Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2022-07-06 Final Packet
(r`l 'Ili,iI 1 ((1 \II�1I(NION,I"�' All Agenda Items Properly Numbered /Contracts Completed and Signed All 1295's Flagged for Acceptance (number of 1295's I ) 01 All Documents for Clerk Signature Flagged On this qk day of 2022 a complete and accurate packet for.A of 2022 Commissioners Court Regular Session Day 0 Mon was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. &i�L Calhoun County Judge/Assistant COMMISSIONERSCOURTCHECKLIST/FORMS AGENDA i NOTICE OF MEETING — 7/6/2022 Richard ]H . Meyer County judge David Hall, Commissioner, Precinct I (ABSENT)Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney Anna Goodman, County Clerk Kaddlie Smith, Deputy Clerk NOTICE OF MEETING The Commissioners'Court of Calhoun County, Texas will meet on Wednesday, July 6, 2022 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Joel Behrens 4. General Discussion of Public Matters and Public Participation. N/A 5. Consider and take necessary action to lift or retain the county burn ban. (RHM) Judge Meyer reinstated the burn ban, declared state of local disaster and banned all fireworks. Page 1 of 4 I NOTICE OF MEETING — 7/6/2022 6. Consider and take necessary action to declare the attached list of equipment as salvage and remove from Road & Bridge, Precinct 2's Fixed Asset Inventory. This equipment will be sold in auction. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 7. Consider and take necessary action to declare the attached list of equipment as salvage and remove from Waste Management's Fixed Asset Inventory. This equipment will be sold in auction or was previously approved for trade in. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 8. Consider and take necessary action to deposit sheet metal recycling check for $1,058.86 from Texas Port Recycling to Road & Bridge, Precinct 2 account 1000-500-53510, Road & Bridge Supplies. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 9. Consider and take necessary action to approve the amended Purchasing Policy to include language recommended by the Texas General Land Office for cost and price analysis and negotiation prior to award of contracts using federal funds. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 10. Consider and take necessary action to approve the amended Budgetary and Financial Management Policies to include language recommended by the Texas General Land Office for principals on advance payments and cost allowability. (RHM) RESULT: APPROVED [UNANIMOUS] OVER: David Hall, Commissioner Pct 1 CONDER: LS Joel Behrens, Commissioner Pct 3 ES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 2 of 4 NOTICE OF MEETING — 7/6/2022 11. Consider and take necessary action to authorize the County Clerk to sign an agreement with DSHS to enable the County Clerk to issue birth certificates from other counties. (RHM) PASS 12. Consider and take necessary action to approve the installation of a credit card terminal at the Calhoun County Museum and authorize the County Judge to sign the service agreement. (RHM) PASS 13. Consider and take necessary action to approve the proposal from G & W Engineers, Inc. for Professional Consulting Services related to the Roof Re-cover Renovations at Calhoun County Annex II, Calhoun County Ag Building and Calhoun County Seadrift Library and authorize the County Judge to sign the proposal. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 14. Accept Monthly Report from the following County Office: I. Tax Assessor -Collector —May 2022 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese 15. 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, Behrens, Reese Page 3 of 4 NOTICE OF MEETING — 7/6/2022 16. Approval of bills and payroll. (RHM) MMC: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese County: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Adjourned: 10:13a.m. Page 4 of 4 1 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Deese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, July 6, 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 � Lo 001�_ L�— K-Call meeting to order. JUL0 j 022 ;��Plvocation. nedges of Allegiance. General Discussion of Public Matters and Public Participation. t5zConsider and take necessary action to lift or retain the county burn ban. (RHM) 6. Consider and take necessary action to declare the attached list of equipment as salvage and remove from Road & Bridge, Precinct 2's Fixed Asset Inventory. This equipment will /be sold in auction. (VL) N: Consider and take necessary action to declare the attached list of equipment as salvage and remove from Waste Management's Fixed Asset Inventory. This equipment will be sold in auction or was previously approved for trade in. (VL) B. Consider and take necessary action to deposit sheet metal recycling check for $1,058.86 from Texas Port Recycling to Road & Bridge, Precinct 2 account 1000-500-53510, Road ,�& Bridge Supplies. (VL) Consider and take necessary action to approve the amended Purchasing Policy to include language recommended by the Texas General Land Office for cost and price analysis and negotiation prior to award of contracts using federal funds. (RHM) Page 1 of 2 I0. Consider and take necessary action to approve the amended Budgetary and Financial Management Policies to include language recommended by the Texas General Land pp OfFlce for principals on advance payments and cost allowability. (RHM) i1. Consider and take necessary action to authorize the County Clerk to sign an agreement with DSHS to enable the County Clerk to issue birth certificates from other counties. (RHM) � - .i-; I /� 0�- P12. Consider and take necessary action to approve the installation of a credit card terminal at the Calhoun County Museum and authorize the County Judge to sign the service agreement. (RHM) 13:Consider and take necessary action to approve the proposal from G & W Engineers, Inc. for Professional Consulting Services related to the Roof Re-cover Renovations at Calhoun County Annex II, Calhoun County Ag Building and Calhoun County Seadrift Library and ��authorize the County Judge to sign the proposal. (RHM) 14. Accept Monthly Report from the following County Office: i. Tax Assessor -Collector — May 2022 K Consider and take necessary action on any necessary budget adjustments. (RHM) 16. Approval of bills and payroll. (RHM) r Richard H. Meyer, County J dg Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.org under "Commissioners' Court Agenda' for any official court postings. Page 2 of 2 # 05 NOTICE OF MEETING — 7/6/2022 Richard Fl. Meyer County judge David Hall, Commissioner, Precinct 1 (ABSENT)Vern Lyssy, Commissioner, Precinct 2 (Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney Anna Goodman, County Cleric ][caddie Smith, ][Deputy Cleric NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, July 6, 2022 at 10:00 a.m. in the Coummnissiomers' Courtrooms in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Joel Behrens 4. General Discussion of Public Matters and Public Participation. N/A 5. Consider and take necessary action to lift or retain the county burn ban. (RHM) Judge Meyer reinstated the burn ban, declared state of local disaster and banned all fireworks. Page 1 of 12 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 I A I "Is)I:II:I1 1"IR(�AI It I.A WHEREAS, on the 6th day of July, 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 County Judge of Calhoun County that all outdoor burning is prohibited in any unincorporated area of the County for 90 days from the date of issuance 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 issued 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. r Richard H. Meyer Calhoun County Judge Page 1 of 1 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 RESOLUTION DECLARING A STATE OF LOCAL DISASTER WHEREAS, the County of Calhoun beginning on the 6th day of July, 2022 and continuing, has suffered widespread or severe damage, injury, or loss of life or property (or there is imminent threat of same) resulting from the prolonged widespread dought and; WHEREAS, the Commissioners' Court of Calhoun has determined that extraordinary measures must be taken to continue to alleviate the suffering of people and to protect or rehabilitate property; NOW, THEREFORE, BE IT RESOLVED, BY THE COMMISSIONERS' COURT OF THE COUNTY OF CALHOUN: 1. That a continuing state of disaster is declared for the County of Calhoun. 2. That the County's Emergency Management Plan has been implemented. 4. That this resolution shall take effect immediately from and after its issuance. SIGNED this the 6th day July, 2022. ; -e-� a d H. Meyer, County Judge Calhoun County Commissioner, Precinct. 1 ✓i � ` DzV�r/�2 v� Joel B hrens Calhoun County Commissioner, Precinct 3 Vern Lyssy Calhoun County Commissioner, Precinct 2 Gary Ree e Calhoun County Commissioner, Precinct 4 Page 1 of 1 Richard ]H[,Meyer County judge David Hall, Commissioner, Precinct fl Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 i���l�ll•' lug �,�,At� �I i III';I_A\�I"i _;I I��!�ltf�l"I"���If�II 1� AREAS AI IlO \ COUNTY, TEXAS X' Whereas, the Texas Forest Service has determined that drought conditions exist in Calhoun County; and Whereas, the Commissioners' Court of Calhoun County has declared a state of local disaster; and Now, therefore, it is hereby ordered by the Commissioners' Court of Calhoun County that the use of all fireworks within unincorporated areas of this county is prohibited. This Order is adopted pursuant to Section 240-904, Local Government Codes, and other applicable statutes. Violation of this Order is a Class C Misdemeanor, punishable by a fine not to exceed $500.00. Approved, this the 6th day of July, 2022, by the Calhoun County Commissioners' Court. r Richard H. Meyer, Kuty Judge Attest: Anna Goodman - 4alhodujnCounty Clerk Page 1 of 1 # 06 NOTICE OF MEETING — 7/6/2022 6. Consider and take necessary action to declare the attached list of equipment as salvage and remove from Road & Bridge, Precinct 2's Fixed Asset Inventory. This equipment will be sold in auction. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 2 of 12 Vern Lyss Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 June 27, 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 next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary to declare the attached list of equipment as salvage and remove from Road & Bridge, Pct. 2's Fixed Asset inventory. Will be sold in auction. Sincerely, ,21,—Z. Vern Lyssy Commissioner, Pct. 2 VL/Ij CALHOUN COUNTY SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Road & Bridge, Pct. 2 Requested by: Commissioner Vern Lyssy Inventory Reason for SurpluslSaivage Number Description Serial No. n.m...e.. 22.0248 1995 Chausse Model 10D0 13048 To be auctioned 22-0189 199013roce Power RJ300 86453 To be auctioned 22-0223 Bush Ho 2815LI Cutter wlfront & rear chains 12.22271 To be auctioned 22-0250 1889 ngergo 4Rand compactor Role Model DD90 5552-S To be auctioned 22-0267 Used Hypac Pneumatic Compactor, Model C630AH 10SA22201973 To be auctioned 22-0262 1991 Case 888 Trackhoe CGG0106819 To be auctioned 22-0279 H ster40 Forklift 14687 To be auctioned 22-0264 A Frame and Hoist To be auctioned 22-0037 Cata illar 910 Wheel 684778 To be auctioned 22-0261 1980 Loader 76-B Clark N443E223CB To be auctioned 22-0252 88 Motot Grader F atall s Model 66 , 369 CID 6CY 68 HP Diesel 60004196 To be auctioned 22-0150 1996 Fiat Allis FG76A 96C04196 To be auctioned 639-0048 John Deere LT133.38" Lawn Tractor MOL133A076153 To be auctioned 22-0171 1999 or 50, bed finor, headache rack, toolbox runt bars 1FTNF20LOXEA16874 To be auctioned 22-0234 1994 Chevrolet Extended Cab S10 1GCCS19ZIR8238162 To be auctioned 22-0083 Fill Rite Gas To be auctioned 22-0226 Vibromax 265 Roller JKC5303306 To be auctioned 22-0089 Stlhl Chain saw 212722964 To be auctioned 22-0122 Stihl Chain saw 23394896 To be auctioned 22-0249 2006 Imperial Water Tank 2000 gallons 3806 To be auctioned 22.0158 - Challenger Aluminum Tool Box To be auctioned 22-0273 09-1996 Case 4WD Tractor, cab & air, 80HP JJF1051640 To be auctioned 22-0294 Case IH.JX 95 Tractor HFJ0370001 To be auctioned 22-0091 IShov built trailer for Water Pump To be auctioned 22-0159 1984 VIMC Flat Bed, Heavy -Duty Trailer 1V8FA2034EV024208 To be auctioned 22-0266 1998 Trallboes Trailer 4SOFP3337W7000557 To be auctioned # 07 NOTICE OF MEETING — 7/6/2022 7. Consider and take necessary action to declare the attached list of equipment as salvage and remove from Waste Management's Fixed Asset Inventory. This equipment will be sold in auction or was previously approved for trade in. (VQ RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 3 of 12 Vern Lyss Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 June 27, 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 next Commissioners' Court Agenda (361) 552-9656 Fax (361)553-6664 • Consider and take necessary to declare the attached list of equipment as salvage and remove from Waste Management's Fixed Asset inventory. Will be sold in auction or was previously approved for trade in. Sincerely, Vern Lyssy Commissioner, Pct. 2 VL/Ij CALHOUN COUNTY SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Waste Management Requested by: Commissioner Vern Lyssy Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration 22-0202 Caterpillar 416C BackhoelLoader 42N21222 Traded in 505-0011 Bobcat 17002 Traded in 605.0003 Max PAC MP 6016 Vertical Baler 15 HP To be auctioned 80-0079 Portable Vermeer Chipper Mode 0 w er ns 4.236 Diesel engine 1VRC14133L1001816 To be auctioned 505-0029 MTD Riding Mower 18.5 46' M Model 13A0772H755 18057B70109 To be auctioned 505-0001 1994 Sams Utility Trailer 8'xt6' 11YUS1920RT000203 To be auctioned • 1: NOTICE OF MEETING — 7/6/2022 8. Consider and take necessary action to deposit sheet metal recycling check for $1,058.86 from Texas Port Recycling to Road & Bridge, Precinct 2 account 1000-500-53510, Road & Bridge Supplies. (VL) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 4 of 12 Vern L Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 June 30, 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 next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary to deposit sheet metal recycling check for $1,058.86 from Texas Port Recycling to Road & Bridge, Pct. 2 account 1000- 550-53510, Road & Bridge Supplies. Sincerely � Lam.,•_, Vern Lyssy Commissioner, Pct. 2 VL/Ij Calhoun County precinct 2 EP:E ATTACHED FOR DETAIL Victoria Facility 3105 Odom Street Victoria, TX 77901 (361) 580-2341 Date: 06/24/22 Check No: 64801103 Texas Port Recycling Victoria Facility _DATE 06/24122 NO. 6+'s01143 e49v6 - 3105 Odom Street - Victoria, TX 77901 VOID AFTER 90 DAYS (361) 580-2341 Wells Fargo Bank, N.A. r CIII GK AMOUNT PAY EXACTLY "1,058 DOLLARS AND 86 CENTS L t,058 86'. To THE Calhoun County Precinct 2 i ouiNi-� V40WNua1.;u.NA,URLS )V„ ,;,;,01 ORDER vaca, Of= Port L Port Lavaca, TX 77979 ------ ---.-::. Aui , n✓-�-t.� s7TDEu,NAiuia. i 1.11. VUI G4I L4 BANK: 64 - TPR-WF BANK -VT Sapnlier=: CALHOI TRADER: SETTLEMENT SUPe?AP,Y FOR: Calhoun. County Precinct 2 20627 'Ts172 Port Lavaca T%; 77979 ------------------------------------- Calhoun County Precinct 2 PortLavaca T\ CAD COINTRACT n LN NATERIA.L DESCRIPTLON----i"EIGHTS (IN LB) :ATE SHIPNNT 4 CODE YD TICKET 4 iREc SHIP4 INITIAL CHECK INVOICE = SETTLE CHECK pFaiCLE NO./ T.RIP4 1 B/Lr --------------------------------------------- 6/20/22 Sheet iron TTQLAR 1020 - TTQLAR 801103 TTQLAR00 TKVI TTQLAR PAGE NO; i OUR PRICE UPM, ACJ• AMOUNT TOTAL AMT YOJR PRICE IDIITIAL FRT iiJITTAL PAY YOUR INVCE Ai",T DEAD FRT FR: ADJ EXCESS FRT OTHER ADJ CHK AMT -------------- ------------------------------------------------------------- RECV G 15860 SH:P G 15860 5.5000 CW .00 236.50 11560 T 11560 3.5000 0^7 .00 N 430C N 4301, 236.50 SETTLE l9GT 1300 23E.50 ------------------------------------------------ Sheet Iron -------------------------------------- RECV G 1528 0 SHIP G 15280 5.5000 C17 .00 211.69 TTQ,JSJ 1020 F T 11120 T 114H 5.5000 a".00 TTQMSJ 801103 it 3860 N I.69 TTQt'SJ00 WGT ADJ -193DIRT SETTLE PtGT. 3667 "KVI TTQh1SJ 201.69 - -----------------_---------- /21/22 Sheet eron RECV G 16220 SHIP G 16220 5.5000 CS" 00 267.30 TTQREN 1020 F 1136C T 11360 5.5000 CW TTQREM 801103 �860 N 860 267.30 .00 T7QM400 SETTLE WGT 4860 TKVI TTQREM ------------------ "1122 TTUN?; TTQUNn00 TKVI ITQUNI ----------------- 21/22 TQiIxY TT.Q6IAY TTQWAY00 T KVI TTQWAY -------------------- Sheet Iron RECV C 15020 SN:,, G 15020 5. 5000 CPS 801108 tl 3580 N 3580 196.90 SETTLE "l T 3550 --------------------- Sheet Iron !O20 F 80' 103 REV G 14000 SHIP G 14000 5.5000 C4r T 1138C T 11380 5.5000 CS' P! 2620 N 2620 i44.10 SETTLE -1. 'GT 262C 20.30 --------------- 00 196.90 # 09 I NOTICE OF MEETING — 7/6/2022 9. Consider and take necessary action to approve the amended Purchasing Policy to include language recommended by the Texas General Land Office for cost and price analysis and negotiation prior to award of contracts using federal funds. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 5 of 12 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Wednesday, June 29, 2022 1:37 PM To: Mae Belle Cassel Cc: Richard Meyer; Katy Sellers Subject: Agenda Item Request -Purchasing Policy Amendment Attachments: county purchasing policy -as amended 2017.06 track changes.pdf Please place the following item on the agenda for July 6, 2022: • Consider and take necessary action to approve the amended Purchasing Policy to include language recommended by the Texas General Land Office for cost and price analysis and negotiation prior to award of contracts using federal funds. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindv.mueller(cicalhouncotx.ore Calhoun County Texas CALHOUN C:OUNTYH TEXAS, PURCHASING POLICY AS PASSED BY COMMISSIONERS COURT ON SEPTEMBER 15, 2000 AND AMENDED ON ➢ECEMBER 29, 2000, JANUARY 13, 2005, SEPTEMBER 14, 2006, AUGUST 13, 2009, FEBRUARY 24, 2011, FEBRUARY 13, 2014, AUGUST 11, 2016, JUNE 22, 2017 AND JULY 6, 2022 All purchases for requirements and operation of Calhoun County must be made in accordance with Texas State Statutes and must be for legal, ordinary and necessary purposes. Prior to payment the county auditor will approve all payments for legality with the various Texas State Statutes and the Commissioners' Court will approve all payments for ordinary and necessary purposes. Invoices not approved for payment by either the county auditor or the Commissioners' Court will be returned to the department head/elected official responsible for the purchase for disposition. 2. All purchases will be for a quantity suitable to the purpose and at the least possible expense to Calhoun County. 3. Purchases under $50,000 will originate with the department head/elected official and should be evidenced by a purchase order/request for payment to the vendor. Prior to the issuance of the purchase order/request for payment the issuing department should obtain quotations from at least three responsible suppliers to determine the lowest and/or best price/proposal. In these instances it is the department head/elected official's responsibility to be able to show evidence that he ordered from the lowest and/or best bid/proposal supplier. Emergency purchases should be curtailed by proper planning and anticipating needs far enough in advance that regular purchasing procedures may be followed. Emergency purchases may be made without obtaining quotations from three responsible suppliers with the department head/elected official's approval and should only be made to keep buildings and machinery in operating condition when their idleness would result in expense to Calhoun County or may be made for extreme emergency cases involving public health and welfare cases. In the case of emergency purchases the purchase order/request for payment should be marked "EMERGENCY PURCHASE". Emergency purchases are subject to approval by the Commissioners' Court. 4. Purchases of $50,000 and over will be made on formal bid or proposal. The request to advertise for bids/proposals along with the appropriate specifications should be submitted directly to the Commissioners' Court. Upon approval of the specifications and authorization to advertise by the Commissioners' Court the county auditor will CALHOUN COUNTY PURCHASING POLICY PAGE 1 OF 7 place the necessary advertisements and notices for the bid/proposal. All formal bids/proposals will be received by the county judge and will be opened in the office of the County Judge one week before the meeting at which the Commissioners' Court will consider the bids/proposals and will be available for study at the County Judge's office. A suggested order could be as follows: The Commissioners' Court hereby orders the approval of the accompanying specifications for the purchase of (item) with the opening of the bids)/proposal's) to be in the County Judge's Office at 10:00 AM on (date one week before consideration) at which place they will be available for study until the Commissioners' Court considers them on (date of Commissioners' Court meeting). The Commissioners' Court will award the bid/proposal to the lowest and best bidder or best proposer taking into consideration the recommendation of the appropriate department head/elected official. After the bids/proposals have been awarded the department head/elected official may issue the necessary purchase order/request for payments. 5. County capital projects under $50,000 will be under the direction of the appropriate department head/elected official. All county capital projects over $50,000 will be under the direction of the county judge unless the Commissioners' Court, by order, appoints someone else to be responsible for the project. 6. All county employees will keep free from obligation by not accepting gifts or entertainment offered by any supplier for Calhoun County. 7. To be properly processed the purchase order/request for payment must contain the following information: a. Date the purchase order/request for payment is originated; b. Vendor complete name, address and telephone number; c. Department name and exact place where item is to be delivered: d. The department account number to which the expenditure is to be charged; e. The quantity desired; f. An exact description of the item and the use for which the item is to be put; g. Quoted price; h. Signature of the department head/elected official or his authorized representative. 8. The purchase order/request for payment should be prepared with three parts. The second part may be signed by the department head/elected official and forwarded to the vendor supplying the goods/services or the department head/elected official may order the goods/services by any other method of communication. The department should retain the third part for its records. The first part (original) should be held until the goods/services are received and verified as to quantity and amount. After verifying that the goods/services are in order, the department head/elected official or his authorized representative should sign the purchase order/request for payment and submit it along with the vendor's invoice to the county treasurer's office for payment. PAGE 2 OF] The Commissioners' Court, at a public hearing, must approve all purchase order/request for payments prior to payment. Purchase order/request for payments submitted to the county treasurer's office less than four business days before the next Commissioners' Court meeting will not be processed for that meeting. 9. Purchase order/request for payments should not be issued for goods/services that do not have an unencumbered budget balance. If funds are not available the department head/elected official should make a request for transfer of funds from other appropriations or additional fands to the Commissioners' Court. The county auditor is required, by statute, to disapprove for payment any payment that exceeds the budgeted amount. Disapproved purchase order/request for payments will be returned to the department head/elected official for disposition. 10. If a purchase requires a trade-in, such as an automobile, office machines or other equipment, the department head/elected official should request approval of the trade- in from Commissioners' Court prior to the purchase of the new asset. The county auditor's office should be sent a copy of the Commissioners' Court approval of the trade-in along with trade-in's county identification number. 11. All lease/purchase agreements must be approved by the Commissioners' Court and signed by the county judge unless the Commissioners' Court authorized someone else to sign the agreement. All lease/purchase agreements must contain the "government clause" authorizing the return of the equipment if the Commissioners' Court does not appropriate funds for the lease/purchase in a future year. Failure to comply with this provision will result in the department head/elected official becoming liable for any losses sustained by Calhoun County. 12. County employees wishing to purchase items from vendors doing business with Calhoun County should set up their own account with the vendors and not use Calhoun County's account. Calhoun County is exempt from state sales taxes; however county employees are not exempt. Any purchases made through Calhoun County for employees' personal use will be deducted from the invoice and the appropriate department head/elected official will be responsible for the payment of the amounts so deducted along with the appropriate sales taxes. 13. All office supplies, equipment and office machinery will be used only for business related to the operation of county offices and departments. Office equipment and supplies will not be removed from its assigned departmental location for any reason other than for business related to the operation of county offices and departments. 14. County employees, with the exception of members of the Commissioners' Court, will be allowed to bid on surplus property offered to the public at public auction, just as any other citizen of Calhoun County. 15. Department head/elected officials are expected to keep appropriate controls over the use of departmental equipment such as telephones, postage, copy machines, computers INTY PURCHASING POLICY PAGE 3OF7 and etc. to assure that use of this equipment is not abused and that Calhoun County is not incurring expense for the personal use of this equipment. 16. County employees traveling on official county business, who incur travel expenses, whether paid personally or through the use of a county credit card, must submit approved travel forms to the County Treasurer or Auditor within 5 days of the completion of the travel. Calhoun County's travel reimbursement plan is an "accountable plan" as outlined in the Internal Revenue Service's regulations. As such, the department head/elected official is responsible for determining what reimbursements for travel will be made by Calhoun County, however in the event that meals are reimbursed where the county employee was not required to spend the night at the travel location, then the meal reimbursement shall be considered additional compensation to the employee and reported on his earnings record as compensation in accordance with Internal Revenue Service regulations. Guidelines for travel are as follows: a. Calhoun County will reimburse actual expense incurred for meals and lodging if detailed receipts are kept by the employee and submitted with the appropriate travel expense form. b. If no detailed receipts are kept, reimbursement to the employee for meals only will be computed at the current federal standard CONUS rates allowable by the Internal Revenue Service for tax purposes for the following: i) Morning Meal ii) Noon Meal iii) Evening Meal In accordance with IRS regulations, the rates will be updated January 1, if applicable, and will be effective for travel during the calendar year. c. No reimbursement will be made for meals or lodging which have been paid by the conference, provided as part of the conference cost or which were not paid for by the employee under this plan. d. Calhoun County will reimburse actual expenses on travel by air, bus or train at the lowest available fares. Department heads/elected officials are responsible for determining the lowest available fares. Detailed receipts are required. e. Mileage reimbursement for authorized use of personal automobiles on county business will be computed at the current rate set by the Internal Revenue Service for tax purposes. f. Calhoun County will reimburse employees for other expense related to the purpose of such travel only if detailed receipts are kept and submitted with the appropriate travel expense form. Exceptions to this rule will be made for reasonable tipping and taxi fees. CALHOUN COUNTY PURCHASING POLICY PAGE 4 OF g. It is the responsibility of each department head/elected official to utilize travel funds only for official county business. These funds are budgeted for the purpose of allowing county employees to attend various association meetings, training seminars, education seminars, other county related purposes and the required law enforcement travel relating to prisoners and probationers. It shall be the responsibility of each department head/elected official to see to the strict enforcement of this policy. h. County officials and employees assigned a County vehicle are prohibited from using such vehicle for personal use except for commuting or de minimis personal use. County officials and employees assigned a County vehicle will be required to sign an annual statement that provides the total amount of miles driven for commuting or that states there was no personal use of the vehicle. The County will report the value of personal use miles as compensation to the employee, calculated in accordance with the appropriate Internal Revenue Service guidelines. It is the official/employee's responsibility to be familiar with the Internal Revenue Service guidelines concerning personal use of employer -provided vehicles. The guidelines are available in Publication 463 at www.irs.eov. All officialslemployees are responsible for maintaining appropriate records to substantiate the use of County - provided vehicles. Should it be determined by the Internal Revenue Service that these guidelines were not followed by the official/employee; the official/employee will be responsible for any penalties, interest, or other charges imposed by the Internal Revenue Service on Calhoun County as a result of the official/employee's failure to comply with the guidelines. i. County law enforcement personnel assigned a County vehicle are required to use the vehicle for commuting. Any personal use of a County vehicle by law enforcement personnel other than for commuting is prohibited. j. Commuting in exceptional circumstances may dictate that such travel is in the best interest of the County and fall within the requirement that travel be reasonably related to County business and therefore not considered as personal use. Travel to public functions such as dedications, civic ceremonies, County fairs, citizens meeting, etc. where attendance is in the interest of the County and not personal or political in nature is considered to be County business travel k. County officials/employees will be required to keep an accurate and timely log of any commuting or personal mileage. 17. Grant applications must be authorized by Commissioners Court. The department head/elected official who is awarded a grant shall adhere to all procurement guidelines, policies, and procedures in the application, assurances, award, and documentation of the state or federal grant. CALHOUN COUNTY PURCHASING POLICY PAGE 5OF7 The department head/elected official must strictly adhere to all procurement requirements of federal grants, programs, or allocations noted in the 2 CFR Part 200 and supplements as applicable by the Catalog of Federal Domestic Assistance (CFDA) Number. The CFDA number is provided for all federal funding sources. Where specific procurement direction is not provided for in 2 CFR Part 200 or supplements, the department head/elected official shall abide by the "common rule" which is published by each separate federal agency. The department head/elected official is responsible for checking the debarment status of all vendors before contracting with or making any purchases with funds from any federal grant. The Excluded Parties Listing Systems (EPLS) is an electronic database of parties excluded from federal procurement and non -procurement programs and is located at httos://www.SAM.Gov. The EPLS identifies those parties excluded throughout the U.S. Government (unless otherwise noted) from receiving Federal contracts or certain subcontracts and from certain types of Federal financial and nonfinancial assistance and benefits. Prior to procuring or entering into contract(s) for any goods/services, the department head/elected official must check the debarment status of the vendor using the EPLS system (https://www.SAM.Gov) and document that verification has occurred. If the vendor is found to be debarred, the vendor may not be used for procurements utilizing federal funds. If the vendor is found not to be debarred the department head/elected official must print the screen from the EPLS indicating the vendor is not debarred and attach this documentation to the invoice when it is submitted to the county auditor for approval. This policy applies to the procurement of all good(s) or service(s) regardless of unit price or quantity. Furthermore, because vendors are being removed and new ones added on a daily basis, department head/elected officials are required to verify and attach documentation that the vendor is not debarred before issuing a new purchase order/check request, contract or single time purchase. 18. Fedeisal-6FaHE,4werdsFederal grant awards should comoly with the following: reasonable. 6 200.323 Contract cost and price proposals. CALHOUN COUNTY PURCHASING POLICY PAGE 6OF7 Formatted: List Paragraph, Line spacing: Multiple 1.0811, Outline numbered + Level: I + Numbering Style: 1, 2, 3, ... + Start at: 1 + Alignment: Left + Aligned at: 0" + Indent at: 0.25" 1.0811 Formatted: Font: (Default) TIMM New Roman, 12 pt Formatted: List Paragraph, Justified, Numbered + Level: 1 + Numbering Style: a, b, c, ... + Start at: 1 + Alignment: Left + Aligned at: 0.25' + Indent at: 0.5" i Formatted: Formatted: Font: 12 pt Formatted: Font: (Default) Tames New Roman, 12 p[ - Formatted: Font: 12 pt id) The cost plus a percentage of cost and percentage of constmction cost methods__ , - Formatted: Font•. (Default) nmes New Roman, 12 pt of contracting must not be used. .---i Formatted: Justified CALHOUN COUNTY PURCHASING POLICY PAGE 7OF7 #10 NOTICE OF MEETING — 7/6/2022 10. Consider and take necessary action to approve the amended Budgetary and Financial Management Policies to include language recommended by the Texas General Land Office for principals on advance payments and cost allowability. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 6 of 12 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Wednesday, June 29, 2022 1:25 PM To: Mae Belle Cassel Cc: Richard Meyer, Katy Sellers Subject: Agenda Item Request Attachments: Calhoun County Budgetary and Financial Mangagement Policies -with Track Changes.pdf Please place the following item on the agenda for July 6, 2022: Consider and take necessary action to approve the amended Budgetary and Financial Management Policies to include language recommended by the Texas General Land Office for principals on advance payments and cost allowability. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindv.mueller@calhouncotx.ore Calhoun County Texas Calhoun County, Texas Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020_ and Amended July 6, 2022 Calhoun County formally adopts the following budgetary and financial management policies to provide sound guidelines in planning the County's financial future. The adoption of and adherence to these policies will help ensure long-term financial stability and a healthy financial position for the County. The fiscal year of the County is January 1 through December 31. General Budgetary Policies Budget Preparation, Public Hearings, Availability of Budget to Public The County Budget shall be prepared in accordance with all applicable State of Texas laws. The budget preparation commences in July. The Budget shall be comprehensive in nature and address all funds of the County. It shall be a requirement each year for the budget of each fund to be balanced. This means that total resources available, including prior yew ending resources plus projected revenues, shall be equal to or greater than the projected expenditures for the coming year. The goal each year shall be for the Proposed Budget as prepared by County Commissioners Court to be filed with the County Clerk and on the County's website for public viewing no later than August 31. No later than the third week of September, public hearing(s) shall be held on the Proposed Budget to provide the citizens of Calhoun County a chance to ask questions as well as an opportunity for the Court to bear any recommendations before final approval of the Budget. Cost Center Accounting and Budgeting It shall he the policy of the County to allocate cost and budget accordingly to the various funds to the extent practical. Bond Ratings It shall be the County's long-term goal to improve its bond ratings for general obligation bonds and revenue bonds. The County's policy shall be to manage its budget and financial affairs in such a way so as to promote enhancement of its bond ratings. This financial management includes the following: • Include a five-year projection plan in the approved annual budget. • Plan in advance for future capital improvements. • Maintain financial procedures to quickly identify financial problems and limit budget shortfalls. • Review projected revenue methodologies annually. • Review method of determining appropriate cash reserve levels annually. Budget Projections for Revenues and Expenditures Most individual budget projections are a collaborative effort between Department Heads, County Commissioners Court, and the County Auditor. Revenue and expense estimates are always to be Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6. 2022 conservative so as to reduce any potential for budget shortfalls. Maintenance of Plant and Equipment The operating budget will provide for the adequate maintenance and replacement of the capital plant, building, infrastructure. and equipment. Deferral of such costs on a long-term continued basis will not be an acceptable policy to use in balancing the budget. Financial Manaeement Policies Fund Balance Policy Purpose The purpose of this policy is to establish a key element of the financial stability of the County by setting guidelines for fund balance in accordance with Governmental Accounting Standards Board (GASB) Statement No. 54. Unassigned fund balance is an important measure of economic stability and it is essential that the County maintain adequate levels of unassigned fund balance to mitigate financial risk that can occur from unforeseen revenue fluctuations, unanticipated expenditures, and other similar circumstances. This policy will ensure the County maintains adequate fund balances in the operating fund with the capacity to: 1. Provide sufficient cash flow for daily financial needs, 2. Secure and maintain investment grade bond ratings, 3. Offset significant economic downturns or revenue shortfalls, and 4. Provide funds for unforeseen expenditures related to emergencies. Definitions Fund Equity -A futufs equity is generally the difference between its assets and its liabilities. Fund Balance - The fund equity of a governmental fund for which an accounting distinction is made between the portions that are spendable and non -spendable. Fund Balance reporting in governmental funds: Fund balance will be reported in governmental funds under the following categories using the definitions provided by GASB Statement No. 54: Non -spendable fund balance - includes the portion of net resources that cannot be spent because of their form (Le, inventory, long-term loans, or prepaid items) or because they must remain in -tact such as the principal of an endowment. • Restricted fund balance - includes the portion of net resources on which limitations are imposed by creditors, grantors, contributors, or by laws or regulations of other governments (i.e., externally imposed limitations). Amounts can be spent only for the specific purposes stipulated by external resource providers or as allowed by law through constitutional provisions or enabling legislation. Examples include bond proceeds, grants and special revenue fees and fines. Committed fund balance - includes the portion of net resources upon which the Commissioners Court has imposed limitations on use. Amounts can be used only for the Page 2 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6. 2022 specific purposes determined by a formal action of the Commissioners Court. Commitments may be changed or lifted only by the Commissioners Court taking the same forma/ action that originally imposed the constraint. The formal action must be approved before the end of the fiscal year in which the commitment will be reflected on the financial statements. Assigned fund balance - includes the portion of net resources for which an intended use has been established by the Commissioners Court. Assignments of fund balance are much less formal than commitments and do not require formal action for their imposition or removal. In governmental funds other than the general fiord, assigned fiord balance represents the amount that is not restricted or committed which indicates that resources are, at a minimum, intended to be used for the purpose of that fund. Authority to Assign — Commissioners Court shall have the authority to assign any amount of funds to be used for specific purposes. Such assignments cannot exceed the available (spendable, unrestricted, uncommitted) fund balance in any particular fund. The assignments may occur subsequent to fiscal year-end. The County Auditor is authorized by Commissioners Court to assign funds balances based on intentions for use for specific purposes communicated by the Commissioners Court. • Unassigned fund balance - includes the amounts in the general fund in excess of what can properly be classified in one of the other categories of fund balance. It is the residual classification of the general fund and includes all amounts not contained in other classifications. Unassigned amounts are technically available for any purpose. Negative residual amounts for all other governmental funds are reported in this classification. Minimum Unassigned Fund Balance • General Fund - It shall be the policy of the County to maintain, if available, stabilization fiords of up to three months of regular General Fund operating expenditures, measured based on the most recently completed fiscal year. This funding is intended to provide. stabilization in case of unforeseen events that may occur such as emergencies, contingencies, revenue shortfalls or budgetary imbalances. In the event that stabilization funding is required to be used and unassigned fund balance is calculated to be less than the policy stipulates, the Commissioners Court shall take necessary budgetary steps to bring the fund balance level into compliance with the policy as soon as state law and economic conditions allow. These steps may include but are not limited to identifying new, nonrecurring, or alternative sources of revenue; increasing existing revenues, charges and/or fees; use of year-end surpluses; and/or enacting cost saving measures such as holding capital purchases and reducing departmental operating budgets. The replenishment of fund balance to the minimum level shall be accomplished within a three-year period. If restoration of the reserve cannot be accomplished within such a period without severe hardship to the County, then the Commissioners Court shall establish an extended timeline for attaining the minimum balance. Page 3 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6, 2022 Appropriation from Minimum Unassigned Fund Balance Appropriation from the minimum unassigned fund balance shall require the approval of the Commissioners Court and shall be utilized only for one-time expenditures, such as capital purchases, and not for ongoing operating expenditures unless a viable revenue plan designed to sustain the expenditures is simultaneously adopted. The Commissioners Court may appropriate unassigned fund balances for emergency purposes, as deemed necessary, even if such use decreases the fund balance below the established minimum. Order of Expenditure of Funds When multiple categories of fund balance are available for expenditure (for example, a construction project funded partly by a grant, funds set aside by the Commissioners Court, or unassigned fund balance), the County will first spend the most restricted funds before moving down to the next most restrictive category with available funds. Monitoring and Reporting The County Auditor shall be responsible for monitoring and reporting the County's reserve balances. The County Auditor is directed to make recommendations to the Commissioners Court on the use of reserve funds both as an element of the annual operating budget submission and from time to time throughout the fiscal year as needs may arise. Compliance with the provisions of the policy shall be reviewed as a part of the annual operating budget adoption process, and subsequent review will be included in the annual audit and financial statement preparation procedures. Revenue Management Policv The County strives for the following optimum characteristics in its revenue system: • Simplicity and Certainty. The County shall strive to keep the revenue classification system simple to promote understanding of the revenue sources. The County shall describe its revenue sources and enact consistent collection policies to provide assurances that the revenue is collected according to budgets and plans. Equity. The County shall make every effort to maintain equity in its revenue system structure. • Realistic and Conservative Estimates. Revenues are to be estimated realistically. Revenues of volatile nature shall be budgeted conservatively. • Review of Fees and Charges. The County shall review all fees and charges annually. Property Tax Revenue All real and business personal property located within the County shall be valued at 100% of the fair market value based on the appraisal supplied by the Calhoun County Appraisal District. Reappraisal and reassessment is as provided by the Appraisal District. A ninety-eight Page 4 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6 2022 percent (980%) collection rate shall serve each year as a goal for tax collections, and the budgeted revenue projection shall be based on average collection rate calculated by the Calhoun County Appraisal District. Property tax rates shall be maintained at a rate adequate to fund an acceptable service level. Based upon taxable values, rates will be adjusted to fund this service level. Collection services shall be contracted out with a central collection agency, currently the Calhoun County Appraisal District. Interest Income Interest earned from investment of available monies, whether pooled or not, shall be distributed to the funds in accordance with the equity balance of the fund from which monies were invested. User Based Fees and Service Charges For services associated with a user fee or charge, the direct and indirect costs of that service shall be offset wholly or partially by a fee where possible. There shall be an annual review of fees and charges to ensure that the fees provide adequate coverage of costs of services. Intergovernmental Revenues/Grants/Special Revenues Grant revenues and other special revenues shall be spent for the purpose(s) intended. The County shall review grant match requirements and include in the budget all grant revenues and expenditures. Collection of Charges The County will follow a policy of collecting, on a timely basis, all fees, charges, taxes and other revenues properly due to the County. The County will follow an aggressive policy of collecting all delinquencies. Revenue Monitoring Revenues actually received shall be regularly compared to budgeted revenues. The County Auditor shall provide a report to Commissioners Court report after the completion of each calendar month. The County Auditor and County Treasurer shall promptly report significant fluctuations between actual and budgeted revenues to Commissioners Court. Expenditure Control Policy Appropriations The responsibility for budgetary control lies with the Elected Official/Department Head. Elected Officials/Department Heads shall not incur expenditures that exceed monies available in the departmental budget. Amendments to the Budget The County Auditor oversees the budget and prepares amendment requests for presentation to Commissioners Court. No amendments shall be made without the approval of the Page 5 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6 2022 Commissioners Court. Expenditure Monitoring Actual expenditures shall be regularly compared to budgeted expenditures. The County Auditor shall provide a report to Commissioners Court after the completion of each calendar month. Purchasing All purchases shall be made in accordance with the Calhoun County, Texas Purchasing Policy and other related polices as approved by Commissioners Court. • htty:Hw .calhouncotx.org/trans/Policies/Calhoun%20County°/20Purchasing°/20Polic v.odf • htto://www.calhouncotxorg/trans/CALHOUN%2000UNTY°/20CREDIT°/20CARD°/ 20POLICY%20AND%20PROCEDURE%202013 02 14 odf • httu://w ,.calhouncotxorg/trans/Policies/CALHOUN°/2000UNTY°/20POLICY°/20 OF%2000MPLIANCE%20LGC%20130 908%202018 06 06 ndf • htto://www.calhouncotx.ore/trans/Policies/CALHOUN%2000UNTY°/20Policv°/20oN/ 20Complimce%20Section%2O2252 908%20TxGovtCode•/u202018 01 31 odf Prompt Payment Elected Officials/Department Heads shall be responsible for prompt submission of invoices to the County Treasurer to initiate the approval for payment process. All invoices approved by the County Auditor and subsequently by the Commissioners Court shall be paid by the County Treasurer within thirty (30) calendar days of receipt, in accordance with the provisions of state law. Lone -Term Debt Policy • The County will not use long-term debt to finance recurring maintenance and operating costs. • The County will limit long -teen debt to only those capital projects that cannot be financed from current revenues. • The County will not issue long-term debt for a period longer than the estimated useful life of the capital project. • Decisions will be made based on long term goals. • Debt Service Funds will be managed and invested according to all federal, state, and local laws. • The County shall always be in strict compliance with the provisions and covenants of the bond order(s) that created the Interest and Sinking Fund account(s). Taxes, as applicable, shall be distributed to the account(s) monthly as received. The balance in the account(s) Page 6 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6. 2022 must be adequate to cover semi-ammal payments as they become due. Other Fund Ilse information Governmental Funds Most government functions are financed through governmental funds. The acquisition, use, and balances of the County's expendable resources and related current liabilities are accounted for through governmental funds. Long-term liabilities and fixed assets are not accounted for through governmental funds. Federal and State Grant Funds The County will have the necessary controls in place and follow all applicable federal and state financial grant requirements, including 2 CFR 200.302(b)(6) on advanced payments, -end-2 CFR 200.303 on internal controls for all grant funding..§ 200.323 on contract cost and Price. Also, For payments received iinm Federal Brant sources. the County will track interest earned on those___ Payments in accordance with $ 200305 Federal pavnient. The Coutav will maintain advance payments of Federal awards in interest-beariuz accounts and monitor that account would not be expected to earn in excess of $500 per year oil federal cash balances or any additional interest earned on Federal advance payments deposited in iutetest-bearing accounts must be remitted annually to the Proprietary Funds These funds are financed through user charges to recover costs of services provided. Proprietary funds use accrual accounting, which means revenues are recognized when they are earned by the County and expenses are recognized when they are incurred. Capital Asset Policy Purpose and Objectives The purpose of the Capital Asset Policy is to establish guidelines to ensure accurate records of assets owned, purchased, replaced, sold miller traded -in are maintained. The objectives are: • To manage and maintain the capital asset portfolio of the County which includes land, buildings, improvements other than buildings, furniture, fixtures, equipment Page 7 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6 2022 (including vehicles), infrastructure, and construction in progress. • To determine the appropriate depreciation method to use in accordance with generally accepted accounting principles (GAAP). • To provide the County with accurate recordkeeping for inventory and financial reporting purposes. Responsibility and Authority The County Auditor shall be responsible for ensuring the principles and policies for capitalization are consistently applied and carried out in conformity with generally accepted accounting principles (GAAP) for government and the financial policies, goals and strategies set forth by the Commissioners Court. Criteria for Capitalization Costs to obtain tangible assets with lives greater than one year are called capital expenditures and are commonly said to be capitalized. Several factors are involved in determining whether an expenditure should be capitalized: • The expected useful life is longer than one year. • The asset has a unit cost of at least $1,000.00 (i.e., capitalization threshold). • The expenditure materially adds to the value or prolongs the life of an existing asset. • The item belongs to one of the general classes of assets as defined by GAAP. o Land o Buildings o Improvements other than Buildings o Fumiture/Fixtures/Equipment o Infrastructure Infrastructure assets are long-lived capital assets that normally are stationary in nature and can be preserved for a significantly greater number of years than most capital assets. Examples include roads, bridges, boat ramps, bulkheads, erosion improvements, runways and taxiways. The capitalization threshold is set by the Commissioners Court at the level recommended by the County Auditor and is based on the cost of a single asset. Assets that do not meet the capitalization threshold will be recorded as operating expenditures of the current period. Accounting for Capital Assets The County will follow GASB 34 guidelines in accounting for capital assets. Proper insurance coverage will be maintained on applicable capital asset classes in accordance with risk management strategies set forth by the Commissioners Court. The County Auditor is responsible for maintaining the capital asset records of the County. Capital assets that meet the minimum threshold will be recorded at historical cost. Donated capital assets that meet the minimum threshold will be recorded at estimated fair market value Page 8 of 9 Calhoun County Budgetary and Financial Management Policies Approved by Commissioners Court May 27, 2020 and Amended July 6. 2022 at the time ownership is accepted by the Commissioners Court. The value of a capital asset will usually include ancillary costs that are related to acquisition (e.g., freight, delivery, installation, training). Depreciation will be calculated on a straight-line method and recorded at fiscal year-end for financial statement purposes. - - I Formatted: lastifed, Indent: Lek: 0" Page 9 of 9 #11 NOTICE OF MEETING — 7/6/2022 11. Consider and take necessary action to authorize the County Clerk to sign an agreement with DSHS to enable the County Clerk to issue birth certificates from other counties. (RHM) PASS Page 7 of 12 Mae Belle Cassel From: Anna.Goodman@calhouncotx.org (Anna Goodman) <Anna.Good man @cal houncotx.org> Sent: Tuesday, June 28, 2022 1:11 PM To: MaeBelle.Cassel@calhouncotx.org Cc: cindy.mueller@calhouncotx.org; Sara.Rodriguez@calhouncotx.org Subject: FW: Draft Agreement with DSHS for Remote Birth Access Attachments: HHSREV100002457_Calhoun Co -Signature Page_062022_rev.pdf Good afternoon, Can you please add this to the next available agenda? This is the contract that must be signed with DSHS in order for our office to issue other counties -birth certificates. The SPI Agreement is completed by Ron because he is in charge of internet security. However, Sara said since this is in regards to our office, I should sign the agreement. INTERLOCAL COOPERATION CONTRACT DEPARTMENT OF STATE HEALTH SERVICES CONTRACT No. HHSREV100002457 And HHS Enterprise Data Use Agreement Attachment C-1 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) Thanks! Anna M Goodman Calhoun County Clerk 361-5534416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.gov (Wells,Gretchen (DSHS))[mailto:Gretchen.Wells@dshs.texas.gov] Sent: Friday, June 24, 2022 5:00 PM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 1 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. Anna 1. Per your request I have attached the updated version of the agreement. 2. DSHS typically signs the contract last because it is our contract and it is not executed until we notify the Field staff that the contract is in place. That said, in order for me to get this signed the Contract Affirmations (pg 15,16 &18) must be completed and signed and the SPI must be completed and signed (pg. 43) before I could route for internal signature. 3. Once the contract has been signed by both Parties I will send the County a copy for their file. 4. We typically try to get contracts in place within 30 days of sending it out for signature. Sincerely From: Anna Goodman <Anna.Goodmangcalhouncotx.org> Sent: Tuesday, June 21, 2022 2:25 PM To: Wells,Gretchen (DSHS)<Gretchen.Wells(Mdshs.texas.¢ov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Good afternoon, I just had an opportunity to look at contract. Can you please change this to my name or just address to The Calhoun County Clerk? Also, once contract is signed, will we receive a copy of the contract with DSHS signatures on it? Commissioner's Court actually requires the vendor to sign first. We then print 2 copies, one stays here and the other is returned to the vendor. Thanks for your help! F1 B. Billingy.1 System Agency will send an itemized billin every month for each Certification of Birth printed. U.S. Postal Service to the Local Government at: Naive: Janice Holladay, Deputy Office address: Calhoun County 211 S Am-i Street, Suite 1 Fort Lavaca, TX 77979 Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.¢ov (Wells,Gretchen (DSHS))[mailto:Gretchen.Wells@dshs.texas.eOV] Sent: Monday, June 20, 2022 12:38 PM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. ***************Please acknowledge Receipt of this email********* Anna, Attached please find your complete contract for review. Please note the following items; 1. I have removed attachment B-1 Special and Supplemental Conditions that was noted on the draft agreement because they don't apply 2. I have updated your information along with the County Attorneys information. 3. Please complete the requested information on Page 42. 4. Signatures are required on Page 3 and page 42 5. Please insert your completed SPI into the document 6. Let me know when you have a date for the docket. 7. As always, let me know if you have any questions. From: Anna Goodman <Anna.Goodman@calhouncotx.ora> Sent: Monday, June 20, 2022 10:34 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.eov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Same address as Dan Heard. sara.roderieuez@calhouncotx.ora 361-553-4426 Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.eov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.govl Sent: Monday, June 20, 2022 10:30 AM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. I need her address, phone number and email address to add to the document From: Anna Goodman <Anna.Goodman@calhouncotx.org> Sent: Monday, June 20, 2022 10:27 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.aov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access He is the DA, but our County Attorney is Sara Rodriguez. Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.eov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.aovl Sent: Thursday, June 16, 2022 12:12 PM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. Anna Is this the correct information for the County Attorney? Dan Heard 211 S. Ann Street, Suite 302 Port Lavaca, TX 77979 361-553-4421 From: Anna Goodman <Anna.Goodman@calhouncotx.org> Sent: Friday, June 10, 2022 9:01 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells(@dshs.texas.gov Subject: RE: Draft Agreement with DSHS for Remote Birth Access TGIF! Yes, they did. We still would like to proceed. I think our IT department head sent the form back. I'm going to check this morning. Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.WellsCa)dshs.texas.eov (Wells,Gretchen (DSHS))[mailto:Gretchen.Wells@dshs.texas.gov Sent: Wednesday, June 8, 2022 3:52 PM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: FW: Draft Agreement with DSHS for Remote Birth Access 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. Anna, Did someone from the field staff reach out to you regarding the LR vs RBA uses and systems? From: Wells,Gretchen (DSHS) Sent: Tuesday, May 31, 2022 10:29 AM To:'Anna Goodman' <Anna.Goodman facaIhouncotx.ore> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Can I call you at 11:00? 5 From: Anna Goodman <Anna.Goodman@calhouncotx.ore> Sent: Tuesday, May 31, 2022 10:25 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.gov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Good morning! Wow this weekend went fast! What is your schedule like this week? Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells(@dshs.texas.gov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas gov] Sent: Friday, May 27, 2022 8:53 AM To: Anna Goodman <Anna.Goodman@calhouncotx.ora> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. When are you available for a call to discuss the SPI? From: Anna Goodman <Anna.Goodman@calhouncotx.ore> Sent: Tuesday, May 24, 2022 11:47 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.gov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Sounds great! Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.WellsPdshs.texas.gov (Wells,Gretchen (DSHS)) (mailto:Gretchen.Wells@dshs.texas ¢ovl Sent: Tuesday, May 24, 2022 11:33 AM To: Anna Goodman <Anna.Goodman@calhouncotx.ore> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. Anna, I received your message. Can you give me a call at 9:00 in the morning so I can talk you through your questions. If that time doesn't work let me know From: Anna Goodman <Anna.Goodman cDcalhouncotx.org> Sent: Tuesday, May 24, 2022 10:35 AM To: Wells,Gretchen (DSHS)<Gretchen.Wells(@dshs.texas.gov> Cc: Janice Holladay <ianice. hoIladav@caIhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access Good morning, I tried to call earlier and left a message. I've got several questions regarding the SPI form. I'm out the rest of the day but will try to call again in the morning. Have a great day! Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells(@dshs.texas.gov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.go Sent: Friday, May 20, 2022 12:09 PM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recosnize the sender and know the content is safe. The SPI was attached to the original email which I have also attached. The purpose of this document is to ensure the security and integrity of the data that we will provide to the County. This is a mandatory requirement of the Data Use agreement. Let me know if you have any questions. From: Anna Goodman <Anna.Goodman@calhouncotx.Org> Sent: Friday, May 20, 2022 9:48 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.gov Subject: RE: Draft Agreement with DSHS for Remote Birth Access TGIF!! What's the SPI? Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.WellsCcDdshs.texas.gov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.gov] Sent: Thursday, May 19, 2022 4:08 PM To: Anna Goodman <Anna.Goodman@calhouncotx.ora> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. I will send you the signed document once I receive the SPI From: Anna Goodman <Anna.Goodman@calhouncotx.ore> Sent: Wednesday, May 18, 2022 9:53 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.gov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access I'm pretty sure he'll have to sign. I know it will have to be submitted to Commissioners' Court for approval. Our policy states the vendor signs first and then the judge. This way we have 2 copies. One original goes with the minutes and the other is returned to the vendor. Anna M Goodman Calhoun County Clerk 361-5534416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.eov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.eovl Sent: Wednesday, May 18, 2022 9:49 AM To: Anna Goodman <Anna.Goodman@calhouncotx.ora> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. Is the signatory the County Judge? From: Anna Goodman <Anna.Goodman@calhouncotx.org> Sent: Wednesday, May 18, 2022 9:47 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells@dshs.texas.gov> Subject: RE: Draft Agreement with DSHS for Remote Birth Access The "Name" would only be Calhoun County Clerk since this is just our office. And in addition, my email address. Anna M Goodman Calhoun County Clerk 361-553-4416 "Every day may not be good, but there's something good in every day." From: Gretchen.Wells@dshs.texas.aov (Wells,Gretchen (DSHS)) [mailto:Gretchen.Wells@dshs.texas.eovl Sent: Wednesday, May 18, 2022 9:41 AM To: Anna Goodman <Anna.Goodman@calhouncotx.org> Subject: RE: Draft Agreement with DSHS for Remote Birth Access 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. Is this the only edit? Is the address correct for the legal notices? From: Anna Goodman <Anna.Goodman@calhouncotx.org> Sent: Wednesday, May 18, 2022 9:06 AM To: Wells,Gretchen (DSHS) <Gretchen.Wells(adshs.texas.gov Subject: RE: Draft Agreement with DSHS for Remote Birth Access I WARNING: This email is from outside the HHS system. Do not click on links or attachments unless you expect them from the sender and know the content is safe. Good morning again, We'll have to change the contact person to me, Anna M Goodman, County Clerk, 361-553-4416 since I will have to be the one to sign documents or bring before Commissioners' Court for approval. Thanks! INTERLOCAL COOPERATION CONTRACT DEPARTAi ENT OF STATE HEALTH SERVICES CONTRACT No. HHSREV 100002457 THE DEP.ART3,wNT OF STATE HEALTH SERVICES ("DSHS" or "System Agency") and Calhoi County ("Local Government" or "Contractor"), each a "Party" and collectively the "Parties,'' ent into the following contract to provide access to the Texas Electronic Registration Remote Syste ("TxEver') for the purpose of issuing individual birth certificate services (the "Contract") pursua to the provisions of the "Interlocal Cooperation Act," Chapter 791 of the Texas Government Codi I. PARTIES System Agency Name: Department of State Health Services Contract Management Section Address: 1100 W 491h Street, MC 1990 City and Zip: Austin, TX 78756 Contact Person: Gretchen. Wells, Contract Manager Telephone: (512)776-2679 E-Mail: Gretchen.wells@dshs.texas.gov Agency Number: 357 Anna M Goodman Calhoun County Clerk 361-553-4416 Local Government Name: Calhoun County District & County Clerk Address: 211 S Ann Street._ Suite 102 City and Zip: Port Lavaca, TX 77979 Contact Person: Janice Holladay, Deputy Telephone: 361-5534418 E-Mail: Janice.Hollada-,tt'2!calhouncotx.arg Agency Number: n%a "Every day may not be good, but there's something good in every day." From: Janice.Holladav@calhouncotx.ore (Janice Holladay) [mailto:Janice. HoIladav@calhouncotx.orel Sent: Tuesday, May 17, 2022 3:42 PM To: Anna.Goodman@calhouncotx.org Subject: Draft Agreement with DSHS for Remote Birth Access From: Gretchen.Wells@dshs.texas.eov (Wells,Gretchen (DSHS)) <Gretchen.Wells@dshs.texas.eov> Sent: Tuesday, May 17, 2022 2:44 PM To: Janice.Holladav@calhouncotx.org Cc: Mendoza,Adan (DSHS) <Adan.Mendoza@dshs.texas.eov> Subject: Draft Agreement with DSHS for Remote Birth Access 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. Janice My name is Gretchen Wells and I was asked by the Vital Statistics Department to Draft a Remote Birth Access agreement for your County. In order to execute this contract we are required to have you complete a Data Usage Agreement and a Security Privacy Inquiry that will become part of the final contract. I am attaching the DUA and related SPI along with the instructions on how to complete the document. I am also sending you a word version of the contract document in case you have any comments or edits. Since I am sure that you are anxious to get this in place I would request that you get any edits back to me by no later than May 24, 2022. Please let me know if you have any questions. Sincerely Due to Covid-19 1 am working remotely. Should you need immediate assistance I can be reached at (737) 999- 3037. Have a good day. Gretchen'Welis, CTC.Td Contract Specialist 17, Contract Management Section Department of State Health Services T'700.70,MC 1990 EmaiG Gretchen."Weffs@DSHS.texas.gov Phone: (512) 776-2679 ,fax: (512) 776-7391 10 ^xTEXAS `�v Heslih snd Namswe Texas Department ofStatt health Services Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 11 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas Anna M Goodman Calhoun County Clerk 361-553-4416 Calhoun County Texas 12 HHS Contract No: HHSREV100002457 Page 1 of 44 INTERLOCAL COOPERATION CONTRACT DEPARTMENT OF STATE HEALTH SERVICES CONTRACT No. HHSREV100002457 THE DEPARTMENT OF STATE HEALTH SERVICES ("DSHS" or "System Agency") and Calhoun County ("Local Government' or "Contractor"), each a "Party" and collectively the 'Parties," enter into the following contract to provide access to the Texas Electronic Registration Remote System ("TxEver") for the purpose of issuing individual birth certificate services (the "Contract') pursuant to the provisions of the "Interlocal Cooperation Act," Chapter 791 of the Texas Government Code. I. PARTIES System Aizencv Name: Department of State Health Services Contract Management Section Address: 1100 W 491 Street, MC 1990 City and Zip: Austin, TX 78756 Contact Person: Gretchen. Wells, Contract Manager Telephone:(512)776-2679 E-Mail: Gretchen.wells@dshs.texas.gov Agency Number: 357 Local Government Name: Calhoun County Calhoun County Clerk Address: 211 S Ann Street, Suite 102 City and Zip: Port Lavaca, TX 77979 Contact Person: Anna M. Goodman Telephone:361-553-4416 E-Mail: Anna.Goodman cgcalhouncotx.ore Agency Number: n/a II. STATEMENT OF SERVICES TO BE PROVIDED The Parties agree to cooperate to provide necessary and authorized services and resources in accordance with the terms of this Contract. Specific services provided are described in Attachment A — Interlocal Statement of Work. III. CONTRACT PERIOD AND RENEWAL The Contract is effective on the signature date of the latter of the Parties to sign this agreement and terminates on August 31, 2024, unless renewed, extended, or terminated pursuant to the terms and conditions of the Contract. The Parties may extend this Contract subject to mutually agreeable terms and conditions. IV. AMENDMENT The Parties to this Contract may modify this Contract only through the execution of a written amendment signed by both parties. V. FEES AND PAYMENT FOR SERVICES All fees associated, and payments made in connection with this Contract, including the manner in which payments will be made are described in Attachment A — Interlocal Statement of Work. HHS Contract No: HHSREV100002457 Page 2 of 44 VI. LEGAL NOTICES Legal Notices under this Contract shall be deemed delivered when deposited either in the United States mail, postage paid, certified, return receipt requested; or with a common carrier, overnight, signature required, to the appropriate address below: System Agency Department of State Health Services Contract Management Section 1100 W 491' Street, MC 1990 Austin, Texas 78756 Attention: General Counsel Local Government Calhoun County Office of the County Attorney 211 S Ann Street, Suite 302 Port Lavaca, TX 77979 Attention: Sara Rodriguez, County Attorney Notice given in any other manner shall be deemed effective only if and when received by the Party to be notified. Either Party may change its address for receiving legal notice by notifying the other Party in writing. V1I. CERTIFICATIONS The undersigned contracting Parties certify that: (1) the services specified above are necessary and essential for activities that are properly within the statutory functions and programs of the affected agencies of state government. (2) each Parry executing this Contract on its behalf has full power and authority to enter into this Contract. (3) the proposed arrangements serve the interest of efficient and economical administration of state government; and (4) the services contracted for are not required by Section 21, Article XVI of the Constitution of Texas to be supplied under a contract awarded to the lowest responsible bidder. The System Agency further certifies that it has statutory authority to contract for the services described in this contract under Texas Health and Safety Code Chapter 191 and Texas Government Code Chapter 791. The Local Government further certifies that it has statutory authority to contract for the services described in this contract under Texas Healthand Safety Code Chapter 191 and Texas Government Code Chapter 791. SIGNATURE PAGE FOLLOWS. HHS Contract No: HHSREV100002457 Page 3 of 44 SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT NO. HHSREV100002457 DSHS Signature Printed Name Title Date CALHOUN COUNTY Signature Printed Name Title Date THE FOLLOWING ATTACHMENTS TO DSHS CONTRACT NO. HHSREV100002457 ARE HEREBY INCORPORATED BY REFERENCE: • ATTACHMENT A: INTERLOCAL STATEMENT OF WORK. • ATTACHMENT B: HHS UNIFORM TERMS AND CONDITIONS - GOVERNMENTAL ENTITY VERSION 3.2 (MAY 2020). • ATTACHMENT C: HHS CONTRACT AFFIRMATIONS V. 2.1 (OCT. 2021). • ATTACHMENT D: HHS DATA USE AGREEMENT, GOVERNMENTAL ENTITY VERSION 8.5 (OCT. 23, 2019); and • ATTACHMENT D-1: DATA USE AGREEMENT SECURITY AND PRIVACY INQUIRY VERSION 2.1(06/2018). HHS Contract No: HHSREV100002457 Page 4 of 44 ATTACHMENT A INTERLOCAL STATEMENT OF WORK I. RESPONSIBILITIES OF THE PARTIES A. Local Government may use the TxEver Remote System to search System Agency databases, locate data, and issue Certifications of Birth to authorized individuals requesting such data. The certifications will be in a format formally approved by System Agency. Local Government will take reasonable efforts to ensure use of the TxEver Remote System is not abused by its staff. Abuse of the access to confidential information in the TxEver Remote System may be cause for termination of this Contract in accordance with Section II.Q. B. System Agency agrees to provide on-line computer services related to Local Government's use of the TxEver Remote System, available from 7:00 a.m. to 6:00 p.m. (CST) Monday through Friday, except holidays. In the event of an emergency or computer application error, System Agency may temporarily suspend services without advance notice. C. Local Government will acquire the necessary data processing equipment, communications, hardware or software, and purchase "bank note" paper, as specified by System Agency. System Agency will provide online assistance in connection of the equipment, furnish the software program and provide technical assistance, if necessary. D. Local Government acknowledges that records may not be located or records which are located may have errors due to: 1. Normal key -entry errors in spellings; 2. Accidental failure on the part of the System Agency to update a file for an amendment or paternity determination; and/or 3. The even year does not exist in the system. E. Local Government shall provide System Agency written notification of errors or suspected errors that exist in the database information at no less than monthly intervals. F. Local Government shall maintain inventory control and account for each document produced on "bank note" paper, including voided documents. G. Local Government will issue Certificates of Birth utilizing remote access to the System Agency system in conformance with Health and Safety Code Chapters 191, 192 and 195, as well as 25 Tex. Admin. Code Chapter 181. H. The Parties are required to comply with all applicable state and federal laws relating to the privacy and confidentiality of this data and records, which includes Texas Government Code Section 552.115. I. The Parties will use confidential records and information obtained under this Contract only for purposes as described in this Contract and as otherwise allowed bylaw. HHS Contract No: HHSREV100002457 Page 5 of 44 II. PERFORMANCE MEASURES The System Agency and Local Government will comply with following Contract Terms and Conditions: J. Governing Law. Regarding all issues related to this Contract's formation,performance, interpretation, and any issues that may arise in any dispute between the parties, the Contract will be governed by and construed in accordance with the laws of the State of Texas. K. Confidentiality. The Parties are required to comply with all applicable state and federal laws relating to the privacy and confidentiality of records that contain Personal Identifying Information (PII) or Personally Sensitive Information (PSI) or other information or records made confidential by law, including Tex. Bus. & Comm. Code Section 521.002. The attached Data Use Agreement (Attachment A) applies to this Contract. L. Exchange of Personal Identifying Information, This Contract concerns personal identifying information. Except as prohibited by other law, Local Government and System Agency may exchange PII without consent, in accordance with Chapter 191 of the Health and Safety Code. M. Records Retention, System Agency will retain records in accordance with DSHS State ofTexas Records Retention Schedule at http://www.dshs.texas.gov/records/schedules.shtm, Department Rules and other applicable state and federal statutes and regulations governing medical, mental health, and substance abuse information. N. Severability. If any provision of this Contract is construed to be illegal or invalid, the illegal or invalid provision will be deemed stricken and deleted to the same extent and effect as if never incorporated, but all other provisions will continue. O. Waiver. Acceptance by either Party of partial performance or failure to complain of any action, non -action or default under this Contract will not constitute a waiver of either Party's rights under the Contract. P. Suspension of Services Under This Contract. In the event of an emergency or information technology system failure, System Agency may temporarily suspend services without advance notice. Use of services for purposes inconsistent with applicable law may also result in a suspension of services. Q. Termination, 1. Convenience. This Contract may be terminated by mutual agreement of theParties. Either Party may terminate this Contract without cause by giving 30 days written notice of its intent to terminate to the non -terminating Party. HHS Contract No: HHSREV100002457 Page 6 of 44 2. Cause. This Contract maybe terminated for cause by either Party for breach or failure to perform an essential requirement of the Contract. Use of services for purposes inconsistent with applicable law may be cause for Contract termination. 3. Notice of Termination. Written notice may be sent by any method that provides verification of receipt, which will be calculated from the date of receipt by the non - terminating Party's Representative provided in Section VI of the Signature Document. 4. Equitable Settlement. At the end of the term of this Contract or termination as provided for in this Section, the Parties will equitably settle their respective accrued interests or obligations incurred prior to termination. IILINVOICE AND PAYMENT A. Fees. Local Government agrees to pay System Agency $1.83 for each Certification of Vital Record printed as a result of searches of the database. Local Government agrees to charge the same base search fee for a birth certificate as System Agency. Additional fees may only be charged as authorized by Texas Health and Safety Code Chapter 191 and 25 Tex. Admin. Code Chapter 181. DSH acknowledges that Local Government's payment obligations to System Agency are payable only from funds appropriated for the current fiscal year and currently available for the purpose of this Contract. Local Government shall provide System Agency with prompt notice of failure of Local Government to make adequate appropriation or a lack of current revenue for any given fiscal year. B. Billing. System Agency will send an itemized billing to Local Government on the I't of every month for each Certification of Birth printed. This billing will be sent through the U.S. Postal Service to the Local Government at: Name: Anna Goodman, County Clerk Office address: Calhoun County 211 S Ann Street, Suite 102 Port Lavaca, TX 77979 Local Government will direct any billing inquiries either by phone to 512-776-7206 or email to vssbusinessservicesJSvstemAgencv.texas.eov C. Payment Method. Local Government will remit payment to System Agency within thirty days after a billing is received by them. Payment by the Local Government will be considered made on the date postmarked. HHS Contract No: HHSREV100002457 Page 7 of 44 Local Government will send payments to System Agency at: Texas Department of State Health Services Cash Receipts Branch MC 2096 P.O. Box 149347 Austin, TX 78714-9347 Local Government will make payment to System Agency out of its current revenues. HHS Contract No: HHSREV100002457 ATTACHMENT B Page 8 of 44 HEALTH AND HUMAN SERVICES CONTRACT AFFIRMATIONS The term "System Agency" used in these affirmations means HHS or any of the agencies of the State of Texas that are overseen by HHSC under authority granted under Texas law and the officers, employees, authorized representatives, and designees of those agencies. These agencies include: HHSC and the Department of State Health Services. By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract: 1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation. 2. Complete and Accurate Information Contractor represents and warrants that all statements and information provided to System Agency are current, complete, and accurate. This includes all statements and information in this Contract and any related Solicitation Response. 3. Public Information Act Contractor understands that System Agency will comply with the Texas Public Information Act (Chapter 552 of the Texas Government Code) as interpreted by judicial rulings and opinions of the Attorney General of the State of Texas. Information, documentation, and other material prepared and submitted in connection with this Contract or any related Solicitation may be subject to public disclosure pursuant to the Texas Public Information Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is required to make any information created or exchanged with the State pursuant to the Contract, and not otherwise excepted from disclosure under the Texas Public Information Act, available in a format that is accessible by the public at no additional charge to the State. 4. Contracting Information Requirements Contractor represents and warrants that it will comply with the requirements of Section 552.372(a) of the Texas Government Code. Except as provided by Section 552.374(c) of the Texas Government Code, the requirements of Subchapter J (Additional Provisions Related to Contracting Information), Chapter 552 of the Government Code, may apply to the Contract and the Contractor agrees that the Contract can be terminated if the Contractor knowingly or intentionally fails to comply with a requirement of that subchapter. HHS Contract No: HHSREV100002457 Page 9 of 44 5. Assignment A. Contractor shall not assign its rights under the contract or delegate the performance of its duties under the contract without prior written approval from HHSC. Any attempted assignment in violation of this provision is void and without effect. B. Contractor understands and agrees the System Agency may in one or more transactions assign, pledge, or transfer the Contract. This assignment will only be made to another State agency or a non -state agency that is contracted to perform agency support. Upon receipt of System Agency's notice of assignment, pledge, or transfer, Contractor shall cooperate with System Agency in giving effect to such assignment, pledge, or transfer, at no cost to System Agency or to the recipient entity 6. Terms and Conditions Attached to Response Contractor accepts the Solicitation terms and conditions unless specifically noted by exceptions advanced in the form and manner directed in the Solicitation, if any, under which this Contract was awarded. Contractor agrees that all exceptions to the Solicitation, as well as terms and conditions advanced by Contractor that differ in any manner from System Agency's terms and conditions, if any, are rejected unless expressly accepted by System Agency in writing. System Agency Right to Use Contractor agrees that System Agency has the right to use, produce, and distribute copies of and to disclose to System Agency employees, agents, and contractors and other governmental entities all or part of this Contract or any related Solicitation Response as System Agency deems necessary to complete the procurement process or comply with state or federal laws. 8. Release from Liability Contractor generally releases from liability and waives all claims against any party providing information about the Contractor at the request of System Agency. 9. Dealings with Public Servants Contractor has not given, has not offered to give, and does not intend to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with this Contract or any related Solicitation, or related Solicitation Response. 10. Financial Participation Prohibited Under Section 2155.004, Texas Government Code (relating to financial participation in preparing solicitations), Contractor certifies that the individual or business entity named in this Contract and any related Solicitation Response is not ineligible to receive this Contract and acknowledges that this Contract may be terminated and payment withheld if this certification is inaccurate. HHS Contract No: HHSREV100002457 Page 10 of 44 11. Prior Disaster Relief Contract Violation Under Sections 2155.006 and 2261.053 of the Texas Government Code (relating to convictions and penalties regarding Hurricane Rita, Hurricane Katrina, and other disasters), the Contractor certifies that the individual or business entity named in this Contract and any related Solicitation Response is not ineligible to receive this Contract and acknowledges that this Contract may be terminated and payment withheld if this certification is inaccurate. 12. Child Support Obligation Under Section 231.006(d) of the Texas Family Code regarding child support, Contractor certifies that the individual or business entity named in this Contract and any related Solicitation Response is not ineligible to receive the specified payment and acknowledges that the Contract may be terminated and payment may be withheld if this certification is inaccurate. 13. Suspension and Debarment Contractor certifies that it and its principals are not suspended or debarred from doing business with the state or federal government as listed on the State of Texas Debarred Vendor List maintained by the Texas Comptroller of Public Accounts and the System for Award Management (SAM maintained by the General Services Administration. This certification is made pursuant to the regulations implementing Executive Order 12549 and Executive Order 12689, Debarment and Suspension, 2 C.F.R. Part 376, and any relevant regulations promulgated by the Department or Agency funding this project. This provision shall be included in its entirety in Contractor's subcontracts, if any, if payment in whole or in part is from federal funds. 14. Excluded Parties Contractor certifies that it is not listed in the prohibited vendors list authorized by Executive Order 13224, "Blocking Property and Prohibiting Transactions with Persons Who Commit, Threaten to Commit, or Support Terrorism, " published by the United States Department of the Treasury, Office of Foreign Assets Control.' 15. Foreign Terrorists Organizations Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or a foreign terrorist organization, as prohibited by Section 2252.152 of the Texas Government Code. 16. Executive Head of a State Agency In accordance with Section 669.003 of the Texas Government Code, relating to contracting with the executive head of a state agency, Contractor certifies that it is not (1) the executive head of an HHS agency, (2) a person who at any time during the four years before the date of this Contract was the executive head of an HHS agency, or (3) a person who employs a current or former executive head of an HHS agency. HHS Contract No: HHSREV100002457 Page 11 of 44 17. Human Trafficking Prohibition Under Section 2155.0061 of the Texas Government Code, Contractor certifies that the individual or business entity named in this Contract is not ineligible to receive this contract and acknowledges that this Contract may be terminated and payment withheld if this certification is inaccurate. 18. Franchise Tax Status Contractor represents and warrants that it is not currently delinquent in the payment of any franchise taxes owed the State of Texas under Chapter 171 of the Texas Tax Code. 19. Debts and Delinquencies Contractor agrees that any payments due under this Contract shall be applied towards any debt or delinquency that is owed to the State of Texas. 20. Lobbying Prohibition Contractor represents and warrants that payments to Contractor and Contractor's receipt of appropriated or other funds under this Contract or any related Solicitation are not prohibited by Sections 556.005, 556.0055, or 556.008 of the Texas Government Code (relating to use of appropriated money or state funds to employ or pay lobbyists, lobbying expenses, or influence legislation). 21. Buy Texas Contractor agrees to comply with Section 2155.4441 of the Texas Government Code, requiring the purchase of products and materials produced in the State of Texas in performing service contracts. 22. Disaster Recovery Plan Contractor agrees that upon request of System Agency, Contractor shall provide copies of its most recent business continuity and disaster recovery plans. 23. Technology Access A. Contractor expressly acknowledges that state funds may not be expended in connection with the purchase of an automated information system unless that system meets certain statutory requirements relating to accessibility by persons with visual impairments. Accordingly, Contractor represents and warrants to System Agency that the technology provided to System Agency for purchase (if applicable under this Contract or any related Solicitation) is capable, either by virtue of features included within the technology or because it is readily adaptable by use with other technology, of: i. providing equivalent access for effective use by both visual and non -visual means; ii. presenting information, including prompts used for interactive communications, in formats intended for non -visual use; and iii. being integrated into networks for obtaining, retrieving, and disseminating information used by individuals who are not blind or visually impaired. B. For purposes of this Section, the phrase "equivalent access" means a substantially similar ability to communicate with or make use of the technology, either directly by features incorporated within the technology or by other reasonable means such as HHS Contract No: HHSREV100002457 Page 12 of 44 assistive devices or services which would constitute reasonable accommodations under the Americans With Disabilities Act or similar state or federal laws. Examples of methods by which equivalent access may be provided include, but are not limited to, keyboard alternatives to mouse commands and other means of navigating graphical displays, and customizable display appearance. C. In accordance with Section 2157.005 of the Texas Government Code, the Technology Access Clause contract provision remains in effect for any contract entered into before September 1, 2006. 24. Computer Equipment Recycling Program If this Contract is for the purchase or lease of computer equipment, then Contractor certifies that it is in compliance with Subchapter Y, Chapter 361 of the Texas Health and Safety Code related to the Computer Equipment Recycling Program and the Texas Commission on Environmental Quality rules in 30 TAC Chapter 328. 25. Television Equipment Recycling If this Contract is for the purchase or lease of covered television equipment, then Contractor certifies that it is compliance with Subchapter Z, Chapter 361 of the Texas Health and Safety Code related to the Television Equipment Recycling Program. 26. Cybersecurity Training A. Contractor represents and warrants that it will comply with the requirements of Section 2054.5192 of the Texas Government Code relating to cybersecurity training and required verification of completion of the training program. . B. Contractor represents and warrants that if Contractor or Subcontractors, officers, or employees of Contractor have access to any state computer system or database, the Contractor, Subcontractors, officers, and employees of Contractor shall complete cybersecurity training pursuant to and in accordance with Government Code, Section 2054.5192. 27. Restricted Employment for Certain State Personnel Contractor acknowledges that, pursuant to Section 572.069 of the Texas Government Code, a former state officer or employee of a state agency who during the period of state service or employment participated on behalf of a state agency in a procurement or contract negotiation involving Contractor may not accept employment from Contractor before the second anniversary of the date the Contract is signed or the procurement is terminated or withdrawn. 28. Disclosure of Prior State Employment If this Contract is for consulting services under Chapter 2254 of the Texas Government Code, in accordance with Section 2254.033 of the Texas Government Code, Contractor certifies that it does not employ an individual who was employed by System Agency or another agency at any time during the two years preceding the submission of any related HHS Contract No: HHSREV100002457 Page 13 of 44 Solicitation Response related to this Contractor, in the alternative, Contractor has disclosed in any related Solicitation Response the following: i. the nature of the previous employment with System Agency or the other agency; ii. the date the employment was terminated; and iii. the annual rate of compensation at the time of the employment was terminated. 29. No Conflicts of Interest A. Contractor represents and warrants that it has no actual or potential conflicts of interest in providing the requested goods or services to System Agency under this Contract or any related Solicitation and that Contractor's provision of the requested goods and/or services under this Contract and any related Solicitation will not constitute an actual or potential conflict of interest or reasonably create an appearance of impropriety. B. Contractor agrees that, if after execution of the Contract, Contractor discovers or is made aware of a Conflict of Interest, Contractor will immediately and fully disclose such interest in writing to HHSC. In addition, Contractor will promptly and fully disclose any relationship that might be perceived or represented as a conflict after its discovery by Contractor or by HHSC as a potential conflict. HHSC reserves the right to make a final determination regarding the existence of Conflicts of Interest, and Contractor agrees to abide by HHSC's decision. 30. Fraud, Waste, and Abuse Contractor understands that System Agency does not tolerate any type of fraud. The agency's policy is to promote consistent, legal, and ethical organizational behavior by assigning responsibilities and providing guidelines to enforce controls. Violations of law, agency policies, or standards of ethical conduct will be investigated, and appropriate actions will be taken. All employees or contractors who suspect fraud, waste or abuse (including employee misconduct that would constitute fraud, waste, or abuse) are required to immediately report the questionable activity to both the Health and Human Services Commission's Office of the Inspector General at 1-800-436-6184 and the State Auditor's Office. Contractor agrees to comply with all applicable laws, rules, regulations, and System Agency policies regarding fraud including, but not limited to, HHS Circular C-027. 31. Antitrust The undersigned affirms under penalty of perjury of the laws of the State of Texas that: A. in connection with this Contract and any related Solicitation Response, neither I nor any representative of the Contractor has violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15; B. in connection with this Contract and any related Solicitation Response, neither I nor any representative of the Contractor has violated any federal antitrust law; and C. neither I nor any representative of the Contractor has directly or indirectly communicated any of the contents of this Contract and any related Solicitation Response to a competitor of the Contractor or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Contractor. HHS Contract No: HHSREV100002457 Page 14 of 44 32. Legal and Regulatory Actions Contractor represents and warrants that it is not aware of and has received no notice of any court or governmental agency proceeding, investigation, or other action pending or threatened against Contractor or any of the individuals or entities included in numbered paragraph 1 of these Contract Affirmations within the five (5) calendar years immediately preceding execution of this Contract or the submission of any related Solicitation Response that would or could impair Contractor's performance under this Contract, relate to the contracted or similar goods or services, or otherwise be relevant to System Agency's consideration of entering into this Contract. If Contractor is unable to make the preceding representation and warranty, then Contractor instead represents and warrants that it has provided to System Agency a complete, detailed disclosure of any such court or governmental agency proceeding, investigation, or other action that would or could impair Contractor's performance under this Contract, relate to the contracted or similar goods or services, or otherwise be relevant to System Agency's consideration of entering into this Contract. In addition, Contractor acknowledges this is a continuing disclosure requirement. Contractor represents and warrants that Contractor shall notify System Agency in writing within five (5) business days of any changes to the representations or warranties in this clause and understands that failure to so timely update System Agency shall constitute breach of contract and may result in immediate contract termination. 33. No Felony Criminal Convictions Contractor represents that neither Contractor nor any of its employees, agents, or representatives, including any subcontractors and employees, agents, or representative of such subcontractors, have been convicted of a felony criminal offense or that if such a conviction has occurred Contractor has fully advised System Agency in writing of the facts and circumstances surrounding the convictions. 34. Unfair Business Practices Contractor represents and warrants that it has not been the subject of allegations of Deceptive Trade Practices violations under Chapter 17 of the Texas Business and Commerce Code, or allegations of any unfair business practice in any administrative hearing or court suit and that Contractor has not been found to be liable for such practices in such proceedings. Contractor certifies that it has no officers who have served as officers of other entities who have been the subject of allegations of Deceptive Trade Practices violations or allegations of any unfair business practices in an administrative hearing or court suit and that such officers have not been found to be liable for such practices in such proceedings. 35. Entities that Boycott Israel Pursuant to Section 2271.002 of the Texas Government Code, Contractor certifies that either: i. it meets an exemption criteria under Section 2271.002; or ii. it does not boycott Israel and will not boycott Israel during the term of the contract resulting from this Solicitation. If Contractor refuses to make that certification, HHS Contract No: HHSREV100002457 Page 15 of 44 Contractor shall state here any facts that make it exempt from the boycott certification: 36. E-Verify Program Contractor certifies that for contracts for services, Contractor shall utilize the U.S. Department of Homeland Security's E-Verify system during the term of this Contract to determine the eligibility of: i. all persons employed by Contractor to perform duties within Texas; and ii. all persons, including subcontractors, assigned by Contractor to perform work pursuant to this Contract within the United States of America. 37. Professional or Consulting Contract If this Contract is an employment contract, a professional services contract under Chapter 2254 of the Texas Government Code, or a consulting services contract under Chapter 2254 of the Texas Government Code, Contractor represents and warrants that neither Contractor nor any of Contractor's employees including, but not limited to, those authorized to provide services under the contract, were former employees of an HHS Agency during the twelve (12) month period immediately prior to the date of the execution of the contract. 38. Former Agency Employees Contractor represents and warrants, during the twelve (12) month period immediately prior to the date of the execution of this Contract, none of its employees including, but not limited to those who will provide services under the Contract, was an employee of an HHS Agency. Pursuant to Section 2252.901, Texas Government Code (relating to prohibitions regarding contracts with and involving former and retired state agency employees), Contractor will not allow any former employee of the System Agency to perform services under this Contract during the twelve (12) month period immediately following the employee's last date of employment at the System Agency. 39. Disclosure of Prior State Employment If this Contract is for consulting services, A. In accordance with Section 2254.033 of the Texas Government Code, a Contractor providing consulting services who has been employed by, or employs an individual who has been employed by, HHSC or another State of Texas agency at any time during the two years preceding the submission of Contractor's offer to provide services must disclose the following information in its offer to provide services. Contractor hereby certifies that this information was provided and remains true, correct, and complete: i. Name of individual(s) (Respondent or employee(s)); ii. Status; iii. The nature of the previous employment with HHSC or the other State of Texas agency; HHS Contract No: HHSREV100002457 Page 16 of 44 iv. The date the employment was terminated and the reason for the termination; and v. The annual rate of compensation for the employment at the time of its termination. B. If no information was provided in response to Section A above, Contractor certifies that neither Contractor nor any individual employed by Contractor was employed by HHSC or any other State of Texas agency at any time during the two years preceding the submission of Contractor's offer to provide services. 40. Abortion Funding Limitation Contractor understands, acknowledges, and agrees that, pursuant to Article IX, Section 6.25 of the General Appropriations Act (the Act), to the extent allowed by federal and state law, money appropriated by the Texas Legislature may not be distributed to any individual or entity that, during the period for which funds are appropriated under the Act: i. performs an abortion procedure that is not reimbursable under the state's Medicaid program; ii, is commonly owned, managed, or controlled by an entity that performs an abortion procedure that is not reimbursable under the state's Medicaid program; or iii. is a franchise or affiliate of an entity that performs an abortion procedure that is not reimbursable under the state's Medicaid program. The provision does not apply to a hospital licensed under Chapter 241, Health and Safety Code, or an office exempt under Section 245.004(2), Health and Safety Code. Contractor represents and warrants that it is not ineligible, nor will it be ineligible during the term of this Contract, to receive appropriated funding pursuant to Article IX, Section 6.25. 41. Funding Eligibility Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 of the Texas Government Code, except as exempted under that Chapter, HHSC cannot contract with an abortion provider or an affiliate of an abortion provider. Contractor certifies that it is not ineligible to contract with HHSC under the terms of Chapter 2272 of the Texas Government Code. If Contractor refuses to make that certification, Contractor shall state here any facts that make it exempt from the certification: 42. False Representation Contractor understands, acknowledges, and agrees that any false representation or any failure to comply with a representation, warranty, or certification made by Contractor is subject to all civil and criminal consequences provided at law or in equity including, but not limited to, immediate termination of this Contract. 43. False Statements Contractor represents and warrants that all statements and information prepared and submitted by Contractor in this Contract and any related Solicitation Response are current, complete, true, and accurate. Contractor acknowledges any false statement or material HHS Contract No: HHSREV100002457 Page 17 of 44 misrepresentation made by Contractor during the performance of this Contract or any related Solicitation is a material breach of contract and may void this Contract. Further, Contractor understands, acknowledges, and agrees that any false representation or any failure to comply with a representation, warranty, or certification made by Contractor is subject to all civil and criminal consequences provided at law or in equity including, but not limited to, immediate termination of this Contract. 44. Permits and License Contractor represents and warrants that it will comply with all applicable laws and maintain all permits and licenses required by applicable city, county, state, and federal rules, regulations, statutes, codes, and other laws that pertain to this Contract. 45. Drug -Free Workplace Contractor represents and warrants that it shall comply with the applicable provisions of the Drug -Free Work Place Act of 1988 (41 U.S.C. §701 et seq.) and maintain a drug -free work environment. 46. Equal Employment Opportunity Contractor represents and warrants its compliance with all applicable duly enacted state and federal laws governing equal employment opportunities. 47. Federal Occupational Safety and Health Law Contractor represents and warrants that all articles and services shall meet or exceed the safety standards established and promulgated under the Federal Occupational Safety and Health Act of 1970, as amended (29 U.S.C. Chapter 15). 48. Signature Authority Contractor represents and warrants that the individual signing this Contract Affirmations document is authorized to sign on behalf of Contractor and to bind the Contractor. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK HHS Contract No: HHSREV100002467 Page 18 of 44 Authorized representative on behalf of Contractor must complete and sign the following: Legal Name of Contractor Assumed Business Name of Contractor, if applicable (D.B.A. or `doing business as') Texas County(s) for Assumed Business Name (D.B.A. or `doing business as') Attach Assumed Name Certificate(s) for each County Signature of Authorized Representative Date Signed Printed Name of Authorized Representative Title of Authorized Representative First, Middle Name or Initial, and Last Name Physical Street Address City, State, Zip Code Mailing Address, if different City, State, Zip Code Phone Number Fax Number Email Address DUNS Number Federal Employer Identification Number Texas Payee ID No. —11 digits Texas Franchise Tax Number Texas Secretary of State Filing Number HHS Contract No: HHSREV100002457 Page 19 of 44 ATTACHMENT C HHS DATA USE AGREEMENT This Data Use Agreement ("DUA"), effective as of the date the Base Contract into which it is incorporated is signed ("Effective Date"), is entered into by and between a Texas Health and Human Services Enterprise agency ("HHS"), and the Contractor identified in the Base Contract, a political subdivision of the State of Texas ("CONTRACTOR. ARTICLE 1. PURPOSE; APPLICABILITY; ORDER OF PRECEDENCE The purpose of this DUA is to facilitate creation, receipt, maintenance, use, disclosure or access to Confidential Information with CONTRACTOR, and describe CONTRACTOR's rights and obligations with respect to the Confidential Information. 49 CFR 164.504(e)(1)-(3). This DUA also describes HHS's remedies in the event of CONTRACTOR's noncompliance with its obligations under this DUA. This DUA applies to both Business Associates and contractors who are not Business Associates who create, receive, maintain, use, disclose or have access to Confidential Information on behalf of HHS, its programs or clients as described in the Base Contract. As of the Effective Date of this DUA, if any provision of the Base Contract, including any General Provisions or Uniform Terms and Conditions, conflicts with this DUA, this DUA controls. ARTICLE 2. DEFINITIONS For the purposes of this DUA, capitalized, underlined terms have the meanings set forth in the following: Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (42 U.S.C. §1320d, et seq.) and regulations thereunder in 45 CFR Parts 160 and 164, including all amendments, regulations and guidance issued thereafter; The Social Security Act, including Section 1137 (42 U.S.C. §§ 1320b-7), Title XVI of the Act; The Privacy Act of 1974, as amended by the Computer Matching and Privacy Protection Act of 1988, 5 U.S.C. § 552a and regulations and guidance thereunder; Internal Revenue Code, Title 26 of the United States Code and regulations and publications adopted under that code, including IRS Publication 1075; OMB Memorandum 07-18; Texas Business and Commerce Code Ch. 521; Texas Government Code, Ch. 552, and Texas Government Code §2054.1125. In addition, the following terms in this DUA are defined as follows: "Authorized Purpose" means the specific purpose or purposes described in the Statement of Work of the Base Contract for CONTRACTOR to fulfill its obligations under the Base Contract, or any other purpose expressly authorized by HHS in writing in advance. "Authorized User" means a Person: (1) Who is authorized to create, receive, maintain, have access to, process, view, handle, examine, interpret, or analyze Confidential Information pursuant to this DUA; HHS Contract No: HHSREV100002467 Page 20 of 44 (2) For whom CONTRACTOR warrants and represents has a demonstrable need to create, receive, maintain, use, disclose or have access to the Confidential Information; and (3) Who has agreed in writing to be bound by the disclosure and use limitations pertaining to the Confidential Information as required by this DUA. "Confidential Information" means any communication or record (whether oral, written, electronically stored or transmitted, or in any other form) provided to or made available to CONTRACTOR, or that CONTRACTOR may, for an Authorized Purpose, create, receive, maintain, use, disclose or have access to, that consists of or includes any or all of the following: (1) Client Information; (2) Protected Health Information in any form including without limitation, Electronic Protected Health Information or Unsecured Protected Health Information (herein "PHI"); (3) Sensitive Personal Information defined by Texas Business and Commerce Code Ch. 521; (4) Federal Tax Information; (5) Individually Identifiable Health Information as related to HIPAA, Texas HIPAA and Personal Identifyine Information under the Texas Identity Theft Enforcement and Protection Act; (6) Social Security Administration Data, including, without limitation, Medicaid information; (7) All privileged work product; (8) All information designated as confidential under the constitution and laws of the State of Texas and of the United States, including the Texas Health & Safety Code and the Texas Public Information Act, Texas Government Code, Chapter 552. "Legally Authorized Representative" of the Individual, as defined by Texas law, including as provided in 45 CFR 435.923 (Medicaid); 45 CFR 164.502(g)(1) (HIPAA); Tex. Occ. Code § 151.002(6); Tex. H. & S. Code §166.164; and Estates Code Ch. 752. ARTICLE 3.. CONTRACTOR'S DUTIES REGARDING CONFIDENTIAL INFORMATION 3,01 Obligations of CONTRACTOR CONTRACTOR agrees that: (A) CONTRACTOR will exercise reasonable care and no less than the same degree of care CONTRACTOR uses to protect its own confidential, proprietary and trade secret information to prevent any portion of the Confidential Information from being used in HHS Contract No: HHSREV100002457 Page 21 of 44 a manner that is not expressly an Authorized Purpose under this DUA or as Required by L 45 CFR 164.502(b)(1); 45 CFR 164.514(d) (B) Except as Required by Law, CONTRACTOR will not disclose or allow access to any portion of the Confidential Information to any Person or other entity, other than Authorized User's Workforce or Subcontractors (as defined in 45 C.F.R. 160.103) of CONTRACTOR who have completed training in confidentiality, privacy, security and the importance of promptly reporting any Event or Breach to CONTRACTOR's management, to carry out CONTRACTOR's obligations in connection with the Authorized Purpose. HHS, at its election, may assist CONTRACTOR in training and education on specific or unique HHS processes, systems and/or requirements. CONTRACTOR will produce evidence of completed training to HHS upon request. 45 C.F.R. 164.308(a)(5)(i); Texas Health & Safety Code §181.101 All of CONTRACTOR's Authorized Users, Workforce and Subcontractors with access to a state computer system or database will complete a cybersecurity training program certified under Texas Government Code Section 2054.519 by the Texas Department of Information Resources or offered under Texas Government Code Sec. 2054.519(I). (C) CONTRACTOR will establish, implement and maintain appropriate sanctions against any member of its Workforce or Subcontractor who fails to comply with this DUA, the Base Contract or applicable law. CONTRACTOR will maintain evidence of sanctions and produce it to HHS upon request.45 C.F.R. 164.308(a)(1)(it)(C); 164.530(e); 164.410(b); 164.530(b)(1) (D) CONTRACTOR will not, except as otherwise permitted by this DUA, disclose or provide access to any Confidential Information on the basis that such act is Required by Law without notifying either HHS or CONTRACTOR's own legal counsel to determine whether CONTRACTOR should object to the disclosure or access and seek appropriate relief. CONTRACTOR will maintain an accounting of all such requests for disclosure and responses and provide such accounting to HHS within 48 hours of HHS' request. 45 CFR 164.504(e)(2)(ii)(A) (E) CONTRACTOR will not attempt to re -identify or further identify Confidential Information or De -identified Information, or attempt to contact any Individuals whose records are contained in the Confidential Information, except for an Authorized Purpose, without express written authorization from HHS or as expressly permitted by the Base Contract. 45 CFR 164.502(d)(2)(i) and (ii) CONTRACTOR will not engage in prohibited marketing or sale of Confidential Information. 45 CFR 164.501, 164.508(a)(3) and (4); Texas Health & Safety Code Ch.181.002 (F) CONTRACTOR will not permit, or enter into any agreement with a Subcontractor to, create, receive, maintain, use, disclose, have access to or transmit Confidential Information to carry out CONTRACTOR's obligations in connection with the Authorized Purpose on behalf of CONTRACTOR, unless Subcontractor agrees to comply HHS Contract No: HHSREV100002457 Page 22 of 44 with all applicable laws, rules and regulations. 45 CFR 164.502(e)(1)(ii); 164.504(e)(1)(i) and (2). (G) CONTRACTOR is directly responsible for compliance with, and enforcement of, all conditions for creation, maintenance, use, disclosure, transmission and Destruction of Confidential Information and the acts or omissions of Subcontractors as may be reasonably necessary to prevent unauthorized use. 45 CFR 164.504(e)(5); 42 CFR 431.300, et seq. (H) If CONTRACTOR maintains PHI in a Designated Record Set which is Confidential Information and subject to this Agreement, CONTRACTOR will make PHI available to HHS in a Designated Record Set upon request. CONTRACTOR will provide PHI to an Individual, or Legally Authorized Representative of the Individual who is requesting PHI in compliance with the requirements of the HIPAA Privacy Regulations. CONTRACTOR will release PHI in accordance with the HIPAA Privacy Regulations upon receipt of a valid written authorization. CONTRACTOR will make other Confidential Information in CONTRACTOR's possession available pursuant to the requirements of HIPAA or other applicable law upon a determination of a Breach of Unsecured PHI as defined in HIPAA. CONTRACTOR will maintain an accounting of all such disclosures and provide it to HHS within 48 hours of HHS' request. 45 CFR 164.524and 164.504(e)(2)(ii)(E). (I) If PHI is subject to this Agreement, CONTRACTOR will make PHI as required by HIPAA available to HHS for review subsequent to CONTRACTOR's incorporation of any amendments requested pursuant to HIPAA. 45 CFR 164.504(e)(2)(ii)(E) and (F). (J) If PHI is subject to this Agreement, CONTRACTOR will document and make available to HHS the PHI required to provide access, an accounting of disclosures or amendment in compliance with the requirements of the HIPAA Privacy Regulations. 45 CFR 164.504(e)(2)(fi)(G) and 164.528. (K) If CONTRACTOR receives a request for access, amendment or accounting of PHI from an individual with a right of access to information subject to this DUA, it will respond to such request in compliance with the HIPAA Privacy Regulations. CONTRACTOR will maintain an accounting of all responses to requests for access to or amendment of PHI and provide it to HHS within 48 hours of HHS' request. 45 CFR 164.504(e)(2). (L) CONTRACTOR will provide, and will cause its Subcontractors and agents to provide, to HHS periodic written certifications of compliance with controls and provisions relating to information privacy, security and breach notification, including without limitation information related to data transfers and the handling and disposal of Confidential Information. 45 CFR 164.308, 164.530(c); I TAC 202. (M) Except as otherwise limited by this DUA, the Base Contract, or law applicable to the Confidential Information, CONTRACTOR may use PHI for the proper management and administration of CONTRACTOR or to carry out CONTRACTOR's HHS Contract No: HHSREV100002457 Page 23 of 44 legal responsibilities. Except as otherwise limited by this DUA, the Base Contract, or law applicable to the Confidential Information, CONTRACTOR may disclose PHI for the proper management and administration of CONTRACTOR, or to carry out CONTRACTOR's legal responsibilities, if: 45 CFR 164.504(e)(4)(A). (1) Disclosure is Required by Law, provided that CONTRACTOR complies with Section 3.01(D); or (2) CONTRACTOR obtains reasonable assurances from the person or entity to which the information is disclosed that the person or entity will: (a)Maintain the confidentiality of the Confidential Information in accordance with this DUA; (b) Use or further disclose the information only as Required by Law or for the Authorized Purpose for which it was disclosed to the Person; and (c)Notify CONTRACTOR in accordance with Section 4.01 of any Event or Breach of Confidential Information of which the Person discovers or should have discovered with the exercise of reasonable diligence. 45 CFR 164.504(e)(4)(ii)(B). (N) Except as otherwise limited by this DUA, CONTRACTOR will, if required by law and requested by HHS, use commercially reasonable efforts to use PHI to provide data aggregation services to HHS, as that term is defined in the HIPAA, 45 C.F.R. § 164.501 and permitted by HIPAA. 45 CFR 164.504(e)(2)(i)(B) (0) CONTRACTOR will, on the termination or expiration of this DUA or the Base Contract, at its expense, send to HHS or Destroy, at HHS's election and to the extent reasonably feasible and permissible by law, all Confidential Information received from HHS or created or maintained by CONTRACTOR or any of CONTRACTOR's agents or Subcontractors on HHS's behalf if that data contains Confidential Information. CONTRACTOR will certify in writing to HHS that all the Confidential Information that has been created, received, maintained, used by or disclosed to CONTRACTOR, has been Destroyed or sent to HHS, and that CONTRACTOR and its agents and Subcontractors have retained no copies thereof. Notwithstanding the foregoing, HHS acknowledges and agrees that CONTRACTOR is not obligated to send to HHSC and/or Destroy any Confidential Information if federal law, state law, the Texas State Library and Archives Commission records retention schedule, and/or a litigation hold notice prohibit such delivery or Destruction. If such delivery or Destruction is not reasonably feasible, or is impermissible by law, CONTRACTOR will immediately notify HHS of the reasons such delivery or Destruction is not feasible, and agree to extend indefinitely the protections of this DUA to the Confidential Information and limit its further uses and disclosures to the purposes that make the return delivery or Destruction of the Confidential Information not feasible for as long as CONTRACTOR maintains such Confidential Information. 45 CFR 164.504(e)(2)(fi)() HHS Contract No: HHSREV100002457 Page 24 of 44 (P) CONTRACTOR will create, maintain, use, disclose, transmit or Destroy Confidential Information in a secure fashion that protects against any reasonably anticipated threats or hazards to the security or integrity of such information or unauthorized uses. 45 CFR 164.306, 164.530(c) (Q) If CONTRACTOR accesses, transmits, stores, and/or maintains Confidential Information, CONTRACTOR will complete and return to HHS at infosecurity@hhsc.state.tx.us the HHS information security and privacy initial inquiry (SPI) at Attachment 1 . The SPI identifies basic privacy and security controls with which CONTRACTOR must comply to protect HHS Confidential Information. CONTRACTOR will comply with periodic security controls compliance assessment and monitoring by HHS as required by state and federal law, based on the type of Confidential Information CONTRACTOR creates, receives, maintains, uses, discloses or has access to and the Authorized Purpose and level of risk. CONTRACTOR's security controls will be based on the National Institute of Standards and Technology (NIST) Special Publication 800-53. CONTRACTOR will update its security controls assessment whenever there are significant changes in security controls for HHS Confidential Information and will provide the updated document to HHS. HHS also reserves the right to request updates as needed to satisfy state and federal monitoring requirements. 45 CFR 164.306. (R) CONTRACTOR will establish, implement and maintain reasonable procedural, administrative, physical and technical safeguards to preserve and maintain the confidentiality, integrity, and availability of the Confidential Information, and with respect to PHI, as described in the HIPAA Privacy and Security Regulations, or other applicable laws or regulations relating to Confidential Information, to prevent any unauthorized use or disclosure of Confidential Information as long as CONTRACTOR has such Confidential Information in its actual or constructive possession. 45 CFR 164.308 (administrative safeguards); 164.310 (physical safeguards); 164.312 (technical safeguards); 164.530(c)(privacy safeguards). (S) CONTRACTOR will designate and identify, a Person or Persons, as Privacy Official 45 CFR 164.530(a)(1) and Information Securi Official, each of whom is authorized to act on behalf of CONTRACTOR and is responsible for the development and implementation of the privacy and security requirements in this DUA. CONTRACTOR will provide name and current address, phone number and e-mail address for such designated officials to HHS upon execution of this DUA and prior to any change. If such persons fail to develop and implement the requirements of the DUA, CONTRACTOR will replace them upon HHS request. 45 CFR 164.308(a)(2). (T) CONTRACTOR represents and warrants that its Authorized Users each have a demonstrated need to know and have access to Confidential Information solely to the minimum extent necessary to accomplish the Authorized Purpose pursuant to this DUA and the Base Contract, and further, that each has agreed in writing to be bound by the disclosure and use limitations pertaining to the Confidential Information contained in this DUA. 45 CFR 164.502, 164.514(d). HHS Contract No: HHSREV100002457 Page 25 of 44 (U) CONTRACTOR and its Subcontractors will maintain an updated, complete, accurate and numbered list of Authorized Users, their signatures, titles and the date they agreed to be bound by the terms of this DUA, at all times and supply it to HHS, as directed, upon request. (V) CONTRACTOR will implement, update as necessary, and document reasonable and appropriate policies and procedures for privacy, security and Breach of Confidential Information and an incident response plan for an Event or Breach, to comply with the privacy, security and breach notice requirements of this DUA prior to conducting work under the Statement of Work. 45 CFR 164.308, 164.316, 164.514(d); 164.530(i)(1). (W) CONTRACTOR will produce copies of its information security and privacy policies and procedures and records relating to the use or disclosure of Confidential Information received from, created.by, or received, used or disclosed by CONTRACTOR for an Authorized Purpose for HHS's review and approval within 30 days of execution of this DUA and upon request by HHS the following business day or other agreed upon time frame. 45 CFR 164.308; 164.514(d). (X) CONTRACTOR will make available to HHS any information HHS requires to fulfill HHS's obligations to provide access to, or copies of, PHI in accordance with HIPAA and other applicable laws and regulations relating to Confidential Information. CONTRACTOR will provide such information in a time and manner reasonably agreed upon or as designated by the Secretary of the U.S. Department of Health and Human Services, or other federal or state law. 45 CFR 164.504(e)(2)(i)(I). (Y) CONTRACTOR will only conduct secure transmissions of Confidential Information whether in paper, oral or electronic form, in accordance with applicable rules, regulations and laws. A secure transmission of electronic Confidential Information in motion includes, but is not limited to, Secure File Transfer Protocol (SFTP) or Encryption at an appropriate level. If required by rule, regulation or law, HHS Confidential Information at rest requires Encryption unless there is other adequate administrative, technical, and physical security. All electronic data transfer and communications of Confidential Information will be through secure systems. Proof of system, media or device security and/or Encryption must be produced to HHS no later than 48 hours after HHS's written request in response to a compliance investigation, audit or the Discovery of an Event or Breach. Otherwise, requested production of such proof will be made as agreed upon by the parties. De -identification of HHS Confidential Information is a means of security. With respect to de -identification of PHI, "secure" means de -identified according to HIPAA Privacy standards and regulatory guidance. 45 CFR 164.312, 164.530(d). (Z) For each type of Confidential Information CONTRACTOR creates, receives, maintains, uses, discloses, has access to or transmits in the performance of the Statement of Work, CONTRACTOR will comply with the following laws rules and regulations, only to the extent applicable and required by law: Title 1, Part 10, Chapter 202, Subchapter B, Texas Administrative Code; HHS Contract No: HHSREV100002457 Page 26 of 44 • The Privacy Act of 1974; • OMB Memorandum 07-16; • The Federal Information Security Management Act of 2002 (FISMA); • The Health Insurance Portability and Accountability Act of 1996 (HIPAA) as defined in the DUA; • Internal Revenue Publication 1075 — Tax Information Security Guidelines for Federal, State and Local Agencies; • National Institute of Standards and Technology (MIST) Special Publication 800-66 Revision 1— An Introductory Resource Guide for Implementing the Health Insurance Portability and Accountability Act (HIPAA) Security Rule; • NIST Special Publications 800-53 and 800-53A — Recommended Security Controls for Federal Information Systems and Organizations, as currently revised; • NIST Special Publication 800-47 — Security Guide for Interconnecting Information Technology Systems; • NIST Special Publication 800-88, Guidelines for Media Sanitization; • NIST Special Publication 800-111, Guide to Storage of Encryption Technologies for End User Devices containing PHI; and Any other State or Federal law, regulation, or administrative rule relating to the specific HHS program area that CONTRACTOR supports on behalf of HHS. (AA) Notwithstanding anything to the contrary herein, CONTRACTOR will treat any Personal Identifying Information it creates, receives, maintains, uses, transmits, destroys and/or discloses in accordance with Texas Business and Commerce Code, Chapter 521 and other applicable regulatory standards identified in Section 3.01(Z), and Individuallv Identifiable Health Information CONTRACTOR creates, receives, maintains, uses, transmits, destroys and/or discloses in accordance with HIPAA and other applicable regulatory standards identified in Section 3.01(Z). ARTICLE 4. BREACH NOTICE, REPORTING AND CORRECTION REQUIREMENTS 4.01 Breach or Event Notification to HHS. 45 CFR 164.400-414. HHS Contract No: HHSREV100002457 Page 27 of 44 (A) CONTRACTOR will cooperate fully with HHS in investigating, mitigating to the extent practicable and issuing notifications directed by HHS, for any Event or Breach of Confidential Information to the extent and in the manner determined by HHS. (B) CONTRACTOR'S obligation begins at the Discovery of an Event or Breach and continues as long as related activity continues, until all effects of the Event are mitigated to HHS's reasonable satisfaction (the "incident response period"). 45 CFR 164.404. (C) Breach Notice: (1) Initial Notice. (a) For federal information, including without limitation, Federal Tax Information, Social Security Administration Data, and Medicaid Client Information, within the first, consecutive clock hour of Discovery, and for all other types of Confidential Information not more than 24 hours after Discovery, or in a timeframe otherwise approved by HHS in writing, initially report to HHS's Privacy and Security Officers via email at: privacy@HHSC.state.tx.us and to the HHS division responsible for this DUA; and IRS Publication 1075; Privacy Act of 1974, as amended by the Computer Matching and Privacy Protection Act of 1988, 5 U.S.C. § 552a; OMB Memorandum 07-16 as cited in HHSC-CMS Contracts for information exchange. (b) Report all information reasonably available to CONTRACTOR about the Event or Breach of the privacy or security of Confidential Information. 45 CFR 164.410. (c) Name, and provide contact information to HHS for, CONTRACTOR's single point of contact who will communicate with HHS both on and off business hours during the incident response period. (2) Formal Notice. No later than two business days after the Initial Notice above, provide formal notification to privacy@HHSC.state.tx.us and to the HHS division responsible for this DUA, including all reasonably available information about the Event or Breach, and CONTRACTOR's investigation, including without limitation and to the extent available: For (a) - (m) below: 45 CFR 164.400-414. (a) The date the Event or Breach occurred; (b) The date of CONTRACTOR's and, if applicable, Subcontractor's Discovery; (c) A brief description of the Event or Breach; including how it occurred and who is responsible (or hypotheses, if not yet determined); HHS Contract No: HHSREV100002457 Page 28 of 44 (d) A brief description of CONTRACTOR's investigation and the status of the investigation; (e) A description of the types and amount of Confidential Information involved; (f) Identification of and number of all Individuals reasonably believed to be affected, including first and last name of the Individual and if applicable the, Legally Authorized Representative, last known address, age, telephone number, and email address if it is a preferred contact method, to the extent known or can be reasonably determined by CONTRACTOR at that time; (g) CONTRACTOR's initial risk assessment of the Event or Breach demonstrating whether individual or other notices are required by applicable law or this DUA for HHS approval, including an analysis of whether there is a low probability of compromise of the Confidential Information or whether any legal exceptions to notification apply; (h) CONTRACTORs recommendation for HHS's approval as to the steps Individuals and/or CONTRACTOR on behalf of Individuals, should take to protect the Individuals from potential harm, including without limitation CONTRACTOR's provision of notifications, credit protection, claims monitoring, and any specific protections for a Legally Authorized Representative to take on behalf of an Individual with special capacity or circumstances; (i) The steps CONTRACTOR has taken to mitigate the harm or potential harm caused (including without limitation the provision of sufficient resources to mitigate); Q) The steps CONTRACTOR has taken, or will take, to prevent or reduce the likelihood of recurrence of a similar Event or Breach; (k) Identify, describe or estimate the Persons, Workforce Subcontractor, or Individuals and any law enforcement that may be involved in the Event or Breach; (1) A reasonable schedule for CONTRACTOR to provide regular updates during normal business hours to the foregoing in the future for response to the Event or Breach, but no less than every three (3) business days or as otherwise directed by HHS, including information about risk estimations, reporting, notification, if any, mitigation, corrective action, root cause analysis and when such activities are expected to be completed; and HHS Contract No: HHSREV100002457 Page 29 of 44 (m) Any reasonably available, pertinent information, documents or reports related to an Event or Breach that HHS requests following Discoverv. 4.02 Investigation, Response and Mitigation. 45 CFR 164.308, 310 and 312; 164.530 (A) CONTRACTOR will immediately conduct a full and complete investigation, respond to the Event or Breach, commit necessary and appropriate staff and resources to expeditiously respond, and report as required to and by HHS for incident response purposes and for purposes of HHS's compliance with report and notification requirements, to the reasonable satisfaction of HHS. (B) CONTRACTOR will complete or participate in a risk assessment as directed by HHS following an Event or Breach, and provide the final assessment, corrective actions and mitigations to HHS for review and approval. (C) CONTRACTOR will fully cooperate with HHS to respond to inquiries and/or proceedings by state and federal authorities, Persons and/or Individuals about the Event or Breach. (D) CONTRACTOR will fully cooperate with HHS's efforts to seek appropriate injunctive relief or otherwise prevent or curtail such Event or Breach, or to recover or protect any Confidential Information, including complying with reasonable corrective action or measures, as specified by HHS in a Corrective Action Plan if directed by HHS under the Base Contract. 4.03 Breach Notification to Individuals and Reporting to Authorities. Tex. Bus. & Comm. Code §521.053; 45 CFR 164.404 (Individuals), 164.406 (Media); 164.408 (Authorities) (A) HHS may direct CONTRACTOR to provide Breach notification to Individuals, regulators or third -parties, as specified by HHS following a Breach. (B) CONTRACTOR shall give HHS an opportunity to review and provide feedback to CONTRACTOR and to confine that CONTRACTOR's notice meets all regulatory requirements regarding the time, manner and content of any notification to Individuals, regulators or third -parties, or any notice required by other state or federal authorities. HHS shall have ten (10) business days to provide said feedback to CONTRACTOR. Notice letters will be in CONTRACTOR's name and on CONTRACTOR's letterhead, unless otherwise directed by HHS, and will contain contact information, including the name and title of CONTRACTOR's representative, an email address and a toll -free telephone number, if required by applicable law, rule, or regulation, for the Individual to obtain additional information. (C) CONTRACTOR will provide HHS with copies of distributed and approved communications. HHS Contract No: HHSREV100002467 Page 30 of 44 (D) CONTRACTOR will have the burden of demonstrating to the reasonable satisfaction of HHS that any notification required by HHS was timely made. If there are delays outside of CONTRACTOR's control, CONTRACTOR will provide written documentation of the reasons for the delay. (E) If HHS delegates notice requirements to CONTRACTOR, HHS shall, in the time and manner reasonably requested by CONTRACTOR, cooperate and assist with CONTRACTOR's information requests in order to make such notifications and reports. ARTICLE 5. STATEMENT OF WORK "Statement of Work" means the services and deliverables to be performed or provided by CONTRACTOR, or on behalf of CONTRACTOR by its Subcontractors or agents for HHS that are described in detail in the Base Contract. The Statement of Work, including any future amendments thereto, is incorporated by reference in this DUA as if set out word-for-word herein. ARTICLE 6. GENERAL PROVISIONS 6.01 Oversight of Confidential Information CONTRACTOR acknowledges and agrees that HHS is entitled to oversee and monitor CONTRACTOR's access to and creation, receipt, maintenance, use, disclosure of the Confidential Information to confirm that CONTRACTOR is in compliance with this DUA. 6.02 HHS Commitment and Obligations HHS will not request CONTRACTOR to create, maintain, transmit, use or disclose PHI in any manner that would not be permissible under applicable law if done by HHS. 6.03 HHS Right to Inspection At any time upon reasonable notice to CONTRACTOR, or if HHS determines that CONTRACTOR has violated this DUA, HHS, directly or through its agent, will have the right to inspect the facilities, systems, books and records of CONTRACTOR to monitor compliance with this DUA. For purposes of this subsection, HHS's agent(s) include, without limitation, the HHS Office of the Inspector General or the Office of the Attorney General of Texas, outside consultants or legal counsel or other designee. 6.04 Term; Termination of DUA; Survival This DUA will be effective on the date on which CONTRACTOR executes the DUA, and will terminate upon termination of the Base Contract and as set forth herein. If the Base Contract is extended or amended, this DUA shall be extended or amended concurrent with such extension or amendment. HHS Contract No: HHSREV100002457 Page 31 of 44 (A) HHS may immediately terminate this DUA and Base Contract upon a material violation of this DUA. (B) Termination or Expiration of this DUA will not relieve CONTRACTOR of its obligation to return or Destroy the Confidential Information as set forth in this DUA and to continue to safeguard the Confidential Information until such time as determined by HHS. (C) If HHS determines that CONTRACTOR has violated a material term of this DUA; HHS may in its sole discretion: (1) Exercise any of its rights including but not limited to reports, access and inspection under this DUA and/or the Base Contract; or (2) Require CONTRACTOR to submit to a Corrective Action Plan, including a plan for monitoring and plan for reporting, as HHS may determine necessary to maintain compliance with this DUA; or (3) Provide CONTRACTOR with a reasonable period to cure the violation as determined by HHS; or (4) Terminate the DUA and Base Contract immediately, and seek relief in a court of competent jurisdiction in Texas. Before exercising any of these options, HHS will provide written notice to CONTRACTOR describing the violation, the requested corrective action CONTRACTOR may take to cure the alleged violation, and the action HHS intends to take if the alleged violated is not timely cured by CONTRACTOR. (D) If neither termination nor cure is feasible, HHS shall report the violation to the Secretary of the U.S. Department of Health and Human Services. (E) The duties of CONTRACTOR or its Subcontractor under this DUA survive the expiration or termination of this DUA until all the Confidential Information is Destroyed or returned to HHS, as required by this DUA. 6.05 Governing Law, Venue and Litigation (A) The validity, construction and performance of this DUA and the legal relations among the Parties to this DUA will be governed by and construed in accordance with the laws of the State of Texas. (B) The Parties agree that the courts of Texas, will be the exclusive venue for any litigation, special proceeding or other proceeding as between the parties that may be brought, or arise out of, or in connection with, or by reason of this DUA. 6.06 Injunctive Relief HHS Contract No: HHSREV100002457 Page 32 of 44 (A) CONTRACTOR acknowledges and agrees that HHS may suffer irreparable injury if CONTRACTOR or its Subcontractor fails to comply with any of the terms of this DUA with respect to the Confidential Information or a provision of HIPAA or other laws or regulations applicable to Confidential Information. (B) CONTRACTOR further agrees that monetary damages may be inadequate to compensate HHS for CONTRACTOR's or its Subcontractor's failure to comply. Accordingly, CONTRACTOR agrees that HHS will, in addition to any other remedies available to it at law or in equity, be entitled to seek injunctive relief without posting a bond and without the necessity of demonstrating actual damages, to enforce the terms of this DUA. 6.07 Responsibility. To the extent permitted by the Texas Constitution, laws and rules, and without waiving any immunities or defenses available to CONTRACTOR as a governmental entity, CONTRACTOR shall be solely responsible for its own acts and omissions and the acts and omissions of its employees, directors, officers, Subcontractors and agents. HHS shall be solely responsible for its own acts and omissions. 6.08 Insurance (A) As a governmental entity, and in accordance with the limits of the Texas Tort Claims Act, Chapter 101 of the Texas Civil Practice and Remedies Code, CONTRACTOR either maintains commercial insurance or self -insures with policy limits in an amount sufficient to cover CONTRACTOR's liability arising under this DUA. CONTRACTOR will request that HHS be named as an additional insured. HHSC reserves the right to consider alternative means for CONTRACTOR to satisfy CONTRACTOR's financial responsibility under this DUA. Nothing herein shall relieve CONTRACTOR of its financial obligations set forth in this DUA if CONTRACTOR fails to maintain insurance. (B) CONTRACTOR will provide HHS with written proof that required insurance coverage is in effect, at the request of HHS. 6,08 Fees and Costs Except as otherwise specified in this DUA or the Base Contract, if any legal action or other proceeding is brought for the enforcement of this DUA, or because of an alleged dispute, contract violation, Event, Breach, default, misrepresentation, or injunctive action, in connection with any of the provisions of this DUA, each party will bear their own legal expenses and the other cost incurred in that action or proceeding. 6.09 Entirety of the Contract This DUA is incorporated by reference into the Base Contract as an amendment thereto and, together with the Base Contract, constitutes the entire agreement between the parties. No change, waiver, or discharge of obligations arising under those documents will be valid unless in writing and executed by the party against whom such change, waiver, or discharge is sought to be HHS Contract No: HHSREV100002457 Page 33 of 44 enforced. If any provision of the Base Contract, including any General Provisions or Uniform Terms and Conditions, conflicts with this DUA, this DUA controls. 6.10 Automatic Amendment and Interpretation If there is (i) a change in any law, regulation or rule, state or federal, applicable to HIPPA and/or Confidential Information, or (ii) any change in the judicial or administrative interpretation of any such law, regulation or rule„ upon the effective date of such change, this DUA shall be deemed to have been automatically amended, interpreted and read so that the obligations imposed on HHS and/or CONTRACTOR remain in compliance with such changes. Any ambiguity in this DUA will be resolved in favor of a meaning that permits HHS and CONTRACTOR to comply with HIPAA or any other law applicable to Confidential Information. HHS Contract No: HHSREV100002457 Paqe 34 of 44 TEXAS HHS Enterprise Data Use Agreement Attachment C-1 Health and Human SECURITY AND PRIVACY INITIAL INQUIRY (SPI) by Services If you are a bidder for a new procurement/contract, in orderto participate in the bidding process, you must have corrected any "No" responses in sections B and C prior to the contract award date. If you are an applicant for an open enrollment, you must have corrected any "No" answers in Sections B and C below prior to performing any work on behalf of any HHS agency. For existing contracts or renewals with "No" responses, there must be an action plan for remediation of Section B and C within 30 calendar days for HIPAA related contracts and 90 calendar days from the date the form is signed for all non-HIPAA contracts. SECTION A: APPLICANT/BIDDER INFORMATION (To be completed by Applicant/Bidder) 1. Does the applicant/bidder access, create, disclose, receive, transmit, maintain, or store HHS ® Yes Confidential Information in electronic systems (e.g., laptop, personal use computer, mobile ® No device, database, server, etc.)? IF NO, STOP. THE SPI FORM IS NOT REQUIRED. 2. Entity or Applicant/Bidder Legal Name Legal Name: Legal Entity Tax Identification Number (TIN) (Last Four Numbers Only): Procurement/Contract#: Address: City: State: ZIP: Telephone #: Email Address: 3. Number of Employees, at all locations, in Applicant Total Employees: Bidder's Workforce "Workforce" means all employees, volunteers, trainees, and other Persons whose conduct is under the direct control of Applicant/Bidder, whether or not they are paid by Applicant/ Bidder. If Applicant/Bidder is a sole proprietor, the workforce may be only one employee. 4. Number of Subcontractors Total Subcontractors: (if Applicant/Bidder will not use subcontractors, enter "0") S. Name of Information Technology Security Official A. Security Official: and Name of Privacy Official for Applicant/Bidder Legal Name. - (Privacy and Security Official may be the same person.) Address: City: State: ZIP: Telephone #: Email Address: B. Privacy Official: Legal Name: Address: City: State: ZIP: Telephone #: Email Address: CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 1 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Paae 35 of 44 6. Type(s) of HHS Confidential Information the Entity or HIPAA CJIS IRS FTI CMS SSA PH Applicant/Bidder will create, receive, maintain, use, ❑ ❑ ❑ ❑ disclose or have access to: (Check all that apply) Other (Please List) • Health Insurance Portability and Accountability Act (HIPAA) data • Criminallustice Information Services (Cus) data • Internal Revenue Service Federal Tax Information (IRS FTI) data • Centers for Medicare & Medicaid Services (CMS) • Social Security Administration (SSA) • Personally Identifiable information (PII) 7.Number of Storage Devices for HHS Confidential Information (as defined in the HHS Data Total # Use Agreement (DUA)) (Sum a-d) Cloud Services involve using a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a personal computer. 0 A Data Center is a centralized repository, either physical or virtual, for the storage, management, and dissemination of data and information organized around a particular body of knowledge or pertaining to a particular business. a. Devices. Number of personal user computers, devices or drives, including mobile devices and mobile drives. b. Servers. Number of Servers that are not in a data center or using Cloud Services. c. Cloud Services. Number of Cloud Services in use. d. Data Centers. Number of Data Centers in use. B. Number of unduplicated individuals for whom Applicant/Bidder reasonably expects to Select handle HHS Confidential Information during one year: Option a. 499 individuals or less ® a. b. 500 to 999 individuals ® b, c. 1,000 to 99,999 individuals ® C. d. 100,000 individuals or more ® d, 9. HIPAA Business Associate Agreement Yes or No a. Will Applicant/Bidder use, disclose, create, receive, transmit or maintain protected ® Yes health information on behalf of a HIPAA-covered HHS agency for a HIPAA-covered ® No function? b. Does Applicant/Bidder have a Privacy Notice prominently displayed on a Webpage or a s Ye ®0 Ye Public Office of Applicant/Bidder's business open to or that serves the public? (This is a ONo HIPAA requirement. Answer "No" if not applicable, such as for agencies not covered by HIPAA) 10. Subcontractors. If the Applicant/Bidder responded "0" to Question 4 (indicating no Yes or No subcontractors), check "No" for both 'a.' and 'b.' to indicate "N/A." a. Does Applicant/Bidder require subcontractors to execute the DUA Attachment 1 0 Yes Subcontractor Agreement Form? ® No b. Will Applicant/Bidder obtain written approval from an HHS agency before entering into ® Yes any agreements with subcontractors to handle HHS Confidential Information on behalf ®No of Applicant/Bidder? CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 2 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) 11. Does Applicant/Bidder have any Optional Insurance currently in place? Optional Insurance provides coverage for: (1) Network Security and Privacy; (2) Data Breach; (3) Cyber Liability (lost data, lost use or delay/suspension in business, denial of service with e-business, the Internet, networks and informational assets, such as privacy, intellectual property, virus transmission, extortion, sabotage or web activities); (4) Electronic Media Liability; (5) Crime/Theft; (6) Advertising Injury and Personal Injury Liability; and (7) Crisis Management and Notification Expense Coverage. ® Yes ® No Section B: PRIVACY RISK ANALYSIS AND ASSESSMENT (To be completed by Applicant/Bidder) For any questions answered "No", an Action Plan for Compliance with a timeline must be documented in the designated area below the question. The timeline for compliance with HIPAA related items is 30 calendar days, PH related items is 90 calendar days. 1. Written Policies & Procedures. Does Applicant/Bidder have current written privacy and Yes or No security policies and procedures that, at a minimum: a. Does Applicant/Bidder have current written privacy and security policies and C) Yes procedures that identify Authorized Users and Authorized Purposes (as defined in the ®No DUA) relating to creation, receipt, maintenance, use, disclosure, access or transmission of HHS Confidential Information? Action Plan for Compliance with a Timeline: Compliance Date: b. Does Applicant/Bidder have current written privacy and security policies and ® Yes procedures that require Applicant/Bidder and its Workforce to comply with the ®No applicable provisions of HIPAA and other laws referenced in the DUA, relating to creation, receipt, maintenance, use, disclosure, access or transmission of HHS Confidential Information on behalf of an HHS agency? Action Plan for Compliance with a Timeline: Compliance Date: c. Does Applicant/Bidder have current written privacy and security policies and procedures ®Yes that limit use or disclosure of HHS Confidential Information to the minimum that is ®No necessary to fulfill the Authorized Purposes? Action Plan for Compliance with a Timeline: Compliance Date: d. Does Applicant/Bidder have current written privacy and security policies and ® Yes procedures that respond to an actual or suspected breach of HHS Confidential ® No Information, to include at a minimum (if any responses are "No" check "No" for all three): i. Immediate breach notification to the HHS agency, regulatory authorities, and other required Individuals or Authorities, in accordance with Article 4 of the DUA; ii. Following a documented breach response plan, in accordance with the DUA and applicable law; & iii. Notifying Individuals and Reporting Authorities whose HHS Confidential Information has been breached, as directed by the HHS agency? CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 3 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 37 of 44 Action Plan for Compliance with a Timeline: Compliance Date: e. Does Applicant/Bidder have current written privacy and security policies and procedures that conduct annual workforce training and monitoring for and correction of any training delinquencies? ® Yes ® No Action Plan for Compliance with a Timeline: Compliance Date: f. Does Applicant/Bidder have current written privacy and security policies and procedures that permit or deny individual rights of access, and amendment or correction, when appropriate? ® Yes ®No Action Plan for Compliance with a Timeline: Compliance Date: g. Does Applicant/Bidder have current written privacy and security policies and procedures ® Yes that permit only Authorized Users with up-to-date privacy and security training, and with a reasonable and demonstrable need to use, disclose, create, receive, maintain, ® No access or transmit the HHS Confidential Information, to carry out an obligation under the DUA for an Authorized Purpose, unless otherwise approved in writing by an HHS agency? Action Plan for Compliance with a Timeline: Compliance Date: h. Does Applicant/Bidder have current written privacy and security policies and procedures ® Yes that establish, implement and maintain proof of appropriate sanctions against any Workforce or Subcontractors who fail to comply with an Authorized Purpose or who is ® No not an Authorized User, and used or disclosed HHS Confidential Information in violation of the DUA, the Base Contract or applicable law? Action Plan for Compliance with a Timeline: Compliance Date: i. Does Applicant/Bidder have current written privacy and security policies and 0 Yes procedures that require updates to policies, procedures and plans following major changes with use or disclosure of HHS Confidential Information within 60 days of No identification of a need for update? Action Plan for Compliance with a Timeline: Compliance Date: CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 4 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 38 of 44 j. Does Applicant/Bidder have current written privacy and security policies and ® Yes procedures that restrict permissions or attempts to re -identify or further identify de -identified HHS Confidential Information, or attempt to contact any Individuals whose ® No records are contained in the HHS Confidential Information, except for an Authorized Purpose, without express written authorization from an HHS agency or as expressly permitted by the Base Contract? Action Plan for Compliance with a Timeline: Compliance Date: k. If Applicant/Bidder intends to use, disclose, create, maintain, store or transmit HHS ® Yes Confidential Information outside of the United States of America, will Applicant/Bidder obtain the express prior written permission from the HHS agency and comply with the ® No HHS agency conditions for safeguarding offshore HHS Confidential Information? Action Plan for Compliance with a Timeline: Compliance Date: 1, Does Applicant/Bidder have current written privacy and security policies and procedures ® Yes that require cooperation with HHS agencies' or federal regulatory inspections, audits or investigations related to compliance with the DUA or applicable law? No Action Plan for Compliance with a Timeline: Compliance Date: m. Does Applicant/Bidder have current written privacy and security policies and 0 Yes procedures that require appropriate standards and methods to destroy or dispose of HHS Confidential Information? ® No Action Plan for Compliance with a Timeline: Compliance Date: n. Does Applicant/Bidder have current written privacy and security policies and procedures ® Yes that prohibit disclosure of Applicant/Bidder's work product done on behalf of HHS ® No pursuant to the DUA, or to publish HHS Confidential Information without express prior approval of the HHS agency? Action Plan for Compliance with a Timeline: Compliance Date: 2. Does Applicant/Bidder have a current Workforce training program? 0 Yes Training of Workforce must occur at least once everyyear, and within 30 days of date of hiring a new ® No Workforce member who will handle HHS Confidential Information. Training must include: (1) privacy and security policies, procedures, plans and applicable requirements for handling HHS Confidential Information, (2) a requirement to complete training before access is given to HHS Confidential Information, and (3) written proof of training and a procedure for monitoring timely completion of training. CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 5 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Pape 39 of 44 Action Plan for Compliance with a Timeline: Compliance Date: 3. Does Applicant/Bidder have Privacy Safeguards to protect HHS Confidential Information in () Yes oral, paper and/or electronic form? ® No "Privacy Safeguards" means protection of HHS Confidential Information by establishing, implementing and maintaining required Administrative, Physical and Technical policies, procedures, processes and controls, required by the DUA, HIPAA (45 CFR 164.530), Social Security Administration, Medicaid and laws, rules or regulations, as applicable. Administrative safeguards include administrative protections, policies and procedures for matters such as training, provision of access, termination, and review of safeguards, incident management, disaster recovery plans, and contract provisions. Technical safeguards include technical protections, policies and procedures, such as passwords, logging, emergencies, how paper is faxed or mailed, and electronic protections such as encryption of data. Physical safeguards include physical protections, policies and procedures, such as lacks, keys, physical access, physical storage and trash. Action Plan for Compliance with a Timeline: Compliance Date: 4. Does Applicant/Bidder and all subcontractors (if applicable) maintain a current list of ® Yes Authorized Users who have access to HHS Confidential Information, whether oral, written ® No or electronic? Action Plan for Compliance with a Timeline: Compliance Date: S. Does Applicant/Bidder and all subcontractors (if applicable) monitor for and remove 0 Yes terminated employees or those no longer authorized to handle HHS Confidential ® No Information from the list of Authorized Users? Action Plan for Compliance with a Timeline: Compliance Date: CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 6 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) Page 40 of 44 Section C: SECURITY RISK ANALYSIS AND ASSESSMENT (to be completed by Applicant/Bidder) This section is about your electronic system. If your business DOES NOT store, access, or No Electronic transmit HHS Confidential Information in electronic systems (e.g., laptop, personal use Systems computer, mobile device, database, server, etc.) select the box to the right, and "YES" will ❑ be entered for all questions in this section. For any questions answered "No", an Action Plan for Compliance with a timeline must be documented in the designated area below the question. The timeline for compliance with HIPAA related items is 30 calendar days, PII related items is 90 calendar days. 1. Does the Applicant/Bidder ensure that services which access, create, disclose, receive, ® Yes transmit, maintain, or store HHS Confidential Information are maintained IN the United ® No States (no offshoring) unless ALL of the following requirements are met? a. The data is encrypted with FIPS 140-2 compliant encryption b. The offshore provider does not have access to the encryption keys c. The Applicant/Bidder maintains the encryption key within the United States d. The Application/Bidder has obtained the express prior written permission of the HHS agency For more information regarding FIPS 140-1 encryption products, please refer to: htW.,Ilcsrc.nist. oov/arouas/STM/cmva/documents/140-11140val-all. htm Action Plan for Compliance with a Timeline: Compliance Date: 2. Does Applicant/Bidder utilize an IT security -knowledgeable person or company to maintain 0 Yes or oversee the configurations of Applicant/Bidder's computing systems and devices? ® No Action Plan for Compliance with a Timeline: Compliance Date: 3. Does Applicant/Bidder monitor and manage access to HHS Confidential Information (e.g., a ® Yes formal process exists for granting access and validating the need for users to access HHS Confidential Information, and access is limited to Authorized Users)? ® No Action Plan for Compliance with a Timeline: Compliance Date: 4. Does Applicant/Bidder a) have a system for changing default passwords, b) require user ® Yes password changes at least every 90 calendar days, and c) prohibit the creation of weak passwords (e.g., require a minimum of 8 characters with a combination of uppercase, C) No lowercase, special characters, and numerals, where possible) for all computer systems that access or store HHS Confidential Information. If yes, upon request must provide evidence such as a screen shot or a system report. Action Plan for Compliance with a Timeline: Compliance Date: CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 7 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 41 of 44 5. Does each member of Applicant/Bidder's Workforce who will use, disclose, create, receive, ® Yes transmit or maintain HHS Confidential Information have a unique user name (account) and private password? ® No Action Plan for Compliance with a Timeline: Compliance Date: 6. Does Applicant/Bidder lock the password after a certain number of failed attempts and ® Yes after 15 minutes of user inactivity in all computing devices that access or store HHS Confidential Information? ® No Action Plan for Compliance with a Timeline: Compliance Date: 7. Does Applicant/Bidder secure, manage and encrypt remote access (including wireless 0 Yes access) to computer systems containing HHS Confidential Information? (e.g., a formal process exists for granting access and validating the need for users to remotely access HHS ® No Confidential Information, and remote access is limited to Authorized Users). Encryption is required for all HHS Confidential Information. Additionally, FIPS 140.2 compliant encryption is required for Health Insurance Portability and Accountability Act (HIPAA) data, Criminal Justice Information Services (CIIS) data, Internal Revenue Service Federal Tax Information (IRS FTI) data, and Centers for Medicare & Medicaid Services (CMS) data. For more information regarding FIPS 140-2 encryption products, please refer to: htto://csrc. nist. oov/arouas/STM/cmvo/documents/140-11140va1-olLh tm Action Plan for Compliance with a Timeline: Compliance Date: 8. Does Applicant/Bidder implement computer security configurations or settings for all ® Yes computers and systems that access or store HHS Confidential Information? (e.g., non -essential features or services have been removed or disabled to reduce the 0 No threat of breach and to limit exploitation opportunities for hackers or intruders, etc.) Action Plan for Compliance with a Timeline: Compliance Date: 9. Does Applicant/Bidder secure physical access to computer, paper, or other systems ® Yes containing HHS Confidential Information from unauthorized personnel and theft (e.g., door ® No locks, cable locks, laptops are stored in the trunk of the car instead of the passenger area, etc.)? Action Plan for Compliance with a Timeline: Compliance Date: GISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 8 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 42 of 44 10. Does Applicant/Bidder use encryption products to protect HHS Confidential Information Q Yes that is transmitted over a public network (e.g., the Internet, Wil'i, etc.). No If yes, upon request must provide evidence such as a screen shot or a system report. Encryption is required for all HHS Confidential Information. Additionally, FIPS 240-2 compliant encryption is required for Health Insurance Portability and Accountability Act (HIPAA) data, Criminal Justice Information Services (CIIS) data, Internal Revenue Service Federal Tax Information (IRS FTI) data, and Centers for Medicare & Medicaid Services (CMS) data. For more information regarding FIPS 140-2 encryption products, please refer to: httn://csrc. nist. aov/arouns/STM/cmvp/documen ts1140-11140val-all. htm Action Plan for Compliance with a Timeline: Compliance Date: 11. Does Applicant/Bidder use encryption products to protect HHS Confidential Information ® Yes stored on end user devices (e.g., laptops, USBs, tablets, smartphones, external hard drives, ® No desktops, etc.)? If yes, upon request must provide evidence such as a screen shot or a system report. Encryption is required for all HHS Confidential Information. Additionally, FIPS 140-2 compliant encryption is required for Health Insurance Portability and Accountability Act (HIPAA) data, Criminal Justice Information Services (CIIS) data, Internal Revenue Service Federal Tax Information (IRS FTI) data, and Centers for Medicare & Medicaid Services (CMS) data. For more information regarding FIPS 140-2 encryption products, please refer to: httn: //csrc.nist. aov/arouas/STM/cmvo/documents/140-11140val-all.h tm Action Plan for Compliance with a Timeline: Compliance Date: 12. Does Applicant/Bidder require Workforce members to formally acknowledge rules ® Yes outlining their responsibilities for protecting HHS Confidential Information and associated ® No systems containing HHS Confidential Information before their access is provided? Action Plan for Compliance with a Timeline: Compliance Date: 13. Is Applicant/Bidder willing to perform or submit to a criminal background check on ® Yes Authorized Users? ® No Action Plan for Compliance with a Timeline: Compliance Date: 14. Does Applicant/Bidder prohibit the access, creation, disclosure, reception, transmission, ® Yes maintenance, and storage of HHS Confidential Information with a subcontractor (e.g. cloud ® No services, social media, etc.) unless HHS has approved the subcontractor agreement which must include compliance and liability clauses with the same requirements as the Applicant/Bidder? Action Plan for Compliance with a Timeline: Compliance Date: CISO-001-NDQ (11/16) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 9 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 43 of 44 15. Does Applicant/Bidder keep current on security updates/patches (including firmware, ® Yes software and applications) for computing systems that use, disclose, access, create, ® No transmit, maintain or store HHS Confidential Information? Action Plan for Compliance with a Timeline: Compliance Date: 16. Do Applicant/Bidder's computing systems that use, disclose, access, create, transmit, ® Yes maintain or store HHS Confidential Information contain up-to-date anti-malware and ® No antivirus protection? Action Plan for Compliance with a Timeline: Compliance Date: 17. Does the Applicant/Bidder review system security logs on computing systems that access ® Yes or store HHS Confidential Information for abnormal activity or security concerns on a ® No regular basis? Action Plan for Compliance with a Timeline: Compliance Date: 18. Notwithstanding records retention requirements, does Applicant/Bidder's disposal Q Yes processes for HHS Confidential Information ensure that HHS Confidential Information is ® No destroyed so that it is unreadable or undecipherable? Action Plan for Compliance with a Timeline: Compliance Date: Section D: Signature and Submission Please sign the form digitally, if possible. if you can't, provide a handwritten signature. 1. 1 certify that all of the information provided in this form is truthful and correct to the best of my knowledge. If I learn that any such information was not correct, I agree to notify HHS of this immediately. 2. Signature 3. Title . Date: To submit the completed, signed form: • Email the form as an attachment to the appropriate HHS Contract Manager. CISO-001-NDQ (11116) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 10 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) HHS Contract No: HHSREV100002457 Page 44 of 44 Section E: To Be Completed by HHS Agency Staff: gency(s): Requesting Department(s): HHSC:11 DADS: DFPS:11 DSHS:11 Legal Entity Tax Identification Number (TIN) (Last four Only): PO/Contract(s) #: Contract Manager: Contract Manager Email Address: Contract Manager Telephone #: CISO-001-NDQ (11116) (V2.0) HHS Enterprise Data Use Agreement, Attachment 2: Page 11 of 17 SECURITY AND PRIVACY INITIAL INQUIRY (SPI) #12 NOTICE OF MEETING - 7/6/2022 12. Consider and take necessary action to approve the installation of a credit card terminal at the Calhoun County Museum and authorize the County Judge to sign the service agreement. (RHM) PASS Page 8 of 12 #13 NOTICE OF MEETING — 7/6/2022 13. Consider and take necessary action to approve the proposal from G & W Engineers, Inc. for Professional Consulting Services related to the Roof Re-cover Renovations at Calhoun County Annex II, Calhoun County Ag Building and Calhoun County Seadrift Library and authorize the County Judge to sign the proposal. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 9 of 12 June 30, 2022 To: Judge Meyer From: The office of the County Auditor For Everett Wood, Building Maintenance Please place the following item on the Commissioners Court Agenda for Wednesday, July 6, 2022: Consider and take necessary action to approve the proposal from G & W Engineers, Inc. for Professional Consulting Services related to the Roof Re-cover Renovations at Calhoun County Annex II, Calhoun County Ag Building and Calhoun County Seadrift Library and authorize the County Judge to sign the proposal. G&WENGINEERS, INC. 205 W. Live Oak • Port Lavaca, TX 77979 • P: (361)552-4509 • F: (361)552-4987 Texas Firm Registration No. F04188 June 30, 2022 Attn: Everett Wood Calhoun County Roof Specifications and Construction services Dear Mr. Wood, G&W Engineers, Inc. (GWE) appreciates the opportunity to submit this proposal to provide Professional Consulting Services related to the Roof Re-cover renovations at the various Calhoun County Facilities listed below in the project description. This proposal provides a brief project description, our proposed scope of services, project schedule, and proposed fees. GWE is planning on providing this proposal through our roofing subcontractor, whom of which we have worked with on multiple projects including but not limited to the Calhoun County Hospital Project. PHASE I — SITE ASSESSMENT GWE subcontractor Amtech will perform a survey of the various roofs under consideration for re-cover to obtain the information required to prepare a written scope of work and project specifications. We will review available building construction plans, documentation of previous roof surveys to identify asbestos (if available), and a summary of roof leak history, if provided. Our survey will document the existing roof assembly, roof edge terminations, penetration conditions, deck slope conditions and existing roof drainage systems. We will not perform roof cores to verify the existing roof assembly. Existing roof core information has already been provided to Amtech by the client. PHASE II — SCOPE OF WORK AND PROJECT SPECIFICATIONS Following the site assessment Amtech will provide a written detailed scope of work for each building's roof areas that complies with the federal, state, and local jurisdiction having code requirements. We will provide a set of project specifications that will include but not be limited to preparation for re -roofing, membranes, insulation, deck repair or re-cover if required, sheet metal requirements, roof related carpentry, sealants, parapets, curbs, coping, stops, roof mounted equipment, penetrations, terminations, gutters and downspouts, drains and other drainage systems, flashings and counter-flashings, pans, trim, walkway pads, pavers and other required features. We will include in the specifications the requirements for performance, submittals, quality assurance, delivery/storage/handling, project conditions, coordination and warranty; product requirements for material selection identifying specific manufacturers/model numbers for components of the work, and a detailed Scope of Work narrative. We will include warranty requirements in the specifications which will require that the installer be currently certified by the manufacturer as an Authorized Applicator, that all components of the roofing system be covered by a 20-year, full material and labor, No Dollar Limit (NDL), non -proportioned warranty from the manufacturer. PHASE III — BID AND CONSTRUCTION SERVICES Amtech will plan to attend a pre -bid meeting with the selected roofing contractors known for successful work on projects with similar size and scope, in the local area. We will assist with bid tabulations as requested and assist the Owner as required to select a successful bidder. We will review submittals and respond to RFIs. Amtech will Engineering Consulting Planning Surveying LJ & W ENGINEERS , I N C evaluate Change Orders and issue Change Directives, if requested by the owner. We will Certify Applications for Payment. A qualified professional will perform periodic site visits during construction to confirm the work is proceeding in accordance with the contract documents. We propose to perform 9 site visits (3 per facility) during construction. We will document the work progress in Site Observation Reports. The reports will be sent via email to your project representative and the contractor following each site visit. We will notify your project representative by phone and/or email of significant noncompliance or project difficulties that may require rapid evaluation and response from the owner. Upon completion of the project, Amtech will perform a final walk-through site visit to develop a punch list of incomplete work items or deficient installation to be addressed by the contractor prior to issue of final payment. Upon completion of the punch list, we will document the completion of the work for final payment. SCHEDULE & REQUESTS Strat of engineering design services to begin upon receipt of purchase order. We request the following support from the building owner/management in order to perform the proposed services. Notify the property occupant(s) of the assessment to be performed and obtain permission for us to have access to all areas of the site during our field visit. Coordinate and arrange for the property management/engineering/maintenance staff to be available to provide necessary access to our team during the site visit. Coordination with property management to arrange for necessary access equipment (keys, ladders, etc.) at no cost to G&W Engineers. - Provide or assist in obtaining all existing drawings and specifications along with any additional data or information relevant to our performance of the proposed scope of services. COMMERCIAL TERMS 1. This proposal is valid for 30 days. 2. This proposal does not include any bonding, letters of credit or any other forms of surety. 3. This proposal does not include any type of taxes. 4. This proposal does not include any liquidated damages. 5. This proposal excludes permitting, and permit procurement. 6. Engineering will be billed monthly, based on percent progress. 7. No retention, net 30 days of invoice. Invoice amounts to be paid in full. Page 2 of 3 G&WENGINEERS, INC. 205 W. Give Oats • Port Lavaca, TX 77979 • P: (361)552-4509 • F: (361)552-4987 Tetras Firm Registration No. F0418$ June 30, 2022 Attn: Everett Wood Calhoun County 17m Dear Mr. Wood, Roof Specifications and Construction services G&W Engineers, Inc. (GWE) appreciates the opportunity to submit this proposal to provide Professional Consulting Services related to the Roof Re-cover renovations at the various Calhoun County Facilities listed below in the project description. This proposal provides a brief project description, our proposed scope of services, project schedule, and proposed fees. GWE is planning on providing this proposal through our roofing subcontractor, whom of which we have worked with on multiple projects including but not limited to the Calhoun County Hospital Proj ect. PHASE I — SITE ASSESSMENT GWE subcontractor Amtech will perform a survey of the various roofs under consideration for re-cover to obtain the information required to prepare a written scope of work and project specifications. We will review available building construction plans, documentation of previous roof surveys to identify asbestos (if available), and a summary of roof leak history, if provided. Our survey will document the existing roof assembly, roof edge terminations, penetration conditions, deck slope conditions and existing roof drainage systems. We will not perform roof cores to verify the existing roof assembly. Existing roof core information has already been provided to Amtech by the client. PHASE II — SCOPE OF WORK AND PROJECT SPECIFICATIONS Following the site assessment Amtech will provide a written detailed scope of work for each building's roof areas that complies with the federal, state, and local jurisdiction having code requirements. We will provide a set of project specifications that will include but not be limited to preparation for re -roofing, membranes, insulation, deck repair or re-cover if required, sheet metal requirements, roof related carpentry, sealants, parapets, curbs, coping, stops, roof mounted equipment, penetrations, terminations, gutters and downspouts, drains and other drainage systems, flashings and counter-flashings, pans, trim, walkway pads, pavers and other required features. We will include in the specifications the requirements for performance, submittals, quality assurance, delivery/storage/handling, project conditions, coordination and warranty; product requirements for material selection identifying specific manufacturers/model numbers for components of the work, and a detailed Scope of Work narrative. We will include warranty requirements in the specifications which will require that the installer be currently certified by the manufacturer as an Authorized Applicator, that all components of the roofing system be covered by a 20-year, full material and labor, No Dollar Limit (NDL), non -proportioned warranty from the manufacturer. PHASE III — BID AND CONSTRUCTION SERVICES Amtech will plan to attend a pre -bid meeting with the selected roofing contractors known for successful work on projects with similar size and scope, in the local area. We will assist with bid tabulations as requested and assist the Owner as required to select a successful bidder. We will review submittals and respond to RFIs. Amtech will Engineering Consulting Planning Surveying G♦ 1 ENGINEERS , I N C evaluate Change Orders and issue Change Directives, if requested by the owner. We will Certify Applications for Payment. A qualified professional will perform periodic site visits during construction to confirm the work is proceeding in accordance with the contract documents. We propose to perform 9 site visits (3 per facility) during construction. We will document the work progress in Site Observation Reports. The reports will be sent via email to your project representative and the contractor following each site visit. We will notify your project representative by phone and/or email of significant noncompliance or project difficulties that may require rapid evaluation and response from the owner. Upon completion of the project, Amtech will perforM a final walk-through site visit to develop a punch list of incomplete work items or deficient installation to be addressed by the contractor prior to issue of final payment. Upon completion of the punch list, we will document the completion of the work for final payment. SCHEDULE & REQUESTS Strat of engineering design services to begin upon receipt of purchase order. We request the following support from the building owner/management in order to perform the proposed services. Notify the property occupant(s) of the assessment to be performed and obtain permission for us to have access to all areas of the site during our field visit. Coordinate and arrange for the property management/engineering/maintenance staff to be available to provide necessary access to our team during the site visit. - Coordination with property managementtoarrange for necessary access equipment (keys, ladders, etc.) at no cost to G&W Engineers. - Provide or assist in obtaining all existing drawings and specifications along with any additional data or information relevant to our performance of the proposed scope of services. COMMERCIAL TERMS 1. This proposal is valid for 30 days. 2. This proposal does not include any bonding, letters of credit or any other forms of surety. 3. This proposal does not include any type of taxes. 4. This proposal does not include any liquidated damages. 5. This proposal excludes permitting, and permit procurement. 6. Engineering will be billed monthly, based on percent progress. 7. No retention, net 30 days of invoice. Invoice amounts to be paid in full. Page 2 of 3 WENGINEEIBS , I N C FEE G&W Engineers, Inc. proposes the following LUMP SUM fee, billed monthly (NET 30) as progress of the project for Professional Engineering and design services: Phase I — Site Assessment Phase II — Scope of Work and Project Specifications Phase III — Bid and Construction Services .......................................................$4,200 .......................................................$9,600 ..................................................... $ 31, 800 If any changes need to be made to the scope of work, please mark said changes and send back. If our proposal is satisfactory, please sign, scan, and return to inarkeranwenaiineers.com. F° W Accepted By (Signature): l ngli, Inc. Printed Name /Title: panParker, P.E. -ry Mechanical Engineer, PM Date: /-- Page 3 of 3 M1r CERTIFICATE OF INTERESTED PARTIES FORD 1295 1 of1 Complete Nos. 1- 4 and 6 If there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no Interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form, and the city; state and country of the business entity's place Certificate Numben of business, 2022-905859 G&W Engineers, Inc. Port Lavaca, TX United States Date Filed: Name of governmental entity or state agency that Is a party to the contract for which the form Is 06/30/2022 being tiled. Calhoun County. Texas Date Acknowledged; 9 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Calhoun County Roof Specs Technical Services 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Tuch, Elton Port. Lavaca, TX United States X Gohike, Anthony Port Lavaca, TX United states X Sappington, Michial Port Lavaca, TX United States X Danysh, Henry Port Lavaca, TX United States X Novian, Brian Port Lavaca, TX United States X 5 check only if there is NO Interested Party. 6 UNSWORN DECLARATION My name is Brian Novian and my date of birth Is My address is ,._ _,_ _, Victoria Wrosq (city) (etato) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Calhoun County, State of TX , on the 30 day of June 20. 2? /J (month) (year) Signature of authorized agent of contracting business entity (0eclaram) Forms provided by Texas Ethics Commission www.ethics,state.tx.us Version V1.1.191b5cdc #14 NOTICE OF MEETING — 7/6/2022 14. Accept Monthly Report from the following County Office: i. Tax Assessor -Collector — May 2022 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Page 10 of 12 SUMMARY TAX ASSESSOR -COLLECTORS MONTHLY REPORT MAY 2022 COLLECTIONS DISBURSEMENTS Title Certificate Fees 482 $ 6,331.00 Title Fees Paid TXDMV $ 3,921.00 Title Fees Paid County Treasurer Salary Fund $ 2,410.00 Motor Vehicle Registration Collections $ 149,303.22 Disabled Person Fees $ 25.00 Postage $ Global Additonal Collections $ - Paid TXDMV $ 123,477.03 Paid TXDMV SP $ 18,255.93 Paid County Treasurer $ - Paid County Treasurer Salary Fund $ 5,810.60 DMV CCARDTRNSFEE $ 1,784.76 $ - GLAdditonal Collections $ - $ GLOBAL (IBC) Credit/Debit Card Fee's $ 1,393.35 GLOBAL Fees In Excess of Collections $ 391.41 MERCH SERVICES STATEMENT. $ Additional Postage • Vehicle Registration $ - Paid County Treasurer - Additional Postage $ - Motor Vehicle Sales & Use Tax Collections $ 605,674.90 Paid State Treasurer $ 605,674.90 Special Road/Bridge Fees Collected - $ 20,430.00 Paid County Treasurer - RIB Fees $ 20,430.00 Texas Parks & Wildlife Collections $ 3,892.00 TPW GLOBAL CC TRANSACTION FEES $ 174.54 GLOBAL ADDITIONAL COLLECTIONS $ - Paid Texas Parks & Wildlife $ 3,502.80 Paid County Treasurer Salary Fund $ 389.20 P&W CCARDTRNSFEE $ 174.54 GLOBAL Additonal Collections $ - GLOBAL (IBC) Credit/Debit Card Fee's $ 141.18 GLOBAL In Excess/Shortage of Collections $ 33.36 Boat/Motor Sales & Use Tax Collections $ 48,106.22 Paid State Treasurer $ 45,700.91 Paid County Treasurer, Salary Fund $ 2,405.31 TABC 5% CO COMMS FOR MONTH OF $ - - TABC 5% CO COMMS FOR MONTH OF $ - Paid County Treasurer, Salary Fund $ - County Beer & Wine Collections $ - Paid County Treasurer, County Beer & Wine $ - Paid County Treasurer, Salary Fund $ - INTEREST EARNED ON OFFICE ACCOUNT $ 26.39 Paid County Treasurer, Nev. East $ 0.01 Paid County Treasurer, all other districts $ 26.38 INTEREST EARNED ON PARKS AND WILDLIFE ACCOUNT $ 5.19 Paid County Treasurer, Interest on P&W Ace $ 6.19 INTEREST EARNED ON REFUND ACCOUNT $ 0.05 Paid County Treasurer, Interest on Refund Ace $ 0.06 Business Personal Property - Misc. Fees $ 58.95 Paid County Treasurer $ 58.95 Excess Funds $ - Paid County Treasurer $ - Overpayments $ 1.62 Current Tax Collections $ 124,542.17 Penalty and Interest - Current Roll $ 9,741.86 Discount for early payment of taxes $ 400.89 Delinquent Tax Collections $ 10,409.82 Penalty & Interest - Delinquent Roll $ 5,183.46 Collections for Delinquent Tax Attorney $ 4,065.37 Advance - FM & L Taxes $ 14.96 Advance - County AdValorem Taxes $ 146,290.01 Paid County Treasurer- Nev. East $ 143.47 Paid County Treasurer- all other Districts $ 3,029.69 Paid County Treasurer- Delinq Tax Atty. Fee $ 4,065.37 Payment in Lieu of Taxes $ - PaidCountyTreasurer- Navig. East $ - Paid County Treasurer -All other Districts $ - Special Farmers Fees Collected $ 56.00 Paid State Treasurer, Farmers Fees $ 65.00 Hot Check Collection Charges $ - Paid County Treasurers, Hot Check Charge $ - Overage on Collection/Assessing Fees $ - Paid County Treasurer, overage refunded $ - Escheats $ Paid County Treasurer -escheats $ TOTAL COLLECTIONS $ 988,026.75 TOTAL DISBURSEMENTS $ 988,026.75 TOTAL OF�ABOVE pRECEIPTS PDPAI )�TO STT/A/TE AND COUNTY $ 988,026.76 KERRIBO D Tax Assessor -Collector RICHA MEYER County Judge #15 NOTICE OF MEETING — 7/6/2022 15. 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 Nall, Behrens, Reese Page 11 of 12 B—a al ;a :z :z �§ .L �§ a k R § ■ © Q ui . � ■ _ Z § B �eek 0 k UziB ƒ§§ ; B § k� � §§§ k ( 7 k § § ■�,7 & m /§ �0) )v § ■ §o = =F LL Z z � LLI I- 2 =J =W Z J W .� =a z Lu 2 =Z N Q C9 = Z =W r Z _ z Z fi z z 99 z z e m rn Ok 0 N 0 N w f owl J 0 0 z z 0 Lli J w yLLI o ;W F W C z a W C W W O Z W Z lu W r r Z � W Q z G w m o c f Z � w w a a7a IL D U) U CD oa =I O O O M aLOto 0 O w » w o O v w w � U Z W ti to g U gLU } U z w g w =2 =Z H =Z =W =_g r Z W = L Q Z z � _W lu = Q hw w i n all 0 Op6� � V3 3 0 0 I n o o v c c v �lo0a �I 0 0 I en v> 0 0 � w �I » » to w S O F Z 0 z U) w � a W 0� Z a a a ui � W Z F W w el J F -0 -00 90 :Z '•W a C. W G 4 19 W 16 W f lu F O N m 0 0 o n m n rn m N N V fA lfl EPr fR V3 alilO N 0 0 0 0 O W ER to fA HJ N 0 0 3 L I x F- z a za z z z z z K 0 CD K 0cDcDcD z z z z z z 00000 L e x rn rn rn rn rn rn rn rn rn rn rn rn rn rn O m O W W W m w O 0 0 z z 0 g a � J ¢z J C Y C Q CC c- ~[ a' Q o Z. w w �r F 0 w Q Q ¢¢2 O W w Z) O o K Ui-OmaU H N0 0 0 N O O p r N 01 W p N _� O W r aD M v 0 m m IT aO u��n�n�nm0 to r 0 � � m N � N d = r =0 = G. w BG O z U w m 01. 0. a LL O w U y LLI �.7 5� 0i ;Z �CZ ' yGCWG Qi W 0 O O c llp �a a z 0 0 mill M M o C6 N N �, ell B C M n 19 $ 6 0 o V v Z L �I a u W � W ' `n w O L w � 6 0I Q xl V! w02 — lu C H 0 LL o o N z p Z R U. z o a O O L6L6x p Z W W g W 19 O Z e z N F W i Q p e W 0 W z rn "' i f9 o aI 6 S W Z _ co r M W Z W Z V x`Iga Z m y e~a Z a z Z a W w O a W > . W a' p Q: N Z W T h f _N W x W N YI � G e Q � z Bxc ;o :z ;z �§ 0. � 2 � LL u ) u ) B | § ) Q0 § 19 06 LU =k o ■ttl ■ / /z to /lu � z §§ § In LLI k I §■ I � / air $ ■■ w �§ cc ale O Z H Z CW G IL W c J F U Z U W tr a w O K m G z 0 O K W V N LLI IA C W W O O 0 6 L uj N azZ N LU VJ y M W z v z O N CW C z z d Z z c i I 6f Z W m w 2 is % a|' \ I § ■ � ( . Z, �\ § 22 \z ft ( \22 « \� § » § �x \ k� k [\ k Ba @)( z % B� § § W§ \z §§ B§ k % /2 U. % � /) o =W § Z §)§ $ §§ § �, #16 NOTICE OF MEETING — 7/6/2022 16. Approval of bills and payroll. (RHM) MMC: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese County: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Behrens, Reese Adjourned: 10:13a.m. Page 12 of 12 N O 0 N N O NO H y� y�OHOOMNMOIbb N Ot N Ot r� W O r� O O N O M O O H m N M N N O N O 0 0 0 0 b N M N O O b W W O H 01 b H L? N H N O H +/} •l} +/} O} V} L! lM L} lh !h i/} 1? L} L} i/} i? M I M PI a P�MPM 04 M P4 94 M r.0 rCcCrCQrC�r.�cCFCRFCriP aP � E+ E+ W F N 7 U a pqopq z m m N m m O W � ]a] > a H m 04 HIH m o a .4pePpq �. ru n AN amam oa N X H X N M M N a a, m zaoaoHozooam a h WF1.NHHm ME2 A lH 'r mHmP4 NgMW 0�y14 OO a� N m N m p 0 OMOAONF 0 R a s H N W'E WNUroU W �A �"�UEp�N F H 014A.4 ��.a74 a OW'rgo W N H D H N O D O H O W U' p N a agpapp�xpIHQpmyWp$uauZav144C1a mhh0 h7 W h W to Mu hNy 0 z w WW 'N W O E am a� Wm W Paz El W �W yg W p m W W H E. H ri qzm uuw FC [H� m OE OU x D W H z H U H HH E>a E �ME rqa ma>ama z0 4 u W z 4 aa' zz ;4EQ w w�W/IO F02 W m OHEU W ggEPi VW1 E W �mAO4 W a W y' y'Oa£ M F4 xr$u H O W arlUa HUUMMA P W MMO E zHcz�z>a,8OuWzOOu' U UHO E fn E. A E E. n w n W W V M M M N W GD C I+I N N lC M e7 M \C b9 fA V3 fi9 Y > MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---July 06 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES,, PAYROLL AND ELECTRONIC' BANK PAYMENTS _ $, T25,579:82 TOTAL TRANSFERS BETWEEN FUNDS $ 104,677.35 ........... . TOTAL NURSING HOME UPL EXPENSES $ 682,844.19 TOTAL INTER -GOVERNMENT TRANSFERS $ 107,374:05 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---July 06, 2022 PAYABLES AND PAYROLL 6/29/2022 Weekly Payables 7/5/2022 Payroll Liabilities -Payroll Taxes 7/5/2022 Payroll Prosperity Electronic Bank Payments 6/27/-6/30-22 Pay Plus -Patient Claims Processing Fee TOTAL PAYABLES,; PAYROLL AND ELECTRONIC; BANK PAYMENTS' TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 228,300.98 123,441.89 373,521.47 315.48 725,579_.82 6/29/2022 MMC Operating to Golden Creek -correction of NH insurance payment 1,375.97 deposited into MMC Operating in error 6/29/2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 14,151.93 deposited into MMC Operating 6/29/2022 MMC Operating to Tuscany Village -correction of NH insurance payment 7,719.37 deposited into MMC Operating 6/29/2022 MMC Operating to Bethany -correction of NH insurance payment deposited 58,438.29 into MMC Operating in error TRANSFER OF FUNDS BETWEEN NURSING HOMES/MMC 7/1/2022 Fort Bend to MMC Operating -correction of MMC Operating insurance 127.46 payment deposited into Fort Bend in error 7/1/2022 Crescent to Tuscany -correction of Tuscany insurance payment deposited into 21,600.00 Crescent in error 7/1/2022 Broadmoor to Gulf Pointe -correction of Gulf Pointe insurance payment 1,264.33 deposited into Broadmoor in error TOTAL TRANSFERS BETWEEN FUNDS NURSING HOME UPL EXPENSES 7/1/2022 Nursing Home UPL-Cantex Transfer 7/1/2022 Nursing Home UPL-Nexion Transfer 7/1/2022 Nursing Home UPL-HMG Transfer 7/1/2022 Nursing Home UPL-Tuscany Transfer 7/1/2022 Nursing Home UPL-HSL Transfer QIPP CHECKS TO MMC 7/1/2022 Ashford 7/1/2022 Broadmoor 7/1/2022 Crescent 7/1/2022 Fort Bend 7/1/2022 Solera 7/1/2022 Tuscany TRANSFER BETWEEN FUNDS TO MMC OPERATING 7/1/2022 Ashford -Interest Earned 7/1/2022 Broadmoor-Interest Earned 7/V2022 Crescent -Interest Earned 7/1/2022 Fort Bend -Interest Earned 7/1/2022 Solera-Interest Earned 7/1/2022 Golden Creek -Interest earned 7/1/2022 Gulf Pointe MM-Interest Earned 7/1/2022 Gulf Pointe PP -Interest Earned 7/1/2022 Bethany -Interest Earned .TOTAL NURSING HOME UPL EXPENSES INTER -GOVERNMENT TRANSFERS 7/5/2022 IGT DSH 2O22 Pass 3 to be paid July 11, 2022 TOTAL INTER -GOVERNMENT TRANSFERS, 376,456.11 9,883.52 60,945.28 121,941.70 24,800.69 28,317.56 10,970.54 9,512.59 11,590.85 11,251.34 16,768.70 59.55 41.32 46.70 26.32 50.68 57.88 27.18 8.71 86.97 104,677.36. $ 68;4844.19 107,374.05 $ 107,374 06 GRAND TOTAL DISBURSEMENTS APPROVED July 06, 2022 $ 1,620,476.41- Page 1 of 13 RECEIVED BY THE COUNTY AUDITOR ON 9 2022 MEMORIAL MEDICAL CENTER 0AKA 0 AP Open Invoice List 11:53 CALHOUN COUNTY, TEXAS Due Dates Through: 07/21/2022 ap_open_invoice.template Vendor# Vendor Name Class Pay Code R1200 ADT COMMERCIAL Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 145845190 ✓ 06/28/20. 06/05/20 06/30/20. 49.18 0.00 0.00 49.18 ,✓ FIRE MONITORING Vendor Totals Number Name Gross Discount No -Pay Net R1200 ADT COMMERCIAL 49.18 0.00 0.00 49.18 Vendor# Vendor Name Class Pay Code A1680 AIRGAS USA, LLC - CENTRAL DIV M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9126870853 ,/ 06/28/20 06/13/20 07/08/20 394.77 0.00 0.00 394.77 OXYGEN 9126846195 06/28/20 06/14/20 07/09/20. 2,356.22 0.00 0.00 2,356.22 ✓ OXYGEN Vendor Totals Number Name Gross Discount No -Pay Net A1680 AIRGAS USA, LLC -CENTRAL DIV 2,750.99 0.00 0.00 2,750.99 Vendor# Vendor Name Class Pay Code A1715 ALCO SALES & SERVICE CO M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2885945IN ,/ 06/27/20 06/13/20 06/27/20 224.00 0.00 0.00 224.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1715 ALCO SALES & SERVICE CO 224.00 0.00 0.00 224.00 Vendor# Vendor Name Class Pay Code A1705 ALIMED INC. ,/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net RPSV03835631 t/ 06/28/20 06/17/20 07/02/20 161.40 0.00 0.00 161.40 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1705 ALIMED INC. 161.40 0.00 0.00 161.40 Vendor# Vendor Name Class Pay Code A1746 ALPHA TEC SYSTEMS INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INVO0105143 06/14/20. 06/01/20 06/14/20 82.97 0.00 0.00 82.97 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1746 ALPHA TEC SYSTEMS INC 82.97 0.00 0.00 82.97 Vendor# Vendor Name Class Pay Code 14028 AMAZON CAPITAL SERVICES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1XQKMK133W91 06/28/20 06116/20 07/01120 829.80 0.00 0.00 829.80 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14028 AMAZON CAPITAL SERVICES 829.80 0.00 0.00 829.80 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2632799 ✓ 06/28/20 06/05/20 07/05/20 3,400.00 0.00 0.00 3,400.00 file:///C:/Users/ltrevino/cpsi/inemmed.cpsinet.com/u88125/data 5/tmp_cw5report438699... 6/29/2022 Page 2 of 13 LAB STAFFING SWA q 2649468 06/28/20 06/20/20 07/15/20 3,293.75 0.00 0.00 3,293.75 LAB STAFFING (@172) Sii44Y Vendor Total: Number Name Gross Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 6,693.75 0.00 0.00 6,693.75 Vendor# Vendor Name Class Pay Code B1150 BAXTER HEALTHCARE ✓ w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 75253873 ,/ 06/15/20. 05/28/20 06/22/20 253.49 0.00 0.00 253.49 SUPPLIES 75441001 06127120. 06/11/20 07/06/20 280.61 0.00 0.00 260.61 SUPPLIES / 75450999 �/ 06/27/20. 06/13/20 07/08/20. 20.96 0.00 0.00 20.96 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 555.06 0.00 0.00 555.06 Vendor# Vendor Name Class Pay Code M2485 BAYER HEALTHCARE M Invoice# Com ant Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 600990742o 06/27/20 06/10/20 06/27/20. 729.68 0.00 0.00 729.68 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCARE 729.68 0.00 0.00 729.68 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net $ 109934234 ✓ 06/15/20 06/01/20 06/26/20 91.43 0.00 0.00 91.43 SUPPLIES 109919108 ✓ 06/28/20. 05/31/2006/25/20. 261.17 0.00 0.00 261.17 109929382 ✓ 06/28/20. 06/02/20 06/27/20 346.00 0.00 0.00 346.00 ✓ SUPPLIES 109927995 ,/ 06/28/20 06/02/20 06/27/20 897.40 0.00 0.00 897.40✓ SUPPLIES / 109927641 06/28/20 06/02120 06/27/20 1,242.07 0.00 0.00 1,242.07✓ SUPPLIES 109934469 ✓ 06/28/20 06/06/20 07101 /20 440.27 0.00 0.00 440.27 SUPPLIES 109963904 ✓ 06/28/20. 06/20/2007/01/20 1,108.22 0.00 0.00 1,108.22 Vendor Total: Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 4,386.56 0.00 0.00 4,386.56 Vendor# Vendor Name Class Pay Code B1650 BOSART LOCK & KEY INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 124379 ✓ 06/21/20 06/15120 07/15120 33.50 0.00 0.00 33.50 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net B1650 BOSART LOCK & KEY INC 33.50 0.00 0.00 33.50 Vendor# Vendor Name Class Pay Code 14064 CAPITAL ONE file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 3 of 13 Invoice# Cc ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1642580047 7 06/28/20. 06/16/20 07/14/20 133.85 0.00 0.00 133.85 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14064 CAPITALONE 133.85 0.00 0.00 133.85 ,. Vendor# Vendor Name Class Pay Code C1325 CARDINAL HEALTH 414, INC. W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8002864519,E 06/28/20 05/31 /20 06/30/20. 673.63 0.00 0.00 673.63 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net , C1325 CARDINAL HEALTH 414. INC. 673.63 0.00 0.00 673.63 Vendor# Vendor Name Class Pay Code 14260 CAREFUSION SOLUTIONS, LLC v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 10018952391 ✓ 06/28/20 06/10/20 07/01 /20 2.00 0.00 0.00 2.00 MAIN 10018952383 06/28/20. 06/10/2007/01/20. 1,788.00 0.00 0.00 1,788.00 MAINT Vendor Totals Number Name Gross Discount No -Pay Net 14260 CAREFUSION SOLUTIONS, LLC 1,790.00 0.00 0.00 1,790.00 Vendor# Vendor Name Class Pay Code 14236 CARRIER CORPORATION Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 90197011 ,/ 06129/20. 05/16/20 06/15/20 12,830.00 0.00 0.00 12,830.00 MAR 22 to JI<r pa,,-}�Q zlzt - a177Ila- /LEASE 90197010 V 06/29/20 05/16/20 06/15/20 12,830.00 0.00 0.00 12.830.00 LEASE FEB 22 C jUr r6A-}iQ.. I�31'Z�27 �22 Vendor Totals Number Name Gross Discount No -Pay Net 14236 CARRIER CORPORATION 25.660.00 0.00 0.00 25,660.00 Vendor# Vendor Name Class Pay Code 13028 CAVALLO ENERGY TEXAS LLC ✓/ Invoice# / Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 631753 ,/ 06129/20 06/17/20 07115120 1,702.38 0.00 0.00 1,702.38 /,ENERGY 631946 ,/ 06/29/20 06/17/20 07/15/20 656.43 0.00 0.00 656.43 ENERGY 631947 ✓ 06/29/20 06/17/20 07/15/20 16.91 0.00 0.00 16.91,,� ENERGY Vendor Totals Number Name Gross Discount No -Pay Net 13028 CAVALLO ENERGY TEXAS LLC 2,375.72 0.00 0.00 2,375.72 Vendor# Vendor Name Class Pay Code C1992 COW GOVERNMENT, INC. ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net Z257956 06/27/20 06/07/20 07/07/20 128.42 0.00 0.00 128.42 SUPPLIES Z590736 ✓ 06/28/20. 06/14/20 07/01/20 257.81 0.00 0.00 257.81 / SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net C1992 COW GOVERNMENT, INC. 386.23 0.00 0.00 386.23 Vendor# Vendor Name Class Pay Code file:///C:/Userslltrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 4 of 13 ✓ 12768 CHEMAQUA Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 7822929 ,/ 06/28/20 06/10/20 06/20/20 518.75 0.00 0.00 518.75 ✓ / WATER TREATMENT Vendor Totals Number Name Gross Discount No -Pay Net 12768 CHEMAQUA 518.75 0.00 0.00 518.75 Vendor# Vendor Name Class Pay Code / C1730 CITY OF PORT LAVACA / W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 061722C 06/29/20 06/17/20 07/05/20 104.00 0.00 0.00 104.00 WATER 061722B 06129/20. 06/17/20 07/05/20. 65.49 0.00 0.00 65.49 WATER 061722A 06/29/20 06/17/20 07/05/20 5,855.10 0.00 0.00 5,855.10 WATER 061722 06/29120. 06/17/20 07/05/20 27.04 0.00 0.00 27.04 WATER Vendor Totals Number Name Gross Discount No -Pay Net C1730 CITY OF PORT LAVACA 6,051.63 0.00 0.00 6,051.63 Vendor# Vendor Name Class Pay Code / ,/ 14080 CORROHEALTH, INC. Invoice# Comment Tran Dt Inv Dt Due Dt 1 Check D Pay Gross Discount No -Pay Net 756143 06/28/20 05/31/20 06/30/20. 2,194.80 0.00 0.00 2.194.80 HIM SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 14080 CORROHEALTH, INC. 2,194.80 0.00 0.00 2,194.80 Vendor# Vendor Name Class Pay Code / 11046 E-MDS, INC J Invoice# Comment Tram Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 508306 ✓ 06/28/20 06/22/20 07/15/20 10,906.00 0.00 0.00 10,906.00 HOSTING SUBSCRIPTION QTF , Vendor Totals Number Name Gross Discount No -Pay Net 11046 E-MDS, INC 10,906.00 0.00 0.00 10,906.00 Vendor# Vendor Name Class Pay Code / C2510 EVIDENT ,/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net T2206091378 ,/ 06/28/20 06/09/20 07/04/20 21,008.60 0.00 0.00 21,008.60 CONSULTING SERV Vendor Totals Number Name Gross Discount No -Pay Net C2510 EVIDENT 21,008.60 0.00 0.00 21,008.60 Vendor# Vendor Name / Class Pay Code 14336 FIRETRON, INC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 200578 / 06/28/2006/14/2007114/20. 1,130.00 0.00 0.00 1,130.00 ✓ SPRINKLER SERVICE Vendor Totals Number Name Gross Discount No -Pay Net 14336 FIRETRON, INC 1,130.00 0.00 0.00 1,130.00 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3552465 / 06/15/20. 06/08/20 07/03/20 124.56 0.00 0.00 124.56 file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 5 of 13 SUPPLIES 3599575 06/27/20. 06/09/20 07/04/20 -27.38 CREDIT INV 3507460 3599577 ✓ 06127/20. 06/09/20 07/04/20 410.72 SUPPLIES 3774397 V 06/27/20 06/15/20 07/10/20. 1,850.72 /SUPPLIES 3599576 06/28/20 06/09/20 07/04/20 ✓ 58.24 ,SUPPLIES 3640371 06/28/20. 06/10/20 07/05/20 80.14 /SUPPLIES 3774396 06/28/20. 06/15/20 07/10/20. ✓ 160.28 SUPPLIES 3818482 / 06/28/20 06/16/20 07/11 /20. 530.94 ✓SUPPLIES / 3818481 ,/ 06/28/20 06/16/20 07/11 /20 203.39 SUPPLIES Vendor Totals Number Name Gross F1400 FISHER HEALTHCARE 3,391.61 Vendor# Vendor Name Class Pay Code / W1300 GRAINGER ,/ M Invoice# C7ment Tran Dt Inv Dt Due Dt Check D Pay Gross 9348949711 ,/ 06/28/20.06/17/2007/01/20, 15.76 SUPPLIES Vendor Totals Number Name Gross W1300 GRAINGER 15.76 Vendor# Vendor Name Class Pay Code G1050 GREENHOUSE FLORAL DESIGNERS ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 9576 06/29/20. 05/10/20 06/01/20 120.00 PLANTS FOR HEALTH FAIR Vendor Totals Number Name Gross G1050 GREENHOUSE FLORAL DESIGNERS 120.00 Vendor# Vendor Name Class Pay Code 11984 GUERBET, LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 18620988 ✓ 06/15/20 06/14/20 06/15/20 1,575.00 SUPPLIES Vendor Totals Number Name Gross 11984 GUERBET, LLC 1,575.00 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 2248029 06/21 /20 06/14/20 07/14/20. 834.45 SUPPLIES / 2248597 ✓ 06/21 /20 06/15/20 07/15/20 104.24 SUPPLIES Vendor Totals Number Name Gross G1210 GULF COAST PAPER COMPANY 938.69 Vendor# Vendor Name / Class Pay Code 14476 HAMILTON MEDICAL, INC. 0.00 0.00 -27.38 0.00 0.00 410.72 / 0.00 0.00 1,850.72✓� 0.00 0.00 5B.24 % ✓✓ 0.00 0.00 80.14 0.00 0.00 160.28 0.00 0.00 530.94 0.00 0.00 203.39 Discount No -Pay Net 0.00 0.00 3,391.61 Discount No -Pay Net 0.00 0.00 15.76 / v Discount No -Pay Net 0.00 0.00 15.76 Discount No -Pay Net 0.00 0.00 120.00 Discount No -Pay Net 0.00 0.00 120.00 Discount No -Pay Net 0.00 0.00 1,575.00 Discount No -Pay Net 0.00 0.00 1,575.00 Discount No -Pay Net 0.00 0.00 834.45 0.00 0.00 104.24 Discount No -Pay Net 0.00 0.00 938.69 file:///C:/Users/ltrevino/epsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report438699... 6/29/2022 Page 6 of 13 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 23221469 ,/ 06/27/2006/16/2007/15/20. 1,201.60 0.00 0.00 1,201.60 SUPPLIES .✓ Vendor Totals Number Name Gross Discount No -Pay Net 14476 HAMILTON MEDICAL, INC. 1,201.60 0.00 0.00 1,201.60 Ventlor# Vendor Name Class Pay Code ✓ 12380 HEALTH SOLUTIONS DIETETICS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 062422 06/28/20 06/24/20 07/15/20. 3,000.00 0.00 0.00 3,000.00 �✓ DIETICIAN SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 12380 HEALTH SOLUTIONS DIETETICS 3,000,00 0.00 0.00 3,000.00 Vendor# Vendor Name Class Pay Code 1 / H0416 HOLOGIC INC ,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 10160056 �/ 06/27/20 06/10/20 06/27/20 472.50 0.00 0.00 472.50 j SUPPLIES✓ ✓ 10162217 06/27/20 06/13/20 06/27/20 3,285.00 0.00 0.00 3,285.00 SUPPLIES 10163842 ,//06/27/20. 06/14/20 06/27/20 472.50 0.00 0.00 472.50 SUPPLIES .✓ Vendor Totals Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 4,230.00 0.00 0.00 4,230.00 Vendor# Vendor Name Class Pay Code 11260 INTOXIMETERS INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 709273 J 06/28/20 06/07/20 07/02/20 29.50 0.00 0.00 29.50 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11260 INTOXIMETERS INC 29.50 0.00 0.00 29.50 Vendor# Vendor Name Class Pay Code / 14432 LGC CLINICAL DIAGNOSTICS, INC. ,/ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 90188217 j 06/28/20 06/09/20 07/01/20 1,710.00 0.00 0.00 1,710.00 2022 RENEWAL Vendor Totals Number Name Gross Discount No -Pay Net 14432 LGC CLINICAL DIAGNOSTICS, INC. 1,710.00 0.00 0.00 1,710.00 Ventlor# 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 19519091 V//06/27/20 06/23/20 07/08/20 177.94 0,00 0.00 177.94 SUPPLIES 19525829✓ 06/27/20 06/24/20 07/09/20 70,03 0.00 0.00 70.03 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 247.97 0.00 0.00 247.97 Vendor# Vendor Name Class Pay Code 4 11141 MEDICAL DATA SYSTEMS, INC. Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 170207 // 01128/20 04/30120 05125/20 1,610.58 0.00 0.00 1,610.58 ✓COLLECTION FEES file:///C:/Userslltrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 7 of 13 170208 / 06/28/20. 04/30/20 05/25/20 6,310.44 0.00 0.00 6,310.44 COLLECTION FEES/COURT Cc 171739 / 06/28/20. 05/31/20 06/25/20 359.32 0.00 0.00 359.32 V COLLECTION FEES 171740 / 06/28/20 05/31 /20 06/25/20. 2,496.57 0.00 0.00 2,496.57 ✓ COLLECTION FEES Vendor Total: Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC. 10,776.91 0.00 0.00 10,776.91 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2211955568 ,/ 06/15/20. 05/19/20 06/13/20. 83.28 0.00 0.00 83.28 SUPPLIES 2214471077,/ 06/21/20 06/08/20 07/03/20 1,506.57 0.00 0.00 1,506.57 SUP/PLIES 2214471076 „! 06/21 /20 06/08/20 07/03/20 116.00 0.00 0.00 116.00 SUPPLIES 2214511809 ,/ 06/27/20 06/08/20 07/03/20 4.27 0.00 0.00 4.27 SUPPLIES 2214511801 06/27/20 06/08/20 07/03/20 27.16 0.00 0.00 27.16 SUPPLIES 2214511807 ✓ 06/27/20 06/08/20 07/03/20 56.56 0.00 0.00 / 56.56 S/UPPLIES 2214511808 ✓ 06/27/20 06/08/20 07/03/20 189.22 0.00 0.00 189.22 ✓' SUPPLIES 2214511803 ✓ 06/27/20 06/08/20 07/03/20 244.98 0.00 0.00 244.98 / SUPPLIES 2214511802 ✓ 06/27/20. 06/08/20 07/03/20. 29.61 0.00 0.00 29.61 SUPPLIES 2214511805 ✓/ 06/27/20. 06/08/20 07/03/20 82.57 0.00 0.00 82.57 SU PLIES 2214605427 06/27/20 06/08/20 07/03/20 459.01 0.00 0.00 459.01 SUPPLIES 2214511813 / 06/27/20 06/08/20 07/03/20. 148.36 0.00 0.00 148.36 SUPPLIES 2214510399 ✓ 06/27/20. 06/08/20 07/03/20 69.86 0.00 0.00 69.86 SUPPLIES 2214511804/ 06/27/20 06/08/20 07/03/20 24.77 0.00 0.00 24.77 SUPPLIES 2214511800 06/27/20 06/08/20 07/03/20 232.84 0.00 0.00 232.84 SUPPLIES 2214511806 06/27/20. 06/08/20 07/03/20 113.62 0,00 0.00 / 113.62 SUPPLIES 2214616842 ✓/ 06/27/20.06/09/20 07/04/20. 256.98 0.00 0.00 256.98 SUPPLIES / 2214919792 ,/ 06/27/20 06/10/20 07/05/20 67.14 0.00 0.00 67.14 SUPPLIES 2214862232 ✓ 06/27/20 06/10/20 07/05/20 22.56 0.00 0.00 22.56 SUPPLIES 2214862231 ✓ 06/27/20 06/10/20 07/05/20 596.92 0.00 0.00 596.92 SUPPLIES file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 8 of 13 2211579860 ✓ 06/28/20 05/17/20 06/11/20 731.00 0.00 0.00 731.00 SUPPLIES 2214471075 ✓ 06/28/20 06/08/20 07/03/20 232.00 0.00 0.00 232.00 SUPPLIES 2215205156 ,/ 06/28/20 06/13/20 07/08/20. 92.93 0.00 0.00 92.93 SUPPLIES 2215270721 ✓ 06/28/20. 06/14/20 07/09/20. 182.28 0.00 0.00 182.28 SUPPLIES 2215429357 ,/ 06/28/20 06/15/20 07/10/20 297,60 0.00 0.00 297.60 SUPPLIES 2215429363 >/ 06/28120. 06/15/20 07/10/20 446.74 0.00 0.00 446.74 SUPPLIES 2215429356 06/28/20 06/15/20 07/10/20. 232.00 0.00 0.00 232.00 SUPPLIES 2215429358 06/28/20. 06/15/20 07/10/20 15.57 0.00 0.00 15.57 SUPPLIES 2215686964 ✓/ 06/28/20 06/16/20 07/11/20. 407.72 0.00 0.00 407.72 SUPPLIES 2215686962 ✓ 06/28/20 06/16/20 07/11/20 17.27 0.00 0.00 17.27 SUPPLIES 2216066554 ,/ 06/28/20 06/20/20 07/15/20 84.07 0.00 0.00 84.07�/ SUPPLIES 2216066555 ,// 06/28/20 06/20/20 07/15/20 129.98 0.00 0.00 129.98 ✓ SUPPLIES 2216066556 ✓ 06/28/20 06/20/20 07/15/20 276.48 0.00 0.00 276.48 SUPPLIES 2216422490 ✓ 06/28/20. 06/22/20 07/15/20 407.72 0.00 0.00 407.72 j SUPPLIES 2216422495 / 06/28/20 06/22/20 07/15/20 189.22 0.00 0.00 189.22 SUPPLIES 2216422494 "/ 06/28/20 06/22/20 07/15/20 527.51 0.00 0.00 527.51 SUPPLIES 2216422489,// 06/28/20 06/22/20 07/15/20 203.86 0.00 0.00 203.86 SUPPLIES 2216422499 ,/ 06/28/20 06/22/20 07/15/20 12.86 0.00 0.00 12.86 SUPPLIES 2216364530/ 06/28/20 06/22/20 07/15/20 169.95 0.00 0.00 169.95---' SUPPLIES 2216422498 ✓/ 06/28/20. 06/22/20 07/17/20 82.17 0.00 0.00 82.17 SUPPLIES Vendor TotalE Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 9,071.21 0.00 0.00 9,071.21 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC ,,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8340521 ✓ 06/28/20. 06/20/20 06/30/20 542.81 0.00 0,00 542.81 r/ INVENTORY 8340520 ,� 06/28/20 06/20/20 06/30/20 318.85 0.00 0.00 318.85 INVENTORY . 8342849 ✓ 06/28/20 06/21/20 07/01/20 32.49 0.00 0.00 32.49 INVENTORY file:///C:/Users/ltrevino/cpsilmemmed.cpsinet.com/u88125/data 5/tmp_cw5report438699... 6/29/2022 Page 9 of 13 8345376 ✓ 06/28/2006/21/2007/01/20. 1,049.27 0.00 0.00 1,049.27 / INVENTORY .� 8342850 ✓ 06/28/20 06/21/20 07/01/20 320.68 0.00 0.00 320.68 INVENTORY 8342851„ 06/28/20. 06/21/2007/01/20 4,326.56 0.00 0.00 4,326.56 INVENTORY 8346482 06/28/20 06/21/20 07/01/20 366.14 0.00 0.00 366.14 INVENTORY ✓ 8342269 06/28/2006/21/2007/01/20. 7.790.36 0.00 0.00 7,790.36 INVENTORY 8346481✓ 06/28120. 06/21/2007/01/20 620.52 0.00 0.00 620.62� INVENTORY 8350924 06/28/20. 06/22/20 07/02/20 48.44 0.00 0.00 48.44 INVENTORY 8350569 ,/ 06/28/20 06/22/20 07/02/20. 976.75 0.00 0.00 l- 976.75 ✓ INVENTORY 8350570 06/28/20 06/22/20 07/02/20 676.01 0.00 0.00 676.01 .� INVENTORY 8348205 06/28/20 06/22/20 07/02/20. 10.62 0.00 0,00 10.62 /INVENTORY 8348206 ,/ 06/28/2006/22/2007/02/20 2,085.23 0.00 0.00 2,085.23 INVENTORY / 8355832 ,/ 06/28/20 06/23/20 07/03/20. 332.35 0.00 0.00 332.35 INVENTORY 2323 ,� 06/28/20. 06/23/20 07/03/20. -848.63 0.00 0.00 -848.63 CREDIT 8360802 06/28/20 06/26/20 07/06/20 7,690.95 0.00 0.00 7,690.95 INVENTORY 8362785 // 06/28/20 06/26/20 07/06/20 40.75 0.00 0.00 40.75 INVENTORY 8362786 ✓ 06128/20. 06/26/20 07/06/20 138.41 0.00 0.00 138.41 INVENTORY , Vendor TotaLNumber Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 26.518.66 0.00 0.00 26,518.56 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC �/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8800911741 ✓ 06/27/20 06/10/20 07/10/20 83,65 0.00 0.00 83.65.E SUPPLIES 8800912707 ,� 06/27/20 06/14/20 07/14/20 337.11 0.00 0.00 337.11 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2659 MXR IMAGING, INC 420.76 0.00 0.00 420.76 Vendor# Vendor Name Class Pay Code 12388 NATIONAL FARM LIFE INSURANCE / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3710665 06/28/20 06/15/20 07/01/20 3,633.48 0.00 0.00 3,633.48 EMP LIFE INSURANCE Vendor Total: Number Name Gross Discount No -Pay Net 12388 NATIONAL FARM LIFE INSURANCE 3,633.48 0.00 0.00 3,633.48 Vendor# Vendor Name Class Pay Code file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report438699... 6/29/2022 Page 10 of 13 12096 NEOGENOMICS LABORATORIES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 5078070 06/28/20 01/31/20 02/28/20 380.00 0.00 0.00 LAB SERV 5154716 r/ 06/28/20 02/28/20 03/31/20 3,186.00 0.00 0.00 , LAB SERV 5244041 ✓/06/28/20. 03/31/2004/30/20 630.00 0,00 0.00 LAB SERV 5329177 / 06128/20. 04/30/2005130/20 1,700.00 0.00 LAB SERVICES Vendor Total: Number Name Gross Discount 12096 NEOGENOMICS LABORATORIES 5,896.00 0.00 Vendor# Vendor Name Class Pay Code 00920 OFFICE DEPOT Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discouni 250091655001 ✓- 06/28/20. 06/17/2007/01/20 60.22 0.00 SUPPLIES 250091654001 ✓/06/28/20 06/17/20 07/01/20. 186.35 0.00 SUPPLIES Vendor Total: Number Name Gross Discount 00920 OFFICE DEPOT 246.57 0.00 Vendor# Vendor Name Class Pay Code 01416 ORTHO CLINICAL DIAGNOSTICS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 1852417149 06/28/20. 05/31/2006130/20. 752.16 0.00 SUPPLIES Vendor Totals. Number Name Gross Discount 01416 ORTHO CLINICAL DIAGNOSTICS 752.16 0.00 Vendor# Vendor Name Class Pay Code 00572 QUILL CORPORATION % W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 25613129 ✓/06/27/20. 06/08/20 07/08/20 258.99 0.00 SUPPLIES Vendor Total: Number Name Gross Discount 00572 QUILL CORPORATION 258.99 0.00 Vendor# Vendor Name Class Pay Code 13460 RELIANT, DEPT 0954 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 3020039541763 06/28/20 06/20/20 07/15/20. 30,620.85 0.00 ELECTRICITY Vendor Total: Number Name Gross Discount 13460 RELIANT, DEPT 0954 30,620.86 0.00 Vendor# Vendor Name Class Pay Code G0425 ROBERTS, ODEFEY, WITTE & WALL W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 83A 06/29/20 05/27/20 06/06/20 297.00 0.00 LEGALSERV 185 ✓ 06/29/20 05/27/20 06/06/20 1,122.00 0.00 LEGALSERV Vendor Totals Number Name Gross Discount 00425 ROBERTS, ODEFEY, WITTE & WALL 1,419.00 0.00 Net; 380.00 3,186.00 i 630.00 0.00 1.700.00 ✓ No -Pay Net 0.00 5,896.00 No -Pay Net 0.00 60.22 0.00 186.35 No -Pay Net 0.00 246.57 No -Pay Net 0.00 752.16 No -Pay Net 0.00 752.16 No -Pay Net 0.00 258.99 No -Pay Net 0.00 258.99 No -Pay Net 0.00 30,620.85 No -Pay Net 0.00 30,620.85 No -Pay Net 0.00 297.00 0.00 1,122.00 No -Pay Net 0.00 1,419.00 file:///C:/Users/itrevino/cpsi/memmed.cpsinct.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 11 of 13 Vendor# Vendor Name Class Pay Code S0900 SAM'S CLUB DIRECT ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 061222 06/28/20 06/12/20 07/08/20 836.30 0.00 0.00 836.30 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 50900 SAM'S CLUB DIRECT 836.30 0.00 0.00 836.30 Vendor# Vendor Name Class Pay Code S1700 SHARN INC ,� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net IN01687885 ,/ 06115/20. 06/07/20 06/15/20 140.71 0.00 0.00 140.71 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net S1700 SHARN INC 140.71 0.00 0.00 140.71 Vendor# Vendor Name Class Pay Code S1800 SHERWIN WILLIAMS W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 35915 ✓ 06/28/20. 06/13/20 06/28/20 78.49 0.00 0.00 78.49 ✓ ' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 81800 SHERWIN WILLIAMS 78.49 0.00 0.00 78.49 Vendor# Vendor Name Class Pay Code S2001 SIEMENS MEDICAL SOLUTIONS INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 116226614✓/06/28/20 06/16/20 07/11/20 2,193.83 0.00 0.00 2,193.83 MAINTENANCE CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net S2001 SIEMENS MEDICAL SOLUTIONS INC 2,193.83 0.00 0.00 2,193.83 Vendor# Vendor Name Class Pay Code S2362 SMITH & NEPHEW / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 943652704 ✓ 06/21/20 06/14/20 07/01120 1,106.00 0.00 0.00 1,106.00 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net S2362 SMITH & NEPHEW 1,106.00 0.00 0.00 1,106.00 Vendor# Vendor Name Class Pay Code 14484 SOUTH TEXAS STRIPING / ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 345278 ✓ 06/28/20 06/21/20 07101/20 1,660.00 0.00 0.00 1,660.00 RE STRIPE PARKING LOTS , Vendor Totals Number Name Gross Discount No -Pay Net 14484 SOUTH TEXAS STRIPING 1,660.00 0.00 0.00 1,660.00 Vendor# Vendor Name / Class Pay Code C1010 SPARKLIGHT ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 061422 06/28/20. 05/14/20 06/30/20 -18.97 0.00 0.00 -18.97 IZ CREDIT 061622A 06/28/20 06/15/20 06/30/20 107.35 0.00 0.00 107.35 CABLE 061622 06/28/20 06/16/20 06/30/20 1,675.15 0.00 0.00 1,675.15✓ CABLE file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report438699... 6/29/2022 Page 12 of 13 061622B 06/28/20 06/16/20 06/30/20 2,250.00 0.00 0.00 2,250,00 CABLE Vendor Totals Number Name Gross Discount No -Pay Net C1010 SPARKLIGHT 4,013.53 0.00 0.00 4,013.53 Vendor# Vendor Name Class Pay Code S2694 STANFORD VACUUM SERVICE ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 283211 / 06/28/20. 06/21/2007/01/20 545.00 0.00 0.00 545.00 GREASETRAP Vendor Totals Number Name Gross Discount No -Pay Net S2694 STANFORD VACUUM SERVICE 545,00 0.00 0.00 545.00 Vendor# Vendor Name Class Pay Code / 10735 STRYKER SUSTAINABILITY ✓ Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 4454458 ✓ 06/27/20 06/14/20 07/14/20 352.71 0.00 0.00 352.71 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABILITY 352.71 0.00 0.00 352.71 Vendor# Vendor Name Class Pay Code T0420 TELEFLEX MEDICAL Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9505622271 ,/ 06/27/20. 06/15/20 06/27/20 239.00 0.00 0.00 239.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net T0420 TELEFLEX MEDICAL 239.00 0.00 0.00 239.00 Vendor# Vendor Name Class Pay Code 13224 TORCH ,/ Invoice# Comment Tran Dt Inv or Due or Check D Pay Gross Discount No -Pay Net 2226228 06/28/20 02/15/20 03/15/20 4,500.00 0.00 0.00 4,500.00 STRATEGIC PLANNING 2227209 ✓ 06/28/20 06/28/20 07/15/20 4,500.00 0.00 0.00 4,500.00 INTERIM STRATEGIC PLANNII• , Vendor Totals Number Name Gross Discount No -Pay Net 13224 TORCH 9,000.00 0.00 0.00 9,000.00 Vendor# Vendor Name / Class Pay Code T3130 TRI-ANIM HEALTH SERVICES INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 65085930 06/27/20. 06/15/20 07/10/20 267.29 0.00 0.00 267.29 ✓/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net T3130 TRI-ANIM HEALTH SERVICES INC 267.29 0.00 0.00 267.29 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 8400397225 / 06/28/20 06/16/20 07/11/20 /LA/UNDRY 204.46 0.00 0.00 204.46 8400397753 06/28/20 06/23/20 07/15/20 ✓ 201.59 0.00 0.00 201.59 LAUNDRY 8400397771 ✓ 06/28/20. 06/23/20 07/15/20 90.62 0.00 0.00 90.62 t/ LAUNDRY 8400397779 / 06/28/2008/23/2007/15/20 1,599.35 0.00 0.00 1,599.35 file:///C:/Userslltrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report43 8699... 6/29/2022 Page 13 of 13 LAUNDRY 8400397755 ✓ 06/28/20. 06/23/20 07/15/20 196.22 0.00 0.00 LAUNDRY 8400397754 06/28/20. 06/23/20 07/15/20 200.81 0.00 0.00 LAUNDRY 8400397752 ✓/ 06/28/20 06/23/20 07/15/20 30.71 0.00 0.00 LAUNDRY 8400397756 06/28/20 06/23/20 07/15/20. 208.13 0.00 0.00 LAUNDRY 8400397960 ✓ 06/28/20 06/27/20 07/15/20 59.82 0.00 0.00 LAUNDRY 8400397959 06/28/20 06/27/20 07/15/20 48.15 0.00 0.00 LAUNDRY 8400397982 / 06128/20. 06/27/20 07/15/20. 2,258.14 0.00 0.00 LAUNDRY Vendor Totals Number Name Gross Discount No -Pay U1064 UNIFIRST HOLDINGS INC 51098.00 0.00 0.00 Vendor# Vendor Name Class Pay Code / 12208 WAGEWORKS Invoice# Co/mment Tran Dt Inv Dt Due Dt Check D Pay Gross INV3919341 06/28/20 06/23/20 07/15/20 ✓ 396.50 MONTLY COMPLIANCE JUNE: Vendor Totals Number Name Gross 12208 WAGEWORKS 396.50 Vendor# Vendor Name Class Pay Code 12548 WAGEWORKS, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 0522DR46779 06/28/20. 05/31/2006/30/20 155.52 COBRA MAY 22 Vendor Totals Number Name Gross 12548 WAGEWORKS, INC 155.52 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross 9111177237✓ 06/27/20. 06/23/20 07/15/20 145.32 SUPPLIES 9111177238 >/ 06/27/20 06/23/20 07/15/20 4,754.31 SUPPLIES 9111173902 �/ 06/28/20 06/15/20 07/10/20. 346.08 SUPPLIES 9111172744 ,/ 06/28/20. 06/15/2007/10/20 1,571.67 SUPPLIES Vendor Totals Number Name Gross 11110 WERFEN USA LLC 6.817.38 Report Summary Grand Totals: Gross Discount 228,300.98 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 196.22 200.81 30.71 ✓ 208.13 / 59.82 48.15 ,/ 2,258.14 Net 5.098.00 Net 396.50 Net 396.50 Discount No -Pay Net 0.00 0.00 155.52 Discount No -Pay Net 0.00 0.00 155.52 Discount No -Pay Net 0.00 0.00 145.32" 0.00 0.00 4,754.31 0.00 0.00 346.08 0.00 0.00 1,571.67 / Discount No -Pay Net 0.00 0.00 6,817.38 No -Pay Net 0.00 228,300.98 APPFIbi/Eo ON JUN 2 9 2022 BY COUNTY AUDIT- CALHOUN COE1N�fiY,,$_ , file:///C:/Users/Itrevino/cpsi/memmed,cpsinet.com/u88125/data 5/tmp_cw5report438699... 6/29/2022 TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) "ENTER 9-DIG IT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" F7"IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" F7,6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER ### ENTER: 941 # �' 22 �' 03 0 C $ 123,441.89 1 $ 62,491,86 $ 14,615.02 $ 46,335.01 CHECK S CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F:WP•Payroll FileslPayroll Taxes12022Wn4 R1 MMC TAX DEPOSIT WORKSHEET 6.30.22 RI.xis 7/5/2022 RonWe; . ..,.. .._...... _ .._._..._ ._.._.. ... .. car. - - • a 5 a r _ a ... ................................................................................................................................. I REGULAR PAY-s± 5,±6.25 .`1 :7 K I??555.6C A./E 425.50 A/E2 A/E3 . RECT-AR PAY-s3 173G.O4 N .r .:N ANAM, ECPs!' ?ci.:. EECI:.F.. F?:i-6: 21, 53. JC N .. 2 REGULAR PAY-E 303.00 'i S N 102ma.:7 CAF 5 CAF: C CAH-D :i92.24 sea._....... _.. . :_ . :- . CA.r__ D DD!T.i. nMIE iB.25 N, .. ., LO,6.6. CEE7:S1 :: AN :FSTAi MME ME :22.;; F:C:r -_,.v....L .L_... .. .... : E?::RP. pus ., .. .� ., iRc7..C7 KY. FEE FOES D 2M T.: 615 . N N AM UVF LE .. 205.3. ILAS. N i6 . _ N N ?7:, 5? .. _. _i7.A RE:J:: EC MY .. CALL :AS 2 144 AC N . N N 256. C'C DR M: ._ .. REPAY _ CALL PAY 1 96AC N . N N 233.0. SA-XE CE: p:a .....:. . ...... ., a .: o ...... .:.. _. C"._.. ..e ... 785... . CO'JID•FFCRA 60.JC N . N N E6256 sili• s45.63 MOM 517.114 SEMI" 33 Ai -:Pc': ........................................................................................................................... Ji": ' _.. ... a:d 2, ,..1c. a. •'-: :3 ?2:O:Ic. ler :Jta]_..' : I I—.♦ .i 941 REC/TAX DEPOSIT FOR MMC PAYROLL REVISED 3/182014 "ENTER VOID CK9 M NEGATIVE IR)NO"S" PAY PERIOD: BEGIN 6117/2022 TOTALS VOIDEDCKnI VOIDED CK I2] ADDITIONAL CK 111 ADDITIONAL CK (1I PAY PERIOD: END 6/3012022 PAY DATE: 71812022 GROSS PAY: S 535,601.27 $ - S 535,601.27 DEDUCTIONS: A/R S 426.00 $ 425.00 ADVANC S BOOTS $ SUNLIFE CRITICAL ILLNESS $ 849.63 - a49.ti3 SUNLIFE ACCIDENT $ 765.66 SUNLIFE VISION S ' SUNLIFE SHORT TERM DIS $ 1,230.26 $ 7.23G 1G BCBS VISION S 981.60 S 981.60 CAFE-D $ 1.592.24 S 1.592.24 CAFE-H $ 22,310.48 S 22,310.48 $ $ CAFE-P S CANCER $ CHILD $ 2,281.01 S 2,281.01 CLINIC $ 65.00 $ 65.00 CONIBIN S 280.87 $ 280.87 CREDUN $ - $ ' DENTAL S - $ - DEP-LF S - SUNLIFE TERM LIFE $ 838.68 S 839.68 SUNLIFE HOSP INDEM S 537.74 $ 537.74 FED TAX S 46,336.01 S 46,336.01 FICA-M $ 7,307.51 S 7.307.51 FICA-O S 31,245.93 S 31,245.93 FIRST C S - S - FLEX S S 3,264.15 S 3,264.15 FLX-FE $ - G ' GIFT S 5 281.23 S 281.23 GRP-IN $ GTL S HOSP-1 S LEGAL S 965.94 S 965.94 OTHER $ 187.04 S 187.04 NATIONAL FARM LIFE S 1,816.80 $ - 1.816.80 MED SURCHARGE S 385.00 S 385.00 PR FIN S S - RELAY S REPAY S STONEOF 4 640.86 S 640.86 STONE 5 STONE 2 S STUOEN S TSA-R S 37,492.16 S 37,492.16 UWIFIOS S - S - TOTAL DEDUCTIONS S 162,079.80 $ - S - S S - S 162,079.80 ••SHg.DI7KREPORT^ ...LD HATCH REPORT••^SHVAD WATCH REPoRT^^SHWLD WTCH REPORT•-IOQLD,MTCH REPoRt^ NET PAY: S 373,621.47 $ S S $ S 373.521.47 •!DID DWICII REPGT.... $NWLD WTCX RE00.Gi—-5NOMD MIITCNREPORT^-S WWTCNRE9ORT`- ^!DI0UDAMEN RENRT^ TOTAL CAFE 125 PLAN: S 31.634.88 Less Exempt: AXABLE PAY: $ 503,966.39 5 503,966.39 "CALCULATED" From MMC RED* rt Difference ICA - MED (ER) ,,.>: S 7.307.51 ICA - MED (EE) , <EL. S 7.307.51 $ 7.307.51 5 - ICA - SOC SEC (ER) E2Ex. $ 31.245.92 ICA. SOC SEC (EE) Esa S 31,245.92 S 31,245.93 S (0.01 ED WITHHOLDING $ 46,335.01 $ 46,335.01 TAX DEPOSIT: S 12344187 - 12344189 FICA - MEDICARE EEEs 5 14.615.02 S14,615.02 FICA - SOCIAL SECURITY 0', 5 62.491.84 S62,491.86 PREPARED BY: FED WITHHOLDING S 46,336.01 $46,335.01 PREPARED DATE: TOTAL TAX: $ 123,441.87 $123,441.89 $ (0.02) Exempt Amt: Employees over FICA -SS Cap: S S S Paycode S - Employee Reim6.: TOTAL: $ Caitlin Clevenger 7/512022 R14 Rt MMC TAX DEPOSIT WORKSHEET 63022 RI As. TAX DEPOSIT WORKSHEET'1512022 So We ZT310 M01-1EL !V. We A. :un :i'F-V. N":Y -',.7- Eli Auss ZMMN 3117 RURI 7 of :2 WO VON : 3ZARTS ELI Vim :- Av. 4HH J05FATI LUG) TORRES 5022 UNK75 WEAN •'A' 21A. 126. 34 WKS 'i 0, L41 CAIL LEE KING 1; 4 ". N DD THEM A .11.1-:!X".1.11 izi. H : " , i .. "I 13 J.;CLV.%' CARREOX ii-13.0 DD 17 TE12 2 Z.!iZRj-' A ."Xz i2l. H T 7 A W 52 BRE!'-w.l. -. .1-ZNA 131 ". '. . .1 -1 :- .il-12 CO271C AINCELA X' RT.-aG:1; 32$.H DD :1/-H!22 R7. E.F 1H.H.J4.1 IiE ,0392 X. CN: C., 7 CARR 003. 96 U :" / H. 1:2 :15 221 7DR2A HN.A 1 7 1 O� :NV SEW L KMT H-ji.�4 :7 I'E, W! =m L RM2;c 1t.13. i? Il. : I--i SHZE�'. E :i E ?"2z 'iND '525.00 3 :71112 S: DZER.'5 E n1iI27ESESI ON." DD 0 H107 -CMBERLY R BL:NKA 133.5.72 DD 7IT22 :wH AMU 002 Eazy W.4; CD :,0 1. 0191 SURON M SPARKS 1572.78 m viH/:2 A SA!Ca�, 4555.;; D: 0'- 5 1. 3 JACKT' E WLIIAMS i6H.52 DD �7/-Hj.,Z :391 101sw :E15 Ackpi-A C GJ"TTj 00. -., .Iz ?-NTA- s11:c.,H2 203: '-AURA GU'U. 11311.65 ND H1.., OIH� OHS Tou x HF=K aj 5: DD 7, H E 3161 H of IE :202 W21 12"A V7& I R O11N. LEK: 7R*1',";A :;ow, 71 on a W O'�H 2HIN Do 70 1-4 52.131 JESSICA 5 BIFFLE 31L70 DE shoph ONE js&= OWN U50 D: H Q : " i 1 -1 D, I E :2416 JA:':-R!- S=: 1164.03 Toe: WE i.,q1z"er my Pend 0601,20-16/3122 on: 1 Num, Nane Ann "."KZ N'T. LEE LIE? n GET. "Ci'N w" !, '.E s. WE STUANIF x STIAZ Who n :, 00 L552 VE.RCNICA 1,0S21 piz.-3 DD C7qo6,122 Ni.; sD :-!.E:,T N,Ci X"iLSA �o N IpM "N' Opp BE m mumum) myz m Km= Ans Z01; A ISTA 1019 vc :- 0 1: N, 7 oN.:: T :-,:i N N7H HWER L KEW WE K 0 50 Cols EIK77m',"Y N FRTDNCY E-1.7.E- D' 71-."t1N4 Non too F =K; VALF 3 :- 07, LK7 XXHIE , Gm.'NE's T :-11*.ol: Iot. NO- Ti j P.-NDT11, 6211-'9 :Z 97/ Q Ess con =2 G TaDW., .110 TJR7;- .o s: ot)U EG:N; A MART2122 L7EL.0 Dv :EN: IIA-RLEA T :7 1 i W., KEY "i; :-:I' q.-Is'.'-'; z N; . A 1: :7 of 1: :121 ETERNE PETUN .751..K :7 A j 0. 0121 :11-H-11 A GuER?h 151c.77 DD 1 --, i &A Wsm LYNN E27 111by a rim N97 C3M2,Rjt:- 3112.62 DT IN N"K NMI FIRSESIS EVA AMH N 115 ids.!. -1 E:N�IjCSA Dc :2151 jUL:4, K.,N-H 2143.p N .EIE" '.Kil" EE,7 w, :E '5171 ESSICA BARRON op,U DD Rots., 3711, S :77 Y ASS :KS NSWES .ILK m :7 100 N 7/,-F 12 Y17L',; :"iH/22 72S.s D: :-iM sz KY ZEN SW NEWS too ...... Y-LLEA :�YCRw;� Z: YELL! GEF I992.Oi x o 7 '..- ,L :u294 .7 . s s i % : 'X;:IHER 755. 3, _; 'D C 7 -.1 ts: :o;s: SAY11 A s- C:.:R ikio on ITTEm 7404 ol.7i T M N s F=:a A N 3A -.' -�Ls.. E13.41 1:2 My —v UA i Ws w;Qw. by Ferad A :7 22—IC142: on. 'rR2SR--R:7 :c;r. Na7e oH N :C7ii' IIANEN Do —.21111.; x Do 2HIS no L AT�. 31W Do MM: 2C,aE7 DAISY MADRIGAL 1520.A ED 2CI-21511 M'PTIII CREEN :...:5 DD 0 DIANA - LEAL 1110.i5 D: P7/109l22 I.;CoBY . 21.7i--E Do :- DEKE.O. LYININ Do :- 2261: H-0-7i"R L SXMH Do :7,','E A 28M MMUMAEMER HIO Do TWISQ2 091 MEW M, ME Do :�wlq KRCTE L FpV-.* 2359AE Do 7,1P022 li A WE MES P&LIFS EVEN no loci Q EAi-- _R i N. *- YNN l., eaN. z 21153A. Dol ... K41 EKE: MI—U ,22..-4 Do :i EWHM A RUENE., 29710.02 Do .21 —221 X -Z lX,- Do Kin Eva REM n111.11 ME 51,19. --- = Do W Qi- w: l- I'E :1 ME KRIETKU F EEO PEP M M. E Q12 iEiZ-' %z:0 Y CZc Do' i.-I: jAP :01N TR-A N i." i i :-:G Do TVI: 921 UNESK ;MUM A 5". i-I. Do l-1011 'Al2 ;.NAKMIA L PEREZ E63.95 M 07/0E/21 —VIU, V. -F.172;l 21. In 4235 REEL, K MINOY i)90.31 Do 5yn q: 401 tam 2211.: 57LA41 n 7 E I R E30 21 A2A 2 Kilos Ito Do :7 WA SCN,,A A r*.;.j,.R:,' 6^5.:5 J CQUE' Ra '. ',' aZ .I., - , 1 -;KISE 9E1.5. Do ?'NE "" 2 4:15 ISLIZI R IYOR 'ELF Do :- BE Z. 406 RISE M322 ITURY 1EH M :nN Qo 4:857 ROXANNA RARTME-2 749.9E Do :-/n?I!n R M-1-ER .251Ali Do c-i,.",n 70F 1 7 V N, :'HEA'.; 602 is is SAMISNA 1531.70 Do 7,0= 7A, to: Fon HNN 1: ;2920 YO:n r C'H.WIRZ E020 DD 11012 ion Me V A A., We :10 hy Senn! 050 A-W3910 on: I Num. Kre k-m='t "GEF, T'N. Wo SMZA S 3151... i a K'S'i -1.3.E ,00H X MEALES 1-1.65.111 Do AN 1:021 dmiz 54.11.1 :"�HJ:2 WI SK73EY MERILE NEU isu M n � E D. 50249 XCKEIM V:LLECW 193.11 OD 5023 = x HALT21 HAVE Do OF= %P3 mus .is-' s:7 7Y -.W..S 1573.2 of T 577i DEE I WEAE: NEW T 7 :.,/:: '.OF'' D-{,DRI IEZ 69F.3^ Dr7",A /22 Em4i Hot : is: EMMET i"H.14 DID :, "E'.2 AW ED 7M 2. HKE cnSML x CnAz 72352 Do Y yd"4 It al EH- HAS2 SSNIT WIN OF 12 EHH 'A'a1z'. 7H A Do :-012 ENE fink 1 ARAKY H-.H Do :"�i :1 via • REUT 1 Rmsconz 'I( a. H DC� :", 0 i :.. 6CI1I )VA LE 535A3 DO '7/,::/22 MA =223 x MILE ATH 2D :-It 11 AW TEIVEN A SWU 14915 0: sail, -2 7: f9i.H Do Ella, 4H.:5 -, -, :" .'i Ia Ems D305 A EZ22 My M 1 0 Pa EE., JESSICA "I C.;LN:O 556.2C Do G?ZZEE 753.m Do 0004 :3501, Hi.H : was SWO M GET HUM 1: 0 12 1329.1 11 J-1-coll 3US:1 743.12 DO 'E7 - M M.a 2iia so: 710sllz GEN: 1XV WHz M SESN MEET Do H/a 65356 "RIMHU GAUCIA 59.:4 ED -H, .. - '2r A PE-Z E57.Es ED 17 OF '22 AM TTLK L FLOES 55455 ROU. RODKGOT, 5E3.42 DO '1'/N/22 EULE 'JZFETEL. Eim )RO S.v_'-;EQ.Jrz 7H.22 Z: � ' )s f22 Ems nsy F LESTAT EAT ED 7 1 Z 'is 5 E WT.H.F.MN.: i295.22 ED C i;'., 2 ;:FEZ Txe: !:AS• By Pend Oi 17 0—TEPT021 on: i Nur... Nale Oun'. CH E 7::E N ii_,:SM .,43 GL21A 1: HID 3130.40 DD ONEW RiK; XULIR 'Ems :51 IKKN 74115 RNIII.F."R R D.RLOCE 701.22 D: r.''Oe/22 EN I C.I.R-11.1. ZH 1LARRE V., -1 20 :1 AM 7WC AID.', .Be 730.3l :Z :7,'0t '1, 2 lE0 CHERY, A SE-2 10911.i9 E V.CFT S I . .7E4. FREN A GO:Z,.LES M257 R 911TRE 1: 7 A 1.1 102 I= M FLUES N61:2 OP A will Sit-' .11MRF. F r.,n,4 l3o jz-SSIA. L V.)VEF, 3007.36 DC . 7,C-/22 lot MKIA F ME 775A2 VAQ: -is; GRET 0 AWY ARS4 :1 70 11 7a775 S,.; 1.1 RORIG KOS.`, 7S7i1 R RCRC.V, 13211.94 :1 97 7^ lo', :;.YL- j M__�A.ZTG..i:N sit.-,.: :_ :" .i, BOID-CE ADI.V, D BESIO 2R3.21 D: E I"�, I 27A 152i.ol :D :7i.P^., c - M 26125 'ISA V TREVINO 9N.79 DD Wi MILEY 2 TANTIEK 1501D Do X2LLI.'5'. 7 L1177LF 3792.0t D: 90320 RUTIM, 3 TRMAS 3535.31 M ONE 12 52K 2MCEMAW :_, H75 CIE= M SWIT, 12 373 0., . 11 , MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT --- JUNE 27, 2022 - June 30, 2022 Date Bank Description 6/27/2022 PAY PLUS ACHTRANS 452579291101000693172873 6/27/2022 IRS USATAXPYMT 220257854175255 6103601000135 6/27/2022 AMERISOURCE BERG PAYMENTS 0100007768 2100002 6/28/2022 PAY PLUS ACHTRANS 452579291101000694028607 6/28/2022 MCKESSON DRUG AUTO ACH ACH05079283 910000131 6/29/2022 PAY PLUS ACHTRANS 452579291101000695091725 6/30/2022 PAY PLUS ACHTRANS 452579291101000696397475 l William Little, CFO Memorial Medical Center PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT -- ESTIMATED ACHS Date 7/11/2022 DSH IGT William Little, CFO Memorial Medical Center Description APPROVED ON JUL 05 2022 BY COUNTY AUDITOR CALHOUN COUNTY. TEXAS MMC Notes 3rd Party Payor Fee Payroll Taxes 3408 Drug Program Expense 3rd Party Payor Fee APPROVED ON 340B Drug Program Expense 3rd Party Payor Fee JUL 01 20K2 3rd Party Payor Fee BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS July 1, 2022 *-Aff,oeedDG-29-2z cc #-* Arr', ,ved 6Lo- 13-22. cc, DSH IGT July 1, 2022 MMC Notes Transaction Summary Transaction Complete Trace # Texas Health and Human Services Commission Memorial Medical Center Operating County Payment Total $107,374.05 Bank Routing and Account Number Settlement Date 7/11/2022 DSH Amount $107,374.05 ML Entered By Marley Moehri Page No:1 of 1 Run Date: 7/512022 Run Time: oe: im Marlev ODonnell From: HHSC PFD DSH Payments <DSHPayments@hhs.texas.gov> Sent: Friday, July 01, 2022 3:57 PM To: traudib@dhcg.com; cassandra.fahey@dhg.com; lindsey@gl-law.com; Skinner, Travis; Toliver, Heather; V.Gloff@gwhf.org; sparde@bkd.com; cklein@lambhc.org; vhopkins@seminolehospitaldistrict.com; konczal@gl-law.com; brinker@gl-law.com; wkjones@cricpa.com; anna.smith@hmh.cc; kyleh@dhcg.com; Stephen.Gillette@dhg.com; briganti@gl-law.com; bblevins@fchtexas.com; cfo@sonora- hospital.org; jpickett@gwhf.org; ayetter@bkd.com; ferguson@gl-law.com; sanders@gl- law.com; ryann.granzin@hmh.cc; lissa.myers@knoxhospital.org; mpattberg@huntregional.org;jclay@gonzaleshealthcare.com; kjudice@oghtx.com; joeb@dhchd.org; cdougherty@ych.us; tracy.betts@hcmhosp.com; cmh.sbarnett@cogdellhospital.com; afutch@seymourtexas.net; dgarcia@echd.com; claudia.falcon@vvrmc.org; priscilla.saiz@conchoch.com; rureta@pcmhfs.com; ssutton@cuerohospital.org; sabrina.hiett@stonewallhospital.org; apuckett@ppgh.com; TPfahning@permianregional.com; terrell.thrasher@umchealthsystem.com; mklock@matagordaregional.org; Marley ODonnell; debbieg@parkviewhosp.org; tammyz@jchd.org; halvarado@lambhc.org; rol78582@yahoo.com; bmeza@connallymmc.org; miwilliams@lmchospital.com; klahey@bkd.com; jaclynn.harrison@christushealth.org;jgulihur@rchd.care; mchong@dimmitregional.com; jsmith@medicalartshospital.org;julieh@rpmh.net, bertodatto@gl-law.com; neil.graff@ardenthealth.com; dkeller@grahamrmc.com; kaylac@brownfield-rmc.org; jmorgan@huntregional.org; markh@dhcg.com; loreet@dhchd.org; cmh.gwolfe@cogdelihospital.com; Lsmajstrla@seymourtexas.net; to@gl-iaw.com; terry.mckenzie@umchealthsystem.com; eloy.garza@starrcountyhospital.com; creeves@medicalartshospital.org; cbitonel@mchd.net; paulg@brownfield-rmc.org; lisa.warner@hmh.cc; kimberlyw@dhcg.com; gtrollope@echd.org; pclark@pcmhfs.com; lewis.robbins@stonewallhospital.org; Roshanda S. Thomas; michael.ramirez@starrcountyhospital.com; blackshare@gl-law.com; Ksalcido@mchd.net, puente@gl-law.com; brooke@walkercountyhospitaidistrict.org; sewing@echd.org; Kyle.Lee@stonewallhospital.org; jmcclain@communityhospitalcorp.com; David Garcia Cc: Hodges,Jandi (HHSQ; Quintanilla,Sarah (HHSQ; Guzman,Kenneth (HHSQ; HHSC PFD Hospitals; Wolfe,Megan (HHSQ; Michalik,Ed W (HHSQ; Grady,Victoria C (HHSQ; Cantu,Rene (HHSQ; Regmi,Asha (HHSQ; Heinemann,David (HHSQ; Dovalina,Jose (HHSQ; Heinemann,David (HHSQ; Jacques,Robert (HHSQ; Brown,Adam (HHSQ; Rios,Mariana (HHSQ; HHSC PFD DSH Payments; Nip,Christina (HHSQ Subject: DSH 2O22 Pass 3 IGT Notification Attachments: 2022 Pass 3 DSH Payment Calculation.xlsx WARNING -Remote VERIFY SENDER 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. DSH Providers: The Texas Health and Human Services Commission (HHSC) Provider Finance Department is adopting a new communication process. As of September 1, 2022, stakeholder announcements will be sent via GovDelivery, a free email subscription service used by HHSC. To receive future GovDelivery announcements and IGT Notifications, click the following link and subscribe to the Disproportionate Share Hospitals (DSH) topic. (Ci_ Attached is the finalized 2022 Pass 3 Disproportionate Share Hospital (DSH) Payment Calculation Workbook. The DSH payments and intergovernmental transfer (IGT) amounts are based on the calculations in the Model Scenario Analysis (see tab labeled "Non -State"). Pass 3 payment amounts for non -state hospitals can be found in column BK of the "Non -State" tab and the corresponding IGT amounts in column BL of the same tab. To ensure that all government entities receive this notification, HHSC strongly encourages providers to send this information to any government entity who is IGT'ing on their behalf. Below are the pertinent dates associated with the DSH Pass 3 payment: • July 8, 2022 Last date to schedule transfer in TexNet • July 11, 2022 Pass 3 IGT Settlement Date • July 29, 2022 Latest DSH Pass 3 Payment Date **Late IGTs will not be accepted. DSH 2O23 Payment amounts cannot be calculated until HHSC is in receipt of the IGT for the Pass 3 Payments. Please ensure you select the DSH bucket in TexNet when you enter your IGT. It is imperative that you send a screen shot/PDF copy of the confirmation/trace sheet from TexNet or an email with the confirmation number, settlement date and IGT amount if the TexNet is submitted over the phone, to DSHPavments@hhs.texas eov Additional information regarding the TexNet process is a_i.; __. State owned hospitals must send a copy of their Journal Entry to DSHPavmentsP,.hs.texas.flov. If you have questions regarding the DSH payment process, please send an email to DSHPawnentscfhhs.texas.sov Thank you, HHSC Provider Finance Payments North Austin Complex Mail Code H-400 4601 Guadalupe St Austin, TX 78751 Texas Health and Human Services Commission •� �„ TEXAS lwV Health dnd Human N Services Proposed Method for State -Owned Hospitals 11 Texas Health and Human Services Commission 5 Non -State Owned Urban Public Hospital Class 1 3 Non -State Owned Urban Public Hospital Class 2 143 Non -State Owned All Other Hospitals S;t], Non -State Owned Totals Texas Health and Human Services Commission 63, 885, 957 193,593,81( 40,149,687 121,665,72( Texas Health and Human Services Commission ($0.0184) 193,593,810 28,141,420 9,286,668 121, 665, 720 17,685,721 5,836,288 $45.827,140,4 Texas Health and Human Services Commission Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON JUN 2 9 202.2 MEMORIAL MEDICAL CENTER 06/29/2022 0 �9" AP Open Invoice List '�i�tINCOUN(Y,TF�(AP ap_open invoice.template `� Dates Through: Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 061722A 06/28/20 06/17/20 07/25/20 578.25 0.00 TRANSFER tU" Jiffi ttli pyt&i- dtpO94a Ih-t1u Ny W-- ovcl',� 061722 06/28/20 06/17/20 07/25/20 797.72 0.00 TRANSFER q it Vendor TotalE Number Name Gross Discount 11836 GOLDENCREEK HEALTHCARE 1,375.97 0.00 Report Summary Grand Totals: Gross Discount No -Pay 1,375.97 0.00 _, 0.00 APPROVED ON JUN 2 9 2022 BY COUNTY AUDITOR _ CALHOUN COUNTY, TEXAS No -Pay Net 0.00 578.25 0.00 797.72 No -Pay Net 0.00 1,375.97 Net 1,375.97 file:///C:/Userslltrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report82O222... 6/29/2022 APPROVED ON JUN 2 9 2022 BY COUNTY AUDITOR _ CALHOUN COUNTY, TEXAS No -Pay Net 0.00 578.25 0.00 797.72 No -Pay Net 0.00 1,375.97 Net 1,375.97 file:///C:/Userslltrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report82O222... 6/29/2022 Page 1 of 1 RECEIVED BY THE COUNTYAUDITOR ON &2% 2022 MEMORIAL MEDICAL CENTER ,(uJ xe. 0 AP Open Invoice List 09:38 ap_open_invoice.template CALHOUN COUNTY,'(@7{A,4 Dates Through: Vendor# Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 061722 06/28/20 06/17/20 07/25/20 5,151.45 0.00 0.00 TRANSFER N N INOVRU_ fyK j dtfa6(4.j iA+ WNKC OV01_+r1� 061722A 06/28/20 06/17/20 07/25/20 9,000.48 0.00 0.00 TRANSFER Vendor Total: Number Name Gross Discount No -Pay 12696 GULF POINTE PLAZA 14,151.93 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 14,151.93 0.00 0.00 APPROVED ON JUN 29 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Net 5,151.45 l 9,000.48 Net { 14,151.93 , Net 14,151.93 I file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report352777... 6/29/2022 Page I of 1 RECEIVED BY THE COUNTY AUDITOR ON JUN 2 9 2022 06/29/2022 CALhR.11�000N7Y 7EStAu MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: 0 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 061722 06'/128/20 06/17/20 07/25/20 7,463.00 0.00 0.00 7,463.00 TRANSFER N rr IftVkvI(P.. p�+ LjtpOSI _j I K_h K'AkL oral'iinb 062122 06/28/20. 06/21/20 07/25/20 256.37 0.00 0.00 256.37 TRANSFER It It . Vendor Total: Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 7,719.37 0.00 0.00 7,719.37 Report Summary Grand Totals: Gross Discount No -Pay Net 7,719.37 0.00 0.00 7,719.37 APPROVED ON9 JUN 2 9 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/Itrevino/cpsi/memmed.cpsinet. com/u88125/data_5/tmp_cw5report478245... 6/29/2022 Page I of 1 13Y 114F RECEIVED ON COUNTYgqAUDTTOR J06330 0222 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 09:38 TEM' ap_open_invoice.template j;ALHOUN COUNTY, 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 061722 06/28/20 06/17/20 07/25/20 14,339.67 0.00 0.00 TRANSFER WN jAWILncP NO &Pd,5ik,J Ilti-h YVtK^(_ 061722A 06/28/20 06/17/20 07/25/20 29.69 0.00 0.00 TRANSFER tt 11 062122 06/28/20 06/21 /20 07/25/20 13,403.23 0.00 0.00 TRANSFER tt it 062222 06/29/20 06/22/20 07/25/20 30,665.70 0.00 0.00 TRANSFER N It Vendor Total: Number Name Gross Discount No -Pay 12792 BETHANY SENIOR LIVING 58,438,29 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 58,438.29 0.00 0.00 F.1147061wffffl JUN 2 9 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Net 14,339.67 29.69 13,403.23 30,665,70 Net 58,438.29 Net 58,438.29 file:///C:/Users/]trevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report571672... 6/29/2022 PAYEE AMOUNT Memorial Medical Center $127.46 FORT BEND CHECK REQUEST Date Requested: 7/1/22 G/L NUMBER: APPROVED ON JUL 01 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS EXPLANATION: CHC PAYMENT BELONGS TO MMC BUT WAS DEPOSITED INTO FORT BEND'S ACCOUNT REQUESTED BY: Mayra Martinez AUTHORIZED BY: Mayra Martinez From: Katrina Hodges Sent: Wednesday, June 15, 2022 7:49 AM To: Mayra Martinez Subject: RE: Deposit support ,.� Belongs to MOO 4' After checking, I had corrected this on June 71' Thanks, Katrina From: Mayra Martinez <mmartinez@mmcportlavaca.com> Sent: Tuesday, June 14, 2022 9:01 AM To: Katrina Hodges <khodges@mmcportlavaca.com> Subject: FW: Deposit support Hey Katrina, When you have time, could you please let me know who the $127.46 belongs to? Thant: you, Mayra. Mart-"ienk Manorial Medical Center Accountant 815 N Virginia. St Port !.avaca, TX 77979 Phone:.;6I.5;2.0450 Fax: 161.551.4504 From: Simms, Tracy M. [mailto:TSimmsCQlcantexcc.com] Sent: Tuesday, June 14, 2022 8:52 AM To: Mayra Martinez <mmartinezCcammcoortlavaca.com> Subject: Fw: Deposit support CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Mayra, The $127.46 payment from Community Health Choice does not belong to Fort Bend. I'm not sure why CHC keeps doing this but please debit the payment from Fort Bend's account when you figure out who it actually belongs to. Thanks! CRESCENT CHECK REQUEST PAYEE TUSCANY Date Requested: 7/1/22 APPROVED ON JUL 01 2022 BY COUNTY AUDITOR AMOUNT $21,600 G/L NUMBER: CALHOUN COUNTY, TEXAS EXPLANATION: DEVOTED PAYMENTS BELONGS TO TUSCANY BUT WAS DEPOSITED INTO CRESCENTS ACCOUNT REQUESTED BY: Mayra Martinez AUTHORIZED BY: Mayra Martinez From: Simms, Tracy M. <TSimms@cantexcc.com> Sent: Wednesday, June 29, 2022 1 A6 PM To: Mayra Martinez; Caitlin Clevenger Subject: Devoted payment Attachments: MMC DEVOTED 322999 6.27.22.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. The attached Devoted payment deposited into Crescent's account yesterday for Memorial Medical Center and does not belong to us. Please debit$18,400 from Crescent's account when you are able to determine who the payment belongs to. Tracy Sinims, Cash Manager Cantex Continuing Care Nencork, Where we are Committed ro Excellence 2537 Golden Bear Drive Carrollton, TX 75006 Tel: 214-954-4114, x115 Fax:214-871-3057 tsimms(a)cantexcc. com The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message and any attachments. Mavra Martinez From: Simms, Tracy M. <TSimms@cantexcc.com> Sent: Wednesday, June 22, 2022 8:08 AM r To: Caitlin Clevenger, Mayra Martinez NV—��f D�� S r u%S(Ct l/I y Subject: Devoted payment Attachments: Devoted PN318272 6.21.22.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. This morning, Crescent received $3,200 into the account via EFT from Devoted for a patient that does not belong to us. Attached is a copy of the remittance so you can identify who it belongs to. Please debit Crescent's account for $3,200. Tracy Simms, Cash Manager Canter Continuing Care Network, 2537 Golden near Drive Carrollton, TX 75006 Tel: 214-954-4114, s115 Fax:214-871-3057 tsintm slicantezcc. com Where we are Cornmitted to Excellence The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message and any attachments. BROADMOOR CHECK REQUEST PAYEE GULF POINTE Date Requested: 7/1/22 APPROVED ON JUL 01 2022 BY COUNTY AUDITOR_ CALHOUN COUNTY; TEAS AMOUNT $1,264.33 G/L NUMBER: EXPLANATION: WELLMED PAYMENT BELONGS TO GP BUT WAS DEPOSITED INTO BRADMOOR'S ACCOUNT REQUESTED BY: Lyra Martinez AUTHORIZED BY: Mayra Martinez From: Sandra Suarez <Sandra.Suarez@ health markgroup.com> Sent: Wednesday, June 29, 2022 4:16 PM To: Mayra Martinez Cc: Caitlin Clevenger Subject: Gulf Pointe Plaza - missing Wellmed payment for $1,264.33 Attachments: WELLMED 051322 1290.Oo.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hello Mayra, Wellmed shows they made a payment for $1.264.33 on a Gulf Pointe Plaza patient but we never received this money. Can you please see if you ever received it? The address on the check is different that usual. It has POB 101844 Atlanta GA 30392. I attached a copy showing they paid on 05/13/22 for $1290.00 minus the Echo Contract fee for $25.67 so the actual check was for the $1,264.33. J ffanf 6, Sandia Suawz .Managed Cane 5i. im% HINVww"' S E R V I C E S. L L C 1780 Hughes Landing Blvd. Ste 500 The Woodlands TX 77380 Sandra.Suarez@ hea Ithma rkgroup.com 210-842-3674 Fax 346-396-4583 vnoureawyvx- Memorial Medical Center Nursing Home UPL Weekly Centex Transfer Prosperity Accounts 7/2/2022 Pmbm Teeev. nnount Beefthe AOI Pen41n{ Be{Innlne Amountto Oe Trantlened lPNune, Nunln[Xome u" a...,. Tnmler.W1 Aran,f-ln /Dae0141 Selene Hem. AofCrd Gardens 116.600.fl 126.46QSB I60.770IM I60.916,09 / 132,438.98 B.nk SA ... e 1fi0---- -- Varlan[e rem In 0{Imn 100.00 Ranting InWmalfon Mr AMmm Gordmn / AShford HerIth Care Lknler Lid O, AMERIGROUPQIPP 20,317.56./ ]P M.'.. 0... Bank April lnten.l 15.02 ✓ ✓/ Malnirro3l 25.03 lone lnleron 19.50/ Adjull BIWIe/Tronder Amt 132,438.98 ✓ � / BTC6dmODl. 179,466 79 ✓1)9,33803 ✓36841.76 / 78970.52 i 66,594.33 ✓ Bank B.I.." 79,970.52 ✓ Vatl.n.e Lave In all... 100.00 AMERIGROUPOPP 10,970.54/ PYMTBELONWTOGUIPPOIME 1.264.33�/ April In1.ro41 31.66 ✓ Me, lnu.xt 11,30.✓ / Iune W."It 12.56 /l Adj.w BA.n.e/Tramler Am 66,594.33 o/ Percent 155.598.22 ✓155.467.45 ✓ 110,914.18 111,044.85 / 79,785.56 Bank B.Unro III.OM.BS ✓ V.H.n[e Lew. In B.I.m . 100.00 AMIRIGROUPQIPP %S12.59 ✓ PYMTB[IONGSTOTUSCANY 18.400.00✓ PYWOEWNGSTOWSCA.NY 3,200.00✓ ApritatinSl U.07� M.ylm.m.t 18.601/ June In, .... I Is'3 {/ Ad...e.lan[ePr.nu.,Amt )5,)85.56 Send 16d.920.7B "64,805.07 /I4)20.62 ✓ 14,036,33 L �Iw Fort u V B.I.- 14,B1fi.33 Varlan[e Le.aln BrNOa 100.00 / AMERIGROUP QIPP 11,590.85{/ April I.M.lt 5.19✓ MrylnlxeO 30.32 ✓ IualntrroM 10.61 ✓ Adjust G.Ian[e/rnrnI., Amt 3,119.16 SOIM4EW NpditOp; 292,170.43✓ 292,037.45V309,033.74 ✓ 109.166.72 / 97,637.24 Bank B.lan[e 109,166R V Van.nro AppROVEO ON laveMBO.nn 100.00 JUL 01 ZOZZ Am.111MUP QIPP 11,151.34✓ 1 3 2 9 L; 3 tS PAYMIMBOONOSTOMMC 127A6V1 BY COUNTY AUDITOR I Brne7e,ppemnnr OUN C0Lj"V TEXAS (j b r ) 9It � 3j 'O AprilIRNro11 13.90✓ C� M.y Ina4l er,08 19 ✓/ 7 9 9 / d ) (; 1...IMr., 1770 Adjull Salan[e7Tram3.l A,nt 97,637.24 ✓ ,' TOTALTRANSFERS 3M 456.11 /1 5 L 1 376, V Approved: . ...... a,.uw wmm�rpn,Ynreelp Menumnpname. WILLIAM LITTLE, CFO 7/l/2022 Note]: [pMe[ipunlhelp Pp[epolvnM of SIMInp MM[depexled to spin otropnr. I \NN Wokry TNntlen\Nn W l fim11v Summary\20RVu11\NNWITnntler Summarv0) 0122 [lu hµH weeUVTramLlp9uk Dawn oad War RoneeoµmIDangrlH Bank Download a6ZI.21 t nV C6301021.a19a MMCPORTION lihf.MmfdW _ nITlJJfiw.Oa TH E rvl Olpp/COmpl mPP/tempi DIPP/mmp] OIpP/WmP4&Mp9R OIpPn 02711022 Cell]) 6137/1.22 AmN140ua Tak HCCLAWPM1T 316395P95S 11I000 6/17/1W3 UHCCOMMUNMPL HCCNIMPMT3a600341191= 6/27/2022 UHCWMMUNOY PLHCMIhIpoosru ]1 isuriM 6/37/1013 CIGNA HCCWMPMT 1326436I69110000130CLIM 6AVM21 UAARdHNingre NCC1AIMPMT 74 WHII91MR 6RO12022 UHC COMMUNM PI HCCMIMPRIT]a ROBS1 S1TN 6/21/2022 MANAGEANDNE11716 MNS PRINT S)I1 BRInO21 AITHISIMP.5CHCCWP.IPMT116334,4241 lLhV 6/2,12022 UHC COMMUNM PI HCCWMPMT 74=3411 liT 6/301 WIRE OUT ASH50P0 HEALTH CAPE C)MCR LTD 6/30/1022 MANAGIANONCT1314 MKS PRINT 9341 6/3022011 UKMMMUNMPIHCCWMPME246COHI19ICCM M30/M}1 AMEAMROYPMRp0[-PAYMFM[M2MM31111W0 6/23/ID13 HNB-LMOXCCNIMPhW746W34116 224963 1/27/2032 UNC COMMUNITY PC HCCIAIMPMT)46MNI191CW3 1/27/2022 CHIC COMMUNM Pi. HCCUIMPMT 346W3411910O1ral 612W2022 UnivirluIlhnre NCCNIMPM534MUll SMASH 5/19/2022 NOVITAS SOLUTION HCCMIMPM1611353A1WWIM 8/Jyr2012 A98AdbA 6IM1022 WIRE OUT CAMEa HIALTH GM CENTERS III 6/3Ar uAladiUWnu HCCMIMIMT 146WL111243" 6/3ya013 NOVOA65OLUTION HCCWMPMT 6743574' 103 113O o22 AMERIOMUPMRME-PAYMIMCE523NW6l3 6/27/2022 CK241 6/27/2022 UNCCOMMUNMPLHCCWMPMT346W3411910000 6/21/2022 NOVITASSOLUTIONIICCIAIMPMT636323420000160 W27/2022 HUMANA CHA DISB HCCIAIMPMT390M4420001511 6/37/1022 DEVOTED IMtTH PHCCWMPMT 121140197931734 6/I8/2D11 UHC COMMUNM P1 XCMIMPW 746M341191MM 6/2012012 HUMANA CHA DIED NCCUTAIPMT390MId]0W01659 6/29/2072 DEVOTED HEALTH P HCCWIMPMT 121140399748035 6/29/2022 M011na HCo3TRHCCIAIMPMTPN166985042$4300 W2912022 MANAGEANDNE)1)10MNSPMNT000MM0000326841 6/2912022 UHCCOMMUNIVPLHCCVIMPMT346W3411910M0 6/29/2022 DEVOTED HEALTH P HCCUIMPMT 12114D391)9]033 6/3O/1G22 Add$d98A nl .. 6/30/2022 WIRE OUT CANTER HEALTH CARE CENTERS HI 6/30/2022 HNB- ECHO HCMIMPMT 74603411440000243539 6/30/2022 UnNedHeallheare HCCUIMPMT 24600341E 1 W3M 11"23 DEVOTED HEALTH PCCCWMPMT 12116M93326%9 613D/2032 AMERI6ROUP CORM f•PANMENT EE513BM933110M fRli..f n AMACCE1 C9183 G/30/1UI2 WIRER UTCANSCE 6/3D/2D21 WIREOUalthum HW1THCW 746WER5111 6/30/IO2 AMIERIGROU4m NSO E4AY EW9534111343M fi/30/I021 AMENGROUPCORPOEiAYMfMEFS]3B6WD111M0 $plaldMW6u NnuNd1 '.. 6/ilRpII CRI2M M2l/1022 MCIma NC 01 lX NCCWMPME PH149]IIR5142M IJ2]/3@2 MPIine M UNITYf SIT CWMPMlPNITTAG IIII I1W 6/271022 UHC COMMUNM Pl HCMIMPMT 74=3411910tt0 6/28i COMMUNUTY 612VZ022 UHCCOMHUMANA MS CO HC NttWMIM62833111491M 6402022 HCAPHCCHfWNCC086242 9W6181WD5f9li9 6/202022 CUB HAHCCUadAPSAT Mt3 2INCOO5n619DUOilA 1121/ID22 NNBP M HCMIM ECUIMP}gWy16619611011 6/29/2022 RmHIOMMUN N[MWPMUIBI2ill9100 6/19/l01} UXC COMMUNM PC XCCWMIMi H6D])I1191W W 63M2 610/022 WIREINCHCACANCER CANCE PICMTIM 11 6/301201E MXC of TV HCCWMPMTPNM9)Mg69UM 6/30/IDl1 HMN4GCAMN$P04M al 2 XHB ECHO NOCIAMENATMM34LI4=243S6l GIMID21 UnIl6HHCLMIMPMl74W1lllZ4 6ARON1 MMgMPMROMJIW 47.953.16 IAD07G6 2,113.18 2A05 11 2 105.25 60.B59.09 SAGS - 31i 2.. 3.9.91219 1930 )0,501.53� NHPORTION • 14,00].Ofi • I3. MUTT )) . 25 60,85BS.09 48.00 1,36063 - 13,931.19 1111.30 2.W1.18 3.M1.18 / M11t61 36.M3N 0.W i6 L31)X ✓ lIl.08 I26.960.M ✓ 160.]]6.04 36.M1% l W.16 Y ]S)56 l2A584 MMCPORTION Ti. tlen l- Ju / TURGIBr•In OIPP/Comps OIPO/Cpmp1 OIPP/Comp! yPP/COmp)6Mpla OIPPTI NHPORTION 18.652.39 ✓ , INS it - 1.048,71 5.I17.68 5.127fib 33.13260 23,I77.60 4.730W 4.730.00 11.77242 14.))3.91 1L56 ' 6.MpW 6,990.00 - ILllfi@ 12.118.02 ]O""" 10966.M )A) 10.9MX 374 1"'338.01 ✓ )5.811.]6 / 30,966.10 TAT 11197054 6787123 MMCPORnON TAGON.GP1 Tn"r aler•an yPP/Cpmpl OIPP/Cpmp1 Q1PP/UmP3 ylPp/CpmpawpM avvn NH PORTION 15,9)2.291/ , 11,883.52 11,861.52 116OIA3 11.60142 - 4,65000 4,65O00 1.200.0 2110000 9,891.36 9.89136 - 6,05834 - AOSB.34 - 18140000 ISAOD.D6 - 5.181.83 5,182.83 319.50 319,50 - 4,641.80 - 4,640.00 SIM.OU 6,00000 + / 16.03 139.495.16 / 16.03 - 7.252.74 ],251.}4 - 1594.39 - 1.594.38 • I2,00O00 120DD.0D / IS In.26 MSI92 LA0138 9Srs.e ✓ )006) 155.467.45✓ IMISE4.0 8.111.92 1.401.34 MMCPOR)ION Trnf� TMnifer-In OIPP/COm03 yPP/Carl OIPP/M.p3 yPPIO.P48Mpw yPPn NH PORTION 19.293.05 V/ . - 20.61 - 10.6E 145.512.02 - 3R45.00 1.141 GO - I1A65.O1 1O)16.N L]A0.3f 3159y66 V/ 0416 161.MS.M ,/ 14.)10.62 _T)i6.fi8 1.1M.1] 11590A5 312971 MMCPyD1pN T nGO r1 1H THURE.r•In yPPlorapl yPP/C0mp1 yPP/0m03 yPP/Wmp18MpM ypPn NNIOROON 18,71574� , 6,030.94 2AI9.34 1A39.28 2,030.94 - 1,W936 48,732.93 9.732.93 B.Pn.93 LM500 - I,440 0 1.19500 1,IM41 },440.GO 1.94530 3.985G0 3.50,20 - 3.500.SO - 3.SM.23 23 - 3.527.70 nw na0 n3.nv1� . 2.1174.40 2.114.10 I,I52.50 - 4,5 M3.68 BMfi9 803, �.IILM i N]19M LR]M ir9 Ml)6 TOTALS _ 918,106.M 434,1H6.0 67.372.0 0.528.78 )26e2A) M MAY 7/112022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Add Group Account Type Search All DDA Data reported as of Jul 1, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $2,975,118.40 $2,991,771.84 52,975,118.40 $4,103,937.2 '4551 CAL CO INDIGENT $5,432.93 $5,432.93 $5.432.93 $5,431.4 HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $10,041.40 $10,041.40 $10.041.40 5120,958.E HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.47 $536.47 $536.47 $536.4 2014 •4357 MEMORIAL MEDICAL $2,253,558.94 S2,262,793.46 S2,253,558.94 $2,271,677.2 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.87 5431.87 5431.87 $431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $160,916.09 J S160,916.09 $160,916.09 $196.232.E CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $78,970.52 ,/ $80,607.34 $78,970.52 $209.671.2 BROADMOOR '4411 MEMORIAL MEDICAL $111,044.85 ,/ $115.044.85 $111,044.85 $219,463.E CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $14,836,33 ✓ $14,836.33 $14.836.33 S145,627.7 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT - $109.166.72 5109,351.74 5109,166.72 S357,788.E WEST HOUSTON '29 8 MMC -MONEY MARKET $703.63 5703.63 $703.63 5479.0 FUND 'S506 MMC •NH BETHANY $24,987.66 $24,987.66 $24,987.66 5307,771.7 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- $61.072.46 $62,646.02 $61.072.46 560.705.E MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE 54,608.13 $4,631.65 $4.608.13 $3,554 c PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $138,810.40 5138,810.40 5138,810A0 5203,606.0 VILLAGE https://prosperity.olbanking.com/onlineMessenger 1l1 Memorial Medical Center Nursing Home UPL Weekly NeziGn Transfer Prosperity Accounts 7/1/2022 Previous Account Beginning Pending Today's Beginning Amount to Be Sterol erred to Nursing Nursing Nome Number Balance Tranaleaout aliumrenln Deposits Balance Nome UebfunGMk'. 111,959.06 -1.820.75 9,903.09 ✓ 1p,Os1.A0 9,883.52 Bank Balance 1p,pe1.A0 vamnee Boullnn Information for Golden CneS: revision Hoalrb at Golden CreeS Wells Fargo Bonk, N.A. Alit A. Note: Only hoserm al over$5,000 willbe hantlemed to the ounln9 home. Note 2: Eath aRm int has a bore batmen o/SIM that Marc depatlied to In atteunr. APPROVED W JUL 01 2022 By cOUNTY AUDITOR ALLHOUN COUNTY,TEXAS Leave In Balance illegal April Interest 12.56✓ Met Interest 20.75 1/. June Interest 19.5E .� 5Sg8 Adjust BdanceRranslerAmt ✓ Apprayed: ��9AB3.SE WIWAMNTTLE,CFO / E/1/2022 1.%NH Weekly T,amle,gNH UPI Transit, SvmmaryV022VAy1NH UPI Transfer Summary 07.91.22,115. GeWmi[.vY 6/I]/]0]] TSTNAMNSNR3T0RCOSTLMT563596.SIOM1]9 6/3]/}0}} AFTN4 ASOUECHO NCCIAUMPMT I16003421"10000ll}19 6/30/2022 HUB VS(TRA GNCCIAIKED 9L 6003411M0000115701 79 6/}9/]0}} TSYS/1MNSFIRST BRC05TLMT5436045558]69l]9 6/30/2031 WIRE UTNEXIm 6/30/2033 WIMOUTNFx STRICOSTON HEALTH N GOLOPNC587 AMCK 6/30/}0]} TfiYS/fRAN5i1RM RICO STUNT 543fiMSS8M691)9 MMCPORTIQN QIPP/Camp TURi3Pn003 Tr9nEmin QIPP/QmPl QRP/C9ma3 QIPP/COm93 M4P34 WPPTI PIN PORTION 3.576.68 - 3,51668 3.935.00 - 3,93S.00 }.}1 1.}1 1.486.00 1,48600 1933 111.820.75 19.5] 663.63 8M.63 113810.75 / 9903.09 9.903a9 7/112022 Quick View Select Quick View Accounts Account Number / Name Account Type Search All DDA Account Number Current Balance Number of Accounts: 15 $2,975,118.40 '4551 CAL CO INDIGENT $5.432.93 HEALTHCARE '4454 / MEMORIAL MEDICAL / $10.041.40 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL $536.47 CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL 52,253,558.94 CENTER - OPERATING '4373 MEMORIAL MEDICAL $431 87 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL $160,916.09 CENTER / NH ASHFORD '4403 MEMORIAL MEDICAL $78,970.52 CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL $111,044.86 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $14,836.33 CENTER / NH FORT BEND '4438 MEMORIAL MEDICAL $109,166.72 CENTER / SOLERA AT WEST HOUSTON '2998 MMC -MONEY MARKET $703.63 FUND 'S506 MMC -NH BETHANY $24.987.86 SENIOR LIVING '5441 MMC -NH GULF POINTE $61.072.46 PLAZA - MEDICARE/MEDICAID 'S433 MMC -NH GULF POINTE $4.608.13 PLAZA- PRIVATE PAY '3407 MMC-NH TUSCANY $138,810.40 VILLAGE hltps:/lprosperity.olbanking.00mlonlineMessenger Treasury Center Select Group Groups Add Group Data reported as of Jul 1, 202: Available Balance Collected Balance Prior Day Balanc $2,991,771.84 $2,975,118.40 $4,103,937.1 $5.432.93 $5,432,93 $5,431.4 $10,041.40 $10,041.40 S120,956 c $536.47 $536.47 5536.4 $2,262,793.46 $2,253,558.94 $2,271,677.2 S431.87 $431.87 $431.E 5160,916.09 S160,916.09 5196,232.E $80,607.34 $78,970.52 5209,671.2 $115,044.85 5111,044.85 5219.463.E $14.836.33 $14,836.33 $145,627.7 $109,351.74 $109,166.72 5357,788.E S703.63 5703.63 5479.( $24,987.66 $24,987.66 5307,771.7 $62,646.02 $61,072.46 $60,705.E 54,631.65 $4,608.13 $3.554 c 5138,810.40 $138,810.40 $203,606.0 r 1l1 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 7/1/2022 PreYlPm Amount lP Be Aaaunt B"Innln, Persist I..,(..d In Herein, Nnme 11mn Tnntln.00 Tnmleeln Csect eaed Oe nin, Tude . bularint Balance Nusin Home OuMPBII1GPbL•PIMMPeY'. 3,3BB.i3 1,10990 :. 01113 /notnn810, Bsn1 BPlma 160B.1Y vsllenr. ..wain N9nc. IM.DO P... I.., Arwnnt tlIdHvNnme Nume.r oanev Pqu�Mddiw�IMedkald Nets, On" bolanres Ifaver$S.OW will be neelf ned rP In nurtnr9 hams. Nele]: EoeA arreunl Fns n eora b.11nre ofSIM In.' MMCdrOwned.. open .,..nI. APPROVED M JUL 01 2022 BY COUNTY AUDITOR CALHOUN COUNTY; TEW APlil Interest 9.16V Me, InUren 3.S6✓ lunem�t�� US "JU11 B.I.nre/tcensl.r Ants 4,499.41 / r� Ameun1. Be Pencil, T,... f.mdto Bent enter. V,rian¢ Le..,rittlsnre 10000 Aptll lnlrtHl L6S✓ Mrylntsnsl I756f lunelnl]As PtlIvn BAmn/Tnmbrgmt B0.91510 / TOTALTRANSSFRS 65,W.10 A roved: .WAM LITRE. CFO 1/I/30 1 wx xYnN Tr.nrhnNlx ul, lands summ.Mlomumxx uPL Tennel sullen m.otll..n. Gulf Pdnta Plsea•PdwM Pav 6/27/2022 HNB-ECHOHCC{ IMPMT746003411448M0224987 6/28/2022 HNB - ECHO HCCIAIMPMT 74GW3411440000265686 0/30/2022 Added To ouM 6/30/2022 HNB- ECHO HCCLAIMPMT 746003411440000243843 Gulf Pointe PlawHWdiote7Medluld 6/27/2022 NORIOIAN 13A HCCLAIMPMT 675892 42MM1674577 6/28/2022 WPYTMEP CONTRAC HCCLAIMPMT 230OBS928521000 6/30/2022 Added WAMUM 6/30/2022 PNC•ECHOHCCIAIMPMT74600341143000129525TI9 MMC PORTION QIPp/Comp gIPP/COmp6 Transfe1.0ut Tranafer•In QIPP/Camp1 2 gIPP/Comp3 &lapf< QIPPTI NH PORTION 67.92 - 67.92 88.81 88.81 211 2,82 - 1,050.36 - 1,050.36 1,209.90 / 1.209.90 MMC PORTION QIPP/Comp QIPP/Comp4 Transfer -Out Transler•In I QIPP/Comps 2 QIPP/Cem 3 &UPS. QIPPTI NH PORTION 36.238.27 - 56.238.27 612.63 - 612.63 7.25 7.25 359.38 35936 5),21).53 5),E17.53 SBA27.43 V 58.4E>.43 7/1/2022 Quick View Select Quick View Accounts Account Number / Name Account Type Account Number Current Balance Number of Accounts: 15 $2,975,118.40 '4551 CAL CO INDIGENT $5.432.93 HEALTHCARE '4454 MEMORIAL MEDICAL / $10.041.40 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER INH CRESCENT '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET FUND '5506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA - MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE https://prosperity.olbanking.com/onlineMessonger $536.47 $2,253,558.94 $431.87 $160,916.09 $78.970.52 $111.044.85 $14.836.33 $109,166.72 $703.63 $24.987.66 $61,072.46 $4,608.13 $138,810.40 Treasury Center Select Group Groups Arld Group Available Balance $2,991,771.84 S5,432.93 $10,041.40 $536.47 $2,262,793.46 $431.87 S160,916.09 $80,607.34 $115.044.85 $14,836.33 S109,351.74 S703.63 S24,987.66 S62,646.02 S4,631.65 S138,810.40 Collected Balance $2,975.118.40 $5,432.93 $10,041.40 $536.47 S2,253,558.94 S431.87 S160,916.09 $78,970.52 $111,044.85 $14,836.33 S109,166.72 S703.63 $24,987.66 $61,072.46 S4,608.13 S138,810.40 1 as of Jul 1, 202: Prior Day Balanc $4,103,937.2 $5.431.4 S120,958.£ $536.4 S2,271,677 $431.E S196,232 S209,6712 S219,463.E S145.627.7 $357.788.E S479.0 $307.771.7 $60,705.E $3,554.£ $203.606.0 r 7l1 Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 7/1/2022 Pnvinw AmOunns Br AI..rd NtlnMn[ Pendinl rmm6mew Nunln N Numbr 3tlmre dnntlm , Tnntlrrvin QtCluntl Br w1LL Tedt $60 IAr n Btlwn Xunin Xomr TYwmyyNrry'.;_ 161,600.63 161.36 as 1lBP1060 - 130.810.40 121,941.70 Bm%Gihnw 13&B1o.10 vrdlna Now Only bolonm ofone$SIM wahr,we lemd to rho nurung h"o more 2: Each 0000un t hw u bwr b olunre of $100 rho' MMC de0w Iced Is rAen Prrcunr. JUL 01 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS lour In erlmv 100.00 AMERIGROBPOIPP 11,763.70 r/ Adlurt BANnw/Inmierhmt 1319 Ap, roved7/IL2012 WI WIWAM IIrILL. CFO 6/27/2022 CK1102 6/27/2022 Molina HC of TX HCCLAIMPMT PN12757178944200 6/27/2022 NOVITAS SOLUTION HCCLAIMPMT 676201 420MO160 6/30/2022 Added to Account 6/30/2022 WIRE OUT LINEAR ENTERPRISES, LLC 6/30/2022 HN3-ECHO HCCLAIMPMT 746003411440000243563 6/30/2022 NOVITAS SOLUTION HCCLAIMPMT 676201420000103 6/30/2022 AMERIGROUP CORPO E-PAYMENT EES2386095111000 MMC PORTION QIPP/Comp QIPP/Comp QIPP/Camp Transfer -Out Transfer -In 3 QIPP/Comp2 3 4&Lapse QIPPTI NHPORTION 28,133.67 - - - - 2,294.04 - 2,284.04 - 68,001.06 - 68,001.06 - 23.97 23.97 133,220.96 - - - 7,744.75 7,744.75 - 42,665.10 42,665.10 • 17,991AS 15,545.91 2,44556 16,768.70 1,222.78 i 261,354.63 138,710.40 5,545.92 2,44S.56 26,768.70 ,/ 121,941.70 7/1/2022 Quick View Select Quick View Accounts Account Number I Name Account Type.. Search All Account Number Current Balance Number of Accounts: 15 $2,975,118.40 '4551 CAL CO INDIGENT 55,432.93 HEALTHCARE '4454 MEMORIAL MEDICAL! $10,041.40 NH GOLDEN CREEK HEALTHCARE '4366 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 •4357 MEMORIAL MEDICAL CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON •2998 MMC-MONEY MARKET FUND 'S506 MMC-NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- MEDICARE/MEDICAID 'S433 MMC -NH GULF POINTE PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE https:/Iprosperity.albanking.com/onlineMossenger $536.47 52,253,558.94 $431.87 $160,916.09 $78,970.52 $111,044.85 $14,836.33 $109.166.72 $703.63 $24,987.66 $61.072.46 $4,608.13 $138,810.40 Treasury Center Select Group Groups Add Graup Available Balance $2,991,771.84 $5,432.93 $10,041.40 $536.47 $2262,793.46 5431.87 $160,916.09 $80,607.34 $115,044.85 $14.836.33 $109.351.74 S703.63 $24.987.66 $62,646.02 $4.631.65 5138,810.40 Data reported as of Jul 1. 202: Collected Balance $2,975,118.40 $5.432.93 $10,041.40 $536.47 52,253,558.94 5431.87 S180,916.09 $78,970.52 $111,044.85 $14.836.33 5109,166.72 S703.63 $24,987.66 $61,072.46 $4,608.13 S138.810.40 Prior Day Balanc $4,103,937.2 $5,431.4 $120,958.£ 5536.4 $2.271.677 5431.E $196,232.! $209,671 5219.463.E 5145,627.7 5357,788.E 5479.0 5307,771.7 $60.705.E $3,554 E 5203.606.0 r 1/1 Memorial Medical Center Nursing Home UPL Weekly HSLTransfer Prosperity Accounts 7/1/2022 AnbMN Nunln[emm� ""' BM[eys9nbr UNdg, . Holee PoIYDaIon[n o/ovn$5,C00-11 be VamfTed to he annal band Note 2: Each 0CeouM hm oboe Dolanceof SIM chat MMCdepomed to open aaaunl. APPROVED ON JUL 01 2C� 1 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS 24,83122 Pending Medlnn Ben69ebnn Velienee Lervem B91mte 29,962.66 100.0 AmOum to Be Lenetemdlo dPllumen.t 27.s9✓ M.'auneM 26.85✓ IunelMer " 32.53.✓ Adjull 6.4anfrnmheAmt / 242000.599 Aomwad, WILLIAM LIM(, C90 7/112022 IANHl4'ee4N innllen\NN UPI TI-1111 laTnSnViO VIAN4 YaLTenlln L un—"'0121.11. BethenvlRnMruwne 6/2012D22 Deposit 6/13/2D22 Deposit 6/27/2022 Deposit 6/22/21322 HNB - ECHO HCCI.UMPMT 766003411610000226802 6/29/2022 Deposit 6/29/2022 NOVITAS SOLUTION HCCLAIMPMT 67648103000018. 61301AU AddedmArA9uM 6/30/2023 WIRE OUT BRHANY SENIOR LIVING, LTD 6/30/2022 Deposit 6/30/2022 HEATH HUMRN SVC HCMIMPMT 174600341130162 MR3CPORTION I Tr*nlf#r.Oul fnjl6r.10 I GIpP/WmPI CLPP/Camp! qVP/Comp! OPP/CPmp"ItleP DSPPTI NNPORTION 1p90.00 1,470Tip 17,640.00 17.640.00 77.00 71.00 069 069 1,209.00 1,70.00 485JR 405]1 3L53 3L53 106.334.06 1.125.22 2.293,04 LI15.22 2,293.04 ]A6,3l6.86 xa,en.Ez N,03)R3 7/1/2022 Quick View Select Quick View Accounts Account Number/Name Account Type Search All DDA Account Number Current Balance Number of Accounts: l5 $2,975,110.40 '4551 CAL CO INDIGENT 55.432.93 HEALTHCARE '4454 MEMORIAL MEDICAL 1 $10,041.40 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL $536.47 CENTER - CLINIC SERIES 2014 *4357 MEMORIAL MEDICAL 52,253,558.94 CENTER - OPERATING '4373 MEMORIAL MEDICAL 5431.87 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL 5160.916.09 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL $78,970.52 CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL $111,044.85 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $14.836.33 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL $109,166.72 CENTER/SOLERA AT WEST HOUSTON '2998 MMC -MONEY MARKET $703.63 FUND '5506 MMC-NH BETHANY $24.987.66 SENIOR LIVING '5441 MMC -NH GULF POINTE $61.072.46 PLAZA - MEDICARE/MEDICAID 'S433 MMC -NH GULF POINTE $4,608.13 PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY $138.810.40 VILLAGE https://prosperity.olbanking.com/onlineMessenger Treasury Center Select Group Groups Add Group Data reported as of Jul 1, 202: Available Balance Collected Balance Prior Day Balanc $2,991,771.84 $2,975,118.40 $4,103,937.1 $5,432.93 $5.432.93 $5.431.4 $10,041.40 $10,041.40 $120,958 c $536.47 $536.47 $536.4 52,262,793.46 $2,253,558.94 $2,271,677.2 5431.87 5431.87 5431.E 5160.916.09 5160,916.09 S196,232.° $80,607.34 $78,970.52 $209,671.2 $115,044.85 $111,044.85 5219,463.E $14,836.33 $14,836.33 $145.627.7 5109,351.74 $109,166.72 5357,788.E 5703.63 S703.63 S479.0 $24,987.66 - $24.987.66 $307.771.7 $62.646.02 $61,072.46 $60.705.E 54,631.65 $4.608.13 53,554.5 5138,810.40 S138,810.40 $203,606.0 111 W P A v c ____... - - - it.;`EDiCAL `"FAN'T rR 1. RKWIPIT MEMORIAL MEDICAL CENTER Oate K,,gtjt s. >d: 7/1/22 I FOR ACC"I. USE ONLY — -- APPROV0OkPa uirnpre sti::sh JUL 01 2022 ❑_.A/PCheck Mai Check to Vendor CADL COUNTYAUDITOFT LHOUNCOIJNTY, TEXAS �REctlrn Check in 172pi. AMOUNT $28 317.56.. G/I NUMBER: 10255040 EXPLAN AT!ON: AMERIGROUP MAY QIPP PAYMENT I I Mayra Martinez I�-------- -..------------_.--------_------•-..__._.._...._. _...._... ...........__._ ....._... _ ........ ... ..__. a K/l F. M t` R I A L ?`zA E D 1 1., C: F N..11M R MEMORIAL MEDICAL CENTER U::d P,eyuestee,j: 7/1/22 F011 ACCT. USE ONLY --y^- --- - --- ---' APPROVED ON' L Irnpre5t 1..d1511 []A/P Cheer. ------'--------_---- JUL O 1 2022 DMoiI ::leek W Vendor BY COUNTY AUDITOR I nRet,arn Cher w Depi: -- CALHOUNCOUNTY,TEXAS t_.__:_._--- _____.___............. ..__ 10255040 ANAOLINT 10970.54 G/tNUNIHFR: I:XPLAN T!OiN: AMERIGROUP MAY QIPP PAYMENT --___. ..._.._.. .. _.... -_.. ..... _.____ ..._......_ .. ._ ..- ---y -.. ._.___._._. Mayra Martinez N/l'E N/I 0 R I A rs A E D! C" A L C F NTE R I." .. ..... r MEMORIAL MEDICAL CENTER Dift! Requested: 7/1/22 FOR ACCTI.USE ONLY APPROVED Om F'JA/P Check JUL 01 2022 i Mail Che.,'k to Vendor I "'ketul 1% Ghcck Lo Oppi BYCOLINTYALIDITOR ------ ---- I ------- CALHOUN COUNTY, TEXAS G/l. NUMBER: 10255040 [.XPLAf%iAl'iGN: AMERIGROUP MAY QIPP PAYMENT Mayra Martinez �! BY. AUY11-:c;id.7F -------- P A r c --- _....... _ MEMORIAL MEDICAL CENTER iet Rn.�uesi:ct;4: 7/1/22 AN/fOUi\T _.$.4,,590.85-_..__._. FOR ACCT. USE ONLY APPROVED OAa El Imprest Cash _-_._-- JUL 01 2022 ❑AiP Check CIsail C7!eci; 4.! Ve•ndOr BYCOUNTYAUDITOR CALHOUN I �Rer.un!Chci:loDcpi ..-...._._..__ COUNTY, TEXAS .. NUMBER: 10255040 1:S:PLA1,1A1,!0id; AMERIGROUP MAY QIPP PAYMENT i Ma ra Martinez r, A Y MEMORWL NAEMCAI. (INTER E, I R J 1: MEMORIAL MEDICAL CENTER D.ItF Re.questefl: 7/1/22 --------- - FOR ACCT. USEONLY APPROVED ON I El I r n pir P. s t Cash JUL 01 2HL P.Mail,'Checl: to Vendor BY COUNTY AUDITOR Fj Rezu, vj 0'u;ck w Dep; OUN COUNTY TEXAS ifl-r A1,1101l10255040 _ _ .. .... .... ......... ..... .... - FXc,LANA1,0NI: AMERIGROUP MAY QIPP PAYMENT ------------- - --------- --- .......... ---- - - Mayra Martinez v NA E M 0 R I A L I'A F I MCCAL CTNTER' K REQ! J E MEMORIAL MEDICAL CENTER 7/1/22 .... ....... F 0 R ACCT. U 5 E 0 NLY APPROVED ON i7im JUL 01 2022 17A/P Checr. 11 Mail Check to Vendor BY COUNTY AUDITOR , I CALHOUN COUNTV, TTE)ZAS Return a c-.d, co De p i AMOUNT �16,79.70 G/L NUMBER: 10255040 --------- - - — ----- EXPLANATION: AMERIGROUP MAY QIPP PAYMENT 0JOU"1 t.[l BYMayra Martinez H 1.7 F, D 87. N/1 F. M 0 R At. [\A E D 1 (A L E W E K" CHIECK MEMORIAL MEDICAL CENTER 7/1/22 A FOR ACCT. USE ONLY APPROVEO OM 11 linprest Cam JUL 01 2022 1—]A/P Check E-] Mail Check to Vendor BY COUNTY AUDITOR I-- CALHOUN COUNTy. TEXAS El Romurn llhe.cl, to Dept A RA. 0 U 1,11 T $59.55 NUMBER: 21400012 f`XPLAHATiON: APRIL — MAY 2022 INTEREST EARNED . ................. . ... -- ........ - - .... . ....... ..... ... I - -- -------- rl", MAYRA MARTINEZ AU I By: '..:PE't. K Ra.Q111J E MEMORIAL MEDICAL CENTER p is Re Iursi:ed: 2/1/22 FOR ACCT. USE ONLY APPROVE—: ON Himorestt:ast, �AlI% Che_k. - JUL 01 2022 maiI Check to V;_ncior BYCOUNiYAUDITOR JRr`.rianiC:>,r.-;J:p i�epi - CALNOUN COUNTY, TtMS -- - AMOUNT $41.32 GIL NUMBER: 21400012 APRIL— MAY 2022 INTEREST EARNED tLi R', MAYRA MARTINEZ - PI,.E B. _ I ........ . ... _ ......._ F. A E 1E'K EiI~C(JE Sl MEMORIAL MEDICAL CENTER 7/1/22 p:�tr. RequestE:d: AMOUNIT $46.70 I.XPLANATiON: APRIL -MAY 2022 INTEREST EARNED FOR ACCT. USE ONLY APPROVED CIM DImprestCash JUL 01 Z022 I I ❑A/> Check C Mail Check to Vendor BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS ILDRerA rn Ctu-.ck to Depl 6/i. NUMBER: 21400012 ___ . _...._.. ,:.,,�I I u.i MAYRAMARTINEZ �i i� .,tl,'E E,l: - ��.�• MEMORIAL MEDICAL ("'EN-FER Hf.-C:K REC)AJEST p MEMORIAL MEDICAL CENTER A AMOUNT $26.32 Date Requested: 7/1/22 FOR ACCT. USE ONLY APPROVED ON LI Imprest Cash �A/P Check JUL 01 2022 FiMx,ilCheck toVendor By COUNTY AUDITOR LJ Re.turri Check Lo Depi: CALHOUN COUNTY, TEXAS L... _.... .__._.._..____.___.__..___. G/L NUMBER: 21400012 Fk:PI Ai'JP.I"CtA�' APRIL— MAY 2022 INTEREST EARNED KEQUFSht E3' MAYRAMARTINEZ ii.c)it17Ft;LY �<.�/ P A y F: MEMORIAL MEDICAL CENTER ((I'r�lft r�9.. CENTER Date Requested: 7/1/22 APPROVED ON JUL 01 2022 BYCOUNTYAUDITOR CACHOU FOR ACCT. USE ONLY 17Imprest Cash []A/P Check L J Mail Check eo Vendor J L Raul rl iji:'l. LU Depi. N COUNTY, TEXAS AMOUNT $50.68 G/L HUNISEP.: 21400012 I:Xi',LAla;\TION: APRIL— MAY 2022 INTEREST EARNED t.E_r}��r�rL Ei f3Y. MAYRA MARTINEZ _... --- ..�_. ..._._._..._....... -... ..... ..... — 1A E M 0 PA I A L INA IE D11 (-' A L " F N '11- ER I- k. I I C.'K RF('�UEST MEMORIAL MEDICAL CENTER Dal�� Requested: 7/1/22 (OR ACCT. U 5 E ON! `r APPROVED ON 11 rn pre. st C. ash JUL 01 2022 nA/P Chr.---k p Mail Check to Vendor BYCOUNTYALIDITOP I jRetun:CheckLuDept CALHOUN COUNTY, TEXAS AMOUNIT $57.88 G/L NUMBER: 21400012 APRIL— MAY2022 INTEREST EARNED i.XPLAWATIONI! MAYRA MARTINEZ p A Y MENIONAL MEDICAL C"ENIFER MEMORIAL MEDICAL CENTER safe. lleque5te.d; 7/1/22 APPROVED ON JUL 0 12022 By COUNTY AUDITOR CALHOUN COUNTY, TEXAS FOR ACCT. USE ONLY [Imprest Cash 0,A/P Check DM,ail Check to Vendor 0Return ""heckto Depi ANAOUNT $27.18 Gi/[ '-JUNABER: 21400012 . ....... ..... APRIL —MAY 2022 INTEREST EARNED MAYRA MARTINEZ RIZE ff� o'. ........ . - ------ ..... .. a n c n O n O n 0 �n 'Az =n >z nn 00 nn 00 moy Mm3 a Cz z -N-, -yNi 3 A 3 3 3 x N H H -i m Co w -Ai vmi r D rD m m c c rn m ? m � O 3 O O fn m A A > n n O n -i -I O U O b O P O w O U O O O O W O O O 5 ym : a n� W m rm mA a n m n O N M b b w A N J b Nn mn yo 000 Zy r-� m.< mK O m� DF mN m'o� � o 0 m A A A C in C in J J C C O O O O W W O O O I O O O O A a n W W W N N N r n R O O O O R 6 N R s zz zz zz o" Oyo n z An a n > n mAy 'A C T T x D O y z '< z � r o y yy J v ' o 3 3 a a a z o N N N c a 1 p P oz"mm'> am> >my a IJ N .�mmm y r'mm mm O A yK po mwx n�ms ymx O Z z< n 0 mE0 �m XO a' O J p J A O P O N N O W U b J O O P J J Ia 0 0 v v g nn nn n n nn nn 00 O O 00 a H a a rC �z �z z z az a00 s az � n n nH nH H H -�yy -Cy HH K n nn r r A a r r X p p 3 x X m m : f w O N O O » P p F O = O = O y O = O A N N O N P A n O O O O aD b n d z m0 Z� a O m > O $Aa y N ry a m 9 0 m Q Z H w rmii G v V� n m lA m y { r H C r9 m � N O 0 O O 0 O U to O O J O F r 0 o a w o 0 0 0 0 0 n A A A > T T '+� A O O G 10 S < m a m Fy n z z ay z 'v P r F R. a o D p n H ICI H O r O O w a Z0 v 3 n w i0 a a a ra-m m 3 ry 0 x n nn O 3 z z a m m a a L F A N tUn VUi V O O P O CJ � O 0 0 0 o O O Q m 9 O N `^ — '^' Z p e �a 0 NA o WWO 0 d NA aNw mi— FG Gl9 w x O,DW nC 'ba y Oa FN[PA ANNA AAA y ym w 3 aCC aCC yrn n H0 imp m a� ° Ozo na J N a N z O `^' O`^� Ow O'er ''� O GP GP PpP 7�o m- nn nn nn n 7Aw Fw �' y n Fo �.D r,a r,D ry Ko Ko Dy a >X c, 3 > Y O w ym n ° CGyn ww X O z n a m , N N w W IJ U N N A A A A J J U U J N A O A Oe Oo O O J J O O O O O G V� C 1n OP T �O b O C n a P w w w w 0 0 0 0 gW a 0w 0z y F9 >[7 m a w m< ro w Zm rm �m a n9 o n � -ni 0o N F P N O P W A Oo O Oe J P P 0 P 0 P 0 P 0 P o P O r n 0 0 0 0 o O p r g w m n n < m n S m 3 m D A a r H o m i; m H z x � A C C m m z z yO� M A P A N �D b to J to OJ A` O O N N N N N N Z N N N N N N N P p F ut A O N J ^ N o< N N o >.y.{ N a O C) o< yy N N O > N O H fD/) .N. y T1 � phn chn 'ohn inn pnn 'Shn hn mAF N eoH rn�A OwH m AF NmH : F;p ooH .<Fa a,H m FA t,,6 H FF o -4 o F O Z F O A O A r P w w 'o 'p � nn �iz) nn A din w w nn w nn n ^ n n mD w> ma a ya asAa N a N N N p lC: a u a VCi u u u u ro n s N N O A N N W W P A P J J u N O J G V1 u O ut O l/U J C O C C O O u O O O O 5 1. 0 0 0 0 0 0 U P m b b b b 9 11� 0 0 0 g-n p m;o map c�aa m map X �m nom no"' m � m z z z m U O A p O A O O N A N N P N 0 0 0 O o w >'y m Gi �m O r y= m �_ m H cm D N x o z < ° m z n y n a v N < n G n > m r to Z N N O O OP. P O b r O O O O N O O p 6 R <j A A n< g gm rn 85 n 0 a zo P c= 'Oa_ g v nz v mD n n w m r 3 aO m m x a n a v P J O N O N O M O O b W N a N N D w a m z v N O O o to y J 3 C O A O O A q ^ nag »> xm ny wm v-X-1 mwm m0y n>m rgy mAm m y y m�� �m nSa vmrn Dy Cm n� a" p yDn n O 2aa yo o z M Om o 3 o y m a 'n m0 y r Z H m A a N W N in A N N O �O A A V to oe C N co N .A O W 0 0 0 0 0 0 n a a o r r me mC mC n IA W ay n0 Dy nf) ay nn mn m mn m mn m K K n mm0 z0 m m ��m n 3 v O > O A .p O O rn m� r y N N w O O N O O O V O O O O w w m`c a`c z`c nz nz x n n n °n mn zn zn m n m m m a m m m z zZ O m m am xm x x m z Nm Nm a a ° m m a � W y A O b O P O P A P W P N P O y m n z n0 c y K to N 0 A a m m m C) m 0 e 0 P U 0 xn OF mm m z N J v b W w O O w O O I O I O O O O r -xe y ^? y n m n o n n A W r rt N O O a r a A 6 w m n � v O m C a r O K ca- �c ca- zr..� m ° b N O 3 3 H J O P N N FAA m D F ul m z r a � � o y o ° o- Go O P O N n R 6 G z°c°ac ° zo a o o 00za °m ° �p Knm 3nm A F n mm mm 3 3 y -i n -i -zi -zi x U A O J N y O O m N b n ut b y g > 93 m O m ° yx m a < z �Z ° n m c A m r ! Om y S C m c n m m N W W W W W N N W W W W ° r U O O O O O O O O O O O N p 6 R ny zm n n ny3a 9 D W w < 0a o� 0? o� o2H 0� 0� y o 0 o x 'aC) v,m v�< as v� ax •v F. ax v� 9f SO � D O 0 Z o zo am z0 z0 z0 ax ax .< r az r r zo zo m C m m m 9 m m •t .< .� r ,< r .< r na w n� lD-' '� w w n> w na w n� w n y �D > z Z O r rzD n� r D m D m rn m m m n m o a J W J J J W J W J W J W J W N A r y b A A U O P P N A f<0 U q b O O G Q O O O O O O N F m 07� nm v So cv era Z�co Z .T. 3F mm C]'a am_ r'a m w A cw �a aW 3z c_ KZ yc zm_a o Fo C10 mmo zo no Cpo o ya o �o Za Via, o ww Ao Od m� C o 0o 90 9 0 0 00 0f Om 0 yo AC y m W A '-7� rn am �a a ma a r <z Zo Dm NCa O Y y0 c7°a� �F m XX p D Z 9m Zl °o tr, c r,Az k 9 m O {O A z a xm pr K rmr -A� vnD m O m O Hp x n R N 0 S 8 3 lA U W W N N O O 0 0 FO pO w � �o mD mA �O AO n z n N— U O O O 4 A � O y y wm 3 am H 9 a c0 y 10 V� m z A P Q T P W W W W W P P P P P to O N N N n< pn n< °-n n< °-n n< °-n n< gn Sp ac02 rn n o- �D Dc �A Ac 9A °F roA 9F �P S9 m0 A' �n wy DS m m m n cm- n cm- m n r A rm- m � O n� y O A O y n n n n n N v O N N N N N W Uri T A A to lA to tJi N 'V J N P N O J P O O O O O m �� m �02°m 7W O9 W mCA7 Mmm Om mr m N N O N N O N N T+N N C N N '��.N XN O A N a N N Oa OP OP OOP zOT 0 C <P n� ANON yP 30� ON .P b� NA O� OA r ON p�A %Ohi OA A— mP m— 'P 'G N w� �� �� =a N �X O N a oo w n S v S cY X Z{ w X n X o � r A N !2 p � W J O O O u T to J oAo J J V V J W W J b N A 0 A 0 e � 3 ^ c rt � O 0 O v n C p n i O y 3 0 0 ti r A � O m Z u, m m n O A H m w w w w w w w w w w w w w r N N N N N N N N N N N N N U O O O O 0 a --77 rz OA O? O? OA OA DAG C DC m �e �m Oj jC 0X OA_ 0? C9 0n �gg �yF �v �F bF C7� O'r''' o-ri rri. r F Ow XO �F v vF Oe 9p o Z ay F F F o b ax a3 � as� KO {ZO jr ,Cr -<� a� AO a� Z � m -An map t� { Zj Zj mmzr nr nr n n !fir r r r C C) a nr nr nr rn< m m m m m m m mm n O O z O C A C -;o A A RN A ww px -1 SO� rx,m mW m ygw W =m mm >m Crow m W OW m nW Cam n m 0 D o O�CzyNA-Ci nwm z-�wm o%i Nr- MVI O Owz<aOR 0y N HI.ZOrn a IS N rArnm) -f] OOW -n an S DornA„� ornN Oy"'*�� S -3r AC Ar a ZWoa n o Oa ly 0rnw d X zm m y rD- �yT A C S3 W �v m T• ,a n z m x w m m lA W J W W ae N C Co O b U J b N A U tJi� b N O A U U J U M J IJ �p O b lJ 0 w O a °no �o m m 0 m O mD n n -z -z n n A W c o p a u, rn f) 0 z m C > Y n G n m Or y x =l n O y A S w A Z m m a w m D y C rm- r m G n m z 9 y O [ n r A y m h T S T T U ,A ut th ut 1A Vi V, J a U n O O O N N O O O O O O O O O U p 6 p O On Oz O�Z OZ Ac AC Cy Gm Dz0 �Cr Ozmn Oznm n 0n2 00 9 cz'"z' m m n y FA OD 3y oa O 'on 9n rA ra xm r C7 T` o T` o D w`n CC m wy y`C< w0 m m O� O yp �a0 -rim -r-1 n m AZ n ZA Z� 3 O O o n n O "i O G m m Z Z n O n a ° z n n y c z n n o z° o °z vOi ,Oi, y ut y Oo b b tOi, O N oo ao Oo ., z d N P W N N b Ce N N J M J J W A W A O O M J N N N N N N p p '3 p W ymp -i OOW D OSZ�W w m°,`W w 9� aW W W a W W ZW Jo rno o m`po o Zo Oo 0 0 0 o m o Go 0 oa yorn a Z�a°„a o. ao' =i °� o. o• a a rw no a Za. a z N Fn =n Z m?n C Oo ny m D yay D m �D m �Wr C z 0 C N r cr) � y N ti 0 Yn p m N O y N y u m O W 0 y x im, m �Tj n m 0 p a• 6 V, O O O O rn '� o m u, V O A > C a m < <A n S O y m p3o a s d z m a O r o > c z 7 m n z z a H m c m y m m w w w o 0 o w w A O O O O O O O a T. z 0 ar� n m m < tnA m -CiP Cm -3 Z� tip �Z 3vj, v b O WO ww n y F � O p m m _ a A x m0 F p n 0 o A N Vf Oe � N OOe J J NO o0 0o GO W C w O �p J O O O Ut A O N ° N 0 w w nN na 000. no 0 mA a00 NC{ P S x� �n N n n Z �m y z y n r D i A a y 0 y y m A J J U 6p W w b O O O O V U W W W a a a a a a n a rn a rn rn a r O O O O O O O n 6 R v � A g°°° °°o°8 Oy°°nn- v v o n m m m m m m m m m m m 9 m m ry A � � � F A A n n n n n n n W Ce W M W CO W O O O O O O O p O lA VI lA U VI fA U '1' C p n C 0 0 0 0 0 0 .p L 2! ,y R^`cF yep ep y 7y nto e.v -7 °° to °O W '-7 � to °0 W A °° CD m Oe 2 aNA ,,,�Jo nJo J o Jo <Jo mJo Jo y OP 00; pop� 000� ,,,SOU Oq Y ON �ON 61^3 Ott. O '�0N mOi� bN 'A T O O 'C VUi 3 O p 9 w a e v _ N A A W t°'ir A N N Q P n 6 M O O EE N P V P P P P P P P P O O N o� Oy -8 m0� a_ a a zoc 3 m m a a `n n 00 N UOi 0o N V�i w w w ao ov o A P a 0 0 D A y A y n y rnm �m om 'z-3 N P u a m P m D r) y y va O A a- w Ja � pe OO n _6 O O O 0 _ ZO p n O m 9 m > 3 3 3 y -zi 0 ti a rn � a � r h n < On n n Oa < � 00 3°z D nA m .ai a z N oNo p � o N H In � z.0 N o p w 3 A G m 3 'no mono ann r-nn *-O S"j i°O ^ {w3 Op $ ooJ n m� R w p C^ O V A Vi w y S O c T � A O W J � J J O O 0 O O_ 9 'O R � z z o e R n z cn- n `z y m m A 'z n y m F n m y 0 o• W 0 0 0 0 0 0 b o 0 0 In � o 0 O O O a m om -� A A o 3 m z z -1 -i o m m n To m 0o n OC r C m y m z� c �o my ym yA R O 0 A c o z O v z O v o y � 3 z z Z� R1N v v r m Wz z zo "o Oz m' z� N w co n v< On < �° z z 0 p Dx N� Z : a 3 � m 3 -i n 6