Loading...
2022-04-27 Final PacketNOTICE OF MEETING-4/27/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 ('vary Meese, Commissioner, Precinct 4 Kadldlc Smith, Deputy Clerk NOTICE OF MEETING The Commissioners'Court of Calhoun County, Texas will meet on Wednesday, April 27, 2022 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, 'Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting called to order at 10:00a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report 6. Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. (RHM) Pass Page 1 of 4 NOTICE OF MEETING-4/27/2022 7. Consider and take necessary action to authorize the Professional Services Work Authorization Number 4 for the GBRA Green Lake Control Structure Re-establishment Permitting Scope of Work. (RHM) RESULT: APPROVED[UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the engineering change order (Work Order No. C-2) for Rebid — Magnolia Beach Fire Station Project for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. C-1. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve the engineering change order (Work Order No. E-2) for Rebid — Little Chocolate Bayou County Park for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to change the name of Huleo Road to Whitaker Road in Precinct 4. (GDR) RESULT: APPROVED[UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to approve the Preliminary Plat of Serendipity Subdivision. (GDR) Terry Ruddick explained prelim plat. RESULT: APPROVED[UNANIMOUS] MOVER: Gary Reese, Commissioner Pct4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NOTICE OF MEETING-4/27/2022 12. Consider and take necessary action to approve the Final Plat of Lot 1R, Block 154 Resubdivision No. 1. (GDR) Terry Ruddick explained final plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Consider and take necessary action to accept an anonymous donation of $75.00 to the Sheriff's Office to be deposited into the Motivation Account (2697-001-49082-679). ' RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action to declare the attached list of Portable Radios from the Emergency Management Department as Surplus/Salvage. (RHM) Pass 15. Consider and take necessary action to declare the attached list of miscellaneous equipment from the Emergency Management Department as Surplus/Salvage. (RHM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 16. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 4 NOTICE OF MEETING-4/27/2022 17. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct I SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner PcL 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned:10:25a.m. Page 4 of 4 (/ All Agenda Items Properly Numbered �/ Contracts Completed and Signed AAII 1295's Flagged for Acceptance (number of 1295's ) ikAll Documents for Clerk Signature Flagged Onthis&goayof 2022 a complete and accurate packet for2q4Cof 2022 Commissioners Court Regular Session Day M Ynth was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoun County Judge/Assistant COMMISSI ONERSCOURTCHECKLIST/FORMS AGENDA Jll' i ��I IViI I hkk "O'-' Richard H. Meyer County judge David Ball, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, April 27, 2022 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA (� The subject matter of such meeting is as follows: AT I FILED �/ /J 9 o'CLOCK�. _L!_V, `f. Call meeting to order. APR 2 2 2022 N.G 530 OP9P,N el�ir BY CL GAL Jl�N COUNTY, TE-M ',/S Pledges of Allegiance. 4. General Discussion of Public Matters and Public Participation. .Hear report from Memorial Medical Center. [6 Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. RHM) Consider and take necessary action to authorize the Professional Services Work Authorization Number 4 for the GBRA Green Lake Control Structure Re-establishment Permitting Scope of Work. (RHM) eo'Consider and take necessary action to approve the engineering change order (Work Order No. C-2) for Rebid — Magnolia Beach Fire Station Project for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun /County 2020 CDBG-DR Contract Work Order No. C-1. (DH) kl Consider and take necessary action to approve the engineering change order (Work Order No. E-2) for Rebid — Little Chocolate Bayou County Park for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. C-9. (DH) F-1 Page 1 of 2 0. Consider and take necessary action to change the name of Huleo Road to Whitaker Road in Precinct 4. (GDR) r1. Consider and take necessary action to approve the Preliminary Plat of Serendipity Subdivision. (GDR) `i2. Consider and take necessary action to approve the Final Plat of Lot 1R, Block 154 Resubdivision No. 1. (GDR) i-3 Consider and take necessary action to accept an anonymous donation of $75.00 to the Sheriffs Office to be deposited into the Motivation Account (2697-001-49082-679). (RHM) 41.0ac-onsider and take necessary action to declare the attached list of Portable Radios from ,the Emergency Management Department as Surplus/Salvage. (RHM) t5. Consider and take necessary action to declare the attached list of miscellaneous Zusider ipment from the Emergency Management Department as Surplus/Salvage. (RHM) 6and take necessary action on any necessary budget adjustments. (RHM) T%. Approval of bills and payroll. (RHM) Richard H. Meyer, Cour Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 NOTICE OF MEETING-4/27/2022 Rich2rd ]H . MeyeT County judge David Hall, Commissioner, Precinct 1 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, April 27, 2022 at 10:00 a.m. in the Commissioners'Courtroom in the County Courthouse at 211 S. Ann Street, mite 104, Port ]Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting called to order at 10:00a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report Page 1 of 13 #5 NOTICE OF MEETING — 4/27/2022 6. Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. (RHM) Pass Page 2 of 13 #6 BURN BAN ORDER — 4/27/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 WHEREAS, on the 27th day of April, 2022, the Commissioners' Court finds that circumstances present in all unincorporated areas of the County create a public safety hazard that would be exacerbated by outdoor burning. IT IS HEREBY ORDERED by the Commissioners' Court of Calhoun County that all outdoor burning is prohibited in the unincorporated area of the County for 90 days from the date of adoption of this Order. The County Judge may rescind this Order upon a determination that the circumstances that required the Order no longer exist Household Trash may be burned in a closed or screened container. This Order is adopted pursuant to Local Government Code §352.081, and other applicable statutes. This Order does not prohibit outdoor burning activities related to public health and safety that are authorized by the Texas Commission on Environmental Quality for: (1) firefighter training: (2) public utility, natural gas pipeline or mining operations; (3) planting or harvesting of agricultural crops; or, (4) burns that are conducted by a prescribed burn manager certified under Section 153.048, Natural Resources Code, and meet the standards of Section 153.047, Natural Resources Code. In accordance with Local Government Code §352.081(h), a violation of this Order is a Class C misdemeanor, punishable by a fine not to exceed $500.00. ADOPTED this 27th day of April, 2022 by a vote of ayes and nays. Richard H. Meyer Calhoun County Judge ATTEST: Anna Goodman, County Clerk Deputy Page 1 of 1 NOTICE OF MEETING — 4/27/2022 7. Consider and take necessary action to authorize the Professional Services Work Authorization Number 4 for the GBRA Green Lake Control Structure Re-establishment Permitting Scope of Work. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 13 Mae Belle Cassel From: Richard.Meyer@calhouncotx.org (Richard Meyer) <Richard.Meyer@calhouncotx.org> Sent: Monday, April 18, 2022 8:35 AM To: Mae Belle Cassel Subject: FW: Green Lake - Permitting work Attachments: 2022-04-14 Work Authorization No.4 - Green Lake.pdf From: bperkins@gbra.org (R. Brian Perkins, P.E.) <bperkins@gbra.org> Sent: Thursday, April 14, 2022 10:08 AM To: Gary.Reese@calhouncotx.org; richard.meyer@calhouncotx.org Subject: RE: Green Lake - Permitting work 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 Reese and Judge Meyer, Attached is the duly executed Work Authorization for the environmental work related to Green Lake. I believe the next step is for you to consider this at Commissioner's Court. Thank you, Brian R. Brian Perkins, P.E. Deputy Executive Manager of Engineering O (830) 560-3983 //''''�� C (512) 589-8244 LJB GUADALUPE-BLANCO RIVER AUTHORITY 933 E. Court St. Seguin, TX 78155 From: R. Brian Perkins, P.E. Sent: Tuesday, March 29, 2022 8:40 AM To: Gary.Reese(@caIhouncotx.org; richard.meverC@calhouncotx.org Subject: Green Lake - Permitting work Good morning Commissioner Reese and Judge Meyer, This morning, I received the next Work Authorization from Arcadis for the Green Lake work. There has been some back and forth on this, and GBRA is now satisfied with the scope and fee for this work. Please see attached. Arcadis has signed it and we are about to route it around for signatures on our end. However, I wanted to give you an opportunity to review. 1 Per our agreement, I believe that once we've executed this Work Authorization, the County will need to consider it before Commissioner's Court and authorize it. At that point, we can give Notice To Proceed. If you'd like to discuss, please let me know. Thanks, Brian R. Brian Perkins, P.E. Deputy Executive Manager of Engineering O (830) 560-3983 C (512) 589-8244 GUADALUPE-BLANCO RIVER AUTHORITY 933 E. Court St. Seguin, TX 78155 Calhoun County Texas PROFESSIONAL SERVICES WORK AUTHORIZATION Work Authorization: 4 GUADALUPE-BLANCO RIVER AUTHORITY GREEN LAKE CONTROL STRUCTURE RE-ESTABLISHMENT PERMITTING SCOPE OF WORK March 24, 2022 GENERAL OVERVIEW The Guadalupe -Blanco River Authority (GBRA) engaged Arcadia U.S., Inc. (Arcadia) in the Engineering Master Services Agreement on June 18, 2018. GBRA has requested that Arcadis provide this scope of work and fee proposal for permitting of the Green Lake control structure re- establishment in Calhoun County, Texas. The project team for this task consists of Arcadis and its subconsuftant(s): HDR Engineering, Inc. (HDR). The overall goal of this project is to re-establish the Green Lake control structure. The existing Green Lake control structure is non -operational. As a result, erosive overflows from Green Lake are causing cuts to form along the north levee of the GBRA diversion canal segment paralleling State Highway 35 (SH35), resulting in a loss of wetland habitat due to erosion. These cuts have allowed undesirable boat access to Green Lake from the diversion canal, further increasing habitat impacts. Furthermore, these cuts may adversely affect water supply operations for the diversion canal through hydraulic connection to Green Lake at lower than desired water surface elevations, causing water loss frorr the diversion canal to Green Lake during water deliveries. In an effort to address the above problems, GBRA and Calhoun County seek to re-establish the Green Lake control structure. The primary objectives of this project are to provide controlled outlets for Green Lake to convey overflows, eliminate direct boat access between Green Lake and the diversion canal, and separate the two water bodies hydraulically during water supply deliveries, thereby allowing GBRA to operate the diversion canal at a higher water surface elevation than Green Lake without water loss (as It has historically). GBRA and Calhoun County also desire the improvements to be simple to construct and to provide reliable and improved long- term maintenance access. The following scope of services outlines anticipated pre -application tasks required to permit the preferred alternative, currently identified as the Goff Bayou alternative control structure location and associated levee maintenance and access road (temporary and permanent) improvements, as described in the Feasibility Study Report dated February 10, 2022. In order to understand the potential Impacts to waters of the U.S. and demonstrate that the preferred alternative is the Least Environmentally Damaging Practicable Alternative (LEDPA) to the U.S. Army Corps of Engineers, environmental field work is proposed for a study area including three potentially practicable alternatives and associated maintenance activities which may be connected actions for which Independent utility has not been confirmed to date, as described in the Feasibility Study Report and depicted in Figures 1 and 2. Page 1 of 6 2022-03-24 Figure 1 — Green Lake Control Structure Location Alternatives Figure 2 — Green Lake Potential Levee Maintenance SCOPE OF SERVICES TASK 100 - PROJECT MANAGEMENT AND ADMINISTRATION Project management activities are to manage communication and coordination between the project team and GBRA, internal project team management, and quality assurance and control. Monthly project update conference calls will be conducted between the GBRA and Arcadis team to discuss ongoing tasks, data needs, technical considerations, and schedule and budget. Page 2 of 6 2022-03-24 Arcadia will also conduct project management and administration activities for the project including planning work activities, maintaining the project schedule and budget, invoicing, and coordination with GBRA. The duration of this permitting phase is assumed to be six (6) months. The Arcadis Project Manager will manage communication and coordination with GBRA and Calhoun County. Task 100 Deliverables • Monthly project progress conference calls. • Meeting agenda(s) and minute(s), as needed. • Monthly electronic invoices including an activity report for the period. TASK 200 — FIELD DELINEATION OF WATERS OF THE U.S. A field delineation will be performed by HDR to collect sub -meter GPS data on potential waters of the U.S., including wetlands, along the project alternatives, as depicted In Figures 1 and 2, and as described below: • The delineation would occur In an approximately 50-foot buffer around the alternative locations preliminary layout and access roads from the feasibility report, as well as the levee maintenance locations, and occur in one mobilization over four days with access coordinated by GBRA and Calhoun County. The delineation at 'dy area consists of approximately 51 acres including the following locations: o Goff Bayou structure site and access road (approximat ly 14 acres) o North canal levee access, Hog Bayou, and previous str cture site (approximately 16 acres) o South canal levee maintenance area (approximately 21 acres) • Delineation will be in accordance with the USACE 1987 Wetland Delineation Manual and the 2010 Atlantic and Gulf Coastal Plain Regional Supplement as well as the USACE Galveston District guidance applicable at the time of the work. • A general habitat evaluation for federally listed threatened and endangered species would occur at the same time as the delineation field work, with a focus on marsh habitat identification that may be considered suitable for Eastern black rail by federal agencies. Presence/absence surveys for threatened and endangered species as well as freshwater mussel surveys are not Included in this scope but could be performed as supplemental services authorized by GBRA. Task 200 Deliverables • Delineation data will be provided as an ArcGIS file in Texas State Plan Coordinate Zone (4204). NAD 83. • A delineation report to include methods, summaries, quantitative results, data forms, and exhibits Illustrating the delineated boundaries of waters, including wetlands, and Page 3 of 6 2022-03-24 uplands. A draft report will be provided in this phase. The report can be finalized in a future phase as a stand-alone report for inclusion in a future permit application package. TASK 300 — UPDATED ENVIRONMENTAL PERMITTING EVALUATION Environmental scientists and project engineers will review each Green Lake control structure alternative to evaluate potential impacts to waters of the U.S. and potential permitting requirements based on the field data collected from Task 200 and the preliminary layouts in the feasibility report. We anticipate the meeting with GBRA/County will be virtual. The anticipated tasks to conduct the updated permitting evaluation include: • Update HDR's existing GIS database for resources of concern, including the following: o Potential waters of the U.S., including wetlands. o Vegetation communities. o State and federal threatened & endangered species. • Define limits of previous soil disturbance and approximate time of construction for existing structures, levees, and access roads to the extent practicable using Task 200 data and publicly available historic aerial photographs and maps. Project engineers will provide input on extent of levee maintenance work needed for the Hog Bayou and previous control structure locations to be feasible and fully operational. • Perform an impact assessment of the three conceptual options for the project from the feasibility report to evaluate the alternatives from the USACE standpoint of the potential to be the LEDPA. The assessment will Include a matrix for inclusion in a 404 permit application or pre -construction notification package. • Coordinate with project design engineers to further define purpose and need, practicability of alternatives, and avoidance and minimization measures that can be taken for each alternative. • Identify potential permit requirements (Nationwide Permit, Regional General Permit, or Standard Permit). • Prepare a draft Technical Memo to summarize the permit evaluation findings. • Respond to one round of question and comments from GBRA/County to the technical memorandum reviewed in a virtual meeting. • Update the draft Technical Memo to address comments and submit a final Technical Memo. Task 300 Deliverables The updated environmental permitting evaluation will be summarized in a Technical Memorandum and provided electronically. Draft and final Technical Memorandum will be provided. Page 4 of 6 2022-03-24 TASK 400 — PRE -APPLICATION AGENCY COORDINATION We will prepare for, coordinate, and participate in a pre -application meeting with regulatory agencies, such as a joint evaluation meeting (JEM) with the USACE Galveston District, commonly attended by Texas Commission on Environmental Quality (TCEQ), Texas Parks & Wildlife Department (TPWD), U.S. Fish and Wildlife Service (USFWS), and National Marine Fisheries Service (NMFS). The JEM may occurvirtually or in person depending on agency health and safety protocols in place at the time, and would allow project information to be presented to the agencies to get preliminary feedback, and present the preferred alternative as the LEDPA, for USACE comment. Up to three HDR permitting specialists/engineers as well as one Arcadia engineer would participate in the meeting to represent GBRA and Calhoun County. Agency feedback would be documented in meeting minutes. Task 400 Deliverables • Agency meeting minutes provided electronically. • Recommendation regarding scope of work for Final Design & Permitting Phase efforts. OWNER TO PROVIDE This scope of work is based under the assumptions that GBRA (and/or Calhoun County) will provide the following: GBRA to coordinate with Calhoun Coun for property access coordination for the field delineation. GBRA to provide boat for south levee access during field delineation. Review of permitting information and feedback as necessary. Up to 3-week review time is assumed for GBRA and Calhoun County concurrent review on technical memorandum. FEE PROPOSAL This work will be performed on personnel time at the hourly rates agreed upon via email on February 18, 2022, plus actual expenses. The estimated fee for each task as described in this scope of services is included in the table in the following page and is based on a 6-month period of performance. A breakdown of the hours for each team member is also attached at the end of this scope of services. Note, Section 404 permit application development, mitigation planning, and coordination support are planned to be included in a future final design phase following the outcome of the pre - application coordination with USACE. Additionally, cultural resource surveys, required species - specific protected species surveys, any state permitting such as aquatic resource relocation plans, sand and gravel permitting, and agency consultation support for National Historic Preservation Act (NHPA) Section 106 and ESA Section 7 will be conducted in future work authorizations. Thus, none of these services are included in the fee proposal. Page 5 of 6 2022-03-24 Task Description Arcadis Total HDRTotal Total Project Cost 100 Project Management and $8,900 $8,280 $17,180 Administration 200 Field Delineation of Waters of the $3,190 $37,015 $40,205 U.S. and Report 300 Updated Environmental Permitting $4,070 $20,620 $24,690 Evaluation 400 Pre -Application Meeting and $7,675 $14,500 $22,175 Coordination TOTAL FEE $23,835 $80,41S $104,250 PROJECT SCHEDULE The field delineation (Task 200) is proposed to occur within 3 weeks on notice to proceed, depending on access, weather, and water levels. The permitting schedule is highly dependent on the findings of the tasks described herein and agency feedback. To the extent possible, Task 300 will be completed within two months of the completion of Task 200, and Task 400 will be completed within two months of the Task 300 completion, pending agency response. Arcadia U.S., Inc. (Engineer) IGuadalupe-Blanco River Authority Charles Schoening DarreliNic o Principal -in -Charge Senior Deputy General Manager Date: March 28, 2022 Date: 13 12Z Page 6 of 6 2022-03-24 4' 8 So8 80 80 $8$e'I; $ .-i; ri a ae ni M 6 d d N Q N N NNN v1 M I N M � VI Y�NN'., M O OI pcol O 8G SO O t0 y` N M • p OSgOgSgOQ CC p pp OS H8$$� S 4SO o S Lq p; .: ry d o ni wi d d p m rri a ri e_, V�Y�NN NM NN N1M1NM� M Y N O i O i O I I 0 O Y Y tq tl N N O f09 N < Y Y e e o f gcg � as G N C ea0mm a a 8 c � � O • � � i 2 E E � a�q� I v E 2QQ SaO Uy= Si $i R O NOTICE OF MEETING-4/27/2022 8. Consider and take necessary action to approve the engineering change order (Work Order No. C-2) for Rebid — Magnolia Beach Fire Station Project for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. C-1. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 13 u 0 uo Mae Belle Cassel From: david.hall@calhouncotx.org (David Hall) <david.hall@calhouncotx.org> Sent: Monday, April 18, 2022 9:54 AM To: MaeBelle.Cassel@calhouncotx.org Cc: 'peggy hall' Subject: FW: Engineering Change Orders for Court Agenda Attachments: WO# C-2 - MB Fire Station G&W Change Order 041822.pdf, WO# E-2 - LCB G&W Change Order 041822.pdf From: smason@gwengineers.com (Scott Mason) [mailto:smason@gwengineers.com] Sent: Monday, April 18, 2022 9:47 AM To:'David Hall' <david.hall@calhouncotx.org> Cc:'Katy Sellers' <katy@ksbr-llc.com> Subject: Engineering Change Orders for Court Agenda the sender and know the content is safe. David, Do not click links or open attachments unless Just wanted to start an email to get on the agenda for next week for the change orders so we can go out for bid on the park and the fire station. Peggy said you need an agenda item for where money is coming from or add it to the agenda item(s). Consider and take necessary action to approve the engineering change order (Work Order No. C-2) for Rebid - Magnolia Beach Fire Station Project for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. C-1. (DH) Consider and take necessary action to approve the engineering change order (Work Order No. E-2) for Rebid - Infrastructure Improvements at Little Chocolate Bayou County Park for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1. (DH) Thanks, Scott P. Mason, P.E. Lead Project Engineer G&W Engineers, Inc. 1 205 W. Live Oak Port Lavaca, Texas 77979 P: (361) 552-4509 F: (361) 552-4987 smason@gwengineers.com Calhoun County Texas Magnolia Beach Fire Station Project Work Order No. C-2 Pursuant to the Contract (Contract) between the County of Calhoun (County) and G & W Engineers, Inc. (Provider) for professional engineering services, as authorized under the County- GLO Contract No. 20-065-064-C182, Provider is authorized to perform the services described below, subject to the Scope of Services; Tasks / Deliverables / Timefiames / Special Conditions; Benclunarks / Budget; and any other conditions of this Work Order. This Work Order modifies and amends the Contract, all provisions of which not specifically amended herein shall remain in full force and effect. This project will improve the infrastructure and amenities at Little Chocolate Bayou County Park in connection with the Performance Statement stated in Attachment A of the County-GLO Contract. The project will include modifications to the original bid package as performed under Work Order No. C-2, which is required as a result of additional floodproofrng measures required by the GLO for the facility location being in a 500 — year floodplain. R"IDEOWKIDUSIM Provider shall perform modifications to the bid documents, including the construction plans which will reduce the scope of the project in a full faith effort to receive bids within the project budget. Provider then will update the bid package and re -advertise the bids for the project. At which time bids are opened and received and a recommendation for award is made by provider the original Work Order Scope and Engineering Budget shall resume. Task 1— Revise Construction Plans & Preparation of Bid Documents and Advertise BMW. Provider will aid County with soliciting a construction contractor and perform other necessary pre - construction activities. Provider will provide the following services: a. Revise Construction Plans as recommended and discussed based upon bids received. b. Prepare a bid advertisement, advertise the bid, and distribute bid documents to prospective bidders. c. Participate in a pre -bid meeting in Calhoun County to meet with potential bidders to discuss project details, answer questions, and review or clarify the scope of construction work. d. Assemble and submit to County a written document containing an attendees list and the pre -bid meeting minutes, listing questions and answers for distribution to all interested parties. e. Prepare addendum(s) to the Project Manual (Bid Package), if needed. Pagel of 3 Deliverables: For each deliverable, digital copies are to be sent to County and the Grant Administrator. 1. Written summary of the pre -bid meeting (submitted within three (3) business days of meeting). 2. Addendum to the bid documents, if needed (submitted within five (5) business days of the last day to submit comments/questions). 3. Bid Advertisement(s) Timeline: Completed within (8) weeks. Task 2 —Bid Proposals and Selection of Contractors. Provider will assist County in the review of submitted proposals for conformance with project requirements. Provider will summarize cost proposals in tabulated format for comparison. Provider will assist County in reviewing bidder qualifications and assist with contract negotiations. Deliverables: 1. Bid Tabulation Summary. 2. Recommendation of Award. 3. Notice to Proceed (to be provided to the selected contractor within two (2) business days of Calhoun County Commissioners Court approval of the contractor). Timeline: Complete Recommendation for Award for presentation to County and digital copies of each deliverable are to be sent to County and the Grant Administrator within two (2) weeks of bid closing. Provider shall submit invoices to the Grant Administrator at the completion of each Benchmark, in accordance with the Project Budget/Payment Schedule provided below. Requests for payment must be supported by documentation as required under the Contract, such as invoices, receipts, statements, stubs, tickets, time sheets, and any other documentation that, in the judgment of the Grant Administrator, provides full substantiation of reimbursable costs incurred. All invoices, reimbursement documents, and deliverables submitted must prominently display "Magnolia Beach Fire Station Project"and "Work Order No. C-2." Failure to include this identification may significantly delay payment under this Work Order. Page 2 of 3 PROJECT BUDGET/PAYMENT SCHEDULE Total compensation due to Provider for services provided or performed pursuant to this Work Order shall not exceed Thirty Thousand Dollars ($30,000.00). Invoices shall be paid in accordance with the Project Budget below: Benchmarks/Deliverables i Amount Paid Per Benchmark Benchmark 1- Revise Construction Plans & Bid Does $30,000.00 Total Budget for This Work Order $30,000.00 Termination or Interruption of Work: County reserves the right to halt or defer all or any portion of the work included in the Scope of Services of this Work Order any time during the performance period. If such an event occurs, the Parties agree that the schedule and budget may require renegotiation. Amendments to Work Order: Material changes to this Work Order may only be made by written agreement of both Parties. All Parties to the Contract executed this Work Order, to be effective as of the date signed by the last party. CO OFCALHOUN Richard H. Meyer Calhoun County Judge Date of execution: 4r-z rzaz: G & W ENGINEERING, INC. w-- Brian P. Novian President Date of execution: - i -�-7o zr Page 3 of 3 NOTICE OF MEETING-4/27/2022 9. Consider and take necessary action to approve the engineering change order (Work Order No. E-2) for Rebid — Little Chocolate Bayou County Park for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 13 #9 Mae Belle Cassel From: david.hall@calhouncotx.org (David Hall) <david.hall@calhouncotx.org> Sent: Monday, April 18, 2022 9:54 AM To: MaeBelle.Cassel@calhouncotx.org Cc: 'Peggy hall' Subject: FW: Engineering Change Orders for Court Agenda Attachments: WO# C-2 - MB Fire Station G&W Change Order 041822.pdf WO# E-2 - LCB G&W Change Order 041822.pdf From: smason@gwengineers.com (Scott Mason) [mailto:smason@gwengineers.comj Sent: Monday, April 18, 2022 9:47 AM To:'David Hall' <david.hall@calhouncotx.org> Cc: 'Katy Sellers' <katy@ksbr-Ilc.com> Subject: Engineering Change Orders for Court Agenda 111rlsl7 David, of the organizatioi or( is unless Just wanted to start an email to get on the agenda for next week for the change orders so we can go out for bid on the park and the fire station. Peggy said you need an agenda item for where money is coming from or add it to the agenda item(s). Consider and take necessary action to approve the engineering change order (Work Order No. C-2) for Rebid - Magnolia Beach Fire Station Project for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. C-1. (DH) Consider and take necessary action to approve the engineering change order (Work Order No. E-2) for Rebid - Infrastructure Improvements at Little Chocolate Bayou County Park for Calhoun County, Texas under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1. (DH) Thanks, Scott P. Mason, P.E. Lead Project Engineer G&W Engineers, Inc. 1 205 W. Live Oak Port Lavaca, Texas 77979 P: (361) 552-4509 F: (361) 552-4987 smasonCoDgwengineers.com Calhoun County Texas Infrastructure at Little Chocolate Bayou County Park Work Order No. E-2 Pursuant to the Contract (Contract) between the County of Calhoun (County) and G & W Engineers, Inc. (Provider) for professional engineering services, as authorized under the County- GLO Contract No. 20-065-064-C182, Provider is authorized to perform the services described below, subject to the Scope of Services; Tasks / Deliverables / Timeframes / Special Conditions; Benchmarks / Budget; and any other conditions of this Work Order. This Work Order modifies and amends the Contract, all provisions of which not specifically amended herein shall remain in full force and effect. toss 1 _s► This project will improve the infrastructure and amenities at Little Chocolate Bayou County Park in connection with the Performance Statement stated in Attachment A of the County-GLO Contract. The project will include modifications to the original bid package as performed under Work Order No. E-2, which is required as a result of the bids that were received and the project being over budget due to the pandemic and higher cost associated with materials. Provider shall perform modifications to the bid documents, including the construction plans which will reduce the scope of the project in a full faith effort to receive bids within the project budget. Provider then will update the bid package and re -advertise the bids for the project. At which time bids are opened and received and a recommendation for award is made by provider the original Work Order Scope and Engineering Budget shall resume. 113,YMMA 1 Billt n i► Task 1—Revise Construction Plans & Prenaratlon of Bid Documents and Advertise Bid(s). Provider will aid County with soliciting a construction contractor and perform other necessary pre - construction activities. Provider will provide the following services: a. Revise Construction Plans as recommended and discussed based upon bids received. b. Prepare a bid advertisement, advertise the bid, and distribute bid documents to prospective bidders. c. Participate in a pre -bid meeting in Calhoun County to meet with potential bidders to discuss project details, answer questions, and review or clarify the scope of construction work. d. Assemble and submit to County a written document containing an attendees list and the pre -bid meeting minutes, listing questions and answers for distribution to all interested parties. e. Prepare addendum(s) to the Project Manual (Bid Package), if needed. Page 1 of 3 Deliverables: For each deliverable, digital copies are to be sent to County and the Grant Administrator. 1. Written summary of the pre -bid meeting (submitted within three (3) business days of meeting). 2. Addendum to the bid documents, if needed (submitted within five (5) business days of the last day to submit comments/questions). 3. Bid Advertisement(s) Timeline: Completed within (6) weeks. Task 2 — Bid Proposals and Selection of Contractors. Provider will assist County in the review of submitted proposals for conformance with project requirements. Provider will summarize cost proposals in tabulated format for comparison. Provider will assist County in reviewing bidder qualifications and assist with contract negotiations. Deliverables: 1. Bid Tabulation Summary. 2. Recommendation of Award. 3. Notice to Proceed (to be provided to the selected contractor within two (2) business days of Calhoun County Commissioners Court approval of the contractor). Timeline: Complete Recommendation for Award for presentation to County and digital copies of each deliverable are to be sent to County and the Grant Administrator within two (2) weeks of bid closing. Provider shall submit invoices to the Grant Administrator at the completion of each Benchmark, in accordance with the Project Budget/Payment Schedule provided below. Requests for payment must be supported by documentation as required under the Contract, such as invoices, receipts, statements, stubs, tickets, time sheets, and any other documentation that, in the judgment of the Grant Administrator, provides full substantiation of reimbursable costs incurred. All invoices, reimbursement documents, and deliverables submitted must prominently display "Infrastructure at Little Chocolate Bayou County Park" and "Work Order No. E-2." Failure to include this identification may significantly delay payment under this Work Order. Page 2 of 3 k Total compensation due to Provider for services provided or performed pursuant to this Work Order shall not exceed Twenty-five Thousand Dollars ($25,000.00). Invoices shall be paid in accordance with the Project Budget below: Benchmarks/Deliverables Amount Paid Per Benchmark Benchmark 1 Revise Construction Plans & Bid Does $25,000.00 j otal Budget for This Work Order $25,000.00 Termination or Interruption of Work: County reserves the right to halt or defer all or any portion of the work included in the Scope of Services of this Work Order any time during the performance period. If such an event occurs, the Parties agree that the schedule and budget may require renegotiation. Amendments to Work Order: Material changes to this Work Order may only be made by written agreement of both Parties. All Parties to the Contract executed this Work Order, to be effective as of the date signed by the last party. CO OF CALH�O%UN Richard H. Meyer Calhoun County Judge Date of execution: y Z? 2 oz L G & W ENGINEERING, INC. 9= 2-1 Brian P. Novian President � Date of execution: ` 11 v Wzz Page 3 of 3 NOTICE OF MEETING-4/27/2022 10. Consider and take necessary action to change the name of Huleo Road to Whitaker Road in Precinct 4. (GDR) RESULT: APPROVED[UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6of13 #10 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 19, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for April 27, 2022. Consider and take necessary action to change the name of Huleo Road to Whitaker Road in Precinct 4. Sincerely, I 'A 0 Gary D. Reese CDR/at P.O. Box 177 — Seadri0, Texas 77983 —email: earv.reese a calhouncotx.ora — (361) 785-3141 — Fax (361) 785-5602 NOTICE OF MEETING-4/27/2022 11. Consider and take necessary action to approve the Preliminary Plat of Serendipity Subdivision. (GDR) Terry Ruddick explained prelim plat. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 13 #11 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 19, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for April 27, 2022. • Consider and take necessary action to approve the Preliminary Plat of Serendipity Subdivision. I cerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift. Texas 77983 — email: Rarv.reese d calhouncom.ore — (361) 785-3141 — Fax (361) 785.5602 8 • ga Eies lines* z ................... .. " 5 � pm R z. w m,. m� yj ... yy Eg $� B !j ................: p 9 p 1 11 11m �4 Lr. 1 1 y{g{ HIM!. Y r e¢gf, g@ it �s 6s. py EUlu! � p zAa4 'eL9I NJ�'yf °p mho 4 m v8 � ass •Faa° �.a z m S $s:. m pas co m '1 0 §o oi, O 1 9 s� 3r 9 5$ m, gm € E4E��E a �s u.E p12 o m q y € 9 � G g � gyp. RN, N 6� T56 ig $y ii o m Mu, "s 8 a Ss pi =age o �, n ��g�oea y �_ ��� o' apj a � � 'A � '£"f� � m z w a i oj"ya y N!! o e="g "� �a � � y s e 4 m ai Ohl W upil �.;a+^�n Q:o3`s __ NOTICE OF MEETING — 4/27/2022 12. Consider and take necessary action to approve the Final Plat of Lot iR, Block 154 Resubdivision No. 1. (GDR) Terry Ruddick explained final plat. RESULT: APPROVED[UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 13 #12 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 20, 2022 Honorable Richard Meyer Calhoun County judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for April 27, 2022. • Consider and take necessary action to approve the Final Plat of Lot 1R, Block 154 Resubdivision No. 1. Sincerely, A �0 Gary D. Reese GDR/at P.O. Box 177 — Seadrifl, Texas 77983 — email: eary reccea�calho�acot� n� — (361) 785.3141 — Fax (361) 785-5602 r— O O n ppA $` Sa E R C/)pl l �; a no C 70 o 6m O j. z O k = k 1y9 9� w N. y5 v , dk' ^gA,! a' i $ € WIN m O: § F R� m I'Hp¢ f� sa @£ 4-0 M s s 8µ83a Sry�yR£ :g$2 Z 2 a Pill oFo € - I B� . Iz = a 4 $ M-N = 3� 3E3JM� r '1 0 9V(}I V I u�W v oli c jIn o��am s"ei'gRq s g��o$5s it n «�.Rmg� 1��o�p zo �V I H M s10'— �z T i R8 m o�oa'89 MR'g"c¢ A I €g]�7 iflm Rig; h 5g m $ qR oR.,zij o.�. z n co '�" sit$g o m =g€e�i o � MjaA Gg� $m� gmI S r gz gggm�5e i ''ji a 5i � 9 3 Rg6 ryajm ]ml "p 0 do, Ry€S N oi I goad g,�o� iRm� NOTICE OF MEETING-4/27/2022 13. Consider and take necessary action to accept an anonymous donation of $75.00 to the Sheriffs Office to be deposited into the Motivation Account (2697-001-49082-679). (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 13 #13 CALHOUN COUNTY9 TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 5534646 FAX NUMBER (361) 5534668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: ACCEPT DONATION TO SHERIFF'S OFFICE DATE: APRIL 27, 2022 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR APRIL27, 2022 * Consider and take necessary action to accept anonymous donation to the Sheriffs Office to be deposited into the Motivation account (2697-001-49082-679) in the amount of $75.00 Sincerely, Wim Bobbie Vickery Calhoun County Sheriff n e 2315 .., t' ✓ `/ r �i / fill✓ Fji i -- -- a ge I /1 FOR A NOTICE OF MEETING-4/27/2022 14. Consider and take necessary action to declare the attached list of Portable Radios from the Emergency Management Department as Surplus/Salvage. (RHM) Pass Page 10 of 13 #14 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: lEmergency Management Requested By: LaDonna Thigpen on 4-27-22 Inventory Number Description Reason for Surplus/Salvage Serial Nn_ 406-0156 406-0157 406-0168 541-0222 541-0223 XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios XTS 1500 Portable Radios 687CPX1253 687CPX1254 687TGWE707 687CLT0197 687CLT0198 687TGWE708 687TGWE709 687TGWE710 687TGWE721 Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project Traded in for new on 2021 APR Radio Project NOTICE OF MEETING-4/27/2022 15. Consider and take necessary action to declare the attached list of miscellaneous equipment from the Emergency Management Department as Surplus/Salvage. (RHM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 11 of 13 #15 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: lEmergency Management Requested By: LaDonna Thigpen Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration The following are not on inventory Sony Digital Mavica Camera MVC-FD90 SN171125 No longer used. Sony Cyber Shot SDC-HX20V Camera P-80808637 No longer used Kodak Easy Share DX6490 Cam KCTCT43034238 No longer used. Sony Digital Handycam DCR-TRV240 404850 No longer used. Kodak Rapid Battery Charger K5000 No longer used. Kroy Duratype Label Maker D064080 No longer used. 240 SE w/4 cartridges NOTICE OF MEETING — 4/27/2022 16. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 13 #16 I M z 2 e T 6 0 w wl Q 0 0 0 0: 0 U F 2 a z 0 U 0 w IL w w LL AF. d11 0 0 0 0 0 0 W 0 w �I a 0 z z U zz LL LL' w 0 0 i0 :40 ?N :0 Z` :r :a :W i� :W :12 0 m a v Z W W yC d ` z W Q .`! z m F , � z e z a � � c � e D h Ib w a a D U) V i e J F r1 � w ' z l z O Q W w z a cW 2 G Q y� W ie 2 N O N m a NOTICE OF MEETING-4/27/2022 17. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner PcL 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned:10:25a.m. Page 13 of 13 # 17 April 27, 2022 2022 APPROVAL LIST - 2022 BUDGET COMMISSIONERS COURT MEETING OF 04/27/22 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 20 $182,647.58 AT&T MOBILITY EMS MARCH 2O22 CELL PHONE SERVICE A/P $ 418.96 CAP PROD CHOCOLATE BAYOU PARR & G&W MAGNOLIA BEACH FIRE STATION A/P $ 50,000.00 PITNEY BOWES SO POSTAGE A/P $ 1,000.00 TOTAL VENDOR DISBURSEMENTS: S 234,066.54 PAYROLL FOR April 29, 20202 P/R S 371,532,461-- TOTAL PAYROLL AMOUNT: S 371,532,46'V" TOTAL INVESTMENT ACTIVITY AND TRANSFERS BETWEEN FUNDS: $ TOTAL AMOUNT FOR APPROVAL: S 605,599.00 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---April 27 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 1,086,356A6 TOTAL TRANSFERS BETWEEN FUNDS $ 90,276.10 TOTAL NURSING HOME UPI, EXPENSES $ 833,07269 TOTAL INTER•GOVERNMENT TRANSFERS $ 04,439.64 GRAND TOTAL DISBURSEMENTS APPROVED April 27, 2022 $ 2,074,143.881" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---April 27 2022 PAYABLES AND PAYROLL 4/21/2022 Weekly Payables 4/21/2022 Citibank Credit Card -see attached 4/25/2022 McKesson-340B Prescription Expense 4/26/2022 Ameriscurce Bergen-3406 Prescription Expense 4/25I2022 Payroll Liabilities -Payroll Taxes 4/25/2022 Payroll Electronic Bank Payments TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 4/21/2022 MMC Operating to Solera-correction of NH insurance payment deposited into MMC Operating 4/21/2022 MMC Operating to Golden Creek -correction of NH insurance payment deposited into MMC Operating in error 4/21/2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment deposited into MMC Operating 4/2l/2022 MMC Operating to Tuscany Village -correction of NH Insurance payment deposited into MMC Operating 4/21/2022 MMC Operating to Bethany -correction of NH insurance payment deposited into MMC Operating in error TOTAL TRANSFERS BETIIVEEN FUNDS NURSING HOME UPL EXPENSES 4/25/2022 Nursing Home UPL-Cantex Transfer 4/25/2022 Nursing Home UPL-Nexion Transfer 4/25/2022 Nursing Home UPL-Tuscany Transfer 4/25/2022 Nursing Home UPL-HSL Transfer TOTAL,NURSING 4DME.UPL EXPENSES' 553,996.42 2,992.82 6,396.20 629.49 129,263.56 392,689.06 387.90 $ 1,086,;355A6. 7,481.39 10,688.78 3,153.20 3,009.25 65,943.48 $ 90r276.10' 428,253.42 110,812.66 84,999.01 209,007.60 INTER -GOVERNMENT TRANSFERS 5/6/2022 IGT CHRIP PGY1 to be paid on May 06, 2022 64,439.64 TOTAL INTER -GOVERNMENT TRANSFERS' $ 64,439.64 , GRAND TOTAL DISBURSLMENTS.APPROVEDrA ril'27,:2022 $ 2,0741;4,188 Page 1 of 12 RECEIVED BY WE COUNTY AUDITOR ON MR110122022 MEMORIAL MEDICAL CENTER 11:27 AP Open Invoice List CA� anN COUNTY, Vendor EX*Name Due Dates Through: 05/12/2022 Class Pay Code 10995 ABILITY NETWORK(SHIFTHOUND) �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 22MOD49740 ✓ 04/12/20 04/06/20 06108/20 647.28 SCHEDULING SERVICES Vendor Totals Number Name Gross 10995 ABILITY NETWORK (SHIFTHOUND) 647.28 Vendor# Vendor Name Class Pay Code 10950 ACUTE CARE INC 0 ap_open_invoice.template Discount No -Pay Net 0100 0.00 647.28 Discount No -Pay Net 0.00 0.00 647,28 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay INV687 ✓ 04/20/20 0420/20 05/20/20 1,400.00 0.00 0.00 RFID FEE Vendor Totals Number Name Gross Discount No -Pay 10950 ACUTE.CARE INC - 1,400,00 0.00 0.00 Vendor# Vendor Name Class Pay Code 12900 AMANDA GRIGGS / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 041322 04/20/20 04/13/20 04/25/20 76.00 0.00 0,00 TREIM-n(CUpA-1'tD"I"ritlyRyIq fdRti_r.M-Vtr`jU&t Vendor Totals Number Name Gross Discount No -Pay 12900 AMANDA GRIGGS 76.00 0.00 0.00 Vendor# Vendor Name Pay Code /Class A2150 ANNOUNCEMENTS PLUS TOO AGAIN t/ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay 705 i j 04/12/20 04/29/20 05/09/20 10.00 0.00 0.00 PRINTING Vendor Totals Number Name Gross A2150 ANNOUNCEMENTS PLUS TOO AGAIN 10.00 Vendor# Vendor Name Class Pay Code A2218 AQUA BEVERAGE COMPANY," M Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 192256 ✓'' 04/2020 04/02/20 04/27/20 64.10 WATER Vendor Totals Number Name Gross A2218 AQUA BEVERAGE COMPANY 64.10 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC bl Invoice# _Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross 2556145✓ 04/20/20 04/11/20 05/11/20 2,412.00 ,TRAVEL LAB STAFFING (3Ia5-3)dT I.%1�}{1lW llit'1'a 2656054 ✓ 04120120 04/11120 05111/20 2,680.00 TRAVEL LAB STAFFING P I AS -3 Ia 1 da� S'1'71 w1+.y 2557941 �i 04/20/20 04/1112005111120 2,760.00 TRAVEL LAB STAFFING L3Id5-3I31)6L7-) (1h4 VMv - 2556112 f 04/20/20. 04/11/20 05/11/20 2,760.00 TRAVEL LAB STAFFING 13�'i7Jr-'7j )'3IOda) SI4�M1IMAi,(n,_-. Vendor Totals Number Name Gross A0400 AUREUS RADIOLOGY LLC 10,612.00 Net 1.400.00 V � Not 1,400.00 Net 75.00 Net 75.00 Net 10.00 Discount No -Pay Net 0.00 0.00 10.00 Discount No -Pay Net 0.00 0.00 64.10 Discount No -Pay Net 0.00 0.00 64,10 Discount No -Pay Net 0.00 0.00 2,412.00 0.00 0.00 2,680.00 ✓- 0100 0.00 2,760.00 ✓' 0.00 0100 2,760.00✓ Discount No -Pay Net 0100 0100 10,612.00 file:///C:/Users/ltrevino/cpsi/memmed,cpsinet,com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 2 of 12 Vendor# Vendor Name Class Pay Code B1150 BAXTER HEALTHCARE „'� w Invoice# Comment Tran Dt Inv Ot Due Dt Check D' Pay Gross Discount No -Pay Net 74449431 yid 04/12/20 03/24/20 04/18/20 330.64 0.00 0,00 330.64 f ,. SUPPLIES 74520493 04/12/2003/30/2004/24/20. 461,35 0.00 0.00 461.35 ri SUPPLIES 7454$365 ,// 04/20/20 04/01/20 04/26/20 140.31 0.00 0.00 140.31 1/! §UPPLIE5 ✓ 74550664 04/20/20 04/01/20 04/26/20 110.91 0.00 0.00 110.91 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net Bi150 BAXTER HEALTHCARE 1,043.21 0.00 0.00 1,043.21 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC ✓ M Invoice# Clmment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 109810971 ✓ 04/20/20 04/06/20 05/01/20 455.52 0.00 0.00 455.52 SUPPLIES 109817544 / 04/20/20 04/11/20 05106/20 748.65 0.00 0.00 74&65 ,SUPPLIES 5456162✓ 04120/20 04/43/20 05/08120 5,016.58 0.00 0.00 5,016.58 MAINT/LEASE 109825807 / 04/20/20 04/13/20 05/08/20 1,438.84 0.00 0.00 1.438,84 yJ` SU PLIES I D9828031 04/20/20 04/15/20 05/10/20 308.58 0.00 0.00 308.58 SUPPLIES U 109827940 ,/ 04120/20 04/15/20 05/10/20 1.288.45 0.00 0,00 1,288.45 Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 9,256,62 0.00 0.00 9,256.82 Vendor# Vendor Name Class Pay Code 12324 BLUE CROSS BLUE SHIELD ✓- Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 041522A 04/20/20 04/15/20 05101/20 1,616.83 0.00 0.00 1,516.83 COBRA MAY 22 041522 04120/20, 04115/2005101120 214,483.59 0.00 0,00 214,483.59 PAYROLL DEDUCT Vendor Totals Number Name Gross Discount No -Pay Net 12324 BLUE CROSS BLUE SHIELD 2113,000.42 0.00 0.00 216,000.42 Vendor# Vendor Name Class Pay Code B1680 BOUND TREE MEDICAL, LLC a% M Invoice# Comment Tran Of Inv Ot Due Dt Check 0Pay Gross Discount No -Pay Net 84483150 ✓ 04120120 04/12120 04/12120 296.82 0.00 0.00 296,82 ✓" SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1680 BOUND TREE MEDICAL, LLC 296.82 0.00 0.00 296.82 Vendor# Vendor Name Class Pay Code 13992 CARIANT HEALTH PARTNERS „%-i Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1112 04/2012004/06/2/004/06/20 2,520.00 0.00 0.00 2,520.00 j TRAVEL NURSE STAFFING ( 3IaN_ 77111)?0-) FU(bt1.L) file:///C:/Users/ltrevino/cpsi/lnemmed.cpsinct.com/u88125/data_5hmp_cw5report287377... 4/21 /2022 Page 3 of 12 1364 04/20120.04/13120 04/13/20 2,520,00 0.00 0.00 2,520,00 TRAVEL NURSE STAFFING ( 41" 4Ih122)I YW& Vendor Totals Number Name Gross Discount No -Pay Net 13902 CARIANT HEALTH PARTNERS 5,040.00 0.00 0.00 5,040.00 Vendor# Vendor Name Class Pay Code 13336 COCA COLA SOUTHWEST BEVERAGES V/ Invoice# Comment Tran Dt Inv of Due of Check D Pay Gross Discount No -Pay Net 24165200735 b'' 04/21/20 04/06/20 05100120 -250.00 0100 0.00 -250.00 CREDIT 24165200734 �. '� 04/21/20 04/06/20 05/06/20 576.00 0.00 0.00 576.00 DRINKS Vendor Total$ Number Name Gross Discount No -Pay Net 13336 COCA COLA SOUTHWEST BEVERAGES 326.00 0.00 0.00 326= Ventlor# Vendor Name Class Pay Code 14404 CON -METAL CONCRETE, LLC ,/ Invoice# Comment TranDt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 042022 04/21 /20 04/20/20 W20/20 281.22 0.00 0.00 281.22 V / SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14404 CON -METAL CONCRETE, LLC 281.22 0.00 0.00 281.22 Vendor# Vendor Name Class Pay Code C2157 COOPER SURGICAL INC ,/� M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6193137 y/ 04/20/20 04/06/20 04/20/20 715.22 0.00 0.00 715.22 Vendor Totals Number Name Gross Discount No -Pay Net C2157 COOPER SURGICAL INC 715.22 0.00 0.00 715.22 Vendor# Vendor Name Class Pay Code 14400 CULINARY CONCESSIONS LLC ✓- Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV00005559 r - 0412012003/31/20 31,636.07 0.00 0.00 31,636.07 FOOD, SUPPLIES, CONTRACT f INV00005559 04/21120 03/31120 04/30/20 31,636.07 0.00 0.00 31,636.07 Vendor Totals Number Name Gross Discount No -Pay Net 14400 CULINARY CONCESSIONS LLC 63,272.14 0.00 0:00 63,272.14 Vendor# Vendor Name Class Pay Code 10509 DA&E ,: Invoice# ✓ Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 17675 04/21/2004/08/2004/08/20 1,540.00 0.00 0.00 1,540.00 CAH MEDICAREREIMBURSEM Vendor Total: Number Name Gross Discount No -Pay Net 10509 DA&E 1,540.00 0.00 0.00 1.540.00 Vendor# Vendor Name /Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net 41124 04/20/20 04/15/20 04/25/20 40,062.50 0.00 0.00 40,062.50 TRAVEL NURSE STAFFING (1-151k) Vendor Total, Number Name Gross Discount. No -Pay Net 11264 EMERGENCY STAFFING SOLUTIONS 40.062.50 0.00 0.00 40,062.50 Vendor# Vendor Name Class Pay Code file:/NC:/Users/Itrevinolepsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 4 of 12 `/ T0383 ERIN CLEVENGER W Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 041422 04/20/20'0`4/14/20 04/25/20 30.42 0.00 OW 30.42 V / TRAVEL Mj4WMA Or.IVNtIwN1 &vmkrUUF- 11111-L, Vendor Totals Number Name Gross Discount No -Pay Net T0383 ERIN CLEVENGER 30.42 0.00 0.00 30.42 Vendor# Vendor Name Class Pay Code 13872 ETHOS MEDICAL STAFFING Invoice# Comment Tran Dt Inv Di Due Dt Check D Pay Gross Discount No -Pay Net / 27509,/ 04/20/20 08/06/20 08/06/20 2.767.92 0.00 0.00 2,767.92 ,. ICU NURSE STAFFING (1,8,3-'I(e ila.�-� tbWAKtL , 27991 ✓ 0412O 20. 09103/20 0 10/03/ 2,865.20 0.00 0,00 2,865.20 C'� ICUSTAFFING L��aa _g�otg�al I l6tKli.- VA4. , 28098 04/20120 09/10/20 10/1010 2,715.48 0.00 0.00 2,715.48y,/ 1 ` ICU STAFFING ( {t I �q I - o) I4I 21 6j/AWL7 L- . 28219 04/20120 09/17/20 10/17120 2,780.30 0.00 0.00 2,780.30 ICU STAFFING (q jq, qj I t l Xt� fh(A((olk' 28336 04/20/20 09/24/20 10/24/20. 2,752.72 0.00 0.00 2,752.72 ICUSTAFFING �FIIaJ�i, el'CA14ak- VendorTotal:Number Name i Gross Discount No -Pay Net 13872 ETHOS MEDICAL STAFFING 13,881.62 0.00 0.00 13,881.62 Vendor# Vendor Name Class Pay Code C2510 EVIDENT M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net T2204081378 04/2012004/08120'05/03/20 33,757.89 0.00 0.00 33,757.89 r'+' Vendor Totals Number Name Gross Discount No -Pay Net C251D EVIDENT 33,757.89 0.00 0.00 33,757.89 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE f� M Invoice# Comment Tran DI Inv Dt Due Dt Cheek D Pay Gross Discount No -Pay Net 1353840 f 04/12/90 03/31/20 04/25/20 147.90 0.00 0.00 147.90 SUPPLIES 1450095 ✓ 04/20/20 03/22/20 04/16/20 317.96 0.00 0.00 _ 317.96 SUPPLIES 1406255 �%� 04/20/20 04/01/20 04/26/20 906.06 0.00 0.00 906.06✓ SUPPLIES . 1450094 ,.�/ 04/20/20 04/04120 04/29/20 637.37 0.00 0.00 637.37 �! SUPPLIES 1497016 +/04/20/20 04/05/20 04/30/20 23.26 0.00 0.00 23.26 SUPPLIES 1596949 V/04/20/20 04/07/20 05/02/20 604.48 0.00 0.00 604.48 SUPPLIES 1596947,,,- 04/20/20 04107/20 05102/20 1,587,56 0.00 0.00 1.587.5611 SUPPLIES 1690941 04/20/20 04/11/20 05/05/20 22.83 0.00 0.00 22.83 UPPLIEB 1740715 04/20/20 04/12/20 05/07/20 89,51 0= 0.00 89.51 ✓f /SUPPLIES 1740716 04/20/20 04/12/20 05/07/20 ✓ 161.50 0.00 0.00 161.50 SUPPLIES file:///C:/Userslltrevinolepsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 5 of 12 Vendor Totals Number Name Gross F1400 FISHER HEALTHCARE 4,498.43 Vendor# Vendor Name Class Pay Code 13960 G & S MANAGEMENT GROUP LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass 340384915 "� 04/20/20 04/12/20 04/22/20 371.15 TRASH SERVICE 340384914 / 04120/2004/1 PJ2004/22/20 1,392.76 TRASH SERVICE 340384948 x 1/' 04/20/20 04/13/20 04/23/20 260,55 TRASH SERVICE Vendor Totals Number Name Gross 13960 G & S MANAGEMENT GROUP LLC 2,024.46 Vendor# Vendor Name Class Pay Code 12404 GE PRECISION HEALTHCARE, LLC ✓ Invoice# Comment Tran Dt Inv Dt Due 01 Check D Pay Gross 6002095435 ✓' 04/20/2004101/2005/01/20 86.67 IMAGING CONTR 6002095632 „/� 04/20/20 04/01/20 05/01/20 868.16 IMAGING CONTR 6002095385 Li 04/20/20 04/01/20 05/01/20 680.00 IMAGING CONTR 60D2095434. 04/20/20 04101/20 05/01/20 8,588,58 IMAGING CONTR 6002095457,/ 04/20/20 04/01/20 05/01/20 5,665,83 MAINT CONTRACT APR 2022 Vendor Totals Number Name Gross 12404 GE PRECISION HEALTHCARE,LLC 10,889.24 Vendor# Vendor Name Class Pay Code G1001 GETINGE USA ✓ Invoice# Comment Tran Dt Inv Ot Due Dt Check Pay Gross 6991859593 :' 04/20/20 03/29/20 04/29/20 39,94 SUPPLIES Vendor Total, Number Name Gross G1001 GETINGE USA 39.94 Vendor# Vendor Name Class Pay Code W1300 GRAINGER w% M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 9269580594 �% 04/20/20 04/05/20 04/30/20 247.90 SUPPLIES Vendor Totals Number Name Gross W1300 GRAINGER 247.90 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY ' M Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross 2213413 ✓ 04/12/20 04/05/20 05/O5/20 856.28 Discount No -Pay 0.00 0.00 Discount No -Pay Oleo 0.00 0.00 0.00 0,00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay oleo oleo Discount No -Pay 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount Nu -Pay G1210 GULF COAST PAPER COMPANY 856.28 0.00 0.00 Vendor# Vendor Name Class Pay Code H1399 HILL -ROM COMPANY, INC M Net 4,498.43 Net 371.15 1,392,76 260.55 Net 2.024,413 Net 86,67 , 868.16 680.00 3,588.58 5.666.83 Not 10,889,24 Net 39.94 ✓ Net 39.94 Net 247.90 Net 247.90 Net 856.28 Net 856.28 file:///C:/Userslltrevinolepsilmenimed.cpsinet.com/u88125/data 5/tmp_cw5report287377... 4/21/2022 Page 6 of 12 Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross Discount No -Pay 2531730 .- 04/20/20 05/31/20 06/30/20 252.00 0.00 0.00 SUPPLIES 2547675 ,i 04/20/20 06/30/20 07/30/20 Net 252.00 126.00 0.00 0.00 126.00 W Vendor Totals Number Name Gross Discount No -Pay Net H1399 HILL -ROM COMPANY, INC 378.00 0.00 0.00 378.00 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 MMCWE040222 ,/' 04120/20 04108120 04/23/20 9,145.00 0.00 0.00 9,145.00 ✓f TRAVEL NURSE STAFFING (S)U-+-}fldlti� �'t 44`t.4 . Vendor Totals Number Name Gross Discount No -Pay Net 14316 JUNXION MED STAFFING 9,145.00 0.00 0.00 9,145.00 Vendor# Vendor Name Class Pay Code 14396 KING RANCH TURFGRASS. L,P. .y` Invoice# Comment Tran Dt Inv of Due Dt Check D- Pay Gross Discount No -Pay Net 01510 04/20/20 04/20/20 04/20/20 620.00 0.00 0.00 620.00 AMERISHADE GRASS V . Vendor Totals Number Name Gross Discount No -Pay Net 14396 KING RANCH TURFGRASS, L.P. 620.00 0.00 0.00 620.00 Vendor# Vendor Name Class Pay Code L0700 LABCORP OF AMERICA HOLDINGS � M Invoice# Comment Tran Dt Inv Dt Due Dt CheckDPay Gross Discount No -Pay Net / 7264580, / 04/20/20 04/02/20 04/270 15.00 0.00 0.00 15.00 ✓ LAB SERVICES / 72469693 ,,.; 04/20/20 04/02/20 04/27/20 36.29 0.00 0.00 36.29 f LAB SERVICES 72607987A✓f 04121/20 (14102120 04/27/20 79.25 0.00 0.00 79.25 LAB SERVICES Vendor Totals Number Name Gross Discount No -Pay Net L0700 LABCORP OF AMERICA HOLDINGS 130.54 0.00 0.00 130.54 Vendor# Vendor Name Class Pay Code 11796 LUDY'S FUDDRUCKERS RESTAURANTS Invoice# Com/mQnt Tran Dt Inv Dt Due on Check D Pay Grass Discount No -Pay Net INV00005456 ✓ 04/20/20 02/28120 03115120 26,193.96 0.00 0.00 26,193.96 ✓ FOOD, SUPPLIES, CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net 11796 LUBY'S FUDDRUCKERS RESTAURANTS 25,193.96 0.00 0.00 26,193.96 Vendor# Vendor Name Class Pay Code J1350 M.C. JOHNSON COMPANY INC ✓ M Invoice# /Comment Tran Dt Inv or Due or Check D Pay Gross Discount No -Pay Net 00390347 ✓ 04/20/20 04/08/20 04/20/20 95.33 0.00 0.00 95.33 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No•Pay Net J1350 M.C. JOHNSON COMPANY INC 95.33 0.00 0.00 95.33 Vendor#Vendor Name Class Pay Code M2178 MCKESSON MEDICAL SURGICAL INC `//' Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 19275008 / 04/13/20 04/12/20 04/27/20 83.84 0.00 0,00 83.84 SUPPLIES file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 7 of 12 19275021 v i 04/13/20 04/12/20 04/27/20 418.69 0.00 0.00 418.69 SUPPLIES Y Vendor Total: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 502.53 0.00 0.00 502.53 Vendor# Vendor Name Class Pay Code M2280 MEAD JOHNSON NUTRITION ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 993369801 y/ 04/12/2004104/2004/12/20 216.00 0.00 0.00 216.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2280 MEAD JOHNSON NUTRITION 216,00 0.00 0.00 216.00 Vendor# Vendor Name Class Pay Code 11612 MEDICAL AIR SERVICES ASSOC. ✓'r Invoice# ,Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1233766✓/ 04120120 04/15120 04130/20 1,588.00 0.00 0.00 1,588.00 v/ MAY 22 INSURANCE . Vendor Totals Number Name Gross Discount No -Pay Net 11612 MEDICAL AIR SERVICES ASSOC. 1,588.00 0.00 0.00 1,588.00 Vendor# Vendor Name Class Pay Cade M2470 MEDLINE INDUSTRIES INC M . Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 2204966109 y// 04/12/20 04102120 04127120 2,546.99 0,00 0.00 2,546.99 V/ SUPPLIES 2204956105 ✓ 04112/20 04/02/20 04/27/20 340,80 0.00 0.00 340.80. f SUPPLIES 2205124371 04/12/2004/04/2004129/20 26A6 0.00 0.00 26,16 SUPPLIES 2205124372 04/1212004/04/2004/29/20 1,291.14 0.00 0.00 1,291.14,/` SUPPLIES 2205124368 , / 04/12/20 04/04/20 04/29/20 12.22 0.00 0.00 12,22 SUPPLIES 2205124370 f 04/12/20 04/04/20 04/29/20 707.19 0.00 0.00 707.19 ./ SUPPLIES 2205124367 �' 04/12/20 04/04/20 04/29/20 114.02 0.00 0.00 114.02 .! SUPPLIES 2204956108 �' 04/12/20 04/12/20 05/07/20 29.40 0.00 0.00 29.40 r 2204756525 W% 04/20/20 04101/20 04/26/20 31,27 0.00 0.00 31.27 SUjPPLIES �,.-- 2205327982 v' 04/20/20 04/05/20 04/30/20 45.80 0.00 0.00 45.80 SUPPLIES 2205327981 Jam. 04/20/20 04/05/20 04/30/20 75.00 0.00 0.00 75.00 SUPPLIES 2205327979 �% 04/20/20 04/05/20 04/30/20 4,27 0.00 0.00 4.27 SUPPLIES 2205327980 ✓/04/20/20 04/O5/20 04/30/20 0.66 0.00 0.00 0.66 ✓ SUPPLIES 2205648494 yr' 04/20/20 04/06/20 05/01 /20 746.82 0.00 0.00 746.82 �..� SUPPLIES 2205548493 s� 04/20/20 04/06/20 05101 /20 185.96 0.00 0.00 185.96 f SUPPLIES file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 8 of 12 2205548495 ✓- 04/20/20 04/06120 05101/20 334.04 0.00 0.00 334.04 u,� SUPPLIES 2205645385 V / 04/20120 04/06/20 06/01/20 -20.65 0.00 0.00 -20.65 CREDIT Vendor Totals Number Name Grass Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 6,471.09 0.00 0.00 6,471.09 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC „% Invoice# Comment Tran or Inv Dt Due Dt Check D Pay Gross 8096334 �` 04/20/2004/13/20 D4/23/20 18.87 INVENTORY 8097723 1 j 04/20/20 04/13/20 04/23/20 38.68 INVENTORY 8095335 .l 04/20/20 04/13/20 04/23120 267.13 INVENTORY 8100777✓ ,. 04(20/20 04/14/20 04/24/20 210.30 INVENTORY 6822 1/ 04/20/20 04/14/20 04/24/20 -32.35 Discount No -Pay Net 0.00 0.00 18.87 �. 0.00 0.00 38.68 ✓� 0,00 0.00 267.13 0.00 0.00 210.30 v 0.00 0.00 CREDIT 8098104 �f` 04/20120 0014120 04/24/20 6,533.69 0.00 ,INVENTORY 8097921 04/20/20 04/14/20 04/24120 3.997.18 0.00 INVENTORY 8098580 f 04120/20 04/14/20 04/24/20 2,561,60 0.00 INVENTORY 6669 Z 04120/20 04/14/20 04/24/20-123.51 0.00 CREDIT / 8100776 „/ 04/20/20 04/14/20 04/24/20 31.05 0.00 INVENTORY Vendor Totals Number Name Gross Discount 10636 MORRIS & DICKSON CO, LLC 12,502.64 0.00 Vendor# Vendor Name Class Pay Code 14124 MSH HEALTH SERVICES LLC _/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount MM00061 ✓/04/20/20 04/04/20 04/19/20 6,463,75 0.00 TRAVEL NURSE STAFFING tala5-31bil Pfi) wVt�tW1x-- MMC0063 ✓ 04/2012004/11/2004126/20'J 5,425.00 0.00 TRAVEL NURSE. STAFFING (411- 4 ll fy) (h0llVtk jlL P-- MMC0064`,/ 04/20/2004/11/2004/26/20 2,960.00 0.00 T',iAVEL NURSE STAFFING (,141111' '\ MMC0065 ✓ 04120/2004/18/20051/03/20 \ 2,940.00 ��' 0.00 NURSE STAFFING L 41 Y - 41 2�! past `-' /TRAVEL MMC0066 04/20/20 04/18/20 05/03/20 5,463.75 ✓ 0.00 TRAVEL NURSE STAFFING tli%- 41Iglr3-) MM00062 ✓/ 04/21/20 04/06/20 04/21/20 2.940.00 0.00 TRAVEL NURSE STAFFING ('171 j - $l3il yy� Dµ,r- VendorTotalsNumber Name Gross Discount 14124 MSH HEALTH SERVICES LLC 26,192.50 0.00 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC ✓�- M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 0.00 0.00 0.00 0.00 D.00 No -Pay 0.00 -32.35 j 5,533.69,,- 3,997.18 ✓. 2,561.60 -123.51 31.05 V/J Net 12,502.64 No -Pay Net 0.00 5,463.75 0.00 5,425.00 ✓� 0.00 2,960,00 0.00 2,940.00 ✓ 0.00 5,463,75 W/ 0.00 2.940.00 1/f No -Pay Net 0.00 25,192.50 No -Pay Net file:///C:/CJsers/itrevino/cpsihnenimed.cpsiiiet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 9 of 12 8600661862 V' 04/20/20 09/03/20 10/03/20 916.51 0.00 0.00 916.51 ✓ SUPPLIES 8800888896'/ 04/20/2004/11/2005/11/20 1,00a.34 0.00 0.00 1,008.34 f' SUPPLIES Vendor Total -Number Name Gross Discount No -Pay Net M2659 MXR IMAGING, INC 1,924.85 0.00 0.00 1,924,85 Vendor# Vendor Name Class Pay Code 12388 NATIONAL FARM LIFE INSURANCE Y% Invoice# fCommenl Tran Ot Inv Dt Due Dt Cheek D Pay Gross Discount No -Pay Net 3666605 ✓ 04120/20 04/11120 05/01/20 4,001.31 0.00 0,00 4,001.31 PAYROLL DEDUCT Vendor TotalE Number Name Gross Discount No -Pay Net 12388 NATIONAL FARM LIFE INSURANCE 4,001.31 0.00 0.00 4,001.31 Vendor# Vendor Name / Class Pay Code 12316 NCS PEARSON, INC, I/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 17865B46 v' 04120/2004/01/2004/01/20 250.00 0,00 0.00 250.00 Wig SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 12316 NCS PEARSON, INC. 250.00 0.00 0.00 250.00 Vendor# Vendor Name Class Pay Code 11472 OCCUPRO LLC 11/ Invoice# Comment Tran DI Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 25607 v/ 04/12/20 04/07/20 05/07/20 48T47 0.00 0.00 487A7 MTHLY PROVIDER LICENSE Vendor Totals Number Name. Gross Discount No -Pay Net 11472 OCCUPRO LLC 487.47 0.00 0.00 487.47 Vendor# Vendor Name Class Pay Code 14252 OLOOP TECHNOLOGY SOLUTIONS Invoice# Comment Tran Dt Inv Dt Due Dt Check 0-Pay Gross Discount No -Pay Net INVAJONES0020 ✓ 04120/2004/05/2004/05/20 6,184.75 0.00 0.00 6,184.75 ' TRAVEL NURSE STAFFING ju'a INVAJONES0019 VX 04120/20 04105/20 05105/20 6,184.75 0.00 0.00 , 6,184.76 TRAVEL NURSE STAFFING jla5' 5131 ) TZ'J {<LS Vendor Totals Number Name Gross Discount No -Pay Net 14252 OLOOP TECHNOLOGY SOLUTIONS 12,369.50 0.00 0.00 12,369.50 Vendor# Vendor Name Class Pay Code 01500 OLYMPUS AMERICA INC r,/� M Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount Nu -Pay Net 32481747 / 04121120 04/07/20 05102/20 1,137.51 0.00 0.00 1,137.51 ✓� LEASE Vendor Total, Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 1,137,51 0.00 0.00 1.137.51 Vendor# Vendor Name class Pay Cade 01416 ORTHO CLINICAL DIAGNOSTICS / Invoice# Comment Tran Dt Inv Dt Due Dt Check D. Pay Gross Discount No -Pay Net 18123391611 f 114,20/20,13/28/2004/27/20 752.16 UPPLIES 0.00 0.00 752.16 Vendor Total[ Number Name Gross Discount No -Pay Net 01416 ORTHO CLINICAL DIAGNOSTICS 752.16 0.00 0.00 752.16 Vendor# Vendor Name Class Pay Code file:///C: /Userslitrevino/cpsilmemmed. cpsinet.com/u8 8 l 25/data_5/tmp_cw5report2873 77... 4/21 /2022 Page 10 of 12 10152 PARTSSOURCE, LLC ✓/ Invaice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 4300806 ��! 04/20/20 04/04/20 05/04/20 89,38 Discount No -Pay Net 0.00 0,00 89.38 L,% 04300265 04/20/20 04/04/20 05/04/20 48.65 0.00 0.00 48.65 ✓' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10152 PARTSSOURCE,. LLC 138.03 0.00 0.00 138.03 Vendor# Vendor Name Class Pay Code / 11080 RADSOURCE ,J Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net SC32090522r/ 04/20/20. 04/1212005/07/20 1,791.67 0.00 0.00 1,791.67 1/ SERVICE AGREEMENT SC13756 a/' 04/21/2003/22/2004/16/20 1,791.67 0.00 0.00 1,791.67 CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net 11080 RADSOURCE 3,583.34 0.00 0.00 3,583.34 Ventlor# Vendor Name Class Pay Cade 12436 SHANNA O'DONNELL, FNP Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 2161637 0412012004/19/2004/25/20 1,299,00 0.00 0100 1,299.00 IJp1110(k OWa lluu+r7<4 (?Vvrtxi IlnetUL#_e (Lkvat(OS Ip6lucim aad-*u ,) Vendor Totals Number Name Gross Discount No -Pay Net 12436 SHANNA O'DONNELL, FNP 1,299.00 0.00 0.00 1,299.00 Vendor# Vendor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES ✓ Invoice# Commen Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 56382200030297 04/20Y2O 04/02/20 04/22/20 4,038.24 0,00 0.00 4,038.24 L! LEASE Vendor Totals Number Name Gross Discount No -Pay Net 10936 SIEMENS FINANCIAL SERVICES 4,038.24 0.00 0100 4,038.24 Vendor# Vendor Name Class Pay Cade 11296 SOUTH TEXAS BLOOD & TISSUE CEN Invoice# C/omment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 107021879 04/20/20 04/15/20 05/10/20 ✓ 4,094.00 0.00 0.00 4,094.00 j BLOOD CM6782 y/ 0020/2004/1512005110/20 -1,896.00 0.00 0.00 •1,896.00 CREDIT Vendor Totats Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 2,198.00 0100 0.00 2,198.00 Vendor# Vendor Name Class Pay Cade 13528 STRYKER FLEX FINANCIAL ./ Invoice# , Comment Tran Ot Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 246940 04121/2004/12/2005/1 PJ20 1,294.26 0.00 0,00 1,294.26 ✓` LEASE Vendor Totals Number Name Gross Discount No -Pay Net 13528 STRYKER FLEX FINANCIAL 1,294.26 0.00 0.00 1,294,26 Vendor# Vendor Name Class Pay Code 12476 SUN LIFE FINANCIAL Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 010121 04/20/200U01/2D 02/01/20 2,484.03 0.00 0.00 2,484.03 file:///C:[Userslltrevinolepsilmemmed.cpsinet.com/ti88125/data_5/tmp_cw5report287377... 4/21 /2022 Page I of 12 PAYROLL DEDUCT Vendor TotalE Number Name Gross Discount No -Pay Net 12476 SUN LIFE FINANCIAL 2,484.03 0.00 0.00 2,484.03 Vendor# Vendor Name Class Pay Code I 10758 TEXAS SELECT STAFFING, LLC ✓� Invoice# Comment Tran DI Inv Dt Due Ot Check D- Pay Gross Discount No -Pay Net 001962951079IN ✓ 04/20/20 03/30120 03/31/20 4,042.50 0.00 0.00 4,042,50 pIlq-'b)all Aa)%'j, 0019695510791N �.�� 04120/20 4,042.50 0.00 0.00 4,042,50 (;)Aq-3'31j??_) jibLhK.L. �f / 18995CM✓ 04/21/20 03109/20 03/10120 -4,115.10 0100 0.00 .4,116.10 r� CREDIT Vendor Totals Number Name Gross Discount No -Pay Net 10758 TEXAS SELECT STAFFING, LLC 3,969.90 0.00 0.00 3.969.90 Vendor# Vendor Name Class Pay Code 14224 THE TACT CORPORATION OF NYC / ' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9266704313/ 04/20/2004/01/2005/01/20 6,228.00 0.00 0.00 6.228.00 L' TRAVEL NURSE STAFFING(3INkijLz) reg1e, / 9266704456 ,/ 04120/20 04/06/20 05/08120 6,228.00 0.00 0.00 6,228.00 �..% TRAVEL NURSE STAFFING (g)p�) �) �) 4%} to 11.. 9266704588 04/20/20 04115/20 05/01 /20 6,228.00 0.00 0.00 6,228.00 ✓/ ✓ TRAVEL NURSE STAFFING 41111 C'Qq le. Vendor TotalE Number Name Gross Discount No -Pay Net 14224 THE TACT CORPORATION OF NYC 18,684,00 0.00 0.00 18,684.00 Vendor# Vendor Name Class. Pay Code 14372 TRIAGE, LLC , / Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net INVI796403400 ,/ 04/20/2003129/2004/15/20 4,212.00 0.00 0.00 4,212.00 Z' STAFFING 13�I-31111z�) shams Vendor Totals Number Name Gross Discount No -Pay Net 14372 TRIAGE, LLC 4,212.00 0.00 0.00 4,212.00 Vendor# Vendor Name Class Pay Cade T3334 TRINITY PHYSICS CONSULTING LLC J/ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 035367 ✓ 04/12/20 04/06/20 05/06/20 660.00 0.00 0.00 660.00 PORTABLE EVALUATION Vendor Totals Number Name Gross Discount No -Pay Net T3334 TRINITY PHYSICS CONSULTING LLC 660.00 0.00 0.00 660.00 Vendor# Vendor Name Class Pay Code 14208 TRUSTED HEALTH, INC i,// Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net INV9308 r,/' 04/2D/20 04/02/20 05/02M 9.970.00 0.00 0.00 9,970.00 TRAVEL NURSE STAFFING INV9309 V/ 04/20/20 04/09/20 05/09/20 5,657.50 0.00 0.00 5,657.50 TRAVEL NURSE STAFFING Vendor TotalE Number Name Gross Discount No -Pay Net 14208 TRUSTED HEALTH, INC 15,627.50 0.00 0.00 16,627.60 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report287377... 4/21 /2022 Page 12 of 12 8400392193 L/ 04/12/20 04/11/20 W06/20 2,346.77 0.00 0.00 LAUNDRY 8400392168 ✓ 04/12/20 04/11/20 05/06/20 45.15 0.00 0.00 LAUNDRY 8400392169 �/ 04/12/20 04/11/20 05/06/20 56.82 0.00 0.00 LAUNDRY 84OD392467 �/ 04/20/20 04/14/20 05/09/20 198.59 0.00 0.00 LAUNDRY 8400392511 ✓% 04/20/20 04/14/20 05/09120 1,614.52 0.00 0.00 LAUNDRY 8400392488 ✓' 04120/20 04/14/20 05109120 163.74 0.00 0.00 LAUNDRY 8400392489 / ✓LAUNDRY 04/20/20 04/14/20 05/09/20 193.01 0.00 0.00 8400392486 v/� 04/20120. 04/14/20 05/09/20 42.82 0.00 0.00 LAUNDRY 840031124110 04/20/20. 04/14/20 06/09/20 199.32 0.00 0.00 L AUNDRY 8400392526✓ 04/20/20 04/14/20 05/09/20 103.78 0.00 0.00 LAUNDRY 8400392503 ✓ 04/20/20 04/14/20 05/09/20 80.90 0.00 0.00 LAUNDRY Vendor Total: Number Name Gross Discount No -Pay U1064 UNIFIRST HOLDINGS INC 5,045.42 0.00 0.00 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 9111145138 / 04/20/20 04115120 05/10/20 1,571.67 0.00 0.00 CONTRACT Vendor Total: Number Name Gross Discount No -Pay 11110 WERFEN USA LLC 1,571.67 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 585.632.49 0.00 0.00 APR 21 2022 G= �i pns 5135, 0, ° 49 31,656°U'r 2,346.77 45.15 56.82 v 19B.59 v'� 1.614.52 ,r/ 163.74 -1-1 193.01 42.82 ✓ 199.32 ✓ 103,78 80.90 Net 5,045.42 Net 1,671.67 Net 1,571.67 Net 685,632.49 131, h34 U7} file:///C;/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report287377,.. 4/21 /2022 flUCEIHAIc COUNTY +.I'IITi UK CORPORATE CAR® APR 21 2022 Account Statement Ceea0001 Card Axoant ROSHANDA S THOMAS ® Account Inquiries: CAI.I-10Uh1 + r) I�lt Fl AS Toll Free; 1-(800)-246AS 3 International: 1-(904).954.7314 Account Number: XXXX-XXXX-XXXX TDDnTY: 1-(877)-505.7276 Send Notice of Billing Errors and Customer Service Inquiries to: CITIBANK, N.A., PO BOX 6125, SIOUX FALLS SO 57117.6125 Transactions Uaen Havance Limn $U Statement Closing Date 04103/2022 Days in Billing Period 31 Post Data Trans Oat. MCC Reference Number oeacriptionfLocatlon Amount """"""""""' NOTICE MEMO ITEM(S) LISTED BELOW ""••'•"......•••. 03108 03/(117 6943 82711162067000001092234 1 SPECIALISTID.COM MIAMI FL 33155 USA a/247.23 03l10 03/09 9399 05134372069600033111192 2 CMS MEDICARE APPLIC FE 410-786-1663 MD 21244 USA ��31.00 iJ 15370723363465171 03/11 03110 9399 05134372070600033867071 3 CMS MEDICARE APPL(C FE 410-786.1663 MD 21244 USA ✓631.00 11524508587929939 03118 03116 W40 52704872076722481376234 4 HYATT REGENCY SAN ANTO 8885874589 TX 78205 USA Y 883.59 '— 41705940 CHECK IN: 0311W022 03/29 03/28 8299 $6436872088130882727696 5 EIMEVIOENCE IN MOTION 502-4427697 KY 40223 USA V&.00 47 437942 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION s®UL1a CITIBANK N.A. CII T6r PO BOX 6125 SIOUX FALLS SO 57117-6125 ROSHANDA 5 THOMAS 202 S ANN ST PORT LAVACA TX 77979.4204 Page / of 2 ipi Hr-)Vaj Up APR 21 2022 6Y COUNti Y AUDITC)a CAI}ipUN COUNTY, TEYAS Account Number XXXX-XXXX-XXXX Statement Closing Date April 03, 2022 Not an invoke. For your records only. 00007905040 • RePmt a lost Or Stale"Cord lmmedyi Ourtelephme linmme Op.o CVory day, 24 hauM o day. Call lh¢Cusmmer Servoe te,epbono numberspaested on the ifteri the 91Omme if to report a 10.1 or I toMn CM Corporate Cold. • Cardholder Crndlf Llno, Each Cardholder has on rdNMWal Crudlt Lino(n parson of which may be used to, Cash Advances), which Is the maximum amount that the Cardhmat can charge at cosy fate. The site Ot each Camhom.1c Crack Line (and Cash Limit. N any), Is detalmined by the Company end la o Fast]. of in, lots, Company Cradle Lino. • To rareese or Sealboale o cam,mmy or Cmdho/dor Credit Lino. The Company may oquast Changes to ends lines by connecting Cm Corporate card Customer Sm0CQg Our telephone lima an Open every day, 24 hours a day at the telephone number spaciled on Postal the mamment. Additional Camookfame: The Company may request applications fro additional Cardhaldem byountading Ctl Corpora le Card Sem,'ce. Ouralephone inm era open ovary day, 24 hours a day at the telephone number sarrested on the front mi the etammenl Limit ante Cie Cmpoole Card per Cmdheltlm. 01d R-Werr 6Online Tool; You can newly manage gout C10 Corporate Card online using the CMManagcr online lool. CtiManager enables you to manage bu•inea6 expenses from anywhere Around the globe from yourcomputor or mobile twice; you can view emlmm nt. online as well as conall, account balances. To QgWto, for ChiManagar, gleam lag on to wwwqXI m" in and slick an the 'Self mg um min for CemholderY IIM. From there, f o, the prompts to establish your account • Payme0m: YOU may make A Payment to your UUMIdUally, billed Cad account COCA Were CIIiManagee Pieces nma that came argxnuadons do not Inma Me Oftwimager 0"Iro payment mature enabled Car Cardh0ldess, It paying by mall, plomo aiow $U ickntmatIngtimo, ROOM writ year account number on the front of the check, For centrally billed aocounto, please an sure to send an Company check as payment lot all Ceramicist balances. It we receive your maXed payment In proper farm at our prncrosrg 4011y W 6:00 p.m. Eastern Time, a wXl be credited as of that day. Payment. Can also be made by elegronm fund transfer, wife transfer. ACH lrandar, direct Cobs, and Other mathods, Call The number on the front of this statement for worm c. • Camp.py, RmPstami/on: By as payment of any amounts charged m the Aemuig,me Company: (I) ratites the original Application low the Account and the authorih of all parsons at the a., of their signing such Application, and (if wuthmime me Continued tea of the Account under the terms of The Corporate Card Agreement by all Cardholders to Wham Castle am bound. $Nets# rformaflm m 0mh Advances: Cmdhoidan may got a Cash Advance at aw r 160,00 locations worldwtde. • The Cardholdmfa Cash Ativonce Limit is a pad of the Cardholder's Total Credit Line. It la not an Wedbnd the of Cant. • For Caoh Advmnccs from ATM,, a .epa.m Pmeanal Idoirthosten Nestor (PIN) Is focused for aocurXy, purposes. Delinquency Fee: My Amount will be delinquent unless the Bank ocabm the amount shown an the bIDkg statement es the balance dus, less any disputed charge, by the payment raw dam. The Bank will show any unpaid pmian M Ina balance due as a paatdue balance an subsequent Calling statements. it any ponbaof the past due Infante apponn on bro commOCUMO 1,111aq statements (approximately 56-60 days after rho billing cycle date), I agree to pay a deiinquenay foe moody based on a percmmge ortW minim past due balance untllmy payment m neeNed by the Bank. A late foe may alma bo imposed mmihly uniP payment for m0 past due balance Is receertd by the Bank • In Case of Ermra or Qd"cns About your Sig: you am res;a0male for Initiating • In the Coke, taus, phrase explain in dotail0 a dispute ad INC reaults al Ind Me dispute resduuon pr... go g year Aeeount statemmtlialeehagas Chat you bell&. Btlompt of resales It with the mmcWnt The letter must include the ameanl Olt unauthorized, incorrect, ice MO,CWndim that has not bean mooned, or (or returned merehandma.You should also litam the P.mee X your Amount Statement InV.NBd, and must be signed by Iho IndlVldual Cardhoder, We will 0-111"ou of the raeulla at ACT efforts, Inconeetly lots a coeds as a charge or N a credit, for which you have been Issued a • It you returned mcrch.ra ice and ocehad a credit slip which has not yet coda slip. Is not shown. To begin the dispute nealueon process, ise been pasted, pmmOelt. 30 days tram the data ft . issued. It It has net dtimanaaer eanvloafn. Wan posted to the Aceeml by than, fomerd a copy of the Cmditalipto us • YOU may also dispute a transaction by writing m M. you may was to us on a at the liNh9dopme add.. spealmol on the front of the elatemenl.AINm, seperote sheet at the address upeaMet on the front of this dotemont es soon m with the copy Of the Credit slip plesa0 Include a letter (signed by the tntlNklual CemholdeQ smd0g that mats Was not omtmtl. Ir a Credit slip possible, Please newly m no later than 60 days after me data of Oe bill On watch the error Of problem pnld letter please p ppoa us the o: Woe not Issued, pro.. rdgWat da. bran the melahanL II the mmekaal account n • the name and amount number. For centrally billed Company Acrounts, cam d Company fiam. The Company name antl Imospocal account number, refuses, pleamwebe m us and explain the detaPs. On nonANpumd..tars or any leaser ah¢wn by (0, Bank cat to be In osoc • The dollar the AfmWMnter of Imp Plat CIA • theo ut antl molar" Iln omen I1.Ne error; N more Inlormo110n error, the Bank may charge the Company or Cardholdef the fee smound In me Corporate Card Agreement for each copy dl any document the Is needs Is n0¢tlM about an Xam, ateasa deaerlhe x 1e ue. A Company or Cmdhokvr aqumts, such ao duplicate period[. sraarm,ft .. Bank rinds you amponscle =a unsuccessful In coming we quality of ;old, We may be able Page 2 of 2 mcall . MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (361) 552C41 0�312�,_ 1' Vendor Name: 1 i b`Vhk Vendor Address: Vendor Phone #: Vendor Fax #: Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (361)5552-0312 Date: 1 5-/ Pa- P.O. # Account # . Initiated Form # 9401 Date Required Expense# Depa[tment Deliver To Line Qty. Catalog Number No, Descripfiort Unit Cost Unit Meas. Extended Cost t o. t ales I D. —-7 -3 z 2472'3 s Ui1 + yl (o,��•f7 631 e A/tcl it c (Y�tvl 4 883. 59 .E b00.00 5 G S dul��cA (03 . 6 -(eke -a C GS. oltl ics g II� m i �J C64 c << �y� �r N n+n°0 iI.(tr YIS-i�'+-�-slit, A� j��pI�OAM� / 1•��, 10 I V, 44fI1 0 W4, Nr11'FS• Est. Freight Est. Total Cost TOTAL COST % jj 1. 01 ' Contact: Quoted By: Buyer. Date: E.T.A. Dept. Director Dir. Nursing Dir. Clinical Services MSKESSON STATEMENT As nt: 04/22/2022 Page: 002 TO swum Proper cre nt to your accourd, detseh and return this m=wn: e000 stub with yow mmi tence DC: 6115 MEMORIAL MEDICAL CENTFA As of: 04/22/2022 Page: 002 Man tw Own: 8000 AMT DUE REMITTED VIA ACH DEBIT Territory: 815 N VIF13INIA STREET statement for Information only ANT DUE AWITT® VIA ACH DEBIT PORT LAVACA TX ]]B]8 Cuslomen 632536 Statement for Information only Date; 04/23/2022 Oust: 632536 PLEASE CHECK ANY Ost. 04/23/2022 ITEMS NOT PAID (r) l Account Wipe Date" e D �MNw NumberReference Description OluouM Amount P (grew) F Amwmt P Resolvable (wt) F Number PF column legend: P = Pan Ow Item, F = Future Due Item, blank = Curren Due Item TOTAU Nnlonal Add 832536 MWOMAL MEDICAL CENTER Subtnele: 6.526.70 USE) Future Due: 0.00 Pen Ow: If Paid By 04126/2022, Ow n PaM On Time: USD 6.396.20 0.00 Pay This Amount: 6,396.20 LED Dix log P Palo and; Leg 2,451,9] 11 Paid After 09/26/20R2, 30.56 Dw II Paid Late: 08/O]12017 /201] Pay thle Amount: 6.526.76 LED LED 6,626.76 44.66 5. 195''8:5 280.60 1 875. 11 6,39.6. 2u ,: AMOVEDON APR 25 2022 f3Y COUNTY AUDITOR CALHOUN COUNTY, T W8 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As d: 04/22/2022 Paget Lot To whom,proper dead to year aaoum, tlalwh and mt.this c pmr: soon mwHub with your mittee DC: 8115 CVS PHS Ao of: 04/22/2022 Page: 001 Mall I. Camp: 6000 MEMO�CYRIAL MEDICAL IAL MEDICAL CH4TFA CENTER AMT DUE REMITTED VIA ACH DEBIT Territory: 400 VICKY KALISIX Statement for Information only AMT DUE F@AITTm VIA ACH DEBIT 615 N $15 N IA Customer 262252 Statement for Mhurallon only AVACVIRGI FONT IAVgCA TX ]]9]9 Date: 04/23/2022 Cud: 202262 PLEASE CHECK ANY Dale: 04/23/2022 ITEPAS NOT PAID (�) Date Due NRemmemumner"Peouna: Acceun[ iyTa Cash Amount P AmeaM P geplvabk 1 Data Date Number Referowe Description Discount (groea) F Portl to Number Codomer Number 262252 CVS PHCY 7006/MFMORIA PHS 04/20/2022 04/26/2022 7337364172 1659127 11SInvolee 0.91 45.57 44.66 /✓ 7337364172 O PF oolmnn legentl: P = Pod Due Item, F = FWma Dun Item, blank = Current Due Item TOTAL' Customer Number 262252 CVS PHCV 7006/MEhl MS Summalc 45.67 USD Rauh Bud 0.00 Due If Pald On Time: If Paltl By 0412612022, USD 44.66 Pent Dun: 0.00 Pay This Amount: 44.66 USD Din feet 6 Pala lets: ✓ laH Payment 8,901,37 If Paid Attu 0412612022, Oee If Paid late: 0.91 09/18/2022 Pay this Amount: 45.57 USD USD 45.57 ► { , `L--L-� For AR Inquiries please contact 800-867-0333 MWESSON smear: emo WALMARI' 1098/MEM MEO PHS MEMORIAL MEDICAL CENTER VICKY HALLOW 815 N VIRCINIA ST POW LAVACA TX 77979 STATEMENTAs of: 0412=022 Pager Out To ewuro proper creditto your account. Mach arld return this 90 With your remlbance, Dc: ells As or: 04/22/2022 Pape: 001 ALIT DUE Hall VIA ACH p®1T Tamory: 400 l Mall to: Comp: 3000 Statement tar infowellon only AMT DUE REMITTEDVIA ACH DEER Cumamen 256942 Statementfor Intonation only Date: 04/23/2022 CM: 256342 PLEASE CHECK ANY Data: 04/23/2022 ITEMS NOT PAID (0) Date Dot Number Account bTJfy96 Cnh (gam) F A P Retthabk Dale Data Number Reference Oeurlptkn Discount M F Number Customer Number 256342 WALMARR 1098/M@6 MEU MS OV18/2022 04/28/2022 7336836713 30484732 1161nvaice 2.31 115.38 04/18/2022 04/26/9022 7336836714 3D518196 1151nvoice 2.81 140.53 113.07✓ '� 7336836713 04118/2022 04/26/2022 733683671E 30568328 1151nvolce 5.80 289.91 137.72 7336836714 04/18/2022 04/26/2022 7337047083 0415220813 1951mmice 0.05 2.53 284.11✓ 2.48✓ 733683671E 04119/2022 04/2MO= 7337132361 30802600 115invoke 16.90 848.78 891.00✓ 7337047083 04/19/2022 04/26/2022 7337132302 30802600 1151nvoico 7,89 394.50 7337132351 04/19/9022 04/26/2022 7337282043 0418221016 1151nvol" 2.62 128.70 386.61/ 7337132362 04/20/2022 04/26/2022 7337384260 30874525 1151nvolce 8.46 422.89 123.26✓ 7337202043 04/20/2022 04/26/2022 7337384251 30232699 1151nvolce 414IA3✓ 7337384250 04/21/2022 04/26/2022 7337622972 30989763 1151nvoice 0.01 0.16 0.16,/ 7337394251 04/21/2022 1141265!022 7337622973 31051596 1154w.en, 0.33 0.32✓ 7337622972 04/21/2022 04/26/2022 7337774383 0420220835 1151nvolce 25.98 0.16 0,16,/ 7337622973 04/22/2022 W26/2022 73379t9239 31108147 1151nvmce 1.298.97 1.272.99 ✓ 7337774333 04/22/2022 04/26/2022 7337919240 311692224 1151nvolue 8.50 22.77 424.88 1,138.69 416.38 7337919939 04/22/2022 04/26/2022 7337919241 31169224 1151mvoke 0.01 0.32 1, 116.92 ✓ 7337919240 04/2W2022 04/96/2022 7337919242 31185206 115Invoice 1.11 55.32 0,31 ✓ 64.21 ✓ 7337918241 04MW2022 04/26/2022 7338067523 0421220848 1951nvalce 0.80 73379192242 42.76 41,90 7338067523 PF column e9enm P = Not Ow Item, F = Future Ow Item, blank : Current Due Item TOTAL• Customer Number 256342 WALMART 1098/MQA MED PH9 Subtotals: 6,301.99 USD Mum Due: 0.00 /,1� �l V - pus N laid On Tlme: Pact Due, 11 Paid By 09/2BMe022, USD 5.105,83 0.00 Pay This Amount: 6,195.63 USD Disc had N Paid We: Lain Payment 8,901.37 11 PoW Ater 041a6/2022, Dw II Paid 06A6 lab: 01/19/2022 Pay this Amount: 5,301.89 USD USD 5.301.89 APPAWDON APR 25 2022 For AR Inquiries please contact 800-867-0333 9Y000NWAUMOR CALHOUN COUNTY. TEXAS MSKESSON STATEMENT As W: 04/22/2022 Paga: 001 To ensure prefer foods to your acceum, de rch and mtum this 0 Prl:eODD stub with your mm„tenou DC: 8/15 As of: 04/22/2022 Page: 001 HIM My FC 490/MBA MC PHS AMT DUE REMITTED VIA ACH OMIT Temrary: 400 Mau to: Comp: 8000 MEMORIAL MEDICAL CENTER KAUSEX Statement for Inionnallon only AMT DUE REMITTED VIA ACH DEBITVICKY 815 N VIRGIAVAC IA ST Cualomm: 484460 Statement for Information only WRT IAVACA T% 77979 Dale: 04/23/2022 Cush 464460 PLEASE CHECK ANY Data: 04/23/2022 ITEMS NOT PAID (1) 011ng D. Number Retueram DRaealvabIl"Homal Auoum 196 CashAmounl P Amount P Ilauivabb Date Datescription Discount (grow) F (net) F Number Customor Number 464460 HIE MY FC 490IMFM MC ME 04/19/2022 04/26/2022 04/19/2022 7337110721 55x451609 1151nvole. 5.09 254.26 249.17 ✓ 7337110721 04/26/2022 7337110722 5SX451012 1151nvoice 0.30 14.05 14.55 ✓ 7337110722 04/19/2029 04/2612022 7337110723 55x451770 1151nva(ce 0.34 17.22 16.88 ✓ 7337110723 PF ouNmn legend: P = Peet Due Drum, F = R4um Due Item, Manic a Cement Due Item TOTAL Cumomvr Number 984950 H® PHY FC 990/MfE MC PHa Subtolah: 296.33 USD Future Due: 0.00 Duo If Pea On Tlma: 11 Paid By 0412612022, USE) 200.60 Put Due: 0.00 Pay This Amount; 280.60 LED Dleo loaf K pald late: Lest 6,901.37 N Attar O4@e/2022, 5.73 Due If Paltl Cato: 04/1B/2022 /2022 y this Pay Chic Amoum: 288.33 USD U30 268.33 lNPp MON APR 25 2022 BYCOUWYAU01TOR CALHOUN COUMY, TOM For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT Cr.,': aaoo CVS PHCY 7475IMM MC NO ANT DUE REMITTED VIA ACH DEBIT MENIMAL MEDICAL CENTER Statement for information only VICKY KALISSK 815 N VIRGINIA ST PORT IAVACA TX 77979 As at: 04/22/2022 Pown 001 To resume Proper emit to your account, tlesch and mtu n this Mob with your romlttesa DC: 8115 As at: 04/22/2022 Page: 001 Territory: 400 Mall to: Comp: 8D00 ANT DUE IRT® VIA ACH DEBIT CustomerCuCustomer835438 3tetemant tar far Information only Data: 04/23/2022 Cum: 035438 PLEASE CHECK ANY Drum 04/23/9099 ITEMS NOT PAID (s) BI01ep Due PawWa6l�etiwei Account �98 Cent Amount P Amount P BSNvabb Data Date Number Rdemnce Description Obscure (grow) F (trot) F Nmnber Customer Number 836430 CVS PNCY 7475/MS7A MC WE 04/20/2022 04/98/2D22 7337655845 1659575 1151nvoice 17.86 892.97 875.11 ✓ 7337566845 PF wtu leaned: P e Pest Due Item, F . Fulum Due Item, blank a Correct Due Item TOTAL Cudomar Number 835438 CVS PNCY 7475/MW MC WE SuMMaN: 892.97 USD FIAure Due: 0.00 Due If Paid On Time: It Past By 0412612022, Uso 875.11 Pad Due: 0.00 Pay This Amount: 875.11 USD Dis loot 8 paltl late: 7AS bm P2022M 0,901.37 If y this Amft. unt: 2042, Due If Pont taus: 04/18/2022 Pay ihle Amount: 892.97 USD U30 882.87 APPROVEDON APR 25 2922 BYCOUNiYAL)WOR CALHOUN COUNTY, TM8 For AR Inquiries please contact 800-867-0333 AmerisourceBe en' STATEMENT Statement Number: 62896331 r9 Date: 04-22-2022 1 of 1 AMERISOURCEBERGEN DRUG CORP WALGREENSe12494340B 1001362841=028180 1270 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER SUGAR LANDTX 7747MI01 1302 N VIRGINIA ST PORT LAVACATX 77979.2608 DEA: RA0289276 Set-FOOteln7daya 868461-9656 AMERISOURCEBERGEN P.O. BOX 905223 NC 2029D5223 Not Yet DowCHARLOTTE 00 . 000 Cunene: 82.49 Peel Due: 0.00 Total Due: 629.49 Ac.9 Balance: 629AO Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 04-18.2022 0429.2022 $089958879 165550 Invoice 2.45 0.0 2.45 W-0&2022 04-29-2022 3089059010 106561 Invoice 0.29 0.00 0.29 04-16-2022 0429-2022 W90000966 185599 Invoice 40.85 0.00 40.88 ON0-2022 04.29-2022 3090000989 165600 Invoice 10.48 0.00 10.4E 0419-2022 0F29-202 309012180E IM607 Involm 208.09 0.00 208.09 (W21-2022 042041)22 309W13441 165622 Invoice 6,1.62 0.00 W.62 , (W22-2022 We-= 30SM7639 loom Invoice 302.42 0.00 3MA2' 04-2D2022 04.294022 3090657980 165633 Invoice 0.09 0.00 0.09 Current 1-16 Days 16-30 Days 31-60 Days 6140 Days 81-120 Days over 120 Days 82B.4B 0.00 0.00 0.00 0.00 0.00 0.00 Thank You for Your Payment Reminders Date Amount Due Date / L // 1 iI Amount 04-22-2022 (208999) 04-29-2022 �I f Total Due: V 620.49 629.49 ` APPROWDON APR 25 2022 BY COUNiYAUDROR CALNOUN COUNTY TOLL FEE PHONE NUMBER: 1-800-SSS-3453 (EFTPS TUTORIAL SYSTEM: 1.800-572-8683) F7"ENTER 9-DIGITTAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" [7"MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" E"IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 15T QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR -12 (DECEMBER) -Oct, Nov, Dec El "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" E_T6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER #qx# ENTER: 0 $ 129,263.56 1 $ 64,311,42 $ 15,040.48 $ 49,911.66 CHECK: C� CALLED IN BY: CALLED IN DATE: CALLED IN TIME: FAAP•Payroll Files\Payroll Tazes12022VQ R1 MMC TAX DEPOSIT WORKSHEET 4.25.22.xis 412512022 PSi...:AL F:E7iC:.:._ 7.•E4 1! PB7xa _ .E S :..--....._f-. �Cesc^oc'ar. Pe,:d ............................................................ crs - 3EGU<_a3 ?F.Y•S! 1769.+70 :: :I :I P %EG7XI PAY -St 231E.75 N., N E::}_. PAY .. N .. %EG�:3S FA'i•S:. .5E.2i ? ;i ti ! %EGU'-;P, PAY_c3 c5.75 `J .. CAL. 2 DNBLE -:ME .. D.7EA XMS •.•• fR:iA. 4r- _ MC.", CFP.'P_ - fAIJ ��iC{'fC 2i J.37 :1 a .. a ?am-T'ISE-eee 15=s.o9 ➢ a n ? CFC p PAID FEE OFF - "30SMON 49.0 11 : :1 11 I .................... n i4]-Cisie: 2Ci-03.c ...... c I :heCRe C1194:• 27 E52 1. Oth T i9 :±re:° 227 Ei!e -- ----------------------------------------------------- ................ a 7'i L'1 L e r _:.__...-__.-. ass cc Tascx ............................................................... 74522.!5 A: J;.NC A"krzs E:3ESI -r5.53 332i2.i5 Cn _ 5 C;%E ' :AE3-C ...:i 'OiL2. CSi_D S^5.'. CLIEliC CG363tI :'..:... CEP•_: _-_ _: ' i9i:... FiC.-'.•C -i'. i> "i F:%ST': SS:X S 65.51 FT- L ..._. .? TES !I".52 M.S^-1 M.4CEER NA-D. ...._.. P3: P... VN- -P2 ci 3LS'17 ctp .h c:: } : SiFCE3 !9CE7.9. U:IIM 'WHOS y5 i,!2 .i5oi:.-. .......-. ° - C . 15255 22 Credit 7•: xk�:' .2exclie. Tem Total: •275 ................................................................. v 941 RECITAX DEPOSIT FOR MMC PAYROLL PAY PERIOD: BEGIN PAY PERIOD: END PAY DATE: GROSS PAY: DEDUCTIONS: A/R ADVANC BOOTS SUNLIFE CRITICAL ILLNESS SUNLIFE ACCIDENT SUNLIFE VISION SUNLIFE SHORT TERM DIS BCBS VISION CAFE-D CAFE-H CAFES CANCER CHILD CLINIC COMBIN CREDUN DENTAL DEP-LF SUNLIFE TERM LIFE SUNLIFE HOSP INDEM FED TAX FICA-M FICA-0 FIRST C FLEX S FLX-FE GIFT S GRP-IN GTL HOSP-1 LEGAL OTHER NATIONAL FARM LIFE MEO SURCHARGE PR FIN RELAY REPAY STONEDF STONE STONE 2 STUDEN TSA-R UWIHOS TOTAL DEDUCTIONS NET PAY: TOTAL CAFE 125 PLAN: TAXABLE PAY: $ 519,753.86 $ 619.753.85 "CALCULATED" Fmm MMC Rasa Difference FICA - MED(ER) ,s.. 5 7,536A3 FICA - MED(EE) ,.m S 7,536.43 S 7.520.24 $ 16.19 FICA -SOC SEC(ER) a1w S 32,22474 FICA -SOC SEC(EE) 4mw $ 32,224,74 S 32,155.71 $ 69.03 FED WITHHOLDING $ 49,911.66 S 49.911.66 TAXDEPOSM S 128434.00 3 129,26355 FICA -MEDICARE 2M $ 15.072.86 515,040.48 FICA - SOCIAL SECURITY •24tl It 54.449.48 $64,311.42 PREPARED BY: FED WITHHOLDING 5 49.911.66 $49,911.66 PREPARED DATE: TOTAL TAX: $ 129,434.00 $129,263.58 $ 170.44 REVISED 3r782014 TOTALS $ 518,640.59 (49.681 (54.741 (1.010.44) 609.70 49, 911.66 7.520.24 32.155.71 5 16.304.93 5 125,951.53 S 392.689.06 Exempt Anal: Employees over FICA -SS Cap: S - S Paycode S -Employee Relmb.: TOTAL: $ Caillin Clevenger 4/252022 R9 RI MMC TAX DEPOSIT WORKSHEET 4.2522.I5. TAX DEPOSIT WORKSHEET 412WO22 Eon Mu A is 2: :,N-VE EL ON Amp E 1=5 MEN an 0 57EPHZIE K YOU 675. 5s Z 2019'. GEGESA U-'.GMIO UL74 Oursw 0;190-1 75239 KAREN V GARCIA 12:1.30 OUSNE 0401.2 325F' RK.'.M h HHEM MIS OCAS, TC2512 'it MW cc 290. OUL �= ZI!12� A VAR.A.S k .11INDIZA .._I A ZENI. I: AN _'i 1-NrKA Y. K71,12; X.".2A I ARE 225.S 3 10. LIN-A i -:J.?611. INC! VE'Ajl j U7.. 03 SF.&REY 3ENAH U 00i22 NIX V -:R!%'Cn 22E CO 5;j2. N c: s$: FDO.: i:5;1351 L2 "57 " N,;RA 6AR1:1. :3C:.H 21 .11 7 TAK NEW E WaTT MA E: aly :-- ::iS' OM KIM= R K27A Ma M A n �:: KIRY 04.01 n :c 25 ,:Vis .,j3;Ll; z SIALay I" :4:n 22.:.:2 rr SAIZERE IW5-3 DE, 1-79:' R.;djSW11-'. j RlIrAy 25021.52 DD 04,21s2.: MI.: R21 R CLEUNG.F. 339.21 DD iii.9122 UZI,' AGAPITA C CANTU 975.71 M RTe.; r,3lllll,-S.:MlsR 23521.;1 CD 1 2 A.V20A. :11 n .-H5 3H.IF 12050 25 11 V. 2-11.73 :233! "ESSICA 9 Bir-K, le" 323;i an,:. N95 MOM M f3z H M XM: IT rate, CC 251: Page Wy NO N=. Nre W15 M;7:CE .267, V:zZEY 20912 DD TWO tl: RMA DAMW OMXZ nPA! 112S a so DAWKnowc mu so Q ,271l jEEICA :Uell. r I..m'TCF.2.q RUDDili: oil, E V 2 Or TZA F :=KKA 10 1 v Z: fc= 1 WHE W&A DD 211, loi! 10.07: a' nawl 57i.,N 21 :4,!ou 02510 D:Allil,. c k.-MNON 252?.79 DD 54 /27,1:2 Erm A TOMEZ 2HSA OYU K 2265.7: CK22 M.12ISSA P,.NCEL :PS, Frl-11-01� 21 �41*. 7: ol:1; D" 13 P UMUU s E.-.3Z 1219.55 CD t-LN!.,Z PADKIT 173C,I5 r., N 47!:. SA�J�-:A ..... JL wr X.;KHA -Y!:4%, mr 73Lo ol =NEEEIE A 5AE117 -42 12n: FWBUY! 1 HE; 2NUT n 7121, ,;ii5 * :SA j ]ENC-11,19A _1. 21 :AU )MA E REMCO DD SG291: 57 3YLHE 1 DMIK 3594.50 DO Nlo/u :5,12! 354.1: Ali :Axl; 1. :5.10 Kly 153210 C2 UM Hui KUM 9 ME 11084 up :129in HK" 29i2,:4 N :412' , 4 E 204e-,. ;RiAlPIA 5 PASSR.CRE 115.39 D2 74,25?:2 11 "AX-.S D W.:N T Allol:: .,:7o :AYUN RAX.Rz. 74:0-1. 7. 4 10751 BE7,12.111.5 x 999.54 %2�f22 oN�. HII.Ei :11 :;ILK 21 Elq D-a:e::4'n T %D!3Ri.L 'SCICr'_ C=,REF. S niiR1T Page : Toe: 1411 ... :hack Regina. {J056 22E J3l i'L :tij2L 12. L:S(IgR.3@L .2E19 HEATHER C Sh!ITH 6T;.i5 CC IGZA. 1550 CD .4/290: sJL i, rSIG. C 912.71 C;I i22 KH9 AMULS .z. G RIA 2342.D5 M Now, a2 Vil . _13 32122: _og JIMENTZ 2D; ... C: A.._ .:;E: ED'nA?D E Piii[i. ?:"i.39 DD u;125i:. 3: c21 aAYi.A f: ;_,:3'tZ 1i53.;3 DS .4in-1:2 ._._, ENE l "ISM ....... __ WO, .__.. .+:3 _ .:IC.. ..... . .... 3 E;13 :E2i :iA ..__... .. ... _._. 3F7D2 PgV. VANEESF. F@GCL i34i. 91 Du Cir'{5'F: ,. 2 laSVOM L H EZ 515.E2 CD . ow—, -_71 TCF.RIi Y. -FV:GO' ._._ DD .. _ ;12;2 i➢7A.iDC iCERES 525. i3 DD D4i2512: ;:_7: ES.?ig @,SIN in?E,:. :D 79i250 .1273 E Low _41E ;XGLL }. tiAJJ�L 11:J .03 DD' v;l:L':• 41501 OLOA I BOLNCOL'RT 550.29 OD 0 ln' :: Kill MCCAW N. G ;HEZ .- .r _T AN ELii..... _.. -:26. . ;i397 ROX-;HA !4:ETI4ZZ 1065.E4 412 :Jfull R MITER 15.21 _ .._... • re.19 .. ..... 42122 SE! A71A :'r,A'XA lEEE.;2 DC :;i 25,'__ '2125 LJCY CwC,l7.r. 353.5; CD 9;i'_?i2: ..n ]. _ ;3FE6 JESSICA FSH 15:.36 DID O;129!22 s5O1E I•:ICHES:E R ROE;,Fg i745.36 DD :419 :2 _.... ...�,.0 P:1'L._., .....5E _. .,, _... Rz: N"lly -AT, 5%il "K-N-Y MIM1.2 ZY',R., 15,�.11 ID JAM W Hwli"M: i0lo JASMINE ",RIMBY a36.91, DD Uill ): c;X171A KC5.7d' :7. D'ESRA K 'AUSTERE, 2244.66 CD '109127 FURICM iRR7- :7il.22 ;se.n 550.1- !REN: 2 PEREZ U C4129122 55252 SHM110%, c1lor/3 IA 16 i5 nn 24125122 T=' --"i R"BERT A P,%-;:7uF2 Kim. NIRA IVAI i 'Kii E. Z A A An"'A c GONIZALElz ;.:3.3e CC' P9129 C. "09, '3 65100 HLTCJ7n R,,%JZ 626.:o FV 0;j29:2 7* ........ K:R 3—*",.,ql;, VC 65Z:; 7EE SIMBLY 21611.01 Do 7 CUZU! R.U.IZA 6 MR77 04i"!:2 iHli-1 ROSA 'RD-.R:G,:Ez 39i.0 CD :9i29,'72 65W Lr-ZA-A i6:E: MSM KUMNEZ iiii.2' I: 737v :LO'TA S RrI: 2607il CD 9r':25122 -:;K RIK.,. FYA ,T7 2' 2 --I 15 0.111-.R F ICK Run Due: GW2Sq2 '=CAL 91-WEER-1 pase N F.R.zet.--.77 %T'. t"ana ktoult OHECK 101. DATE .s. N :4,2i N �2!c N' 63Fc AMA jim-112Z 114S.6; N/25-N 76313 ?A.XU L BART:!] 2D 14 -''C3 'ATRi.11A A Im .10 1 til; N y- SEE -,'I' 2,L1RA F PESNA f7E. dZ DD —i' VIXE. RA -Ril-ill; 21,52 1: A 21 Z P; --5 OW :4 R :2 266.?f Cr 01*12'.iill IOU DOR% N. Ewums WA Zr 041912 'KK :1y:- ' HYK :1* 4.1-!Nl 70H MMM L GnER inm 3 EWN0 117 FAAR : 27N.62 M Ia75 YESE?l:. Q'::Z;LA ;-1.4 .40 DD ;4 'yN' i57.1� 30. 622277 CZ7L:!.' A CLE.1-EGER 1436.fs DD 4j2+122 a6412 L BOM ---D H,H2 VF-CM X --,'R—F ULU n ANO. Hl�l !I TRI-vii;'.1 NAVO ilzR . X. 1.11RE5 :13I.n Amscl. MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT--- April 18, 2022 - April 24, 2022 Date B100 MM[ Notes CP51 Ame Puy 4/18/2022 PAY 1921002 6111 111 .3rd Party Payer Fee 60,Zg1:'g G 4/18/2022 TEXAS COUNTY DRSRECEIVA8LE 041923000021569 TEXAS CSACHTBR$ RECEIVABLE 402156 - R¢tiremen[Funding 158038.5 6II 2� 6 0 0 4/19/2022 PAY PLUS ACHTRANS452579291101000697745464 -3rd Party Payer Fee °58.29za SR • 29 = 4/19/2022 MCKESSON DRUG AUTO ACH ACH04990704910000140 - 340B Drug Program Expense �k9,01.e <i 5P. y 4/20/2022 WEBFILE TAX PYMT DO 9021056311M 21000029424 -Sales Tax 1,347.1491- 4/20/2022 PAY PLUS ACHTRAN5452579291101000698844880 - 3rd Party Payer Fee 252 Sty U ' � I 4/21/2022 PAY PLUS ACHTMN54525]9291101000699fi03502 3rd Party Payor Fee O;gj' j 6 I�ti 4/22/2022 PAY PLUS ACHTRANS 4525792911010011690513625 - 3rd Party Payer Fee IN 4/22/2022 AMERISOURCE BERG PAYMENTS 01000U77682100002 - 3408 Drug Program Expense 2,069.99* 4 4U .., ; 170,744.98 17 * '( C Lt S 6 April 25, 2022 :6, L' - � ' " % Anthony Richardson 8+901 / - Memorial Medical Center 7r p"v&APROSPERITY BANK G,069:.'; - ELECTRONICTRANSFERS FOR OPERATING ACCOUNT -ESTIMATED ACHS"II�y°''- . 2�g klovoYLA 0 4•Ub•2t[t- ' 98'7 • 90 ; Date Rewrote. MMC NOW Amount 5/6/2022 IGT CHIRP IGT MA39.64 38 / " 9 U + J8'i-4ll - 11 0 • O U x nn 1 � 4 64A39.69 �J�' April 25, 2022 Anthony Richer son v Memorial Medical Center �R..•.',xl rgr e . APR 25 2022 CALHOUN COUNTY,'if�7M Transaction Summary Transaction Complete Trace 4-:( Texas Health and Human Services Commission Memorial Medical Center Operating County Payment Total $64.439.64 Bank Routing and Account Number Settlement Date 5/6/2022 CHIRP Amount $64,439.64 Entered By Marley Moehri Page No:1 or i Run Date: 4/2112022 Run Time: 11:5s:59 Marley ODonnell From: Luba Kubinski <luba@ahcvcom> Sent: Wednesday, April 20, 2022 5:18 PM To: jaclynn.harrison@christushealth.org; kristina.alldredge@christushealth.org; joel.vigil@christushealth.org; chris.nicosia@hcahealthcare.com; Steve King; Eric.Hamon@dchstx.org; Mike_Healey@chs.net; eric_,graves@chs.net; michael tea@chs.net; czafereo@cmcvtx.org; pstrauss@cmcvtx.org; Duane.Woods@cmcvtx.org; Roshanda 5, Thomas; Anthony Richardson; Marley ODonnell; David Lee; sparker@rcmhospital.org; jmoehler@rcmhospital.org; Jonny F. Hipp (NCHD; Belinda Chism (NCHD); Jared A. Konczal (konczal@gl-law.com); Lance Ramsey Cc: Colt Sullivan; David Elliot; Robin Daniel; Justin Flores Subject: PGY1 Final CHIRP IGT- Nueces SDA Attachments: CHIRP PGY1 Final Recommended Allocation.pdf organization. Do not eliek,links or open attachments unless you Good afternoon, It's that time again! Based on HHSC's notification email below, the PGY1 Final CHIRP IGT submission deadline is Thursday, May 51h, and the Nueces SDA will need to identify $37,763,348.44 in available funding. To ensure 100% funding of the SDA prior to the May 5'h deadline, we are requesting confirmation of the amounts and funding sources within the attached 'CHIRP PGY1 Final Recommended Allocation' by the deadlines listed below. PRIVATE HOSPITALS - Please confine the non-ftaderal share allocation attributable to your facility and tht Intended funding source by Tuesday, April 26th. If you believe any of the information provided in the attached summary is incorrect, please let us know immediately. PUBLIC HOSPITALS- Please provide a copy of the TexNet sent to HHSC by Friday, April 29th to those copied on this email. If you expect the amount will be different than the amount noted within the attached Allocation Summary, please let us know as soon as possible. Thank you for your part in ensuring that your facility, and the other hospitals in the SDA continue to receive the maximum payments from CHIRP. If you have any questions or concerns, please don't hesitate to reach out! Best regards, Luba Kubinski Financial Analyst AHCV -Adelanto HealthCare Ventures L.L.C. 401 W. 15th Street, Suite 840 Austin, TX 78701 Direct: 512-508-9545 https:gahcv.com/ From: Texas Health and Human Services Commission <txhhs@oublic.eovdeliverv.com> Sent: Monday, April 4, 2a22 2:54 PM Subject: Comprehensive Hospital Increase Reimbursement Program (CHIRP) IGT Notification —Settlement Deadline Extended •.. This email is from an external address. If it looks like it is from an AHCV employee, please forward as attachment to t ITSu000rtOAHCV.com as it is likely a harmful email. "' TEXAS Health and Human Services Comprehensive Hospital Increase Reimbursement Program (CHIRP) IGT Notification - Settlement Deadline Extended The original settlement date for CHIRP was set to be April 16th, 2022 (21 days following receipt of federal approval from CMS). The settlement date has been extended from Monday, April 18, 2022, to Friday, May 6, 2022. HHSC received federal approval from the Centers for Medicare and Medicaid Services (CMS) to move forward with the Comprehensive Hospital Increase Reimbursement Program (CHIRP) on March 25, 2022. The purpose of the Comprehensive Hospital Increase Reimbursement Program (CHIRP) is to provide increased Medicaid payments to hospitals for inpatient and outpatient services provided to persons with Medicaid enrolled in STAR and STAR+PLUS. Texas Medicaid managed care organizations receive additional funding through their monthly capitation rate from HHSC and are directed to increase payment rates for participating hospitals. This is a follow-up notification to the Intergovernmental Transfer (IGT) suggestions for the 2nd Half of Year 1 (SFY 2022) sent via email to participating providers on November 4, 2021, which noted that IGTs would be due 21 days following receipt of federal approval from the Centers for Medicare and Medicaid Services. The original settlement date for this program was set to be April 16m, 2022 (21 days following receipt of federal approval from CMS). The settlement date for this program has been extended from Monday, April 18, 2022, to Friday, May 6, 2022. The calculations for IGT amounts by provider can be found on the Provider Finance CHIRP website under "Suggested IGT Transfer Amounts per provider". Suggested IGT amounts are listed in cells ATS:AT422 on tab CHIRP Payment Calc of the posted file. Please transfer funds through TexNet following these instructions, and email a screen shot or PDF of the confirmation/trace sheet to HHSCPFDCHIRPPavments(o)hhs texas ctov. Please email any questions regarding this change or the calculation in general to PFD Hosoitalsahhsc.state. tx.us. You have subscribed to get updates about Texas Health and Human Services (HHS). For more information about HHS, please visit our website. Stay Connected no M (en espafioq SHARE Subscriber Services Manage Preferences I Unsubscribe I Hell) CHIRP SFY2022 Payment Calculation State snare CHIRP PGY1 Final WORKING DRAFT Recommended IGT Allocation SUBJECT TO CHANGE Nueces SDA Nueces Courdy LPPF 121776403 1689641680 Christus S ohn Hos Sal Co us Christi 4,752,904.59 Nunes County LPPF 020873601 1608810573 Co us hristl Medieal Center 6,768,092.14 Nunes Coun LPPF 132812205 154 286172 Driscoll Chiklrens Hospital 21,759,338:07 Nunes Coun LPPF 094222903 100388SU41 lChnstus3 ohn Hospital Alice 365,612.05 Nueces County LPPF 1 020811801 1 1447228747 lChristus5 ohn Hospital Beeville 327,906.35 Nueces county LPPF 43 1356606 1 1093783391 lChfistus S ohn Hospital Kleberg 32g754.77 Nunes LPPF Total $ 34,294,607.07 GreggCounty LPPF 094118962 1 1851343909 jDatar Hospital Neat" 2,594,620.93 TM99 LPPF Total $ 2 594 820.93 Self -Funded 137907508 1124062162 Cidnns Medical Center 742,138.88 Self -Funded 137908111 I 1889630865 imentonal Medical Center 64 439:84- Sett -Funded 138412710 1699772541 Kamea Coun Hoe Ital District 27,017.92 Self•Funded 020881801 1842240188 Refu io Cou Memorial Hospital iMl District 40.523.10 Self•Fundetl Total $ 874,119.54 ueces UIJA I tual.' 37;78 i .. " Confidential For Discussion Purposes Only 4/20/2022 Page I of 1 €0EIVEU BY THE UN Y AUDITOR ON APR A/WOU MEMORIAL MEDICAL CENTER 11:45 AP Open Invoice List 0 WirlwJtilwW111.TY;,TEXAt3 Dates Through: ap_open involce.tem�late Vendont Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay 041522 04/20/20 04/15/20 05/13/20 7,481.39 0.00 0.00 TRANSFER N�1115U YaYl(e P�KA Aeptif,14.d ittim IY.1HL optw+yll Vendor Total: Number Name Gross Discount No -Pay 11828 SOLERA WEST HOUSTON 7,481.39 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 7,481.39 0.00 0.00 APR 21 2022 ALCONONYDIACUCUS Net 7,481.39 Net 7,481.39 Net 7,481,39 file:///C:/Users/itrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report550837... 4/21/2022 Page 1 of 1 RECEIVED BYTHE COUNTY AUDROR ON AM21IF MEMORIAL MEDICAL CENTER 0 G 1 2022 AP Open Invoice List 11:44 ap_open_invoice.template Dates Through: CALHWPld'ADVhftrrTW" Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay, Net 041122 04/20/20 04/11/20 05/13/20 3,552.31 0.0y0 0.00 / 3,552.31 ✓ TRANSFER NO 1ftVjKtL p K4 dgxti17{, trk IttIt M1uovt ,T no 041122A 04/20/2004/11120 5/13/20 5,302.28 0.00 0.00 5,302.28 .� TRANSFER It 11 041122E 04/20/20 04/11120 05/13/20 157.93 0.00 0.00 157.93 � TRANSFER It 11 041322 04/20/20 04/13/20 06/13/20 133,67 0.00 0.00 133.67 TRANSFER tt II , 041522 04/20/20 04/15/20 06/13/20 302.69 0.00 0.00 302.69 TRANSFER tt of 041522A 04/20120041M5/2005/13/20 1,239.90 0.00 0.00 1,239.90 TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 10,688.78 0.00 0.00 10,688.78 Report Summary - Grand Totals: Gross Discount No -Pay Net 10,688.78 0.00 0.00 10,688.78 APPROVEDON APR 21 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/Itrevino/epsi/memmed.cpsinet,com/u88125/data_5/tmp_cw5report295607... 4/21 /2022 Page I of 1 RECEIVED BY MEMORIAL MEDICAL CENTER rrAPry2fgg 0 2022 AP Open Invoice List 11:4$ ap_open invoice.lemplate Dates Through: C"9w&wwyr,ww Class Pay Code 12095 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net - 041322 04/20/20 04/13/20 05/13/20 3,153.20 0.00 0.00 / 3,153,20 ✓ TRANSFER NH insurance PIKI dquiI�J. Ih-1` mw-(- Out, ' Vendor TotalE Number Name Gross Discount No -Pay Net 12695 GULF POINTE PLAZA 3.153.20 0.00 0.00 3,153,20 Report Summary Grand Totals: Gross Discount No -Pay Net 3,15320 0.00 0.00 3,153.20 APR 21 2022 UDrTG CALHCOUN OUNTTY,, 7E%AS file:///C:/Usersllt evino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report205515... 4/21/2022 Page 1 of I RECEIVED BY THE COUNTY AUDITOR ON APR 21 2022 04/21/2022 MEMORIAL MEDICAL CENTER CAWOU16&UNTY,TlEXAS AP Open Invoice List 0 ap_apen_invoice.template Dates Through: Vendor#Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 041122 0,,4/II20/2004/11/2005113/20 2,124.57 0.00 0.00 TRANSFER t, IVft IftK►UL V601 i�y,Lpll6t,4 [K-h RKL UjA*V, 041222 04/20/20 04/12/20 05/13/20 569.66 0.00 0 TRANSFER tt 1` 041322 04/20/20 04/13/20 05/13/20 315.00 0.00 0.00 TRANSFER Vendor Totals Number Name Gross Discount No -Pay 13004 TUSCANY VILLAGE 3,009.25 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 3,009.25 0.00 0.00 AmF vm o1 APR 2 12022 ACALYFi�U'-�N I�iIYa§ Net 2,124.57 Z 569.68 $15.00 Net 3.009.25 Net 3.009.25 file:///C:/Userslltrevino/cpsilniemmed. cpsinet.com/u88125/data_5/tmp_cw5report291170... 4/21 /2022 Page I of 1 TOR ON ,Comp 0 2 2022 MEMORIAL MEDICAL CENTER APR/ �./2 AP Open Invoice List C,ALA� A° COUP' 0 ap_open_Invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 041122 04/20/20 04/11/20 05113/20 21,084.22 0.00 0.00 / 21,084.22 TRANSFER NII iftaNt, Mki krwf4l ''10 MYN(. optrx�, 041222 04/2Qt20 04/12/20 05/13/20 42.396.88 0.00 0.00 42,396.88 TRANSFER It I) 041322 04/20/20 04/13/20 05/13/20 2,462,38 0.00 0.00 2.462.38 TRANSFER k it Vendor Totals Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 65,943.48 0.00 0.00 65,943.48 Report Summary Grand Totals: Gross Discount No -Pay Net 65,943.48 0.00 0.00 65,943.48 APR 21 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS tile:!//C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report432917... 4/21/2022 Memorial Medical Center Nursing Nome UPI. Weekly Cortex Transfer Prosperity Accounts 4/25/2022 .ununt xumY. AW 00,190.03 ✓ 90.69a.01 a1131,Ni,66 d ltwfti1 A F12t,1 1 97.592.10 �/.9,493e0�a6,459.3) / ;F�9TIiJ��i.1{Tv3,.`��'4. P,551.<55/ i1p51.a5./ 39A219 a{n,93{.V ! 13AI9129./13Z9 0.1I,6.41433 / 22=562•-(iI + Rm,�nR<n6,Ri�mm�a< 121,OU +bn 146=459-;�J 98 4 2 8 = 2 ; 5 • to YNan wn9 mm M.<44<Rnn,wYnRmnrm„m I:VItI W<tlNinmlm\.INVI<inmMSummary\M31WfiNIN WIDmJx Summiryq 33.21.tln upnnlna amw,nmerirmJ.nwuxunMe ewm. Nnm, II,161.O1 � T2,362A3 Blot&lanes ]3p63A1 Va6an<e Yrvnln ltlmY 3OAN IM IMIRMT I10 YTER15r RLRIMMEST Atllu.t BlNnre/iramimamt 323RA1 121,103.0 was.Nnw 311,303.66 ✓ VNbn<e YY1140.Nnb 1"M MNINI@FST FEOIRRRIST =MRIM[RIST AVNe OYm<i/fwn<lerPm= a1,00i M6,Ss9.31 / Yn4YlanY 3<6,559.3> Varlm[a Yrv<InblmY JOAN 2AN IMLRMT IGINNRVIT MRRIMRRFST Atllml6aunte?wmlmwnt IR.0937 ✓ 39,N741 M.&O, nw 39.%1.49 V.N.nm A.W."l.na 100.00 J'ARMRIST TYIMRST MMINYRIN 4G1wtYNM<Rtantl<rAmt 3AN1.49 / V 94S34R9 Ynk Olin« 94625.89 ✓ VaOan<e Yn.In e.lm. 200.00 121,005.66 145AS9.3T 39,942A9 9490.09 APPROVEDON APR 2 5 2022 MNIMER5T 10o"NEREST BY COUNTY AUDFFOR MMIMIFREST CALHOUN COUNTY, TEXAS Adry.1 BaLme/rrm.lN Not 79 TmnsTR,kNII[R /5 / Iwo � Ri ssl.0 APprw4d: I v �/ ANTHONY MCHAROSON, INTERIM CFO 4/25/2022 JANHW Lnn, Ingrnl 0oxmme wo,whmAZWI0l.gNN Bm4 W 0.01 D4Lmum042wm3Lu MMCPORTON Fit +u� ' '•a �, 3' mi R .s^-w:•., ai..,:xl•_.r. 7E90tlSC9W ,04M.l0 OIPPIGUMPI QIM/C 22 OIPP/Gael 41 PK WOIaPv LIIIPT q/IB%1023 YN[COMMUNRYpI MCC WMpM1�CtaW T 3gWp31110100 105.9E 4/IWM22 HEALTH HUMAN SVC HCCWMPMTlAGM31113 GS } 71400 41NUMI2 WIDE OUTASNPOBDNEALTICARECENTEB LTD 41M12023 Ame116mup TNSCN[[IAIMPMT31])]5}3W 111000 4/21/2022 G1])2 41211202E MANAGEM3pNEC}31BMNSPMNTWO0o0W0p00p9141 4/21/1022"UNl VPlXSCHCCWMPMT3l77BN}I3111NO VIVIAN CH1179 4/2212012 UHCCOMMUNITPPINCCIAIMpMT746W341I9IUOW 4/22/30E} HOVITAS3OLUTIONHCMIMPMT6)A1342000192 4/IVIOxE McNn N[of iHN[CWMPMT PNI6698fi04364EW A/19/ID22 M49m 11CaITNNCCIAIMPRIT /N16fi98W43342W 4/19/220022 NMUeM9vA,NHACCeHiADIED HCACIMWPIMMPTMPT JON 14211000W14 9 41IW2U HUMANHAOMPMT390B61g2WWS45 4119/02Z HEALTHHUMAN SVC HDCMR2 V20/2WREOUTANTEXRAtTHCGOECLAEADD, 42/20n ECHO NCCIAMMPM 7I603Iall 44O10025340 4/21/1UI2 CID MAMA 4/21/t0U MANAGFANpNET])lB MNS PMMTOW000WOOW}9541 4/2V2.21 CNE04 1/2V2022 [Hi03 4/20/2002 M4ILN NCd TNHCQAIMPMT PN16698W1334200 4/2V2022 NOVITASSGLUTION HCMIMPMT6763574100011151 imompow 6pBg013 P3pp P4YStnn 991LI1328351861 MINIM 4/11112022 UNITEDNEALTHGREHCCWMPMTTI603411124394 4/1912022 WB� ECNOHCOjUMPMTi46W3411140000216884 4/19)2022 WMEO HUMNN XHIALTUCAREITI)ERSIM 13W82 4/2012U22 WIRFOUTGNIENXEALTHCARECFNTG5111 4/20/1022 NNH T N HUMAN S MC C,]46P034114,NMIISWI 4/20/2W2 HEALTH HUMAN SW IICCIAIMPMT 4x16W3Q13W92 412UN22 CME- 4/21/2022 "MITB.ECNOHTMN HCCTT4W03A111100W 17I 4/21/2022 HUMAN fOLUTN)Nc,AIMpMIAT6]63x94200W1x1 I/Euma CK236 INSCTN[[IAIMPMT3909649300WS18I66 4"CODE CH236 01221202E G235 4/22/20EE [[E34 41221502E HIPIANAOMINISTNCPW74 M111410 10021al 4121202E NNB[CNO HCCWMPM xI6W3LL1410WO22115) 4/2L3022 HOVRAf SOLUTION N[CWMMT6)6333A2ppW I8] I/ty20f2 NVMNAIHSCONCCWMPMT3909619300op550293 A/lI/SOIL NFAITN MUMAHSW: HCCW MPM 1]46p0211130092 A/I6/2022 MANAGEANBNET1x14MNSPMNi O00WO4WWA".Al n 4110022 HMB-ECRONCCWMPMT74,nAI1440pOp216638 412012022 WIREOVTGNTEX REALM GRE CENTERS III 4/21/2022 CCl]] 4/21/2022 MANAGGNDNE 1719 MNSPMNT W W WWOp0429441 4/22/2022 CCI78 4/2212922 CH119 4123120I3 NON2AS SOLUTION NCCWMPM 6256631Ep00N1B1 1]IS115 / 19A1]19 39 DAN NAME W.150.09 3,Sil.J3 I6.i05.39 3,W9.W LLJL6> 30,4B9,9C Eq.I NN PORTION 1059E EDAM • ]6.93 ' }9 3 32 .22 l� }L3 CAT MMCPORTIN IN.11,14ho J3p2SPI40 QIPP/Gem 1 QIPPKMPPx QIPPfC pa; QlreKpmw tap, WPPT NNPOMON 116b0 ' 1 9i6.W - 9,5 3.56 ' 7417 9,534.56 6.9ISM)SIXI ]4.1) 7670.66 - 6,975.00 ),SSLg9 - 69ss.]A - Lss149 12,,I,B)5.50 12,0895 - 81399 83i98.59 e13.98 90.602.0E IILW5.fi6 83 >8958 ]2 ODS.fifi MMCPORTION iV^JLL941 TjiM(9ljp QIPP/Gm91 QIPP/CPTP2 QMI/CO WPI/Cpmp6Llq! QIPPT 0.0 NN IORTON - 7.6B0.W am 12b92.29 BANCO, • 4,11&n 11,612.29 4440,10 11116W 4,1g2N ILWI-0p 14,II2.84 S,SM.03 31,WL]0 52,19 2.SS).97 1,0950.1E 52,902.I5 2O022.27 5.91P.I1 ,W. ]0,31)A5 • -- '.'fix .� . ... -_ �tZ +: 4/3B/2012 "NB'CC pk Ct. "MF WMPMi]12" 22 3 OWNED Ame09mVp T35[N[[WIMPMT 3l]I6012911110W 1131191302E MUMNAIHS CO X[CWMPM 3PoBfi]8300W341]83 41191202E NUMANAIHSCOHCCWMPM3W9823QpW094RA 4/2012WE WIRE OUTCSCOHCCWTH CAN CI8TEM III S91t83 4MI202Z WBEOUIGNCHHEAIMFMT 17"521111 4/1D/2012 ftetWUKCOM P 13ITY PL HC WMFW 7/5L611110W 4/41/7022 C.123Z MUNNY PL MCCWMPM i46W341}9IOOW 4/211)@3 WMG 4121120221MNAGGNONETI>1BMN5 PMNT 000000ppop0248E11 412112022 4II2/2022DE(= NOWTAS SOIUTH>N HfCUIMPM6)632042WWI>1 CHI)33 411212022 922 G1I33 41237.03E NOMTA150lMI0N HCCIAIMPMi 6)83101200W181 2LSW46 0" ' 3,337.4E 31.400.00 4,914.4E t$36.16 2.930.W 4.91 A$ 329.21 / 2,930.00 310 J 6459.3) / x 316A59.E} MMCPoRT IN n II-ln?�9t T"nomrlp I NM/Comet QIPP/Comet OIPP/f ,A OIIIKpmp{BlapN gMPT AN ""ON135.W 11111.4E 135.00 8.311.41 6.462.9E 13.34L$ 3565 23].00 L1LIA3 21EAB MMCPORTIN ]T.Idt"O. TMMieM,n OIIPKm DA QUP/Ce T,2 QIPE/CemPl ryPP/C4me1L49N QI PT NM 7704 IOATOX M,352W ]M.W - W0.10 33.352.60 1,924AD 91010 - ),IW.00 - 1,924.49 - LAWS.W 3,160.00 88.421I6 LIBSW 366.49 • 21.6E 156,48 6,553.14 21,62 3,195.00 ' Sl NAL 31155W 361022.27 - 51,504111 11.97E.14 . L03D1! E9W) 3DID 73 TOTALS "VASSM 418,15L86 AEON AS 4/25/2022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number f Name Groups Account Type Add Group r [DDA Data reported as of Apr 25, 202; Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $8,210,347.92 $8,602,461,95 $8,210,347.92 $7,903,162.3 '4551 CAL CO INDIGENT $52,612.57 552,612.57 $52,612.57 $52.612.t HEALTHCARE -4454 MEMORIAL MEDICAL NH GOLDEN CREEKEK $110,912.66 $113,350.40 $110.912.66 $2,832.2 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES S536.26 $536.26 $536.26 S536,5 2014 '4357 MEMORIAL MEDICAL S6,210,091.14 S6,345,719.46 S6,210,091.14 S6,059,891.2 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.71 S431.71 $431.71 $431.7 WAIVER CLEARING '4381 MEMORIAL MEDICAL $22,462.01 J $88.269.43 $22,462.01 $38.977.7 CENTER I NH ASHFORD Am MEMORIAL CENTER NH MEDICAL $121.105.66 ,� S142,666.60 S121,105.66 S75,164.2 BROADMOOR '4411 MEMORIALMEDICAL $146,559.37 ✓ S175,722.27 S146,569.37 S150,132.c_ CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $39,947.49 ✓ $43,258.16 $39,947.49 S13,960.e CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL CENTER / SOLERA AT $98.678.89 ✓ S139,345,47 $98,678.89 $134,547E WEST HOUSTON '2998 MMC-MONEY MARKET $1,110,015.19 $1,110,015.19 S1,110,015.19 S1,110,015A FUND '5506 MMC-NH BETHANY $209,107.60 S209,107.60 S209,107.60 5198.899.E SENIOR LIVING '5441 MMC •NH GULF POINTE S1,654.98 $95,057.00 S1,654.98 51,654.E PLAZA - MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE 51,13138 $1,270.82 $1.133.38 $2,617.1 PLAZA - PRIVATE PAY •3407 MMC-NH TUSCANY S85,099.01 $85,099.01 S85.099.01 S60,787.E VILLAGE r htlps:/lprosperity.olbenking.comlonlineMessenger 1f1 Memorial Medical Center Nursing Home UPI. Weekly Nexion Transfer Prosperity Accounts 4/25/2022 P.W.vF Asmunl Si621.56 Nole:. Eo balaamrr havn$$,020callbe rF510,h tl re MenminP M1 t. Nam S: £acn emaan t has v bvre bvbnw vJ$tW,A vl MMC depoeifed m open Pma unr. APR 2 5 2022 BY COUNTY AUDTFOR CAL HOUN COUNTY, TEXAS n\xx weekMnamtm\xx unumd.r mmma�yµax3W ngxx uPE uMner wmmama.ss.n.ara P.O., today, a.9innlne / neunno ee rranrrlrt" to N.Wng - 110,932.6E E,nk 110,913.66 .ft.a Variable laay. In arbnce IM.00 EM WERE$T FEBINTEREST MMIINTEREET Ad1u,t B.bmcfrramler Pml ,F/3,E�1E1' rI1/3/011A13�3/./6Rt1'��//// Aoara & MITHONY RIOVMa50N,INTF111M EFO q19/20ti V102022 TSYf/IMNSSIRSTBRNSTIMSS}36u555BI69114 � � ]I « ' 1 �� 4/20/2022 WIOEOYINMNNNNSRSTNPT6 N0SSEN 9/ll/1022 0161 9/ll/1022 MRS-ECHO ICCWMOSLIMTS<I6615558)69l}9 </2V102} MDLTM MONCCWMPCCUMMI 917M 1418}611 9/2VI0}} NM11N NYM6X SVCXtt1A1MPMf 1]96003tl1301] 2 41222022 NCWA </}VID21 NOVRF6501UNOH N[MIMPMf 0603)0200001p 4/2}/}031 0614 KKCU1MPMf 199M2996{91W W SM}6163 MMCPOPTIOH pIPP/UmpC II101{i22 in,4150D plpP/Camel OIPP/(nmPi plPl/Pemp3 !b pI1PT1 NMpOR}IQY A9900 17.751.82 N.669.]< U21M 15Lw 353.m 351.N 73126 731.B6 ]8.06661 38p66.93 39,06145 - i9AN1.05 9]2." • 81}.60 SWISS 110.1UN Mom" 4/25/2022 Treasury Center Quick View Select Quick View Accounts Account Number/Name Select Group Groups Account Type Add Group t�-, Data reported as of Apr 25 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balane Number of Accounts: 15 $8,210,347.92 $8,602,461.95 $8,210,347.92 $7,903,162.2 '4551 CAL CO INDIGENT $52,612.57 $52.612.57 $52,612.57 $52,612.° HEALTHCARE '4454 MEMORIAL MEDICAL f NH GOLDEN CREEK 5110.912.66 x/ $113,360.40 5110,912.66 52,8325 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $536.26 5536.26 $536.26 $535.2 2014 '4357 MEMORIAL MEDICAL 56,210,091.14 56,345,719.46 $6,210,091.14 S6,059,891.2 CENTER• OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431 71 5431.71 5431.71 5431.7 WAIVER CLEARING '4381 MEMORIAL MEDICAL $22,462.01 $88,269.43 522,462,01 $38.977.7 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $121.105.66 $142,666.60 5121,105.66 $75,164.2 BROADMOOR '4411 MEMORIAL MEDICAL $146.559.37 5175,722.27 $146,559.37 5150.132.E CENTER! NH CRESCENT '4446 MEMORIAL MEDICAL $39.947.49 $43,258.16 $39,947.49 513,960.E CENTER l NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $98,678.89 5139,345A7 598,678.89 $134,647.E WEST HOUSTON , '2998 MMC-MONEY MARKET $1,110.015.19 51,110,015.19 $1,110,015.19 $1,110.015.1 FUND 'S506 MMC •NH BETHANY $209.10T60 $209,107.60 5209,107.60 5198,899.E SENIOR LIVING 'S441 MMC -NH GULF POINTE PLAZA - $1.654.98 595,057,00 $1.654.98 $1,854 c MEDICARE/MEDICAID '5433 MMC NH GULF POINTE S1.133.38 $1.270.82 $1,133.38 $2.617.3 PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $85,099.01 $85.099.01 _ $85.099.01 $60,787.E VILLAGE hltps:tiprosperity.olbanking,comlonlineMessenger 111 Memorial Meolwl [enter Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 4/25/2022 heAI.[ bmynl b{YINnL 9fn6M An1eY, nntap IWIE XOmf M•��— bYMf �Il atlhOM Lr[MIfFn 0[LMttd DfeMIM1 M Q� 11. `, rY}W'}1��„yl, 9,SloeL ✓ SIA]0.9a V LBS9.SL 1.t53.19 nOlnnllLl bnY O[Ln[e 1.133.3, Van Inveln bim[e INLIHR w FEBINm1F9T MARom EST / xdjut WLn[e/iOnElefNnl 3,03J1 J In,kn, NRW,In Bn snow[ bllmin{ P9ntlYy TMphmd9. XyryIFe MLm[ NvmMr Be... Tniuler-0.t .T LMIfFIn r6rbnnd p Ted[ [Bn nnln Btl[n Hom. 'l \ 6,025.13 Y,9]B.li 3:SSi.9B - ;65491 - bnkblLna ;65L.99 Vnlan[e Nnrc mNenrwLnaRW.ss,wowalbrren[Immm[Mn.n+yxwne. NeM1]: ram.[aa.m ML. emaealan[ee/5ta0lb5MMr dKnRel rorym nrmutr. Fil1i igL57l ti,s.' APR 25 2022 CAL44OUN COUNCOMY TY, i qS I:SXX We4h Tnn[NnWN V91Tnn%W S.mmNS]UATLp d LNLTtndwl.mm.mM 75]2,I64 teminblan[e IMW MIMUST Er81NTERLtr MMINRRFST / .W1.[]b4n[e/rm[la4nl L9H.9L ✓ TOTALTNWSF3R3 MIMI end: PNMOXYMCX flO30N.IN MQO 4/25/2022 NUM MA 4/19/2012 WISE HMGS SERVICES, MC 6249924100003999 412112022 WIRE 0113 NMG6ERV1[ES, MC 4/21/2022 61p% 4/22/2022 HN1-ECXO H[CIAIMPMT ]46009411 M00003/P216 4/n/tax: cxioll 4N9/2011 NNe-ECHOHCCIMMWf5,UC 34I1410000i]665) 4/x0/ID;; HNIIEOUTHMG1,M&IP 74 4/;0/3@; NNB-ECHO HCCUM1pMi T46W39444RpCp233440 MMCIORggN gIPP(C9M1 gIPP/COmp9 YMa -09ar j T�s^�(erin pIIP/CamP1 2 gIPP/Cem 3 6E9pu pIPPTI NN PORl1pN - T4opo - T40.00 15.34394 15.361.30 293.39 IAP.00 293.39 S1.110.94 1.033.35 101131 MMCPGRMM QI/P/Comp QIPP/C6mP4 TT .d.i,GP3 TMSft&n QI/P/fOfllp3 I QIpP/CemP3 /4M! QIPPiI I NNPGRMON - 1ROx19 1.20149 M.929.13 - - 332.69 35I.fi9 44.92S.13 3559,91 135198 %.736M E.611.36 231136 4/2512022 Quick View Select Quick View Accounts AccounLNumber t Name Account Type Treasury Center Select Group Groups Atltl Group Account Number Current Balance Available Balance Collected Balance Prior Day Selene Number of Accounts; 15 $8,210,347.92 $8,602,461.95 $8,210,347.92 $7,903,162.2 *4551 CAL CO INDIGENT HEALTHCARE $52,612,57 552,612.57 $52,612,57 $52,612.1 *4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $110,912.66 $113,350.40 $110.912.66 $2,832.2 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $636.26 $536.26 $536.26 $535.2 2014 '4357 MEMORIAL MEDICAL CENTER -OPERATING 56,210,091A4 56,345,719.46 $6.210,091.14 56,059,891.: •4373 MEMORIAL MEDICAL CENTER - PRIVATE $431 71 $431.71 $431.71 5431.7 WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD 522,462.01 $88.269.43 $22.462.01 S38,977.7 '4403 MEMORIAL MEDICAL CENTER/NH $121,105.66 $142,666,60 5121,105.56 575.164.2 BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT $146,559.37 5175,722,27 5146,559.37 $150,132 c '4446 MEMORIAL MEDICAL CENTER NH FORT BEND $39,947.49 $43,258.16 $39,947.49 513,960.E '4438 MEMORIAL MEDICAL CENTER ISOLERA AT 598.678.89 5139345A7 598.678.89 5134,647.E WEST HOUSTON '2998 MMC-MONEY MARKET FUND $1,110,015.19 51,110,015.19 $1,110.015.19 51,110,015.1 'S506 MMC -NH BETHANY SENIOR LIVING 5209.107,60 5209,107.60 S209.107.60 $198,899.E 44 MMC -NH GULF POINTE PLAZA- / $1,654,98 ,/ 595.057.00 $1,664.98 $1,654.E MEDICARE/MEDICAID 'S433 MMC-NH GULF POINTE $1,133.38 ,� $1,270.82 $1,133.38 $2,617.9 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $115,099.01 585,099.01 $85,099.01 560,787.E VILLAGE https;liprosperity.olbanking.com/onlineMessenger 111 Memorial Medical Center Nursing Home JPL Weekly Tuscany Transfer Prosperity Accounts 4/25/2022 Pn.bm RttOVnI nunlyN ...r MI.. all, ontna/.wss.PaPwVbe OaM/meerorM1<nwrmpbeme Nate 2. f2rte.—.1 ga..W1. b.W..(iJW rbm MMCdepaurtglo Wm Mmwc APR 2 5 2022 BY COUNTY AUDITOR CALHOUN COUNTY. TEXAS Bunt I.I.Baes'Mou VMuntt Atllun Bu6"n/y�t� a1HB.01 APpumed: Ip&ZOP]///�' np&30}] gMNONY NC B qIM 4/19/2022 HNB-ECHO HCCLAIMPMT 746003411440000216691 4/20/2022 WIRE OUT LINEAR ENTERPRISES, LLC 4/20/2022 NOWTAS SOLUTION HCCLUMPMT 676201420000166 4/21/2022 CK1097 4/21/2022 HNB-ECHO HCCIAIMPMT 746003411440000287611 4/21/2022 NOWTAS SOLUTION HCCLAIMPMT 676201420DO0171 4/22/2022 CK1099 4/22/2022 Molina KC of TX HCCLAIMPMT PNIZ757179944200 4/22/Z022 KS PLAN AOMINIST HCCLAIMPMT 179111000020499 4/22/2022 HNB-ECHO HCCLAIMPMT 746003411"0000221157 MMCPORTION QIPP/Camp QIPP/Comp OJPP/Comp Transfer -Out Tonsfer-In 1 QIPP/Comp2 3 4Blapse QIPPTI NH PORTION - 34,545.58 - 34,545.58 SO,449.85 - • 0.41 - 0.41 9.805AS - - 7,744.75 - 7,744.75 - 502.96 - 502.96 17,894.17 - 3,449.52 - 3,449.52 • 37,465.00 - 37,465.00 4125/2022 Quick View Select Quick View Accounts Account Number / Name Account Type Searrh All DDA Account Number Currant Balance Number of Accounts: 15 $8,210,347.92 5 1 CAL CO INDIGENT $52,612.57 HEALTHCARE '4454 MEMORIAL MEDICAL 1 $110.912.66 NH GOLDEN CREEK HEALTHCARE ,4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.26 2014 '4357 MEMORIAL MEDICAL S6,210,091.14 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE y431.71 WAIVER CLEARING 381 MEMORIAL MEDICAL $22,462.01 CENTER/NH A5HFORD 403 MEMORIAL MEDICAL $121.105.66 CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL $146,569.37 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $39.947.49 CENTER/NH FORT BEND -4438 MEMORIAL MEDICAL $98,678.89 CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET $1,110.015.19 FUND '5506 MMC -NH BETHANY S209,107.60 SENIOR LIVING •5441 MMC -NH GULF POINTE $1,654,98 PLAZA- MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE S1,133.38 PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $85,099.01 VILLAGE https://prosperity.olbanking.com/onlineMesseagef Treasury Center Select Group Groups Atld Group Data reported as of Apr 25, 202: Available Balance Collected Balance Prior Day Balanc $8,602.461.95 $8,210,347.92 $7,903,162,3 $52.612.57 $52,612.57 $52,612.E S113,350.40 $110,912.66 S2,832.1' $536.26 $536.26 S536.2 $6,345,719.46 $6,210.091.14 S6.059,891.2 S431.71 S431.71 S431,7 $88.269.43 $22,462.01 $38,977.7 S142,666.60 S121,105.66 $75,164.e 6175.722.27 8146,559.37 S150.132.E $43,258.16 $39.947.49 S13,9601 S139.345.47 S98,678.89 8134,647.E S1,110.015.19 $1,110,015.19 S1,110.015.1 $209,107,60 S209,107.60 5198,899.E $95,057.00 $1.654.98 $1,654.S $1,270.82 S1,133.38 S2,617.; $85,099.01 $85,099.01 560.787.E i/1 Memorial Medial Center Nursing Home UPL Weekly HSLTransfer Prosperity Accounts e/25/2022 AawaL r�.rMaa -11. +N6abn[rtofowrSE,00J wBl 6rtmeymrrd to rArnunw0 aemr. Na[r 2:fadaawn[Aom ameavlvnav/$1 W tAo[MMc"Powe towm APR 2 5 2022 By COUNTY AUDRIOR CALHOUN COUNTY. TEXAS I:VM w AIN trmnmVlx YN eamM2ummamUR2W AK UN nangn semmln Was 22Ju r.atlols M.dk . b,n2 uhn[e V.dm lureln LNn[. 2W,tBrM 290.W Am.antm Re Tnnalerredov IAN INTEREST fIBINIEREST efo NRmw / Atl1u11B111M.E09001M y/ MRravo4 / ' / aXTNBf1YR1 eeN, TF 1/25J10EE 2':0 4/143025 NOW InV20S3 WIREO SOWnON 5ENIO M%Ni6]6101450000156 1/SDN022 WIPE OOTPfiNRNY5EHI0PLIVING. LTD 4120JI032 NGV 4/20(2022 N ffAs5OLIliIONMCMDArM36]6401420000166 4/]3/3022 NOV?ASSOLD]IONNCLUIMPME6]fMBt 42Y0001]1 4p2R022 04001 4/22/20 22 NW ICEOF SOU N NCMIMPME$1112l$ 00004 4/SS/i0i3 XDSPI[EOE SODnI PaymelPf NE 113123650016654 MMCMTI v TI.W'3 y5 T..f W Q,"IUMP3 OPPI&mp9 a9p/UmP9 Qpp/fM1Muou Opp" I NHPOWDON IX.. 5.104.96 3,140.74 3, .74 109,361.96 7,39AW - 2,163.00 IM,263.. 133,262.66 2.M 2.1s 2A .w 1,4M CO .'"O s9 4630.50 603.23 693.22 f99.96i96 509.00].60 MA0IN 4/2512022 Quick View Select Quick View Accounts Account Number I Name Account Type Treasury Center Select Group Grou s Atltl Graup Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 75 $8,210,347.92 $8,602,461.95 $8,210,347.92 $7,903,162 1 •4551 CAL CO INDIGENT HEALTHCARE $52.612.57 $52,512,57 $52.612.57 $52,612.E '4454 MEMORIAL MEDICAL! NH GOLDEN CREEK $110.912.6fi $113,350,40 $110,912.66 52,832.Z HEALTHCARE ,4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $536.26 5536.26 553626 . 5536.<' 2014 ,4357 MEMORIAL MEDICAL CENTER -OPERATING $6,210,091.14 56,345,719.46 $6.210.091.14 $6,059,891.2 '4373 MEMORIAL MEDICAL CENTER - PRIVATE $q31 71 5431.71 . 543171 $4317 WAIVER CLEARING ,4381 MEMORIAL MEDICAL CENTER! NH ASHFORD $22,462.01 $58,269.43 $22,462.01 $38.977.7 •4403 MEMORIAL MEDICAL CENTER/NH $121,105.66 $142,666.60 $121,105.66 $75,164.2 BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT $146,559.37 5175,722.27 $146,559.37 5150,132.E '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND $39.947,49 $43,258.16 $39,947.49 513,960.E '4 38 MEMORIAL MEDICAL CENTER / SOLERA AT $98.678.69 5139,345.47 $98.678.89 5134,647.; WEST HOUSTON '2998 MMC-MONEY MARKET FUND $1,110,015.19 $1,110,015.19 51,110,015.19 51,110,015.1 '5506 MMC -NH BETHANY SENIOR LIVING $209.107.60 ✓ 9209.107.60 5209,107.60 5198,899.F '5441 MMC -NH GULF POINTE PLAZA- 51,654.98 $95,057.00 51.654.98 $1,654,E MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE PLAZA 'PRIVATE PAY 51,133.38 $1,270.82 $1.133.38 $2,617.3 '3407 MMC •NH TUSCANY VILLAGE $85.099.01 $85,099.01 $85,099.01 580,787.E h8ps:/Jprosperity.olbanking.comfonlineMessenger r 1J1 O 00 00 c a z c cry ?� zd DS zr e r O p a r D m y O d O y O O V p m a m z '� ac z� ac zy c � ac z me r n r m z� m:4 n z r =h H y �-h >y O O 00 m < c0 A c A A C h v J N O c O c p c O r 'm m m w m y �^ y o A a a n V' T U A N pn rt Ua yA > > > n nn 00 O O O O O m $^ r -zi y n 'n 9 9 > z = N O m a a a m z z Nr z r a r a r a r a m A m m O a c n n n n > j o > a > a a a z r vyyy�� � a m w °` _• a a a a O y n 3 _ N _ O 3 S ' -I N N V '9n ' Aon n'�Q y- �N� m0� mOz Nz mno mno �0 r-O N O>Z <�z ,oZ Inc Inc c nin� n+[ajn A W -i n�3 nm 3 n o x o k a X �-ri x x �H g-3 '�>q Nmr w 3p m�K A� yPn '-3 mNn Hip m-N Vi ...gyp op A O ti m cS f O _Ann n-i ' nw r w �w = D wn �H Nn c >y =�� z o ox O <_-4 Q O Z m a C z a z p => A 'n' O z Z F O O -]'nj -ln m� ma wK tJ� mN mm� f> _Q A U N U U W � p p o o 0 00 yz ry D a o n �n�aa Oa r zy rd m p< � n m w O 0 z C m A { m m lA P P P P O O O O O 0 ¢ a� D0 Z�O FAFmOm�O O y m m yDm o a? D > > D A' > 9 y Y N > y-i z p= OZ r0 A r0 r0 r0 r0 r0 r0 r0 r0 c0 A K K { O C VUi U N N N P � Q P U 4Nl P a N G N N N N N N N O O O O O O O N N N N N O O O p p N N N N N N N N G O nnn nnn nnn ynn nn inn inn Ann xnn ann ann inn nnn yw� yN> yy> mmy Ayy ny O y-3 nc-Ai-3 x c- 3c A7 3c A D C: a C A7 mmy mmy a"3 mmy 2 -ai =u'D--7 <m D-7 vCi M-4 mmy DmD amp ZmD n_ny N N r N r N r N r N r D N r Z N r N r N N N N r =N y y �u''£. ca ND N`a C]N'G> ND AN Ga ND NGa DNDG aoD of aoy ao ao yo a'-`Zpc ao ao ao a� a. An= A= �� n n x w a A r < 3 3 a 0 ^ P W N W W O O VJi S O VNi VJi N O S � N in o u o 71 Z, O O 00 00 00 v x z �z �z A z i m m A m m A X 9 X j O .> z m m U 0 N O O p Q N Np F n O O O o °a z �E0 z ocr -ri m ZyZ x a oaz a zz x D r>- j n czr m q D l>- S 0 F 3' O z = 0 m < > a n w m X z n n cm^ O z y C m > y C 0 z n m '3 n 0 m n `m O m O O O P O O O O O o O P O p a rt m p A = y A m c 7m� p y r, A 10 ta- m m r � X O > lr- O F o m 2 D > x X o r r no n n m r > C m co ? z Z r,>i, < n X O m o D n > y y z m m m z0 z a o y o o m D P P U W P U W W W A O zo H pw o = N w O pw A J W VNi O a D J O J N mW000 3-+ nEHX>X n-� o^+ >X 3-j nn -ya n n yn -� P lyrea w w Z V M ZD >>mD rrM n_yX OyX y.>.�X zRCO N-a3 N mzw �.]w oww �y m 4 Mr A mD m W'�i n� n n> n O O zw� A.� mZcz� '�-o y.o\n mn A ml7o m A> v r ev xnO�� npU zv p- zJ - rro w mw Zmlj C) ~> Naj mm mnm 3� Oo zo >'n >E >mw mAE Z� ya r� z 3 m0 r 43 g -1 mm O zm y > yz r -�Cd N O C y A C>1 m rmii rmi, N m N - 0 Q W N A U A O ro J W O D J O O O J W A O D O N J O n 3 0 o p 0 o S ❑ Nm m m O O O R 3 C C rj m D K r u = o = a e o 0 9 .Co m y 0 4p C7�J mp m p N Q D nOD ro A n y y Cz w m m v K _y m O m z N ❑� J W W J J J ❑� p. ❑� � n O O O O O O W O O O p a m y_ Nm r F �� a na na m x < O1m n mx m mx m a : D y H ? y 3 y p X N- _ ; _ N a O N 0 O p z r I r� N x N y m r m r m j ti A m m n N p N m D A r N C c C ti H p A r/ w y rail � _ p o Or�' aa 3mo OC�n'.: nNmNm , Dn0 NNW O 0 yx0 �yv -4-aOa wwa m>o0 Ca D CDD xD D a DN OZmm> n" pomr;v zaz m xw omans Cnmm0n rZo p - 3 t a yii r- n A -9'i noun Oma C m a a m OmC,vp,v Ormi, lap ONx m�0 m G0 OA O Zm0 n .Cow o- yD Z-i p z y OO,r C�O.h zn mn za O iK as pO ym wA>P, i�a N zN r n y OZ S9[' a� Z3 cl D y D N N ON '❑J n K 0 Oz s a o ry o C N m Z n Z S z C n = m 0 v O� N N N N b VNi W O A �D N O ❑� U W W N N �D J to N W A U O N R H W W O O T J �p pa O ❑� O O T R n O O O O O O 9 C)z= _ mv� 0055 0AOm m Ord On y z z m m o a o o P 0 0 Y 00� m O O D O Y z0 m m on m y y m J o P P P P P O N N O y0 m0- O n G 0 m mZs y a 00 3 -Da A Zm m m A m Z G m U e D U 'O- P � N O � p � A ro -im Ax Don y�D Dam zDx x< <m >10 zoo °Am mZ y x0 maw CSZ y mn0 p� Soo rZ rOZ A� ww Z3 Can yam m < jC) Q1 � r< 00 m Dm Z � m �o 0 O v n > -Ci Z [0' [- 'n m m a A 0 H C rm- > O C m A < S np 6 O V J S P N W n r p O O O O O O O p N r to 6 W D C D x NA v'D D m0 Ar D AT. Ax �m �Z p D On H� n0 y 0 o r 0 A� �O p00 0 y'a FD--i m �,p', 0 Dv f7 n y N Z A G X > Z m o y 3 P w N O N d C g A O Oa W w ^ ^ p y N gm Og rAm vy 'nZm c)moym m3 cSo3 m C3 Lim D3 -1 ^' yy W C Ley Fow Zy "3 "� 'oo �+ po yrno M o m Onrn 0 o Ao q�a >m m oy Y -1 0 -yi~ y> - < Dm zy W<y Or n O m� nD mZD am 0ym Zm -lA v N o W o Sq A A P N P +1 Oi N �p J J W Oa J w O O O O C O O c n 8. a Y M Z m Z S M3 zo z3 > z� Z D- am y O O m {z ncz o °z c N � m N Po O p' w^ N J O U p N J U N P lA CA m� C p 3a C-Ci m m a4 Z tmr. O m r Z zr ma z �n r y m N ..� m z zN O <❑ a Z 3 y N z D Z r n O c m n m J E w a a r S Z O y N w pAP� QAP� pPA� P w U U U U P w > zF Dm Dw z M aw Zm Sn DC n y 3 Oz-M °z < m > z z°R �n o 0 N r m Om Om OM a0 v O 'O S S 2 A r OC D z M z N m c m Z Z Z n < r F n D M M M J U 0 O y a A A A O J P J P b w O O q NDD nn? npma OmD a` zma zmD AD Nrr Z r z-P o-P 030 3-AP >MOM- 3-iP no ' Z O5 M<o M M A M3o m w A w A m o -3 A A mnN -i 'A S mnt� M A o lab Fr5 "C:5 M F N o A w o b n M N n M N M b - N D OHO z "Z E•i m< mpg mm< m3 OO n1 w m �y rz y m a`r°N aMw n r) A a a N a M M P m a a yo O O O b J N O b b O O O b U Oa J b J J O O O O b O J P J w b b W K r z N m m O m n N M c z r n y P r O O J- c No n O. ng 'o.o < z3� cr nAnn m r A v a a (v o a a c 6 3 C A W P O P ^ = o o y o > a rOA0 0 � O C C 9 L o � ' W C C fin w my M ti mN Y � m Z z mn mn mn mn o ym w bm :om m m m m � O O �O �O MO nO 9 O xe U a U a A ae A y u y A O O O O r O r r m m a< r 9 yO m n m mr O O n r O z z F w y O m A Z n n y w G y y m Z m { o y 6 ci 6 r R d w O m S� mm zac x � `oo z n m n z o mD D > O m F c F a z y m r A A F = m D n m m Z r m O 3 3 z a n O A N J a W mC mC o„n a qmn a IJ VJP awn O W W ma <n <n y P awn y P awn <S 0 �� NY z o O C] o z C+ �. V y O O mA> m-- m;o mWU -o a ao p�: a= mwU wwU» -imn o asa OJ z� Mn nczn In ma yym 0cz� mx y m a ;mc m k m Nrn m a rn u YC �•. -ni " nz N G" x� nr y N N Z Z m m N 0 O' ^ U n a a o $ o $ § ( ( ( ( § \ \ � (/ )) / \) \ \ \ ) - -yE §«!§ \\} \\�ZM \( �a� a !` ) )\ } \ \ ) } \\ \ \ \ \\\ §� \ \ \(j fE ! _ )0 )) k 0 E\G ,E / ao ao ZAc zA°c o o a m g Ayz Ayz m m o �pyZ mZm mZm A A m n a, m m m m 3 3 aa z z z g o N o e m S U b W ny y m W y >b3 '9s w A mp n D A A m a s O v Z m r Q y o O b y 2 j r z A m m yZ n m 00 m m v h C m m •n K '7 n ii y 3 �a K y b o 3 ? a m h h a o zr w eZn Z O O p K D w w N N N W O W W W n O• O• U WV N N J b Oq y r O O O O O N O O O N O O• � O a o< rtKj yn >a A C- [mm O yp W W n 0 � ga pm pm <> m Z OK KO Z Cr n A Z A> D m 9D a? D> mk K Z m m m Kn s rm A a z z 2 m 9 n r r O O A m C a n A b A 0 0 A a a y a m -yi K .. W J N O• T J Vy L b O N b O b U Po O S N r. mw mAW W mmm amm �w aW Snm mp pp >x mmb no �o o ba_no ono c- o zn- =Aim O y .A=� *= W .AL A a =m m m A Z O n a 3 a mOU mZ (pZ 0E2 fm0 o D a Om T? m0 H ZO o Am ,-v1m mwm Do 2 ,O _o mZ _pn Cn nz Om 'DYz Oz^-i� Ww:o 9owo .byo �m `w_C bm tnno A no 00 ym.,� y o ra D9 m v,j �+j rni�< H mOo m Om "mom AK o Z m z O w ur W 0 i3 W a O P U U ^ N J U U A J N y U U J J O O• b O O _ O O P O A Co O O O O n R 6 O O O O O p O O O 0 c m D Z C n a m r rm- y D n O w " n xO O A m H Z ;ma y m m 3 Na H �a r ti y m ryO 6 n N N O O O O O U N O O O O p R 09 R a nm rm z< n my m-1 ay my yy m� m-1 rn OZ xn Dc x a O ? Z yC n y �Z Dm n8 no vD D m � 9'a mD Dm n� ar m K A� ma W H gn Z Dx a Sin o 2 9 0^ nA F z Z-an AA rZiA A0 0 AO D <O Fz AO 3 ? l� y no C C C C m r-1 m Zm -C m n n Z z n y nm O Z A m y z z z C ry- z r xsm p U A ,O p N p JV N 3 U N N na Wm - mo roymanmJ NzW nznm p m-n...�a�w ram mp m_ m WwN oa>m o rrOrN n� +9�^ ti__OO J N N TNpn9WznmWm r�z> rU "OmO CzS m z 0 7 z yz .:WaCNA m9 np<p 'y N N nVp yrN 'Jrp oN nr?pApD A! = Po iAoAr 0O -t mN MK-nR y a m m N O A�oO �>.',pAaJA � rJ _ O W caD am ma � D mx CDmn c nZ zg mcao cA u, a > A K 9 K trl Y A v rain o o N O h j a a g D p J J N U O O O N P N 9 o 6 a0 AO 0 a0 .b0 nv nv no no mD mD' my ao ac m0 m0 m n m n n n RP W W N J O O O R p p 9 P {Un n O p -pin =n •bo m m �' A � '1 •top m 3 p �p F y n a o m o Z � c m to W In W U W to W {A to w w u U N W to U V1 P n W W W W W W W P r O O O O U N N N N N N O O O O W p 6 n n-� n-i 3a ga rpn y xn xn xn xn nH any N Op O� yC yG nZ O >yn ',sr AcG" >a Acc" Gr AOG c> O F p, •3of � -i zo -i so oa •O vt pt •• O v pt ax ZO a ZO Zb zb wN y En Fnn gn Fn 0 cx n-i 3y a Dt r ma ma n w a0 y0 y0 y0 > y p> a 0-j alp •*1 3 gym�(( t v, t b t z J ✓ J J J m P W W w W A Np P P pW� J J J P N P N Oa N U J N A n N 3 a -p �' p 0m nxp -I A ap G C9 m t0 tP zw IP O S O= m rw n p A A P r 3� 9 c b� !/1 lI) o p G •O n n !� n rt � ' .j � z v n � J O O• A A J � to �p J W �O in �O �O O W IJ n n W O � � O e a O O y AO n n A 0 O V n 0 > a c Y a a p Z p Z [n O w > > A m m m m 6 O m O n C w c y r r n N m p r m > n D m y y W W W W lA .P b W lA P P b lA o. p O D-7 wr Rom 3n m� m� z� zz < m Dm m m m c r c a Dy 3 O n> -'fin m m T. m m'm 'n. Dz n a a m a a a a �m Ac Ac a a a nO p Z w y y 6 m a mp o oa x x c x 00 O � � D > O O J W N q P q q U O J q b U q b b P O ry W ( U U U Aa O O .DD q 3 W A N O C w A U O P U w J A b q D U y a J q p� p N N W b A N W N N w_q .bp a 5 D W N a ^' n .''.. yy m 0 a0 0 m O O ny 0 y y y > ym mw DOw rw mw A mm w >am �w � a0 DO O >o 0 0 0 0 55 ...�-r m> ZA W F. ':A A > aA > aA V2 pA AyN mQ��AWNA :El ArN mP A n'PO >poi mN n-0OU nU nW O nc n r rm a D > r0 rw z z> z z z -70=1mn ,s yw0 p�u 'n RC Q W wwrn A zo r> >. m$ O O N r r Z o > m O m m m a c Z �' x � .Np �• rm- n m C7 p v ^ P O W W P N A Vi w �D 0 0 0 a a v y y m a z z n n m m 3 3 m m z z -I -1 o 0 w a n O o m m� mn 6 e cn- � _ r A r Gn Z ALG A H vC .D.7 m m r r n y y m Z o y �i a n O O N .QP L O O O p 6 r � 6 R o a A -i 0 X �O m � Z� n zn f p •m-I Z o a p D A D n y n w Z m 91 6, c A 2 v m O 3 D Z r O V N U m w oo O 3 3 'o o Z& IJ J IJ A> ZO Ao m0 AN 0 N mOOO =Oo ••j N oD Jy z waFD '"'din() D< Dv a o >00 DOo� p _ IAA�OT mA— p z o z mZ zz U yn m zo �o� zn N 3 aDta z� m v' nA mnE Am zz C) o m r H� m z z O F Q P U A W N N J U N N J T U O O U O A U U O W tJn 9 u I Q E § 2 2 ! f n \m m- 2 § m 2 o O O .p o v � a y3a m � zmz o � O n o- w O O O O J V O O O O O O O a y � 3 3 3 z z D e � b 3 'O '9 O n w n r � m Ua � J � 6 n a a -a a� z ho p 0 > O r o �3 c ZO 3n o n � � IJ J N N O P O O z O a � m m 9 9 R 3 3 n N N r �n = 6 a npn 3z n -Z'• x m o ry~j Z > ap K Z rt ° o z'z A 0 Q z z 0 e A 3 3 Z Z y y O � b b R � b n b b 0 R T ; _ fz § ) \ ® §k $k - \ ( \ (§ )\ \ \\\ j z ! - - - z¥ r /§/ >M; ! >j\ §E rz§ | ( �z ` >` ` 7\ - _,