fully authorized with complete legal capacity and approval to do so. D. Intellectual Property, In order that Agency may promote the Services and Certified's role in providing the Services, Certified grants to Agency a revocable, non-exclusive, royalty -free license to use Certified's logo and other service marks (the "Certified Marks") for such purpose only. Agency does not have any right, title, license or interest, express or Implied, in and to any object code, software,: hardware, trademark, service mark, trade name, trade dress, formula, system, know-how, telephone number, telephone line, domain name, URL, copyrighted image, text, script (including, without limitation, any script used by Certified on Certified's wobsite) or other intellectual property right of Certified. All Marks, the System and all rights therein (other than rights expressly granted in this Agreement) and goodwill pertaining thereto belong exclusively to Certified. E. Force Majeure. Certified is released from liability hereunder for failure to perform any of the obligations herein where such failure to perform occurs by reason of any acts of any other party or third party or any acts of God, fire, flood, storm, earthquake, tidal wave, computer or communications failure, software failure, network problem, sabotage, war, military operation, national emergency, mechanical or electrical breakdown, civil commotion, or the order, requisition, request, or recommendation of any governmental agency or acting governmental authority , Certified's compliance therewith or government proration, regulation, or priority, or any other cause beyond Certified's reasonable control whether similar or dissimilar to such causes. F. Remedies. Agency's sole remedy In the event of Certified's failure to perform the Services as set forth herein shall be to terminate the arrangement contem. plated by this Agreement. G. Notice, Any notice to be given hereunder shall be in writing and may be affected by personal delivery, in writing or by registered or certified mail, return receipt requested, addressed to the proper party, at the following address: AGENCY: Calhoun County, Texas 211 South Ann Street Port LaVaca, Texas CERTIFIED PAYMENTS: Certified Payments, a division of Accelerated card Company, LLC Attn: General Counsel 100 Throckmorton Street, Suite 200 Fort Worth, TX 76102 noticesi certifiedpayments.net ACC OP SPA 10.01.21 Page 2 Service Provider Agreement, continued H. American Express. Agency warrants that it does not hold third parry beneficiary rights to any agreements between Payment Service Provider and American Express and at no time will attempt to enforce any such agreements against American Express, 1. Agency ACKNOWLEDGES AND AGREES THAT IN NO EVENT SHALL AMERICAN EXPRESS, ITS AFFILIATES, AGENTS, SUCCESSORS, OR ASSIGNS BE LIABLE TO AGENCY FOR ANY DAMAGES, LOSSES, OR COSTS INCURRED, INCLUDING INCIDENTAL, INDIRECT, SPECULATIVE, CONSEQUENTIAL, SPECIAL, PUNITIVE, OR EXEMPLARY DAMAGES OF ANY KIND (WHETHER BASED ON CONTRACT, TORT, INCLUDING NEGLIGENCE, STRICT LIABILITY, FRAUD, OR OTHERWISE, OR STATUTES, REGULATIONS, OR ANY OTHER THEORY), ARISING OUT OF OR IN CONNECTION WITH THE AGREEMENTI, J. Term of Arrangement, Unless sooner terminated In accordance with the provisions of this Agreement, this Agreement shall be in effect for three(3)years from the Effective Date of this Agreement ('Term"). Thereafter, the Term will automatically extend for consecutive one (1) year peri- ods, unless either parry provides the other with written notice of termination at least sixty (60) days prior to the end of the then -current term. K. Termination. Certified's performance of this Agreement is subject to the rules and regulations of the Card Brands, the Debit Card Networks, federal, state and local laws or regulations applicable to the Services. Receipt of a written directive from banking regulators, a member bank, Visa, MasterCard or other credit or debit card company or brand to terminate shall be Immediate upon such event. L. Governing Law. In the event a dispute arises between any of the parties to this agreement, all parties hereby agree that such a dispute shall be governed by the laws of the State of Texas M. Assignment.This Agreement may not be assigned by eitherparty without the prior written consent of the other party, which consent shall not be unreasonably withheld; provided, however, the rights and obligations of Certified under this Agreement may be provided or fulfilled by, or assigned to, any parent, subsidiary affiliate, successor entity (by stock or asset purchase or merger) or subcontractor of Certified. N. Entire Agreement; Modifications. This Agreement, together with the exhibits and schedules hereto constitutes the entire agreement between Certified and Agency with respect to the subject matter hereof. There are norestrictions, promises, warranties, covenants or undertakings other than those expressly set forth herein and therein. This Agreement supersedes all prior negotiations, agreements, and undertakings between the parties with respect to such matter. This Agreement, including the exhibits and schedules hereto may be modified or amended only by an instrument in writing executed by the parties or their permitted assignees. 0. Severabiliry. If any provision of this Agreement is held by a court or arbitrator of competent jurisdiction to be contrary to law, then this Agreement shall be deemed modified to delete any such provision, and the remaining provisions of this Agreement will remain in full force and effect. P. Conflicts. in the event of a conflict between the provisions explicitly stated in this Agreement and those stated in any document referenced herein, the terms explicitly stated in this Agreement shall control. IN WITNESS WHEREOF, the parties have executed and delivered this Agreement on Feb 10th 2022 (the "Effective Date"). AGENCY'S ACCERANCE: AGENCY NA r i at, n unty, Texas By: ,G Ag cy Signature L/ Agency Signature - Second Signature (if required) Printed Name and Title Printed Name and Date CERTIFIED'CERTIFIED'S ACCEPTANM ACCELERATED RD COMPANY, LLC d/b/e CERTIFIED PAYMENTS By: Authorized Representative Abagail Hernandez Operations Manager Printed Name and Title Date Date ACC CP SPA 10.01.21 Page 3 EXHIBIT A SCHEDULE OF FEES Confidential This Exhibit A to the Service Provider Agreement between Certified and Agency provides as follows: 1. Schedule of Credit Card Convenience Fees. Cenifled and Agency agree to the following provisions: A. 2.35 %or a minimum at $ 1 .00 shall be the agreed upon Convenience Fee that the Agency agrees to allow Certified to charge to Customers for tax payments when Customer uses a Credit Card. B.2 35 =/o or a minimum of S 1.00 shall be the agreed upon Convenience Fee that the Agency agrees to allow Certified to charge to Customers for nomtax payments when Customer uses a Credit Card. The fees charged are subject to change. by Certified. 2. Schedule of Debit Card Convenience Fees Transaction Amount Tax Payments Non -Tax Payments $0.01- $50.00 Flat r 2.95 Flat rate debit $2.95 $50.01-$100.00Elat rate debit $2,95 Flat rate debit $2.95 $100.01 - $250.00 Flat rat e debit $2.95 Flat rate debit $2.95 $250.01-$500.00' Flat rate debit $2.95 Flat rate debit $2.95 Transactions greater than $500.00 will be assessed the credit card convenience fee rate. 3. Schedule of Equipment Cost. POS Terminal / Equipment Price quantity Subtotal Ingenica 1PP 320 $ 230.00 2 $ 0.00 ID Tech USB Card Reader $ 55.00 $ Other: $ $ Equipment Total $ 0.0 AGREEMENT (IF NO PAYMENT TYPE IS SELECTED. ACH PAYMENT WILL BE USED) 0 ACM: Agency hereby authorizes Certified or its designee to automatically withdrew all amounts owed in conjunction with the above Equipment Cost by initiating ACH debit entries from Agency's Bank Account. The authority is to remain in full force and effect until all obligations of Agency have been performed and paid in full or Certified or its designee has received written notification from Agency of its termination in such a manner as to afford Certified or its designee reasonable opportunity to act on It. In the case that any ACH's are not honored by the Agency's Bank Account for any reason, the Agency agrees to make amounts awed available to Certified in immediately available funds. ❑ Check e: (ONLY MAKE CHECKS PAYABLE TO CERTIFIED PAYMENTS) AGENCY'S ACtTd97 AGENCY NAM altl •n County Texas By: 3 Age cy signature Date Printed Name and Title ACCELERAT D RD COMPANY, LLC dlb/a CERTIFIED PAYMENTS _�/i ^� Authorized Representative Date jh�GralldrTitle n�n��r Print Name an ACC CP EX A Flat -Rate Debit 05,01.18 EXHIBIT B AMERICAN EXPRESS ADDENDUM This Instrument (the'Addendum"i effective Feb Wth , 2022 , amens and supplements the cemoun County: Texas Agreement (as defined below) and the Certified Payments Agreement (as defined below), including any and all exhibits, amendments, addenda, appendices and supplements thereto respecting the acceptance of the American Expresstp Card. For the purpose of this Addendum, "Certified Payments" means Accelerated Card Company, LLC d/b/a Certified Payments, a Delaware limited liability company, located at 100 Thmckmorlon Street, Suite 200, Fort Werth, TX 70102, The term "Calhoun County Texas Agreement" shall mean the Agreement for American Express Card Services dated Feb 10th and any Amendment and/or Addendum to such Agreement whereby American Express and Camoun County Texas have made available Card Acceptance for Government offices, agencies, and educational Institutions and entities; and, such Calhoun County Texas agencies have initiated American Express Card acceptance. The term 'Certified Payments Agreement'shall mean the agreement dated October, 2003 whereby American Express and Certified Payments, as the successor in interest to CaMtren2, Inc., have Initiated American Express Card acceptance on behalf of various state and local governments. All other terms in this Addendum shall have the same meanings as they have in the Calhoun Coumv Texas Agreement anal or the Certified Payments Agreement as such Agreements pertain to the parties of those Agreements, Certified Payments hereby agrees to accept the Cam on behalf of barren County Texas (as permitted by Calhoun County Taxes ), The partles further agree that the Cellsen County Texas Agreement and the Certified Payments Agreement shall be deemed amended so that the Discount associated with such Charges on behalf of Calhoun County Texas to Certified Payments shall be paid to American Express by Certified Payments. Payments for charges submitted on behalf of Calhoun County Texas shall be paid directly to Calhoun County Texas The parties also agree to the following: Disputed Transactions and Chargebacks: American Express will send requests regarding a claim,complaint, or question related to a Disputed Charge to Certified Payments and not to Calhoun County Taxas . Certified Payments will retrieve all requested information relatingto ins Disputed Charge and provide such to American Express. It a Cardmember contests the Convenience Fee relating to a Charge, the payment of that Charge to Calhoun County Texas also will be treated as contested. it the Disputed Charge results In a reversal of the Charge ("Chargeback"l, both the Calhoun County Texas payment of that Charge and the Convenience Fee will be charged back by American Express, Calhoun County Taxes payments will be charged back to Calhoun County Taxes ; Convenience Fees will be charged back to Certified Payments. In no case shall a Convenience Fee be charged back to Cerlified Payments without the related Charge also being charged back to Calhoun County Texas Certfied Payments will provide reports to Calhoun County Texas of any Chargebacks either prior o or on the day the Chargeback is posted to Calhoun County Texasg bank account, American Express will deduct any Chargebacks from amounts owed to Calhoun County Texas for Charges. Reporting: Corgfied Payments will provide reports to Calhoun County Texas that include all transactions, Including Chargebacks and adjustments In a format agreeable to Calhoun County Taxes Refunds; Refunds will be processed through Calhoun county Texas agency's standard refund processes. The specific refund policy for each Calhoun County Texas agency will be posted on Calhoun County Texas agency's web she. American Express will accept proof of the refund via Calhoun County Texas agency's pasted refund process in the event of a Dispute, and not allow the Chargeback. Limitation of Liability: In no event will Certified Payments or American Express be responsible hereunder for damages to Calhoun County Texas arising from delays or problems caused by any telecommunications carder or banking system or Internet Services Provider ("ISP"); provided, however, that the foregoing shall have no effect upon American Express' rights of Full Recourse, as used in the Agreement. Except as specifically Indicated above, all terms and conditions of the Calhoun County Texas Agreement and the Certified Payments Agreement shall remain In full force and effect. Authority to Sign: Each party represents that the individual who signs this Addendum has authority to do so and to bind It to the terms and conditions of this Addendum. Each party further represents that they are authorized to sign and enter into this Addendum on behalf of their subsidiaries, afflllates and licensees that accept the Card. By: Date: AGENCYNAM : emoun County Taxes By Date: DOMPANY. LLC dlbla CERTffIED PAYMEN By: Date: A � I 01 ACC CP EX B 09.01.15 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Come ete Nos 1- a and 6.1 there are interested parties. OFFICE USE ONLY Compete Nos 1 2, 3 5, and 6 f (here we no interested parties CERTIFICATION OF FILING Certificate Number: i Name of business entity filing form, and the city, state and country of the business entit)'s Place of business. 2022-850569 Accelerated Card Company Fort Worth, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party tot the contract for which the form is 02/1412022 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. 2022 Electronic Payment Processing Services 4 Name of Interested Patty 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 , f r,ly name is PlD i f fn i I ii r r n(i h(I e z. PP,` j4-f•rifl'1\ IV1Q Yl/11 /and my date of birth is, My address i5 ...-_.__..nr.f ,.,.i , IX LT2. ITil/t1/ (street) (city) (stale) (zip code) (country) I dedwe under penalty of perjury that the foregoing is one and correct. E,ecu[ed in QI 1'r r it Courry, State of �BXCI S , on the day of r,ut, 20 Z 2-. (march) (year) Signatuni of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.ot.us Version V1.1.191b5cdc #12 NOTICE OF MEETING — 3/2/2022 12. Consider and take necessary action to approve Addendum Number 1 to the Invitation to Bid and Specifications for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05. (RHM) Everett explained Addendum No. 1 RESULT: APPROVED [UNANIMOUS] MOVER: SECONDER: Gary Reese, Commissioner Pct 4 AYES: David Hall, Commissioner Pct 2 Judge Meyer, Commissioner Hall, Behrens, Reese Page 9 of 19 February 23, 2022 To: Judge Meyer From: The office of the County Auditor Submitting for Everett Wood, Building Maintenance Superintendent Please place the following item on the Commissioners Court Agenda for March 2, 2022: • Consider and take necessary action to approve Addendum Number 1 to the Invitation to Bid and Specifications for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05. CALHOUN COUNTY, TEXAS ADDENDUM NO. 1 to the INVITATION TO BID AND SPECIFICATIONS FOR THE CALHOUN COUNTY COURTHOUSE ANNEX ROOFTOP AIR CONDITIONER REPLACEMENT Bid Number: 2022.05 Page 1 of 4 Addendum No. 1 Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement Bid Number 2022.05 Clarification and revisions to the original Invitation to Bid and Specifications have been deemed necessary. Once approved by Commissioners Court, Addendum No. 1 shall automatically become part of the Invitation to Bid for the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05 and shall supersede any previous specification(s) and/or provision(s) in conflict with this Addendum No. 1. If discrepancies and/or inconsistencies exist between these specified revisions and the original Invitation to Bid and Specifications, said Addendum No. 1 shall govern. To acknowledge receipt of Addendum No. 1: 1. Sign and date on page 4 2. Return with your bid (pages 1-4) Clarifications and Revisions to the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05: INVITATION TO BID REMOVE: Third (31) paragraph (page 1 of 2): • 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). REPLACE: With the following: • The bid for the rooftop heating/cooling unit shall be for the removal and disposal of the existing unit and curb adapter, complete purchase and complete installation. The bid must include as required by the specifications, removal and disposal of existing unit and curb adapter, installation of new heating/cooling unit and new curb adapter, including consideration of equipment weight and mounting footprint as compared to the existing unit, all permits, if any are required, all electrical and connections of controls required to install the unit, all equipment and material required to install the unit and curb adapter, start-up per manufacturer's specifications, and TDI Windstorm field inspections(s) and required certificate(s). Page 2 of 4 SPECIFICATIONS FOR COMPLETE PURCHASE AND INSTALL REMOVE: From first (15t) paragraph under DESCIPTION (page 1 of 2): • roof mounting frame REPLACE: With the following: • curb adapter REMOVE: From #1 under SUBMITTAL REQUIREMENTS (page 2 of 2): • roof mounting frame REPLACE: With the following: • curb adapter REMOVE: Entire section - "Other Work Included Within This Specification" (page 2 of 2): • 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). REPLACE: With the following: • Other Work Included Within This Specification 1. Removal and disposal of existing unit and curb adapter 2. Installation of new heating/cooling unit and new curb adapter must include: a. Consideration of equipment weight and mounting footprint as compared to existing unit b. All permits, if any are required c. All electrical and connections of controls required to install the unit d. All equipment and material required to install the unit and curb adapter e. Start-up per manufacturer's specifications 3. TDI Windstorm field inspection(s) and required certifications(s) Page 3 of 4 ACKNOWLEDGEMENT OF ADDENDUM NO. 1 The undersigned affirms that they are duly authorized to acknowledge receipt of Addendum No. 1 to the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05. The undersigned affirms thatAddendum No. 1 to the Calhoun County Courthouse Annex Rooftop Air Conditioner Replacement, Bid Number 2022.05 has been incorporated into their bid. Company Name Authorized Signature Printed Name of Authorized Signature Title of Authorized Signature Date Page 4 of 4 #13 NOTICE OF MEETING — 3/2/2022 13. Consider and take necessary action to continue participation in TAC HEBP ARTS Program and authorize the County Judge to sign the agreement. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 10 of 19 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Tuesday, February 22, 2022 12:37 PM To: Mae Belle Cassel Cc: rhonda kokena; Richard Meyer Subject: Agenda Item Request Attachments: ARTS Renewal Confirmation Program Agreement 2022.pdf; ARTS Renewal Confirmation Program Agreement 2022.pdf Please place the following item on the agenda for March 2, 2022: Consider and take necessary action to continue participation in TAC HEBP ARTS Program and authorize County Judge to sign agreement. No 1295 is needed because TAC is a governmental entitiy. Please initial pages 1 and 2, sign/date page 3. Note that some parts of the filloble form did not work correctly. Please return one original to me for forwarding to TAC. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindv.mueller@calhouncotx ore Calhoun County Texas ASSOCIATION AND EMPLOYEE February 21, 2022 Affordable Care Act Reporting and Tracking Service (ARTS) Renewal Information The Texas Association of Counties Health and Employee Benefits Pool (TAC HEBP) has begun the renewal process for those counties and districts participating in the Affordable Care Act Reporting and Tracking Service (ARTS). Renewal will enable your entity to produce the forms required by IRS Sections 6055/6056 for calendar year 2022, assuming this reporting continues to be a requirement. Reporting will consist of Form 1095C, which must be provided both to employees and the IRS (plus transmittal Form 1094C, filed with IRS). Current law requires all employers with 50 or more full-time equivalent employees to file these forms. ARTS will provide measurement period tracking for 2022 and beyond (to determine whether an employee must be offered health coverage), as well as affordability testing for groups that require employee contributions toward the cost of their own health coverage. As your county or district provides health benefits through TAC HEBP, ARTS will continue to be available at NO COST in 2022, assuming program deadlines are met. Your entity will need to continue sending employee, payroll, and unpaid leave of absence files to TAC HEBP in order to utilize this service for the 2022 reports. Payroll data must be provided for each payroll cycle. Employee files must be provided, at a minimum, once per quarter. LOA files may be provided if and when applicable. The information provided will be used to determine: 1) whether individuals are eligible for a federal premium subsidy or tax credit; and 2) whether your entity is subject to penalties under the ACA employer mandate. Some payroll vendors have worked with TAC to produce these files for you. You will be responsible for the completion of required information in your payroll system and submission to TAC, but this eliminates the need for manually producing additional spreadsheets. If you use a payroll system that will produce the required IRS forms, and you determine that your entity does not need measurement period tracking or affordability monitoring, you may not need ARTS. It is a service offered by TAC and is completely optional. Enclosed is the ARTS Renewal Confirmation Program Agreement. Please return a signed copy (initials on pages 1 and 2, signature on page 3) to your Employee Benefits Consultant or email to ARTS@county.org no later than EMl/202211 if your entity wishes to continue its participation in the program. If you have any questions, please contact your Employee Benefits Consultant at (800) 456-5974. #14 NOTICE OF MEETING — 3/2/2022 14. Consider and take necessary action to approve a Blanket Access Easement Agreement between Calhoun County and the Calhoun County Independent School District as described in the attached document and authorize the County Judge to sign all relevant documents. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 11 of 19 State of Texas § County of Calhoun § § BLANKET ACCESS EASEMENT AGREEMENT Legal Description: (Tract A) A0035 MAXIMO SANCHEZ, TRACT PT 25, ACRES .93. (Tract B) A0035 MAXIMO SANCHEZ, TRACT PT 25, ACRES 31.4909. Ownership: __..---- Tract A: Calhoun County, Signatory, Judge Richard Meyer Tract B: Calhoun County Independent School District, Signatory, Larry Nichols DEFINITIONS "Tract" or "Tracts" means the real property, or a part of the real property, defined above as "Property." "Owner" or "Owners" means the record owner, whether one or more persons or entities, his, her or its heirs, successors, and assigns, of any right, title, or interest in or to the Property or any part thereof. RESERVATION OF EASEMENTS The access across Tract A for access to Tract B is reserved for the nonexclusive right for vehicular and pedestrian ingress and egress: (1) to and from the adjacent right-of-way of Sandcrab Boulevard. (2) across common boundaries across, between, and among the Tracts. CONFORMITY WITH ALL APPLICABLE LAWS &is",B,la�,#�et Access Agreement (Agreement) is entered into and effective this��iday of 2023y, Jrrdae Richa, e_ dMyer and by, �nperiant lat Larry l�tieholae as the designated Signatories of the properties referred to as Tract A and Tract B, Port Lavaca, Texas. CCISD and CC blanket access agreement Page I of 8 02182022 WHEREAS, pursuant to Section 42-1 of the Code of Ordinances and the Drainage Criteria Manual, the City of Port Lavaca specifies design criteria which must be met, in order to ensure proper drainage and establish the access granted by this blanket access agreement, NOW, THEREFORE, in consideration of satisfying the recitals and mutual obligations of the parties herein expressed, we hereby bind ourselves as follows: Owner(s) declare that the Property must be held, sold, and conveyed subject to the following easement to assure access to and from the Property for pedestrian and vehicular traffic. Subject property consisting of Tract A, owned by Calhoun County, Signatory, Judge Richard Meyer, agrees to provide this blanket easement to subject property Tract B, owned by Calhoun County Independent School District, Signatory, Superintendent Richard Nichols, as shown as Exhibit A to this Agreement. The subject property or portion thereof on which the access will not be made subject to any other covenant or contract for use which interferes with the access, without prior written consent of the City. OBLIGATIONS TO RUN WITH THE LAND This Agreement is in perpetuity and can only be terminated with the approval of the City of port Lavaca or replaced with another access agreement. This Agreement shall be kept on file with the City of Port Lavaca and shall be recorded in the real property records of Calhoun County, Texas. SEVE+ IBABILITY If any part, or the application of this Blanket Access Easement is for any reason held to be unconstitutional, invalid, or unenforceable, the validity of the remaining portions of this Blanket Access Easement are not affected thereby. All provisions of this Blanket Access Easement are severable to maintain in full force and effect the remaining provisions of this Blanket Access Easement. CCISD and CC blanket access agreement Page 2 of 8 02182022 Signatory of Subject Property (Tract A) Printed Name: /t C-4 A r-A 9, Judge Richard Meyer Signatory of SubjecVlperty (Tract A) Signature: Richard Meyer Date: *By entering my name in the signature box above, I am acknowledging the requirements noted above. **Notary Use Only TEXAS NOT State of Texas County of Calhoun On this 09 day of 20 2 Z I certify that the foregoing instrument was subscribed and sworn before. Seal �pv erg'. MAE BELLE CASSEL •° My Notary ID # 132012524 Expires May 14, 2023 Notary Public Signature lei l ltle or Rany 132O12524 Notary's Registration Number CCISD and CC blanket access agreement Page 3 of 8 02182022 Signatory of Subject Property (Tract B) Printed Name: Superintendent Larry Nichols Signatory of Subject Property (Tract B) Signature: Nichols Date: l i *By entering my name in the signature box above, I am acknowledging above. the requirements noted **Notary Use only TEXAS NOTARIIAL C2RTIIII+IICAT2 State of Texas § County of Calhoun § On this g 4k day of Ql 20 9!I, I certify that the foregoing instrument was subscribed and sworn before. 69 111 Seal \\��OpN1M( b': N 5 r9TF OF'(E�P ••' ��' 1111359� Not I Public Signat red SIC Title or R ----------�--- Notary's Registration Number CCISD and CC blanket access agreement Page 4 of 01242022 EXHIBIT "All CCISD and CC blanket access agreement Page 5 of 8 02182022 CCISD and CC blanket access agreement Page 6 of 8 02182022 CCISD and CC blanket access agreement Page 7 of 8 02182022 EXHIBIT "B" ,&UNMAN CC p l 11 0. r — 0 C7 CCISD and CC blanket access agreement Page 8 of 8 02182022 #15 NOTICE OF MEETING — 3/2/2022 15. Consider and take necessary action on the Special Road Use Indemnity Agreement and Permit from Tres Bahias Solar Power, LLC., and authorize the County Judge and Commissioner Behrens to sign all relevant documents. (JB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 12 of 19 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 —Fax (361) 893-5309 Email: iceLhehrens(a)calhouncotx om Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for March 2, 2022. Please Consider and Take Necessary Action on the Special Road Use Indemnity Agreement and Permit from Tres Bahias Solar Power, LLC., and allow Judge Meyer and Commissioner Behrens to sign all documents. Sincerely, Joel Behrens Commissioner Pct. 3 Lynette Adame -08-W-W� From: Sent: To: Subject: Attachments: William, MPritchard@swiftcurrentenergy.com (Michael Pritchard) <M Pritchard@swiftcurrentenergy.com> Thursday, February 24, 2022 2:52 PM William Kelsey; Joel Behrens; richard.meyer@calhouncotx.org; lynette.adame@calhouncotx.org; Nikki Tate Fwd: Tres Bahias - Calhoun County Road Use Agreement, Judge's Letter, and Bond image001.png; 4853-9315-7389.1 Calhoun County - SPECIAL ROAD USE INDEMNITY AGREEMENT AND PERMIT (HB Comments 2.10).docx; Road Use Agreement Redline.docx email originated from butsjde of the he sender and know the content is sa not click links or Can you please sign the clean version of the CRUA and scan and email a copy to all? Thanks, Michael Pritchard Development Manager I Swift Current Energy 1290 S. Willis Street Suite 94 Abilene, Tx 79605 M:325-267-0288 E: m ritchard@swiftcurrentener¢v com f�x �--- Begin forwarded message: From: Michael Pritchard <MPritchard@swiftcurrentenergy.com> Date: February 24, 2022 at 12:53:()0 PM MST To: Joel Behrens <joel.behrens@calhouncotx.org>, richard.meyer@calhouncotx.org, lYnette.adame@calhouncotx.org Subject: FW: Tres Bahias - Calhoun County Road Use Agreement, Judge's Letter, and Bond Dear Commissioner Behrens and Judge Meyer, Please find attached our redline of the County Road Use Agreement and Judge's Permit letter. Can we please be put on next week's agenda for Commissioner's Court to discuss and take action on the County Road Use Agreement and the Judge's Permit Letter? Thanks, SPECIAL ROAD USE INDEMNITY AGREEMENT AND PERMIT THE STATE OF TEXAS COUNTY OF CALHOUN KNOWN ALL MEN BY THESE PRESENTS CALHOUN COUNTY ROAD USE AND CROSSING AGREEMENT On this /57- day of /(,//> 2022, Tres Bahias Solar Power, LLC, a Delaware limited liability company ("Project Company"), makes application for the following: (A) Permission to use and connect to via project access roads the county roads and bridges of Calhoun County, Texas, for access, ingress, and egress to and from that certain solar energy project to be constructed by the Project Company in Calhoun County, Texas, (the "Project"), by foot, vehicle, truck, tractor, machine, crane, or other combination Of vehicles, with or without loads, including, without limitation, those that have a gross weight greater than thirty thousand (30,000) pounds or a weight greater than ten thousand (IO,000) pounds carried on any one axle, and includes any such vehicles operated by Project Company or its agents, employees, servants or independent contractors in the course of Project Company's business. This is for permission to access, ingress, and egress during the planning and construction phases of, and thereafter during the operation and maintenance phase of, the Project until said Project is completely abandoned: and (B) Permission to cross county roads of Calhoun County with underground and/or overhead communication lines, electric collection lines, an electric transmission lines (each, an "Electric Line'') under or over the county roads listed below. Electric Line Crossing • County Road 301 This agreement is authorized by the Calhoun County Commissioners Court to grant such application on behalf of Calhoun County. The permission requested above should be and is hereby granted, subject to the following conditions: I . Underground lines will be buried at least 3 feet below the normal bottom of the barrow ditch. 2. The county road and barrow ditch at each crossing location will be placed back in the same condition as it was prior to the crossing of the county road. 3. If an Electric Line must be moved or improved, it will be at the sole expense of the Project Company. 4. All maintenance and repair cost of an Electric Line will be at the sole expense of the Project Company unless caused by the negligence of Calhoun County employees. Page 1 of5o o// 5. Project Company will place a marker describing each underground Electric Line on the edge of property directly above underground Electric Line. 6. All underground Electric Lines, where practicable, shall be located to cross roadbed at approximately right angles thereto. 7. There will be no trenching of any roads, only boring. VEHICLES shall include any vehicles, tractor or combination of vehicles, with our without loads, that have a gross weight greater than thirty thousand (30,000) pounds or a weight greater than ten thousand (10,000) pounds carried on any one axle, and includes any such vehicles operated by Project Company or its agents, employees, servants or independent contractors in the course of Project Company's business. II. It is understood and agreed that the provisions of this agreement apply to Project Company's vehicles operating on any Calhoun County road, whether with or without a permit. Project Company hereby agrees that it is its responsibility and obligation to determine, in consultation with the County, (1) the weight limits for any roads traveled by Project Company's vehicles and (2) the strength and design sufficiency of the roads and bridges and culverts on the roads to carry and withstand the weight of Project Company's vehicles traveling on the roads. Project Company hereby agrees to pay Calhoun County for the reasonable, actual cost of repairing damages to the road bed, road surface, bridges, culverts, signs, structures, fences; right- of-ways that are caused by the movement of Project Company's vehicles over the roads described in this agreement or any other Calhoun County road. Project Company further agrees that its liability for any such damage is not limited to the amount of the bond required for the issuance of the permit. Project Company hereby agrees to promptly report any such damage to the County Commissioner of the precinct where the damage occurred. Project Company hereby agrees that his failure to either (i) repair any such damaged or pay the reasonable cost of repairing any such damages as described within thirty (30) days after billing to Project Company at the address shown on this agreement; or (U) reasonably dispute that such damages were caused by Project Company, shall be grounds for the Calhoun County Commissioners Court to revoke Project Company's permit hereunder without hearing, and to immediately file suit for such damage. It is hereby agreed by the parties that this Agreement shall be governed by the laws of the State of Texas and that any action or proceeding arising from a dispute concerning this agreement shall be brought in Calhoun County, Texas. Project Company shall use commercially reasonable efforts to minimize the disruption to the county roads and bridges and shall repair any damage to said county roads and bridges caused by Project Company or Project Company's contractors or suppliers during the course of Page 2 of 5 41 1 constructing, repairing, or maintaining the Project to the condition they were in prior to the Project Company's use of the county roads and bridges, normal wear and tear excepted. IV. Any violation of this "Special Road Use Indemnity Agreement and Permit" by undersigned Project Company, its employees, or anyone validly acting on its behalf, that continues for ten (10) days after Project Company receives notice of said violation may result in its temporary suspension by the County Commissioner of the precinct in which the road agreement applies. In the event of such temporary suspension, the Commissioners' Court shall, at its next regularly scheduled meeting, and after notice to the undersigned Project Company, determine whether to reinstate, or revoke this road use agreement and permit V. Project Company hereby agrees that once a permit has been suspended or if Project Company operates vehicles on county roads without a permit, damages are not an adequate remedy at law for the enforcement of Calhoun County's rights, and the Calhoun County may maintain an action for injunctive relief to prohibit Project Company's vehicles from using any Calhoun County roads without a permit Project Company further agrees that Calhoun County shall be held harmless for any actual, incidental, consequential or other damages Project Company may suffer as a result of any action of Calhoun County involving any such injunctive relief. Project Company hereby agrees that no action or inaction by Calhoun County shall be considered an election of its rights and remedies, and Calhoun County is free to seek all remedies available at law or inequity to enforce its legal rights or the terns of this agreement. VI. To insure performance of this Agreement, the Project Company hereby agrees to do one of the following: i. Post a surety bond in accordance with § 623.012 of the Texas Transportation Code. 2. Provide a commercial umbrella liability insurance policy, or self-insurance, in the amount of at least $1,000,000.00 valid until production ceases. If more than one project site is established and serviced from same road the provision of this agreement are in effect until production ceases at all locations. All surety bonds and umbrella liability insurance policies shall meet the requirements set forth below and shall be approved by Commissioner Court before any permit is issued under this agreement. 1. The bond or insurance policy must be written by an insurance company licensed to do business in the State of Texas. Page 3 of 2. The bond to be set by the Commissioner(s) whose precinct the Project Company will be operating shall be sufficient to guarantee the payment of any damage to a road or bridge as a consequence of the road use, but no less than $100,000.00. J. The bond amount must also be sufficient to cover all damage which might be incurred during the term of the bond. 4. The bond shall be payable to Calhoun County, Texas. 5. The bond shall be conditioned that the Project Company will pay Calhoun County, Texas for any damage sustained to any county roads or bridges because of the movement of Project Company's vehicles on such roads or bridges. VII. Nothing herein shall be construed as a waiver by a Commissioner, the Commissioners Court or the County Judge of the authority granted by the Texas Transportation Code. The Agreement contains the entire agreement between the parties relating to its subject matter. The Calhoun County Commissioners Court, on behalf of Calhoun County, agrees that, aside from this Agreement, no permits, approvals, or authorizations are necessary for any use, crossing, or improvement of, or impact or addition to, any Calhoun County roads. This Agreement is binding on all parties, successors, and assigns forever for the purposes stated herein. Project Company understands that this is for County Road(s) PROJECT COM (William Kelsey, Tres Bahias Solar Power. LLC PROJECT COMPANY'S NAME - PROJECT COMPANY'S ADDRESS ALHOUN CO V JUDGE wkelsevr swi f icurrenteneray.com PROJECT COMPANYS EMAIL 713-502-.1965 PROJECT COMPANY'S PHONE COJ2&L, ag� MMI SIGNER PCT. k Original to be mailed to: 211 South Ann Street, Suite 102 " Port Lavaca, Texas 77979 Page 4 of 4 The Honorable Richard Meyer Calhoun County Courthouse 211 S. Ann St, Ste. 301 Port Lavaca, TX 77979 E-mail: richard.meyer@calhouncotx.org March 2, 2022 Tres Bahias Solar Power, LLC c/o Swift Current Energy 184 High Street, 7th Floor Boston, MA 02110 Attention: Legal Re: Calhoun County Approvals To Tres Bahias Solar Power, LLC, its successors, and assigns: Except with respect to (1) that certain Calhoun County Road Use and Crossing Agreement dated March 2, 2022, and (2) that certain Calhoun County Development Permit (Permit #6349) issued on November 5, 2021, I affirm that there are no rules or ordinances of Calhoun County, Texas (i) that require zoning approval, a license, an authorization, an agreement, or a permit for the construction, operation or maintenance of a solar energy project (including all its facilities, such as racking, solar panels, substations, operation and maintenance buildings, roads, underground collector lines, overhead lines, and/or other support facilities or structures), or (ii) regarding decommissioning, safety buffer zones, setback requirements, noise restrictions, or other zoning rules or regulations affecting the proposed location, construction, operation or maintenance of a solar energy project and its respective facilities. I also affirm that there are no additional requirements for floodplain development, and no further approvals or permits are required. Regar The Honorable Richard Meyer Calhoun County Judge HB: 4822-2694-9036.1 #16 NOTICE OF MEETING — 3/2/2022 16. Consider and take necessary action regarding the expiration of the MIMIC Underground Storage Tank Policy on March 13, 2021 which is no longer renewable. (RHM) Roshanda Thomas explained the situation. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 13 of 19 Mae Belle Cassel From: pfikac@mmcportlavaca.com (Pam Fikac) <pfikac@mmcportlavaca.com> Sent: Friday, February 18, 2022 9:14 AM To: Mae Belle Cassel (maebelle.cassel@calhouncotx.org) Subject: FW: Storage Tank Agenda Item Wording Attachments: MMC-Non renewal.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Good morning Mae Belle, Please see message below from Roshanda Thomas. Please see attachment. Please let me know if you have any questions. Thank you. J am..g&= Executive Assistant Credentialing Coordinator MEMORIAL MEDICA nl CANTER So From: Roshanda S. Thomas Sent: Friday, February 18, 2022 9:04 AM To: Pam Fikac <pfikac@mmcportlavaca.com> Subject: FW: Storage Tank Agenda Item Wording FYI ... please forward the statement below to Ms. Maebelle alone with the attachment to add to Commissioner's Cou -t 4inda (March 2ntl) newable act 3/13/21 which is no longer reion regarding the expiration of the MMC Underground Storage Tank Policy on "Consider and take necessarya — — new Roshanda S. Thomas, MHA I Interim Chief Executive Officer Memorial Medical Center 815 N. Virginia St., Port Lavaca, TX 77979 Ph(361)552-0240 Fax(361)552-0220 rthomas@mmcportlavaca.com From: candice villarreal <candice.villarrealPcalhouncotx org> Sent: Thursday, February 17, 2022 4:47 PM To: Roshanda S. Thomas <rthomas@mmcportlavaca com> Subject: Storage Tank Agenda Item Wording - - - -- - outside of the brganization. Do not click links or open attachme-nts unless you. Roshanda, Here is possible wording for the Commissioners Court agenda item about the Underground Storage Tank Policy. "Consider and take necessary action regarding the expiration of the MMC Underground Storage Tank Policy on 3/13/21 which is no longer renewable." I have attached the notice regarding the policy. We will not be having Commissioners Court next week because of the holiday on Monday and then the Commissioners will be out of town at a conference. The agenda item can still be sent to MaeBelle for court on March 2nd. Will you be able to attend court this day? Let me know if you have any questions. O Candice Villarreal PAssistantAudritor Calhoun CountyAufiitors Office 202 S. Ann Street, Suite B (Port Lavaca, 7X 77979 None (361)5534612 Calhoun County Texas #17 NOTICE OF MEETING — 3/2/2022 17. Consider and take necessary action to extend the Interlocal Agreement with the following agency and authorize the County Judge to sign the contract and purchase order. (RHM) Calhoun County Soil and Water Conservation District No. 345 $ 7,750.00 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 14 of 19 CALHOUN COUNTY 202 S. ANN STE. A PORT LAVACA, TX 77979 CHECK REQUISITION/ PURCHASE ORDER DATE: 2/4/2022 DEPT#: 11201 PURCHASE ORDER NO. 2022-0010 VENDOR INFORMATION DEPARTMENT INFORMATION NAME: Calhoun Soil & Water Conservation (NAME: Soil and Water Conservation ADDRESS: P O BOX 553 ":.if ADDRESS: CITY: Port Lavaca cm: STATE: TX -!STATE: ZIP: 77979 !ZIP: PHONE: 'PHONE: J VENDOR#: '9999 ACCOUNT NO. FUND DEPT GL INVOICE DATE INVOICE NO. DESCRIPTION rT0 BEENTEREO /NTO MIP TOTAL 1000 120 61280 Contribution to Expense $ 7,750.00 Agreement approved in Commissioners' Court on February 9,2022 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 $ 7,750.00 SERVICES WERE RECEIVED BY ME IN GOOD CONDITON AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION. COUNTYAUDITOR APPROVAL ONLY APPROVAL/DEPARTMENT HEAD DEP TMENT HEAD DATE BY DATE INTERLOCAL AGREEMENT between CALHOUN COUNTY and CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 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 the CALHOUN SOIL & WATER CONSERVATION DISTRICT 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, CALHOUN SOIL & WATER CONSERVATION DISTRICT #345, hereinafter referred to as CALHOUN SOIL & WATER CONSERVATION DISTRICT #345, is engaged in various functions involving agricultural production - including livestock, crops, aquaculture, horticulture and forestry and providing services 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 CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 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, CALHOUN SOIL dam' WATER CONSERVA77ON DISTRICT #345 shall be entitled to a sum not to exceed $7,750.00 per annum. Such amount shall be disbursed by COUNTY to CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 after January 1, 2022, upon written request from CALHOUN SOIL & WATER CONSERVA77ON DISTRICT #345. 2. Insurance: CALHOUN SOIL & WATER CONSERVA77ON DISTRICT #345 shall at all times maintain a policy of liability insurance for premises liability for personal injury. The County will require documentation of General Liability insurance coverage, with adequate limits to be determined individually, depending on exposure. 3. Services: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall provide services to the residents of COUNTY by providing diverse services including the following: providing secretarial help to the Natural Resource Conservation Service, which in turn provides technical time for assistance to our local government, drainage districts, industry, local businesses, farmers and ranchers, in addition to developing and carrying out programs for the conservation, protection and development of soil, water, and related plant and animal resources and shoreline erosion projects with the County. 4. Most Recent Financial and Performance Reports: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall submit to COUNTY Auditor and COUNTY Judge each a copy of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345's most current independent financial audit or end -of -year financial report of all expenditures and income for the period of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 fiscal year ending in calendar year 2021, within 30 days of the approval of this contract. CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 gives details of services provided and clients served for the previous COUNTYfiscal year, within 30 days after the approval of this contract. 6. Prospective Financial and Performance Reports: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall submit to COUNTY Auditor and COUNTY Judge each a copy of CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345's independent financial audit or end -of -year financial report of all expenditures and income for the period of CALHOUN SOIL dam° WATER CONSERVATION DISTRICT #345's fiscal year ending in calendar year 2021, by the earliest of thirty days following its receipt by CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 or by September 30, 2022. CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 gives details of services provided and clients served for CALHOUN SOIL & WATER CONSERVATION DISTRICT #345's fiscal year ending in calendar year 2021, by September 30, 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 CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 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. 9. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 10. Non -Discrimination: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 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: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 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: CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or worker's compensation. This clause places a duty to meet the requirements of such laws only if the law itself places such a duty on CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345. 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 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, not shall any single or partial exercise of any right, power or privilege constitute such a waiver not 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 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 CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 may not assign this contract without COUNTY's 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. 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 law. 18. 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 COUNTI' have any obligation or liability whatsoever with respect to any, debts, obligations or liability of CALHOUN SOIL 6- IFATER CONSERT ATION DLSTRICT #345, and C<ILHOUN.S'OIL & IU<ITER CON.S'ERI ATIONDLS'IRICC #345 shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUN71' are delegated to CALHOUN SOIL 6' If ATER CONVERT A'1'ION DISTRICC #345 by this contract and any provision which is or may 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 COUivn, and CALHOUN SOIL & IF -]TER CON.S'ERF ATION DISTRICT #345, except as herein otherwise provided. 20. Total Agreement: This contract is a total and complete integration of any and 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 By: /Z - Date: -g — 7- ` ZZi CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 CALHOUN SOIL and WATER CONSERVATION DISTRICT NO. 345 Post Office Box 553 Port Lavaca, Texas 77979 February 22, 2022 Richard Meyer, Judge Calhoun County Commissioners Court 211 South Ann Street, Suite 301 Port Lavaca, Texas 77979 Dear Judge Meyer and Commissioners: Calhoun Soil and Water Conservation District is making request to receive the contribution from Calhoun County Commissioners Court that was allocated in its 2022 budget. Thank you for your assistance. Sincerely, Jo ce May ecutive Secretary #18 NOTICE OF MEETING — 3/2/2022 18. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $7,969.71 for damages incurred during the Winter Storm the week of February 15, 2021. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 15 of 19 Mae Belle Cassel From: candice.villarreal@calhouncotx.org (candice villarreal) <ca ndice.vi Ila rreal @cal hou ncotx.org> Sent: Thursday, February 24, 2022 9:35 AM To: maebelle.cassel@calhouncotx.org Cc: Richard H. Meyer, David Hall; vern lyssy;joel.behrens@calhouncotx.org; Gary Reese Subject: Agenda Item - Winter Storm Attachments: TAC Insur Proceeds Winter Storm.pdf Good Morning MaeBelle, Please add the following to the next Commissioners Court agenda. • Consider and take necessary action on insurance proceeds check from TAC in the amount of $7,969.71 for damages during the Winter Storm the week of February 15, 2021. Have a Blessed Day! O Candice Viffarrea! IslAssistant Auditor Caflioun County Auditors Office 202 S. Ann Street, Suite B Port Lavaca, V 77979 ('hone (361)553-4612 Calhoun County Texas TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS 56163 .VENDOR NAME I ACCOUNT NUMBER DATE I ',INVOICE Np. 5.. ) DESCRIPTION - I - AMOUNT 2/15/2022 PR20219650-1 m 56163 FflosT BANK TEXAS ASSOCIATION OF COUNTIES w RISK MANAGEMENT Po)6L-CLAIMS 3o-s/nao a 1210 SAN ANTONIO STREET * * AUSTIN, TX 78701 5-%e (512)478-8753 COpN�l DATE AMOUNT 2/15/2022 $ 7,969.71 PAY SEVEN THOUSAND NINE HUNDRED SIXTY-NINE AND 711100 DOLLARS VOID AFTER 180 DAYS m a.E TO THE Calhoun County ORDER 202 S Ann St Ste B' OF. Port Lavaca, TX 77979-4204 N rfl ® F i Ila056i6311' w -V ,f TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS �: +4 � a r r .`r x x✓ i t fn h s n+"- Calhoun County 202 S Ann St Ste B Part Lavaca, TX 77979-4204 56163 TO REORDER CALL: (706)327-8550 W148F001014M 05/21 #19 NOTICE OF MEETING — 3/2/2022 19. Consider and take necessary action to accept an insurance proceeds check from TAC in the amount of $2,095.70 for damages from a windstorm to the Port O'Connor Community Center Pavilion roll up doors on January 31, 2022. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 16 of 19 Mae Belle Cassel From: candice.villarreal@calhouncotx.org (candice villarreal) <candice.vil larrea I@cal houncotx.org> Sent: Thursday, February 24, 2022 12:09 PM To: maebelle.cassel@calhouncotx.org Cc: Richard H. Meyer; David Hall; vern lyssy;joel.behrens@calhouncotx.org; Gary Reese Subject: Insurance Proceeds - POCCC Pavilion Doors Attachments: TAC Insur Proceeds 013122 POCCC.pdf MaeBelle, Please add the following the next available Commissioners Court Agenda. • Consider and take necessary action on insurance proceeds from TAC in the amount of $2,095.70 for damages from a windstorm to the Port O'Connor Community Center Pavilion roll up doors on January 31, 2022. Thank you, O Candce'Viliarreaf 151AssistantAuditor Calhoun County Auditors Office 202 S. Ann Street, Suite B Port Lavaca, V 77979 Phone (361)5534612 Calhoun County Texas TEXAS ASSOCIATION OF COUNTIES CHECK DATE CHECK NO. 56237 RISK MANAGEMENT POOL -CLAIMS 2/22/2022 56297 VENDORID _ VENDOR NAME ACCOUNT NUMREA - INVOICE NO_ . 2/22/2022 PR202Z1606-1 Deductible $-2500.00 pss 00' FROSTBANK 56237>a TEXAS ASSOCIATION OF COUNTIES w o RISK MANAGEMENT POOL -CLAIMS 30-9/1140 F z 1210 SAN ANTONIO STREET * * AUSTIN, TX 78701 (512)478-8753 CO9Nq� DATE AMOUNT 2/22/2022 $ 2,095.70 PAY TWO THOUSAND NINETY-FIVE AND 70 / 100 DOLLARS L,J L VOID AFTER 180 DAYS TO THE Calhoun County ORDER 202 S Ann St Ste B OR :51 B71® 1 /} Port Lavaca, TX 779794204 1-�YtiL L- UU IP0Sr. 23?1,' d*w st xi 1a; Sys „. TEXAS ASSOCIATION OF COUNTIES .(' 5 6 2 3 7 RISK MANAGEMENT POOL -CLAIMS Calhoun County 202 S Ann St Ste B Port Lavaca, TX 779794204 TO REORDER CALL: (706)327-8550 W148F001014M 05/21 # zo NOTICE OF MEETING — 3/2/2022 20. Accept Monthly Reports from the following County Offices: I. District Clerk — January 2022 ii. Justice of the Peace, Precinct 3 — January 2022 iii. Justice of the Peace, Precinct 4 — January 2022 iv. Tax Assessor -Collector —January 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 17 of 19 *Treasurer Receipts Numbers: F2022JAN001, F2022JAN026, F2022JAN027 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/10/2022 ACCOUNT NUMBER COURT NAME: DISTRICT CLERK MONTH OF REPORT: JANUARY YEAR OF REPORT: 2022 ACCOUNT NAME DEBIT CREDIT 1000-001-44190 SHERIFF'S SERVICE FEES $2,389.06 1000-001-44140 JURY FEES $220.00 1000-001-44045 RESTITUTION FEE $0.00 1000-001-44020 DISTRICT ATTORNEY FEES $0.00 1000-001-49010 REBATES -PREVIOUS EXPENSE $6.50 1000-001-49030 REBATES-ATTORNEY'S FEES $60.47 1000-001-44058 DISTRICT CLERK ELECTRONIC FILING FEES $0.00 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEES $40.90 1000-001-43049 STATE REIMB- TITLE IV-D COURT COSTS $0.00 DISTRICT CLERK FEES CERTIFIED COPIES $553.00 CRIMINAL COURT $12.65 CIVIL COURT $3,263.75 STENOGRAPHER $355.00 CIV FEES DIFF $0.00 1000-001-44050 DISTRICT CLERK FEES $4,184.40 1000-999-20771 FAMILY VIOLENCE FINE $0.00 1000-999-10010 CASH - AVAILABLE $6,901.33 2706-001-44055 FAMILY PROTECTION FEE $0.00 2706-999-10010 CASH - AVAILABLE $0.00 2740-001-45055 FINES - DISTRICT COURT $237.91 2740-999-10010 CASH - AVAILABLE $237.91 2620-001-44055 APPELLATE JUDICIAL SYSTEM $75.00 2620-999-10010 - CASH - AVAILABLE $75.00 2648-001-44055 COURT FACILITY FEE FUND $260.00 2648-999-10010 CASH -AVAILABLE $260.00 2670-001-44055 COURTHOUSE SECURITY $326.57 2670-999-10010 CASH - AVAILABLE $326.57 2673-001-44055 CRT RECS PRESERVATION FUND- CO $110.00 2673-999-10010 CASH - AVAILABLE $110.00 2725-001-44055 LANGUAGE ACCESS FUND $39.00 2725-999-10010 CASH - AVAILABLE $39.00 2739-001-44055 RECORD MGMT/PRSV FUND - COUNTY $412.12 2739-999-10010 CASH - AVAILABLE $412.12 2737-001-44055 RECORD MGMT/PRSV FUND -DIST CLRK $110.79 2737-999-10010 CASH - AVAILABLE $110.79 2731-001-44055 LAW LIBRARY $525.00 2731-999-10010 CASH - AVAILABLE $525.00 2663-001-44050 CO & DIST CRT TECHNOLOGY FUND $1.25 2663-999-10010 CASH - AVAILABL $1.25 7040-999-20740 BREATH ALCOHOL TESTING- STATE $0.00 7040-999-10010 - CASH - AVAILABLE $0.00 2667-001-44055 CO CHILD ABUSE PREVENTION FUND $0.08 2667-999-10010 CASH - AVAILABLE $0.08 7502-999-20740 JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE $45.00 7502-999-10010 CASH-AVAILABE $45.00 7383-999-20610 DNA TESTING FEE - County $0.04 7383-999-20740 DNA TESTING FEE - STATE $0.37 7383-999-10010 CASH - AVAILABLE $0.41 7405-999-20610 EMS TRAUMA FUND - COUNTY $3.22 7405-999-20740 EMS TRAUMA FUND - STATE $28.94 7405-999-10010 CASH -AVAILABLE $32.16 7070-999-20610 CONSOL. COURT COSTS - COUNTY $3.11 7070-999-20740 CONSOL. COURT COSTS - STATE $27.99 7070-999-10010 CASH - AVAILABLE $31.10 7072-999-20610 STATE CONSOL. COURT COSTS- COUNTY $53.20 7072-999-20740 STATE CONSOL. COURT COSTS- STATE $478.80 7072-999-10010 CASH -AVAILABLE $532.00 2698-001-44030-010 DRUG CRT PROG FEE - COUNTY (PROGRAM) $5.44 2698-999-10010-010 CASH -AVAILABLE $5.44 7390-999-20610-999 DRUG COURT PROG FEE - COUNTY (SVC FEE) $1.09 7390-999-20740-999 DRUG COURT PROG FEE - STATE $4.34 7390-999-10010-999 CASH -AVAILABLE $5.43 7865-999-20610-999 CRIM - SUPP OF IND LEGAL SVCS - COUNTY $0.05 7865-999-20740-999 CRIM - SUPP OF IND LEGAL SVCS - STATE $0.43 7865-999-10010-999 CASH - AVAILABLE $0.48 7950-999-20610 TIME PAYMENT - COUNTY $2.88 7950-999-20740 TIME PAYMENT - STATE $2.88 7950-999-10010 CASH - AVAILABLE $5.76 7505-999-20610 JUDICIAL SUPPORT-CRIM - COUNTY $0.21 7505-999-20740 JUDICIAL SUPPORT-CRIM - STATE $1.19 7505-999-10010 CASH - AVAILABLE $1.40 7505-999-20740-010 JUDICIAL SALARIES -CIVIL- STATE(42) $462.00 7505-999-10010-010 CASH AVAILABLE $462.00 2740-001-45050 BOND FORFEITURES $0.00 2740-999-10010 CASH - AVAILABLE $0.00 2729-001-44034 PRE-TRIAL DIVERSION FUND $0.00 2729-999-10010 CASH - AVAILABLE $0.00 7857-999-20610 JURY REIMBURSEMENT FUND- COUNTY $0.10 7857-999-20740 JURY REIMBURSEMENT FUND- STATE $0.86 7857-999-10010 CASH - AVAILABLE $0.96 7860-999-20610 STATE TRAFFIC FINE- COUNTY $0.00 7860-999-20740 STATE TRAFFIC FINE- STATE $0.00 7860-999-10010 CASH -AVAILABLE $0.00 7403-999-22888 DIST CRT- ELECTRONIC FILING FEE - CIVIL $320.00 7403-999-22991 DIST CRT- ELECTRONIC FILING FEE - CRIMINAL $1.55 CASH - AVAILABLE $321.55 1000-001-44050 DISTRICT CLERK FEES $115.01 1000-999-10010 CASH -AVAILABLE $115.01 2739-001-44055 RECORD MGMT/PRSV FUND - COUNTY $71.88 2739-999-10010 CASH -AVAILABLE $71.88 2669-001-44050 COUNTY JURY FUND $2.88 2669-999-10010 CASH - AVAILABLE $2.88 2670-001-44055 COURTHOUSE SECURITY $28.75 2670-999-10010 CASH - AVAILABLE $28.75 2663-001-44050 CO & DIST CRT TECHNOLOGY FUND $11.50 2663-999-10010 CASH - AVAILABLE $11.50 2676-001-44050 COUNTY SPECIALTY COURT FUND $71.88 2676-999-10010 CASH -AVAILABLE $71.88 TOTAL: $301.91 7855-999-20784-010 DIST CRT - DIVORCE & FAMILY LAW - STATE $0.00 7855-999-20657-010 DIST CRT - DIVORCE & FAMILY LAW - COUNTY $0.00 7855-999-20792-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - STATE $145.50 7855-999-20658-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY $4.50 7855-999-20740-010 DIST CRT - OTHER CIVIL PROCEEDINGS - STATE $104.50 7855-999-20610-010 DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY $5.50 7855-999-20790-010 DUE TO STATE - NONDISCLOSURE FEE $0.00 7855-999-10010-010 CASH - AVAILABLE $260.00 2677-999-20740-999 COUNTY DISPUTE RESOLUTION FUND $195.00 2677-999-10010-999 CASH - AVAILABLE $195.00 7858-999-20740-999 DIST CLK - DUE TO STATE CONSOLIDATED FEE 2022 $1,723.00 7858-999-10010-999 CASH AVAILABLE $1,723.00 TOTAL (Distrib Req to Oper Acct) $13,224.56 $12,922.65 DUE TO OTHERS (Distrib Req(s) attached) ATTORNEY GENERAL (RESTITUTION) 0.00 OUT -OF -COUNTY SERVICE FEES 850.00 REFUND OF OVERPAYMENTS 4.50 DUE TO OTHERS 0.00 TOTAL DUE TO OTHERS $854.50 REPORT TOTAL - ALL FUNDS 13,777.16 PLUS AMT OF RETURNED CKS 0.00 LESS: TOTAL TREASURER'S RECEIPTS (13,777.15) Revised 01/31/20 OVER / (SHORT) $0.00 DISTRICT COURT STATE COURT COSTS REPORT SECTION ]'REPORT FOR OFFENSES COMMITTED 0111/20 - Present 01/01/04-12131/19 09/01/01-12131/03 09101 /99 - 08131 /01 09101/97 - 08/31/99 09/01/95 - 08/31/97 09/01/91 - 08/31/95 COLLECTED $30,57"- it ,,,ri =:� -^�?:` €g JANUARY COUNTY 53.20 3.06 0.02 0.03 - - JANUARY 2022 STATE 478.80 27.51 0.18 0.30 - - TOTALSI 1 506.79 BAIL BONDS FEES DNA TESTING FEES 0.41 0.04 0.37 EMS TRAUMA FUND 32.16 3.22 28.94 JUV. PROB. DIVERSION FEES JURY REIMBURSEMENT FEE $0.96 0.10 0.86 INDIGENT DEFENSE FUND $0.48 0.05 $0.43 STATE TRAFFIC FEES $0.00 - $0.00 DRUG CRT PROG FEE $10.87 $6.53 4.34 SECTION II: AS APPLICABLE STATE POLICE OFFICER FEES FAILURE TO APPEARIPAY FEES - - JUD. FUND-CONST. CO. CRT. JUD. FUND -STATUTORY CO. CRT. MOTOR CARRIER WEIGHT VIOLATIONS TIME PAYMENT FEE $6.76 2.88 2.88 DRIVING RECORD FEE JUDICIAL SUPPORT FEES $1.40 0.21 1.19 ELECTRONIC FILING FEE -CR $1.55 $1.55 TOTAL STATE COURT COSTS $616.69 $ 69.34 $ 547.35 CIVIL FEES REPORT JANUARY COLLECTED COUNTY STATE BIRTH CERTIFICATE FEES MARRIAGE LICENSE FEES DECL. OF INFORMAL MARRIAGE ELECTRONIC FILING FEE - CV $320.00 $320.00 NONDISCLOSURE FEES 0$0.00 $0.00 JUROR DONATIONS JUSTICE CRT. INDIG FILLING FEES STAT PROB CRT INDIG FILING FEES STAT PROB CRT JUDIC FILING FEES STAT CNTY CRT INDIG FILING FEES STAT CNTY CRT JUDIC FILING FEES STAT CNTY CRT -JUDICIAL SUPPORT CONST CNTY CRT INDIG FILING FEES CNST CNTY CRT JUDIC FILING FEES DIST CRT DIV & FAMILY LAW $0.00 - - DIST CRT OTHER THAN DIV/FAM LAW 9 $150.00 4.50 145.50 DIST CRT OTHER CIVIL FILINGS 19'I $110.00 5.50 104.50 FAMILY PROTECTION FEE JUDICIAL SUPPORT FEE 11 $462.00 $462.00 JUDICIAL & COURT PERSONNEL TRANING FEE 18 $45.00 - $45.00 2022 STATE CONSOLIDATED FEE - 25: $1,723.00 $1,723.00 COUNTY DISPUTE RESOLUTION FUND 195.00 195.00 TOTAL CIVIL FEES REPORT $ 3,005.00 $ 10.00 $ 2,995.00 TOTAL BOTH REPORTS $ 3,621.69 $ 79.34 $ 3,542.35 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 420 A 44602 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Anna Kabela Address: Title: District Clerk City: State: Zip: Phone: ACCOUNT NUMBER DESCRIPTION AMOUNT 7340-999-20759.999 District Clerk Monthly Collections - Distribution $12,922.65 JANUARY 2022 V# 967 1 / Signature of Official TOTAL 12,922.65 Date ENTER COURT NAME: ENTER MONTH OF. REPORT ENTER YEAR OF REPORT 2022 CODE CASH BONDS ADMINISTRATION FEE -ADMF BREATH ALCOHOL TESTING - BAT CONSOLIDATED COURT .COSTS -CCC STATE CONSOLIDATED COURT COST- 2020 LOCAL CONSOLIDATED COURT COST- .2020 COURTHOUSE SECURITY -CHS CJP CIVIL JUSTICE DATA REPOSITORY FEE - CJDR CORRECTIONAL MANAGEMENT INSTITUTE -CMI CR CHILD SAFETY -CS CHILDSEATBELT FEE - CSBF CRIME VICTIMS COMPENSATION -CVC DPSC/FAILURE TO. APPEAR - OMNI - DPSC ADMINISTRATION FEE. FTA/FTP (aka OMNI). 2020 ELECTRONIC FILING FEE -EEF FUGITIVE APPREHENSION - FA GENERAL REVENUE -GR CRIM- IND LEGAL SVCS.SUPPORT - IDF JUVENILE CRIME & DELINQUENCY - JCD JUVENILE CASE MANAGER FUND -JCMF JUSTICE COURT PERSONNEL TRAINING - JCPT JUROR SERVICE FEE - JSF LOCAL ARREST FEES -LAF LEMI LEDA LEOC OCL PARKS & WILDLIFE ARREST FEES - PWAF STATE ARREST FEES- SAF SCHOOL CROSSINGICHILD SAFETY FEE - SCF SUBTITLE C - SUBC STATE TRAFFIC FINES -EST 9.1.19- STF TABC ARREST FEES-TAF TECHNOLOGY FUND• TF TRAFFIC -TFC LOCAL TRAFFIC FINE- 2020 TIME PAYMENT -TIME TIME PAYMENT REIMBURSEMENT FEE- 2020 TRUANCY PREVENTION/DIVERSION FUND -TPDF LOCAL&STATE WARRANT FEES -WRNT ' COLLECTION SERVICE FEE-MVBA- CSRV .DEFENSIVE DRIVING COURSE-. DDC DEFERRED FEE -DFF DRIVING EXAM FEE-PROV OIL FILING FEE - FFEE STATE CONSOLIDATED CIVIL FEE - 2022 LOCAL CONSOLIDATED CIVIL FEE - 2022 -FILING 'FEE SMALLCLAIMS -FFSC JURY FEE - JF COPIES/CERTIFEDCOPIES - CC INDIGENT FEE - CIFF or INDF JUDGE PAY RAISE FEE -.JPAY SERVICE. FEE - SFEE OUT -OF -COUNTY SERVICE FEE ELECTRONIC FILING FEE- EEF CV EXPUNGEMENTFEE-EXPG EXPIRED RENEWAL -EXPR ABSTRACT OF JUDGEMENT -AOJ ALL WRITS -WOP / WOE DIPS FTA FINE - DPSF LOCAL FINES - FINE LICENSE & WEIGHT FEES - LWF PARKS& WILDLIFE FINES - PWF SEATBELT/UNRESTRAINED CHILD FINE- SEAT - JUDICIAL & COURT PERSONNEL TRAINING-JCPT OVERPAYMENT .(OVER $10)-OVER OVERPAYMENT ($10 AND LESS) -OVER TOTAL ACTUAL MONEY RECEIV TYPE: TOTAL WARRANT FEES ENTER LOCAL WARRANT FE STATE WARRANT FIE DUE TO OTHERS: DUE TO CCISD-50% of Fine on JV cases DUE TO DA RESTITUTION FUND REFUND OF OVERPAYMENTS. OUT -OF -COUNTY SERVICE FEE CASH BONDS IRS RE( [CKS, M REVISED 02/02/2021 214.88 434.00 98.00 21.49 0.24 30.78 25.00 21.50 24.47 37.38 79.39 227.94 21.49 7.94 - 13.68 5.42 32.31 10.76 223.85 246.00 239.00 150.00 147.00 231.00 32.22 354.00 0.00 1,265.28 418� 6.00 4MOUNT 223.85 SOAO RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT $1Z3.85 RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT 4MOUNT 0.00 PLFASEINCLUGE DR. REQUESTING DISBURSEMENT 0.00. PLFASEINCLUDE GR. REOUESTINGDIBBURSEMENi 0.00 1PLEASEINCLUDE OR. REQUESTINGDISRURSEMENT. 0.00 PLEASEINCLUDE D.R. REOUEINGDISBURGEMENT 0.00 PLEASEINCLUDE D.R. REQUESTING DISBURSEMENT (IF REQUIRED) $0.00 4MOUNT 4;185.00 CalCUlate from ACTUAL Treasurer's Receipts 4186.00 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/9/2022 ACCOUNT NUMBER 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 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 tiC2L ACCOUNTNAME AMOUNT FINES 1,255.28 SHERIFF'S FEES 243.45 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 21.62 ADMINISTRATIVE FEES 239.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 TOTAL ADMINISTRATIVE FEES 260.62 CONSTABLE FEES -SERVICE 354.00 JP FILING FEES 150.00 COPIES / CERTIFIED COPIES 0.00 OVERPAYMENTS (LESS THAN $10) 0.00 TIME PAYMENT REIMBURSEMENT FEE 32.31 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 246.00 TOTAL FINES, ADMIN. FEES & DUE TO STATE $2,541.66 CR 2670-001-44063 COURTHOUSE SECURITY FUND $50.42 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $5.37 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $49.49 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $25.00 CR 2730-001-44063 LOCAL TRUANCY PREVENTION & DIVERSION FUND $35.00 CR 2669-001-44063 COUNTYJURYFUND $0.70 CR 2728-001-44063 JUSTICE COURT SUPPORT FUND $175.00 , CR 2677-001-44063 COUNTY DISPUTE RESOLUTION FUND $35.00 CR 2725-001-44063 LANGUAGE ACCESS FUND $21.00_ STATE ARREST FEES DPS FEES 42.25 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 42.25 CR 7070-999-20610 CCC-GENERAL FUND 21.49 CR 7070-999-20740 CCC-STATE 193.39 DR 7070-999-10010 214.88 CR 7072-999-20610 STATE CCC- GENERAL FUND 43.40 CR 7072-999-20740 STATE CCC- STATE 390.60 DR 7072-999-10010 434.00 CR 7860-999-20610 STF/SUBC-GENERAL FUND 3.97 CR 7860-999-20740 STF/SUBC-STATE 75.42 DR 7860-999-10010 79.39 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 9.12 CR 7860-999-20740 STF- EST 9/1/2019- STATE 218.82 DR 7860-999-10010 227.94 Page 1 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/9/2022 COURT NAME: JUSTICE OF PEACE NO. 3 CR 7950-999-20610 CR 7950-999-20740 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 DR 7950-999-10010 TP-GENERAL FUND TP-STATE 2.71 2.71 Page 2 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/9/2022 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: JANUARY YEAR OF REPORT: 0 to2,L 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 3.08 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 27.68 DR 7865-999-10010 30.76 CR 7970-999-20610 TUFTA-GENERAL FUND 0.00 CR 7970-999-20740 TUFTA-STATE 0.00 DR 7970-999-10010 0.00 CR 7505-999-20610 JPAY- GENERAL FUND 3.22 CR 7505-999-20740 JPAY-STATE 29.00 DR 7505-999-10010 32.22 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 2.15 CR 7857-999-20740 JURY REIMB. FUND- STATE 19.35 DR 7857-999-10010 21.50 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.02 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.22 DR 7856-999-10010 0.24 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 5.38 7998-999-20701 JUVENILE CASE MANAGER FUND 5.38 DR 7998-999-10010 10.76 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 Acct) $4,185.00 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 0.00 WATER S ETY FINES 0.00 TOTAL DUE TO OTHERS $0.00 TOTAL COLLECTED -ALL FUNDS $4,185.00 LESS: TOTAL TREASUER'S RECEIPTS $4,185.00 REVISED 02/02/2021 OVER/(SHORT) $0.00 Page 3 of 3 02-16-22;10:15 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 1/ 5 FAX COVER SHEET FEBRUARY 16, 2022 FROM: JUSTICE COURT PCT. 4. CALHOUN COUNTY 103 W. Dallas Street, P.O. Box 520 Seadrift, Texas 77983 PHONE: 361-785-7082 FAX: 361-785-2179 TO: County Judge Office Ref: Money Distribution Report FAX:361-553-4444 NOTE: The JANUARY 2022 report is attached. Please give me a call if you have any questions. PAGES TO FOLLOW: _5_ INCLUDING THI5 COVER PAGE Thank you, JUNE CANTRELL, CLERK ,fudge 'Wesley J. 3-Cunt 02-16-22;10:15 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 2/ 5 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/1612022 COURT NAME: JUSTICE OF PEACE NO, 4 MONTH OF REPORT; 0 YEAR OF REPORT; 0 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 1,128.37 OR 1000-001.44190 SHERIFF'S FEES 167.00 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 5.52 ADMINISTRATIVE FEES 0.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 5.52 CR 1000-001-44010 CONSTABLE FEES -SERVICE 160.00 CR 1000-001-44051 JP FILING FEES 0.00 OR 1000-001.44090 COPIES / CERTIFIED COPIES 0.00 OR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000.999.20741 DUE TO STATE -DRIVING EXAM FEE 0.00 OR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999.20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 OR 1000-999.20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000.999.20770 DUE TO JP COLLECTIONS ATTORNEY 209.10 TOTAL FINES, ADMIN, FEES & DUE TO STATE $1.659,99 CR 2670-001.44061 COURTHOUSE SECURITY FUND $33.50 CR 2720.001-44061 JUSTICE COURT SECURITY FUND $3.00 OR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $32.00 OR 2699-001-44061 JUVENILE CASE MANAGER FUND $10.00 CR 2730-001-44061 LOCAL TRUANCY PREVENTION & DIVERSION FUND $25.00 OR 2689.001.44061 COVNTYJURYFUND $0.50 CR 2728-001.44061 JUSTICE COURT SUPPORT FUND $50.00 CR 2677-001.44061 COUNTY DISPUTE RESOLUTION FUND $10.00 OR 2725-001.44061 LANGUAGE ACCESS FUND $6.00 STATE ARREST FEES OPS FEES 23.00 P&W FEES 0.00 TABC FEES 0.00 OR 7020-699.20740 TOTAL STATE ARREST FEES 23.00 CR 7070-999-20610 CCC-GENERAL FUND 12.00 OR 7070-999.20740 CCC-STATE 108.00 DR 7070.999-10010 120.00 CR 7072-999-20610 STATE CCC- GENERAL FUND 31.00 OR 7072�999.20740 STATE CCC- STATE 279.00 DR 7072-999.10010 310.00 CR 7860-999-20610 STF/SUBC-GENERAL FUND 0.00 CR 7860-999-20740 STF/SUBC-STATE 0.00 DR 7860-999.10010 0.00 CR 78SM99.20610 STF- EST 9/l/2019- GENERAL FUND 3.68 CR 7860-999-20740 STF- EST 9/l/2019- STATE 88.33 DR 786Q-$00.10010 92.01 Page 1 of 3 02-16-22;10:15 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 3/ 5 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2116=22 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: 0 YEAR OF REPORT: 0 CR 7950-999.20610 TP-GENERAL FUND 37.50 CR 79SM99-20740 TP•STATE 37.50 OR 7950-999-10010 75.00 Page 2 of 3 02-16-22;10:15 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 4/ 5 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 2/1612022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: 0 YEAR OF REPORT: 0 CR 7480.999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 OR 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 0.60 OR 7865.999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 5.40 DR 7885-999.10010 6.00 OR 7970-999.20610 TUFTA-GENERAL FUND 30.00 OR 7970.999-20740 TUFTA-STATE 60.00 DR 7970-999.10010 90.00 CR 7605-999.20610 JPAY-GENERALFUND 1,80 CR 7505-999-20740 JPAY - STATE 16.20 DR 7505.999-10010 18.00 OR 7857.999-20610 JURY REIMB, FUND- GEN. FUND 1.20 CR 7857-999-20740 JURY REIMB. FUND- STATE 10.80 DR 7857-999.10010 12.00 CR 7856.999-20610 CIVIL JUSTICE DATA REPOS,- GEN FUND 0.01 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.-STATE 0.09 DR 7886.999.10010 0.10 OR 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 3.00 7998.999-20701 JUVENILE CASE MANAGER FUND 3100 DR 7998.999.10010 6.00 7403.999-22689 ELECTRONIC FILING FEE - CV STATE 0.00 OR 7403.999.22889 0.00 7858-999.20740 STATE CONSOLIDATED CIVIL FEE 42.00 42.00 TOTAL (Distrib Req to Oper Acct) $2,624,10 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISO 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 $2,624.10 LESS: TOTAL TREASUER'S RECEIPTS $2,624.10 REVISED 02/0212021 OVERI(SHORT) $0.00 Page 3 of 3 02-16-22;10:15 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 5/ 5 CALHOUN COUNTY 201 West Austin PAYEE Name: Calhoun County Oper. Acct. Address: City: State: Zip: Phone: of Offlclal Date DISTRIBUTION REQUEST DR# 450 A 44608 PAYOR Official: Wesley Hunt Title: Justice of the Peace, Pat. 4 SUMMARY TAX ASSESSOR -COLLECTORS MONTHLY REPORT JANUARY 2022 COLLECTIONS DISBURSEMENTS Title Certificate Fees 397 $ 5,161.00 Title Fees Paid TXDOT $ 3,176.00 Title Fees Paid County Treasurer Salary Fund $ 1,986.00 Motor Vehicle Registration Collections $ 136,271.65 Disabled Person Fees $ 60.00 Postage $ - Global Additonal Collections $ - Paid TXDOT $ 3,699.00 Paid TXDOT SP $ 18,149.30 Paid County Treasurer $ 108,155.92 Paid County Treasurer Salary Fund $ 4,730.96 DMV CCARDTRNSFEE $ 1,596.38 $ - OIL Additonal Collections $ - $ - GLOBAL (IBC)Credit/Debit Card Fee's $ 1,291.37 GLOBAL Fees In Excess of Collections $ 305.01 MERCH SERVICES STATEMENT $ - Additional Postage- Vehicle Registration $ - Paid County Treasurer - Additional Postage $ - Motor Vehicle Sales & Use Tax Collections $ 502,252.83 Paid State Treasurer $ 502,262.83 Special Road/Bridge Fees Collected $ 18,300.00 Paid County Treasurer- R/B Fees $ 18,300.00 Texas Parks & Wildlife Collections $ 2,094.00 TPW GLOBAL CC TRANSACTION FEES $ 89.77 GLOBAL ADDITIONAL COLLECTIONS $ - Paid Texas Parks & Wildlife $ 1,884.60 Paid County Treasurer Salary Fund $ 209.40 P&W CCARDTRNSFEE $ 89.77 GLOBAL Additonal Collections $ - GLOBAL (IBC) Credit/Debit Card Fee's $ 134.71 GLOBAL In Excess/Shortage of Collections $ (44.94) Boat/Motor Sales & Use Tau Collections $ 22,711.03 Paid State Treasurer $ 21,576.48 Paid County Treasurer, Salary Fund $ 1,135.55 TABC 5% CO COMMS FOR MONTH OF $ - TABC 5%CO COMMS FOR MONTH OF.DECEMBER 2022 $ - Paid County Treasurer, Salary Fund $ - County Beer & Wine Collections It 890.00 Paid County Treasurer, County Beer & Wine $ 845.50 Paid County Treasurer, Salary Fund $ 44.60 INTEREST EARNED ON OFFICE ACCOUNT $ 64.87 Paid County Treasurer, Nev. East $ 0.02 Paid County Treasurer, all other districts $ 64.85 INTEREST EARNED ON PARKS AND WILDLIFE ACCOUNT $ 2.35 Paid County Treasurer, Interest on P&W Acc $ 2.35 INTEREST EARNED ON REFUND ACCOUNT $ 0.05 Paid County Treasurer, Interest on Refund Aso $ 0.05 Business Personal Property - Misc. Fees Paid County Treasurer Excess Funds Paid County Treasurer Overpayments Current Tax Collections Penalty and Interest - Current Roll Discount for early payment of taxes Delinquent Tax Collections Penalty & Interest - Delinquent Roll Collections for Delinquent Tax Attorney Advance - FM & L Taxes Advance - County AdValorem Taxes Paid County Treasurer - Nev. East Paid County Treasurer - all other Districts Paid County Treasurer- Delinq Tax Atty. Fee Payment In Lieu of Taxes Paid County Treasurer - Nevig. East Paid County Treasurer - All other Districts Special Farmers Fees Collected Paid State Treasurer, Farmers Fees Hot Check Collection Charges Paid County Treasurers, Hot Check Charge Overage an Collection/Assessing Fees Paid County Treasurer, overage refunded Escheats Paid County Treasurer -escheats $ 1,130.37 $ 1,130.37 $ 9.29 $ 6,447,584.66 $ 14.41 $ 1,014.72 $ 11,182.60 $ 3,945.26 $ 3,104.36 $ 1.54 $ 6,170,117.67 $ 2,084.16 $ 289,518.13 $ 3,104.36 $ $ 65.00 $ 65.00 TOTAL COLLECTIONS $ 7,164,933.30 TOTAL DISBURSEMENTS TOTAL OF ABOVE RECEIPTS PAID TO STATE AND COUNTY LAA 6UL KERR[BOY Tax Assessor -Collector $ 7,164,933.30 $ 7,154,933.30 RICHARD k{�R YER County Judge #21 NOTICE OF MEETING — 3/2/2022 21. Consider and take necessary action on any necessary budget adjustments. (RHM) 2021 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2022: RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 18 of 19 WfRR. a § §eee z k @ Q ■a LL kLu §� % § k §g !B B§k B)k uj z _� m U Z ) � _� « 57 )s coLLs q -( \ \JU L z ■e2 § (§ � � §^) ;k ;o :z ;z �§ �2 2 Sim ■ � §§aa gem ■�, §)) k Hl k j § § � k�� ) B�k § ) )§ § ■ - 7 =z =k a§a; .■ § § )� LLI / § BHE" k � ; o k § a )w § 4c \x ( §& '■ »& \k \\ k§ § k §mm (W § G « 91 �o )li § .LLI LU k )E B\ §� 2 B§\ ch0 �Ez D ch �/ uj B� § Ion \\ ■ )� • \ =) z ■qe B©) § B� % § � F ; 21 z k ; B� - - 22- ■- 2 �§asa NOB""- - k k © z m � A k k z kLU § a � 0 z k § z on � z L % o § k 2 §s B B § § �§ :o :z :z �§ a § && /$ ■ kk kMOM m S mm § ■ 2 LLI �FA § ;■ ■ § o :z k B �LLI uj § 1-4 § .§ yj « B § k oc j 2 § § k k « k § 2 § § w - ° z - § \ (Ln )o ■z !� §§ )� )CL )§ :z § LLI |L ■ :IU§ _ :k & :■ ■ :m � § :� NO [ICZ* ■ B % :a :z :§ .19 :L :§ §■§ ■ } §§ 4} - �aaa2 §� 2 :In 2 7 k \ (D N 7 2 2 e ■:S §§(2 21 Z LL QJ W LU g Z Z o 0 0 0 = e CC��QQ e W O fA O O =0 W p =0 N o»o 0 0 =y =0 NN N O =WC o 0 0 0 =WC C W W V3 E9 W RH = G L . _a _a =W =W Q _ Z C o o =F O W =W W Z p p 0 IpzZ - g =C =W g rn rn _a � w =c =U1 C a a05 =Q = NJ F a w = Q ='L W Q Z =_ E lu Q w =1Y =Q z a a w =a =Z w w =Z Z z =Z W ==Z __ W 0: 2 z = C Z W =d C e Q _ Z anro =L W W p�9 O O O pe�C'p Mbi H3 N i 0 0 0 W N � Vi H3 6 C p 0 0 0 0 W fA fA fA fA V $ w W� Q N J_ Z m a d z H H H H z z z z F () (D 0 0 f O O O O :! Z z z z z AG SW? W e arnrnrnrn F H � rn rn rn rn rn rn rn rn � ? p °Q N W F z w w Z O o O w J z a_ Z W= Z a �<npzd N > Q ¢ W w b Z W �Zzz Z F c� a ❑ W O O z ro U z o 0 0 0 I� . O M qe M of N u C O N t0 (D N CGI Wi O to O c 6 z z z z e z s w 3 rn rn U K a� w g z Ow w maw�0w O U w > W LU w w z N xw N M v M � 6 m � c u J Q 0 0 F z Z !w G IL w 0 O z =Z W W Co 9 N 7 W � o -W =� W -0 SW Z H =W LLI i `C r Z lu =a o ° =uj la Z o a 2 e o c Ma 00 z z e s rn rn m m e U uj x U �a 0 a>g x � K O w J wQ z F w U O O 6 0 � o» w w M O O b O rn a b O O w LO ky OM OM 0 0 0 0 (y 69 to J Q F z !W G a w 0 O z # 22 NOTICE OF MEETING — 3/2/2022 22. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2021 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 2022 Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Adjourned: 10:38 a.m. Page 19 of 19 March 2, 2022 2022 APPROVAL LIST - 2022 BUDGET COMMISSIONERS COURT MEETING OF 03/02/22 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 27 $287,265.08 FICA P/R $ 55,702.32 MEDICARE P/R $ 13,027.06 FWH P/R $ 36,953.82 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 4,855.00 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 1,002.46 BARNES APPRAISAL SERVICE APPRAISAL FOR RING FISHER BEACH PARR A/P $ 1,400.00 TOTAL VENDOR DISBURSEMENTS: $ 400,205.74 PAYROLL FOR 03/04/2022 P/R S 341,789.10 SUPPLEMENTAL PAYROLL FOR 02/18/2022 P/R S 2,711.06 TOTAL PAYROLL AMOUNT: $ 344,500.16 CALHOUN COUNTY INDIGENT HEALTH CARE TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: S TOTAL AMOUNT FOR APPROVAL: $ 744,705.90 March 2, 2022 2022 APPROVAL LIST - 2021 BUDGET COURT MEETING OF BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 1 PAYROLLFOR SUPPLEMENTAL PAYROLL CALHOUN COUNTY INDIGENT HEALTH CARE 03/02/22 $7,346.84 TOTAL VENDOR DISBURSEMENTS: $ 7,346.84 .� TOTAL PAYROLL AMOUNT: P/R P/R TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: S TOTAL AMOUNT FOR APPROVAL: $ 7,346.84 m m �� (\ \ : ) $ ]� \ ( ( 2 E ) 2 ! 10 ; / 2 ®§ § ; > ( \, « j) 2 ( § / yr k �`/ 2E§ E 2or | 2 /§ } § k �w oa o 0 oa L a >S m3 m m m3 0 0 ZZ m ti m y m ti ti m w n n m o v A A m W N J Er a A N b J J n O O O z ma n >m m rzi,m � n c O v. n a a P P P P P P P P P P J b N r N N O O O O O O O O O O O p W n m Z n m Z xn Yyc ,sr xn �c r mn Sc ar xa >c ar xn ac zr xa ac ;er a c r xn ac ar nm o'er0 g gw p0 n < �n n o nFyn C O O anAn 0� AcmO Adm>' >yn A> >cOn >c7� O>y m>'i my m� m j [rm n rt n m m `r' rri cri n p m P P P P P P P P C 0 3 00 J P b O. 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N 4 3o yDm z jaz zaz zo 0 zo 0 a0 y < zpxm DO D O 0 :m m y Z'oo<. 3 ae y m O v v zy zN a z n zz zp i z ar �D m J N •+ — A J W W P P J b 9 U C OO 0 � J � O p •3 i T P W � V J v NV Can p m nm m�a mxa a xa a Oa Na mF Na g a -7 mm m >m m m rOrm XOm m am m cm mm Dm cm m � A> A r A w w m w a y w n y w w a w w N w a w n w S w > w N r N `� z m N a m N N O N N N p N N r N z 0 m w m N m mw� A P J NJ CN U 'pN FDA �aA N aU b 3J CP pb yP aO A F- C am 'v c rmi,rn z m me OF a r A 9F O O bm Y Cm pz i z^J' 00 r cpJ A a N c z Ony w m zr9-i >y z a rm'-+. mz N y w 3O z N 0 O a p z 0 a a U y 0 N U U W W �O IJ N W N O W J A U U N U U O N CO U P U N W �l P N T IJ IJ 4e in O N Ge C N b O P N n 6 O O O j C 91 V_ H R a c c z m o am y A s o a a 3 O O -i j m n $ ra- y a H to In O O O O O O O O YJ O O J (T Q O O A A O o O o O O O O N O O P A O R a� a9 Hn Hn n Hn Hn Hn ncezy p x or tiAtFS NnAfx ZnmD mD mma O O n nyD DD m mwy ym o a q rr rr H rr rr rr rr rr rr Cn O mH m'-7 iC Z �z00 00 r0 r0 D r0 r0 r r m m nm r0 Wn Z ran m <Z nm nm P nm nm nnnm r r m m Z m m m m m m O Z Y S x W m r r O m n O z 5 O C 0 O O O O O O O O O J O N J m m'n c�z 3m 3 'n �c''> 3� v mam 3m MMM, mW o xm N O N O m A m A N N p A A.mj H A m W O O O %t zVI O O O O a O O� N W D D oo A� m Ap om m om o r C mAD 0� <pn O O O O n n �Jy w w N P �O icy moe W O _ A u mz n n v m A y Z H o 0 Q W to N N W U W P A O Oa O �D O b P to O to N p O J O to W C. to A A J J J O O Ge O N 3 a P a U a W N N O 'zAz nA np 3� -mph Za za O na z z N WA m �> O A C) ^ -mn ma � ad n y a N i e e v v 0 � a � n °z m < K < 0 m a 3 � m z O O O N O O O Q m> m> mX> nm mg m 0 o < j xy r. ran O O rr n0 rr n0 rr n0 C- zA 3 3 r Zm 3 z m z m z m 9 m m O Y > n z z N N N tV'A �D b J p A z p e � N [3i1 A mp [3*f A r nF z py A -�a 7� cAr]D m Am0 ZO >$ m0 m0 m0 va$ 'j •� N 0 a zr.,0 - A o0 no m p o w o a o m N z c Z o c o o E El p 9 a a w Y N O rt S N N A P P O O O o O O e - � a � � z 0 0 0 0 0 0 0 o c N N N N N N N N n O °z °z °z °z m nnnnn nn n m m m m m m m m d g o 0 0 0 0 0 r r r r r r r r >z>zzz>z >z>z >z Wo Wo c o o 0 0 o O o 0 0 0 0 0 0 0 0 b W F J A A w VJi W G1 Oi A J O\ �O C O� C mA W 1ppa O 8 Wp Co W w pwp A AWA x A A w p A n A N W Q A T x N VNi n mm�mQmQ 00 9O_ > O 0O O OO y y rxii y y 8 C s eT zs . s O O a m m y a y y 3 3 z A � 0 o e -i -3 E d R O / - \ \ 2 ! f k\<0 \\ k} )�)� { )§ \ \ ](\) \ / k O O v w D b 3 3 z Q o O v O 9 � y a y ro N N N u A P A A A < n R a3 DAn rnn nn nn zn zzn Oyll<r«z� �r m-X yS yX X S nOaOOOOn c Occ y >Z�r zr z Z K n n n On On on m z z z a a a oo vo vo m A A F Oa P P P Q N N N N C p N N M M m M y iC N!G NX N N X A zM NX X m X o N n O A N n N n N N m n N rnH Or oo Or � ioiA O-�• ti z°O C m oz a y� O K rnA v,A m ti A D N N V N to Co N O p c n c 0 0 0 y y C-7 m 9 O m D z O < m y � z � y � < n r y y z m O C v, D\ Q N n Eo N W p n 3 H m 3 0 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---March 02 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 $ 1,736,709:17 $ 330,391.15 " $ 2,224,,10115- V/ TOTALINTER-GOVERNMENTTRANSFERS $ GRAND TOTAL DISBURSEMENT$ APPROVED March 02, 2022 $ 4,291,200:41. ✓ MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---March 02, 2022 PAYABLES AND PAYROLL 2/2412022 Weekly Payables 1,066,448.61 2/24I2022 Itersouree Corporation-ACD License 4,237.50 212412022 Jeannie Orta-banking error 200.00 2/22/2022 Allyson Swope-cantraclworker 3,984.75 2/22/2022 Pablo Garza -contract worker 2,461.88 2/2212022 Dearborn Life Insurance Company -insurance 3,880,01 2/2212022 Blue Cross Blue Shield -Insurance 232,754.32 2/2812022 McKesson-340B Prescription Expense 6,228.28 2/2812022 McKesson-3408 Prescription Expense 8.165.10 2/2812022 Amedsource Bergen-3408 Prescription Expense 414.26 2/28/2022 Amedsource Bergen-340B Prescription Expense 918.60 2/2812022 Payroll Liabilities -Payroll Taxes 97,99SAl 2/28/2022 Payroll 306,976.44 Prosperity Electronic Bank Payments 211512022 Credit Card & Lease Fees 192.13 2/14-2125122 Pay Plus -Patient Claims Processing Fee 1,237.62 2/1812022 ExpertPay child support 614.20 TOTAL PAYA# LMtIPAYRMLI ANO ELECTRONIC;BAN KJPAYMENTS $ 1,73fi,7p9,11; TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 2125/2022 MMC Operating to Ashford -correction of NH Insurance and QIPP payment 4,780.82 deposited Into MMC Operating 212512022 MMC Operating to; Solera-correction of NH QIPP payment deposited into 1,853.46 MMC Operating in error 212512022 MMC Operating to Fort bend -correction on NH insurance and QIPP payment 6,452.33 deposited Into MMC Operating 212512022 MMC Operating to Broadmoor-correction of NH QIPP payment deposited into 2,034.14 MMC. Operating 2125/2022 MMC Operating to Crescent -correction of NH insurance and QIPP payment 10,764.63 deposited into MMC Operating in error 212512022 MMC Operating to Golden Creek -correction of NH Insurance and QIPP 51,130.97 payment deposited into MMC Operating in error 2125/2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance and QIPP 33,595.60 payment deposited into MMC Operating 2/26/2022 MMC Operating to Tuscany Village -correction of NH insurance and QIPP 55,53T87 payment deposited Into MMC Operating 2/25/2022 MMC Operating to Bethany -correction of NH insurance payment deposited 91,762,67 Into MMC Operating in error 2/2512022 Tuscany to Bethany -correction of NH insurance payment deposited into Tuscany in error 1,855,00 2/25/2022 Balers to MMC Operating -correction of NH insurance payment that was corrected over the amount that was deposited 100.56 MEDICARE ADVANCE PAYMENT RECOUP 2/28/2022 Broadmoor to MMC Operating -correction of Broadmoor medicare recoup 6,160.Bo taken from MMC Operating 2/2812022 Broadmoor to TuscanyVillage-correctionof Broadmoor medical recoup 10,780.10 taken from Tuscany Village 2128/2022 Crescent to MMC Operating -correction of Crescent medicare recoup taken 6,160.80 from MMC Operating 2/28/2022 Crescent to Tuscany Village -correction of Crecent medicare recoup taken 10,780.10 from Tuscany Village 2/28/2022 Salem to MMC Operating -correction of Balers medicare recoup taken from 5,160.80 MMC Operating 2/28/2022 Solaro to Tuscany Village -correction of Solera medicare recoup taken from 10,780.10 Tuscany Village 2/2812022 Tuscany to Golden Creek -correction of Tuscany medicare recoup taken from 5,988.11 Golden Creek TRANSFER OF FUNDS BETWEEN NURSING HOMES 2/2812022 Gulf Pointe Plaza -PP -correction of Ashford insurance payment deposited into 13,712.29 Gulf Pointe Plaza -PP in error TOTAL TRANSFERS BETWEEN jFUNDS, $ 330,394.15J; NURSING HOME UPL EXPENSES 212812022 Nursing Home UPL-Cantex Transfer 2/28/2022 Nursing Home UPL-Nexion Transfer 2128/2022 Nursing Home UPL-HMG Transfer 2128/2022 Nursing Home UPL-Tuscany Transfer 212812022 Nursing Home UPL-HSL Transfer QIPP CHECKS TO MMC 2/28/2022 Ashford 212812022 Broadmoor 2/28/2022 Crescent 2/28/2022 Fort Bend 2/28/2022 Solera 2/2812022 Golden Creek 2/2812022 Gulf Pointe 2/28/2022 Tuscany TOTAL , MING,!HOM,,UPL EXPENSES TOTAL_If1TEid-GbUERNMENT TRANSFERS 1,109,130.40 224,601.72 265,249,84 162,482.13 297,481,66 46,618.71 21,914.54 15,529.01 21,404.53 20,775.16 9,688.65 5,602.10 23,721.71 $_2,224,10015 Page 1 of 27 itECEMB BY THE tL'OUNTY AUDITOR ON RUA P0, MEMORIAL MEDICAL CENTER 0 AP Open 1CALita Invoice List 0OUNTY Tp= Due Dates Through: 03/16/2022 ap_open_Involce.template Vendor# Vendor Name I Glass Pay Code 10995 ABILITY NETWORK (SHIFTHOUND) / Invoice# Comment Tram Dt Inv Dt Due or Check D Pay Grass Discount No -Pay Net 22M0016590 ✓ 02/10/20 02/03/20 03/05/20 647.28 0.00 0.00 647.28 Vendor Totals Number Name Gross Discount No -Pay Net 10995 ABILITY NETWORK (SHIFTHOUND) 647,28 0.00 0.00 647.28 Vendor# Vendor Name Class Pay Code R1200 ACT COMMERCIAL ✓ Invoice# Comment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 143993957 t/ 02/24/20 02/02/20 02/27/20 49.18 0.00 0.00 49.18 FIRE MONITORING , Vendor Totals Number Name Grass Discount No -Pay Net R1200 ACTCOMMERCIAL 49.18 0.00 0.00 49.18 Vendor# Vendor Name Class Pay Code 11464 ADVANCES BY TED LLC ✓.- Invoice# Comment. Tram Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net tncc022522 V 02/21/2002125/2002/25/20. 1,200.00 0.00 0.00 1,200.00 TNCC BOOK Vendor Total: Number Name Gross Discount No -Pay Net 11464 ADVANCES BY TED LLC 1,200.00 0.00 0.00 1,200.00 Vendor# Vendor Name Class Pay Code A7680 AIRGAS USA, LLC - CENTRAL DIV ✓ M Invoice# Comment Tram Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net 9122094526 D212112001/27/2002121/20 239,85 0.00 0.00 239.85 1/ OXYGEN 9986063887✓ 02/21/20 01/31/20 02/25/20 760.46 0.00 0.00 760.46 AIR 9986067018 ✓' 02/21/2001/31/2002/25/20. 518.79 0,00 0.00 518.79✓ CYLINDER 9986067020 02124/20 01/31/20 02125/20 226.76 0.00 0.00 226.76✓ RENTAL 9122146555 ✓ 02/24/20 01/3V20 OPJ25120 2,316.23 0.00 0.00 2,316.23 RENTAL Vendor TotalENumber Name Grass Discount No -Pay Net A1680 AIRGAS USA, LLC -CENTRAL DIV 4,062.09 0.00 0.00 4,062.09 Vendor# Vendor Name Class Pay Cade 14028 AMAZON CAPITAL SERVICES v' Invoice# Comment Tram DI Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net 1 RF66JORCTGJ ✓ 02/09/20 02/07/20 03107120 55.80 0.00 0.00 55.60 SUPPLIES- ER 13H49RP46X44 ✓ 02/23/20 01/24/20 02/23/20 159.80 0.00 0.00 159.80 G/ SUPPLIES 1DDLWPGHR9VK 02/24/2002104/2003/06/20 240.92 0.00 0.00 240.92 SUPPLIES (d1ti (CFUIIt"]1n 1W0FAVK4F6X4B- 02/24/20 02108120 03/10/20 370.00 0.00 0.00 370.00Li SUPPLIES 144MVWWHFM33 „% 02/24/2002J1012003JI 2/20 137.98 0.00 0.00 137.98 ✓� ftle:l//C:lUsers/ltrevinolcpsilmemmed,cpsinct.com/U88125/data 5/tmp_cw5report6l0999... 2/24/2022 Page 2 of 27 SPACEHEATER 144MVWWHJ9wJ 02/24/200211012003/12/20. %99 0.00 0100 6B.99 �. HEATER 1 L3MWKG9073T ¢// 02124/20 02110/20 03112120 137,98 0.00 0.00 137.98 w=' SPACE HEATERS. 1H4NiQXF9YLGV 02/24/20 02/10/20 03/12120 137,98 0.00 0.00 137.98v HEATERS 1MQ7DQW9CX4Xti' 02124/20 0010/20 03/12120 137.98 0.00 0.00 137.98 4i SPACE HEATER 1JYQLRJGL39G ✓ 02/24120. 02/10/20 03/12/20 68,99 0.00 0.00 68.99 ,- HEATER 133YMGXJTKNM ✓ 07(24/200211212003114/20 37.58 0.00 0.00 37.58 OFFICE SUPPLIES . Vendor Tolale Number Name Gross Discount No -Pay Net 14028 AMAZON CAPITAL SERVICES 1,554.00 0.00 0.00 1,554,00 Vendor# Vendor Name Class Pay Coda 11632 AMERICAN CONSTRUCTION ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1684 ./' OW16/20 02/O7/20 02/08/20 760.00 0.00 0.00 750.00 REPLACEDOORS Vendor Totals Number Name Gross Discount No -Pay Net 11632 AMERICAN CONSTRUCTION 750.00 0.00 0.00 750.00 Vendor# Vendor Name Class Pay Code 12828 AMERICAN PRECISION MEDICAL GAS Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 242563,/ 02/21/20 01/12/20 02/12/20 2,458.75 0.00 0.00 2,458.75 GAS ALARM WORK Vim. Vendor Total. -Number Name Gross Discount No -Pay Net 12828 AMERICAN PRECISION MEDICAL GAS 2,458.76 0.00 0.00 2.458.75 Vendor# Vendor Name Class Pay Code A1360 AMERISOURCEBERGEN DRUG CORP ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net a03181383,/ OPJ21/20 10/15/20 10121120 413.18 0.00 0,00 413.18 V' INVENTORY 803296800 02/21/2012/31/2001/06/20 514.66 0.00 0.00 514.66 INVENTORY 3083690795 v' 02/23/20 02/17/20 02/23/20 205.67 0,00 0.00 206.67 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1360 AMERISOURCEBERGEN DRUG CORP 1,134.51 0.00 O.00 1.134.51 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC ✓ Invoice# Comment Tran Dt .Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2470820 r 02/10/20 02/07/g20 03/09/20 2,680.00 0.00 0.00 2,660.00 ✓ LAB STAFFING C112-1- 1{2"(pZv'xa i Sint blrq 2471005 02/10/20 02/07/20 03/09/20 2,730.25 0,00 0.00 , 2,730.25 LAB STAFFING (1! 2q- 11'2-1 172-j- }-) tVAW I4il1y 2470925 02/10/20 02/07/20 03/09/20 2,725.50 0.00 0.00 2,725.50 ✓ LABSTAFFING t1Iyl.- Si41DxaJ✓ 2480167 02121120 02/14120 03/16/20 2,378.50 0.00 0.00 2,378.50 L,-' LAB STAFFING tile:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report610999.,, 2/24/2022 Page 3 of 27 2430114 020/20 0014/20 03/16/20 98&25 0.00 0.00 983.25 LAB STAFFING t I j 7, G- 7-J31 5 hj q,u,_t , , 2480011 ✓ 02/21/2II002/14/2003/16/20 2,495.75 0.00 0.00 2,495.75 LAB STAFFING I f �- F h> i'b1t �� S'11641 Vendor Total¢ Number Name Grass Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 13,99325 0.00 0.00 13,993.25 Vendor# Vendor Name Class Pay Code 13516 AVANTE HEALTH SOULTIONS ✓f Invoice# Comment Tran 01 Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net AR0144269 ✓ 02/16/20 02/07/20 02/07/20 237.00 0.00 0.00 237.00 ✓� SUPPLIES Vendor Total, -Number Name Gross Discount No -Pay Net 13516 AVANTE HEALTH SOULTIONS 237,00 0.00 0.00 237,00 Vendor# Vendor Name Class Pay Code B0436 BARD ACCESS a/ - Invoice# Comment Tran Ot Inv of Due Dt Check D Pay Gross Discount No -Pay Net 21547905✓' 01/18120 10/04/20 03105/20 -31,50 0,00 0.00 -31.50 CREDIT 46573585 ✓ 02/15/20 01/28/20 02/15/20 150.00 0.00 . 0.00 150.00 SUPPLIES Vendor Totak Number Name Gross Discount No -Pay Net B0436 BARD ACCESS 118.50 0.00 0.00 118.50 Vendor# Vendor Name Class Pay Code B1150 BAXTER HEALTHCARE ✓ w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount NoaPay Net 73671862 ✓ 02/15/20 01/24/20 02/18/20 118.32 0,00 0.00 118.32 SUPPLIES 73697390 ✓ 02/15/20 01/26/20 02/20/20 140.31 0.00 0.00 140.31 �z 3 SUPPLIES 7380815 02116/2002/03/20 OW28/20 20,96 0.00 0,00 20.96 SUPPLIES 73835713 ✓ 02/15/20 02/03/20 02/28/20 604.83 0.00 0,00 604.83 N' SUPPLIES 73803913 r,r/ 02/15/20 OPJ03120 02/28/20 269.10 0.00 0.00 269.10 rr' 73840734 ✓ 02/15/20 02/04/20 03/01/20 140.31 0.00 0.00 140.31 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 1.293.83 0.00 0100 1.293,83 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC ,/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 109676114 ✓ 02110/20 02108/20 03/05/20 1,847.55 0.00 0.00 1,847.55 +/ SUPPLIES 109677875 ✓ 0010/20 02/08/20 03/O5/2O 437,20 0.00 0.00 437.20 SUPPLIES 109677847 ✓ 02/10/20 02/08/20 03/05/20 690.51 0,00 0.00 690.51 SUPPLIES 109677018 ✓ 02/10/20 02/08/20 03/05/20 239.60 0;00 0.00 239.60 SUPPLIES 109693627✓ 02/10/20 01/31120 02/25/20 5,165.37 0.00 0.00 5,165.37 file:///C:/Users/ltrevino%psi/memmed.cpsinet.com/u&8125/data_5/tmp cw5report610999... 2/24/2022 Page 4 of 27 SUPPLIES 109675895 ✓ 02/16/20 02/07/20 03/04/20 6,877.77 0.00 0.00 6,877.77 V SUPPLIES 109674953 v/ 02/16/20 02f07/20 03/04/20 233.85 0.00 0.00 233,85 v� SUPPLIES 109675735 ✓S02/16/20 02/07/20 03/04/20 786.48 0.00 0.00 786.48 SUPPLIES 109671223 ✓ 02/16/20 02/07/20 03/04/20 82,48 0.00 0.00 82.48 SUPPLIES 109690097 ✓' 02/16/20 02/10/20 03/07/20 428.48 0.00 0.00 428.48 SUPPLIES 109688199 ✓z 02/16/20. 0211012003/07/20 202.84 0.00 0.00 202.84 SUPPLIES 109692002 1/ 02/16/20 02111 /20 03/08/20 856.96 0.00 0.00 856.96 >' SUPPLIES 5453445 " 02/16/20 02/13/20 03/10/20 5,016.58 0.00 0.00 5,016.58 V SUPPLIES 109696093 „s'` 02/21/20 02/14120 03/11120 2,998.91 0.00 0.00 2,998.91 109700236 ✓� 02/211200211512003/12/20 1,288.45 0.00 0.00 1,288.45✓" LEASE AND RENTAL , 109700152 ✓ 02/21/20 02/15/20 03/12/20 75.60 0.00 0.00 75.60 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net B1220 BECKMAN COULTER INC 27.228.63 0,00 0.00 27.228.63 Vendor# Vendor Name Class Pay Code B1320 BEEKLEY CORPORATION ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV1503034✓ 02/1512002/03/2002/18/20 327.45 0.00 0,00 327.45 w/ SUPPLIES Vendor Totak Number Name Gross Discount No -Pay Net B1320 BEEKLEY CORPORATION 327,45 0.00 0.00 327.45 Vendor# Vendor Name Class Pay Code 14272 BESTICA ,f Invoice# Comment Tran Dt Inv Dt Due Dt Check D.Pay Gross Discount No -Pay Net MMM005" 02109/2002/05/2003/05/20 21,307.38 0.00 0.00 21,307.38 ✓ NURSE STAFFING I r l YbiaoV. Vendor Totals Number Name Gross Discount No -Pay Net 14272 BESTICA 21,307.38 0.00 0.00 21,307.38 Vendor# Vendor Name Class Pay Code 14753 BIOMERIEUX, INC Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 1212730356 .i" 02/16/20 02/01/20 02116/20 4,210,89 0.00 0.00 4,210,89 tJ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14753 BIOMERIEUX, INC 4,210.89 0.00 0.00 4,210.89 Vendor# Vendor Name _ Class Pay Code B1650 BOSART LOCK & KEY INC V M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 123620 i / 02/09/20 02/03/20 03/05/20 22.80 0.00 0.00 22.80 KEYS file:///C:/Users/Itreviuo/epsi/memmed.epsinet.com/u88125/data_51tmp_cw5report610999... 2/24/2022 Page 5 of 27 Vendor Totals Number Name Gross Discount No -Pay Nei B1650 BOSART LOCK & KEY INC 22.80 0.00 0.00 22.80 Vendor# Vendor Name Class Pay Code 131655 BOSTON SCIENTIFIC CORPORATION a/ M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 983261202✓ 02/18/20 02/00/20 03109/20 11103.00 0.00 0.00 1,103.00 SUPPLIES Vendor Total. -Number Name. Gross Discount No -Pay Net B1655 BOSTON SCIENTIFIC CORPORATION 11103.00 0100 0.00 1,103.00 Vendor# Vendor Name Class Pay Code 13216 BRIANNA PASSMORE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 072721 ✓ 02/16/20 02/05/20 02(05/20 9.66 0.00 0.00 f 9,66 r! TRAVEL gjwd &Ukvl 1'-71:1--II;,-I-"I I l.t-1, . 010522 02/16/20 02/05/20 02/05/20 10.47 0.00 0.00 10.47 ✓-' TRAVEL Ulund clya�I ( tie, - 120121 ,: 02/16/20 02/05/20 02/05120 11.04 0.00 0.00 11.04 ✓ TRAVEL r�lu„d 4'tiU� j ( I -1i i - i IA 2--s1 zt) 090821 02/24/20 09/08/20 02/24M 11.04 0.00 0,00 11.04 TRAVEL BLOOD DRAWS Vendor Total: Number Name Gross Discount No -Pay Net 13216 BRIANNA PASSMORE 42.21 0.00 0.00 42.21 Vendor# Vendor Name Class Pay Code 11224 CABLES AND SENSORS , , Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross/ Discount No -Pay Net 6192 v� 01/12/20 01/07/20 03/05/20 .150t00 0.00 0.00 -1 �0 CREDIT � 6191 01/12/20 01/07/20 03/05/20 -11/ 0,00 0.00 .1)0./00 CREDIT Vendor Total: Number Name Gross Discount No -Pay Net 11224 CABLES AND SENSORS -26/00 0.00 0.00 .26p0 Vendor# Vendor Name Class Pay Code /I 13992 CARIANT HEALTH PARTNERS ✓ Invoice# Comment Tran of Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 132654 ✓ CPJ24/20 02116/20 787,50 0.00 0.00 787.50 ✓ TRAVEL NURSE STAFFING 2I4 �"L,_ fvtus . Vendor Totals Number Name Gross Discount No -Pay Net 13992 CARIANT HEALTH PARTNERS 787.50 0,00 0100 787.50 Vendor# Vendor Name Class Pay Code C1390 CENTRALDRUG ✓ W Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 012422 02/2112001/31/2003102120. 19,40 0.00 0.00 19.40 INVENTORY Vendor Totals Number Name Gross Discount No -Pay Net C1390 CENTRAL DRUG 19.40 0.00 0.00 19.40 Vendor# Vendor Name Class Pay Code 13264 CERVEY, LLD ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 14668 ✓ 02/21/20 02/15120 03/12/20 1,699.00 0.00 0.00 1,699.00 ✓ MNTLY LICENSING FEE . Vendor Totals Number Name Gross Discount No -Pay Net file:!//C:/Users/ltrevino/cpsi/memmed,cpsinct.corn/u88125/data_5/tmp_cw5report610999... 2/24/2022 Page 6 of 27 13264 CERVEY, LLC 1,699.00 0.00 0.00 1,699.00 Vendor# Vendor Name Class Pay Code 11720 CLINICAL COMPUTER SYSTEMS INC ✓ Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net OBMN00000384 02/21/20 IPJ24/2012124/20 5,775.00 0.00 0,00 5,775.00 ✓/ OBIX QfTRLY ( -11 1 - '113a 1-2-1) OBMN00000385 ✓ 02/21120 12124/20 12/24/20 5,775.00 0.00 0.00 , 5.775.00 OBIXQRTRLY (IOjI"dYl ^.1,z9� OBMN0000386✓ 02121120. 1212412001/01/20 5,775.00 0.00 0.00 5.775.00 ✓-� OBIX QRTRLY (l)I-31aljj1 ) Vendor Total: Number Name Gross Discount No -Pay Net 11720 CLINICAL COMPUTER SYSTEMS INC 17.325,00 0.00 0.00 17,325,00 Vendor# Vendor Name Class Pay Code 11029 COASTAL REFRIGERATION ,/ Invoice# Comment Tran Dt Inv Ot Due Ot Check D Pay Gross Discount No -Pay Net 021422 V/ OPJ21/20 02/14/20 02 I4120 31250.00 0.00 0.00 3,250.00 REPLACE COMPRESSOR Vendor Totals Number Name Gross Discount No -Pay Net 11029 COASTAL REFRIGERATION. 3.250,00 0.00 OAO 3,250.00 Vendor# Vendor Name Class Pay Code 14080 CORROHEALTH, INC.✓ Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 710610 ✓ 02/21/20 02/03/20 Oa/05/20 2,681.55 0.00 0.00 2,681.55 HIM SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 14080 CORROHEALTH, INC. 2,681.55 0.00 0.00 2,681.55 Vendor# Vendor Name Class Pay Code 10006 CUSTOM MEDICAL SPECIALTIES Invoice# Comment Tran Dt Inv Dt Due Ot Check. DPay Gross Discount No -Pay Net 291222 i 02/18/20 =14/20 03/14/20 349.13 0.00 0.00 349,13 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Not 10006 CUSTOM MEDICAL SPECIALTIES 349,13 0.00 0.00 349.13 Vendor# Vendor Name Class Pay Code 11368 CYRACOM LLC v'' Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1458333 ✓ 02115/20 01/31/20 09/02/20 405.57 0.00 0.00 405.57 INTERPRETATION SERVICES Vendor Totals Number Name Grass Discount No -Pay Net 11368 CYRACOM LLC 405.57 0.00 0.00 405.57 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON :/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 6714500 ` O2/09120 02/07/20 03/04/20 17.60 0.00 0.00 17.60 SUPPLIES 6714530 ✓ 02 O9120 02/07/20 03/04/20 12,93 0.00 0.00 12.93 ,,,,✓ SUPPLIES SURGERY 6714670 v 02/09/20 02/07/20 03/04/20 166.96 0.00 0.00 166.96 SUPPLIES 6726960 ✓ 02/23/20 02 I7120 03/14/20 8.21 0.00 0.00 8.21 1 x SUPPLIES file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report6l0999... 2/24/2022 Page 7 of 27 6725820 ✓ 02/23/20 02/17/20 03/14/20 18.63 0.00 0.00 18.63 SUPPLIES 6726630 v' 02/23/20 02/17/20 03/14/20 478.86 0.00 0.00 478.86 ✓`� OFFICE SUPPLIES 6725930 u;' 02/23/20 02/17/20 03/14/20 139.22 0.00 0.00 139.22 a! OFFICE SUPPLIES , Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 842.41 0.00 0.00 842.41 Vendor# Vendor Name Class Pay Code 11011 DIAMOND HEALTHCARE CORP Invoice# Comment Tran Ot Inv DI Due Dt Check DPay Gross Discount No -Pay Net IN20055159 % 02/21/20 02/01/20 02/26/20 31,144.58 0.00 0,00 31,144.58 BEH HEALTH SVS IN20055160 02/21120 02/01/20 02126/20 19,166.67. 0.00 0.00 19,166.67,, CARDIAC REHAB SVS . Vendor Total! Number Name Gross Discount No -Pay Net 11011 DIAMOND HEALTHCARE CORP 50,311.25 0.00 0.00 50,311.25 Vendor# Vendor Name Class Pay Code 10789 DISCOVERY MEDICAL NETWORK INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMCO21522 ., 02/23/2002/i6/2002116/20 179,796.40 0.00 0.00 179,796.40 PROFEESCLINIC % II- %'-pJV- 1, Vendor Total: Number Name Gross Discount No -Pay Net 10789 DISCOVERY MEDICAL NETWORK INC 179,796.40 0.00 0.00 179,796.40 Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL ✓` Ptvi116b.t. Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 7190 �/ 02/23/20 01/08/20 02/02120 5bh,LV 1,171'00 0.00 0,00 1,17..00 511.5.UU PEST CONTROL 7470 02129l2001/25/2002/19/20 iyU w1,17ki60 0.00 0100 1,775a600U-UU PEST CONTROL 7499 02/23/2001126/2002/20/20 105,0L1 1,174.00 0.00 0.00 1,176.00 lb�-00 PEST CONTROL Vendor TotalE Number Name Gross Discount No -Pay Net� 11291 DOWELL PEST CONTROL 610. tp 3,52,e00 0.00 0.00 ff 3,52,6.00 470. 00 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS 1 / Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 40956 f 02/15/20 02115l20 02/25/20 40,062.60 0.00 0.00 40,062.50 a: � ER PHYSICIANS 1 l'-1-1; j 40967 v` 02/21/20 12/31/20 01/10/20 24,750,00 0.00 0.00 24,750.00 QUATERLY SHORTFALL Vendor Total: Number Name Gross Discount No -Pay Net 11284 EMERGENCY STAFFING SOLUTIONS 64.812.50 0.00 0.00 64,812.50 Vendor# Vendor Name Class Pay Cade 10042 ERBE USA INC SURGICAL SYSTEMS Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 732202 U' 02/16/20 02/10/20 02li 6120 139.50 0.00 0,00 139,50 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 10042 ERBE USA INC SURGICAL SYSTEMS 139.50 0.00 0.00 139,50 file:!/!C:/Usets/Itrevino/epsi/memmed.cpsinet.com/u88125/data_51tmp_cw5 report610999... 2/24/2022 Page 8 of 27 Vendor# Vendor Name Class Pay Code C2510 EVIDENT 1/ M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 994968 ,/ 02/15/20 01/31/20 02/25/20 1,047.48 0.00 0.00 1,047.48 ✓ AP CHECKS 994967 02/15/20 01/31/20 02/25/20 446,27 0.00 0.00 446.27 PAYROLLCHECKS . Vendor TotalsNumber Name Grass Discount No -Pay Net C2510 EVIDENT 1,493.75 0.00 0.00 1,493.75 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP. ✓'� w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 765635009 ,j 02/24/2002/10/2003107/20 14.85 0.00 0.00 14.86 .. Vendor Totals Number Name Gross Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 14,86 0.00 0.00 14.86 Vendor# Vendor Name Class Pay Code 10788 FIRETROL PROTECTION SYSTEMS 1/' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1000G63228 ./ 02/21/20 01/01/20 01/11/20 -'s 0.00 0.00 •38 CREDIT '88d Vendor Totals Number Name Gross Discount No -Pay Net 10788 FIRETROL PROTECTION SYSTEMS -388 8 0.00 0.00 / -388,g8 Vendor# Vendor Name Class Pay Code (./! 14092 FIRST CONNECT CENTER LLC Invoice# Comment Tran Dt Inv Dt Due of Check D Pay Gross Discount No -Pay Net 3862 rJ' 02/16/20 02/04/20 03/06/20 4,46B.75 0.00 0.00 41468.75 ✓" P1N1'hi e31nfE'�r�r� lizS'I�3u)2'L R,urn6twv� 3861 02/16120 02/05/20 03/07/20 4,593.75 0.00 0.00 4,593.75 NURSE STAFFING MS Z Iy2S-11-1-1I-11) I!+UYK}V-dVV1 Vendor Totals Number Name Gross Discount. No -Pay Net 14092 FIRST CONNECT CENTER LLC V 9,062.50 0.00 0.00 9.062.50 Vendor# Vendor. Name Class Pay Code F1400 FISHER HEALTHCARE a' M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 8764248 1i 02/15/20 0112EV20 02/20/20 139.32 0.00 0.00 139.32 SUPPLIES 8764247✓� 02/15/20 01/26/20 02/20/20 78.63 0.00 0.00 78.63 SUPPLIES 8821606v' 02/15120 01/27/20 02121120 2,089.30 0.00 0.00 2,089.30 SUPPLIES 8821605 Tom. 02/15/20 01/27120 02/21/20 68.00 0.00 0.00 68.00 L SUPPLIES 8877722 ✓' 02/15/20 01/28/20 02/22/20 474,70 0.00 0.00 474.70 SUPPLIES $877721 v 02115/2001/28/2002/22/20 354.78 0.00 0.00 354.78 SUPPLIES 9064866 ✓ 02/15/20 02/02/20 02/27/20 328.09 0.00 0.00 328.09 SUPPLIES 9121232 ✓ 02/15/20 02/03/20 02/28/20 192.04 0.00 0.00 192.04 SUPPLIES file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.cam/u88125/data_5/tmp_cw5report610999... 2/24/2022 Page 9 of 27 9174485 ✓ 02/15/20 02/04/20 03/01/20 72.12 0.00 0.00 72.12 SUPPLIES 9279370 ✓ 02/16/20 02/08/20 03/05/20 1,14B.62 0.00 0.00 1,146.82 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 4,943.80 0.00 0.00 4,943.80 Vendor# Vendor Name Class Pay Code 11183 FRONTIER .`/ Invoice# Comment Tran Ot Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 022622 02/24120 02/26/20 02/26/20 1,113.86 0.00 0100 1,113.86 INTERNET Vendor Total$ Number Name Gross Discount No -Pay Net 11183 FRONTIER 1.113.86 0100 0.00 1,113.86 Vendor# Vendor Name Class Pay Code 13960 G & S MANAGEMENT GROUP LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 340384325 02/15/20 02/08/20 02/18/20 345.39 0.00 0.00 345.39 DISPOSAL SERVICE 340384323 02/15/2o 02/08/20 02/18/20 2,324,31 0.00 0.00 2,324.31 DISPOSAL SERVICE 340384324 �% 02/15/20 02/08/20 02/18/20 254.42 0.00 0.00 254.42 ✓' DISPOSAL SERVICE Vendor Total: Number Name Gross Discount No -Pay Net 13960 G & S MANAGEMENT GROUP LLC 2.924.12 0.00 0.00 2.924.12 Vendor# Vendor Name Class Pay Code 12404 GE PRECISION HEALTHCARE, LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6002048708,,/ 02/09/2002/01/2003/03/20 572.33 0.00 0.00 572.33 - IMAGING CONTRACT 6002048781 02/10/20 02/01/20 03/03/20 86.67 0.00 0.00 , 86.67 '✓' IMAGING CONTR 6002048979 i/� 02/10/20 02/01/20 03/03/20 868.16 0,00 0.00 868.16 1Z IMAGING CONTRACT 6002048782 ✓ 02/10/20 02/01/20 03/03/20 61.67 0.00 0.00 61.67„/� IMAGING CONTR 6002048707 -.,' 02/10/20 02/01/20 03/03120 680,00 0.00 0.00 880.00i,, IMAGING CONTR 6UO2048780 y/ 0010/20 02/01/20 03/03/2o 3,588.58 0.00 0.00 3.688.58 IMAGING CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net 12404 GE PRECISION HEALTHCARE, LLC 5,857,41 0.00 0.00 5,857.41 Vendor# Vendor Name Class Pay Code 10901 GENESIS DIAGNOSTICS, Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 52823 >% 02/15/20 02/07/20 03/09/20 225.39 0,00 0.00 225.39 -" SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net 10901 GENESIS DIAGNOSTICS 225.39 0.00 0.00 225.39 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY ✓ M Invoice# Comment Tran Dt Inv Dt DUe Dt Check D Pay Gross Discount No -Pay Net file://!C:/Users/ltrevino/cpsi/memmed,cpsinet. corn/088125/data_5/tmp_cw5report610999... 2/24/2022 Page 10 of 27 2179330 �� • 02/15/20 02/01/20 03/03/20 734.09 0.00 0.00 734.09 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 734.09 0.00 0,00 734,09 Vendor# Vendor Name Class Pay Code 11784 HALF LEAGUE STORAGE ✓`� Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 020122 02/21/20 02101120 02/01/20 360.00 0.00 0.00 360.00 RENT FEB-APR Vendor Totals Number Name Gross Discount No -Pay Net 11784 HALF LEAGUE STORAGE 360.00 0.00 0.00 360.00 Vendor# Vendor Name Class Pay Code 10804 HEALTHCARE CODING & CONSULTING ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 11979 v OPJ16120. 01/31/2003/02120 $10.25 0.00 0.00 816.25 ram' CODING. SERVICES Vendor TotalENumber Name Gross Discount No -Pay Net 10804 HEALTHCARE CODING & CONSULTING 816.25 0.00 0.00 616.25 Vendor# Vendor Name Class Pay Code 14256 INFICARE HEALTH; INC. V" Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net MMC0124 - 02/16/20 01/20/20 02/04/20 3,224.00 0.00 0.00 3,224.00 Vendor Totals Number Name Gross Discount No -Pay Net 14256 INFICARE HEALTH, INC. 3,224,00 0100 0.00 3.224.00 Vendor# Vendor Name _ Class Pay Code 11108 ITERSOURCE CORPORATION Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 711454 1i 02/16/20 02/08120 02/08/20. 131.87 0.00 0.00 131.87 v' HARDWARE FOR IT , Vendor Totals Number Name Grass Discount No -Pay Net 11108 ITERSOURCE CORPORATION 131.67 0.00 0.00 131.87 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC V Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net 928027701 ✓ 02/15/20 01/31/20 03/02120. 727.09 0.00 0.00 727.09 y SUPPLIES 928042097 /` 02/15/20 02/01/20 03/03/20 84.00 0.00 0.00 84,00 -- V, SUPPLIES 928147237 r-� 02/16/20 02/09/20 03/11/20 1,645.92 0.00 0.00 1,645.92 ✓ SUPPLIES 928167556 ;+ 02/18/20 02/10/20 03/12/20 165.44 0,00 0.00 165.44 v SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net J0150 J & J HEALTH CARE SYSTEMS, INC 2,622,45 0.00 0.00 2,622.45 Vendor# Vendor Name Class Pay Code 14316 JUNXION MED STAFFING Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MEM012922 02/16/2001/20/2002/04/20 1182125 0.00 0.00 1,821.25 y/ ICU NURSE STAFFING 2"i27) 1)_•-11 .1�� _ MMCWE020522 V 02124/20 02/12/20 02/27120 9,261.25 0.00 0.00 9,26125%/ file;///C:/Users/ltrevino/epsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report6lO999.., 2/24/2022 Page 11 of 27 ICU NURSE STAFFING I I j. Vendor Total: Number Name Gross Discount No -Pay Net 14316 JUNXION MED STAFFING 11,082.50 0.00 0.00 11.082.50 I Vendor# Vendor Name Class Pay Code L0700 LABCORP OF AMERICA HOLDINGS [/ M r Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 72049863 Ir 02/21/20 01/29/20 02/23/20 990.00 0.00 0.00 990.00 IX SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net L0700 LABCORP OF AMERICA HOLDINGS 990.00 0.00 0.00 990.00 Vendor# Vendor Name Class Pay Code 11600 LEGAL SHIELD ,/ Invoice# Comment Tran Ot Inv Of Due Dt Check DPay Gross Discount No -Pay Net 021522 02/17/20 02/15/20 02/15/20 398.80 0.00 0.00 398.60 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net 11600 LEGAL SHIELD 398.80 0.00 0.00 398.80 Vendor# Vendor Name Class Pay Code 12628 LEGATO Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 02251 02/16/2001/31/2003102120 1,966,66 0.00 0,00 1,966.66 . ACCOUNT MANAGEMENTS Vendor Totals Number Name Gross Discount No -Pay Net 12628 LEGATO 1,966.66 0.00 0.00 1,966.66 Vendor# Vendor Name Class Pay Code L1640 LOWE'S BUSINESS ACCT/SYNCB .,i% W Invoice# Comment Tran Dt Inv Of Due Ot Check O Pay Gross Discount No -Pay Net 010222 ,% 0`111112001/02/2003/05/20 56.82 0.00 0,00 56.82 ..E SERVICE CHARGES 012622 02124120 01/31/20 02/28/20 237.39 0.00 0.00 237.39 SUPPLIES N, 011022 ;- 02/24/2001/31/2002128/20 132.80 0.00 0.00 132.80 SUPPLIES 011222 02124/2001/31120 OM8120 16.62 0.00 0.00 16,62 SUPPLIES 013122 ' 02/24/20 01 /31120 02/28/20 42.27 0.00 0.00 42.27 ✓- INTEREST AND FEES Vendor Totals Number Name Gross Discount No -Pay Net L1640 LOWE'S BUSINESS ACCT/SYNCB 485.90 0.00 0.00 485.90 Vendor# Vendor Name Class Pay Code 11796 LUBY'S FUDDRUCKERS RESTAURANTS +- Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net INV00005320.r 02/16/2001/31/2002/15/20 28,516.57 0.00 0.00 28,516.57., - FOOD, SUPPLIES, CONTRACT Vendor Totals Number Name Dross Discount No -Pay Not 11796 LUBY'S FUDDRUCKERS RESTAURANTS 28,516.57 0.00 0.00 28,516.57 Vendor# Vendor Name Class Pay Code / 10972 M G TRUST �/ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 021022 02116120 02116/20 02/16/20 640.86 0.00 0.00 640.86 . PAYROLL DEDUCTIONS file:///C:/Users/Itrevino/cpsi/n-ie=ed,opsinet.com/ii88 125/data-5/tnip cw5report610999... 2/24/2022 Page 12 of 27 Vendor Totals Number Name Gress Discount No -Pay Net 10972 M G TRUST 640.86 0.00 0.00 640.86 Vendor* Vender Name Class Pay Code J1350 M.C. JOHNSON COMPANY INC ;� M Invoice# Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net � `Comment 00389789 V 02/15/20 02/04/20 03/04/20 100.66 0.00 0.00 190.66 SUPPLIES .mil, , Vendor Totals Number Name Gross Discount No -Pay Net J1350 M.C. JOHNSON COMPANY INC 190.56 0.00 0.00 190.66 Vendor# Vendor Name Class Pay Code M2178 MCKESSON MEDICAL SURGICAL INC f Invoice# Comment Tran Di Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 18914679>/ 02/1512001/02/2001117120 165.86 0.00 0100 165.8611- SUPPLIES 12056481 y/ 02/15120 01/31/20 02/15120 5.41 0,00 0100 5.41 ✓ FINANCE CHARGES 19049175/ 02/15/20. 02/08/20 02/23/20 26.07 0.00 0.00 26.07 L j SUPPLIES 19047175 02/18/20 02/08/20 02/23/20 2fjt07 / 0.00 0:00 26p7 SUPPLIES 19068555 tr' 02/18/20. 02/14/2003101/20 127.05 0.00 0.00 127.05 SUPPLIES 19068729L% 02/18120 02/14/20 03101/20 588.09 0.00 0.00 5B8.09 jx- SUPPLIES 19068593 V 02/18/20 02/14/20 05/01/20 80.92 0.00 0.00 80.92 t/ SUPPLIES 19068559 ,l J 02/18/20 02/14/20 03/01/20 417.49 0.00 0.00 417,49 /SUPPLIES 19073484 j/ 02/18/20 02/15/20 03102/20 89.45 0.00 0.00 89.45 UPPLlE3 19055751 02122/20 02/10/20 02/25/20 105.79. 0.00 0.00 105.79,1.1 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 1,630.20 0.00 0.00 ! 1,63V..20 1 �01�•115 Vendor# Vendor Name Class Pay Code 11612 MEDICAL AIR SERVICES ASSOC. r,/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gress Discount No -Pay Net 1188430 1/ 02/17/20 02/15/20 02/15/20 1,629.00 0.00 0.00 1,829.00 1,1/ INSURANCE Vendor Total: Number Name Gross Discount No -Pay Net 11612 MEDICAL AIR SERVICES ASSOC, 1,629.00 0.00 0.00 1,629,00 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC,,' A/P _ Invoice# Comment Tran or Inv of Due Dt Check D, Pay Gross Discount No -Pay Net 30266052 02/15/20 02/08/20 02/06/20 18,64 0.00 0.00 18.64 -f INDIGENT CARE Vendor Total: Number Name Gross Discount No -Pay Net 1003 MEDIMPACT HEALTHCARE SYS, INC. 18.84 0.00 0.00 18.64 Vendor# Vendor Name Class Pay Code / M2827 MEDIVATORS t! M Invoice# Comment Tran of Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net f le:///C:/Users/ltrevino/epsi/memmed.cpsinet.com/u88l25/data_5/tmp_cw5report610999... 2/24/2022 Page 13 of 27 91230731 v' 02/18/20 02/10/20 02/18/20 202.80 0.00 0,00 202.80 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2827 MEDIVATORS 202.80 0100 0.00 202.80 Vendor# Vendor Name Class Pay Cade M2470 MEDLINE INDUSTRIES INC ✓ M Invoice# Comment ✓ Tran Dt Inv Dt Due or Check D Pay Gross Discount No -Pay Net 1983347478 01/3112001/19/2003/05120 22,503.55 0.00 0.00 22,503.55 V' SUPPLIES L'dy.,V WA 19840264281// 02/1512001/21/2002/15/20 152.53 0.00 0.00 152.53 v' SU/PPLIES 1984046614 02/15/20 01/22/20 02/16/20 44,44 0.00 0,00 44.44 SUPPLIES 1984046615v 02/15/20 01/22/20 02/16/20 67.17 0.00 O.DO 67.17, SUPPLIES 198404661E y 02/15/20 01/22/20 02/16/20 25.99 0.00 0.00 25.99 SUPPLIES U 1984385212 ✓ 02/15/20 01/24/20 02/18/20 187.53 0.00 0.00 187.53 SUPPLIES 1984434834t- 02/15/20. 01/2512002/19120 431.04 0.00 0.00 431.04 ;..' SUPPLIES 1984431151 02/15/20 01/25/20 02/10/20 285.52 0.00 0.00 285.52✓ SUPPLIES 1984662467✓ 02/15/20 01/26/20 02/20/20 33.68 0.00 0.00 33.68 SUPPLIES 1984662458'1' 02/15/20 01/26/20 02/20120 2,746.78 0.00 0.00 2,746.78✓- SUPPLIES 1984612022 V 02/15/20 01/26/20 02/20/20 91360,00 0.00 OM 9,360.00 SUPPLIES 1984822388 V' 02/15/20 01/26120 02120/20 134.08 0100 0.00 134.08 V` SUPPLIES 1984662457V/ 02/15/20 01126/20 02120/20 635.45 0,00 0.00 635.45 SUPPLIES ✓ 1984662466V/ 02115/20 01/26/20 02/20/20 165.32 0.00 0.00 165.32 ti SUPPLIES 1984622389/ 02/15/20 01126/20 02120120 92.93 0.00 0.00 92.93 SUPPLIES 1984662469V% 02/15/20 01/26/20 02/20/21) 5,606.45 0.00 0.00 5,606.45 ✓ SUPPLIES 1984662454 ✓ 02/15/20 01/26/20 02/20/20 73,31 0.00 0.00 73.31 v SUPPLIES 1984662463 c'' 02/15/20 01/26/20 02/20/20 46.48 0.00 0.00 46.48! SUPPLIES 1984662460Y 02/15/2001/26/2002/20/20 166.56 MO 0.00 166.56V SUPPLIES 1984612023 1 02/15/20 01/26/20 02/20/20 9.360.00 0.00 0.00 9,360.00 SUPPLIES i 1984662465 y'' 02/15/20 01/26/20 02/20/20 83.28 0.00 0.00 83,28 ;. SUPPLIES 1984612026 f- 02/15/2001/26/2002/20/20 6,240.00 0.00 0.00 6,240.00 SUPPLIES file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report610999.., 2/24/2022 1984662464 ✓ 02/15/20 01/26/20 02/20/20. SUPPLIES 1984612027 Y 02/15/20 01/26/20 02/20/20 SUPPLIES 1984662474 rr 02/15/20 01126/20 02/20/20 SUPPLIES 1984612025N 02/15/20. 01/26/20 02/20/20 SUPPLIES -f I r, l" 1984612021, 02/15120. 01/26/20 02/20/20 SUPPLIES 1984662473 02/15/20 01/20/20 02/20/20 1984662455 d 02/15/20 01/26/20 02/20/20 SUPPLIES 1984662472 i% 02/15/20 01/26/20 02/20/20 SUPPLIES 198466246' 02/16/20 01/26/20 02/20/20 SUPPLIES 1985129412Z,,/ 02/15/20 01/28/20 02/22/20 SUPPLIES 1985129413 v 02/15/20 01 /28/20 02/22/20 SUPPLIES 1985645926✓ 02/15/2002/01/2002/26/20 SUPPLIES r 1985645930,/ 02/15/2002/01/2002/26/20 SUPPLIES 19856887501/ 02/15/20 02/01/20 02/26/20 CREDIT FOR FREIGHT 1985688752 v 02115/20 02/01/20 02126/20 CREDIT FOR FREIGHT 1985645928 V 02/15/20. 02/01/20 02/26/20 SUPPLIES 1985645929 %" 02/15/20 02/01/20 02/26/20 SUPPLIES 1985595743 / 02/15/20 02101 /20 02/26/20 SUPPLIES 1985805820 .v, 02/15/20 02JO2120 02/27/20 SUPPLIES 1985805822 y/ 0015/20 02/02/20 02/27/20 SUPPLIES 1985805831 / 02/15/20 02/02/20 02/27/20 SUPPLIES 1985789499 1 / 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805832 ✓/ 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805825,H, 02/1512002/0212002/27120 SUPPLIES 19858058281; ' 02/15/20. 02/02/20 02/27/20 SUPPLIES 1985805817 ., 02/15/20 02/02/20 02/27/20 30,93 0.00 0.00 326.00 0100 0.00 11.14 0.00 0.00 12.480.00 0,00 0.00 30.54 0,00 0.00 93.30 0.00 0.00 25,80 0,00 0,00 2,114.65 0.00 0.00 88.88 0.00 0.00 226,20 0.00 0.00 83.16 0.00 Mo 57,00 0.00 M10 46.48 0100 0.00 42.77 0.00 0.00 -22.31 0.00 0.00 32.68 0.00 0.00 185.92 0,00 0.00 3.245.89 0.00 0.00 366.13 0.00 0.00 115.54 0.00 44.44 0.00 887.96 0.00 1,911.25 0.00 158.49 0.00 37.10 0.00 83.28 0.00 0.00 0.00 0,00 0,00 0.00 0.00 0.00 Page 14 of 27 30.93 326.00 11.141.E 12,480.00 30,54 v 93.30 25.80 2,114,65 'f 86.88 �/ 226.20 t 83.16 57.00 a/ 46.48 ✓" -42.77 -22.31%` 32.68 V 185.92 ' 3,245.89 :. 366.13 1 115.54 44.44 887.96 1,911.25 L' 158.49 U' 37.10 v' 83.28 ✓' file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.coinlu88125/data_5 /tmp_cw5report610999... 2/24/2022 Page 15 of 27 SUPPLIES 1985805835 1/ 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805826 ,/ 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805633,/ 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805819 V 02/15/20 02/02/20 02/27/20 SUPPLIES 198680,9827 ✓ 02/15/20 02/02/20 OPJ27/20 SUPPLIES 1985805823 T' 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805818' 02/15l20 02/02/20 02/27/20 SUPPLIES 1985805806 Y 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805821 y/ 02/15120 02/02/20 02/27/20 SUPPLIES 1985790601 y 02/15/20 OPJ02/20 02/27/20 SUPPLIES 1985805829 �, 02/15/20 OPJ02/20 02/27/20 SUPPLIES 1985805834 6,,' 02/15/20 02/02/20 02/27/20 SUPPLIES 1985805830 Z. 02/15/20 02/02/20 02/27/20 SUPPLIES 1986332617 v 02/15/20 02/04/20 03/01/20 SUPPLIES 1986332616 j/ OVIS120 02/04/20 03/01/20 SUPPLIES 1986342575 0/ 02/15/20 02/05/20 03/02/20 SUPPLIES 1986342574 / 02/15/20 02/05/20 03/02/20 SUPPLIES 1986605968 ✓ OPJ15/20 02JOB120 03105120 SUPPLIES 1986605967 y 02/15/20 02/08/20 03/05/20 SUPPLIES 1986814517,' 02/15/20 02/09/20 08/06/20 SUPPLIES 1986814519 / 02/15/20 02/09/20 03/06/20 SUPPLIES 1986695552 ,/ 02/15/20 02/09/20 03/06/20 SUPPLIES 1986814513 c/ 02/15/20 02/09/20 03/05/20 SUPPLIES 1986814520 ,/ 02/15/20 02/09/20 03/06/20 SUPPLIES 1986814615 'V 02/15/20 02/09/20 03/06/20 SUPPLIES 226.20 0.00 0.00 226.20 ,✓ 27.72 0.00 0.00 27.72 •'� 123.00 0.00 0.00 12300 868.77 0.00 0.00 868.77 ✓''. 232.00 0.00 0.00 232.00 135.48 0100 0,00 135,48 ✓' 29.40 0.00 0.00 29.40v� 42,77 0.00 0.00 42.77 V' 277.61 0.00 0.00 277,61,1 " 208.09 0.00 0,00 208.09 ✓ 165.32 0.00 0.00 165.32 V 23.15 0.00 0.00 23.15 4,184.47 0.00 0100 4,18447 7% 168.23 0.00 0.00 168.23 33,65 0.00 0.00 33.65 i1 51,55 0.00 0.00 51.55 30.93 0.00 0.00 30.93y✓ 49.27 0.00 0.00 49.27 {/ 86.60 0,00 0.00 86.60 ✓! 4,557.41 0.00 0.00 4,557.41 � ,. 287.27 0.00 0.00 287.27 ✓/ 424.66 0.00 0.00 424.66 501.06 0.00 0.00 501.06 .� 113,10 0.00 0.00 113.10 58.12 0.00 OM 58.12 , file:///C:/Users/Itrevino/epsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report610999... 2/24/2022 Page 16 of 27 i 1986895550 ✓ 02/15/20 02/09/20 03/06/20 57.14 0100 0.00 57.14 ✓. SUPPLIES 1986895549 V 02/15/20 02/09/20 03/06/20 400.84 0.00 0.00 400.84 SUPPLIES^` 1986814514 i/ 02/15/20 02/09/20 03/06/20 165.32 0,00 0.00 165,32 +'- SUPPLIES 1986814516f 02/15/2002/09/2003106/20 1,670.47 0.00 0100 1,570.47v% SUPPLIES 1986814518 r 02/15/20 02/09/20 03/06/20 120.32 0.00 0.00 120.32 SUPPLIES 1986895561 / 02/15/20 02/09/20 03/06/20 31.77 0.00 0.00 31.77 SUPPLIES 1986105309 ,✓, 02/15/20 02/15/20 03/12/20 -83.26 0.00 0.00 .83.28 y' SUPPLIES 1985805824 V 02116/20 02/15120 03/12/20 156.94 0.00 0.00 156.94 .% SUPPLIES 1980644870 / 02115/2012131/2001125/20 82.22 0.00 0100 62.22Y SUPPLIES 1986613234 V 02J16/20 02/08/20 03/05/20 237.54 0.00 0.00 237.54 ✓ SUPPLIES 1986613233 / 02/16/20 02/08/20 03/05/20 8.80 0.00 0.00 8.80 SUPPLIES 1702689451 %� 02/23/2001/2212002J16/20 134.49 0.00 0,00 134.49 IN7ERES7 1987465182 V 02/23/20 02/12/20 03/09/20 93.30 0.00 0.00 93.30 SUPPLIES 1987638949 V 02J23/m 02/15/20 03/1 PJ20 284.01 0.00 0.00 284.01 L/ SUPPLIES 1987676634✓ 02/23/2002/15/2003/12/20 150.00 0100 0.00 150.00✓� SUPPLIES 1987676633,E 02/23/2002I512003/12/20 224.00 0.00 0100 224.00 j SUPPLIES 1987889739 02/23/20 02/16/20 03/13/20 82.66 0.00 0.00 82.66 L% SUPPLIES 1987889742 v 02J23/20 02/16/20 03/13/20 27.72 0.00 0.00 27.72 SUPPLIES 1987889737,/ 02/23/20 02/18/20 03/13/20 295.80 0.00 0.00 295.80 v' SUPPLIES 1987889743 v � 02/23/20 02/16/20 03/13/20 235.95 0.00 0.00 235.95 SUPPLIES 1987889740 02123/20 02/16/20 03/13/20 1,164.80 0.00 0,00 1,164.80 SUPPLIES 1987884042 , M23/2002/16/2003/13120 80.14 0.00 0,00 80.14 SUPPLIES 1987889735✓ 02/23120 0016/20 03/13120 58.12 0.00 0100 98,12 SUPPLIES 1987889741 „f 02/23/20 02/16,20 03/13/20 6,488.37 0.00 0.00 5,488.37 SUPPLIES ,,- 1987889744 17 OPJ23/20 02/16/20 03/13/20 123.00 0.00 0.00 123.00,;, SUPPLIES 1987889745✓` 02/23/20 02116/20 03/13/20 123,00 0.00 0.00 123.00 file:///C:/Users/Itrevino/cpsi/memmed,cpsinct.com/u88125/data 5/tmp_cw5report610999... 2/24/2022 Page 17 of 27 SUPPLIES 1987889738 u/ 02/23/20 02M 6/20 03/13/20 295.80 0.00 0.00 SUPPLIES 1987889786 % 02/23/20 02/16/20 03/13/20 296.80 0.00 0.00 SUPPLIES 1987884043v/ 02123/2002/16/2003/1 Mo 1,863,72 0.00 0.00 SUPPLIES 1702708820 V✓ 02/23/20 02/19/20 03/16/20 167.85 0.00 0.00 INTEREST Vendor Totals Number Name Gross Discount No -Pay M2470 MEDLINE INDUSTRIES INC 107,882.21 0.00 0.00 Vendor# Vendor Name 11 Class Pay Code 10963 MEMORIAL MEDICAL CLINIC V Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No•Pay 021022 02/16/2002/1612002/16/20 320.00 0.00 0.00 PAYROLL DEDUCTIONS Vendor Totals Number Name Gross Discount No -Pay 10963 MEMORIAL MEDICAL CLINIC 320.00 0.00 0.00 Vendor# Vendor Name Class Pay Code 10182 MERCEDES SCIENTIFIC./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay 2553305 / 02/15/20 01/31/20 03/02120 61.62 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay 10182 MERCEDES SCIENTIFIC 61.62 0100 0100 Vendor# Vendor Name Class Pay Code 10904 MERCK SHARP & DOHME CORPY` Involee# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 7015872091,/ 01101/20 01/04/20 03/15/20 808.11 0.00 0.00 INVENTORY Vendor Totals Number Name Gross Discount No -Pay 10904 MERCK SHARP & DOHME CORP 808.11 0.00 0.00 Vendor#Vendor Name Class Pay Code ` M2621 MMC AUXILIARY GIFT SHOP „/ w Invoice# Comment Tran DI Inv Or Due Dt Check DPay Gross Discount No -Pay 021022 02/15/20 02/10/20 02/10/20 $09.33 0.00 0.00 GIFT SHOP PR DEDUCTIONS Vendor Totals Number Name Gross Discount No -Pay M2621 MMC AUXILIARY GIFT SHOP 309,33 0.00 0.00 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC „�/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 992B ✓ 02/16/20 02/02/20 02/12/20 -25.53 0.00 0.00 CREDIT 0258 y/ 02/16/20 02/03/20 02/13/20 -5.00 0.00 0.00 CREDIT 78371 all 02/16/20 02/03/20 02/13/20 624.28 0,00 0.00 INVENTORY PHARM 7834403 02/16/20 02/03/20 02/13/20 4.73 0.00 INVENTORY PHARM CM16266A . /02/16/20 02/03= 02/13/20-1.087.88 0.00 N}IrD1 0.00 295.80 , 295.80._,,/ 1,863.72 v'" 167.85 Net 107,882.21 Net 390.00 1,- Net 320,00 Net 61,68�% Net 61.62 Net 808.11 Net 808.11 Net 309.33 ✓' Net 309.33 Net 26.53✓ 624.281: 4.73 f -1,087.88 V file;///C:/Users/ltrevino/epsi/memmed.cpsinct.com/ti88125/data_5/tinp_cw5report6l O999... 2/24/2022 Page 18 of 27 CREDIT 7834402v 02/16120 02103/20 02/13/20 609.91 0.00 0.00 609.91 INVENTORY PHARM . 7837160 02/16120. 02/03/20 02/13/20. 8.92 0.00 0.00 8.92 ✓ INVENTORY PHARM 7835588 V 02/16/20 02/03/20 02/13/20 34.74 0.00 0.00 $4.74 INVENTORY PHARM . 7841142-,' 02/16/20 02/06/20 02/16120 1,077.17 0,00 0.00 1,077,M'" ,.INVENTORY PHARM 7841144'✓ 02/16/20 02/06/20 02/16/20 140.17 0.00 0.00 140.17�./ INVENTORY PHARM . 7841143 " 02/16/20 02/06/20 02/16/20 8.58 0.00 0.00 3.58 .. INVENTORY PHARM . 7843279'/ 02/16/20 02/06/20 02/16/20 852.67 0.00 0.00 852.67 INVENTORY PHARM . 7843278 v 02/16/20 02/06/20 02/16/20 5.39 0.00 0.00 5.39 "" . INVENTORY PHARM 78411451' 02/16120 02/06/20 02/16/20 9.615.74 0.00 0.00 9,815.74 0' INVENTORY PHARM 7841146 ✓ 02116/20 02/06120 02/16/20 1,807.64 0.00 0.00 1,807.64 ✓ .INVENTORY PHARM 7847644 02/16/20 OM/07/2002/17/20 89,52 0.00 0.00 89.52 INVENTORY PHARM 7847645 ✓ 02/16/20 02/07/20 02/17/20 282,64 0.00 0.00 282.64,, INVENTORY PHARM / 7852394 / 02/16/20 02/08/20 02/18/20 4.08 0.00 0.00 4.08 j INVENTORY PHARM 7852395 ;% 02/16/20 02/08/20 02/18/20 58954 0.00 0.00 589.54 INVENTORY PHARM 7849917s% 02/16/20 02/08/20 02/18/20 45.33 0.00 0.00 45.33 INVENTORY PHARM 7857157 11/ On0/20 02/09/20 02/19/20 431,16 0.00 0.00 431.16 y' ' INVENTORY PHARM 7855379 02 I6120 02/09/20 02/19/20 2,233.80 0.00 0.00 2,233.80:-� INVENTORY PHARM 7855376, f 02/16/20 02/09/20 02/19/20. 3.20 0.00 OM , 3.20 INVENTORY PHARM 7855375 ,, " 02/18/20 02/09/20 02/19/20 47.94 0100 0.00 47.94. INVENTORY PHARM 7858835yj 02116/20 02109/20 02/19120 10.95 0.00 0.00 10.95 ..% INVENTORY PHARM 7856093 02/16/20 02/09/20 02/19/20 95.73 0.00 0.00 95.73 +f INVENTORY PHARM 7855378 / 02/16/20 02/09/20 02/19/20 411.45 0.00 0.00 411.45 ✓ INVENTORY PHARM 7858836 ✓ 02/16/20 02/09/20 02/19/20 64,57 0.00 0,00 64.57 v" INVENTORY PHARM 7860596 ,/ 02/16/20 02/10/20 02/20/20 241.39 0.00 0.00 241.39 INVENTORY PHARM 7860597,�" 02/16/20 02/10/20 02/20/20 31.64 0.00 0100 31.64 INVENTORY PHARM " file:/1/C:/Users/ltrevino/cpsi/memmed.cpsinet.coln/u88125/data 5/tmp_cw5report610999... 2/24/2022 Page 19 of 27 7868423 �/ 02/16/20 02/13/20 02/23/20 27.87 0.00 0.00 27.87 ✓ INVENTORY PHARM 7870508 ✓/ 02/16/20 02/13/20 02/23/20 1.196.48 0.00 0.00 1,196.48 V' INVENTORY PHARM 7870509V 02/15/20 02/13/20 02123120 4.50 0.00 0.00 4.50 V,l INVENTORY PHARM 7868424 vz 02/16/20 02/13/20 02/23/20 74.32 0.00 0.00 74.32 INVENTORY PHARM 7870507 ✓ 0M 6/20 02/13/20 02/23/20 103.10 0.00 0,00 103.10 INVENTORY PHARM 7868422.., / 02/16/20 02/13/20 02/23/20 417.19 0.00 0.00 417.19 a . INVENTORY PHARM 7872000 �,' 02/21/2002/1412002/24/20 241.22 0.00 0.00 241.22 - INVENTORY U 7878099 ! 02/21/2002/1412002/24/20 2,721.74 0.00 0.00 2,721.74 INVENTORY 7875098 / 02/21/2002114/2002J24120 17,72 0,00 0.00 17.72 INVENTORY 7879184 / 02/21 /20 02/15/20 02/25/20 V 469.01 0.00 0.00 469.01 INVENTORY 7879183„/ 02/21120 02/15/20 02/26/20 86.79 0.00 0.00 86.79 %INVENTORY 7877228✓. 02/21/200211512002/25/20. 138,68 0.00 0.00 138.68 INVENTORY 7879938 02/21/20 02/15/20 02/25/20 7.69 0.00 0.00 7.69 /INVENTORY 7884514 ,/ 02/23/20 02/16/20 02/26/20 46.36 0.00 0.00 45,36 SUPPLIES 7882455 02/23/20 02/16/20 02/26/20 1,394.72 0.00 0.00 1,394.72 ✓� SUPPLIES 7884513 / 02/23/20 02/16/20 02/26/20 40,98 0.00 0.00 40.98 7882454,i 02/2312Q 02/16/2002J26/20 666.82 0.00 0.00 666,82 SUPPLIES ` 78845155.i� 02/23/2002/16/2002126/20 373,03 0.00 0.00 373.03-,- 3528✓ 02/23/20 02/17/20 02/27/20 •786.38 0.00 0.00 -786.38 REDIT FOR MDK-3366012 7890206 ✓ 02/23/20 02/17/20 0212712U 111.89 0.00 0.00 111.89 SUPPLIES 7690207� 02/23/20 02/17/20 02/27/20 93.42 0.00 0.00 93.42 SUPPLIES 7891735 ' 02/2312D 02/18/20 02/28/20 7,790.36 0.00 0.00 7,790.36E SUPPLIES 7897299 / 02/23/20 02/20/20 03/02/20 8,906.29 0.00 0.00 8,906.29 y, ' SUPPLIES 7895203 ;/ 02/23/20 02/20/20 03/02/20 218,57 0.00 0.00 218.57 SUPPLIES 7897299 ✓ -' 02/23/20 02/20/20 03/02/20 887.82 0.00 0.00 887.82 ' `SUPPLIES 7901384,! 02t=2002/21/2003/03/20 9,521.91 0.00 0.00 9,521.91 Fite:///C:/Users/Itrevino/cpsi/memmed.cpsinet.comhi88125/data_5/tinp_cw5report610999.., 2/24/2022 Page 20 of 27 SUPPLIES 7898765 02/23/20 02/21 /20 03/03/20 416.88 0.00 0.00 416.88 SUPPLIES 7901383 %, 02/23/20 02/21/20 03/03/2o 217.64 0.00 0.00 217.64 -� SUPPLIES 7900953/ 02/23/20 02/21/20 03/o3/20 34.74 0.00 0.00 34.74 SUPPLIES 7898764 %- 02/23/20 02/21/20 03/03/20 28.28 0.00 0.00 28.28 SUPPLIES .- 7900659„/ 02123/20 02/21120 03103/20 342,36 0.00 0,00 342.36 Mj SUPPLIES 7898766 02/23/2002/21/2003/03/20 239.07 0.00 0.00 239.07 SUPPLIES 7903922 -✓ 02/23/20 02/22/20 03/04/20 47,62 0.00 0.00 47.62 _rf SUPPLIES 7907102, 02/23/20 02/22/20 03/04/20 4,401.48 0.00 0.00 4.401.48, SUPPLIES 7903926 .;' 02/23/20 02/22/20 03/04/20 63.65 0.00 0.00 63.65 SUPPLIES 7903925 ✓ 02/23/20 02/22/20 03/04/20 12.80 0.00 0.00 12,80 �. SUPPLIES 7903924 ✓ 62/23120. 02/22/20 03/04/20 110.43 0.00 0.00 110.43 SUPPLIES 7903923/ 02/23/20 02/22/20 03/04/20 59.06 0.00 0.00 59,06 SUPPLIES CM19718 // OW23120 02/22/20 03/04/20 -19.30 0.00 0.00 -19,30.i' CREDIT FOR ITEM 224279 7907101�// 02123120 02122/20 03/04120 3,723.36 0.00 0.00 3,723.36 SUPPLIES 7906042..; 02/23/20 02/22/20 03/04/20 5.99 0.00 0.00 5.99 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 62,909.63 0.00 0.00 62,909.63 Vendor# Vendor Name Class Pay Code 14124 MSH HEALTH SERVICES LLC V/ Invoice# Comment Tran or Inv Dt Due Ot Check D- Pay Gross Discount No -Pay Net MMC0037.,/ 01117/20 01/10/20 03/05/20 2,736.00 0.00 0.00 2,736.00�/ TRAVEL NURSE STAFFING MMC0046 „% 02/21120. 02/08/20 02/23/20 4,406.25 0,00 0.00 4,406.25 MEDSURGSTAFFING Lij-1 Vendor Total: Number Name Gross Discount No -Pay Net 14124 MSH HEALTH SERVICES LLC 7,142.25 0.00 0.00 7,142.26 Vendor# Vendor Name Class Pay Code 13548 NACOGDOCHES TRANSCRIPTION Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 7621 02/21/2002/16/2002/26/20 405.86 0,00 0.00 405.86 TRANSCRIPTION ([ 1 tr7_- Vendor Totale Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 405.86 0.00 0.00 405.86 Vendor# Vendor Name Class Pay Code 11472 OCCUPRO LLC V/ fil e:///C:/Users/ltrevino/cpsi/memmed,cpsinet,com/u 88125/data_5/tmp_cw5 report610999... 2/24/2022 Page 21 of 27 Invoice# Comment Tran Dt Inv Dt Due Dt ! Check D Pay Gross Discount No -Pay Net 24838 ✓ 02/09/20 OPJ07/20 03/09/20 487.47 0100 0.00 487,47, MNTHLY PROV LICENSE Vendor Totals Number Name Gross Discount No -Pay Net 11472 OCCUPRO LLC 487.47 0.00 0.00 487.47 Ventlor# Vendor Name Class Pay Code 01500 OLYMPUS AMERICA INC += M Invoice# Comment Tran Dt Inv or Due Dt Check 0Pay Gross Discount No -Pay Net 32115169'✓ 02/.15/20 01/25/20 02/19/20 187.50 0.00 0.00 187.50 SUPPLIES 32161964V 02/18/2002/03/2002128/20 187.60 0.00 0.00 187.50, SUPPLIES 32176816v/ 02121120 02107120 03/04120 1,137,51 0.00 0.00 1.137.51�,.% MAINT CONTR Vendor Totals Number Name - Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 1,512.51 0.00 0.00 1,512.51 Vendor# Vendor Name Class Pay Code 11155 PARA ✓ Invoice# Comment Tram Dt Inv DI Due or Check 0 Pay Gross Discount No -Pay Net 10457 ,/ 02/02/20. 02/01/2003/03/20 3,084,00 0,00 0.00 3,084.00 REVENUE INTEGRITY PROGH Vendor Totals Number Name Gross Discount No -Pay Net 11155 PARR 3,084.00 0.00 0.00 3,084.00 Vendor# Vendor Name Class Pay Code 14328 1 1 / Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net NGUCPH0001 W16/20 02111120 02/11120 84.00 0.00 0.00 84.00 PT REFUND CLINIC Vendor Total. Number Name Gross Discount No -Pay Net 14328 84.00 0.00 0.00 84.00 Vendor# Vendor Name Class Pay Code 10032 PHILIPS HEALTHCARE Invoice# Comment Tran Ot Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net 9479683211.1 02/21/2010/29/2011/23/20 76,639.41 0.00 0,00 78,639.41 CARDIAC MONITOR SYSTEM 948267603 KI 02/21/2012/06/2012131/20 154,193.78 0.00 0.00 154,193.78 CARDIAC MONITOR SYSTEM 948402492V 02/21/20 12123/20 01/17/20 `JU)?44✓ 4,5344.00 0,00 0.00 CARDIAC MONITOR SYSTEM I r 9484992W 02/21120. 01/07/20 02/01/20 7,800.00 0.00 0.00 7.300.00 CARDIAC MON SYSTEM PART 94823353 ✓ 02/21/20 01/11/20 02/05/20 361.92 0.00 0.00 361,92✓ SUPPLIES 948665577✓ 02/21/20 02/17/20 03/14/20 116.08 0.00 0.00 116.08 ✓ SUPPLIES 948782936✓ 02/21 /20 02/17/20 03/14/20 392.22 0.00 0.00 392.22 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net ;S 70032 PHILIPS HEALTHCARE 243,537.41 O.Oo 0.00 243,537.rS1 Vendor# Vendor Name Class Pay Code 12480 PRO ENERGY PARTNERS LP file:///C:/Users/Itrevino/cpsi/memmed.cps inet.com/u88125/data_5/tmp_cw5report610999... 2/24/2022 Page 22 of 27 Invoice# Comment Tian Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 22010600 02/21/2001/31/2002/15/20 7,178.37 0100 0.00 7,178.37 gas Vendor Totals Number Name Grass Discount Na-Pay Net 12480 PRO ENERGY PARTNERS LP 7,178,37 0.00 0.00 7,118.37 Vendor# Vendor Name Class Pay Code 14060 RADCOM ASSOCIATES, LLC e Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross INV000539 ✓ Discount No -Pay Net 02/15/20. 01131/2003/02120 900,00 0100 0.00 900.00 PHYSISIST EVAL-QTRLY Vendor Totals Number Name Gross Discount No -Pay Net 14060 RADCOM ASSOCIATES, LLC 900.00 0100 0.00 000.00 Vendor# Vendor Name Class Pay Code S2353 SMITHS MEDICAL ASD ING - Involce# Comment Tran 01 Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 16554391 r/ 02/15/20 01/27/20 02/26/20 265,12 0.00 0.00 265.12 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net S2353 SMITHS MEDICAL ASD INC 265.12 0.00 0.00 285.12 Ventlor# Vendor Name Class Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE CEN ," Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net CM6373 V1 02121/20 02/15/20 03/12/20 .11896A0 0.00 0.00 -1,896.00 BLOOD CREDIT 107020584 / 02121/2002/15/2003112120 6,012.00 0.00 0.00 6,012.00� BLOOD Vendor Totals Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 4,116.00 0.00 0.00 4,116.00 Ventlor# Vendor Name Class Pay Code S2345 SOUTHEAST TEXAS HEALTH SYS ,/ w Invoice# Comment Tran Dt Inv Dt Due Dt Check Or Pay Gross Discount No -Pay Net f 26625 ! 0015/20 02/04/20 03/06/20 125.00 0.00 0.00 125.00 f CREDENTIALING- C THURLKII. Vendor Totals Number Name Gross Discount No -Pay Net S2345 SOUTHEAST TEXAS HEALTH SYS 126.00 0.00 0.00 125.00 Vendor# Vendor Name Class Pay Code l C1010 SPARKLIGHT V IN Invoice# Comment Tran Ot Inv Dt Due Ot Check D' Pay Gross Discount No -Pay Net 030222A 02/24/20 03/02/20 03/02/2o 2,250.00 0.00 0.00 2,250.00 CABLE 030222C 02/24/20 03/02/20 03/02/20 93.29 0.00 0.00 93.29 ✓ CABLE 0302228 02124/2003/02/2003/02/20 1,875.15 0.00 0.00 1,675.15L„/ CABLE 030622D 02124/20 03/06120 03102/20 93.33 0.00 0100 93,33 CABLE Vendor Totals Number Name Gross Discount No -Pay Net C1010 SPARKLIGHT 4,111,77 0.00 0.00 4.111.77 Vendor# Vendor Name / Class Pay Code 12288 SPBS CLINICAL EQUIPMENT SRVC "' Invoice# Comment Tran Dt Inv Dt Due Dt Check Q Pay Gross Discount No -Pay Net file:///C:/Userslltrevino/cpsilmemmed.cpsinct.com/u88125/dat,L5/tmp_cw5report6lO999... 2/24/2022 Page 23 of 27 INV010807A 02/21120 02121/20 02/21/20 62.50 0.00 0.00 62.50 REPAYING CREDIT MEMO _ Vendor Totals Number Name Gross Discount No -Pay Net 12288 SPBS CLINICAL EOWPMENT SRVC 62.50 0,00 0.00 62.50 Vendor# Vendor Name Class Pay Code 10094 ST DAVIDS HEALTHCARE / Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMCPL2021-07 / 02/23/20 08/26/20 08/26/20 745.00 0.00 0.00 745.00 CONNECTIVITY FEE JULY 21 MMCPL2021-09 ✓ 02/2312011/03/2011/03/20 795.00 0.00 0.00 795.00 CONNECTIVITY FEE SEPT21 ` MMOPL2021.10 ✓ 02/23/2012/05/2012/05120 420.00 0.00 0,00 420.00 CONNECTIVITY FEE OCT 21 Vendor Totals Number Name Gross Discount No -Pay Net 10094 ST DAVIDS HEALTHCARE 1,960.00 0.00 0.00 1,960.00 Vendor# Vendor Name Class Pay Code 10735 STRYKER SUSTAINABILITY Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4361488, 02/15/20 02/01/20 03/03/20 335.72 0.00 0.00 335.72 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABIUTY 336.72 0.00 0.00 335.72 Vendor# Vendor Name Class Pay Code 14324 Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net HERTEOo001 02/15/20 02/08/20 02/08/20 70.00 0.00 0,00 70.00 f'f Vendor Total: Number Name Grass Discount No -Pay Net 14324 70.00. 0.00 0.00 70,00 Vendor# Vendor Name Class Pay Code 10627 TEXAS DEPARTMENT OF STATE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 022822 02/15/20 02/28/20 02/28/2o 21035.00 0.00 0.00 2,035.00 HAD CONTROL LICENSE Vendor Totals Number Name Gross Discount No -Pay Net 10627 TEXAS DEPARTMENT OF STATE 2,035:00 0.00 0.00 2,035.00 Vendor# Vendor Name Class Pay Code T2204 TEXAS MUTUAL INSURANCE CO W Invoice# CPmment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1003421725 / 02/15/20 02/03/20 03/03/20 3,925,00 0.00 0.00 3,925.00 v� WRK COMP INS Vendor Totals Number Name Grass Discount No -Pay Net T2204 TEXAS MUTUAL INSURANCE CO 3,925.00 0.00 0.00 3,925.00 Vendor# Vendor Name Class Pay Code 12984 TEXAS ORGANIZATION OF RURAL f Invoice# Comment Tran Dt Inv of Due Dt Check D Pay Gross Discount No -Pay Net / 2225840 �/ 02/16/20 12/16/20 01/01/20 3,850.00 0.00 0.00 3,860,00 MEMBERSHIP DUES Vendor Totals Number Name Gross Discount No -Pay Net 12984 TEXAS ORGANIZATION OF RURAL 3,850.00 0.00 0.00 3,550.00 Vendor# Vendor Name Class Pay Code file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_51tmp_cw5report610999... 2/24/2022 Page 24 of 27 10758 TEXAS SELECT STAFFING, LLC I Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 001915651079IN 02/16/20 02/03/20 02/04f2O 4,042.50 0.00 0.00 4,042,50 MED SURG STAFFING (tl4-11411'&) ,1 L�N1 W. �.- ✓ 001899551079IN,✓ 02/24/2001/13/2001114120 4,042.50 0,00 0.00 4,042.50✓. STAFFING MED SURG (11$1.- Il7,41ti7,) jL6tkU, 001921451079IN ✓ 02/241200211012002/t 1/20 4,015.00 0.00 0.00 4,015,00 STAFFING MEO SURG ( 2.11- JR b &L4L 001927051079IN.✓ 02124/20 02117/20 02118120 3,987.50 0.00 0.00 , 3,987.50 TRAVEL NURSE STAFFING C'A-1L--4112-) 3,t U%t. �- Vendor Total=Number Name Gross Discount No -Pay Net 10758 TEXAS SELECT STAFFING, LLC 16,087,50 0.00 0.00 16,087.50 Vendor# Vendor Name Class Pay Code T2235 TEXAS SOCIAL SECURITY PROGRAM W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay. Net 9291922-2022 02/16/20 02/04/20 02/04/20 42,0p. 0.00 0.00 4 . 0 ANNUAL FEE Vendor Totals Number Name Gross Discount No -Pay Not T2235 TEXAS SOCIAL SECURITY PROGRAM 42.j1( 0.00 0.00 42. Vendor# Vendor Name Class Pay Code 14224 THE TACT CORPORATION OF NYC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 9266702546✓ 01/12/2001YO712003108120. 3,840.00 0.00 0.00 3,940.001-/ TRAVEL NURSE STAFFING ( I �) 94- 1;13 t1 CdgU 9266702503 ✓ 01/12120 01/07120 03/08/20 1,920,00 0.00 0.00 1,920,00 ,✓' TRAVEL NURSE STAFFING 01 112 9266702707t% 01/187200111412003115/20 6,760.00 0.00 0100 5,760.00 4/ TRAVELd NURSE STAFFING (t14-Ith>) Wq6 / 9266703063 ✓ 02/113/20 02/04/20 03/06/20 5,760.00 0.00 0.00 5,760.00 ER NURSE STAFFING t 111 v-111u) tayl.t. . 9266703208 „✓ 02/16/20 02/11/20 03/13/20 5,760.00 0.00 0100 5,760.00 ✓- ERNURSESTAFFING (2I01-a1311.>-) 6+t Vendor TolalE Number Name Gross Discount No -Pay Net 14224 THE TACT CORPORATION OF NYC 23,040.00 0.00 0.00 23,040.00 Vendor# Vendor Name Class Pay Code T2250 TK ELEVATOR CORPORATION M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3006396756✓ 02121/20 02101/20 03/01/20 1,398.81 0.00 0.00 1.398.81 ELEVATOR SERVICE Vendor TotaiE Number Name Gross Discount No -Pay Net T2250 TK ELEVATOR CORPORATION 1,398.81 0.00 0.00 1,398.81 Vendor# Vendor Name Class Pay Code 14208 TRUSTED HEALTH, INC ./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV7994v1 OPJ16/20 01/29/20 02/28/20 4,000.00 0.00 0.00 4,000.OL/' INV8110 02/24/20 02/05/20 03/07/20 4,718.75 0.00 0.00 4,718.75 AGENCY ATAFFING INV8267 ✓ 02/24/20,0211212003114120 6,218.75 0.00 0.00 6,218,75v, TRAVEL NURSE STAFFING Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/Users/]trevino/cpsi/memmed.cpsinet,com/u88125/data_5/tmp_cw5report610999... 2/24/2022 Page 25 of 27 14208 TRUSTED HEALTH, INC 14,937.50 0.00 0.00 Vendor# Vendor Name Ciass Pay Code U1064 UNIFIRST HOLDINGS INC Invoice# Com`mant Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 8400387406 / 02/15/20 02/03/20 02/28/20 136.58 0100 0,00 LAUNDRY CLINIC 8400387391V/ 02/15/20. 02/03/20 02/28/20 1,773.46 0.00 0.00 LAUDNRY 8400387385 w,i/ ON1512D 02/03/20 02/28/20 86,15 0.00 0.00 LAUNDRY 8400387371 a 02/15120. 02/03/20 02/28/20 199.32 0.00 OM LAUNDRY SURGERY 8400387370 OP115/20 02/03/20 02/28/20 187.75 0.00 0.00 LAUNDRY 8400387367 y/ 02/15/20 02/03/20 02/28/20 40.15 0.00 0.00 LAUNDRY 8400387363 LAUNDRY 02/15/20 02/03/20 02/28/20 137.15 0.00 0,00 8400387538 v/ 02/15/20 02/03/20 02/28/20 45.15 0.00 0.00 LAUNDRY 8400387369 y/Z 02/15/2D 02/03/20 02/28/20 168.98 0.00 0.00 LAUNDRY PT 8400387539 02/15/20 02/07/20 03/04/20 40.10 0.00 0.00 LAUNDRY 8400887664 ✓ 02/15/20 02/07/20 03/04/20 2,074.09 0.00 0.00 LAU DRY 8400387883 02/15/20 02/10/20 03/07/20 194.31 0.00 0.00 LAUNDRY 8400387882 ✓/ 02/15/20 02/10/20 03/07/20 199.06 0.00 0.00 LAUNDRY PT 8400367881 ✓ 02/15/20 02/10/20 03107/20. 137.15 0.00 0.00 LAUNDRY 8400387902 ✓ 02/15/20 02/10/20 03/07/20 1,988.57 0.00 0.00 LA/UNDRY 8400387880 ✓ 02/15/20 02/10/20 03/07/20 34.90 0.00 0.00 LAUNDRY 8400387916 ✓ 02/15/20 02/10/20 03/07/20 80.02 0.00 0.00 LAUNDRY CLINIC / 8400387884 1 OPM 5/20 02/10/20 03/07/20 199.32 0,00 0.00 LAUNDRY SURGERY 8400388079 ,/ 02115/2002/14/20 o3/11/20 2,583,28 0.00 0.00 LA DRY 84003880521% 02/15/20 02/14/20 03/11/20 45.15 0.00 0.00 LAUNDRY OB 0400386053 V,--� 02/15/20 OPJ14120 03/11120 40.10 0.00 0.00 LAU DRY 8400388377 02123/20. 02/17/20 03/14/20 72.95 0100 0.00 SUPPLIES 8400388381 ,/' OPJ23/20 02/17/20 03/14/20 199.32 0.00 0.00 SUPPLIES 8400388413 / 02/23/20 02/17/20 03/14/20 117.57 0.00 0.00 14.937.50 Net 136.58 1,773.46 86.15 199.32 187.75 ✓ 40.15✓ 137.15 45.15 168.98 % 40.10,,- 2,074.09 194.31 199.06 137.15 f 1,988.57 34.90 ✓ 80.02 " 199.32 2,583.28 r/ 45.15 40.10 ✓ 72.95 t/ 199.32 117.57 file:///C:/Clsers/ltrevino/epsilmemmed. cpsinet.ccm/u88125/data_5/tmp_cw5 report610999... 2/24/2022 Page 26 of 27 SUPPLIES 8400388396 ✓ 02/23/200211712003/14/20 1,180.35 0.00 0100 1,180.35�j� SUPPLIES 8400388379 „// 02/23/20 02/17/20 03/14/20 201.14 0100 0.00 201.14 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 12,162,07 0,00 0.00 12,162.07 Vendor# Vendor Name Class Pay Code U2000 US POSTAL SERVICE y,/ Invoice# Comment Tran Ut Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net PERMIT5000 02/15/20 OPJ08/20 02/08/20 265.00 0.00 0.00 265.00 BUSINESS REPLY PERMIT Vendor Totals Number Name Gross Discount No -Pay Net U2000 US POSTAL SERVICE 265.00 0.00 0.00 285.00 Vendor# Vendor Name Class Pay Cade V0552 VERATHON INC ✓ / Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 80417094 02/15/2001/11/2002/05120 43.69 0.00 0.00 43,69 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net V0552 VERATHON INC 43.69 0.00 0,00 43.69 Vendor# Vendor Name Class Pay Code V1058 VICTORIA ANESTHESIOLOGY ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net JAN22 02/15/20 01/31/20 02/15/20 47,648.28 0.00 0100 47,648.28 ANESTHESIOLOGY SVS Vendor Totals Number Name Gross Discount Nu -Pay Net V1058 VICTORIA ANESTHESIOLOGY 47.648.28 0.00 0.00 47,648.28 Vendor# Vendor Name Class Pay Code / 10793 WAGEWORKS, INC. �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 021022 02/16/20 02/16/20 02/16/20 3,532.62 0.00 0.00 3.532.62 PAYROLL DEDUCTIONS Vendor Tousle Number Name Gross Discount No -Pay Net 10793 WAGEWORKS, INC. 3,532.62 0.00 0.00 3,532.62 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC .% Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9111107655 ,,-/ 02/0112002/01/2002/26/20 1,476.20 0.00 0.00 1,476.20 SUPPLIES 9111105702 �� 02115/20 01131/20 02/25/20 1,025.29 0.00 0.00 1,025.29 SUPPLIES ✓-' 9111109496 ✓ 02/15/20 02/03/20 02/28/20 489,78 0.00 0.00 489.78 SUP LIES ✓ 9111110749 02/15/20 02/07/20 03/04/20 768.00 0.00 0.00 768.00 ✓�' SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 11110 WERFEN USA LLC 3,759.27 0.00 0,00 3,759.27 Vendor# Vendor Name Class Pay Code Z1000 ZIMMER BIOMET M Invoice# Comment Tran Di Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net file:///C:/Users/Itrevino/cpsi/memmed.cpsinet,com/u88125/data 5/tmp_cw5report610999... 2/24/2022 Page 27 of 27 563915PJ7952 „/ 02/15/20 02/01/20 03101/20 11.76 0.00 0.00 11.76 / SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net Z1000 ZIMMER SIOMET 11.76 0.00 0.00 11,76 Report Summary Grand Totals: Gross Discount No -Pay Net 1,068,718.20 0.00 0.00 1 068 718 20 265.00 670 UU 388 J8 � 26,U _. 4n534-0i 4^534•110 + 42.OLi — 1>066—L4,q-oI APPROV®ON FEB 2 4 2022 BY COU1149Y AUDITOR CALHOUN COUNTY, TEXAS P5 5 GYruiiW� t966'.00 P9 -7 015d5.90> t OID-00 i'S g rorrhwt t38g•o8 P5 la tav,-r.�w�- �<a6•o�� f'S 21 COWLL44t '1<4153N•0o> h 4163LI.q0 P9 a torvr c�iwt i <'+a•o o ) 4IIODU'L .• I file:///C:/Users/ltrevino/cpsi/memmed. cpsinet.com/u88125/data_5/tmp_cw5repott610999... 2/24/2022 MEMORIAL MEDICAL CENTER 02l2512022 0 AP Open Invoice List Y5:37 ap_open_invaice.template Due Oates Through: Vendor# Vendor Name Class Pay Code 11108 ITERSOURCE CORPORATION Invoicek Comment Tran Ot Inv Ot Due Dt Check D Pay Gross Discount No -Pay 141164+ 02/16/20 02/08120 02/08/20 1$1 W 0.00 0.00 uiARewnsn aoa.la 711452 ✓ 02125/2002/07/2002f26120 4,237.50 0.00 0.00 ACD LICENSE Vendor Total:Number Name Gross Discount No -Pay // 11108 ITERSOURCE CORPORATION µ a'If'Lrj'J 4,369.37 0.00 0.00 Report Summery // Grand Totals: Gross Discount No -Pay 4136/37 0.00 0.00 A PPROM ON FEB 2 4 Z022 BY COUt4TY AUDITOR CALHOUN COUN'N' fo" Page 1 of I Net - 444 87� 4,237.50 / Net 4,36 .37 q'w J-1 •� Net� 4,369%7 file:///C:/Userslltrevinolepsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report758714... 2/25/2022 02/28/2022 11:29 Vandont Vendor Name 12516 JEANNIEORTA MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check 0, Pay Gross 022522 02/25/2002/24/2003/15/20 200.00 RETURNED DEPOSIT Vendor Totale Number Name Gross 12516 JEANNIE ORTA 200.00 Grand Totals: FEB 2 4 2022 BY COUNTY AUD)TOR CALHOUN COUNTY, TExAg Report Summary Gross Discount 200.00 0.00 Page I of 1 0 ap_open jnvoice.template Discount No -Pay Net 0.00 0.00 200.00 Discount No -Pay Net 0.00 0.00 200.00 No -Pay Net 0.00 200.00 fi le JNC:/Users/itrevino/epsi/memmed.cpsinet.com/u88125/data_5/tTnp_cw5report5O9836... 2/28/2022 02/17/2022 MEMORIAL MEDICAL CENTER AP Open Invoice List 12:05 Dates Through: Vendor# Vendor Name Class 10958 ALLYSON SWOPE t/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 021622 02/16/2022 02/16/2022 02/16/2022 CLINIC SVCS Vendor Totals: Number Name Gross 10956 ALLYSON SWOPE 3,984.75 9ehdrl Summary Grand Totals: Gross Discount 3,984.76 0.00 APPROVED ON FEB 212022 BY COUNTY,AUDITOR CALHOUN COUNT/, TEXAS 0 ap_open_Invoice.tempiate Pay Code Gross Discount No -Pay Net 3,984.75 0.00 0.00 3,984.75V Discount No -Pay Net 0.00 0.00 3.984.75 No -Pay Net 0.00 3,984.75 02/17/2022 MEMORIAL MEDICAL CENTER 12:06 AP Open Invoice List 0 Dates Through: ap_open_invoice.temptate Vendor# Vendor Name Class Pay Code 11069 PABLO GARZA Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 021522 02/16/2022 02/15/2022 02/15/2022 2.461.88 0.00 0.00 2,461.88 IT SVCS CLINIC 17-11 -21141 zz' Vendor Totals: Number Name Gross Discount No -Pay Net 11069 PABLO GARZA 2,461.88 0.00 0.00 2,401.88 Fepnrt 3wm;,ar Grand Totals: Gross Discount No -Pay Net 2,461.88 0.00 0.00 2,461.88 APPROVED ON FEB 2 2 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS 02/17/2022 MEMORIAL MEDICAL CENTER 0 12:01 AP Open Invoice List ap_open_invotce.template Dates Through: Vendor# Vendor Name Class Pay Code 14292 DEARBORN LIFE INSURANCE COO ./ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 012422 02/17/2022 01/24/2022 02/01/2022 3.880.01 0.00 0.00 3,880.01 VISION AND VOLUNT LIFE Vendor Totals: Number Name Gross Discount No -Pay Net 14292 DEARBORN LIFE IN 3,880.01 0.00 0.00 3,880.01 i Siwimaly Grand Totals: Gross Discount No -Pay Net 3,880,01 0.00 0.00 3,880.01 APPROi+�]i ak�j FEB 2 2 2022 CALHOUN O NTY,, 7E�)cAS 02/17/2622 MEMORIAL MEDICAL CENTER 12:01 AP Open Invoice List Dates Through: Vendor# Vendor Name / Class 12324 BLUE CROSS BLUE SHIELD. Involce# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 030122 02/17/2022 02/16/2022 03/01/2022 HEALTH AND DENTAL INS Vendor Totals: Number Name Gross 12324 BLUE CROSS BLUE 232,754.32 Grand Totals: Gross Discount 232,754.32 0.00 APPRDVEI) ON FEB 2 2 2022 BY COUNTYAUDITOR CA LI40UN COUNTY, TEXAS 0 ap_open_invoice.template Pay Code Gross Discount No -Pay Net 232,754.32 0.00 0.00 232,754.32 Discount No -Pay Net 0.00 0.00 232,754-32 No -Pay Net 0.00 232,754.32 M2A%CJDVItl STATEMENT wmomv: aom MEMORIAL MEDICAL CENTER ANT DUE RH,IITTED VIA ACH DEBIT AP Statement for intonation only 815 N VIRGINIA STREET PORT LAVACA TX 77979 As 0: 02/25/2022 Page: 002 To ensure papr oredA to your account, detach and return this Main wtth your mmktanu DC: 8115 As of: 02125MO22 Page: 002 Territory: Mall to: Comp: 8000 AMT DUE an VIA ACH OMIT Customer. 632536 nt for ink Statement for inlarmallon only Dale: 02/26/2022 Cum: 632536 PLEASE CHECK ANY Date: 02/26/2022 ITEMS NOT PAID (._) Filing Dud Rumhuiblvatlonal Amount ryapg Cash Amount P Amount P Receivable Date Date Number Referelma Description Discount (greaa) F (not) F Number PF nolumn largest: P = Past Due It... F = Raure Due Item, blank = Current Due Item TOTAL National Accra 632636 MEMORIAL MEDICAL CENTER Suistande: 6,355.40 USD Puture 0. 0.00 OnnmeII VIS- Paid By 0310112022, 1 218.26 Pact Dan: 0.00 Pry This Amount: 6,228.28 USD Dim loan R faa d late: Led Payment 2,451.97 IT PoM Altar 2022, Dud If Peitl Late: 27.12 08/07/2017 Arrested: Pay this Amami: 8,355.40 USD LED 6.355.40 177.7U 4, 299 •'7 iT .,. 10.09 1 969°4U 771.3I . 6:•22fl•28 APPROVEDON FEB 2 8 2022 CALLHOUN COUP TTOAt3 For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT HIM PHCY 04341MEv1 Mm MIS AMT DUE REdITTm VIA ACH DE81T MWORIAL MEDICAL CENTEf Statement for Information only VICKY KAUSEK 815 N VIRGINIA ST PORT LAVACA TX 77979 As of: 02/25/2022 NO: 001 To elmnm poem saint to your accours. detach eM mum this she with your mmhtance DC: 8115 A. ol: 02/25/2022 Page: 001 Mail to: Comp: 8000 Territory: 400 Altar DUE R m VIA ACH DEBTCustomer. 180813 Statement forr Information only Data: 02/26/2022 Cum: 190813 PLEASE CHECK ANY Dale: 02/28/2022 nEAS NOT PAID (�) ailing Due Pase.00tlonel Amount VA8R/A6 cosh Data Dale Number Reference Dascdptlon Discount Amount P Amount P Peccivabla —1 (gmea) F (mot) F Number Customer Number 190E13 HES PHCY 0434/MEN MED PHIS 02/23/2022 03101/2022 7326359530 2017046261 1151nvoice 3.63 181.41 111.76/ 7326359530 O PF Column legend: P = fast Dus Item, F = Future Due hem, bank = Corning Due Item TOTAL• Clutoma Numbm 190813 HEOPHCY 0434/M133 Mal PHS Sabi 181,41 USD Future Due: 0.00 Due If led Time: If Prod BY 0310112022, USD 177.78 .� Past Due: 0.00 Pay This Amount: 177.78 USD Dux tom h paid late: 3.63 teal Payment 8.053.76 It laid After 03101/2022, Dan If Paid Irate: 02/14/2022 Pay this Amount: 181.41 USD USD 181.41 APPIMMON FEB 2 8 2922 13Y COUNIV ALIWOR CALHOUN COUIM-TOM For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As of: 02125/2022 Page' 001 To amuw proper rwdK to your award, detach and whin IN. damoa,r: eoco stub wIlh your condemn WALMART 1098/MEM MED PHS MMORIAL MEDICAL CENTER AMT DUE RBARJED VIA ACH DEER VICKY KALISEK Statement for information only 815 N VIRGINIA ST PORT LAVACA TX 77979 DC: 8115 TenOory: 400 Cualomor. 256342 Dane: OW2612022 A. of: 02/26/2022 Pagr. 001 Melt to: Comp: 8000 ANT t T DUE R2forInformationITTEmy DEBIT Cud: 256342 I I EASE CHECK ANY Data; OWI!W2022 REMS NOT PAID (.�) spine Dun Date Date Recehrehl11altonal Account rym2p536 Number Reference Description each Oberman Amount P (gmsN F Amount P IiecNvahla (mi) F Numhor Cugamad Number 256342 WAWAR71m)6/MEM MED PHS 02/21/2022 03/DI/2022 7325802020 25697634 1151nvolce 51.14 2.556.83 2,505.691/ 7325802020 02/21/2022 03101/2022 7326802021 25723313 1151nvelce 8.49 424.39 415.901/ 7325802021 02/21/2022 03/01/2022 02/21/2022 03/01/2022 7325802022 25732769 7325977374 0218220739 1151nvcice 1951nvoice 11.35 0.97 568.12 40.60 556.76✓ 7325802022 47.63✓ 7325977374 02/21/2022 03/0112022 7325977375 0218220821 1151nvoico 2.52 125.78 123.261/ 7325977376 02/22/2022 03/01/2022 7326115149 25072013 115lnvoice 0.10 0.10✓ 7326115149 02/2W2022 OW0112022 02/23/2022 03/01/2022 7326286837 0221220946 7326380943 25961612 1151nvoice 11 simire 1.59 2.21 79.61 110.28 78.02✓ 7326286637 100.07✓ 7326380943 02/23/2022 03/0112022 02/24/2022 03/01/2022 02t24/2022 03/01/2022 7326569625 0222220734 7326656440 26038246 7326799402 0223220857 1951nvoice 1/5lnvolm 1151nvoice 4.59 0.02 0.98 229.27 1.08 48.88 224.68 ✓ 7326569525 1.061/ 7326656440 47.90✓ 7326799402 02/25/2022 03/01/2022 7327061179 0224220837 115Iromice 2.92 146.00 143.08✓ 732]0811]9 02/25/2022 00/01/2022 7327061180 0224220867 1951nvoice 0.97 48.52 47.55 ✓ 7327061180 PF edumn WifurM: P = Peal Due Item, F = R4uw Due Kam, blank = Current Due Item TOTAL CuetOmx Numbed 256342 WAIMARy I WINUMEd MED .5 Subtolaf8: 4,367.46 USD R4uw am: 0.00 Due It Pak On Dme: Pan Dun:: 11 Pak muSD 0.00 Pay TKla Amount: 4,298.70 I USO 4,298.70 Unl: plat Ian 8 paid late: Last Payment 02/21/2022 8,105.10 If Paid Alter 03/01/2022, Pay this Amount: 4,387.46 USO 87.76 Due It Paid late: USO 4,387.46 APPAOMON FEB 288 2022 cByCOUGs�F1pig". For AR Inquiries plena contact 800-867-0333 M=RC,DVIV STATEMENT As of:02/25/2022 Cnmpy�y: rut. DO. 8115 CVS MCY 7006/MEMORIA PIS AMT DUE RWITTED VIA ACH DEBIT TerMory: 400 MBaORIAL MEDICAL CEN"ER Statement for Information only VICKY KAUSEK 815 N VIRGINIA Custamer. 262252 PORT IAVACA TX 77979 Dme: 02/26/2022 Page: 001 To ensure proper oretl6 to your .M, "am am alum this stub with your resonance A. of: 0225/2022 Page: 001 Mail 1. Comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for information only CUM: 262252 PLEASE CHECK ANY Data: 02/26/2022 ITEWS NOT PAID (✓( Offing 0. Isttwiidatiorul Account PA55f36 Dealt Amount P Amount P Receleabo am. Data Number Reference Onediation Discount (gross) F (ast) F Number Customer Number 262252 CVS PNCY 70061MEMOmA PHIS 02/23/2022 03/01/2022 7326363715 1582426 1151molce 0.21 10.30 10.09 v/ 7326363715 O PF column legend: P = Pawl Due Item, F = Future 0. Item, blank = Current On Item TOTAL• Customer Number 262252 CVS PNCY 7006IMMONA MIS ' Sumamis: 10.30 USO Future Oue: 0.00 Duo N Paitl On Time: If i By 0310112022, U51 10.09 Past Duo: 0.00 Pay This Amount: 10.09 USD Oise tart V told Imo: 0.21 test Paymen[ 8,165,10 If Pool After 0310112022. Due If Poltl late: OW2112022 Pay this Amount: 10.30 USD USD 10.30 FEB 28 2922 BY COUNTY AUDITOR CALHOUN COUtM'1VX0 For AR Inquiries please contact 800-867-0333 MWESSONI STATEMENT omv�w: eoov HES MY Ib 490/ME4 MC PHS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for inlomation only VIC" KALISM 815 N VIRMINIA ST MIT LAVACA TX 17879 As of: 02/25/2022 Page: 001 To ensure proper oredil to your aceount, detach end return this stub with you madumue DC: 8115 As of: 02/25/2022 Page: 001 Territory: 400 Mel, I. Comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Customer. 464450 Statement for information only Date: 02/26/2022 Cud: 464450 PLEASE CHECK ANY Who 02126/2022 ITBAS NOT PAID I✓•) Nmlanal A...unl 8 oeie Oat. Number mnc. Description Discount (game) F F.1,un1 F NNunberbk Cumomo Number 464450 HER MY FC 490/1fiBA MC ME 02/21/2022 03/01/2022 7325718454 55x349395 IIShm,010e 11.25 562.46 551.21✓ 7325718454 02/21/2022 03/01/2022 7325718455 55x349409 115Invoice 0.18 8.96 8J0✓ y325r18455 02/22/2022 03/01/2022 7320093396 55x352503 1151nvoice 0.10 5.13 5.03`� T3260933:: 02/23/2022 03/01/2022 7325336796 561,355005 115Invoice 8.23 411.57 403.34 7326336796 02/25/2022 03/O1/2022 7328878414 55x359459 1151nvm0e 0.02 1.06 1.04 7326878414 PF column legend: P = Past Due Item, F = Future Due item, blank = Commit Due hem / TOTAL Customer Number 464450 N® MY FC 490/M13M MC ME SuMomle: 989.18 USD Future Due: 0.00 If Paid By 03/0112022, Pam Due: 0.00 Pay This Amount: 969.40 USD lam Payment 8,165.10 If Pald After 03/01/2022, 0212112022 Pay Ihk Amount: 909.18 USD A"ROMON FEB 28 2022 C�a NC�a.1mv, For AR Inquiries please contact 800-867-0333 'A Due O Pdd On Tide: USE) 969.40✓ Die lost K paid We: 19.70 Due It I%id W.: USD 989.18 MSKESSONSTATEMENT A. 0: OW2512622 Page: Out TO where proper credit to your euourd, deech and mt. this mmoa�: e000 eub with your remhterwe OC: 8116 A. of: 02/25/2022 Page: 001 CVS PHCY 74751MW MC Plus ANT DUE REMffTED VIA ACN D®IT Tenkmy: 400 Mall to: Camp: 8000 MC" AL CBJTDi Sieement for information only AMT DUE REMITTED VIA ACH DEBIT KALISIX SEEK Customan Solemenl for information only 815 N 815 N IA ST 836438 AVACVIRGI PORT LAVACA TX ]]9]9 Date: 02/26/2022 Cue: 835438 PLEASE CHICK ANY Date: 02/26/2022 ITEMS NOT PAID (r) BIIOng Oue b�4.11.1 Account Nye Date, Date Number Men. Cosh Description Olsooun[ Am4um P (gmw) F Amount P ReceNebk (not) F Number uv2312022 03/01/2022 7326574374 1582754 1151moice PF eaumn fusee: P = Pant Due Item, F = Fldure Due hem, Mark = Closet Duo Item TOTAL' Customer Number 835438 CVS PHCY 7475lMEM MC she Sublet Future Ole: 0.00 If Paid By 03/01/2022, Past On.: 0.00 Pay This Amount: I" Payment 6A65.10 K Paid After 03101/2022, 02/21/2022 Pay this Amowd: APPROVEDON F=6 2 8 2022 8Y COUINM AIIU[rOR CAINDUNW11Nii'r MUS! 15.74 797.05 771.31V� 7326574374 ]0T.05 USD l Due If Poltl On Time: USD ]TL31 ]]1.31 USD Disc lust If ped lain: 15.]4 Due It Paid late: 787.06 USD USO 787.06 For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT As 0: 02/18/2022 comma: aosv DC: 8115 MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBT Territory: AP Statement for inlo rrallon only 815 N VIRGINIA STRFEt Customer: 2536 PORT LAVACA TX 77979 Dale: 02/1919/2022 Page: 002 To enawe proper could to year account, Amach and return this stub with yoor remblenn As of: 02118/2022 Page: 002 Mail to: Comp: 8000 AMT DUE REMITTED VIA ACH OMIT Statement for information only Cush 632536 PLEI CHECK ANY Date: 02/19/2022 ITEMS NOT PAID (,) DIIIinp Due Bmalsor lretionl Account b3U%Is Cash Amount P Amount P Receivable Date Dete Number Relarence Description Changed (gross) F (am) F Number PF column legend: P = Peal Due Item. F = Futum Due Ham, blank = Current Due bad, Fulum Duo: Pam Due: lLad Payment 08/07MO19 36°54 332.40 8.+ 1.6 5 • 1 0 APPROVEDON FEB 28 2022 BY COLIWYAUD1TOR CALROUN COUNTY, TEXAS ..n ..Lmmo.-we.chRbNt Sum.f 8,331.74 USD 0.00 N Palrl By 0212212022, 0.00 Pay This Amount: 8.165.10 USD 2.451.97 N PaiE Alter 0212212022, Pay this Amount: 8,331.74 USD For AR Inquiries please contact 800-867-0333 Due If Pelt On Tbnm TJ/ " USD 8.165.10 Disc tom it peM late. 166.64 Oue H Isam late: USD 8,331.74 MSKESSON r<mve.y: eaoo WALMART 1088/MGN MED PHS MEMORIAL MEDICAL COVTDi VICKY KAUSIX 815 N VIRGINIA ST PORT IAVACA TX 77979 STATEMENTAe Of: 02/18/2022 Page: 001 To ensure, proper credit to your account, ddech ant relum this dub No your lemNmnee OC: B115 Ae at: 02/18/2022 Page: 001 AMT DUE ED VIA ACH DEBIT Territory: 400 Mad to: Comp: 8000 Statement I., for minlolormelion only AMT DUE id' m VIA ACH OMIT Cudomae for inlo256342 Statement for rmalion only Dale: 02/19/2022 Cud: 256342 P[F46SE CHECK ANY Del.: 02/19/2022 ITEMS NOT PAID 11) a Biling Due Needvabb rvelmnat wcceum WIP6 Coah Amount P Amount P Reu Date Number hehk� Oale gvlaronce Omdptlon Dledueed P (good (net) F Number Customer Number 256342 WALMANT 1096/MBA M® R15 02/14/2022 02/22/2022 7324369328 25209087 1151nv41ce 02/14/2022 02/22I2022 7324358329 25259491 1151redoe 02Y1412022 02/2212022 7324589708 0211220856 1151nvoice 0215/2022 02/2212022 7324693816 25360075 1151nvoica 02/15/2022 02/22/2022 7324693819 2541011A 1151nvoiee 02/15/2022 02/22/2022 7324693822 25410114 1151nvcico OVIS/2022 02122/2022 7324868956 0214220918 1151nveica 02/16/2022 02122/2D22 7324951732 25499440 1t51nvolc. 02/16/2022 02/22/2022 7324951734 25505234 1151nvolce 02/16/2022 02/22/2022 7325114463 0215220729 1951re.1ee 02116/2022 02/22/2022 73251t4464 0215220908 1151molee OW1712022 02/22/2022 7325237629 25528550 1151rude. 02/17/2022 02/22/2022 7325237631 25572896 1151nvoice 02/18/2022 02/22/2022 7325488590 25601507 1Islnvcice 02/18/2022 02/22/2022 7325488591 25645932 1lslnvoiso 02/16/2022 02/22/2022 7325644250 0217220818 1951nvoice 02/10/2022 0222/2O22 7325644251 0217220746 1151nveice m coWmn logond: P = Past Om Item, F = Mum Cue It... blank = Current Cue Hem TOTAL Cudemer Number 255342 WALMART 1083/MBA MED R1S 9uMMde: Future Due: 0A0 Ped Due: 0.00 tad payment 8,063.76 02114/2022 APPRImmom FEB 2 8 2022 BYCOLIWY AUDITOR CA LHOUN COUNTY, TEXAe 11 Paid BY 0212212022, Pay This Amount: If Feld After 02122/2022, Pay IN- Amount: 8.37 2.29 4.43 0.97 22.72 15.26 11.36 22.72 7,76 0.01 13.93 5.68 5.68 1.22 0.68 3.89 418.42 114,28 221.33 48A3 1.136.02 0.14 763.23 668.01 1,136.02 307.92 0.32 696.32 284.09 284.19 60.84 34.14 194.29 410.051/ 111.99 ✓ 216.90 ✓ 47.46 '/ 1.113.30`/ 0.141/ 747.97.E 556.65 /, 1.113.30 ✓ 380.16 ✓ 0.31 ✓ 682.39/ 278.41 ✓ 278.51 ✓ 59.62 ✓ 33.46 ✓ 190.40 / 7324358328 7324358329 7324589708 7324603816 7324693019 7324693622 7324868956 7324961732 7324951734 7325114463 7325114464 7325237629 7325237631 73254BOS90 7325488591 7325644250 7325644251 6,347.99 USD rre It Pad On Tim.: USD 6,221.a2,� 6.221.02 USD Otee led H paid late: 126.97 Due N Paid late: 6.347.99 USU USD 6.347.99 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT A. of: 02/18/2022 Page: 001 To sonless proper erMK to your aeroumk , detach e�means this cem,m.r eons dub with your mm8tanm DC: 8115 As of: 02118/2022 Page. 001 CVS PHCV 7006/lASMOFIA PPS AMT DUE 11 411FT® VIA ACH D®IT Territory: 400 Mall to: COmP: 8000 MEDICAL CENTER MC" Statement for Information only AMT DUE REMITTED VIA ACH D®IT KAL KIRGINI Customer. 262252 Statement far information only 815 N 615 N AVAC IA POflT LAVACA TX ]]9]9 Date: 02/19/2022 Cod: 262252 PLEASE CHECK ANY Data: 02/10/2022 ITWS NOT PAID (e) aping Dm Recelveblk"a"mel Account 91up6 Data Data Number Reform. Cash D.d tfon vacuum Amount P (gross) F Amount P Receivable O t) F Number 02/16/2022 0&22/2022 7324950430 1572564 1151neaice 0.75 37.29 36.54 1/ 7324960430 O PF column legend: P = Pad Due Us., F = Future One Item, blank - Current Due Item TOTAL Customer Number 262252 CVS PNCV 7006/MEMORIA MS 6ubtatals: 37.29 USD Future On. 0.00 H Paid By 0212212022, Due If Pald On Time: USD 36.54 ✓ Past Due: 0.00 Pay This Amount: 36.54 USD Dim lost If pent late: Im1 Payment 8,053.76 If Alter ny22/2022, If Paid late: 0.]5 02114/2022 Payy this Amount: 37.29 USD USD 37.29 NPROVMON FEB 28 2022 gy COUNTY AUDITOR CAIHOUN COUNT', TEAS For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT comma, s000 HEB MY FC 490/MEM MC pHs AMT DUE 11WITTED VIA ACH DEBIT MEMORIAL MEDICAL CMTEA Statement for Information only VICKY KALISEE 815 N VIRGINIA ST PORT IAVACA TX ]]979 As of: 02/18/2022 Patio: 001 To onmre proper amtlh to your amount, Mach and renton this Rub with your remittance DC: ells As of: 02/18/2022 Page: 001 Territory: 400 Mail to: comp: 8000 AMT DUE REMITTED VIA ACH DEBIT Customer. 484450 Slalemenl IOr information only Date: 02119/2022 Cum: 464450 PLEASE CHECK ANY Date: 02/19/2022 RBaS NOT PAID (,) Eiain Due Mmlvablrtlllarml Amaunl t9la36 9 r Cash Arose) P Amount P Ileceivebk Date Data Number Relerenm Descri lion Discount P (green) F (ml) F Number Customer Number 464450 HES MY PC 490/MEM MC MS 02M02022 02122/2022 9324364407 55x336991 1151nva1ce 0.01 0.63 0.62✓ 7324354407 OW14/2022 02/22/2022 7324354408 55.337216 1151nvo1Ce 9.85 492.50 482.651/ 73243:"0: 02/14/2022 02/22/2D22 7324354409 55x337260 1 151nvolce 0.94 47.02 46.08 ✓ T3243410 OV15/2022 02/22/2022 7324702647 55039780 1151nid.s 6.66 333.10 326.44 ✓ 7324702647 02/15/2022 02/22/2022 7324702549 SSx339867 IISInvalce 1.41 70.53 69.12 ✓ 7324702649 02/16/2022 02/22/2022 7324931792 55x342673 1151nvolCe 13.20 659.77 646.57 7324931792 02/18/2022 02/22/2022 7325467968 55x347029 1151nvoice 0,07 3,73 / 3.66 ✓ 7325467968 PF Column legend: P e NO Due item, F e No. Due Item, blank = Current Dm It,, TOTAL Customer Number 464450 H® MY FC 490/MW MC MS SuMmala: 1,607.28 USD Forum Due: 0.00 Due II Paitl On Time: II By 2022, USD 1,675.14 ✓ Past Oua: 0.00 Payy This Amountmmant: 1,575.14 USD Dim lost H paid late: 32.14 Last Peymam 8,053.76 It NO Afto 0212212022, Due If Pak late: OW14/2022 Any this Amount: 1,607.28 USD USD 1,607.28 APPAMMON FEB 2 8 2022 SY COUNTY ALIWOR CALHOUN COUNTY, TEM9 For AR Inquiries please contact 800-867-0333 m�nCJJv1Y STATEMENT As of:02118/2022 Lempvny' aDOD PC: 8115 CVS PHCY 7475/META MC PHS AMT DUE RndITTED VIA ACH DEBIT Territory: 400 MWORIAL MEDICAL CENTER Statement for Inlom rtkn only VICKY KALISEK Cudemec 835438 815 N VIRGINIA ST PORT LAVACA TX 77979 Date: 02/19/2022 Pean 001 To ensure Proper cred8 to your account, detach and nature this aide With Your mrNilaMe As of: 00/8/2022 Page: 001 Mall to: ComP: 8000 AMT DUE REMITTED VIA ACH DEBIT Statement for information only CUR: 835438 PLEASE CHECK ANY Dale: 02/19/2022 ITEMS NOT PAID (v) Oliing Due Rx4vablPauomt Amount b3'a45y4a Cash Allrolml P Amount P RooNvehk Date Data Number Reference Description Discount (vrem) F (.t) F Number Cudomar Number 835438 CVS PHCY 7475IMEM MC PHS 02/16/2022 02/22/2022 7325147408 1572939 1151nveise 6.78 339.18 332.40 ✓ 7325147408 O PF column levered: P = Pad Due Item, F = Future Due Item, blank = Current Due Item TOTAL DPsionar Norther 835438 CVS PHCY 7475/MEM MC PHS SPMdahu 339.18 USD Future Due: 0.00 t16and It Paid On Time: If Paid By 0212219022, USD 332.40 ✓ Not Due: 0.00 Pay This Amount: 332.40 USD Dim Lod 0 Paid late: B.T8 Led Payment 8,053.76 N y this AAm Amount: 2022, Due If Paid late: 02/14/2022 Pay This Amoud: 339.18 USD USD 339.18 APPROVEDON FEB 2 8 2022 BV COUNTYALIWOR CALHOUN COUNTY, TEAS For AR Inquiries please contact 800-867-0333 1 Of 1 29 STATEMENT Statement Number: 62563880 AmensourceBergen` Date: 02-25-2022 AMERISOURCEBERGEN DRUG CORP WALGREENSe124943409 12727 W. AIRPORT BLVD, MEMORIAL MEDICAL CENTER 10013528,1/ 037028186 SUGAR LAND TX 77478-6101 1302 N VIRGINIA ST PORT IAVACAT% 77979.2509 DEA: RA0289276 Sat - Ed Due in 7 days 888451-9655 AMERISOURCEBERGEN P.O. Box 905223 CHARLOTTE NC 2829OZ223 Not Vet Due: O.DO COaeat: 304.260 Past Due; 0.00 Total Due: 304.26 Amount Balance: 304.26 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 02-21-2022 0304-2022 30S4070926 164802 Invoice 95.19 0.00 95.19 02-21-2022 030N-2022 306407OW7 184B03 Invoice 0.09 0.00 0.09 02-21-2022 03042022 3OM07OUB 164805 Invoke 8.63 0.00 8.63 02.214022 03 2022 3084106266 184851 1.1. 36.14 0.00 36.14 02-22-2022 Oo-m-2022 30N233503 164859 Invoice 37.37 0.00 37.37 02-22-20U 03414-2022 3OU233504 Imam Invalce 0.09 ON 0.09 02-23.2022 03-0 2022 3OM376980 164868 Invoice 86.05 0.00 66.05 02.24.2022 03-0 2022 30MV4615 1US77 Invoice 25:34 0.00 25.34 02-252022 03042021 3064658255 imam Invalce 15.36 0.00 15.m Curren[ 1-15 Days 16-30 Days 31-60 Days 61.90 Days 91.120 Days Over 120 Days 304.26 0.00 0.00 0.00 Boo 0.00 0.00 Thank You for Your Payment Reminders Date Amount Due Date Amount 02-25-2022 (918.80) 03A4-2022 304.28 Total Due: 304.26 APPROVEDON FEB 28 2022 BYCOUNTu IT,TOgg STATEMENT statement Number: 62577687 AmensourceBergen- Date: 02-25-2022 1 Of 1 AMERISOURCEBERGEN DRUG CORP US BIOSERVICES CARROLLTON 340E 1002706911018628707 501 PATRIOT PARKWAY 5025 PLANO PARKWAY SUITE 100 ROANOKE T% 76262-6330 CARROLLTON TX 75010 DF.A: RA0316958 Set- Fn Due in 7 days 866451-9655 AMERISOURCEBERGEN P.O. Box 976740 Not Yet Due: 0.00 OALLAS T% 75397-8740 Cunenl: 55.00 Past Oue: OAD Tate[ Due: 55.00 Accounlaaience: 85.00 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 02-25-2022 034 2022 344988638 Invoice 55.00 am 55.00 Current 1.15 Days 16-30 Days 31.60 Days 61-90 Days 91-120 Days Over 120 Days 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Reminders APPROVEDON Due Date Amount 03-044022 55.00 FEB 2 8 2022 Due: 65.00 BYCOUWYAUDnOR CALNOUN COUNTY, 7MO /Total l Of 1 IN STATEMENT Statement Number: 62577974 AmerlsourceBergen` Date: 02-25-2022 AMERISOURCEBERGEN DRUG CORP SENDERRA RK PHY 340B 1002NO781037983771 501 PATRIOT PARMNAY MEMORIAL MEDICAL CENTER - ROANOKE TX 76262-6335 1301 E ARAPAHO RD STE 101 RICHARDSONTX 75D81 DEA: RA0316058 Set- Fri Due In ] days 866451-9655 AMERISOURCEBERGEN f P.O. Boa 978740 OALLAS TX ]539]-6740 Not Yet Dug: 0.00 Current: used Past Due: 0.00 Total Due: 55.00 Account Balance: 55.00 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 0245-2022 03-04.2022 344986358 Invoice 55.OD 0.00 55.00 Current 1-15 Days 16-30 Days 31.60 Days 61-90 Days 91.120 Days Over 120 Days 55.00 O.OD 0.00I 0L0 0.00 DOD 0.00 Reminders Due Date Amount D3.04-2022 55.00 FEB 28 2022 Total Due: 55.00 Cw�N�AUDITOR NTTY,T �J 1 STATEMENT Statement Number: 62538114 AmensourceBergen" Date: 02-18-2022 1 of AMERISOURCEBERGEN DRUG CORP WALGREENS #12494 340E 1001352" 1037028186 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER SUGAR LAND Tx 77478-6101 1302 N VIRGINIA ST PORTLAVACAT% 77979-2509 DEA: RA0289276 Sal-Fd Due in 7 days 866 «51-9656 AMERISOURCEBERGEN P.O. Box 904223 Nod Yet Due: 0.00 CHARLOTTE NC 28290.5223 Curtent: 918.80 Past Due: 0.00 Tolal Due: 919.60 Account Balance: 918.60 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 02-14-2022 0-25.2022 3083326679 164707 Invoice 32.04 0.00 32.04 02-14-2022 02-25.2022 300327010 164708 Invoice 20.84 0.00 36.83 02-14-2022 0245.2022 3083327011 164709 Invoice 209.61 0.00 20161 02-14.2022 02-25.20N 3083362809 1647S5 Invoice 103.07 a.00 103.07 0245-2022 02-2&2022 30OU929M IU764 Invoice 255.81 0.0 255.81 02-1&2022 02-25-2022 3D83634425 164773 Invoice 15.01 0.00 16.01 02-17-2022 02-25-2022 W83774771 IN703 Involve 190.84 0.00 Islas 02-IT2022 02.25.2022 3083923866 164792 Invoice 38.74 0.00 38.74 02-18-2022 024652022 3083923887 164793 Invoice 36.84 0.00 W.84 Current 1.15 Days 16.30 Days 31.60 Days 61.90 Days 91-120 Days Over 120 Days 918.60 0.00 0.00 0.00 0.00 0.00 0.00 Thank You for Your Payment Reminders Date Amount Due Date Amount 02-18-2022 (1.247.59) 0246.2022 918.50 Total Due: 918.60 APPROVED ON FEB 28 2022 �1L 13P111 BY COUNTY AUDITOR CALHOUN COUNTY, TENA9 TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1800-572-8683) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" ETENTER 2-DIGIT TAX FILING YEAR" El "ENTER 2-DIGIT TAX 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" FT6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER $H04 ENTER: ### F b $ 97,995.41 1 $ 51,023.48 $ 11,932.90 $ 35,039.03 CH EL_ n 5 CALLED IN BY: CALLED IN DATE: CALLED IN TIME: FAAP-Payroll FileslPsyroll TaxesA2022*5 R1 MMC TAX DEPOSIT WORKSHEET 2.24.22.xls 2128/2022 RZ CBS: K _.. 1cNC°;A Y_.c __Page ..'.r. am .. 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ME =+_CS Ell .3sil 6041i "aEi_:9Y'r'ER '_...;.: 'X :.AS 105:21 0300 9JIc: _:E THV.12 :SI:.JG CEH252 03002 CONi MLEE'f,IN. "._.06 :a Dole 00063 SYLVIA A VARGAS 1006.79 DD D510:1!22 e0M94 SYLVIA A MEtIDOZA 762.115 DD 03109 '22 :'v'i3 7AMT ClrGCI; I!<"'.if iL Di!Ci; 'e619P Dr - Ef_51'N H,-i 90 :3'041,:2 Vol"MA.:iJEBIi2i. ::il. [ cc Oe4CQ VEM d Plan 699.9E Dr. 0j10:122 .-:_-1 S-ERR'i _ :a'.;a cI?§... ^ C'•3!06 22 .,.nl Mil W FIG, Jea.K LE .. .. W...E iNi iu-.i3 .. .. ... .. • 1 J h9_ ...`.E!i^Yi;v.'L� 006K EEaOM E'9I7IMEEEE7 6S.E7 c, Oi k4!r 00697 tG,RIA C FAHAS 1175.69 ➢O WOV22 M17 SIMEERLY R MEET !EE4.E6 DE HISAll 01015 St!SA!; E <_SR:L'i i622.65 DD OilD; 'f DAY SUM M, 01254 JEIum ;i c'.LI2; :"?ALAS Dn 'i5'C41.2 iy3E" M.°iL1". n Si'ERS ^cC.E: Ac 370iI -EIa .. 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LSU LL'Ia ::ENK •L 25i., 2F _.. wi CVO.. 31525 ST- .A3Y.EE. .7v0. -: 2 .7'li::. 31E:': .I�....... r._::1lLE �� 3152'. 'e'.RTr_,1 }: Y_iiu•.EZ 21 E. `.5 ... .S'Ls'2: 3M5 EST= F f. itif"? 4'22 Hill EE@AA OR?A. 16156 E9 C 0412 35'02 7Jc1'r. %WNEESn PFIN£G 3i3.f'Y 7: 43i 54!22 41112 MASTASIA L FER:Z H9.52 CL C3; Gi!2E 911i1 iOYME 14 TREVINO 4 .. DE J3� 'r !4122 Ads JUTETIE AL11ARZUC 7E1.11 GC C310401 4122 LESLIE A CRAIGEI 311, DE 03/NY2 41255 PAi4ELA X VW".11)Y :225.54 E£ 02; N i'22 i12i2 t FEN TCRRES 523.5C' 2E n mJ2 4154 RAGEC OWN >16.Of .,. .3�G4!22 9li4" ?L:R?ALtiA: S::.AECS Dz Sd:'i4l2. 4*.H? _oUlm A LEAL .. _.iE _., i3�v:i22 413?' ._.F. S 3ETIu;;C!7,i ?5i.3'e nD .ii 6411,2 ..... STEEL __':OC 115 HIS .: .. .. .. X;F.1NFL' ._.- _. .. ... .. ilici ROLLER; _l..a1 .., v.. ... ._ C J: ......E:T HOW SEE,:. ._ A . .. a_2 _:CC:SC..PIZAL. 5F.1 13 SW .:: L':O. SOTS! ER:TIIIEY N:£aELL£ Z8?0 =. 107.64 SC245 NCUNN; ViL.EoAS 5307 ._ 0310h papa . KEW Pace P263ST1 Y '.WE DE2 a F EWE .'Bi __ !ME BETTY S E:IS 1540.50 N AmQ 50%19 DEBRA 3 Fkumm NEV iO DC A'00.1 HEA 'r.CDUCIt EZ 5'3.3. __ N,10;'22 535i1 SACLYt! B A.4TL ''S1555 cD - C'3 (0;IL2 E5025 LBA ' RBSETEEZ E10 d2 DD 0,'01./22 SSW6 ME B ENE BEE, DC NAM 55105 CRYSTAL R 'RAVEZ 545,36 CC 03/08!22 5512" APiIL !I!P�AIs i5ii.5? LD C31Ci. 22 _. r. 5UKA BEP wn!l1 309 ED C31402 EASE S ARM JA"TU: 1c EE CC i3'9i%2: ..._. ...-. _ eCt_u_... ..... CC .3!0i, _.. ,2 ...__ .'.a_... . [.nE..c1 . AnA RE .. ...._ ZUlm 505:5 =.29T3Y }.:.C.IPCk2d. i3E.C'2 .., .... . a11i SF]i=Y. Giu.CiA ERR ... . 53209 GASCIi "nlini': 10.1 P.3i RE ./14ill 55100 FELICITA BC:NZ 505.52 CD 03104/22 55121 VIVEAVA P HEDNA 283.E3 CC i'3/0;i22 5EISI ELIA CLACBIA 5,19.16 CC C'310ii£2 65213 _E SISISRL'i 1260.56 CD 0104 lil J:CILA l.fHZ DE MKIII; 595.:_ CE i3/0i/i2 5535E CY:II:iIA SAE:IA 613. a3 CC C3/34122 .. O A%TIA.: F.'Ns "N.92 CC :'i:2 .;i55 P:Cai REr."-.3.'c"E ,Bi65 iIZZ c LEDEM.. i31.. .. G3 '.... .c:5: .nYaTA1 . 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B RE A/0;!22 it s m:Go Pay Fr tricd 17.2 L, - :2 7013 m:.B , w; = m;u ' ;AP = ea s / { \ /§\ :m LAM, . , w, = s;= �IARY ae =oa« \ 1 MEF \� � \ //\\ ;cam . = wa = j D 4 m :a : a _ : "Al « ` .A � ' %}\\ \ ;c _ . ma = eoe ,e WRE.m;A = es = e;= , ;}\^ / / j\\ ,a ASMEYMEY u = « M�a nU2 �SARP. \2S — F !JANIAK NUT = m;« w: +c c o = 1 22 -Us, Cl � e =»a« ,m m : a a = ,a« m: !GRIP, am =,m« :w m ,MK as = m;« � 06 E / ED 03 , : as ED :e MARLEY; WIE2 M e = :. . | R = d/ /\§\ HNI n m� am = »a= ; ; c, =m 3HP6 a 941 REClTAX DEPOSIT FOR MMC PAYROLL -e PAY PERIOD: BEGIN 2/1112022 VV9 PAY PERIOD: END 2/2412022 PAY DATE: 314/2022 GROSS PAY: $ 443,743.66 DEDUCTIONS: AfR S 537.00 ADVANC BOOTS SUNLIFE CRITICAL ILLNESS S 851.68 SUNLIFE ACCIDENT S 815.19 SUNLIFE VISION S - SUNLIFE SHORT TERM DIS 5 1,259.69 SOBS VISION S 1,012.86 CAFB-D S 1,633.29 CAFE•H 5 22,588A4 S - 5 - CAFE-P CANCER CHILD 5 609.70 CLINIC S 125.00 COMBIN 5 306.119 CREDUN DENTAL S DEP-LF SUNLIFE TERM LIFE S 765.60 SUNLIFE HOSP INDEAI S IRIZ35 FED TAX 5 36,039.03 FICA-M1t 5 5,966.45 FICA-O 5 25,511.74 FIRST C $ - FLEX S S 3,442.96 FLX-FE S GIFT S S 419.16 GRP4N GTL HOSP-I LEGAL S 1.010.99 OTHER S 348.63 NATIONAL FARM LIFE 5 1,886 11 MED SURCHARGE- 5 470.00 PR FIN S RELAY REPAY STONEDF $ 640.86 STONE STONE2 S1'UDEN TSA-R S 30,944.60 UWIHOS S - TOTAL DEDUCTIONS: 5 136.767.12 S ^uau�owuxAfPaxr NET PAY: S 306,976.46 S ^6MOUIOMAtMFfPoef" TOTAL CAFE 125 PLAN: 5 32,244.67 Le 3 AXABLE PAY: S 411,498.89 S 411 498.89 "CALCULATED" Fmm MMC Renert Difference ICA- MED(ER) uss S 5.966.73 ICA- MED(EE) iAsy S 5,966.73 S 5,966.45 5 0.21 ICA - SCC SEC (ER) exx S 25,512.93 ICA - SOC SEC (EE) fAx S 25,512,93 S 25.511.74 S 1.11 ED WITHHOLDING S 35,039.03 S 36,039.03 S 5 TAX DEPOSIT: S STEM 35 4 97995 AI FICA -MEDICARE zaw S 11,933.46 311,932,90 FICA -SOCIAL SECURITY ,:..>w. S 51,025.86 $51,023.46 PREPARED BY; FED WITHHOLDING S 35,039.03 535A39.03 PREPARED DATE: TOTAL TAX: $ 97,998.35 $97,996.41 $ 2.94 S REVISED 3/182014 NALCK III I TOTALS S 443,743.66 5 537,00 S - 5 $ 861.68 S 815.19 S S 1259.69 S 1,012.86 S 1.633.29 S 22,588.14 S S - 5 - -s 5 609.70 S 125,00 5 306.09 765.60 582.35 35,039.03 5,966 45 25.511.74 3.442.96 s19.rs 010.99 349.63 1.686.11 .170A0 640.86 S 30,944.60 S - S 136,767A2 $ 306,976.44 Exempt Amt: Employees over FICA -SS Cap: S - Shanna Odonnell $ Roshanda Thomas S - Paycode S - Employee Relmh.: TOTAL: $ Caitlin Clevenger 2/11/2022 45 RI MMC TAX DEPOSIT WORKSHEET 22422.ps. TAX DEPOSIT WORKSHEE7 2R84012 FAI PIC 2c - 21 A ., 36-4/ . MEMORIAL MEOICALCENTER 102 • e , PROSPERITYBANR `L 4 S ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT—Febuary 14, 2022- February 29, 2022 2•8t, pale Bank O62422251tion 2/15/2022 PAY PLUS ACHTRANS 452579291101000694222515 MMCNotez LT., o n[ 5 1 ' 2 t3 0 52 ' 2/15/2022 PAY PLUS - 3rd Patly Payor fee - 3rd Parry Payor Fee $ S «20W42 'W4)�� 145' 13 ON DRUG AUTONS CH ACHIMR145251)0HO 2/15/2022 MCKETEXAS - 3408 Drug Program Expense $ 8,053.761 CON TYDRS RECEIVABLE LEH049]21WW24019181 2/1S/2022 TEXAS COUNTY M952-173ABLENO41 - Retirement Funding 5 165:291.16%* 66 E+• 16 = 2/16/2022 PyMT O1252520 4/059625 . Credit Card Processing Fee $ 192.13 re1u 237+'-f,2 PAMSFOMS HTRANS45257291W0 051 2/17/2022 PAY PLUS ACHTRANS 452592911010000723054D - 3rd Party Payor Fee $ W2122 - 2/18/2022 PAY PLUS ACHTRANS 452579291 10100069)130540 - 3rd Party Payor fee $ 'Z41aP, C 2/18/2022 PAY ACHTRANS 291IDID0060100014 - Bud Party Payar Fee $ e-Rs' 192' 13 + 2/18/2022 SATAXPYMT22U4990LUS USATAXPYMT 22024499WT81496303601000148 -Payroll Taxes $ 140.99* IRS USATAXPVMT -Payroll Taxes S 95,295.68* 192 2/18/2022 EMERTPAYEE ERGAYM6003411 TS OlOUM7768093604 2/18/2022 PAYPAYROLL -Child So ... It Payment $ a61420:e Oqu+ rx� VV�r``(( F•-"/VI MEMORIAL MEDICAL 7410341118222650 2/18/2022 MEMOUTCONOINC . 3409 Dust Program Expense -Payroll $ $ 1,247.59/1- 293,936.31# `: 614 2U 2/18/2022 WIREOUTCBNAIN Do 902/9ETTLEM 665555 210000OUNT MINGSVTLEMEN1 CCOU T 2/22/2022 WEBFILE TDIS -CitiOank Corporate Card Payment Sales Tax $ 8634811�� yyrr f3, {4 • c`4,1 AOITAAX 4S2S79 9/10100698 75702 2/22/2022 PAYPLUON 010006591O - 3rd Party Payor Fee $ $ 1,052.209{ �414k, & 2/22/2022 MCEESSONORUGNUTOACHACH04919499MOS001]3 DRUG AUTO ACH ACH 0 - MOB Drug Program Expense $ 8,16S.101F1{9� 1+237°61 2/24/2022 PAY PLUS ACHTRANS 452579291101MG691037665 . 3rd Parry Payor fee $ '.0621 2/24/202i PAY PLUSACHTRAN54525]929130300069308)665 -3rd Party Payor Fee 5 aA5:19:: 192=1? 2/25/2022 PAY PLUS ACHTRANS 452579291101000691934704 -3d Party P.,, Fee $ '661136- 6 14• 2U - 2/25/2022 AMERISOURCE BERG PAYMENTS 01000077692100002 - 340B Drug Program Expense 918.6* tT- 2,04i L 574,900.42 .. 5721+yUR•42 - Anthony Richardson 28, 2022 &, 0 5 3 Memorial Medical Center p,,Fxe.�,�ruary +r "p,1,1.',•,•�r"� 07•�$'i�/Gi• 16 :+ 191 h - PROSPERITY BANE �'(E ;": ut � 2a��by�gy4 C(�tanairr ELECTRONICTRANSFERS IVA- illLM FOR OPERATING ACCOUNT -ESTIMATED ACHS ,yt-fpw' WLLL. C9W Date Deaerlodpn MMCNotes Amount 1 47 5 9 - bb ,> Y v Anthony Richardson February, 28, 2022 t+ 1 N 60 - Memonal madmal Ceder 2+ 0 It J 9 5 2.043`95. 2,U4J• 0•UIJ ; Page 1 of 1 RECEIVED ElY THE COUNTY AUDITOR ON FEB 2 2022 02/25/2022 MEMORIAL MEDICAL CENTER CAUi(9811iCOUNTY TEXAS Open Invoice List 0 ap_open_Invoice.template Dates Dates Through: Vendor# Vendor Name Class Pay Code 11816 ASHFORD GARDENS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 021122 02/15/2002/11/2003117/20 4,780.82 0.00 0.00 YR 4 ADJ 1 JHC QIPP Vendor Totak Number Name Gross Discount No -Pay 11816 ASHFORD GARDENS 4,780.82 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 4.780.82 0.00 0.00 ON FEB 29 2022 SYCOUNIYAUDTTOR CALHOUN. MINTY.. TEXAS Not 4.780.82 Net 4,780.82 Net 4,780.82 file:///C:Nsers/ltrevino/cpsi/memmed, cpsinet. com/u8 8125 /data_51tmp_ew5 report779941... 2/25/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON 5/ 022 MEMORIAL MEDICAL CENTER 5 2022 AP Open Invoice List Dates Through: OALIii§64lPtYk/�D,6u8 Class Pay Code 11828 SOLEFIA WEST HOUSTON Invoiceli Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 021122 02/15/20 02/11/20 03/17/20 1,853.46 YR 4 ADJ UHC OIPP Vendor Totals Number Name Gross 11828 SOLERA WEST HOUSTON 1,853.46 Report Summary Grand Totals: Gross Discount 1,853.46 0.00 FEB 2 5 2022 8Y COUNTY AUDITOR CALHOUN COUNTY, TOM 0 ap_open_i nvoice, template Discount No -Pay Net 0.00 0.00 1,85346 Discount No -Pay Net 0.00 0.00 1,853.46 No -Pay Net 0.00 1,853.46 file:///C:/Users/ltrevino/cpsilmemmed.cpsinet.com/u88l25/data 5/tmp_cw5report658306... 2/25/2022 Page 1 of 1 HECEIVED BY THE COUNTY AUDITOR ON FEB 2 5 2022 02/25/2022 MEMORIAL MEDICAL CENTER CALHI i,`��0UNTY,iEJIA.S AP Open Invoice List 0 Dates Through: ap_open_invoice.tempiate Vendor# Vendor Name Class Pay Code 11820 FORTBEND HEALTHCARE CENTER Invoice# Comment Tran Dt Inv Dt Due Dt Check DP Pay Gross Discount No -Pay Net 020722 4,266.50 0.00 0.00 0.00 4,266.50 t/ ''012/15/2002/07/2003117/20 TRANSFER NH Ilu j-d�.iny�r�a ivkh ,, Lif.{rkr�/ 021122A 02/15/2002/1112003/17120 2,185.83 0.00 j� 0.00 2,185.83 r/ YR 4 ADJ 1 UHC QIPP Vendor Total; Number Name Gross Discount No -Pay Net 11820 FORTBEND HEALTHCARE CENTER 6,452.33 0.00 0.00 6,452.33 Report Summary Grand Totals: Gross Discount No -Pay Net 6,452.33 0.00 0.00 6,452,33 APPROM ON FEB 2 $ 2022 MM CALHOUN COUN` OUNTY TRAS file:///C:/Users/Itrevino/cpsi/memmed.cpsi net.com/u88125/data_5/tmp_cw5report721801... 2/25/2022 Page 1 of 1 COUNTY AUDITOR ON FEB 0 r �022 MEMORIAL MEDICAL CENTER 02/25/2 2 0 AP Open Invoice List Dates Through: ap—open_invoice.template Vendor# Vendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay 021122 02115120 02/11/20 03/17/20 2,034.14 0.00 0.00 YR 4 ADJ 1 UHC QIPP Vendor Totals Number Name Gross 11832 BROADMOOR AT CREEKSIDE PARK 2,034.14 Report Summary Grand Totals: Gross Discount 2,034.14 0.00 FEB 2 $ ZOZZ BY COUMY AUDTTOR GAUAOUN COUNNI TEXAS Discount No -Pay 0.00 0.00 No -Pay 0.00 Net / 2,034.14 1/ Net 2,034.14 Net 2,034.14 file:///C:/Users/ltrevino/cpsi/memmed.epsinet.com/u8 8125/data_5/tmp_cw5report492398... 2/25/2022 RECEIVED BY THE COUNTY AUDITOR ON FEB 2 5 2022 02/26/2022 MEMORIAL MEDICAL CENTER CALHOIm�;�P UNrY,1-E" P Open Invoice List 0 Dates Through: ap_open_invoice,template Vendor# Vendor Name / Class Pay Code 11524 THE CRESCENT ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 020722 02/15/20 02/07/20 03/17/20 9,600.00 0.00 0.00 021122 TRANSFER u N insov"(1— Qy xi Ata In}t MBw,(, 6nGilt_+t V 02/16/20 02111/20 03/17/20 1,164.63 0.00 Qb 0.00 YR 4 ADJ 1 UHC QIPP Vendor Total; Number Name Gross Discount No -Pay 11824 THE CRESCENT 10,764.63 0.00 0.00 Page I of 1 Net 9,600.00 1,164.63 Net 10,764.63 Report Summary Grand Totals: Gross Discount No -Pay Net 10,764.63 0.00 0.00 10,764.63 APPIRAM ON FEB 2 T 2022 BY COUNTY ALIXFOR CALHOUN COUNTY, 78M file:///C;/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report471536... 2/25/2022 Page 1 of I RECEIVED BY THE COUNTY AUDITOR ON F12/28425 2022 MEMORIAL MEDICAL CENTER 09:09 AP Open Invoice List 0 CALHOUNCOUNTY, TEXAS Dates Through: ap_open_invoice.template Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 013122A 01/31/2001/31/2003/17/20 26,044.92 0,00 0.00 % 26,044.92 ✓ TRANSFER tJN'i+n,Su Oak d"t'ra jt& o t?L It - opt& 020822 02/15/20 02/08/20 03/17/20 516.66 0.00 0.00 51 B.66 ✓/ TRANSFER 11 021122A 02/15/20 02/11/20 03/17/20 228.00 0.00 0.00 228.00 TRANSFER 021122 02/15/20 02/11120 03117/20 3,913.33 0.00 Oleo 3,913.33,/ YR 4 ADJ 1 UHC QIPP 021122C 02/16/20 02/11/20 03/17/20 19,932.02 0,00 0.00 19.932.02 TRANSFER 021122E 02/16/20 02/11/20 0$/17/20 496.04 0.00 0.00 496.04 TRANSFER Vendor TotalE Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 51,130497 0.00 0.00 51,130,97 Report Summary Grand Totals: Gross Discount No -Pay Net 51,130.97 0.00 Oleo 51,130.97 A"VMIC91 FEB 2 4 2022 13Y COUNTY AUO1TOp CALHOUN COUNTY TEXAS file:///C:/Userslltrevino/cpsi/memmed.cpsinet.eom/u88125/data_5/tmp_ew5report275419.., 2/25/2022 Page 1 of I O 4N pEC AUp FEB02/252'022.. MEMORIAL MEDICAL CENTER gg�� AP Open Invoice List 0 CgLNOUN�l"lly Dates Through: ap_open_invoice.lemplate Vendor#Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0131228 /'31/2001/31/2003/17/2`0 500.00 0.00 0100 500.00 '0r11D„ TRANSFER 17 ivum MIK7- w{} A x I� N`I"'' 1&1` wwv- 013122C 0 1131/20 01/31/20 03/17120 195.00 0.00 00 195.00,/ TRANSFER IL 11 013122D 01131/20 01/31/20 03/17/20 1,243.57 0.00 0.00 1,243.57,/ TRANSFER 4 it 020722B 02/15/20 02/07/20 03/17/20 5,565.00 0.00 0.00 TRANSFER tt il 020722A 02/15120 02107/20 03/17/20 4,488.00 0.00 0.00 4,488.00w_� TRANSFER " Ij 020722 02/15/20 02/07/20 03/17/20 385.64 0.00 0.00 385.64 ✓ TRANSFER 11 It 020622 02/15/20 02/08/20 03/17/20 500.00 0.00 0.00 500.00 f TRANSFER N 1) 021022A 02/15120 02/10120 03/17/20 1,122.32 0.00 0.00 1,122.32 TRANSFER II t, 021022 02/15/20 02110/20 03117/20 5,473.73 0.00 0.00 5,473.73� TRANSFER K t1 021122 02/15/20 02/11/20 03/17/20 2,307.32 0.00 0.00 2,307.32 ,✓ YR 4 ADJ i UHC QIPP 021122A 02/16/20 02/11/20 03/17/20 9,468.68 0.00 0.00 9,458.66 TRANSFER 1% It 021122E 02/16120 02111120 03/17120 2,356.36 0.00 0.00 2,356.36 ✓ TRANSFER 11 h Vendor Totals Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 33,595.60 0.00 0.00 33,695.60 Report Summary Grand Totals: Gross Discount No -Pay Net 33.595.60 0.00 0.00 38,595.60 FEB 2 5 2022 BY COUNTY AUDITOTI CALHOUN COUNTY, TOM file:///C:/Users/Itrevino/cpsilmemmed,cpsinct.com/u88125/data_5/tmp_cw5report410552... 2/25/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON FEB 2 5 2022 02/25/2022 MEMORIAL MEDICAL CENTER AP Open Invoice List CfiL1R�dk3 COtlNTV,Y11 0 ap_open_Invcice.template . Dates Through: Vendor# Vendor Name Class Pay Cade 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 013122A 01/31/20 01/31/20 03/17/20 069.25 0.00 969.25 J�, TRANSFER g* j%QVu1.(R.. Moll 44111ro1_ jVl, i WWL LVUI� _0.00 013122E 01/31/2001/3112003117/20 18,312.32 0.00 U 0.00 18,312.32 TRANSFER 4 11 020122 02/15/20 02/01/20 03/17/20 742.00 0.00 0.00 742.00 TRANSFER It 11 020422 02115120 02/04/20 03/17/20 3,845.66 0.00 0.00 3,845.66 TRANSFER In II 020722 02/15/2002/07/2003117/20 3.825.87 0.00 0.00 3,825,87 TRANSFER K 1t 020822 02/15/20 02/08/20 03/17/20 3,512.00 0.00 0.00 3.512.00 ✓ TRANSFER 1L 11 021022 02/15/20 02/10/20 03/17/20 1,048.48 0.00 0.00 1,048.48 ✓ TRANSFER 0 11 021122A 02/16/20 02/11/20 03117/20 12,355.30 0.00 0.00 12,355,30 j TRANSFER It 11 021122 02/15120 03/17/20 03117/20 1,604.07 0.00 0.00 1,604.07 YR 4 ADJ 1 UHC QIPP 021122C 02/16/90 02/11/20 03/17/20 9,322.92 0.00 0.00 9,322.92 ,✓ TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 55,537.87 0.00 0.00 55,537.87 Report Summary Grand Totals: Gross Discount No -Pay Net 55,537,87 0.00 0.00 55,637.87 AMOVRIGH FEB 2 5A 20Z22�p; By YLFIdUN U 1 T�I' a ^9 file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp—cw5report341658... 2/25/2022 Page 1 of 1 RECEIVED BY THE COUNTY AuDrrOR ON F582925027 MEMORIAL MEDICAL CENTER 08:58 AP Open Invoice List 0 COUNTI,TEXAS Dates Through: ap_open_involce.template CALFIeUN endor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING V/ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Grass Discount No -Pay Net 013122B 01/31/20 01/31/20 03/17120 6,935,72 0.00 0.00 6,935.72 020722 TRANSFER tjH INUMUL PyKi 4Ir,{IwfeA in-h tKtau, pptyti.+vlw 02/15/20 02/07/20 03/17/2o 7,549.67 0.00 0.00 7,549.67 TRANSFER I1 D 020822 02/15120 02108120 03/17/20 2,909.85 0.00 0.00 2,909.85 ✓ TRANSFER " II 020822A 02/15/2002/08/2003/17120 5,286.92 0.00 0.00 5,286.92 ✓ TRANSFER u N 021022 02/15/20 02/10/20 03/17/20 2,012.28 0.00 0.00 2,012.28 ✓ TRANSFER 1r n 021022A 02/16/20 02/10/20 03/17/20 3,940.20 0.00 0.00 3,940,20 I/ TRANSFER II 1I 021122 02/15/20 02/11/20 03/17/20 23,222.88 0.00 0.00 23,222.88 TRANSFER U tI 021122B 02/16/20 02/11/20 03/17/20 39,905.15 0.00 0.00 39.905.15 TRANSFER 11 1r Vendor Totals. Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 91,762.67 0.00 0.00 91,762.67 Report Summary Grand Totals: Gross Discount No -Pay Net 91,762.67 0.00 0.00 91,762.67 ',;�4 1 t=I .L;I FEB 2 4 N22 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/ltrevino%psi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report320660... 2/25/2022 Facility ID Facility Name Total UHC Deposits 4811 Ashford 18,413.32 105818 Broadmoor 7,731.14 105314 Crescent 5,268.87 4628 Fort Bend 7,948.22 105006 Solera 7,177.25 102540 Golden Creek 14,268.38 100806 Gulf Polnte 8,424.02 103462 Tuscany 8,397.28 Bethany Total UHC Desosit 77,628.48 MMC PORTION QIPP/ComPI QIPP/Comp2 QIPP/Comp3 QIPP/Comp4& Lapse QIPP TI NH PORTION 8,851.68 1,628.20 2,626.05 5,307.39 13,632.50 4,780.82 3,662.86 675.08 1,575.08 1,818.12 5,697.00 2,034.14 2,939.61 542.68 93.27 1,693.31 4,104.24 1,164.63 3,576.57 661.68 1,535.52 2,174.45 5,762.40 2,185.83 3,470.33 641.82 2,029.43 2,035.67 5,323.79 1,859.As 6,441.72 1,182.44 2,757.82 3,886.40 10,355.05 3,913.33 3,809.39 699.94 1,631.501 2,283.19 6,116.711 2,307.32 5,189.14 749.60 853.091 1,605.45 6,793.21 2,604.07 37,941.30 1 6,781.44 12, 001.76 20,803.96 1 57,784.89 19,843.59 FUNDS DEPOSITED': INTO MMC OPEj}ATING. NEED TO ISSUE PAYMENTS TO NURSING HOME... MAKE CHECK REQUESTS FOR EAOHtNUR51NG HDME FOR HIGHLIGHTEDYELLOW AMOUNTS, YEAR 4 ADJ 1 UHC QIPP 18,413.32 7,731.14 5,268.87 7,948.22 7,177.25 14,268.38 8,424.02 8,397.28 77,628.48 TUSCANY TRANSFER REQUEST PAYEE BETHANY 2/28/2022 X"amm FEB 28 2022 c�+oUN00orAir�Y9 tA5 AMOUNT $1,855 EXPLANATION: TRANSFER PAYEMENT THAT BELONGS TO BETHANY BUT WAS PAID TO TUSCANY REQUESTED BY: Matra Martinez AUTHORIZED BY:- krI Mayra Martinez From: Misty Passmore Sent: Tuesday, February 22, 2022 12:54 PM To: Mayra Martinez Subject: RE: PAYMENT FOR $1,855.00 NO TV RESIDENT +w)jftRhanySenibr hiI' g' -----Original Message ---- From: Mayra Martinez Sent: Tuesday, February 22, 2022 12:52 PM To: Misty Passmore <mpassmore@mmcportlavaca.com> Subject: FW: PAYMENT FOR $1,855.00 NO TV RESIDENT Good afternoon Misty, Could you identify which nursing home this money belongs to? Tuscany said this is not one of their residents Thank you, Mayra Martinez Memorial Medical Center Accountant 815 N Virginia, St Port Lavaca, TX 77979 Phone: 361.552.0450 Fax: 361.551.4504 -----Original Message ----- From: rrarenazas@tuscanyvillagecare.net [ma ilto:rrarenazas@tuscanyvillagecare.net] Sent: Tuesday, February 22, 2022 11:07 AM To: Mayra Martinez <mmartinez@mmcportlavaca.com> Subject: PAYMENT FOR $1,855.00 NO TV RESIDENT 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. Mayra, Good morning. The attached payment is not Tuscany's resident. Hest regards, Rachel Arenazas, SOLERA TRANSFER REQUEST PAYEE Memorial Medical Center 2/28/22 FES 2 8 2022 ESY (OUMY AUDROR CALHOUN COUNTY, TEXAS AMOUNT $100.56 G/L NUMBER: EXPLANATION: CORRECT PAYMENT THAT WAS PAID OUT TO SOLERA FOR THE WRONG AMOUNT REQUESTED BY: Mavra Martinez AUTHORIZED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST Date Requested: P6Y�.�I�II�SP/�tid A i4a FOR ACCT, USE ONLY E SLR"�O1yrt i/� ��OD 1�1Y a g _ i �� O Imprest Cash E A/P Check i n /�/� 1,rni�j/J C) Voucher Check AMOUNT..21330 3� GIL NUMBER: EXPLANATION: I 111, 1111,1111, U Lv i t l'.J,lu' I" V U v t vv vl REQUESTED BY: AUTHORIZED BY: CAT # 10303 I FM 1e00 Request for Transfer of Funds pale R.q::mma 9+N+ Re Nmmee 9 Y Pepuetlar'sam+ll Repueneff pM1ene number Olnrin wCuunry f+Jllry p R@MWM Orl[e+nd EOB Ilr:wrybl+hnfrylnmm�npV:mnlar+Mq::w4p4w M^MFe EOeMermMla JrM •IqM N+:W BnaolhNt+MpnrvnrAl+SmenllmmBcnllWa lAbmupMlNMauL PaNrynm P6Nmm: nrvrf)rnm[ov Ymar eam mmanmfllPdOd,Allt]l4faL^a &$• .ED)/I6/3] ER 9].69 ERW6]NB fi51 BROpOMCORH/A thyL'w Ef1R191331/]))E03} EEi t,t 5.350A3 EFlfiN9133 CVWgWIi}W69 ]10.56}/1 N}3 RTWp W 1}/S9/m't F!ROOM11Ni 1330113E Fii )OS}89 ff)c}m333 /q _ 5014.6) fR6N}d} W6A�IX EDN Efl 'himS C" 5)S.S] Ef16E0SM0 P.111/] WOARMq}6869 38.1E POApMWRPiCREERLOF MP 1 MD "1 $ 34t.n EFi6N6101 00"(MN069 52% BpOADMOORp CWHIM N/A ______ 1/ll/}D12 Fit 5 20]150 tt'Pl.Sfi NOAPWD . 111.1EN/P 1/I3 303E FR $ I.61p.65 ffi6lOM9095.65 B.AMIOORATGEGLOE WA 1/I1/NSS fR 5 ]010.30 ffi6T1399) NDpgWN14%9 13)A9P X/A 1/Il/10}i ES! t5 IS]BS It'PUP 30 NOAPIXV]36069 W.59 BPOAOMOOflPICRFE{ROE N/p N/4 1/ll/}pES [fi Is u.n ff}6111956 MAADW1.69 348.1E BPOP0.Mppp AT(PfEg510F X/P N/q 1/10 3Dl} Eff $ 6HIOR I.P'E69 VpPgO[f416B69 ]i51 BROgDMOJRATGEEMROF N/p N/q 1/19/SD}3 [R $ 44963 fF16316986 CVpPgMW}WW S9]1 BPOpO}MV'PAtGEERVat N/A IPA 1 M.P ER $ 39986 Efffi215958 At... 53p6 ROgpMWRP)CPfEC51pE N/p NIA 1/S WION ffi $ 1,0}p.66 Efi631%91 C`ApgWLE6069 )1.4 BROADMCORPTCP(ECSME IVA _ N/A 1/11/]D}3 EET S [t`t 2. 66) QZAI.PWII 10.53 BPOPOMGO0.Pi[R(F[LOF N/A WA 1/11/3013 Eft 5 2533 ]5 Ef16R1634 CVpppNW3W69 16BB8 0g040MOOPAI[RffASDE NM WA i/SS/N23 "I $ 39]]< M612930) CVpppMWS6869 NAB DPOgOMWgPTCPEfI[ypL WA PM 1/M/NrEI (ft $ 1.96p91 Efi6135145 Npptt il0N 130.73 BROA.PDRATOEEMDE N/A Ih1 N}i Eli 5 Mots Ef762357IS MAR.P6869 ,it M.ADML R..(F.Mli N/p NO, 11311.3E ER S 218.5E Efi IPP.6 NpggODtE6869 }ISN SROAO RATLA MPE X/A N/A 1/ w.,, tR S 1.35)AS Ef163E8318 NOAgWD334RE9 9 M SR000RAIMEE[SIOE X/A N/A 1/3430}3 ON3301% NOMWT36869 8.5E 6P040MMgPTGFFRROE WA WA S/3/2p1E (!T 5 6133]A6 MAR.PtSPI BROAOM000.4TQFWIOf WA XA ]lV3pN Lfi $ }.W5.p3 Efi6S36140 [MAAOON36B69 19.6E BgOAOM00APT[REf[SIOE NoN/A l/I ml) fTt $ Efi6]l6]3B CVpgRWW16B69 4959 AOM..Ap .EL[SIOE N/A 3/ n Ei! 5 113m R6}38163 CVpPRW[OSfi869 BPOAOMOpp ATGEFNSDf "IA X/q y8/1W3 EfT $ I.OfA.90 pO0p36869 OPONOORATGEEKSME X/A N/4 3/9FEOS} ER $ OtO.nt I t.- BPOAp MAT.M.P1 N/q ]/10/Nlt EI 5 91p.91 EA6141031 Vppp6W1t6B49 q[IYS:OF FR 5 GI.,t, EifWIt559 NOPPWN}W69 lSB.33 BROAOMWgpiplFFkSNE FJIA X%A t/11/lON E n.2 5 OIXUNBW 9.E0 DROAOMOOq AICRFREIOE WA WA H/P 3/IS/N}S ER 5 Xpll Efi63F549F NpPROMVl6669 ]6.}8 BgOAOMOOPpi GFERNOf PPIAI IthO.N m l4MRIIW wIh Me erlelMNleel[9AEw. PaPa aby: MPYM PR IM{i oilnnpen Nan F+Jllry: to f+r'I1ry: MMfuNK: Y wN E8 28 2022 CAI: CONN O Nry, TEyAS Request for Transfer of Funds nsnM x: Nmnpquea... Fein MpueTeEhy. Mllly paa . aequealoffemall rppnramo,eMm_m[yo_n_Lva,.a[yn: flequealo![pl: one num he, 361-35S O1<3 OIII,IC.1 Lau." .1h... .do' Memrvlal M M bl Centel pAp}11..— FgVIPEJ NIeo93Fn1 RF. el p$MLqwm lw.el6aam g9mlNnua6rin _ tllm herWo M1mlalgn r u 3 3/l0U EFT $ 611.i91 fRfiUl106 NpgP6CNx6669 $ 61 \+x9 BMIPYMOOR xMMI1 EFi $ Mo.l' 1916139M9 NOaRCM)$6869 $ IOLII 3PWWMOOR S/1/10}i EFi $ 0..U1 Ffi dolll9 NOgPWa016669 $ 313;5 ORQ9OMOOP W.Md] IPT 5 Md"I EFT623144 NO,odoo2fiM $ 551A7 L'9/3033 FR $ 441A)) FFS613. [WgNW]OS6OW 5 491.93 UfOh03i FR $ I6.50 6Fi6140129 "Mood'116fi69 $ 6.0 x/11/zOU ff1 $ W .941 FFTIM. NOaPWOOS6969 $ S3O.94 ....... Ffl N00.9LOMIz6969 OPOMOM 1M.LL S (i199.51 $ x114.54 iohe 1111eE eut by Me mo1111MNIFfI Nl9Na.e a99FWee hy: OMa911FanFleF: 4n wwlr. ..do, �e of dnaler.wlr 1 hamwtll io Falll xQn1/1 vz9xz araa Magn xEf 3 1 ]ozx -Requwxw MML l`19154'. /UEV/IV/Ey�/ FEB 2 S 2922 By COUNTYAUOR'OR CAGHOUN COMM TEXAS Request for Transfer of Funds ranNx x: Date Mquestea M.22 hyer MEDIME Requested by: MCIIELAflEHAM$ Repu.'1, emtll ras191us rrvllnre[r, e.nel RepueseoM1 pbone number ]I3-])O R3B0 D154iRorCousXy BPA20RIA iaallity TUSEANVVIl1A6E etlev nenPmm e m or pvao mm JRRgWNanC RE DI MEQUIU Mee E DIMR RA]e Mpnmen! TweolyaxMn[ IDmeWfEd Vavmem SApWnon qld Numher CWm Number p[NmneMMEerx ry.JrpSnraunGa .S Ydlpa[mu Neen 115.11 Eff 5 ISo.l] ehb2219)3 WO/NOmICCUp36B6. 5 $ V Due Tulmnylmm B:a ool 1.36.2E EfT 5 19.]a0.e9) e1L62L5]95 W pARECW1fiB69 5 9,)ems Due Nlsany hom Broadmmr 1R8.22 EFi 5 Pe9.a eh6228171 WD/LV.A 6869 S 999.1a Dve Tusnny Iom Bmatlmoor TDTN p0,]80.101 ID.IBB.30 Tabe611W out Memorul Metlkal@nter: Dneu zozz Approvetl by. MAYRq MAgTINE2 Date er: 32 3E imm f.111wazlllry: ; BgRO DR" to EarGty: nsCAxy D=*1J)rm.A, oaI.N r V� 1.ft l jl: from dlry TofatRlty: AmauM: FEB 28 2022 BYCOUNTYAUDITOR CAINOUN COUNTY, TEXAS Request for Transfer of Funds pae PepemM P3Ylr Pepue9etlby: PapueAel.emap Peque319Y5Pllwu numbr gMNter[eunry not, nsmd9elL RemlNnmMkembELb Iiwrei444nyrWlxmrpmumwrrtwgxn(ItlevmpMNFO6MwerpbtlNm •0Ww9XxN.44ASxh WMpu(WB HempMNnalGNemim4NNtleu4 pemNn eAlA®m. 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S i151 5 SI beta MN Wrt P.ee. ivarrl .......Nan M �r7vY r' M FEB 2 8 2022 CAAUA00UNNCTOtO V6Y o GULF POINTE TRANSFER REQUEST PAYEE ASHFORD 2/28/2022 FEB 2 S 2022 gY OOUNiY AUDITOR CALHOUN COUNTY, TEXAS AMOUNT $13,712.29 L 4oK{v EXPLANATION: TRANSFER PAYEMENT THAT BELONGS TO BETHANY BUT WAS PAID TO-TISG-ANY REQUESTED BY: Matra Martinez AUTHORIZED BY: L�PP- Mhf&4. WellMed Medical Management, Inc. ?ea P.O. Box 30508 Soh Luke City, UT 8J130 MEMORIAL MEDICAL CENTER 7210 Northline Dr Houston TX 77076 R61�rd 17o11Z.2-q �WELLMED y Hrrwnca. ivc Page 2 of 3 Attention Non -contracted ?ledicore Providers Appeals Process for Non -contracted Medicare Providers Pursuant to federal regulations governing the Medicare Advantage program, nun -contracted providers may request reconsideration (appeal)of a Medicare Advantage plan payment denial determination including issues related to bundling or downcoding of services. To appeal a claim denial, submit a written request within 60 calendar days of the remittance notification date and include at a minimum: —A statement indicating factual or legal basis for appeal _ A signed Waiver of Liability form (you may obtain a copy by going to hl7prlAvwv ems unrlMedicare!Anncals-and-Ci'uwt tc'Mh1C 1G'Wlic •<- mJ-Form hl nl at the bottom of the page under the "Downloads" section select the tip file for'Model Waiver of L.iability_1762019008' ). _ A copy of the original claim _ A copy of the remittance notice showing the claim denial _Any additional information, clinical records or documentation Mail the appeal request to: Unitedl lealtheare P.O, Box 6106. Cypress. CA 90630 MS: CA124.0157. Payment Dispute Process for Non -contracted Medicare Providers Pursuant to federal regulations governing the Medicare Advantage program, non -contracted providers may file a payment dispute for a Medicare Advantage plan payment determination. A payment dispute may be tiled when the provider disagrees with the amount paid. To dispute a claim payment. submit a written request within 120 calendar days of the remittance notification date and include at a minimum: _ A statement indicating factual or legal basis for the dispute _ A copy of the original claim _ A copy of the remittance notice showing the claim payment _ Any additional information, clinical records or documentation to support the dispute Mail the payment dispute to WeIIMed Networks Inc. - Payment Disputes P.O. Box 400066 San Antonio, TX 78229-1966 If you have additional questions relating to a dispute decision made. you may contact us at: Phone:(800)550-7691 Fam (855)821-8135 Mail: WeIIMed Networks Inc. - Payment Disputes P.O. Box 400066 San Antonio. 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Account Number Number of Accounts: 15 •4551 CAL CO INDIGENT HEALTHCARE `4454 MEMORIAL MEDICAL ! NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL CENTER -OPERATING •4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER INH BROADMOOR '4411 MEMORIAL MEDICAL CENTER! NH CRESCENT '4446 MEMORIAL MEDICAL CENTER INH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET FUND 'S506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE https:l/prosperlty.olbanking.com/onlineMessonger Treasury Center Select Group Groups Add Group Data reported as of Feb 28 202: Current Balance Available Balance Collected Balance Prior Day Balanc $10.004,202.36 $10,216,041.54 $10,004,202.36 $9,470,348.3 $5,460.66 $5,460.66 $5.460,66 $5,836.4 $315,982,49 $319,265.48 $315,982.49 5178,770A 5536.13 $536.13 $536.13 5536.1 56,473,068.86 56,562,709.44 56,473,068.86 56,331,122.0 $431.61 $431.61 $431.61 $431.6 $349,679,01 ✓, $366,777.18 S349,679.01 5282,772. A // $251.300.79 1 5256,534.93 $251.300,79 $206,492.E $190.421,53 ✓ 5215.568.92 5190.421.53 5183,563.1 $114,134.05 ✓ $116.401.24 $114.134.05 $111,604A $381,325.22 ✓ $386,281,18 $381,325.22 5327,69T7 51,109,566.76 $1.109,566.76 51,109.566,76 $1,109.566.7 $297,607.35 $303.075.40 $297.607.35 5293,638.E $252.359.28 $252,612.90 $252,359,28 5212,550.E $68.181.67 $68,333.59 $68,181.67 $32,498.E $194,146.95 $254.496,12 $194,146.95 $193,266.5 r 1!i Memorial Mediwt Center Nursing Home UPL Weekly Nezion Transfer Prosperity Accounts 2/28/2022 Pr<vl0vi ACWunt Be{IMIn{ Penlln{ TcdaYl BeBIMInB Amount to Be Tnndfrr0p to Nureln9 Mural Nome Number ealanw mnahr.0ut TWMenln Bal— He— I80,BT8.31 86,113.99 i0L]fB.14 915,982A9 / 229,501.72 Bony ealancv 315,982A9 a/ VZAma Line In Bal.. 100.O0 SUPERIOR YR a A011 OIPP 9,990d5✓ WITNNOLBrfIPPPAYMENT 61,651A8 im INTEREST LL04 FEBINIEREST MA0.INTEREST Adryn BalanW?nndea Anat vR L]] Nole:OnbbvAnm ofaWrSB,LY'O will be bpni/rmtlfo l8rnunbrp hemr. 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OCCII[COSRM31015MS561691)q ]/1U}0}14fKOWNHRRIM9M( 0 1039 � / L930.00 37U6 4930 D] S/I)/SOIL VnU01rtlrIAST HMLTNnT40lIXNCeLf[ ATWM RIIK ]er501A)q/ ]/1)/SOiI YSBS/TMNSSIK(OXC05RMi]I]6Y3355]Hp9 4,156W 4r256.00 2/l11l.il xSEIIlEMLNi Sf0VKf 4{OSS]14399wE693Ui 211pS.1e 2/1]/1p1] NWff" SOLVTON NCCWIMPMT 61609142 MI97 - 680.2i L19S.10 2/11/1011TSI UMSFMT 0000 S"T SaUSISS5V69179 - 691.P YnviOYY COS2 3�)'4e'00 6.113.1Y l/Y3/2012nYf/LMNS9111fi0Y{05)LM54368435511695)9 y{y{B4 I/23/2011 CM35 5.741.12 , 1311N In312021 Calls xn3/lo22 nn/IPAWNMi eICosTMrsu6MSsse>69na 1'1W'M wino l NWRAS MIWMNMCC4IMPMI6>M9)43PW16] U4e1494 UI3/10]3NGRMHUWIS VCNCMIMPMi1)16M34113(9 - IAISA2 1111811.34 SM11UT ]/I4g0U n"IT"OVUM 9yiCy 1,96ei I/14AWI XOVTAf SOWNONMCC41MPMf 616W1RMM]94 67609742MI S,V2512In" p11.W Y MXx10X NCCWMPM161Po3HYMM150 35,3369 5.991.06 C4A.S. l/Lf1101]'Cmxn�64Mpm. egl0q)01I9b14311000N16 zm/; - 14NI.a 33.510.9) e4m.99 Llale.14 m1I014 mMEPOMON NN -Alm v� e. ..P a� }LZM�' 11d➢I�StJy OIVV/Comic yYV/Lwnpl pWP/Wnp 3M mIVT VN0.TON U9/iNi bn.[em Mliui1ma60(f1I �65iI15}A lli[fA 14KI.31 4I13.B3 1m IA19A) )p1A). IM6 4,MA) - 1465ll1 A.)I39! 3f6M I.019A1 lAl)AI 9,fip9.65 49646) 2/28/2022 Quick View Select Quick View Accounts Account Number/Name Account Type Treasury Center Select Group Groups Add Group Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $10,004,202.36 $10,218,041.54 $10,004,202.36 $9,470,348.2 '4551 CAL CO INDIGENT HEALTHCARE $5,460.66 $5.460,66 $5.460.66 $5,836.4 '4454 MEMORIAL MEDICAL! NH GOLDEN CREEK $315,982.49 / ,/ $319,255.48 r $315,982.49 $178,770.4 HEALTHCARE '4366 MEMORIAL MEDICAL CENTER -CLINIC SERIES $536-13 5536.13 $536.13 5536.1 2014 '4357 MEMORIAL MEDICAL CENTER -OPERATING 56,473,068.86 56,562,709.44 56,473,068.85 56,331,122.0 '4373 MEMORIAL MEDICAL CENTER - PRIVATE $q31 61 $431.61 $431.61 5431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER l NH ASHFORD $349,679.01 $366.777.18 $349,679.01 5282.772.E '4403 MEMORIAL MEDICAL CENTERINH $251.300.79 $256,534.93 $251.300.79 $206,492.E BROAOMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT $190,421.53 $215,568.92 $190,421.53 $183,563.1 '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND $114,134.05 $116.401.24 $114,134.05 $111,604,1 '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $381.325.22 $386,281.18 5381,325.22 5327,697.7 WEST HOUSTON '2998 MMG-MONEY MARKET FUND $1,109,566.76 S1.109,566.76 $1.109,566.76 51,109,566.7 '5506 MMC -NH BETHANY SENIOR LIVING $297.607.35 $303,076A0 S297.607.35 5293,638.2 'S441 MMC -NH GULF POINTE PLAZA- $252.359.28 $252,612.90 $252,369.28 5212,550.E MEDICARE/MEDICAID 'S433 MMC-NH GULF POINTE $88,181.67 $68,333.59 $68,181.67 $32,498,8 PLAZA -PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE $194.146.95 $254,496.12 $194,146,95 S193,266.� r https://prosperity,olbanking.com/onlineMessenger ill Memorial MedicNI Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 2/28/2022 Bmlaxa A[[Bunt B<dmdp Harlow ANaunt NurtN Nom[ u....n.- AadirneaManmlelbasLLYBdpne NM[: OnfYddmmr NOW SS.W]Wlb[INN/emd KCMnunln9 dam[. 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MMCWW N NPPlW pa NH TmtJer-0u[ T Antler -In pllP/Camp] gIPP/Cmmp2 Olvy/Comp9 Eam OMPM PORTON yP/MEE XNB E[xOX[MIMPMT)96W31{1MCWDESi9W - 6311 63.71 V1412012 HNB-ECHO NC[WMPME]46W34111CD ZSW25 320,07 - 14..0 VIS/202E HUMANA INS CO HCCWMPMT6349838300 US723 - 1,411.1E - 1,428.22 2t15/20E2 HUMANA DISO HCCVJM982410PW1414 14,E31.22 14,231.22 y16/20II NN1-ECHO HOWMPMT)1MUllHttO31I316 - 417,04 , 41].W 2/16/2022 HUMANA INS CO HCCW MPMT 6E498203WK590204 4,07O00 4,070,W E/17/ID4 NUMANA(iIq OOB HLCWMPMT6249834200WID80 l,iESK - 2 21221202E CK2071 I6,014A6, ,lES.K 213213013 XN8-E8-ECNOXC[WMPMi]4600341144000OI0SK - WEIS .95 213MO22 HNB-ECHO HCCIAIMPMT 74MUll WOW0347508 - 3,090.15 - 1,0090.D.05 21231203E CN1072 y23/3DII NUMANACHA015B HC[WMPMT6E498}4300W168> � Ig.91 y2412022 HNB- ECHOHCCWMPMT)9000]41144WW25328I _ - I3. 19.91 yE412032 HNB-ECHO N[cWMPMii4fgp311]HOW OE53}el - 335.3030 21).61 33 2/4/202E HNB - ECHO HCCWMPMT )46003411 MODW295111 - 31AHo - 34.30 y35/2033 ON. MlneNme RCN.OpB]b919l914.D1I0000336 �- 35641K� / .30 l5 fi90Og ]9,12)35 ✓ 6023]0,57 KOW3) MMCPORTION NIP/[ynp16 NH hln3ElN0ue TnnMer-In NIP/Tnmpl NPP/Campl NPP/CemP3 Lapv gIIPO PORTION yA/1WI NMlTHNUMAN SVC Nf[UIMPMI'1)A600311130A2 - 1,692.31 1.892.92 }/1)/L112 WIREOVTNMG SfRVKE3. LLG K,}p,18/ _ yE3/W33DWIR - 5.749.31 _ 5.749.32 y23/5021 NORMAN I3A HCMIMPMT6751924200K1339593 53).5) - 53).5} yu/11OU HOWDAH I3A HCCLAIMIMTKK914]Lb001K0851 104,185.08 ON,265.W 21ZW2022 WPS.TOeNCCORM HCCWMPMT24))123521W0 4W.96 - 405.86 y25/2033 NORIDAN I3A HO"IMPMT 67539242000012MO61 39AO2J3 / / 39,403.73 K.i11�38� 352E166 IW,WAS 312.313M 3MIM.3 MMCPORTION OIPP/C—A NH l R!M!6-0Pt Tnn5 ,.W I QPP/Camp[ WPP/CnmP] CJPP/Ca Wpe OIPPT I PORTION 0/9/9039 GameM1.M...CCD/MMT691335I6111000 e,a10.6i ;791150 SILW 4mm I'M9.47. SFOLID 0,sm.51, 9,610.61 L79339 SU." L196.93 1509.0 S6ULI0 160040 2/2812022 Quick View Select quick View Accounts Account Number/Name Account Type Searoh Atl DDA Treasury Center Select Group Groups Add Group Data reported as of Feb 28 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts; 15 $10,004,202.36 $10,218,041.64 $10,004,202.36 $9.470,348.2 '4551 CAL CO INDIGENT S5.460.66 S5,460.66 $5,46DA6 $5,836.4 HEALTHCARE '4454 MEMORIAL MEDICAL I NH GOLDEN CREEK $315.982.49 S319,255.48 $315,982.49 S178,770.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $536.13 $536.13 $536.13 S536.1 2014 '4357 MEMORIAL MEDICAL S6,473,068.86 $6,562,709.44 S6,473,068.86 S6,331,122.0 CENTER -OPERATING -4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.61 $431.61 $431.61 S431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $349,679.01 $366,777.18 $349,679.01 S282.772.E CENTER f NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $251,300.79 $256.534.93 $251,300.79 S206,49Z.E BROADMOOR '4411 MEMORIAL MEDICAL CENTER I NH CRESCENT $190,421.53 $215.568,92 $190.421.53 S183,563.1 '4446 MEMORIAL MEDICAL $114,134.05 $116.401.24 $114,134.05 $111,604.1 CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $381.325.22 $386,281.18 $381,326.22 S327,697.7 WEST HOUSTON '2998 MMC-MONEY MARKET FUND $1,109.566.76 $1,109,566.76 $1,109,566.76 S1.109,566.7 '5506 MMC-NH BETHANY SENIOR LIVING $297.607.35 $303,075.40 $297,607,35 $293,638,E '5441 MMC -NH GULF POINTE S252.359.28 PLAZA- J $252,612.90 $262,359.28 S212,550.E MEDICAREIMEDICAID •5433 / MMC -NH GULF POINTE PLAZA - PRIVATE PAY $68,181.67 + $68,333.59 $68,181.67 $32,498,E '3407 MMC-NH TUSCANY VILLAGE S194.146.95 $254,496.12 S194,146,95 $193,266,f htips;!lprosperity.olbanking.comloniineMessanger 1/1 Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 2/2g/2022 vrnlen PmawitpM A. bainMnl Pmdlnt Tnn,lemdtp NW Xome Numbr bAnn nMer-Ou[ Tnnallrin Wnnsnd 0. I T p6a lnnl a4n uNn Name ll3.006.63 ]llb45.fix 19(Pp6. - - 1p1,1K.p) S6E,162.13 Palant! )HrIK.9S Varlann V.H Ipnaln bYnn IN" / PMEN40.WP41 15,ID91p MUI)XPg1 1,611.91I�y MFe1GRFPFIAYMfMM6414d LAQF ),9N.11Y PPiMFHTCORRFCIIIXI TO6RMANY IAfi).Po9/ Adj. Gel. nger Ifi vO p/ NWe: enM16Wen[eWPra ss,Orolsilaetrna/mNMMCd NMWZ rmeA: Nu!]:futl�a[¢w[hmolaptWbnhpJb)W )M1tt MMCdepalfadrpaprn![awmt PNn)q)y 4 }x roxz FEB 2 S 2022 BY COUNTY AUDYrOrl CALHOUN COUNTY, T-MN 2/15/2022 NOVMASSOlMONHCCWMPMT67620142NN193 416/2012 MOLINA HEALTMCAR MOLINAACH 610324944200MIS Z/17/2022 WIRE COT LINEAR ENTERPRISES, IIC 2/17/2022 HNB-ECHO HCCIAIMPMT 74MMII 4WON277792 2/19/2022 HNB-ECHO HCCIAIMPMT 746CKIMll 440000217611 2/18/2022 0 PUN ADMINIST HCCLAIMPMT 17911100N2119S 2/22/2022 CK1092 2/Z2/2022 AMERIGROUPCORPOE•PAYMENPEB23147953130p0 2123/2022 NOVITASSOWTIONHCCIAIMPMT676ZO142NN161 2/24/2022 HNB• ECHO HCCW MPMT 746COUll 4NOOZ53701 2/2512022 M PLAN ADMINW HCCIAIMPMT 179 IIIN0020586 MMC PORTIQN QIPP/Comp4 Transfer -Out er-In OIPP/CemP1 QIPP/ComPZ gIPP/COmp3 &lapse giPPTI NHPORTION - 3.071.31 - 3,071.21 16,80..81 2,3S0:03 14AN.78 BA21.9I 4A21.92: - 1,721.06 - 11721A6 - 13,768.46 13,76B.44 - 4,525.94/ 28,531100 - - 28,530.00 - 3D,59959 4,269.24 26,330.35 15,299:80 15,299J0 - 96,209.32 96,209.32 - 2,422.92 2,422.52 - SSO.N - 880.00 131606.62 1 .046.95 6,62917 an 8>n.0 nmm 37032515 2/2812022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Add Graup Account Type �i Search All DDA Data reported as of Feb 28 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $10.004,202.36 $10,218,041.54 $10.004,202.36 $9,470,348.1 •4551 CAL CO INDIGENT $5,460.66 55,460.86 55,460.66 $5,836A HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $315,982.49 $319,255A8 $315,982.49 5178,770.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES 5536.13 $536.13 $536.13 $536.1 2014 '4357 MEMORIAL MEDICAL $6,473,068.86 $6,562,709.44 $6,473,068,86 $6,331,122.( CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.61 $431,61 $431.61 $431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $349,679.01 $366,777.18 $349,679.01 $282,772.E CENTER NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $251,300.79 $256.534.93 $251,300.79 $206,492.5 BROADMOOR •4411 MEMORIAL MEDICAL $190,421.53 $215,568.92 $190,421.53 5183,563.1 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $114.134.05 $116,401.24 $114,134.05 $111,604.1 CENTER/NH FORT BEND •4438 MEMORIAL MEDICAL CENTER ISOLERA AT $381,325.22 $386,281.18 $381,325.22 5327,697.7 WEST HOUSTON '2998 MMC -MONEY MARKET $1,109.666.76 51,109,566.76 $1,109,566.76 $1,109.666.7 FUND `5506 MMC -NH BETHANY $297,607.35 $303,075.40 $297,607.35 $293,638.4 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- $252,359.28 $252,612.90 5252,359.28 $212,550,E MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE $68,161.67 $68.333.59 $68,181.67 532,498.E PLAZA -PRIVATE PAY '3407 MMC-NH TUSCANY $194,146,95 �/ 5264,496.12 $194.146.05 $193,266.E VILLAGE https:/7prosperityalbanking.com/onlineMessenger 1/1 Memorial Medical Center Nursing Home UPL Weekly HSLTransfer ProSperity ACCOVAIS 2/28/2022 hMom Pq w Amwnrtob P[wunt NIkWJ MPdlnn lnwlmedm 61nk0ibM! ]PI6o].]P V[rnnn leave In Hl]ns IWN MNIHRaMr ]5.69/ f italNTf M0.911[R I gdfWlBWwe [In C//l ✓/ 1.66 rvPle: pJPGalPnma/wn 550.ro�n11pebW/[nedM MenuvnPAwne. Note 3:HWo[raxt/w[alwnWlw[ePf$IMNa1MMCtlelpll(wire apenanwnl. LMTIGVYRI X,CfO a/ie/tdn FEB 28 2022 SYCOUNTYAUDROR CAwoUN COUNTY, TVAS IpxH We[Xl ll.ndMn UPL]nmlerfYnn.rviro]]tFMUPrvV]X UPIlnMfeS .nO.vA]aln V1412012 Deposit 2/14/2022 Deposit 2/15/2022 Deposit 2/16/2022 Deposit 2/17/2022 WIRE OUT BETHANV SENIOR LIVING, LTD 2/17/2022 HOSPICE OF SOUTH PoV..MS NF 1131226SM14741 2/18/2022 D.pcsh 2/18/2022 NOVITAS SOLUTION HCCNIMPMT 676461420000120 2/22/2022 Deposit 2/22/2022 NOVITAS SOLUTION HCOIAIMPMT 676,11814201100122 212312022 NOVITAS SOLUTION NCCIAIMPMT 61MI 420 USI 2/24/2022 Deposit 2124/2022 NOVITA5 SOLUTION HOMAIMPMT 67MI114200110194 2/25/2022 TMNP HCCUUMPMT 41559210121000023509300 2/25/2022 NOWTAS SOLUTION HCCUVMPMT 67USI 41000050 2/25/2022 HOSPICE OF SOUTH Peym.nts NF 31312265W37816 2/25/2022 HEALTH HUMAN SVC HCCUAIMPMT 174600341130162 MMCPONTfON gIPP/CamP4 Transfer,Out Tmnsfer4n OIPP/Compl WPP/Camps gIPP/CsmP3 BUipse OIPPTI NH PORTION • 1.252.00 - 1,25SW $9,510.14 - 59, 10.14 11,133.43 - 11,133.43 - 1.757.05 - 1,757.05 13),035.05 - - Steel 648.61 8.757.38 6,757.38 - 6,105.49 6,105A9 - 13,843.08 - 13,641.08 - 159,590A9 - 159,550.89 - 5,228.14 - 5,228.14 - 999.07 - 989.07 - 24,699.40 - 24,09.40 • 233.00 - 233.00 745AS 745.48 - 648.61 - 643.61 - 1,341.69 _ ].A., R4 237.0ss.05 ]9bN1.66. - 29U8166 2/28/2022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Groups Add Group Account Type (ODA Data reported as of Feb 28 202: Account Number Current Balance Available Balance Collected Balance Prior Day Belem: Number of Accounts: 15 $10,004,202.36 $10,218,041.54 $10,004,202.36 $9,470,348.1 '4551 CAL CO INDIGENT $5,460.66 $5.460.66 $5.460.66 $5,836.4 HEALTHCARE '4454 MEMORIAL MEDICAL/ NH GOLDEN CREEK $315.982.49 $319.255.48 $315,982.49 $178,770.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $535.13 $536.13 $536-13 S536.1 2014 '4357 MEMORIAL MEDICAL S6,473,068.86 S6,562,709.44 S6,473,068.86 56,331,122.E CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE 5431.61 S43t61 S43t61 5431.E WAIVER CLEARING '4381 'MEMORIAL MEDICAL $349,679.01 S366.777.18 S349,679.01 5282,772E CENTER INH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $251,300.79 S256,534.93 $251,300,79 5206,492.E BROADMOOR '4411 MEMORIAL MEDICAL $190.421.53 $215.568.92 S190.421.53 $183,563.1 CENTER INH CRESCENT '4446 MEMORIAL MEDICAL $114,134.05 $116,401.24 $114.134.05 $111,604.1 CENTER INH FORT BEND '4438 MEMORIAL MEDICAL CENTER! SOLERA AT $381.326.22 S386,281.18 $381.325.22 S327,69Z7 WEST HOUSTON '2998 MMC-MONEY MARKET S1,109,566.76 $1.109,566.76 S1,109,566.76 S1,109,566.7 FUND '5506 MMC -NH BETHANY $297.607.35 $301075.40 S297,607.35 S293,638.2 SENIOR LIVfNG •5441 MMC -NH GULF POINTE PLC- $252,359.28 S252,612.90 $252.359.28 5212,550.E MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $68,181.67 $68,333.59 $68,181.67 $32,498.E PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $194.146.95 $254.496.12 S194.146.95 S193,266.E VILLAGE https://prosperity,olbanking.comionlineMessenger 1l1 N/lEMORIA1. MEDICAL CENTER l."HECK REQUEST MEMORIAL MEDICAL CENTER DwE Request(od: 2/28/22 APPROVEDON FEB 2 8 2022 . OY COUNTY AUDITOR FOP, ACCT. USE ONLY l7imprest clsh RAjP l-h,,, Elfvlail Check to Vendor Tllleiurn Check 6D Dept CALHOUN COUNTY, TEXAS AMOUNT _L4�6,618.71 GANUNIBER: 10255040 AMERISOURCE YR 5 Ql AND MOLINA YR 5 Ql QIPP i0'QtJFSTF('j BY: Mayra Martinez AUTHORIZF D BY: F, A y I ..EMORIAL INAEDICAL CENTER HE:';(( R E C). 1. J E MEMORIAL MEDICAL CENTER Dalt7 RiNuestec: 2/28/22 FOR ACCT. USE ON I.V A"OVM Ohl Imprest Cash �A/P CheckFEB 2 8 2022 Mail Check W Vendor --08 A"COLHOUUNTYAQ131TOR QN Return Check La Dept — - —UNN, TEyAq AN/lOON'T GANUMBF11: 10255040 CXPLANAT!0NI: AMERISOURCE YR 5 Ql AND MOLINA YR 5 Ql QIPP !V.QuriFH) Bv: Mayra Martinez AUHOMHP BY: l\ACKC)POAL NAPIWAL CENTER CH R k.. MEMORIAL MEDICAL CENTER Date Requested: 2/28/22 A FOR ACCT. USE ONLY y APPRMDON Dimprest Cash E []A/P Check FEB 2 8 2022 [jM@il Chcck to Vendor BYCOUNTYAUDFMR I rLJRetwrnChrckioI)epl CALHOUN COUNTY, TeXAS AN/10U.NT __$15,529.01 C7/L NUMBER: 10255040 CXPLA,,NAPON: AMERISOURCE YR 5 Ill AND MOLINA YR 5 Q1 QIPP 11110UFIT'-D BY. -- -- - ------------ — ----------- Mayra Martinez A!l--'.-H,'-'RVFfl BY: ---- -- ---- I .... . .... —77' MIEMC MAL MtDir'AL CENTER ?"'P.'- :l( REQUEST MEMORIAL MEDICAL CENTER A )die Requested: 2/28/22 Y � FEB 2 8 2022 �B1'COUNryAU FOR ACCT. USE ONLY ,—Imprest Cash EA/P Ched u Mail Check to Vendor 71Return Check to Dept L OUN OOUN)'yO B 4uU:\'f 21404.53 G/L NUMBER: 10255040 EXPLANA.TICPN: AMERISOURCE YR 5 Q1 AND MOLINA YR 5 Ql QIPP Iti.: i'lUIS rED O", Mayra Martinez _,a; jllORIZET) BY: M E M 0P,iA L MlED6 CAL (7FNTEF, 1-. MEMORIAL MEDICAL CENTER +)ate Requested: 2/28/22 Y E E Ah4OUNT $20,775.15 ---.-..___----_.---- FOR ACCT. USE ONLY ""RVM)ON ulmprest Cash FEB 2 8 2022 L]A%P Check Mail Check to Vendor C�OONr TYAUouNTDrMFjywr l�F''�Return Check io Depl GJL NUfvIBF.R: 10255040 [XPLA!`IA':"!ONI: AMERISOURCE YR 5 Q1 AND MOLINA YR 5 Q1 QIPP Ma ra Martinez UL L1-,BY y RILF Bi: l i IMIENJORIAL MEDICAL CENTER 4� MEMORIAL MEDICAL CENTER _ D.ite Requested: 2/28/22 A Y E. FOR ACCT. USE ONLY ulrrprest Cash F�A%P Check FEB 2 S 2022 j Mail Check to Vendor BYCOLIWYALID(TOp ❑Return Check to Dept CA -NOUN COUNTY,1'Wq !-- -------.__-- AIViOLhVT $9688.65G/LNUMBER: 10255040 t:XPI. AN'kT!ON: AMERISOURCE YR 5 Ql AND MOLINA YR 5 Ql QIPP Mayra Martinez — — .._..------- _ ------ ;j ail j ;•lr'lll7[ i : y_ T� r IrA X P A Y E r`. I\f!EN/110RIAL MEDICAL CENTER CHECK RE..O.WiST MEMORIAL MEDICAL CENTER -- pate. Requested: 2/28/22 FOP,ACCT. USE ONLY I_�ImprestCash FEB 2 8 2022 ❑A/P Chea ❑Mail Check to Vendor BY COUNTY AUDITOR � .----CALHOUNCOUNTY, TEXAS ��Return Check Depl: AMOUNT _,.$5692.10_ G/LNUNlBERt 10255040 EXPLANATION: AMERISOURCE YR 5 Ql AND MOLINA YR 5 0.1 QIPP i F;f JI. -iCEG B'. Mayra Martinez ali'i ;��RILED BY. i- i�4:ICRfEC4JEri r MEMORIAL MEDICAL CENTER — 4 Date Requested; 2/28/22 A FOR ACCT. USE ONLY Llhnpfe.StGish APPROVEDON f�A/P Check FEB 2 6 2022 ElMall Check to Vendor OReturn Check to Dept BYCOUNTY AUDITOR --.-- _--------- CALHOUN COUNTY, TOM AMUUidT _$23,,721.71__ G/I.NUMBE: 10255040 r.XP1,A JAP0N: AMERISOURCE YR 5 Q1 AND MOLINA YR 5 Q1 QIPP RLOUIIE[ rE6 BY: Mayra Martinez A:f+.I;�JRfLEDEi`.