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2022-09-21 Final Packet\I.IIl I ((1\I_ I 11.11, '( 01 16 I 10119191 wj�3 Rol IN ✓ All Agenda Items Properly Numbered ✓ Contracts Completed and Signed N A All 1295's Flagged for Acceptance (number of 1295s _) All Documents for Clerk Signature Flagged (All documents needing to be attested to need to be signed day of Commissioner's Court.) On this Z.3 today of Gm,%ex 2022 a complete and accurate packet for 7jeA— of Der 2022 Commissioners Court Regular Session Day Wonth was submitted from the Calhoun County Judge's office to the Calhoun County Clerk's Office. uam4L Calhoun County Judge/Assistant C:\Users\Maebelle.Cassel\Appdata\Local\Microsoft\Windows\Inetcache\Content.0utlook\3CU9II QW\PACKET COMPLETION SHEET.Docx AGENDA I NOTICE OF MEETING 9/21/2022 Richard lH . Meyer County judge David Hall, Commissioner, Precinct I Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 ]Kadldlae Smith, Deputy Clerk REGULAR TERM 2022 § September 21, 2022 BE IT REMEMBERED THAT ON SEPTEMBER 21, 2022, THERE WAS BEGUN AND HOLDEN A REGULAR MEETING OF COMMISSIONERS' COURT. The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at 10:00 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Vern Lyssy Texas Flag- Commissioner Gary Reese 4. General Discussion of Public Matters and Public Participation. Lou Svetlik, Airport Manager, gave a short report on upcoming event. 5. Consider and take necessary action to approve the proposal for services from Frontier Communications and authorize all appropriate signatures. (DEH) Ron Reger explained the proposal for new services. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct'1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 1 of 4 NOTICE OF MEETING-9/21/2022 6. Consider and take necessary action to approve the Specifications and RFQ Packet for the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 and authorize the County Auditor to advertise for the RFQs. RFQs will be due before 2:00:00 PM on Wednesday, October 19, 2022. American Rescue Plan funds will be utilized for this project. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to award the bid for Magnolia Beach (21st Street) and Indianola Fishing Piers Hurricane Nicholas Rehabilitation Project for Calhoun County, Texas and alltheFeze the Geunty 9tidge te sign the GeAtFaet. (DEH) Lowest bid awarded to "Shirley and Son's. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to pay Clarke Mosquito Control Products Inc. for an order of Altosid XR Briquets as they did not win the bid. Veseris won the bid. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct3" AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to deposit proceeds for the 7/28/2022 Auction in the amount of $61,140.40 to the Road & Bridge, Precinct 2 account 1000-550-73400 Machinery and Equipment. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to install a stop sign on Th Street at the Intersection of Th and Main Street in Port O'Connor, Texas. (GDR) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NO-1 ICE OF MEF.I ING — 9/21/2022 11. Consider and take necessary action to transfer the attached list of items from the District Attorney's Office inventory to the Calhoun County Sheriff's Office inventory. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Accept Monthly Reports from the following County Offices: I. District Clerk — August 2022 ii. Justice of the Peace, Precinct 4 — August 2022 iii. County Treasurer — March 2022 iv. County Treasurer — Interest Report for Quarter Ending March 31, 2022 v. County Treasurer — Quarterly Statement of Balances RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 4 NOTICE OF MEETING—9/2:1/2022 14. Approval of bills and payroll. (RHM) MMC Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Indigent Healthcare `RESULT: APPROVED'[UNANIMOUS] MOVER: David Hall, Commissioner Pct SECONDER Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese ` County Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER:;, Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned:10:29 a.m. Page 4 of 4 NOTICE OF MEETING--9/21/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Crary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, 'Texas will meet on Wednesday, September 21, 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: ,FILED A%__..__. _ O'CLOCK_ 1!1, — 'f. Call meeting to order. 4' Invocation. SEP 16 2022 G0 € 7 15 Pledges of Allegiance. g� O W General Discussion of Public Matters and Public Participation.. Consider and take necessary action to approve the proposal for services from Frontier /Communications and authorize all appropriate signatures. (DEH) K Consider and take necessary action to approve the Specifications and RFQ Packet for the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 and authorize the County Auditor to advertise for the RFQs. RFQs will be due before 2:00:00 PM on Wednesday, October 19, 2022. American Rescue Plan funds will be utilized for this project. (DEH) 7 Consider and take necessary action to award the bid for Magnolia Beach (211t Street) and Indianola Fishing Piers Hurricane Nicholas Rehabilitation Project for Calhoun County, Texas and authorize the County Judge to sign the Contract. (DEH) `S Consider and take necessary action to pay Clarke Mosquito Control Products Inc. for an order of Altosid XR Briquets as they did not win the bid. Veseris won the bid. (VLL) d/ 9. Consider and take necessary action to deposit proceeds for the 7/28/2022 Auction in the amount of $61,140.40 to the Road & Bridge, Precinct 2 account 1000-550-73400 Machinery and Equipment. (VLL) Page 1 of I NOTICE OF [VIE E[IN G--9/21/202Z ib. Consider and take necessary action to install a stop sign on 5lh Street at the Intersection of 5t nd Main Street in Port O'Connor, Texas. (GDR) 1. Consider and take necessary action to transfer the attached list of items from the District Attorney's Office inventory to the Calhoun County Sheriff's Office inventory. (RHM) 12. Accept Monthly Reports from the following County Offices: `r District Clerk — August 2022 lt'�3ustice of the Peace, Precinct 4 — August 2022 Ki County Treasurer - March 2022 itr!Sounty Treasurer — Interest Report for Quarter Ending March 31, 2022 ,� v. County Treasurer— Quarterly Statement of Balances i . Consider and take necessary action on any necessary budget adjustments. (RHM) 144.. Approval of bills and payroll. (RHM) "/`' Richard H. Meyer, Coun - dge 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 Calhoun County Commissioners Court Public Participation Form NOTE: This Public Participation Form must be presented to the County Clerk or Deputy Clerk prior to the time the agenda item (or items) Vou wish to address are discussed before the Court. Instructions: Fill out all appropriate blanks. Please print or write legibly. �y NAME:l� ADDRESS: TELEPHONE: PLACE OF EMPLOYMENT: (/:¢4% r� /� wy EMPLOYMENT TELEPHONE: _3 "- L�r —/-,o Do you represent any particular group or organization? YES NO (Circle one) If you do represent a group or organization, please provide the name, address and telephone number of the group or organization: Which agenda item (or items) do you wish to address? In general, are you for or against the agenda item (or items)? 1 hereby swear that any statement 1 make will be the truth, and nothing but the truth, to the best of my knowledge and ability. Signature: # 05 NOTICE 0 F MF. F-i1NG -- 9/21/2022 5. Consider and take necessary action to approve the proposal for services from Frontier Communications and authorize all appropriate signatures. (DEH) Ron Reger explained the proposal for new services. RESULT: APPROVED [UNANIMOUS]; MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy,l Behrens, Reese Page 2 of 11 David E. Hall Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for September 21st, 2022. Consider and take necessary action to approve proposal for services from Frontier Communications and authorize all appropriate signatures Si morel , David E. Hall DEH/apt Frontier BUSINESS' Isn't it time your business was Custom(er) Fit? Proposal For: CALHOUN COUNTY COURTHOUSE 09/07/2022 Quote Number: 00062381 Jorge Semerene Phone: (903) 583-1503 Mobile: +1 2145334857 Email: jorge.semerene@ftr.com Frontier Business 401 Merritt 7, Norwalk, CT 06851 1 business.frontier.com 10 1 Quote Number: 00062381 Why you should partner with Frontier Frontier (NASDAQ: FTR) is more than a technology and communications provider — we're also your partner. We work closely with you to solve real business problems and enhance the way you operate through resources including: • Flexible equipment options (premise -based, cloud, managed, or hybrid configurations) • Dedicated enterprise support when you need it most • Reliable state-of-the-art technology to keep the focus on productivity • Cost-effective plans to make the most of every dollar • Secure connections and compliant data storage to protect vital information • Multisite solutions to seamlessly link different locations • Strong partnerships with industry -leading equipment manufacturers and specialty solutions providers • Financing options available to protect your investment against obsolescence, while tailoring your payment scenario to fit your budget Frontier offers end -to -end data, voice and video solutions to businesses of all sizes. We're committed to providing next generation technology that's flexible and reliable — ready to grow with your business. And you'll enjoy the convenience of having one single, responsive source for all your communications needs. You can count on the strength and stability of a Fortune 500 company along with the flexibility to deliver on a personal scale. Frontier Business will keep your business connected and running strong. Choose from our fully integrated product portfolio that includes: • Ethernet Solutions • Dedicated Internet Access • VoIP (hosted and premise based) • Communications & Network Equipment • Optical Transport Services • Social Media Marketing • Audio, Web & Video Conferencing • Wireless Data Access/Wi-Fi • Business Continuity Solutions • Business High -Speed Internet • Local & Long -Distance Service • Managed Services • Internet & Data Security • State-of-the-art Network • 2417 expert tech support • 100% U.S.-based workforce • Global Capabilities • Customized Solutions • Comprehensive Product Portfolio • Dedicated Account Executive Jorge Semerene has created a custom -designed plan based on your needs and budget all backed by our 24/7 expert technical support. Plus, we monitor the Frontier network to ensure that your business communications run without interruption. It's all part of our dedication to helping you succeed. Quote Number: 00062381 Situation Analysis Your company's current communications capabilities include: Based on what we learned from you, your immediate and future communications needs are: Executive Summary Our team of Business Specialists is dedicated to gaining a full understanding of your capabilities and challenges. That way, we can custom -tailor a solution that meets your needs and gives you the confidence to move forward. Our recommendations based on the needs defined above include: Service Term: 36 Months Service Location: 211 S Ann St, Port Lavaca, TX 779794203 SIP Trunkine 26 $519.74 $0.00 DID Number- Included 50 $0.00 $0.00 LD Block of Time - Included 1 $0.00 $0.00 SIP Network Access 1 $0.00 $0.00 Platinum Rack Mount Bracket 1 $0.00 $0.00 Install Kit 1 $0.00 $0.00 Managed Router 1 $0.00 $0.00 Router Installation Charge 1 $0.00 $0.00 DIA (Dedicated Internet Access) 1 $1,190.00 $0.00 Silver 1 Gbps IP 1 $0.00 $0.00 /29 =51Ps SIP DID Number - Additional 150 $37.50 $0.00 Total: $1,747.24 $0.00 The services set forth in this proposal will be provided by Frontier Communications and its affiliates (collectively referred to herein as "Frontier"). Frontier does not consider the proposal itself to be a legally binding offer to contract. Pricing contained within this document is budgetary, and a site survey may be required prior to a final quote. This quote is valid for up to thirty days from the date hereof. Taxes and surcharges are not included. This proposal is confidential and contains proprietary information. The contents contained herein are not to be shared with panes other than the customer and Its employees named In this document is confidential and the property of Frontier Communications Corporation. Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) Frontier Business Frun(ie, ::oande Tns I FRONTIER This is Schedule Number S-5550067406 to the Frontier Services Agreement dated 0710112016 ("FSA") by and between CALHOUN COUNTY COURTHOUSE ("Customer') and Frontier Communications of America, Inc. on behalf of itself and its affiliates ("Frontier"). Customer orders and Frontier agrees to provide the Services and Equipment identified in the Schedule below. Schedule Date: 09/09/2022 Schedule Type/Purpose: DIA Schedule_02012021 Service Term: 36 Months Service Location: 211 S Ann St, Port Lavaca, TX 779794203 DIA (Dedicated Internet Access) 1 $1,190.00 $0.00 Silver 1 Gbps IP 1 $0.00 $0.00 /29 = 5 IPs Total: $1,190.00 $0.00 1. Service Description: a. Dedicated Internet Access) DIA"1 DIA is a dedicated bandwidth from Customer Service Location to the Frontier IP network then to the public Internet which provides reliable, secure and scalable bandwidth. Physical termination shall conform to applicable rules and regulations with respect to Minimum point of entry (MPOE) and demarcation point. If Customer requests extensions beyond the MPOE, such extension (s) shall be subject to Frontier's cabling service policies and Frontiers charges related thereto per separate Frontier Cabling Service and Fee Schedule. 2. Pre -Installation cancellation fees. FOC Notice and Special Construction. a. Pre -installation cancellation fees. Notwithstanding any provision of the FSA: (1) If Customer cancels any Service or Equipment prior to delivery of any Equipment or installation of the Service or Equipment, Customer shall pay a processing fee of $750 (the "Processing Fee") and (2) Frontier will provide Customer with notice (the "FOC Notice) of the project completion date (the "FOC Date") as soon as possible in light of the requested services and customer's location. If Customer cancels more than ten (10) business days after the issuance of the FOC Notice, Customer shall pay the Processing Fee and the total costs and expenditures of Frontier in connection with establishing the Service and / or providing the Equipment prior to Frontier's receipt of notice of cancellation including but not limited to any construction and engineering costs and Equipment restocking fees. b. Special Construction: All Services are subject to availability and Frontier Network limitations. The rates identified in this Schedule are estimated based on standard installation costs and Services may not be available at all service locations at the rates identified. If Frontier determines, in its reasonable discretion, that the costs of provisioning Service to any service location are materially higherthan normal, Frontier will notify Customer of the additional costs associated with provision of the Services and request Customer's acceptance of such costs as a condition to proceeding ("Special Construction'). Upon notification that Special Construction is required, Customer will have ten (10) business days to notify Frontier of its acceptance. If the Customer does not agree to the Special Construction within ten (10) business days, the Customer shall be deemed to have cancelled the Service Schedule without further liability. If the Customer agrees to the Special Construction, Frontier and Customer will execute a replacement Schedule. Notwithstanding the foregoing, Customer shall not be required to pay construction, engineering and Processing Fees if the cancellation is within ten (10) business days of receipt of Frontier's notification of additional special construction and engineering costs pursuant to this Service Schedule. 3. Obligations of Customer. Customer is responsible to ensure appropriate processes and protocols are in place for rate shaping to the amount of throughput ordered. Customer acknowledges that failure to comply with this responsibility may negatively impact Service performance. 4. After Hours/Holiday Labor Hours. If Customer desires coordinated turn up services ("After Hours') during non -business hours, defined below, then the After Hours services shall be provided at the rate of $175.00 per hour. Non -business hours include: (1) weeknights between the hours of 5:00 p.m. and 7:59 a.m. local time; (2) weekends, including Saturday and/or Sunday and (3) the Frontier designated holidays (New Year's Day, Martin Luther King Day, President's Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day and Christmas Day). Ver. 04252022 EVPL EIA_TPA_Vlociry V. l l Pagel Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) Frontier Business r,o„ve, co„ r:da„ t"I FRONTIER Such After Hours services may be subject to change, based upon Frontiers reasonable determination of increases in actual costs to provide such After Hours services, determined in accordance with generally accepted commercial accounting practices, and consistent with After Hours service charges for projects comparable to the project outlined in this Schedule. 5. Internet Acceptable Use Policy and Security. Customer shall comply, and shall cause all Service users to comply, with Frontier's Acceptable Use Policy ("AUP"), which Frontier may modify at any time. The current AUP is available for review at the following address, subject to change: http:/lwww.frontler.com/policies/commercial auo/. Customer is responsible for maintaining awareness of the currentAUP and adhering to the ALP as it may be amended from time to time. Failure to comply with the ALP is grounds for immediate suspension or termination of Frontier Internet Service, notwithstanding any notice requirement provisions of the FSA. Customer is responsible for the security of its own networks, equipment, hardware, software and software applications. Abuse that occurs as a result of Customers systems or account being compromised or as a result of activities of third parties permitted by Customer may result in suspension of Customer's accounts or Internet access by Frontier. Customer will defend and indemnify Frontier and its affiliates with respect to claims arising from Customers or third parties' usage of Frontier Internet access through Customer's hardware or software. 6. Service Level Agreement. The Ethernet Service Level Agreement for the described Ethernet Services is attached hereto and incorporated herein as Exhibit 1. This Schedule is not effective and pricing, dates and terms are subject to change until signed by both parties. This Schedule and any of the provisions hereof may not be modified in any manner except by mutual written agreement. The above rates do not include any taxes, fees, regulatory fees/surcharges or surcharges applicable to the Service. This Schedule, and all terms and conditions of the FSA, is the entire agreement between the parties with respect to the Services described herein, and supersedes any and all prior or contemporaneous agreements, representations, statements, negotiations, and undertakings written or oral with respect to the subject matter hereof. Frontier Communications of America, Inc. CALHOUN COUNTY COURTHOUSE Signature: Signature: Printed Name: Timothy Beauchamp Printed Name: Title: Director, Enterprise Business Acquisition Title: Date: Dale: Ver. 04252022_EVPL_EIA_TPA _Vlocity v. 11 Page 2 Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) Frontier Business FRONTIER EXHIBIT 1 EVPL AND DIA SERVICE LEVEL AGREEMENT This Ethernet Service Level Agreement ("SLW) applies to Ethernet Services ordered pursuant to an EVPL Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) executed by and between CALHOUN COUNTY COURTHOUSE ("Customer') and Frontier Communications of America, Inc. ("Frontier'). The terms of this SLA apply exclusively to the Ethernet network elements directly within Frontier's management responsibility and control ("EVPUDIA Service," or where specifically designated "EVPL Service"). 1. Operational Objectives a. On Time Provisioning: The objective for On -Time Provisioning for On -Net Services, where available, (specifically. qualified Tampa operating area), is determined from (a) the date the order is submitted and approved into the Frontier ordering system (by Frontier) to (b) successful testing by Frontier, within 30 calendar days. Customer must contact Frontier's dedicated phone number (1-800-921-8002) within 30 days of objective target date. If Frontier's failure to meet the On Time Provisioning objective is validated, Customer will receive a one month MRC credit (taxes, fees and surcharges are excluded). The Customer credit will appear within two (2) billing cycles from the time of credit validation. The On -Time Provisioning objective excludes bandwidths of 1G to 10OG On -Net Service or Customer requested non-standard bandwidth speeds. The On -Time Provisioning credit is also subject to Sections 3 and 4 below, as applicable. Customer is required to provide (i) suitable building facilities (including but not limited to space, circuitry, power, backup power, and surge protectors) for the installation, operation, and maintenance of Frontier's Network in accordance with manufacturer's documentation and Frontiers installation standards, and (ii) a well -lighted and safe working area that complies with all local safely standards and regulations. b. jiu swunauuuv. i.nwit rivanaumry is we aunuy w exchange data packets with the nearest Frontier Internet Point of Presence ("POP") or DIA Customer egress port (Z location) via the ingress port (A location). "Service Outage" occurs when packet transport is unavailable or when the output signal is outside the limits of this service guarantee. Availability is measured by the number of minutes during a calendar month that the On -Net Service is operational, divided by the total minutes in that calendar month. Calculation is based on the stop -clock method beginning at the date and time of the Customer -initiated trouble ticket and Table 1A: Dedicated Internet Access_ Circuit Availability (CA) MRC Service Credit Below 99.99% Service Availability 99.99% Credit 30% MRC ends when Frontier restores SLA-compliant circuit operation. Frontiers On -Net Service Availability commitment and applicable Service credit are outlined in Table 1A, subject to Sections 3 and 4 below. c. Mean Time to Repair IMTTR): MTTR is a monthly calculation of the average duration of time between Trouble Ticket initiation (in accordance with Section 2B) and Frontier's reinstatement of the DIA Service to meet the Availability performance objective. The MTTR objectives, and credits applicable to a failure to meet such objectives, are outlined in Table 1 B, subject to Sections 3 and 4 below. 2. Service Outage Reporting Procedure. Table 1S: Dedicated. Internet Access Mean Time To Repair I MRC Service Credit MTTR 4 Hours 25 °'0 MRC above 4 hrs 50%MRC above 6 hrs. a. Frontier will maintain a point -of -contact for Customer to report a Service Outage, twenty-four (24) hours a day, seven (7) days a week. b. When EVPUDIA Service is impacted from a Service Outage, Customer must contact Frontier's commercial customer support center (also known as the "NOC") at 1-(888) 637-9620 to identify the Service Outage and initiate an investigation of the cause ("Trouble Ticket'). Responsibility for Trouble Ticket initiation rests solely with Customer. Once the Trouble Ticket has been opened, the appropriate Frontier departments will initiate diagnostic testing and isolation activities to determine the source. In the event of a Service Outage, Frontier and Customer will cooperate to restore the Service. If the cause of a Service Outage is a failure of Frontiers equipment or facilities, Frontier will be responsible forthe repair. If the degradation is caused by a factor outside the control of Frontier, Frontier will cooperate with Customer to conduct testing and repair activities at Customers cost and at Frontier's, then current, standard technician rates. c. A Service Outage begins when a Trouble Ticket is initiated and ends when the affected EVPUDIA Service is Available; provided that if the Customer reports a problem with a Service but declines to allow Frontier access for testing and repair, the Service will be considered to be impaired, but will not be deemed a Service Outage subject to these terms. d. If Frontier dispatches a field technician to perform diagnostic troubleshooting and the failure was caused by the acts or omissions of Customer or its employees, affiliates, contractors, agents, representatives or invitees; then Customer will pay Frontier for all related time and material costs at Frontiers standard rates. Ver. 04252022_EVPL_EIA_TPA _Vlocity v. 11 Page 3 Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) Frontier Business ;nkc__homier Confiticntlal FRONTIER 3. Credit Request and Eligibility. a. In the event of a Service Outage, Customer may be entitled to a credit against the applicable On -Net Service MRC if (1) Customer initialed a Trouble Ticket; (ii) the Service Outage was caused by a failure of Frontiers equipment, facilities or personnel; (iii) the Service Outage warrants a credit based on the terns of Section 1; and (iv) Customer requests the credit within thirty (30) days of last day of the calendar month in which the Service Outage occurred. b. Credits do not apply to Service Outages caused, in whole or in part, by one or more of the following: (i) the acts or omissions of Customer or its employees, affiliates, contractors, agents, representatives or invitees; (ii) failure of power; (iii) the failure or malfunction of non -Frontier equipment or systems; (iv) circumstances or causes beyond the control of Frontier or its representatives; (v) a Planned Service Intermption; (vi) Emergency Maintenance or (vii) interruptions resulting forth Force Majeure events as defined in Customer's FSA. In addition, Customer will not be issued credits for a Service Outage during any period in which Frontier is not provided with access to the Service location or any Frontier network element, or while Customer is testing and/or verifying that the problem has been resolved. "Planned Service Interruption" means any Service Outage caused by scheduled maintenance, planned enhancements or upgrades to the Frontier network; provided that Frontier will endeavor to provide at least five (5) business days' notice prior to any such activity if it will impact the Services provided to Customer. "Emergency Maintenance" means maintenance which, if not performed promptly, could result in a serious degradation or loss of service over the Frontier network. c. Except for the On -Time Provisioning credit (if applicable), all credit allowances will be limited to maximum of 50% of the MRC for the impacted EVPUDIA Service, per month. For cascading failures, only the primary or causal failure is used in determining Service Outage and associated consequences. Only one service level component metric can be used for determining credits for a Service Outage. In the event of the failure of the Service to meet multiple metrics in a one -month period, the highest Service credit will apply, not the sum of multiple Service credits. For example, If Customer's Service Outage triggers both operational objectives (i.e. Circuit Availability and Mean Time to Repair), Customer will receive the highest available Service Credit, but not both. d. This SLA guarantees service performance of Frontiers Ethernet data services only. This SLA does not cover TDM services [DS1, NXDS1, or DS3 services] or other voice or data services provided by Frontier. This SLA does not apply to services provided over third party non - partner facilities, through a carrier hotel, or over Frontier facilities which terminate through a meet point circuit with a third party non -partner carrier. e. The final determination of whether Frontier has or has not met SLA metrics will be based on Frontiers methodology for assessment of compliant performance. Service Outage credits are calculated based on the duration of the Service Outage, regardless of whether such Service Outage is the result of failure of the Service to meet one or more performance metric. f. Credit allowances, if any, will be deducted from the charges payable by Customer hereunder and will be expressly indicated on a subsequent bill to Customer. Credits provided pursuant to this SLA shall be Customers sole remedy with regard to Service Outages. 4. Chronic Outage: An individual EVPUDIA Service qualifies for "Chronic Outage' status if such service fails to meet the Availability objectives, and one or more of the following: (a) a single Trouble Ticket extends for longer than 24 hours, (b) more than 3 Trouble Tickets extend for more than 8 hours, during a rolling 6 month period, or (c) 15 separate Trouble Tickets of any duration within a calendar month. If an EVPUDIA Service reaches Chronic Outage status, then Customer may terminate the affected EVPUDIA Service without penalty; provided that Customer must exercise such right within ten (10) days of the EVPUDIA Service reaching Chronic Outage status and provide a minimum of 15 days prior written notice to Frontier of the intent to exercise such termination right. Ver. 04252022_EVPL_EIA_TPA _Mocity v. 11 Page 4 SIP Trunking Schedule Frontier Business ri.. I. io nfl Jo r,L, I FRONTIER This is Schedule Number S-5650067407 to the Frontier Services Agreement dated 2016.07-01 ("FSA") by and between CALHOUN COUNTY COURTHOUSE ('Customer) and Frontier Communications of America, Inc. on behalf of itself and its affiliates ("Frontier"). Customer orders and Frontier agrees to provide the Services and Equipment identified in the Schedule below. Primary Service Location: 211 S Ann St, 77979.4203 Schedule Date: 2022-09-09 SPOC: Jorge Semerene Schedule Type/Purpose: Order for new Services Service Term: 36 Months Service Location: 211 S Ann St. Port Lavaca, TX 779794203 SIP Trunking (Concurrent Call Session) 26 $14.99 $389.74 $0.00 Service Type: PRI — Hand Off DID Number - Included Included DID 100 LD Block of Time - Included 5000 minutes @ $0/mo., $0.037/min SIP DID Number -Additional 100 $0.25 $25.00 $0.00 4.74 _04252022 v. 19 Page 1 of 8 SIP Trunking Schedule Frontier Business FRONTIER 1. Service Descriptions. A. SIP Trunking 1. Service Description. A. Frontier SIP Trunking Service is a business voice communications service using Internet Protocol (IP) technology. It provides voice communications between a station on an IP-capable PBX (IP-PBX) on Customer's local area network (LAN) and (i) for off -net Services, a station on the Public Switched Telephone Network ("PSTN"); (it) for on -net Services, a station on Frontiers converged services network, in each case using IF technology and SIP Trunking service functionality. B. Frontier SIP Trunking Service provides the following: • Access to the PSTN, or additional ports on Frontiers converged services network • VoIP service using the Session Initiation Protocol (SIP) to provide telephone services to Customer's equipped with a SIP -based private branch exchange (IP-PBX) • Access to 9-1-1 Emergency Services, subject to the limitations and terms in this Schedule. B. SIP Service with TOM Handoff 1. Service Description. A. SIP Service with TOM Handoff is a business voice communications service using Internet Protocol (IP) technology. It provides voice communications between a station on a TDM-capable PBX on Customers local area network (LAN) and (i) for off -net Services, a station on the Public Switched Telephone Network ("PSTN'); (ii) for on -net Services, a station on Frontiers converged services network, in each case using IP technology and SIP Trunking service functionality. B. Frontier SIP Service with TOM Handoff provides the following: • Access to the PSTN, or additional ports on Frontier's converged services network • VoIP service using the Session Initiation Protocol (SIP) to provide telephone services via an IAD to Customer's equipped with a TDM-based private branch exchange (PBX) • Access to 9-1-1 Emergency Services, subject to the limitations and terms in this Schedule C. Service related to the IAD consists of the following: • Confiouration. Frontier will configure the IAD based on documented Customer requirements. • Response. Frontier will work to isolate and determine the source and severity of the problems. If a problem is caused by either the network transport or the IAD, Frontier and Customer will cooperate to restore the IAD to operational condition. If the source of the problem is within the IAD, Frontier will be responsible for the repair or replacement of the IAD, in Frontiers sole discretion. If the source of the problem is not the IAD, at Customer's request Frontier will cooperate with Customer to conduct testing and repair activities, subject to Frontiers standard technician rates. • Exclusions. Frontier has no responsibility with respect to: (i) electrical work external to the IAD, including but not limited to power or back-up power to or from the IAD; (ii) IAD failures caused by factors not related to the IAD or outside Frontiers control, including but not limited to failure of the Service Location or any of Customer's other network equipment or facilities to conform with Frontier's specifications; (iii) use of the IAD for any purpose other than as intended by the manufacturer; (iv) damage caused by anyone other than an Frontier employee or representative; (v) IAD supplies, accessories, painting, or refurbishing; and (vi) any activity related to anything not furnished by Frontier, or use of IAD which fails to conform to manufacturer or Frontier specifications. C. Ethernet Virtual Private Line (EVPL) is a data transport configuration providing point-to-point or point-to-multipoint Ethernet connections between a pair of User Network Interfaces (UNIs). EVPL as a point-to-point configuration can be used to support delivery of eligible Frontier services to a designated Customer. Location (e.g. Frontier Connect —Cloud). EVPL is a carrier grade data networking service featuring Quality of Service (QoS) and the following progressively higher Class of Service (CoS) levels: Platinum Service (Real Time). Frontier provides EVPL Silver Service on a standard best efforts' basis and subject to unspecified variable bit rate, latency, and packet loss with dependencies on current traffic load(s) within Frontiers Shared Infrastructure. EVPL will be designed, provisioned and implemented according to standard switched Ethernet components consisting of service multiplexed capability over UNIs and Ethernet Virtual Connections (EVCs) through the use of Virtual Local Area Networks (VLANs) in order to secure traffic separation, privacy and security between Customer's Service Locations over Frontier's shared switch and backbone infrastructure. Ethernet Virtual Private Line will accept and carry untagged and or tagged traffic as described per IEEE 802.1Q networking standards specific to Frontiers Ordering Guidelines for this Service. Physical termination shall conform to applicable rules and regulations with respect to Minimum point of entry (MPOE) and demarcation point. If Customer requests extensions beyond the MPOE, such extension (a) shall be subject to Frontier's cabling service policies and Frontier's charges related thereto per separate Frontier Cabling Service and Fee Schedule. 2. Emergency 911 Service. A. E911 LIMITATION ISSUES: Customer acknowledges that the Service is provided directly to Customer's IF PBX server, and the outgoing telephone number or numbers (Emergency Location Identification Numbers, or "ELIN") sent to Frontier's network and used for Automatic Number Identification ("ANI") for locating the origination position of an E911 call is/are provisioned and programmed Into the PBX. Customer understands and acknowledges that changing the Service location affects emergency 911 location services, and agrees that the SIP Trunking Service will not be used at any location other than the Primary Service Location identified in this Schedule. Customer requests and agrees that all emergency 911 calls made through Frontier's network will be sent to the Public Safety Answering Point serving the Primary Service Location. If Customer wishes to change the Primary Service Location, Customer will contact Frontier, and Frontier will provide Customer with information about how to update the registered location of the Equipment. Customer is responsible for managing and maintaining the accuracy of ANI with respect to the Services, including but not limited to providing timely, accurate and Inclusive information 04252022 v. 19 Page 2 of 8 SIP Trunking Schedule Frontier Business Ifoi,a�, canfidanovi FRONTIER to Frontler for submission into the E911 database. Frontier assumes no liability for use of the Service other than as described herein. Customer is responsible for notifying each individual using the Service that the Equipment can not be used for any calls (including but not limited to emergency calls) if the broadband connection or electrical power to the Equipment fails. CUSTOMER SPECIFICALLY ACKNOWLEDGES RECEIPT OF AND UNDERSTANDS THE LIMITATIONS OUTLINED HEREIN. CUSTOMER WILL DEFEND, INDEMNIFY, AND HOLD FRONTIER HARMLESS FROM ANY LOSS, COST, EXPENSE OR LIABILITY (1) ARISING FROM OR IN ANY WAY RELATED TO CUSTOMER'S FAILURE TO PROVIDE THE REQUIRED NOTICES, OR (II) OTHERWISE RELATED TO THE USE OF E-911 SERVICES, EXCEPT TO THE EXTENT CAUSED BY FRONTIER'S GROSS NEGLIGENCE OR WILLFUL MISCONDUCT. B. DISCLAIMER: 911 SERVICE IS OFFERED SOLELY AS AN AID IN CONTACTING AN APPROPRIATE PSAP IN CONNECTION WITH FIRE, POLICE AND OTHER EMERGENCIES. FRONTIER IS NOT RESPONSIBLE FOR ANY LOSSES, CLAIMS, DEMANDS, SUITS OR ANY LIABILITY WHATSOEVER, WHETHER SUFFERED, MADE, INSTITUTED OR ASSERTED BY CUSTOMER OR BY ANY OTHER PARTY OR PERSON FOR ANY PERSONAL INJURY TO OR DEATH OF ANY PERSON OR PERSONS, AND FOR ANY LOSS, DAMAGE OR DESTRUCTION OF ANY PROPERTY, WHETHER OWNED BY CUSTOMER OR OTHERS, CAUSED OR CLAIMED TO HAVE BEEN CAUSED BY: (1) MISTAKES, OMISSIONS, INTERRUPTIONS, DELAYS, ERRORS OR OTHER DEFECTS IN THE PROVISION OF EMERGENCY 911 SERVICE, OR (2) INSTALLATION, OPERATION, FAILURE TO OPERATE, MAINTENANCE, REMOVAL, PRESENCE, CONDITION, LOCATION OR USE OF ANY EQUIPMENT AND FACILITIES FURNISHING THIS SERVICE. FRONTIER IS NOT RESPONSIBLE FOR ANY INFRINGEMENT OR INVASION OF THE RIGHT OF PRIVACY OF ANY PERSON OR PERSONS, CAUSED OR CLAIMED TO HAVE BEEN CAUSED, DIRECTLY OR INDIRECTLY, BY THE INSTALLATION, OPERATION, FAILURE TO OPERATE, MAINTENANCE, REMOVAL, PRESENCE, CONDITION, OCCASION OR USE OF EMERGENCY 911 SERVICE AND THE EQUIPMENT ASSOCIATED THEREWITH, OR BY ANY SERVICES FURNISHED BY FRONTIER INCLUDING, BUT NOT LIMITED TO, THE IDENTIFICATION OF THE TELEPHONE NUMBER, ADDRESS OR NAME ASSOCIATED WITH THE PHONE USED BY THE PARTY OR PARTIES ACCESSING EMERGENCY 911 SERVICE, AND WHICH ARISE OUT OF THE NEGLIGENCE OR OTHER WRONGFUL ACT OF FRONTIER, CUSTOMER, ITS END USERS, AGENCIES OR MUNICIPALITIES, OR THE EMPLOYEES OR AGENTS OF ANY ONE OF THEM. 3. Service Availability. A. Customer's Local Area Network ("LAN") environment must meet the requirements for speed, duplex, bandwidth, and appropriate "Managed Switch" support. LAN wiring must be Category 5 (CATS) or better. Any IP-PBX used by Customer must be validated by Frontier for service availability. Frontier's IP-VPN (without limitation) is not available at all locations, depending on the availability of appropriate enabling facilities and the condition of the facilities serving Customer's location. B. Customer is responsible for the correct setup and Customer is responsible for maintaining the quality and condition of its LAN, and thus, Frontier is not responsible for poor quality or outages of the Service that result from the quality or condition of Customer's LAN. Frontier reserves the right to reject any order for Services for any reason, including without limitation the inability or impracticality of providing such Service in a particular geographic area in which Frontier does not have sufficient presence, capacity, corporate infrastructure or network technical infrastructure to effectively support the requested Service. In addition, Customer understands that use of the Services is restricted in the following manner: (i) Al any given time, Customer may only place as many concurrent calls as it has purchased simultaneous calling capacity; (ii) Customer may modify Frontier installed design and/or configuration at their own risk; (iii) Customer may not utilize auto -dialers or any similar type of device in connection with Frontier SIP Trunking Service; and (iv) Customer may not use Frontier SIP Trunking Service for telemarketing, fax broadcasting, fax blasting, or continuous or extensive call forwarding CUSTOMER EXPRESSLY ACKNOWLEDGES THAT ANY VIOLATION OF THE FOREGOING RESTRICTIONS ON ITS USE OF THE SERVICE MAY RESULT IN THE IMMEDIATE TERMINATION OF THE SERVICE BY FRONTIER. 4. Obligations of Customer. A. Customer shall properly use any equipment or software, and all pass codes, personal identification numbers ("PINs") or other access capability obtained from Frontier or an affiliate or vendor of Frontier and shall surrender the equipment and software in good working order to Frontier at a place specified by Frontier and terminate all use of any access capability upon termination or expiration of this Schedule. Customer shall be responsible for all uses of PINs, pass codes or other access capability during or after the term hereof. B. Except as otherwise expressly stated herein, Customer is responsible for obtaining, installing, configuring and maintaining all equipment (including, but not limited to, SIP phones, and frewalls), software, wiring, power sources, telephone connections and/or communications services necessary for linlerconnection with Frontiers network or otherwise for use in conjunction with IP Service (Facilities). Customer is responsible for ensuring that such Facilities are compatible with Frontier's requirements and that they continue to be compatible with subsequent revision levels of Company -provided equipment, software and services. Frontier is not responsible for the availability, capacity and/or condition of any Facilities not provided by Frontier. Customer is responsible for operation and configuration of its computer(s) and LANANAN. If Customer connects any Facilities to IP Service that Customer reasonably should know may not be compatible with IP Service, Customer is solely responsible for any effects that arise from that connection and Customer waives any claims against Frontier relating to the performance of IF Service. Customer may purchase CPE necessary for use of the Services, as well as extended Maintenance in such CPE from Frontier under the terms of a separate Equipment Purchase, Installation and Maintenance agreement. C. Use of IF Service, like other network -based services, carries certain security risks to the systems and networks of Customer, Frontier and third parties including, but not limited to: misuse; unauthorized access; alterations; theft; destruction; corruption; and attacks ("Occurrences'). Customershall, at its own expense, take security measures including but not limited to use of firewalls, passwords, access restrictions, encryption, policies, and physical access restrictions ("Security Measures") to protect from Occurrences all Services, IP traffic, Facilities and other equipment, software, data and systems located on Customer's premises or otherwise in Customer's control and used in connection with IF Service, whether owned by Customer, Frontier, or Frontiers subcontractors. _04252022 v, 19 Page 3 of 8 SIP Trunking Schedule Frontier Business „'e, 1,10endai FRONTIER D. Customer agrees that Frontier is not liable, in contract, tort, or on any other basis, for any loss resulting from any Occurrences or use of Services, Facilities or other equipment, software, data and systems. Customer is responsible for all security measures, even if Customer uses a third party or Frontier to configure and implement them. E. Customer is responsible to ensure appropriate processes and protocols are in place for rate shaping to the amount of throughput ordered. Customer acknowledges that failure to comply with this responsibility may negatively impact Service performance. F. Customer shall permit Frontier to access the Router's Simple Network Management Protocol (SNMP) variables, and Customer shall, at Frontiers request, permit one or more Frontier network management systems to be the recipient of SNMP trap messages. Frontier will perform monitoring based on standard SNMP traps received from the Router. Frontier will work to isolate and determine the source and severity of the problems. If a problem is caused by either the network transport or the Router, Frontier and Customer will cooperate to restore the Router to operational condition. If the source of the problem is within the Router, Frontier will be responsible for the repair or replacement of the Router, in Frontier's sole discretion. If the source of the problem is not the Router, at Customer's request Frontier will cooperate with Customer to conduct testing and repair activities, subject to Frontier's standard technician rates. Frontier has no responsibility with respect to: (i) electrical work external to the Router, including but not limited to power or back-up power to or from the Router; (11) Router failures caused by factors not related to the Router or outside Frontier's control, including but not limited to failure of the Service Location or any of Customer's other network equipment or facilities to conform with Frontier's specifications; (111) use of the Router for any purpose other than as intended by the manufacturer; (iv) damage caused by anyone other than an Frontier employee or representative; (v) Router supplies, accessories, painting, or refurbishing; and (vi) any activity related to anything not furnished by Frontier, or use of Router which fails to conform to manufacturer or Frontier specifications. 5. Equipment or Software Not Provided by Frontier. A. Upon notice from Frontier that the facilities, services, equipment or software not provided or approved by Frontier is causing or is likely to cause hazard, interference or service obstruction, Customer shall immediately eliminate the likelihood of hazard, interference or service obstruction. If Customer requests Frontier to troubleshoot difficulties caused by the equipment or software not provided by Frontier, and Frontier agrees to do so, Customer shall pay Frontier at its then current rates. B. Frontier reserves the right to approve/reject the make, model and or software of the Customer -provided router and modem to be used as the gateway to the Frontier network. Frontier will identify for Customer makes or models of routers and modems with which it has experience, but no such information shall be deemed a recommendation, representation or warranty with respect to such equipment. C. Frontier and Customer will cooperatively establish the initial configuration for the Customer -provided router's interface with the Frontier network. D. Frontier may, from time to time, procure Services or facilities from an affiliate of Frontier, and in doing so, may act as an agent and not a principal for the affiliated entity with respect to the procurement and provision of the Service or facility. The Service or facility may be provided by an affiliate or vendor that is a common carrier, in which case the provision of the service or facility may be provided pursuant to terms and conditions stated in a fled federal or state tariff, which Customer agrees will govern the provision of the service or the facility. 5. Pre -installation cancellation fees, FOC Notice and Special Construction. (a) Pre -installation cancellation fees. Notwithstanding any provision of the FSA: (1) If Customer cancels any Service or Equipment prior to delivery of any Equipment or installation of the Service or Equipment, Customer shall pay a processing fee of $750 (the "Processing Fee') and (2) Frontier will provide Customer with notice (the "FOC Notice") of the project completion date (the "FOC Dale") as soon as possible in light of the requested services and customer's location. If Customer cancels more than ten (10) business days after the issuance of the FOC Notice, Customer shall pay the Processing Fee and the total costs and expenditures of Frontier in connection with establishing the Service and / or providing the Equipment prior to Frontier's receipt of notice of cancellation including but not limited to any construction and engineering costs and Equipment restocking fees. (b) Special Construction. All Services are subject to availability and Frontier Network limitations. The rates identified in this Schedule are estimated based on standard installation costs and Services may not be available at all service locations at the rates identified. If Frontier determines, in its reasonable discretion, that the costs of provisioning Service to any service location are materially higher than normal, Frontier will notify Customer of the additional costs associated with provision of the Services and request Customer's acceptance of such costs as a condition to proceeding ("Special Construction"). Upon notification that Special Construction is required, Customer will have ten (10) business days to notify Frontier of its acceptance. If the Customer does not agree to the Special Construction within ten (10) business days, the Customer shall be deemed to have cancelled the Service Schedule without further liability. If the Customer agrees to the Special Construction, Frontier and Customer will execute a replacement Schedule. Notwithstanding the foregoing, Customer shall not be required to pay construction, engineering and Processing Fees if the cancellation is within ten (10) business days of receipt of Frontier's notification of additional special construction and engineering costs pursuant to this Service Schedule. 7. SERVICE LEVEL AGREEMENT. The Ethernet Service Level Agreement for the described Ethernet Services is attached hereto and incorporated herein as Exhibit 1. 04252U2 v. 19 Page 4 of 8 0 FRONTIER Ethernet Virtual Private Line (EVPL) Dedicated Internet Access (DIA) Frontier Business Frontlet Confidential Such After Hours services may be subject to change, based upon Frontiers reasonable determination of Increases In actual costs to provide such After Hours services, determined In accordance with generally accepted commercial accounting practices, and consistent with After Hours service charges for projects comparable to the project outlined in this Schedule. S. Internet Acceptable Use Policy and Security. Customer shall comply, and shall cause all Service users to comply, with Frontiers Acceptable Use Policy ("AUP"), which Frontier may modify at any lime. The current ALP is available for review at the following address, subject to change: hno:/Nnvw.frontleccomloolicieslcommerNal auo/. Customer is responsible for maintaining awareness of the current ALP and adhering to the AUP as it may be amended from time to time. Failure to comply with the ALP Is grounds for immediate suspension or termination of Frontier Internet Service, notwithstanding any notice requirement provisions of the FSA. Customer is responsible for the security of Its own networks, equipment, hardware, software and software applications. Abuse that occurs as a result of Customers systems or account being compromised or as a result of activities of third parties permitted by Customer may result in suspension of Customers accounts or Internet access by Frontier. Customer will defend and indemnify Frontier and Its affiliates with respect to claims arising from Customers or third parties' usage of Frontier Internet access through Customer's hardware or software. S. Service Level Agreement. The Ethernet Service Level Agreement for the described Ethernet Services Is attached hereto and incorporated herein as Exhibit 1. This Schedule is not effective and pricing, dates and terms are subject to change unit signed by both parties. This Schedule and any of the provisions hereof may BW be modified in any manner except by mutual written agreement. The above rates do not Include any taxes, fees, regulatory fereslsurcharges or surcharges applicable to the Service. This Schedule, and all terms and conditions of the FSA, Is the entire agreement between the parties with respect to the Services described herein, and supersedes any and all prior or contemporaneous agreements. representations, statements, negotiations, and undertakings written or oral with respect to the subject matter hereof. Frontier Communications of America, Inc. CALHOUN Signature: nmotiry froohamF (Sep,21,202214:14 EDT) Signature: Printed Printed Name: Timothy Beauchamp Name: Title: Director, Enterprise Business Acquisition Title: Date: 09/21/2022 Date: Vet. 04252o22 EVPL-EIa TPatwadb Y. I Page 2 SIP Trunking Schedule Frontier Business F, Done, Co n r,d emial FRONTIER This Schedule is not effective and pricing, dates and terms are subject to change until signed by both parties, and may not be effective until approved by the FCC and/or applicable State Commission. This Schedule and any of the provisions hereof may not be modified in any manner except by mutual written agreement. The above rates do not include any taxes, fees or surcharges applicable to the Service. This Schedule, and all terms and conditions of the FSA, is the entire agreement between the parties with respect to the Services described herein, and supersedes any and all prior or contemporaneous agreements, representations, statements, negotiations, and undertakings written or oral with respect to the subject matter hereof. Frontier Communications of America, Inc. CALHOUN COUNTY CO SE Frontier's Signature., Customer's i nature, ,o Printed Name: Timothy Beauchamp Printed Name: 9 Title: Director, Enterprise Business Acquisition Title: �T` ��� �.y/,�—�J' � Date: Date: _04252022 v. 19 Page 5 of 8 FRONTIER EXHIBIT 1 ETHERNET SERVICE LEVEL AGREEMENT SIP Trunking Schedule Frontier Business This E-LINE Service Level Agreement ("SLA") applies to Ethernet Services ordered pursuant to an E-LINE Ethernet Virtual Private Line (EVPL), Ethernet Private Line (EPQ Schedule executed by and between CALHOUN COUNTY COURTHOUSE ("Customer) and Frontier Communications of America, Inc. ("Frontier'). The terns of this SLA apply exclusively to the Ethernet network elements directly within Frontiers management responsibility and control ("E- E-LINE Service'). 1. Operational Objectives (EVPL) A. Availability: Circuit Availability is the ability to exchange data packets with the nearest Frontier Internet Point of Presence or E-LINE Customer egress port (Z location) via the ingress port (A location). "Service Outage" occurs when packet transport is unavailable or when the output signal is outside the limits of this service guarantee. Availability is measured by the number of minutes during a calendar month that the E-LINE Service is operational, divided by the total minutes in that calendar month. Calculation is based on the stop -clock method beginning at the date and time of the Customer -initiated trouble ticket and ends when Frontier restores SLA- - Table IA:: EVPL Circuit Availl bility MRC Service Credit Availability 99.99% Below 99.99% Service Credit 30% MRC compliant circuit operation. Frontier's E-LINE Service Availability commitment and applicable Service credit are outlined in Table 1A, subject to Sections 3 and 4 below. B. Mean Time to Repair (MTTR): MTTR is a monthly calculation of the average tluration of time between Trouble Ticket initiation (in accordance with Section 213) and Frontiers reinstatement of the E-LINE Service to meet the Availability performance objective. The MTTR objectives, and credits applicable to a failure to meet such objectives, are outlined in Table 1 B, subject to Sections 3 and 4 below. 2. Performance Objectives Table 1B: EVPL Mean Time To Repair MRC Service Credit MTTR 4 Hours 25 °/n MRC above 4 hrs 50% MRC above 6 hrs. A. Packet Delivery: The Frame Loss Ratio (FLR) is a round trip measurement between ingress and egress ports (NIDs) at the Customers A and Z locations of packet delivery efficiency. FLR is the ratio of packets lost, round trip, vs. packets sent. Packet delivery statistics are collected for one calendar month. Credits will be based on Frontier's verification of packet delivery performance between NIDs at Customers Service Location. The packet delivery SLA applies to CIR-compliant packets on Ethernet LAN i WAN circuits only. This packet delivery guarantee does not apply to Ethernet Internet services. Frontier offers three FLR Quality of Service (QoS) levels for Ethernet Data Service. The applicable SLA is based on the QoS level, as outlined in Table 1C. Ethernet Gold and Platinum are premium level services designed to support commercial customers' mission -critical and real time applications. • Silver QoS service is Frontiers basic business class data service with improved performance across all standard performance parameters. Ethernet Silver SLA, termed Standard Data (SD) Service, is Frontiers upgraded replacement of Best Effort Ethernet designed specifically for the commercial customer. • Gold QoS service is a premium business data service featuring enhanced performance parameters with packet forwarding priority set to Priority Data. • Platinum QoS service carries Frontier's highest QoS performance parameters and includes voice grade packet forwarding priority set to Real Time. If packet delivery performance falls below the applicable packet delivery percentage, Customer will be entitled to a Service credit as outlined in Table 1C, subject to Sections 3 and 4 below. Table 1C: E-LINE. Frame Loss Ratio FLR Packet Loss QoS Level Frame Loss Ratio (FLR) Frame Loss Ratio (FLR) Frame Loss Ratio (FLR) MRC Service CITY STATE Inter -STATE Credit Silver [Standard Data Service]. 0.10% i 0.10% 0.10% 10% Gold [Priori Data Service] 0.01% 0.01% 0.025% 150/6 .Platinum Real Time Data Service] 0.01°/ 0.01% 0.025% 20% _04252022 v. 19 Page 6 of 8 SIP Trunking Schedule Frontier Business FRONTIER B. Latency: Latency, Frame Transfer Delay (FTD), is the maximum packet delivery time measured round-trip between Customer's A and Z locations at the Committed Information Rate (CIR). Latency is measured across On -Net Service paths between ingress and egress NIDs. Measurements are taken at one -hour intervals over a one month period. Credits are based on round-trip latency of 9511 percentile packet. Customer must meet the following criteria to qualify for Service credits on the E-LINE Latency SLA outlined in Table ID: • Access loops at Customer locations A and Z may be fiber or copper connectivity from the Serving Wire Center to the NIDs at each premise to qualify for the circuit SLA. • Each SLA guarantee is associated with ONLY one QoS Level. Frontier will honor the Service credit associated with the QoS level ordered for On -Net Services. Customer will be entitled to Service credits if the Service fails to meet applicable Performance Objective as outlined in Table 1 D subject to Sections 3 and 4 below Table tD: E-LINE Frame Transfer Delay(FTD): Latency QoS Level Round Trip Delay CITY Round Trip Delay STATE Round Trip Delay Inter -STATE MRC Service Credit Silver [Standard Data Service] 5 56 ms 5 100 ms 5 250 ms 10% Gold[Priority Data Service 5 26 ms 5 60 ms 5 160 ms 15% Platinum Real Time Data Service] 5 14 ms 5 36 ms 5 140 ms 20% C. Jitter: Packet Jitter, Frame Delay Variance (FDV), is the difference in end -to -end one way delay between selected packets in a data stream with any lost packets being ignored. Frontier guarantees average FDV (inter -packet differential) performance on E-LINE Service transmissions will meet performance parameters outlined in the table below. Credits are based on the monthly average Frame Delay Variance. Customer must meet the following criteria to qualify for Service credits on the E-LINE Jitter SLA: • Access loops at Customer Service Locations A and Z may be fiber or copper connectivity from the Serving Wire Center to the NIDs at each Service Location to qualify for Fiber Loop FDV SLA. • Each SLA guarantee is associated with ONLY one QoS Level. Frontier will honor the Service credit associated with the OoS level ordered for E-LINE Services, as outlined in the applicable Ethernet Service Schedule. Customer will be entitled to the credit as outlined in Table 1 E if E- LINE Services fail to meet applicable service level objectives, subject to Sections 3 and 4 below. Table 1 E: E-LINE Frame Delay Variance (FDV): Jitter QoS Level Average Jitter Per Site CITY Average Jitter Per Site STATE Average Jitter Per Site Inter -STATE MRC Service Credit Silver [Standard Data Service] n/s nls nts 10% Gold [Priori Data Service] 5 8 ms 5 40 ms 5 40 ms 15% Platinum [Real Time Data Service] 5 3 ms 5 8 ms 5 1 o ms 20% 3. Service Outage Reporting Procedure. A. Frontier will maintain a point -of -contact for Customer to report a Service Outage, twenty-four (24) hours a day, seven (7) days a week B. When E-LINE Service is suffering from a Service Outage, Customer must contact Frontier's commercial customer support center (also known as the "NOC')at 1-(888) 637-9620 to identify the Service Outage and initiate an investigation of the cause ("Trouble Ticket"). Responsibility for Trouble Ticket initiation rests solely with Customer. Once the Trouble Ticket has been opened, the appropriate Frontier departments will initiate diagnostic testing and isolation activities to determine the source. In the event of a Service Outage, Frontier and Customer will cooperate to restore the Service. If the cause of a Service Outage is a failure of Frontier's equipment or facilities, Frontier will be responsible for the repair. If the degradation is caused by a factor outside the control of Frontier, Frontierwill cooperate with Customer to conduct testing and repair activities at Customer's cost and at Frontier's standard technician rates. C. A Service Outage begins when a Trouble Ticket is initiated and ends when the affected E-LINE Service is Available: provided that if the Customer reports a problem with a Service but declines to allow Frontier access for testing and repair, the Service will be considered to be impaired, but will not be deemed a Service Outage subject to these terms. D. If Frontier dispatches a field technician to perform diagnostic troubleshooting and the failure was caused by the acts or omissions of Customer or its employees, affiliates, contractors, agents, representatives or invitees; then Customer will pay Frontier for all related time and material costs at _04252022, 19 Page 7 of 8 SIP Trunking Schedule Frontier Business I.,Hale[ c,,:,na,t,CJ" FRONTIER Frontier's standard rates. 4. Credit Request and Eligibility. A. In the event of a Service Outage, Customer may be entitled to a credit against the applicable On -Net Service MRC if (1) Customer initialed a Trouble Ticket; (ii) the Service Outage was caused by a failure of Frontier's equipment, facilities or personnel; (ill) the Service Outage warrants a credit based on the terns of Section 1; and (iv) Customer requests the credit within thirty (30) days of last day of the calendar month in which the Service Outage occurred. B. Credits do not apply to Service Outages caused, in whole or in part, by one or more of the following: (1) the acts or omissions of Customer or its employees, affiliates, contractors, agents, representatives or invitees; (ii) failure of power; (ill) the failure or malfunction of non -Frontier equipment or systems; (iv) circumstances or causes beyond the control of Frontier or its representatives; (v) a Planned Service Interruption; (A) Emergency Maintenance or (vii) interruptions resulting form Force Majeure events as defined in Customer's FSA. In addition, Customer will not be issued credits for a Service Outage during any period in which Frontier is not provided with access to the Service location or any Frontier network element, or while Customer is testing and/or verifying that the problem has been resolved. "Planned Service Interruption" means any Service Outage caused by scheduled maintenance, planned enhancements or upgrades to the Frontier network; provided that Frontier will endeavor to provide at least fve (5) business days' notice prior to any such activity if it will impact the Services provided to Customer. "Emergency Maintenance' means maintenance which, if not performed promptly, could result in a serious degradation or loss of service overthe Frontier network. C. Notwithstanding anything to the contrary, all credit allowances will be limited to maximum of 50% of the MRC for the impacted E-LINE Service, per month. For cascading failures, only the primary or causal failure is used in determining Service Outage and associated consequences. Only one service level component metric can be used for determining Service credits. In the event of the failure of the Service to meet multiple metrics in a one -month period, the highest Service credit will apply, not the sum of multiple Service credits. D. This SLA guarantees service performance of Frontier's Ethernet data services only. This SLA does not cover TDM services [DS1, NxDS1, or DS3 services] or other voice or data services provided by Frontier. This SLA does not apply to services provided over third party non -partner facilities, through a carrier hotel, or over Frontier facilities which terminate through a meet point circuit with a third party non -partner carrier. E. The final determination of whether Frontier has or has not met SLA metrics will be based on Frontier's methodology for assessment of compliant performance. Service Outage credits are calculated based on the duration of the Service Outage, regardless of whether such Service Outage is the result of failure of the Service to meet one or more performance metric. F. Credit allowances, if any, will be deducted from the charges payable by Customer hereunder and will be expressly indicated on a subsequent bill to Customer. Credits provided pursuant to this SLA shall be Customers sole remedy with regard to Service Outages. 5. Chronic Outage: An individual E-LINE Service qualifies for "Chronic Outage' status if such service fails to meet the Availability objectives, and one or more of the following: (a) a single Trouble Ticket extends for longer than 24 hours, (b) more than 3 Trouble Tickets extend for more than 8 hours, during a rolling 6 month period, or (c) 15 separate Trouble Tickets of any duration within a calendar month. If an E-LINE Service reaches Chronic Outage status, then Customer may terminate the affected E-LINE Service without penalty; provided that Customer must exercise such right within ten (10) days of the E-LINE Service reaching Chronic Outage status and provide a minimum of 15 days prior written notice to Frontier of the intent to exercise such termination right. _04252022 v. 19 Page 8 of 8 # 06 ' NOTICE O F MEETINC:i — 9/21/2.022 6. Consider and take necessary action to approve the Specifications and RFQ Packet for the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 and authorize the County Auditor to advertise for the RFQs. RFQs will be due before 2:00:00 PM on Wednesday, October 19, 2022. American Rescue Plan funds will be utilized for this project. (DEH) RESULT: APPROVED [UNANIMOUS]'; MOVER: David Hall Commissioner Pct'1 SECONDER: Vern Lyssy, Commissioner Pcf2 AYES: Judge Meyer, Commissioner Hall, Lyssy,!Behrens, IReese Page 3 of 11 David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for September 21st, 2022. Consider and take necessary action to approve the Specifications and RFQ Packet for the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 and authorize the County Auditor to advertise for the RFQs. RFQs will be due before 2:00:00 PM, Wednesday, October 19, 2022. American Rescue Plan funds will be utilized for this project. Sqerel , David E. Hall DEH/apt CALHOUN COUNTY, TEXAS REQUEST FOR QUALIFICATIONS ENGINEERING, ARCHITECTURAL AND SURVEYING SERVICES FOR THE COMBINED DISPATCH BUILDING RFQ 2022.08 SEALED RFQS ARE DUE BEFORE: 2:00:00 PM, WEDNESDAY, OCTOBER 19, 2022 AT THE OFFICE OF: Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 South Ann Street 3" Floor, Suite 301 Port Lavaca, Texas 77979 Public Opening of the RFQs will be conducted immediately after the closing of the 2:00:00 PM deadline, Wednesday, October 19, 2022 in the County Judge's office, Calhoun County Courthouse, 211 South Ann Street, V Floor, Suite 301, Port Lavaca, Texas 77979. The RFQs will be considered for award Wednesday, October 26, 2022 during Calhoun County Commissioners Court. Award information will be sent to all bidders that submitted a Request for Qualifications and, as time permits, will be posted on the County's website (www.calhouncotx.org) under Public Notices, Bid Notices and Results, Results, 2022. Page 1 of 48 CONTENTS • Request for Qualifications • Specifications • Scope of Work • General Conditions • Required Forms to be returned with the submitted RFQ o Affidavit o Conflict of Interest Questionnaire (Form CIQ) o Certification Regarding Debarment & Suspension and Other Responsibility Matters o Certification Regarding Lobbying o Disclosure of Lobbying Activities o House Bill 89 o Professional Liability Insurance —Must provide proof of current Professional Liability Insurance o Residence Certification o System for Award Management - Must provide a print out that includes the record date showing that the Company, and its Principals, have an active registration with the System for Award Management (www.SAM.gov) AND are not debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM). • Required Contract Provisions • Copy of Rating Sheet Page 2 of 48 REQUEST FOR QUALIFICATIONS Notice is hereby given that the Commissioners Court of Calhoun County, Texas will receive sealed Requests for Qualifications for: ENGINEERING, ARCHITECTURAL AND SURVEYING SERVICES FOR THE COMBINED DISPATCH BUILDING, RFQ 2022.08 Calhoun County is soliciting Requests for Qualifications for Engineering, Architect and Surveying services. These services are being solicited to assist Calhoun County in its project implementation of a Combined Dispatch Building. Scope of work will include, but is not limited to, initial engineering and design support, engineering and final design support, bid and award support, contract management and construction oversight and specialized services. Calhoun County will utilize funds from the American Rescue Plan and/or other local funding sources to support Critical Infrastructure activities in Calhoun County. Entities should have past experience with federally funded programs. Multiple contracts may be awarded as a result of this solicitation. Calhoun County will, in its sole discretion, determine the number of contracts awarded, and may decide not to award any contracts. The Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 can be downloaded from the County's website, www.calhouncotx.org under Public Notices, Bid Notices and Results, Bid Notices, 2022 or by contacting Peggy Hall, Calhoun County Assistant Auditor at 361-553-4610 or peggy.hall@calhouncotx.org. SEALED RFPS ARE DUE ON OR BEFORE 2:00:00 PM, WEDNESDAY, OCTOBER 19, 2022. Immediately after the closing of the 2:00:00 PM deadline, all RFQs will be publicly opened and acknowledged in the County Judge's office in the Calhoun County Courthouse at 211 South Ann Street, 3'' Floor, Suite 301, Port Lavaca, Texas. It is the responsibility of the submitting entity to ensure that the sealed Request for Qualifications is received in a timely manner. Calhoun County does not accept faxed or emailed RFQs. Calhoun County accepts no financial responsibility for any cost incurred by any entity in the course of responding to the RFQ. RFQs received after the deadline will not be considered for award, regardless of whether or not the delay was outside of the control of the submitting entity or individual. All Request for Qualifications, consisting of one (1) original and four (4) copies must be delivered to the office of the Calhoun County Judge before 2:00:00 PM, Wednesday, October 19, 2022 in a SEALED 9 x 12 or larger envelope, clearly marked on the outside: Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative will be the official clock that shall be used in determining the time the RFQ is received and the 2:00:00 PM deadline. Sealed RFQs may be hand delivered or mailed to: Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 South Ann Street 3'' Floor, Suite 301 Port Lavaca, TX 77979 Calhoun County Commissioners Court reserves the right to waive any formality or irregularity, reject any or all RFQs and to accept the RFQ or RFQs deemed to be in the best interest of Calhoun County. Calhoun County Page 3 of 48 reserves the right to negotiate with any and all entities or individuals submitting a Request for Qualifications, per the Texas Professional Services Procurement Act and the Uniform Grant and Contract Management Standards. Successful entity shall abide by all Local, State and Federal requirements within the RFQ. Calhoun County is an Affirmative Active/Equal Opportunity Employer. Calhoun County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in the employment or the provision of services. Section 3 Residents, Small Business Enterprises, Minority Business Enterprises, Women Business Enterprises, and Labor Surplus Area Firms are encouraged to submit Requests for Qualifications. Cindy Mueller County Auditor Calhoun County, Texas Page 4 of 48 Specifications Request for Qualifications Engineering, Architectural and Surveying Services For the Combined Dispatch Building RFQ 2022.08 Calhoun County is seeking to contract with a competent engineering, architectural and surveying entity that is registered to practice in the State of Texas, is in good standing as a professional engineer per the Texas Engineering Practice Act and has had experience in the following areas: • Construction, including but not limited to, new construction projects; • Federally -funded construction projects; and • Projects located in this general region of the state The following outlines this Request for Qualifications. Scope of Work/Services The engineering, architectural, and surveying contract will encompass all project -related engineering, architectural, and surveying services to Calhoun County under its Combined Dispatch Building project including, but not limited to, the following: Services • Initial Engineering and Design Support • Engineering and Final Design Support • Bid and Award Support • Contract Management and Construction Oversight • Specialized Services Specify actual tasks to be performed under each of these categories. II. Statement of Qualifications Qualifications shall be submitted in the following format. The detailed requirements in this Request for Qualifications are mandatory. Failure to adhere to the required format may be cause for rejection of the RFQ. To facilitate selection review, submissions should conform to the following: 1. Format: Submit responses on single sided paper. The RFQ may be bound or in a binder. 2. Report Content: a) Cover Letter: Briefly describe your ability and interest in conducting the described work. Letter must be signed by a person having authority to enter into a contract. b) Company Narrative: Include: (1) The year the company was founded, background and history (and parent company, if applicable) and, if incorporated, the state in which the company is incorporated and the date of incorporation. If the company is an out-of-state entity, a Certificate of Authority to do business in Texas from the Secretary of State must be provided as an attachment; (2) The company ownership structure (corporation, partnership, LLC, or sole proprietor); (3) Location of company headquarters and location of the primary office(s) that will service any contract resulting from this RFQ in addition to a listing of offices intended to support the contract with city, state, telephone number and email contact address. Page 5 of 48 c) Staffing Profile: Name, address, telephone number and email address of the entity's point of contact for a possible contract resulting from this RFQ. Entity should provide brief resumes for key staff responsible for the performance of any contract resulting from this RFQ. The staff profile(s) should describe personnel by discipline and should identify the Texas Professional Engineer(s) who will sign/seal engineering work products. d) Entity Justification: Complete information regarding how the entity is qualified to provide the services described in the Scope of Services, focusing on the company's key strengths and advantage to Calhoun County to select the entity. Please note experience with State and Federally funded projects and include a list of past local government clients. e) Major Sub -consultant Information: Entity must identify any sub -consultants with whom the entity intends to utilize in performing work under any work order resulting from this RFQ. Entity must indicate whether or not the entity holds any financial interest in any sub -consultant activities. f) List of References: Provide three (3) references familiar with your quality of work as it pertains to the referenced scope of work. g) Scope of Work/Services: Specify actual tasks to be performed under the services listed, but not limited to: Section I. Scope of Work and page 8-11 the Scope of Work. h) Other Supporting Data: Include the makeup of the project team, including sub - consultants (if applicable) and any other information you feel will be relevant to the selection of your company. i) Required Forms: All respondents must complete the following forms and return with the submission of the RFQ. o Affidavit o Conflict of Interest Questionnaire (Form CIQ) o Certification Regarding Debarment & Suspension and Other Responsibility Matters o Certification Regarding Lobbying o Disclosure of Lobbying Activities o House Bill 89 o Professional Liability Insurance— Must provide proof of current Professional Liability Insurance o Residence Certification o System for Award Management— Must provide a print out that includes the record date showing that the Company, and its Principals, have an active registration with the System for Award Management (www.SAM.gov) AND are not debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM). Additional data, exhibits, statements and information which respondent feels will help ensure total understanding and evaluation of their RFQ may be submitted. Intentionally Left Blank Page 6 of 48 III. Evaluation Criteria The RFQs received will be evaluated and ranked according to the following criteria: Criteria Experience Work Performance Capacity to Perform Total Maximum Points 60 25 15 100 Respondent's qualifications will be evaluated and the most qualified Respondent will be selected, subject to negotiation of fair and reasonable compensation. IV. Small and minority businesses, women's business enterprises, and labor surplus area firms Section 3 residents, small and minority businesses, women's business enterprises, and labor surplus area firms are encouraged to participate in this RFQ. If the awarded entity is a prime contractor and may use sub -contractors, the following affirmative steps are required of the prime contractor. 1. Placing qualified small and minority businesses, and women's business enterprises on solicitation lists; 2. Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; 3. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; 4. Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; 5. Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce V. Deadline for Submission The complete submittal, consisting of one (1) bound original and four (4) bound copies, of your Request for Qualifications and all required forms must be received in the County Judge's office before 2:00:00 PM, Wednesday, October 19, 2022. It is the responsibility of the submitting entity to ensure that the Request for Qualifications is received in a timely manner. Calhoun County does not accept faxed or emailed RFQs. RFQs received after the deadline will not be considered for award, regardless of whether or not the delay was outside the control of the submitting entity. Calhoun County accepts no financial responsibility for any cost incurred by any entity in the course of responding to the RFQ. The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative will be the official clock that shall be used in determining the time the RFQ is received and the 2:00:00 PM deadline. Sealed RFQs may be mailed or hand delivered to: Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 South Ann Street 3rd Floor, Suite 301 Port Lavaca, TX 77979 The RFQ must be delivered in a sealed 9 x 12 or larger envelope clearly marked on the outside: Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08 Page 7 of 48 �fde7l:4TIVIIIIIINCI The Contractor shall provide the following scope of services: SCOPE OF SERVICES REQUESTED The engineering, architectural and surveying contract will encompass all project -related engineering, architectural and surveying services to Calhoun County under its Combined Dispatch Building project, including but not limited to the following: Services • Initial Engineering and Design Support • Engineering and Final Design Support • Bid and Award Support • Contract Management and Construction Oversight • Specialized Services DESCRIPTION OF SERVICES AND SPECIAL CONDITIONS Respondents will be required to show the ability to provide all the Engineering services described below. Respondent shall then provide a detailed description of how they meet the requirement, describing their knowledge and experience, as well as providing discrete examples of previous work where applicable. General Requirements • Coordinate, as necessary, between Calhoun County and its service providers (i.e., Engineer, Environmental, Contracted Construction Company, and Grant Administrator, etc.) regarding project design services; • Provide monthly project status updates; • Funding release will be based on deliverables identified in the contract Initial Engineering and Design Support Respondents will be required to show the ability to provide all the Engineering services described below: • Assist with the development of grant applications, as necessary; • Provide all project information necessary to ensure timely execution of the environmental review; • Provide preliminary engineering, investigations, and drawings sufficient to achieve the preliminary design milestone, including at a minimum: a. Cross sections/elevations b. Project layout/staging areas c. General notes d. Special notes e. Design details f. Specifications g. Utility relocation designs h. Construction limits, including environmentally sensitive areas that should be avoided during construction L Required permits j. Quantities Page 8 of 48 k. Estimate of construction costs to within +/- 25% I. Schedules for design, permitting, acquisition and construction • Design surveying, topographic and utility mapping; • Perform subsurface explorations for project sites, as necessary; • Prepare horizontal alignments/layouts for all proposed project alternatives necessary to fully describe the project scope, anticipated limitations, and potential project impacts; • Recommend value engineering options (alternative design, construction methods, procurement, etc.) that may improve efficiency, expedite the schedule, or reduce project costs for Calhoun County; • Identify, acquire and submit all necessary permits and approvals required for design approval and construction; • Submit all necessary deliverables to the appropriate entity for review and comment. Adjust project and/or design to satisfactorily address any comments, as necessary; • Prepare plans and profiles, including vertical design information for the selected alternative; • Identify and address potential obstacles to project implementation (i.e., pipelines, easements, permitting, environmental, etc.) prior to moving forward with the final design; • Support Calhoun County with acquisition or property/servitudes/right-of- way documentation as required by the City to facilitate the project, preparing right of way surveys and/or property boundary maps and legal descriptions of parcels to be acquired Engineering and Final Design Support Respondents will be required to show the ability to provide all the Engineering services described below as they relate to final design support: • Prepare plans and profiles, including necessary design information for the selected alternative sufficient to achieve all detailed design milestones. Examples include, but are not limited to: a. Cross sections/elevations b. Project layout/staging areas c. General notes d. Special notes e. Design details f. Specifications g. Utility relocation designs h. Construction limits, including environmentally sensitive areas that should be avoided during construction i. Required permits j. Quantities k. Estimate of construction costs to within +/- 20% I. Schedules for design, permitting, acquisition and construction • Provide information to appropriate individuals for the development of environmental fund release reports and floodplain maps; • Identify, acquire and submit all necessary permits and approvals required for design approval and construction; • Provide hard copy, if necessary, reproducible plan drawings and bid documents, in addition to electronic copies to Calhoun County, upon design completion, and as requested during design. Page 9 of 48 Electronic copies should be in the native format (AutoCAD DWG) along with PDF packages and should contain all corresponding references, databases, or files associated with the completed design documents; • Assist Calhoun County and any service provider related to the project with all necessary documentation to ensure compliance with all Program requirements and regulations Bid and Award Support Respondents will be required to show the ability to provide all the Engineering services described below as they relate to bid and award support: a. Submit appropriate items and support Calhoun County in the development of complete bid package; b. Prepare and assist Calhoun County in the advertisements for bid solicitation; c. Support development and issuance of bid -related documents necessary to complete bid process (e.g., bid proposal form, bid addenda and supporting documentation); d. Attend and support Calhoun County at pre -bid conference and bid opening; e. Support Calhoun County with ongoing communication during bid process; f. Support Calhoun County to complete bid tabulation and evaluation of responses and provide recommendation for award; g. Support Calhoun County to negotiate and finalize contract documents, including issuance of the Notice to Proceed, in accordance with program and Calhoun County requirements; h. Support Calhoun County in the conducting of a preconstruction conference Contract Management and Construction Oversight Respondents will be required to show the ability to provide all the Engineering services described below as they relate to contract management and construction oversight: a. Ensure delivery of Calhoun County project in accordance with contract; b. Provide ongoing Construction Oversight Reports detailing the status of construction for Calhoun County project; c. Review all service provider submittals to ensure compliance with construction contract documents and provide recommendations to Calhoun County; d. Provide periodic and final inspections and tests reports, as required for the project; e. Provide on -site supervision and oversight of construction activities at a minimum on a bi- weekly basis or as directed by the GLO or Calhoun County; f. Review Construction Change Orders and provide recommendation to Calhoun County as to appropriate action; g. Review invoice/draw requests and provide recommendation to Calhoun County as to appropriate action, in compliance with the construction contract documents; h. Obtain independent cost estimates for validation purposes, as required; i. Review and respond to requests for information/clarification; j. Support Calhoun County with issue identification and claims resolutions; k. Develop a final "as built' report of quantities, drawings, and specifications; I. Issue to the Calhoun County, for execution, a Certificate of Construction Completion within 30 days of final inspection approval; m. Deliver "as -built' drawings to the Calhoun County within 30 days of project completion; Page 10 of 48 n. Host and/or attend project coordination meetings in person, by phone, or by video conference, which may or may not fall during normal business hours; o. Perform other contract management and construction oversight duties as required to ensure success of the Calhoun County project; p. Provide necessary certifications to regulatory agencies of project completion and compliance (ex. TCEQ); q. Submit all final invoices within 60 days after contract or work order expiration Specialized Services Respondents will be required to show the ability to provide all the Engineering services described below as they relate to specialized services: a. Provide Geotechnical Investigations as may be required for a project; b. Provide Detailed Surveying as may be required for a project; c. Provide Site Specific Testing as may be required for a project; d. Provide Archeological Studies as may be required for a project; e. Provide Planning Studies as may be required for a project; f. Provide Feasibility Studies as may be required for a project; g. Provide Legal documentation for property and/or easements to be acquired (i.e., field notes, etc.); h. Provide Phase I and Phase II environmental site assessments as requested Page 11 of 48 CALHOUN COUNTY, TEXAS GENERAL CONDITIONS General Conditions apply to all advertised Invitations to Bid (hereinafter called Bid), Request for Proposals (hereinafter called RFP), Request for Qualifications (hereinafter called RFQ), Contracts/Agreements/Leases (hereinafter called Contract); however these may be superseded in whole or in part by the scope, special requirements, specifications or special sections of Texas Government Code and/or Texas Local Government Code. Governing Law: Bidder/Vendor is advised that the Bid, RFP, RFQ and/or Contract shall be fully governed by the laws of the State of Texas and that Calhoun County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney concerning any portion of the Bid, RFP, RFQ and/or Contract. All parties agree that the venue for any litigation arising from this Bid, RFP, RFQ and/or Contract shall be held in Port Lavaca, Calhoun County, Texas. Completion of Bid. RFP. RFQ. and/or Contract Forms: Once the Bid, RFP, RFQ, and/or Contract is released for bidding, Calhoun County will not answer any questions except through an addendum that has been approved by Calhoun County Commissioners Court or at a mandatory pre -bid meeting. Complete, sign, and return to the Calhoun County Judge's Office the required number of Bid forms, RFP forms, RFQ forms, and/or Contracts, and any other required information by the day and time the Bid, RFP, RFQ and/or Contract is due. The Bid, RFP, RFQ and/or Contract must be signed and dated by an officer, employee or agent who is duly authorized to execute this Bid, RFP, RFQ, and/or Contract, and affirms that this company, corporation, firm, partnership or individual has not prepared this Bid, RFP, RFQ and/or Contract in collusion with any other bidder/vendor or any official or employee of Calhoun County, and that the contents of this Bid, RFP, RFC, and/or Contract as to prices, terms or conditions of said Bid, RFP, RFQ and/or Contract have not been communicated by the individual signing nor by any employee or agent to any other person engaged in this type of business or to any official or employee of Calhoun County prior to the official opening of this Bid, RFP, RFQ and/or Contract. The use of liquid paper or white out is not acceptable and may result in the disqualification of the bidders/vendor's Bid, RFP, RFQ and/or Contract. If an error is made, the bidder/vendor must draw a line through the error and initial each change. All responses typed or handwritten in ink must be clear and legible. Submission of Sealed Bid, RFP. RFQ, and/or Contract: All Bids, RFPs, RFQs, and/or Contracts must be delivered to the County Judge's Office in a SEALED envelope. When submitting a SEALED Bid, RFP, RFQ and/or Contract the envelope must be taped and/or glued closed in order for it to be accepted as a SEALED Bid, RFP, RFQ and/or Contract. The bidder/vendor must submit the original and required number of copies of their completed Bid, RFP, RFQ and/or Contract and any additional required information/forms in a SEALED envelope to the Calhoun County Judge's Office, Calhoun County Courthouse, 211 South Ann Street, 3' Floor, Suite 301, Port Lavaca, Texas. The Bid, RFP, RFQ and/or Contract will specify the date and time due. Page 12 of 48 The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative is the official clock that will be used in determining the time the Bid, RFP, RFO, and/or Contract is received and the time deadline that the Bid, RFP, RFC, and/or Contract will be opened. A late delivery with an early postmark or delivery of the Bid, RFP, RFQ and/or Contract to the wrong office will not suffice. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be considered for award, regardless of whether or not the delay was outside of the control of the submitting bidder/vendor. The door to the County Judge's office will be closed once the due date and time has been reached and no other bids will be accepted. Calhoun County will not be responsible for the delivery of your Bid, RFP, RFQ and/or Contract to the office of the Calhoun County Judge. Calhoun County is not responsible for late deliveries due to postal mail or other mail delivery services delays. Calhoun County is not responsible for the delivery of the Bid, RFP, RFQ, and/or Contract to the wrong office. Calhoun County does not accept faxed or emailed Bids, RFPs, RFQs, and/or Contracts. If the bidder/vendor would like to confirm the delivery of their Bid, RFP, RFQ, and/or Contract, the bidder/vendor may call the Calhoun County Judge's office at 361-553-4600. Late Bids, RFPs, RFQs, and/or Contracts will not be accepted. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be opened and shall be considered void and unacceptable. Bids, RFPs, RFQs, and/or Contracts must be submitted in a SEALED 9 x 12 or larger envelope, addressed as follows: Richard H. Meyer, County Judge, Calhoun County Courthouse, 211 S. Ann St., Suite 301, Port Lavaca, TX 77979. The outside of the SEALED envelope must be clearly marked: SEALED BID (RFP, RFQ, or Contract) and the name of the Bid, RFP, RFQ or Contract. If the Bid, RFP, RFQ, and/or Contract is sent by UPS, FedEx or other delivery service, the outside of this envelope must be clearly marked: SEALED Bid (RFP, RFQ or Contract) and the name of the Bid, RFP, RFQ, or Contract. Withdrawal of Bid, RFP. RFQ, and/or Contract: A bidder/vendor may withdraw their Bid, RFP, RFQ and/or Contract before Calhoun County's acceptance of the Bid, RFP, RFQ and/or Contract without prejudice to the bidder/vendor, by submitting a written request for its withdrawal to the Calhoun County Judge and mail or hand deliver to the address the Bid, RFP, RFQ, and/or Contract was submitted to. A Bid, RFP, RFQ and/or Contract that was opened are not subject to amendment, alteration, or change for the purpose of correcting an error in the Bid, RFP, RFQ, and/or Contract price. Bids, RFPs, RFQs, and/or Contracts containing an error may be offered "as is" or withdrawn by the bidder/vendor in accordance with applicable State Laws. Opening and Award of Bid, RFP, RFQ, and/or Contract: Bidders/vendors are invited to be present at the opening and awarding of the Bid, RFP, RFQ and/or Contract. Governing Forms: In the event of any conflict between the terms and provisions of these conditions, the Bid, RFP or RFQ specifications or contract, if applicable, shall govern. In the event of any conflict of interpretation of any part of this overall document, Calhoun County's interpretation shall govern. Addendums: When specifications are revised, the Calhoun County Auditor's Office will send each bidder/vendor that received a Bid, RFP, RFQ, and/or Contract packet the addendum once it has been approved by Calhoun County Commissioners Court. No addendum can be sent out until Calhoun County Commissioners Court has approved the addendum or approved the addendum to be sent out by the Engineer with the approval from the County Commissioner or County Department in charge of the project. Page 13 of 48 Indemnification/Hold Harmless: The successful bidder/vendor shall defend, indemnify and hold Calhoun County and its officials, agents, and employees harmless from all suits, actions, orfor personal injury, death and/or property damage arisingfrom any cause whatsoever, resulting directly or indirectly from bidder's/vendor's performance. Bidder/vendor shall procure and maintain, with respect to the subject matter of this Bid, RFP, RFQ, and/or Contract, appropriate insurance coverage including, as a minimum, general liability and property damage, workers' compensation, employer's liability and auto insurance with adequate limits to cover bidder's/vendor's liability as may arise directly or indirectly from work performed under terms of this Bid, RFP, RFQ, and/or Contract. Certification of such coverage shall name, by policy endorsement, Calhoun County as an additional insured and be provided to Calhoun County upon request. Waiver of Subrogation: Bidder/vendor and bidders/vendors insurance carrier shall waive any and all rights whatsoever with regard to subrogation against Calhoun County and its respective officials, employees, and insurers as an indirect party to any suit arising out of personal or property damages resulting from bidders/vendors performance under this Bid, RFP, RFC, and/or Contract. Insurers and all policies of insurance provided shall contain a provision and/or endorsement stating that the insurance carriers and underwriters waive all rights of subrogation in favor of Calhoun County and its respective officials, employees, and insurers. Bonds: If the Bid, or RFP, requires submission of bid or proposal guarantee and performance bond, there will be a separate page explaining those requirements. Bids or RFPs submitted without the required bid bond or cashiers checks are not acceptable. Taxes: Calhoun County is exempt from all sales tax (state, city and county sales tax) and federal excise taxes under Section 151.309 of the Texas Tax Code. Tax exempt forms will be furnished upon request to the bidder/vendor. Tax exempt forms can be obtained from the Calhoun County Auditor's Office. Bidder/vendor is to issue its Texas Resale Certificate to vendors and subcontractors for such items qualifying for this exemption, and further, bidder/vendor should state these items at cost. Pricing: Prices for all products/goods, services, and/or contracts shall be firm for the duration of the Bid, RFP, and/or Contract and shall be stated on the Bid, RFP, and/or Contract form. Prices shall be all inclusive. All prices must be written in ink or typewritten and must be legible. Pricing on all transportation, freight, and other charges are to be prepaid by the bidder/vendor and included in the Bid, RFP, and/or Contract prices. If there are any additional charges of any kind, other than those mentioned above, specified or unspecified, bidder/vendor must indicate the items required and their costs or forfeit the right to payment for such items. Additional charges added to the Bid, RFP, and/or Contract prices may void the Bid, RFP, and/or Contract. Where unit pricing and extended pricing differ, unit pricing prevails. Inspections: Calhoun County reserves the right to inspect any products/goods or service location for compliance with specifications and requirements and needs of the using department before accepting them. When applicable, Calhoun County reserves the right to enter upon any County leased premises at any time to inspect said premises. Page 14 of 48 Testing: Calhoun County reserves the right to test equipment, supplies, materials, and products/goods bid, proposed, and/or agreed upon for quality, compliance with specifications and ability to meet the needs of the user. Should the equipment, supplies, materials, products/goods and/or services fail to meet requirements and/or be unavailable for evaluation, the Bid, RFP, and/or Contract is subject to rejection. Material Safety Data Sheets: Under the "Hazardous Communications Act", commonly known as the "Texas Right To Know Act", a bidder/vendor must provide to Calhoun County with each delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the bidder/vendor to furnish this documentation will be cause to reject any Bid, RFP, and/or Contract applying thereto. Awards: Calhoun County reserves the right to award this Bid, RFP, RFQ and/or Contract on the basis of lowest and/or best Bid, RFP, RFQ and/or Contract that met specifications in accordance with the laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one bidder/vendor, to reject any or all Bids, RFPs, RFQs, and/or Contracts and to be the sole judge in determining which Bid, RFP, RFQ and/or Contract will be most advantageous to Calhoun County. Calhoun County will evaluate and may award a Bid, RFP, RFQ, and/or Contract based on lowest and/or best Bid, RFP, RFQ and/or Contract meeting specifications. "Lowest and/or best Bid, RFP, RFQ, and/or Contract' means a bid or offer providing the best value considering associated direct and indirect costs, including transport, maintenance, reliability, life cycle, warranties, the county's past experience with the bidder/vendor and customer service after a sale. Calhoun County reserves the right to accept and/or reject any/all of the options Bid, any/all of the RFPs, any/all of the RFQs, and/or any/all of the Contracts as it deems to be in the best interest of the County. An award is final only upon formal execution by Calhoun County Commissioners Court. Per Local Government Code, Sec. 262.027, Calhoun County reserves the right to reject all Bids, RFPs, RFQs, and/or Contracts and to go out for new Bids, RFPs, RFQs, and/or Contracts. In the event of tie Bids, RFPs, RFQs, and/or Contracts, the winning Bid, RFP, RFQ and/or Contract is determined per the Texas Local Governmental Code 262.027(b). Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit Bids, RFPs, RFQs, and/or Contracts. Assignment: The successful bidder/vendor may not assign, sell, sublease or otherwise transfer the Bid, RFP, RFQ, and/or Contract without first obtaining the written approval of Calhoun County Commissioners Court. A change in ownership or management shall cancel the Bid, RFP, RFC, and/or Contract unless a mutual agreement is reached with the new owner or manager to continue the Bid, RFP, RFQ and/or Contract under the awarded provisions and approved by Calhoun County Commissioners Court. Term of the Bid, RFP, RFQ, and/or Contract: If the Bid, RFP, RFQ and/or Contract is intended to cover a specific time period, said time will be given in the specifications, instructions, and/or contracts. Page 15 of 48 Obligation of the Bid, RFP, RFQ, and/or Contract: Bids, RFPs, RFQs, and/or Contracts are awarded only upon formal execution by Calhoun County Commissioners Court. If a contract is required, the Calhoun County Judge or other person authorized by Calhoun County Commissioners Court must sign the contract before it becomes binding on Calhoun County. No person is authorized to sign contracts until authorized by Calhoun County Commissioners Court. Calhoun County is not responsible for any contract signed without Commissioners Court approval. Delivery: All items shall be shipped F.O.B. inside (or site location) delivery unless otherwise stated in the specifications. Default in promised delivery (without accepted reasons) or failure to meet specifications, authorizes Calhoun County to purchase supplies from the next lowest bidder/vendor that met specifications. Resections: Articles not in accordance with samples and specifications must be removed by the bidder/vendor at the bidder's/vendors expense. All disputes concerning quality of equipment, supplies, materials, products/goods, and/or services delivered under this Bid, RFP, RFQ, and/or contract will be determined by Calhoun County Commissioners Court or their designated representative. Termination: Calhoun County reserves the right to terminate the Bid, RFP, RFQ and/or Contract for default if the bidder/vendor breaches any of the terms therein, including warranties of bidder/vendor or if the bidder/vendor becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper products/goods and/or services within the proper amount of time, and/or to properly perform any and all services required to Calhoun County's satisfaction and/or to meet all other obligations and requirements. Bids, RFPs, RFQs, and/or Contracts may be terminated without cause upon thirty (30) days written notice to either party unless otherwise specified. The bidder/vendor or Calhoun County must state therein the reasons for such cancellation. Calhoun County reserves the right to award cancelled Bid, RFP, RFQ and/or Contract to the next lowest and best bidder/vendor that met specifications and is deemed to be in the best interest of Calhoun County. Delinquent Property Taxes: Calhoun County reserves the right to reject any Bid, RFP, RFQ, and/or Contract submitted by a bidder/vendor owing delinquent property taxes to Calhoun County, Texas. If the bidder/vendor subsequently becomes delinquent in the payment of Calhoun County taxes this may be grounds for cancellation of the Bid, RFP, RFQ, and/or Contract. Despite anything to the contrary, if the bidder/vendor is delinquent in payment of Calhoun County taxes at the time of invoicing, bidder/vendor assigns any payments to be made under this Bid, RFP, RFQ, and/or Contract to the Calhoun County Tax Assessor Collector for the payment of delinquent taxes. Certificate of Interested Parties — Form 1295 Section 2252.908 was added to the Government Code by the 84th Texas Legislature through adoption of House Bill 1295. Senate Bill 255 adopted by the 85" Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Page 16 of 48 Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 ofthe Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal: https://www.ethics.state.tx.us/whatsnew/elf—info—forml295.htm. The law states that a County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) has been completed and provided to the County at the time the contract is considered for action by Commissioners Court. The term "business entity' includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract (Bids, RFPs, and/or RFQs also require Form 1295). The law does not apply to a Bid, RFP, RFQ, and/or Contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within thirty (30) days of approving a contract, and/or awarding a Bid, RFP, RFQ, and/or Contract with a business entity. Governmental transparency is the objective of the law. A business entity must generate Form 1295 online. A business entity must use the application at the Texas Ethics Commission websiteto enterthe required information on Form 1295 and print a copy of the completed form, which will include a certification of filing that will contain a unique certification number and date filed in the box marked "Office Use Only" located at the top right hand corner of the form. An authorized agent of the business entity must sign and complete the bottom portion of the printed copy of the form affirming under the penalty of perjury that the completed form is true and correct. Calhoun County Commissioners Court will not consider for action any Contract with a business entity unless it is accompanied by a completed and signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. A business entity will generate Form 1295 online after notification of award and submit with their signed contract. (See Attachment A to General Conditions) No later than thirty (30) days after Calhoun County Commissioners Court approves a contract with a business entity, the Calhoun County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. The Texas Ethics Commission will post the completed Form 1295 to its website within seven (7) business days after Calhoun County acknowledges receipt of the form. Debarment: Bidder/vendor certifies that at the time of submission of its (their) Bid, RFP, RFQ, and/or Contract, the bidder/vendor, as well as the bidder's/vendor's principals, are not on the federal government's list of suspended, ineligible or debarred bidders/vendors and that the bidder/vendor and its (their) principals have not been placed on this list between the time of the Bid, RFP, RFQ and/or Contract submission and the time of execution of the Bid, RFP, RFQ and/or Contract. A print out of the search results that includes the record date showing that the Company, and its Principals, if any, have an active registration with the System for Award Management (www.SAM.gov) AND are not Page 17 of 48 debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM) must be included with the bidders/vendor's Bid, RFP, RFC, and/or Contract. If bidder/vendor or its (their) principals are placed on this list during the term of the Bid, RFP, RFQ, and/or Contract, the bidder/vendor shall notify the Calhoun County Auditor. False certification or failure to notify may result in termination of the Bid, RFP, RFC, and/or Contract for default. Invoices and Payments: All invoices are subject to approval by the Calhoun County Auditor's Office. Invoices shall be billed to Calhoun County to the attention of the County Department that the invoice pertains to and, if applicable, have all necessary backup information needed. Invoices shall be itemized (detailed) and free of sales tax (state, city and county sales tax) and federal excise taxes, if applicable. Invoices that are not billed to Calhoun County to the attention of the County Department that the invoice pertains to, not itemized (detailed) and/orfree of sales tax (state, city and county sales tax) and federal excise taxes, if applicable, maybe returned to the bidder/vendor for corrections. Calhoun County will not incur any fees and/or charges for this request and/or delay in payment of the invoice(s) that was originally submitted incorrectly. Approval of payment of all invoices will be made once the purchase order and invoice(s) are properly and timely submitted to the Calhoun County Treasurer's Office by the appropriate County department. Each County department is responsible for submitting their purchase orders for payment to the Calhoun County Treasurer's Office by the deadline time and date set forth by the Treasurer's office. No payment can be made or mailed out until approved by Calhoun County Commissioners Court. Purchase order due dates/times and Commissioners Court dates/times are subject to change. Calhoun County's obligation is payable only and solely from funds available forthe purpose of this purchase. Lack of funds shall render the order null and void to the extent funds are not available and any delivered but unpaid goods will be returned to the seller by the county. Gratuities: Calhoun County may, by written notice to the bidder/vendor, cancel any order and/or service without liability, if it is determined by Calhoun County that gratuities, in the form of entertainment, gifts, or otherwise were offered or given by the bidder/vendor, or any agent or representative of the bidder/vendor to any official, employee, or agent of Calhoun County with a view toward securing a Bid, RFP, RFC, Contract, order, and/or service. In the event a Bid, RFP, RFQ, Contract, order, and/or service is canceled by Calhoun County pursuant to this provision, the County shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by bidder/vendor in providing such gratuities. Warranty Product: Bidder/vendor warrants that products/goods sold to and/or services provided to Calhoun County shall conform to the highest commercial and/or professional standards in the industry and laws established by the U.S. Department of Labor, U.S. Department of Homeland Security, Occupational Safety and Health Administration and OSHA Act of 1970. In the event products/goods sold and/or services provided do not conform to OSHA Standards, where applicable, Calhoun County shall return the product/item for correction or replacement at the bidder's/vendor's expense. In the event that services do not conform to OSHA Standards, Calhoun County Page 18 of 48 may immediately stop the services and seek reimbursement for said services at the bidder's/vendor's expense. In the event the bidder/vendor fails to make the appropriate correction within a reasonable time, correction made by Calhoun County shall be at the bidder's/vendor's expense. Bidder/vendor shall not limit or exclude any implied warranties and any attempt to do so shall render this Bid, RFP, RFQ, and/or Contract voidable at the option of Calhoun County. Bidder/vendor warrants that the products/goods and/or services furnished and/or performed will conform to the specifications, scope of work, general conditions, drawings, and/or descriptions listed in the Bid, RFP, RFQ, and/or Contract and to the sample(s) furnished by bidder/vendor, if any. In the event of a conflict between the specifications, scope of work, general conditions, drawings, and/or descriptions, the specifications shall govern. All products/goods must be new, in first class condition, unless otherwise specified. The design, strength and quality of materials must conform to the highest standards of manufacturing practice. Products/goods, and/or services supplied and/or performed under this Bid, RFP, RFQ, and/or Contract shall be subject to Calhoun County's approval. Successful bidder/vendor shall warrant that all products/goods and/or services shall conform to the proposed specifications and/or all warranties as stated in the Uniform Commercial Code and be free from all defects in material, workmanship and title. Any products/goods and are services found defective or not meeting specifications shall be picked up and promptly replaced or corrected to Calhoun County's satisfaction by the successful bidder/vendor at no expense to Calhoun County. Cancellation: Calhoun County shall havethe right to cancel fordefault all orany part of the undelivered portion of an order and/or services if bidder/vendor breaches any of the terms hereof including warranties of bidder/vendor, or if the bidder/vendor becomes insolvent or files for protection under the bankruptcy laws. Such rights of cancellation are in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Calhoun County shall not incur any fees and/or charges related to the cancellation. The bidder/vendor shall be responsible for any fees and/or charges that are related to the cancellation. Force Majeure: Force Majeure means a delay encountered by a party in the performance of its obligations under this Bid, RFP, RFQ, and/or Contract, which is caused by an event beyond the reasonable control of that party. Without limiting the generality of the foregoing, "Force Majeure" shall include but not be restricted to the following types of events: acts of God or public enemy; acts of governmental or regulatory authorities; fires, floods, epidemics or serious accidents; unusually severe weather conditions; strikes, lockouts, or other labor disputes; and defaults by subcontractors. In the event of a Force Majeure, the affected party shall not be deemed to have violated its obligations under this Bid, RFP, RFQ, and/or Contract, and the time for performance of any obligations of that party shall be extended by a period of time necessary to overcome the effects of the Force Majeure, provided that the foregoing shall not prevent this Bid, RFP, RFQ and/or Contract from terminating in accordance with the termination provisions. If any event constituting a Force Majeure occurs, the affected party shall notify the other parties in writing, within twenty-four (24) hours, and disclose the estimated length of delay, and cause of the delay. Page 19 of 48 Waiver: No claim or right arising out of a breach of any Bid, RFP, RFQ and/or Contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. Applicable Law: To the extent it is applicable, this Bid, RFP, RFQ, and/or Contract shall be governed by the Uniform Commercial Code. Whenever the term "Uniform Commercial Code" is used it shall be construed as meaning the "Uniform Commercial Code" as adopted in the State of Texas as effective and in force on the date of this Bid, RFP, RFQ and/or Contract. Otherwise, Texas state and federal law shall apply. Prohibition against Personal Interest in Bids. RFPs, RFQs, and/or Contracts: No official, employee, or agent of Calhoun County shall have financial interest, direct or indirect, in any Bid, RFP, RFQ and/or Contract with Calhoun County, or shall be financially interested, directly or indirectly, in the sale/lease to Calhoun County of any land, materials, supplies, or service, except on behalf of Calhoun County as an official, employee, or agent. Any willful violation of this section shall constitute malfeasance in office, and any official, employee, or agent guilty thereof shall be subject to disciplinary action under applicable laws, statutes and codes of the State of Texas. Any violation of this section, with the knowledge, expressed or implied of the company, corporation, firm, partnership, or individual contracting with Calhoun County shall render the Bid, RFP, RFQ and/or Contract involved voidable by the Calhoun County Commissioners Court. Insurance: Proof (copy of bidder's/vendors current insurance) of the below listed insurance may be required to be returned with the Bid, RFP, RFQ and/or Contract. As additional security for Calhoun County and as separate obligations of bidder/vendor not in conjunction with any other provisions of the Bid, RFP, RFQ and/or Contract, bidder/vendor agrees to carry and maintain during the term of the Bid, RFP, RFQ and/or Contract the minimum insurance coverages stated below. Before commencing work, the successful bidder/vendor shall be required, at his own expense, to furnish the Calhoun County Auditor within ten (10) days of notification of award with a certificate(s) of liability insurance (Form ACORD 25 or equivalent) showing, at least, the following minimum insurance coverage to be in force throughout the term of the Bid, RFP, RFQ and/or Contract. Higher rates and/or additional coverage may apply depending upon type of Bid, RFP, RFQ and/or Contract. o General Liability ($100,000/$300,000 or greater) o Workers' Compensation (at Statutory Limits) o Employer's Liability ($1,000,000 or greater) o Auto Insurance ($100,000 BIPP/$300,000 BIPO/$100,000 PD or greater) o Professional Liability Insurance (if applicable) o Farm Liability Insurance (if applicable) Coverages shall apply on an occurrence basis. The certificate(s) must reflect, by policy endorsement, that Calhoun County, Texas is an additional insured on all required policies. Each certificate of liability insurance (Form ACORD 25 or equivalent) to be furnished by successful bidders/vendors insurance agent shall include, by endorsement to the policy, a statement that a notice shall Page 20 of 48 be given to the Calhoun County Auditor by certified mail thirty (30) days prior to cancellation, material change, or non -renewal in coverage. Calhoun County's receipt of or failure to object to any insurance certificates or policies submitted by the bidder/vendor does not release or diminish in any manner the liability or obligations of the bidder/vendor or constitute a waiver of any of the insurance requirements forthe Bid, RFP, RFO, and/or Contract. Replacement certificate(s) of liability insurance (Form ACORD 25 or equivalent) evidencing continuation of such coverage and naming, by policy endorsement, Calhoun County as an additional insured, shall be furnished to the Calhoun County Auditors office priorto the expiration of the current policies. Should bidder/vendor at any time neglect, refuse to provide, or cancel the insurance required, Calhoun County shall have the right to terminate the Bid, RFP, RFQ and/or Contract or pursue any remedy available by law. The insurance coverage requirements in the Bid, RFP, RFQ, and/or contract will in no way be construed as limiting the scope of indemnification. OSHA Requirements: Bidder/vendor must meet all Federal and State OSHA requirements. The bidder/vendor hereby guarantees to Calhoun County that all materials, supplies, equipment and/or services listed on the Bid, RFP, RFQ, Contract, Purchase Order or Invoice shall conform to the requirements, specifications and standards promulgated by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970, as amended and in force at the date hereof. Protest Procedures: All protests and disputes will be held in Port Lavaca, Calhoun County, Texas. Any actual or prospective bidder/vendor who believes they are aggrieved in connection with or pertaining to a Bid, RFP, RFQ, and/or Contract may file a protest. The protest must be delivered in writing to the Calhoun County Auditor's Office, in person or by certified mail return receipt requested prior to award. The written protest must include: o Name, mailing address and business phone number of the protesting party; o Appropriate identification of the Bid, RFP, RFQ, and/or Contract being protested; o A precise statement of the reasons for the protest; and o Any documentation or other evidence supporting the protest and any alleged claims. The Calhoun County Auditor's Office will attempt to resolve the protest, including at the County Auditor's option, meeting with the protesting party. If the protest is successfully resolved by mutual agreement, written verification of the resolution, with specifics on each point addressed in the protest, will be forwarded to Calhoun County Commissioners Court. If the Calhoun County Auditors Office is not successful in resolving the protest, the protesting party may request in writing that the protest be considered by Calhoun County Commissioners Court. Applicable documentation and other information applying to the protest will be forwarded to Calhoun County Commissioners Court, who will promptly review such documentation and information. If additional information is required, Calhoun County Commissioners Court will notify the protesting party to provide such information. The decision of Calhoun County Commissioners Court will be final. Page 21 of 48 Public Information Act: All governmental information is presumed to be available to the public. Certain exceptions may apply to the disclosure of the information. Bidder/Vendor waives any obligation to the release to the public of any documents submitted in accordance with the Bid, RFP, RFQ, and/or Contract. Governmental bodies shall promptly release requested information that is not confidential by law, either constitutional, statutory, or by judicial decision, or information for which an exception to disclosure has not been sought. CALHOUN COUNTY AUDITOR To request information from Calhoun County, please contact: Calhoun County Auditor Calhoun County Courthouse Annex II 202 S Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 The Packet, Invitation for Bids, Request for Proposals and/or Request for Qualifications are posted on Calhoun County's website, www.calhouncotx.org, under Public Notices, Bid Notices and Results. Page 22 of 48 ATTACHMENT A CALHOUN COUNTY, TEXAS GENERAL CONDITIONS CERTIFICATE OF INTERESTED PARTIES FORM 1295 A business entity will generate Form 1295 online after notification of award and submit with their signed contract. Form 1295 must be filled out and submitted online, printed, complete #6, signed and returned with the Agreement, Contract, or Lease. See Calhoun County, Texas — Policy of Compliance TO FILL OUT FORM 1295: Go to: https://www.ethics.state.tx.us/File 1. If you have an account, login and proceed with the processor if you do not have an account, follow the instructions to set up an account and then proceed with the process. 2. Submit and print a copy of the form which will contain a unique certification number and date submitted in the upper right hand box that is marked "Office Use Only". 3. The Respondent or an authorized agent of the Respondent must sign and date the printed copy of the form (making sure all of #6 is completed). 4. The completed Form 1295 must be included with your Agreement, Contract or Lease, when it is submitted to Calhoun County. For help in filling out the form: #1 Name of Business Entity filing the form, and the City, State and Country of the Entity's place of business #2 Calhoun County, Texas (Also, if applicable, insert name of County Department) #3 • Contract number, if not given, can be the year or dates associated with the Agreement, Contract, Lease or if for a Bid, RFP, or RFC, the Bid, RFP, RFQ number and dates the Bid, RFP, RFQ pertains to • Description is description of Agreement, Contract, Lease or name of Bid, RFP, RFQ On #4 and #5, complete only the one that applies to you #4 Fill in the correct information if this applies OR #5 Mark an X in the Box if this applies #6 Fill in the correct information, submit and print After printing, the respondent or an authorized agent of the respondent must sign and date (making sure all of #6 is completed) When you print you should see a Certificate Number and Date in the upper right hand box that is marked "Office Use Only". Page 23 of 48 CERTIFICATE OF INTERESTED PARTIES FORM 1295 OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. ♦`� 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. ♦ 3 Provide the identification number used by the governmental entity or state agency to t k o identify the contract, and provide a description of the services, goods, or other property to be provided ;e contract. 4 City, State, Country :Nature of Interest (check applicable) Name of Interested Party (place of business) • Controllin 9 Intermediary Vol 5 ❑Check only if there' I terested Party. 6 UNSWORN DECjIlQ N My name is � and my date of birth is My addre'r --(street) (city) (state) (zip code) (country) edn'derpenalty of perjury that the foregoing is true and correct. Executed in County, State of on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) ADD ADDITIONAL PAGES AS NECESSARY Form provided by Texas Ethics Commission w vethics.state.tx.us Revised 12/22/2017 Page 24 of 48 Calhoun County, Texas POLICY OF COMPLIANCE SECTION 2252.908 TEXAS GOVERNMENT CODE Approved by Commissioners Court January 28, 2016 Amended by Commissioners Court January 31, 2018 and September 14, 2022 BACKGROUND Section 2252.908 was added to the Government Code by the 84th Texas Legislature through the adoption of House Bill 1295. The law states that the County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) is provided to the county at the time the contract is considered for action by Commissioner's Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract. The law does not apply to a contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within 30 days of approving a contract with a business entity. Governmental transparency is the objective of the law. Senate Bill 255 adopted by the 851h Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal https://www.ethics.state.tx.us/whatsnew/elf_ info _form1295.htm. A business entity will generate Form 1295 online. Calhoun County will acknowledge online the receipt of Form 1295 after a contract is executed. Within seven business days, Form 1295 will be available for public viewing on the Commission's website. COMPLAINCE Calhoun County Commissioners Court will not consider for action any contract with a business entity unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than 30 days after Commissioner's Court approves a contract with a non-exempt business entity, the County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. Page 25 of 48 STATE OF TEXAS 0 COUNTY OF 0 (Type or Print Name) the of AFFIDAVIT being first duly sworn, deposes and says: that he or she is (Type or Print Title) (Type or Print Name of Company/Firm) principal address at (Type or Print Physical and Mailing Address) having its who submits herewith to Calhoun County the attached Request for Qualifications (RFQ); that he or she is the person whose name is signed to the attached RFQ; that said RFQ is genuine; that the same is not sham or collusive; that all statements of fact herein are true; and that such RFQwas not made in the interest or behalf of any person, partnership, company, association, organization or corporation not herein named or disclosed. Affiant further deposes and says: that himself/herself/itself/themselves has not directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interests of Calhoun County, or of any other respondent, or anyone else interested in the RFQ contract; and that himself/herself/itself/themselves has not in any manner sought by collusion to secure for himself/herself/itself/themselves an advantage over any other respondent. Affiant further deposes and says: that prior to the public opening and reading of the Request for Qualifications, himself/herself/itself/themselves: a) did not, directly or indirectly, induce or solicit anyone else to submit a false or sham RFQ; b) did not, directly or indirectly, collude, conspire, connive or agree with anyone else that himself/herself/itself/themselves or anyone else would submit a false or sham RFQ or that anyone should refrain from submitting a RFQ or withdraw their RFQ c) did not, in any manner, directly or indirectly, seek by agreement, communication or conference with anyone to fix the RFQ of himself/herself/itself/themselves or of anyone else, or to fix the outcome of the award of the RFQfor himself/herself/itself/themselves or of that of anyone else; d) did not give, offer to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to any official, employee or agent of Calhoun County in connection with the submitted RFQ and e) did not, directly or indirectly, submit their RFQ or the contents thereof, or divulge information or data relative hereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent, thereof, to any individual or group of individuals, or to any official, employee or agent of Calhoun County prior to the official opening of this RFQ. Affiant further deposes and says: that the information contained in this RFQ has been carefully checked and is submitted as true and correct, agrees to furnish any and/or all items/services if awarded and upon the conditions and requirements contained in the RFQ. Signature of Affiant Printed Name and Title of Affiant SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this day of 120. Signature of Notary Public Notary Stamp/Seal Page 26 of 48 CONFLICT OF INTEREST QUESTIONNAIRE For vendor doing business with local governmental entity Acomplete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.legis.state.tx.us/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form. Local Government Code § 176.0010-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on: (A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity; (B) a transaction conducted at a price and subject to terms available to the public; or (C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency. Local Government Code § 176.003(a)(2)(A) and (B): (a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if: (2) the vendor: (A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor; (B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that: (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor. Local Government Code § 176.006(a) and (a-1) (a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and: (1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A); (2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1); or (3) has a family relationship with a local government officer of that local governmental entity. (a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of: (1) the date that the vendor: (A) begins discussions or negotiations to enter into a contract with the local governmental entity; or (B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or (2) the date the vendor becomes aware: (A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a); (B) that the vendor has given one or more gifts described by Subsection (a); or (C) of a family relationship with a local government officer. Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 Page 27 of 48 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO For vendor doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. !J Name of vendor who has a business relationship with local governmental entity. 2 Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated El completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. Name of Officer 4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor? F]Yes FlNo B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? ElYes FIND 6 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more. 6 ❑Check this box if the vendor has given the local government off icer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1). 7 Signature of vendor doing business with the governmental entity Date Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 Page 28 of 48 DEBARMENT & SUSPENSION Executive Order 12549--Debarment and Suspension Source: The provisions of Executive Order 12549 of Feb. 18, 1986, appear at 51 FR 6370, 3 CFR, 1986 Comp., p. 189, unless otherwise noted. By the authority vested in me as President by the Constitution and laws of the United States of America, and in order to curb fraud, waste, and abuse in Federal programs, increase agency accountability, and ensure consistency among agency regulations concerning debarment and suspension of participants in Federal programs, it is hereby ordered that: Section 1. (a) To the extent permitted by law and subject to the limitations in Section 1(c), Executive departments and agencies shall participate in a system for debarment and suspension from programs and activities involving Federal financial and nonfinancial assistance and benefits. Debarment or suspension of a participant in a program by one agency shall have government -wide effect. (b) Activities covered by this Order include but are not limited to: grants, cooperative agreements, contracts of assistance, loans, and loan guarantees. (c) This Order does not cover procurement programs and activities, direct Federal statutory entitlements or mandatory awards, direct awards to foreign governments or public international organizations, benefits to an individual as a personal entitlement, or Federal employment. Sec. 2. To the extent permitted by law, Executive departments and agencies shall: (a) Follow government -wide criteria and government -wide minimum due process procedures when they act to debar or suspend participants in affected programs. (b) Send to the agency designated pursuant to Section 5 identifying information concerning debarred and suspended participants in affected programs, participants who have agreed to exclusion from participation, and participants declared ineligible under applicable law, including Executive Orders. This information shall be included in the list to be maintained pursuant to Section 5. (c) Not allow a party to participate in any affected program if any Executive department or agency has debarred, suspended, or otherwise excluded (to the extent specified in the exclusion agreement) that party from participation in an affected program. An agency may grant an exception permitting a debarred, suspended, or excluded party to participate in a particular transaction upon a written determination by the agency head or authorized designee stating the reason(s) for deviating from this Presidential policy. However, I intend that exceptions to this policy should be granted only infrequently. Sec. 3. Executive departments and agencies shall issue regulations governing their implementation of this Order that shall be consistent with the guidelines issued under Section 6. Proposed regulations shall be submitted to the Office of Management and Budget for review within four months of the date of the guidelines issued under Section 6. The Director of the Office of Management and Budget may return for reconsideration proposed regulations that the Director believes are inconsistent with the guidelines. Final regulations shall be published within twelve months of the date of the guidelines. Page 29 of 48 Sec. 4. There is hereby constituted the Interagency Committee on Debarment and Suspension, which shall monitor implementation of this Order. The Committee shall consist of representatives of agencies designated by the Director of the Office of Management and Budget. See. 5. The Director of the Office of Management and Budget shall designate a Federal agency to perform the following functions: maintain a current list of all individuals and organizations excluded from program participation under this Order, periodically distribute the list to Federal agencies, and study the feasibility of automating the list; coordinate with the lead agency responsible for government -wide debarment and suspension of contractors; chair the Interagency Committee established by Section 4; and report periodically to the Director on implementation of this Order, with the first report due within two years of the date of the Order. See. 6. The Director of the Office of Management and Budget is authorized to issue guidelines to Executive departments and agencies that govern which programs and activities are covered by this Order, prescribe government -wide criteria and government -wide minimum due process procedures, and set forth other related details for the effective administration of the guidelines. Sec. 7. The Director of the Office of Management and Budget shall report to the President within three years of the date of this Order on Federal agency compliance with the Order, including the number of exceptions made under Section 2(c), and shall make recommendations as are appropriate further to curb fraud, waste, and abuse. Implementation in the SRF Programs A company or individual who is debarred or suspended cannot participate in primary and lower -tiered covered transactions. These transactions include SRF loans and contracts and subcontracts awarded with SRF loan funds. Under 40 C.F.R. 32.510, the SRF agency must submit a certification stating that it shall not knowingly enter into any transaction with a person who is proposed for debarment, suspended, declared ineligible, or voluntarily excluded from participation in the SRF program. This certification is reviewed by the EPA regional office before the capitalization grant is awarded. A recipient of SRF assistance directly made available by capitalization grants must provide a certification that it will not knowingly enter into a contract with anyone who is ineligible under the regulations to participate in the project. Contractors on the project have to provide a similar certification prior to the award of a contract and subcontractors on the project have to provide the general contractor with the certification prior to the award of any subcontract. In addition to actions taken under 40 C.F.R. Part 32, there are a wide range of other sanctions that can render a party ineligible to participate in the SRF program. Lists of debarred, suspended and otherwise ineligible parties are maintained by the General Services Administration and should be checked by the SRF agency and all recipients of funds directly made available by capitalization grants to ensure the accuracy of certifications. Additional References C 40 C.F.R. Part 32: EPA Regulations on Debarment and Suspension. Page 30 of 48 CERTIFICATION REGARDING DEBARMENT & SUSPENSION AND OTHER RESPONSIBILITY MATTERS In accordance with the Executive Order 12549, the prospective primary participant certifies to the best of his / her knowledge and belief, that its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; b. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offence in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction or records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification. d. Have not within a three-year period preceding this application / proposal had one or more public transactions (federal, state, or local) terminated for cause of default. e. Acknowledge that all sub -contractors selected for this project must be in compliance with paragraphs (1) (a— d) of this certification. Name and Title of Authorized Agent Signature of Authorized Agent I am unable to certify to the above statements. My explanation is attached. Date Page 31 of 48 Certification Regarding Lobbying (To be submitted with each bid or offer exceeding $100,000) The undersigned certifies, to the best of his or her knowledge and belief, that (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (c) The undersigned shall require that the language paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). The Contractor, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official Printed Name and Title of Contractor's Authorized Official Date Page 32 of 48 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether sub awardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the sub awardee, e.g., the first sub awardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Sub awardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services,and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348- 0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathedng and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046). Washington, DC 20503 Approved by OMB 0348-0046 Page 33 of 48 Approved by OMB Disclosure of Lobbying Activities Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure) 0348-0046 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial filing _ b. grant b. initial award _ b. material change c. cooperative agreement c. post -award d. loan For material change only: e. loan guarantee Year quartet' f. loan insurance Date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Prime Subawardee Name and Address of Prime: Tier_, if Known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, ifapplicable: 8. Federal Action Number, ifknown: 9. Award Amount, ifknown: 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address iJ' (if individual, last name, first name, MI): different front No. 10a) (last name, first name, MI): 11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This Signature: disclosure of lobbying activities is a material representation of fact upon which reliance was placed Print Name: by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 Title: U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public Telephone No.: Date: inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97) Page 34 of 48 HOUSE BILL 89 VERIFICATION FORM Certification Required by Texas Government Code Section 2270.001 The 85' Texas Legislature approved new legislation, effective September 1, 2017, which amends Texas Local Government Code Section 1, Subtitle F, Title 10, Government Code by adding Chapter 2270 which states that a government entity may not enter into a contract (which includes contracts formed through purchase orders) with a company for goods or services unless the contract contains a written verification from the company that it: 1) Does not boycott Israel; and 2) Will not boycott Israel during the term of the contract Pursuant to Section 2270.001, Texas Government Code: 1. "Boycott Israel' means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli - controlled territory, but does not include an action made for ordinary business purposes; and 2. "Company" means a for profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or any limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of those entities or business associations that exist to make a profit. I, (authorized official) do hereby verify the truthfulness and accuracy of the contents of the statements submitted on this certification underthe provisions of Subtitle F, Title 10, Government Code Chapter 2270 and that the company named below: 1) Does not boycott Israel currently; 2) Will not boycott Israel during the term of the contract; and 3) Is not currently listed on the State of Texas Comptroller's Companies that Boycott Israel List located at https://comptroller.texas.gov/purchasing/publications/divestment.php Company Name Signature of Authorized Official Title of Authorized Official Printed Name of Authorized Official Date Page 35 of 48 INSERT CERTIFICATE OF PROFESSIONAL LIABILITY INSURANCE • Must include proof (a copy) of your Current Certificate of Professional Liability Insurance Page 36 of 48 RESIDENCE CERTIFICATION Pursuant to Texas Government Code §2252.001 et seq., as amended, Calhoun County requests Residence Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of governmental contract; pertinent provisions of §2252.001 are stated below: Sec. 2252.001(3) "Nonresident bidder" refers to a person who is not a resident. ❑ Icertifythat (4) "Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state. (Company Name) is a "Nonresident Bidder" of Texas as defined in Government Code §2252.001 and our principal place of business is (City and State) ❑ I certify that (Company Name) defined in Government Code §2252.001. Signature of Authorized Agent Printed Name and Title of Authorized Agent Date is a "Resident Bidder" of Texas as Page 37 of 48 INSERT SYSTEM FOR AWARD MANAGEMENT (SAM) RECORD SEARCH FOR COMPANY AND COMPANY'S PRINCIPAL(S), IF ANY • Must include a printout of the search results that includes the record date showing that the Company, and its Principals, if any, have an active registration with the System for Award Management (www.SAM.gov) AND are not debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM). Page 38 of 48 REQUIRED CONTRACT PROVISIONS 2 CFR 200.326 Contract provisions. The non -Federal entity's contracts must contain the applicable provisions described in Appendix II to Part 200—Contract Provisions for non -Federal Entity Contracts Under Federal Awards. The non -Federal entity's contracts must contain the applicable provisions described in Appendix II to Part 200—Contract Provisions for non -Federal Entity Contracts Under Federal Awards. All Contracts THRESHOLD PROVISION CITATION Contracts for more than the simplified acquisition threshold currently set at >$150,000 $150,000, which is the inflation adjusted amount determined by the Civilian (Simplified Agency Acquisition Council and the Defense Acquisition Regulations Council 2 CFR 200 Acquisition (Councils) as authorized by 41 U.S.C. 1908, must address administrative, APPENDIX II Threshold) contractual, or legal remedies in instances where contractors violate or breach (A) contract terms, and provide for such sanctions and penalties as appropriate. All contracts in excess of $10.000 must address termination for cause and for 2 CFR 200 >$10,000 convenience by the non -Federal entity including the manner by which it will be APPENDIX II effected and the basis for settlement. (B) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of "funding agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or 2 CFR 200 None performance of experimental, developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the requirements of 37 APPENDIX II (F) CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be made to parties listed on the government - wide exclusions in the System for Award Management (SAM), in accordance with 2 CFR 200 None the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR APPENDIX II part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 2235), "Debarment (H) and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. Records of non -Federal entities. The U.S. Department of Housing and Urban Development (HUD), Inspectors General, the Comptroller General of the United States, the Texas General Land Office (GLO), and the pass -through entity, or any of their authorized representatives, must have the right of access to any None documents, papers, or other records of the non -Federal entity which are 2 CFR 200.336 pertinent to the Federal award, in order to make audits, examinations, excerpts, and transcripts. The right also includes timely and reasonable access to the non -Federal entity's personnel for the purpose of interview and discussion related to such documents. Financial records, supporting documents, statistical records, and all other non - Federal entity records pertinent to a Federal award must be retained for a period of three years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the None submission of the quarterly or annual financial report, respectively, as reported to 2 CFR 200.333 the Federal awarding agency or pass -through entity in the case of a subrecipient. Federal awarding agencies and pass -through entities must not impose any other record retention requirements upon non -Federal entities. The only exceptions are the following: Page 39 of 48 (a) If any litigation, claim, or audit is started before the expiration of the 3-year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. (b) When the non -Federal entity is notified in writing by the Federal awarding agency, cognizant agency for audit, oversight agency for audit, cognizant agency for indirect costs, or pass -through entity to extend the retention period. (c) Records for real property and equipment acquired with Federal funds must be retained for 3 years after final disposition. (d) When records are transferred to or maintained by the Federal awarding agency or pass -through entity, the 3-year retention requirement is not applicable to the non -Federal entity. (e) Records for program income transactions after the period of performance. In some cases recipients must report program income after the period of performance. Where there is such a requirement, the retention period for the records pertaining to the earning of the program income starts from the end of the non -Federal entity's fiscal year in which the program income is earned. (f) Indirect cost rate proposals and cost allocations plans. This paragraph applies to the following types of documents and their supporting records: indirect cost rate computations or proposals, cost allocation plans, and any similar accounting computations of the rate at which a particular group of costs is chargeable (such as computer usage chargeback rates or composite fringe benefit rates). (1) If submitted for negotiation. If the proposal, plan, or other computation is required to be submitted to the Federal Government (or to the pass -through entity) to form the basis for negotiation of the rate, then the 3-year retention period for its supporting records starts from the date of such submission. (2) If not submitted for negotiation. If the proposal, plan, or other computation is not required to be submitted to the Federal Government (or to the pass -through entity) for negotiation purposes, then the 3-year retention period for the proposal, plan, or computation and its supporting records starts from the end of the fiscal year (or other accounting period) covered by the proposal, plan, or other computation. Contracting with small and minority businesses, women's business enterprises, and labor surplus area firms. (a) The non -Federal entity must take all necessary affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used when possible. (b) Affirmative steps must include: None (1) Placing qualified small and minority businesses and women's business 2 CFR 200.321 enterprises on solicitation lists; (2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; Page 40 of 48 (4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; (5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce; and (6) Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs (1) through (5) of this section. Verification No Boycott Israel. As required by Chapter 2270, Government Code, CONTRACTOR hereby verifies that it does not boycott Israel and will not boycott Israel through the term of this Agreement. For purposes of this verification, "boycott Israel" None means refusing to deal with, terminating business activities with, or otherwise taking Texas any action that is intended to penalize, inflict economic harm on, or limit commercial Government relations specifically with Israel, or with a person or entity doing business in Israel or in Code 2270.002 an Israeli -controlled territory, but does not include an action made for ordinary business purposes. Foreign Terrorist Organizations. Pursuant to Chapter 2252, Texas Government Code, [Company] represents and certifies that, at the time of execution of this Agreement neither [Company], nor any wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of the same (i) engages in business with Iran, Sudan, or None any foreign terrorist organization as described in Chapters 806 or 807 of the Texas Texas Government Code, or Subchapter F of Chapter 2252 of the Texas Government Code, Governme Government nt or (ii) is a company listed by the Texas Comptroller of Public Accounts under Sections Code 252.152 806.051, 807.051, or 2252.153 of the Texas Government Code. The term "foreign terrorist organization" in this paragraph has the meaning assigned to such term in Section 2252.151 of the Texas Government Code. Option Contract Language for contracts The contract award is contingent upon the receipt of CDBG-DR funds. If no such Optional awarded prior to funds are awarded, the contract shall terminate. Grant Award Page 41 of 48 EO Clause for Construction Contracts > $10K including administration & engineering contracts associated with construction contracts THRESHOLD PROVISION CITATION Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, 41 CFR §60- >$10,000 "Equal Employment Opportunity" (30 FIR 12319, 12935, 3 CFR Part, 1964-1965 1.4(b) and Comp., p. 339), as amended by Executive Order 11375, "Amending Executive 2 CFR 200 Order 11246 Relating to Equal Employment Opportunity," and implementing APPENDIX II (C) regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." 41 CFR 60-1.4 Equal opportunity clause. (b) Federally assisted construction contracts. (1) Except as otherwise provided, each administering agency shall require the inclusion of the following language as a condition of any grant, contract, loan, insurance, or guarantee involving federally assisted construction which is not exempt from the requirements of the equal opportunity clause: The applicant hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modification thereof, as defined in the regulations of the Secretary of Labor at 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a grant, contract, loan, insurance, or guarantee, or undertaken pursuant to any Federal program involving such grant, contract, loan, insurance, or guarantee, the following equal opportunity clause: During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (3) The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or Page 42 of 48 individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. (4) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (6) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (7) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (8) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of Page 43 of 48 regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, Government contracts and federally assisted construction contracts pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions: Cancel, terminate, or suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. (c) Subcontracts. Each nonexempt prime contractor or subcontractor shall include the equal opportunity clause in each of its nonexempt subcontracts. (d) Inclusion of the equal opportunity clause by reference. The equal opportunity clause may be included by reference in all Government contracts and subcontracts, including Government bills of lading, transportation requests, contracts for deposit of Government funds, and contracts for issuing and paying U.S. savings bonds and notes, and such other contracts and subcontracts as the Director of OFCCP may designate. (e) Incorporation by operation of the order. By operation of the order, the equal opportunity clause shall be considered to be a part of every contract and subcontract required by the order and the regulations in this part to include such a clause whether or not it is physically incorporated in such contracts and whether or not the contract between the agency and the contractor is written. (f)Adaptation of language. Such necessary changes in language may be made in the equal opportunity clause as shall be appropriate to identify properly the parties and their undertakings. Page 44 of 48 THRESHOLD PROVISION CITATION Compliance with the Davis -Bacon Act (40 U.S.C. 3141 at seq.) as supplemented by Department of Labor regulations (29 CFR part 5) and with the Copeland 'Anti -Kickback" Act (18 U.S.C. 874; 40 U.S.C. 3145) as supplemented in Department of Labor regulations (29 CFR part 3): Davis -Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non -Federal entities must include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction"). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing >$2,000 wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. 2 CFR 200 The non -Federal entity must place a copy of the current prevailing wage APPENDIX II (D) determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non -Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer >$100,000 on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not 2 CFR 200 less than one and a half times the basic rate of pay for all hours worked in excess APPENDIX 11 (E) of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended —Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non -Federal >$150,000 award to agree to comply with all applicable standards, orders or regulations 2 CFR 200 issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal APPENDIX 11 (G) Water Pollution Control Act as amended (33 U.S.C. 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). Byrd Anti -Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid 2 CFR 200 for an award exceeding $100,000 must file the required certification. Each tier APPENDIX 11 (1) >$100,000 certifies to the tier above that it will not and has not used Federal appropriated and funds to pay any person or organization for influencing or attempting to influence 24 CFR an officer or employee of any agency, a member of Congress, officer or §570.303 Page 45 of 48 employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier un to the non -Federal award. as the Section 3 clause): A. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u (Section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD -assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing. B. The parties to this contract agree to comply with HUD's regulations in 24 CFR part 135, which implement Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 135 regulations. C. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum number and job titles subject to hire, availability of apprenticeship and >$100,000 training positions, the qualifications for each; and the name and location of the 24 CFR §135.38 person(s) taking applications for each of the positions; and the anticipated date the work shall begin. D.The contractor agrees to include this Section 3 clause in every subcontract subject to compliance with regulations in 24 CFR part 135, and agrees to take appropriate action, as provided in an applicable provision of the subcontract or in this Section 3 clause, upon a finding that the subcontractor is in violation of the regulations in 24 CFR part 135. The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24 CFR part 135. E.The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR part 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR part 135. F. Noncompliance with HUD's regulations in 24 CFR part 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. G. With respect to work performed in connection with Section 3 covered Indian housing assistance, section 7(b) of the Indian Self -Determination and Education Assistance Act (25 U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i) Page 46 of 48 preference and opportunities for training and employment shall be given to Indians, and (ii) preference in the award of contracts and subcontracts shall be given to Indian organizations and Indian -owned Economic Enterprises. Parties to this contract that are subject to the provisions of Section 3 and section 7(b) agree to comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with section 7(b). A non -Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the 2 CFR 200 item exceeds $10,000 or the value of the quantity acquired during the preceding APPENDIX II (J) fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. [78 FIR 78608, Dec. 26, 2013, as amended at 79 FR 75885, Dec. 19, 2014] Mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the 42 U.S.C. 6201 Energy Policy and Conservation Act. Page 47 of 48 Rating Sheet Engineering, Architectural, and Surveying Services For the Combined Dispatch Building RFQ 2022.08 Grant Recipient: Calhoun County Name of Respondent: Evaluator's Name: Experience -- Rate the respondent for experience in the following areas American Rescue Plan Date of Rating: Factor Max.Pts. 1. Has previously designed type of projects 20 2. Has worked on federally funded construction projects 15 3. Has worked on projects that were located in this general region. ,; Note: Location for A/E (Architect/Engineer) may be a selection " criterion provided its application leaves an appropriate number of qualified firms, given the nature and size of the project to compete for the contract 2 CFR 200 319(b) 4. Extent of experience in project construction management 15 Subtotal Experience -Enter Be„to•y''• 50 Score Comments Work Performance Factor Max.Pts. Score 1. Past projects completed on schesiple a, 10 2 Manages projects within budg'ry constraints T,''5 3 Work product is of high quali '+ 10 ._........................................................... ______ _ _ ._ ._._._._ _._._._.. Subtotal, Pe ormance-Enter Below•.! 25 461 NOTE: information necessary to assess the respondent on these criteria may be gathered from past experience with the respondent and/or by contacting oast/current clients. Factor .. Max.Pts. 1. Staff Level / Expenence, &tStaff 5 2. Adequacy of Resources .--- ___----.............. .......................... ................................................... -.................. . --__._._._._....._..._--- 5 3. Professional liability insurance is in force 5 Subtotal, Capacity to Perform -Enter Below 15 TOTAL SCORE FROM EACH ABOVE CATEGORY Factor p Experience Max.Pts. 60 O Work Performance 25 O Capacity to Perform 15 TOTAL SCORE 100 Score Score Page 48 of 48 # 07 NOTICE OF MEETING;-9/21/2022 7. Consider and take necessary action to award the bid for Magnolia Beach (21st Street) and Indianola Fishing Piers Hurricane Nicholas Rehabilitation Project for Calhoun County, Texas and autherize the Gaunty 9bidge te sign the GemtFaet.(DEH) Lowest bid awarded to Shirley and Son's. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall,=Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy,`Behrens, Reese Page 4 of 11 Mae Belle Cassel From: David.Hall@calhouncotx.org (David Hall) <David.Hall@calhouncotx.org> Sent: Monday, September 12, 2022 8:13 AM To: Mae Belle Cassel Subject: Fwd: Pier Repairs Project Attachments: 9115.027 - Pier Repair - ROA 090622.pdf, Bid OpeningTab - PIERS.pdf, Bid Itemized Bid Tab - Piers.pdf Sent from David's iPhone David Hall Commissioner Precinct 1 Calhoun County Office 361-552-9242 Cell 361-220-1751 Begin forwarded message: From: smason@gwengineers.com Date: September 12, 2022 at 8:12:18 AM CDT To: David Hall <david.hall@calhouncotx.org> Cc: Glynis King <gking@gwengineers.com>, cindy mueller<cindy.mueller@calhouncotx.org>, Candice Villarreal <Candice.Villarreal@calhouncotx.org>, peggy hall <peggy.hall@calhouncotx.org>, angela.torres@calhouncotx.org Subject: RE: Pier Repairs Project CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. David, We would like to officially request the following agenda item: Consider and take necessary action to award the bid for Magnolia Beach (21st Street) & Indianola Fishing Piers Hurricane Nicholas Rehabilitation Project for Calhoun County, Texas and authorize the County Judge to sign the Contract. (DH) Please let me know if you need any more information or have any questions. Respectfully Submitted, Scott P. Mason, P.E. Lead Project Engineer G&W Engineers, Inc. 205 W. Live Oak Port Lavaca, Texas 77979 P: (361) 552-4509 F: (361) 552-4987 smason@gwengineers.com From: Scott Mason <smason@gwengineers.com> Sent: Wednesday, September 7, 2022 3:54 PM To: 'David Hall' <david.hall@calhouncotx.org> Cc: 'Glynis King' <gking@gwengineers.com>;'cindy mueller' <cindy.mueller@calhouncotx.org>;'Candice Villarreal' <candice.villarreal@calhouncotx.org>;'peggy hall' <peggy.hall@calhouncotx.org> Subject: Pier Repairs Project David, Please see the attached as discussed for discussing with the insurance company. When we feel good about the award, let me know and I will request an agenda item. Thank you, Scott P. Mason, P.E. Lead Project Engineer G&W Engineers, Inc. 205 W. Live Oak Port Lavaca, Texas 77979 P: (361) 552-4509 F: (361) 552-4987 smason(@ewenaineers.com Calhoun County Texas G&WENGINEERS, INC. 205 W. Live Oak • Port Lavaca, TX 77979 • p: (361)552-4509 • f: (361)552-4987 TBPE Firm Registration No. F04188 September 6, 2022 Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 S. Ann St., 3rd Floor, Suite 301 Port Lavaca, TX 77979 RE: LETTER OF RECOMMENDATION Magnolia Beach (21" Street) & Indianola Fishing Piers Hurricane Nicholas Rehabilitation Project Dear Honorable Judge & County Commissioners, Bids for construction of the above referenced project were received at the County Judge's office until 2:00 p.m., Thursday, September 1, 2022, at which time Bids were publicly opened and read aloud. The enclosed Bid Opening Table and Bid Itemized Table indicate there were a total of five (5) bidders submitting bids, however; two bidders did not acknowledge the Addendum, thus not meeting the specifications. This leaves Shirley & Sons Construction Co., Inc. as the "Apparent Low Bidder". We have had the privilege of working with Shirley & Sons Construction Co., Inc. on several projects and they are qualified and capable of performing the required work. Therefore, we recommend that the Construction Contract be awarded to Shirley & Sons Construction Co., Inc. for the Total Base Bid Amount $80,000.00. If the County concurs with this recommendation, and upon your direction, we will prepare a Construction Contract package immediately and deliver it to Shirley & Sons Construction Co., Inc. for processing. Please call me @ (361) 552-4509 if you have any questions. Sincerely, G & W Engineers, Inc. Scott P. Mason, P.E. Enclosures: Bid Opening Table & Bid Itemized Table cc: file 911 S. 027 Engineering Consulting Planning 0 Surveying U wZ Oz N O o 00 0 00 0 0 00 0 0 P: o o 00 c 0 c 00 0 0 0 0 0 a o a J K O Vl N N O N Lo �z U U (wjJ o 0 0 o 4 w iZ O N O N O O O O C O N O 001 O Z U 0o ? N U o o o n '�'' o m o o 0 o U J N U N y U w E N c � � D O z O 0 Oj N ww E aKy Z C p� O D a J O> Eoi nE Y E ny Emmno n$oEm �i $iS m� �+D N m>. ,m. gmm C O m_ arnDo N y H m 01 �m ND m'Q Nm YIL Fa 'rd mmmS m> 0 gym, u `�v` a�w `gym>cw w� aci v� Nry yt Q�rn Ery apj Enom n�sq Ef n2 E L a "M11 m ��T N O_ "' •� Q_ C j m n m -E O T up C D N m N m> D r N �` N M L amp N Z' d m J m Ev wD E E9 ,-c E EmaEd �L aE m�..o '� mn`K monm �p Ei;-T "✓�Em D `w 'ao u.75o m m E "a 98y 2Z 4 n y w.a . �c 'X i m .E q N E n ry d C y m ��c m 0 �cc°-' ry O m C C m O C U o mm gym= vI- NEDiw cm� �cm`vdi 'E msC j h �+N 1.'� Nr N `OF r/IS C N `O m Yq O N�0 N Up 2 O wDN • �O CYU 6m N a t-$ N .5 C Sy "O m N O 6O 9 Q O a O L y c"1=mw W djpL v�Dmm aCc U vy c c G K a90 '5 mDco I 1ac0SEo2m� °.3pn. oE dn P wz oaCrecm aaf$m OmUwQmI-f i44�VVUrwJ O , c CmN 43 m m � M 8 m`g o " _Eonw m o oEv�m $ n O O L E E L —H p O N CZ N t+l V N ro r W. � r r Y 00 rn N UJ J N 33� 45 N r N (L ¢ ? O CC) 0) It Q U cl N N N N O O 0 N Z m O a) a) O O (fl (Al N c W O U Z wg Z Z } } a) 0 O z YLLI O cl z Y O N N N N N o U m 0 U C7 Z U F Z — U O Z Z O O � F o_ O ¢ m U U) M U) J Z F U 0 w O Z Z J K N OU w 2 O w U oa W W U- W ¢ J m m ¢ x 00 f4 N N m m a • 1: NOTICE OF MEETING — 9/21/2022 8. Consider and take necessary action to pay Clarke Mosquito Control Products Inc. for an order of Altosid XR Briquets as they did not win the bid. Veseris won the bid. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Oct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy„Behrens„Reese Page 5 of 11 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 September 8, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda • Consider and take necessary action to pay Clarke Mosquito Control Products Inc. for order of Altosid XR Briquets as they did not have the bid, Veseris has the bid. Sinc ely, Vern Lyssy VL/lj PO 550 - 9/6/2022 - 6 COMMNSIONERS COUNT PAYMENT DATE 9/6/2022 DATE OETICE 8/30/2022 DEPARTMENT NUMBER AND NAME 550ROAD AND BRIDGE -PRECINCT #2� VENDOR CODE AND NAME \� 61 CLARKE 1 16277 COLLECTIONS CENTER DR CHICAGO IL 60693 vi102345 1 V"9/1/2022 ALTOSID XR BRIQUETS - 1 CASE //$787.60 53630 TOTAL 787.60 1 eff r5l� . 5'3LL�O,o1e?,V YILJ'I'Of l f +; IN CI 1d +o 60)L wA4-iI COU-Vi aFP!uucocYnd L� o to v_Q /r+--f& d- I CERTIFY THAT THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES, THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION AND THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD COND TION ANrIQU T THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION. n DEPARTMENTNEADIN OMZENSIGNATURE DATE Tuesday, September 6, 2022 IgtP� Page: 1(1) www.clatke.com INVOICE TOLL -FREE: e00.323-5727 PHONE: 630-694-2000 �o r ' AN Emall: eccountsreceivable5tclarke.mm, AN Dept ExL 3139 Payment Instructions: Clarke Mosquito Control Products, Inc. ACH Banking: Bank of America - Account: 8666607212 - Routing: 071000039 Payment Online: Visit our websiteat https://WWW.clarke.com/billpay Paver Check: 16277 Collections Center Drive, Chicago. IL 60693 Invoice # 5a02345 Invoice Date: 9/01/22 Customer #: 017249 Terms: Net 30 Days Due Date: 09/30/22 Calhoun County Precinct 2 Commissioner Lyssy 5812 FM 1090 N Port Lavaca, TX 77979-5168 Your Order No. W9's can be found on our website at www.clarke.com Calhoun County Precinct 2 Commissioner Lyssy 5812 FM 1090 N Port Lavaca, TX 77979-5168 787.60 787.60 Clarke manufactured pesticide products referenced on this invoice meet the quality standards described in Title 40, Chapter I of the Code of Federal Regulations, Part 158, section 175. For a certificate of analysis for each production lot on this invoice, please call (630) 671-3123. 'Please note that Altosid, Duplex-G, Strike, and Zenivex products are sold to you by Clarke as an agent under agreement with Wellmark International. As an Agent, we are authorized to invoice and collect under the terms of Agency contract. Unless directed otherwise in writing from Wellmark or Clarke, the amount due under this invoice is payable to Clarke. Clarke Mosquito Control Products, Inc. is a Clarke Clarke will charge applicable sales taxes unless a valid exemption certificate is Entailed to: accountsreceivable@clarke.com or faxed to: 630-672-7439 A 15% restocking fee plus freight costs may be assessed to any returned items, Items must be returned within 120 days of shipment and in an acceptable condition. Helping make communities around the world more livable, safe and comfortable. Farm !(Rev. O2Depanmthe Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification ► Go to wwwdirs.govfFormW9 for instructions and the latest information. Give Form to the requester. Do not 'send to the IRS. :.1 Name (as shown on your Income tax retum). Name is required on this line; do not leave this line blank. Clarke Mosquito Control Products, Inc. 2 Business name/dlsregarded entity name, If Different from we 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codas apply only to 0 following seven boxes. certain entitles, netindividuals; see o ❑ Individual/sole Proprietor. ❑ C Corporation 0 S Corporation ❑ Partnership ❑ TrusUestate Instructions on page 3): single -member LLC Exempt payee code of any) ❑ Limited liability company. Enter the tax classificatlon (C=C corporation, S=S corporation, P=Partnership)► p 2 Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting LLC if the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is '.. coda Of C ( another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC the '.4Er Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. Other (we imtructbns)► .. _. _. (sc,+ f..awxun,n•mm•e�wu.sJ y S Address (number, street, and apt, or wife no.) See Instructions. Requesters name and address (optional) 675.Sidwell Court IS City, state, and ZIP code St. Charles, IL 60174.. 7 Ust account numbers) here (optionaq I-MTNTaxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid ( social security number j backup withholding. For individuals, this is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, sea the instructions for Part I, later. For other _ m _ FFM entities, it Is your employer identification number (EIf�. If you do not have a number, sea How to get a TIN, later. or.. Note: If the account Is in more than one name, am the Instructions for fine 1. Also see What Nam and Emplo r identification number Number To Give tits Requester for guidelines on whose number to enter. ) j—j'_F_j�""1'"" under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer identification number (or I am wafting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup whhholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report ail interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S, citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (d any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 aboveif you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later..; xalyu �_ Signature of Here '. U.S. Mw n I General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its Instructions; such as legislation enacted after they were published, go to www.i s.gov1FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an Information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (praceads from real estate transactions) • Form 1099-K (merchant card and third parry network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-0 (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. if you do not return Form W-9 to the requester with a 71N, you might be subject to backup withholding. See What is backup withholding, later. ..Cat No. 10231x Form W-9 (RBV. 10-2018) PACKING SLIP d� CENTRAL SCIENCES 806434606 SHIP FROM: Wellmark International / Farnham Companies, Inc. Central Life Sciences 12111 Ford Road Dallas, TX 75234 SHIP TO: CALHOUN CO PRECINCT 2 5812 FM 1090 N PORT LAVACA TX 77979 Phone No: 888-528-8058 Fax No: 866-499-2419 CORPORATE ADDRESS: Central Life Sciences 1501 E. Woodfield Rd Suite #2OOW Schaumburg, IL 60173 SOLD TO: CALHOUN CO PRECINCT 2 5812 FM 1090 N PORT LAVACA TX 77979 DELIVERY NO 806434606 CUST. NO 1126145 FREIGHT LTL INCO TERM FOB Orgn i Prepaid & Add SHIPPED VIA DATE 08/31/2022 ITEM DESCRIPTION UNIT QTY QTY QTY WEIGHT NUMBER ORD SHIP OPEN PO: 1033493/15765 100508842 ALTOSID XR BRIQUETTES S-VER 220/CS CA 1 1 0 22.8 LB BATCH: 2206245304 1 1.0 CA / 22.8 LB 1 CONTACT: COM SSIONER LYSSY / PHONE: 361-552-9656 REFERENCE POtt i 0334931157656 CONTACT. COM SSIONER LYSSY / PHONE: 361-552-9656 REFERENCE PO# 0334931157656 Total Weight -Net CA 1 22.8 LB 10.3 KG Total CA Weight -Gross Total Load Weight -Gross n v Equal Employment Opportunit Clause: Executive Order 11246, as amended, Sec. 402 of the Vietnam Era Veterans Readjustment Act of 1974, as am�eH-Sec. 503 oi-(�bTfation Act of 1973, as amended, and Sec. 61-250.51e1 and Public Law 95-507 contain required contract clauses Page 1 Of 1 relative to equal opportunity and are incorporated herein by specific reference at 41 CRF 60-1.4(a,d), 60-4.3, 60-250.5p) and 60-741.51a1. Page: 1(1) co o to rm AR Dept. Ext, rayment Instructions Clarke Mosquito Control Products, Inc. nking: Bank of America - Account: 8666607212 - Routing: 071000039 Online: Visit our website at httos://www.clarke.com/billpay heck: 16277 Collections Center Drive, Chicago, IL 60693 Invoice #: 5102345 Invoice Date: 09/01/22 Customer #: 017249 Terms: Net 30 Days bs g Due Date: 09/30/22 a Calhoun County Precinct 2 l Calhoun County Precinct 2 i Commissioner Lyssy� Ii Commissioner Lyssy 5812FM1090N 5812FM1090N t EM x Port Lavaca, TX 77979-5168 :� r,N Port Lavaca, TX 77979-5168 ; Your Order No. W9's can be found on our website at www.clarke.com Clarke manufactured pesticide products referenced on this invoice meet the quality standards described in Title 40, Chapter I of the Code of Federal Regulations, Part 158, section 175, For a certificate of analysis for each production lot on this invoice, please call (630) 671-3123. 'Please note that Altosid. Duplex-G, Strike, and Zenivex products are sold to you by Clarke as an agent under agreement with Wellmark International. As an Agent, we are authorized to invoice and collect under the terms of Agency contract. Unless directed otherwise in writing from Wellmark or Clarke, the amount due under this invoice is payable to Clarke. Clarke Mosquito Control Products, Inc. is a Clarke M olarke.wm INVOICE TOLL -FREE: 800-3235727 PHONE: 630-BU-2000 AR E,nail: accountsreceivable@clarke.com, 3139 787.60 Clarke will charge applicable sales taxes unless a valid exemption certificate is Entailed to: accountsreceivable@clarke.com or faxed to: 630-672-7439 A 15% restocking fee plus freight costs may be assessed to any returned items. Items must be returned within 120 days of shipment and in an acceptable condition. Helping make communities around the world more livable, safe and comfortable. # 09 NO] ICE OF MEETING.- 9/21/2022 9. Consider and take necessary action to deposit proceeds for the 7/28/2022 Auction in the amount of $61,140.40 to the Road & Bridge, Precinct 2 account 1000-550-73400 Machinery and Equipment. (VLL) RESULT:- APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct2 SECONDER: Joel Behrens, Commissioner Pet 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 11 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 September 14, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda Consider and take necessary to deposit proceeds for the 7/28/22 Auction in the amount of $61,140.40 to the Road & Bridge, Pct. 2 account 1000-550-73400, Machinery and Equipment. Sincerely, Vern Lyssy Commissioner, Pct. 2 VL/Ij #10 NOTICE OF MEE l ING -- 9/21./2022 10. Consider and take necessary action to install a stop sign on 5th Street at the Intersection of 5th and Main Street in Port O'Connor, Texas. (GDR) RESULT; APPROVED [UNANIMOUS] MOVER: Vern Lyssy) Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 11 Gary D. Reese County Commissioner County of Calhoun Precinct 4 September 12, 2022 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for September 21, 2022. • Consider and take necessary action to install a stop sign on 5th Street at the intersection of 5e & Main Street in Port O'Connor, Texas. Si cerely, -y Gary D. Reese CDR/at P.O. Box 177 — Seadrift. Texas 77983 — email: earv.reese.r calhouncolx.or8 — (361) 785-3141 — Fax (361) 785-5602 #11 NOTICF_ OF MFF_-IING 9/21/2022 11. Consider and take necessary action to transfer the attached list of items from the District Attorney's Office inventory to the Calhoun County Sheriffs Office inventory. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall,Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy Behrens, Reese Page 8 of 11 Criminal District Attorney Calhoun Countv, Texas a06. IIaIf Mon" Roof I ,hihnusc RANDY R. CRIDER DAN W. HEARD SARA M. RODRIGUEZ Investigator Assistant Criminal District Attornec ALICIA F. GONZALES Victim Assistance Coordinator September 13, 2022 Hon. Richard Meyer Calhoun County Judge P.O. Box 1001 • 211 South Ann Street Port Lavaca, Texas 77979 (361) 553-4422 • Fax (361) 553-4421 CHRISTY BROWN DUNN Assistant Criminal DistrietAttorney W.A.(BILL) WHITE Assistant Criminal District Attornec Calhoun County Commissioners Court RE: Inventory Transfer Request Dear Judge Meyer and Commissioners: This letter is to request the attached listed items to be transferred from the District Attorney's Office inventory to the Calhoun County Sheriff's Office inventory: Accordingly, please place this on the next available Commissioner's Court agenda. Thank you for your attention to this matter. Ve u yours, DAN W. HEARD, Criminal District Attorney for Calhoun County, Texas DWH:Iaj Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: District Attorney's Office Inventory Number Description Serial No. Transfer From/To Department Hon 4 drawer metal filing cabinet District Attorney / Sheriffs Office Hon 4 drawer metal filing cabinet District Attorney / Sheriffs Office Hon 4 drawer wood filing cabinet District Attorney / Sheriffs Office Hon 4 drawer wood filing cabinet District Attorney / Sheriffs Office #12 NOTICE OF MEETING -.. 9/21/2022 12. Accept Monthly Reports from the following County Offices: I. District Clerk — August 2022 ii. Justice of the Peace, Precinct 4 — August 2022 iii. County Treasurer — March 2022 iv. County Treasurer — Interest Report for Quarter Ending March 31, 2022 v. County Treasurer — Quarterly Statement of Balances RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct'2 SECONDER: Gary Reese, Commissioner Pct' 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens,; Reese` Page 9 of 11 * Treasurer Receipt Numbers: F2022AUG005,016, 026,036,042 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 9/13/2022 COURT NAME: DISTRICT CLERK MONTH OF REPORT: AUGUST YEAR OF REPORT: 2022 ACCOUNT NUMBER ACCOUNT NAME DEBIT CREDII 1000-001-44190 SHERIFF'S SERVICE FEES $1,560.73 1000-001-44140 JURY FEES $220.00 1000-001-44045 RESTITUTION FEE $0.00 1000-001-44020 DISTRICT ATTORNEY FEES $0.00 1000-001-49010 REBATES -PREVIOUS EXPENSE $2.28 1000-001-49030 REBATES-ATTORNEY'S FEES $593.78 1000-001-44058 DISTRICT CLERK ELECTRONIC FILING FEES $0.00 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEES $40.44 1000-001-43049 STATE REIMB- TITLE IV-D COURT COSTS $0.00 DISTRICT CLERK FEES CERTIFIED COPIES $69.00 CRIMINAL COURT $84.33 CIVIL COURT $2,583.36 STENOGRAPHER $475.00 CIV FEES DIFF $0.00 1000-001-44050 DISTRICT CLERK FEES $3,211.69 1000-999-20771 FAMILY VIOLENCE FINE $0.00 1000-999-10010 CASH - AVAILABLE $5,628.92 2706-001-44055 FAMILY PROTECTION FEE $0.00 2706-999-10010 CASH - AVAILABLE $0.00 2740-001-45055 FINES - DISTRICT COURT $1,225.55 2740-999-10010 CASH - AVAILABLE $1,225.55 2620-001-44055 APPELLATE JUDICIAL SYSTEM $95.00 2620-999-10010 CASH - AVAILABLE $95.00 2648-001-44055 COURT FACILITY FEE FUND $380.00 2648-999-10010 CASH - AVAILABLE $380.00 2670-001-44055 COURTHOUSE SECURITY $420.69 2670-999-10010 CASH - AVAILABLE $420.69 2673-001-44055 CRT RECS PRESERVATION FUND- CO $60.30 2673-999-10010 CASH - AVAILABLE $60.30 2725-001-44055 LANGUAGE ACCESS FUND $57.00 2725-999-10010 CASH - AVAILABLE $57.00 2739-001-44055 RECORD MGMT/PRSV FUND - COUNTY $707.42 2739-999-10010 CASH - AVAILABLE $707.42 2737-001-44055 RECORD MGMT/PRSV FUND -DIST CLRK $75.57 2737-999-10010 CASH - AVAILABLE $75.57 2731-001-44055 LAW LIBRARY $665.00 2731-999-10010 CASH - AVAILABLE $665.00 2663-001-44050 CO & DIST CRT TECHNOLOGY FUND $8.47 2663-999-10010 CASH - AVAILABL $8.47 7040-999-20740 BREATH ALCOHOL TESTING - STATE $0.00 7040-999-10010 CASH - AVAILABLE $0.00 2667-001-44055 CO CHILD ABUSE PREVENTION FUND $0.51 2667-999-10010 CASH - AVAILABLE $0.51 7502-999-20740 JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE $20.01 7502-999-10010 CASH-AVAILABE $20.01 7383-999-20610 DNA TESTING FEE - County $3.41 7383-999-20740 DNA TESTING FEE - STATE $30.73 7383-999-10010 CASH - AVAILABLE $34.14 7405-999-20610 EMS TRAUMA FUND - COUNTY $18.59 7405-999-20740 EMS TRAUMA FUND - STATE $167.33 7405-999-10010 CASH - AVAILABLE $185.92 7070-999-20610 CONSOL. COURT COSTS - COUNTY $24.38 7070-999-20740 CONSOL. COURT COSTS - STATE $219.41 7070-999-10010 CASH - AVAILABLE $243.79 7072-999-20610 STATE CONSOL. COURT COSTS- COUNTY $50.62 7072-999-20740 STATE CONSOL. COURT COSTS- STATE $455.58 7072-999-10010 CASH -AVAILABLE $506.20 2698-001-44030-010 DRUG CRT PROG FEE - COUNTY (PROGRAM) $52.30 2698-999-10010-010 CASH -AVAILABLE $52.30 7390-999-20610-999 DRUG COURT PROG FEE - COUNTY (SVC FEE) $10.46 7390-999-20740-999 DRUG COURT PROG FEE - STATE $41.84 7390-999-10010-999 CASH - AVAILABLE $52.30 7865-999-20610-999 CRIM - SUPP OF IND LEGAL SVCS - COUNTY $0.36 7865-999-20740-999 CRIM - SUPP OF IND LEGAL SVCS - STATE $3.21 7865-999-10010-999 CASH - AVAILABLE $3.57 7950-999-20610 TIME PAYMENT - COUNTY $41.13 7950-999-20740 TIME PAYMENT - STATE $41.12 7950-999-10010 CASH - AVAILABLE $82.25 7505-999-20610 JUDICIAL SUPPORT-CRIM - COUNTY $1.62 7505-999-20740 JUDICIAL SUPPORT-CRIM - STATE $9.17 7505-999-10010 CASH - AVAILABLE $10.79 7505-999-20740-010 JUDICIAL SALARIES -CIVIL- STATE(42) $253.25 7505-999-10010-010 CASH AVAILABLE $253.25 2740-001-45050 BOND FORFEITURES $0.00 2740-999-10010 CASH - AVAILABLE $0.00 2729-001-44034 PRE-TRIAL DIVERSION FUND $0.00 2729-999-10010 CASH - AVAILABLE $0.00 7857-999-20610 JURY REIMBURSEMENT FUND- COUNTY $0.91 7857-999-20740 JURY REIMBURSEMENT FUND- STATE $8.18 7857-999-10010 CASH - AVAILABLE $9.09 7860-999-20610 STATE TRAFFIC FINE- COUNTY $0.00 7860-999-20740 STATE TRAFFIC FINE- STATE $0.00 7860-999-10010 CASH - AVAILABLE $0.00 7403-999-22888 DIST CRT- ELECTRONIC FILING FEE - CIVIL $170.00 7403-999-22991 DIST CRT- ELECTRONIC FILING FEE - CRIMINAL $10.47 CASH - AVAILABLE $180.47 -44050 DISTRICT CLERK FEES $109.44 -10010 CASH - AVAILABLE $109.44 -44055 RECORD MGMT/PRSV FUND - COUNTY $68.40 -10010 CASH - AVAILABLE $68.40 -44050 COUNTY JURY FUND $2.74 -10010 CASH - AVAILABLE $2.74 -44055 COURTHOUSE SECURITY $27.36 -10010 CASH - AVAILABLE $27.36 -44050 CO & DIST CRT TECHNOLOGY FUND $10.94 -10010 CASH - AVAILABLE $10.94 -44050 COUNTY SPECIALTY COURT FUND $68.40 -10010 CASH - AVAILABLE $68.40 TOTAL: $287.28 7855-999-20784-010 DIST CRT - DIVORCE & FAMILY LAW - STATE $0.00 7855-999-20657-010 DIST CRT - DIVORCE & FAMILY LAW - COUNTY $0.00 7855-999-20792-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - STATE $97.00 7855-999-20658-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY $3.00 7855-999-20740-010 DIST CRT - OTHER CIVIL PROCEEDINGS - STATE $57.02 7855-999-20610-010 DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY $3.00 7855-999-20790-010 DUE TO STATE - NONDISCLOSURE FEE $0.00 7855-999-10010-010 CASH - AVAILABLE $160.02 2677-999-20740-999 COUNTY DISPUTE RESOLUTION FUND $285.00 2677-999-10010-999 CASH - AVAILABLE $285.00 7858-999-20740-999 DIST CLK - DUE TO STATE CONSOLIDATED FEE 2022 $611.00 7858-999-10010-999 CASH AVAILABLE $611.00 Revised 01/31/20 TOTAL (Distrib Req to Oper Acct) $12,589.09 $12,301.81 DUE TO OTHERS (Distrib Req(s) attached) ATTORNEY GENERAL (RESTITUTION) 0.00 OUT -OF -COUNTY SERVICE FEES 635.00 REFUND OF OVERPAYMENTS 47.00 DUE TO OTHERS 0.00 TOTAL DUE TO OTHERS $682.00 REPORT TOTAL -ALL FUNDS PLUS AMT OF RETURNED CKS LESS: TOTAL TREASURER'S RECEIPTS OVER / (SHORT) 12,983.81 0.00 (12,983.81) $0.00 DISTRICT COURT SECTION I: REPORT FOR OFFENSES COMMITTED 01/1/20 - Present 01/01/04 - 12/31/19 09/01/01 - 12/31/03 09/01/99 - 08/31/01 09/01 /97 - 08/31/99 09/01/95 - 08/31/97 09/01 /91 - 08/31 /95 DNA TESTING FEES EMS TRAUMA FUND JUV. PROB. DIVERSION FEES JURY REIMBURSEMENT FEE INDIGENT DEFENSE FUND STATE TRAFFIC FEES DRUG CRT PROG FEE SECTION II: AS APPLICABLE STATE POLICE OFFICER FEES FAILURE TO APPEAR/PAY FEES JUD. FUND-CONST. CO. CRT. JUD. FUND -STATUTORY CO. CRT. MOTOR CARRIER WEIGHT VIOLATIONS TIME PAYMENT FEE DRIVING RECORD FEE JUDICIAL SUPPORT FEES ELECTRONIC FILING FEE - CR TOTAL STATE COURT COSTS CIVIL FEES REPORT BIRTH CERTIFICATE FEES MARRIAGE LICENSE FEES DECL. OF INFORMAL MARRIAGE ELECTRONIC FILING FEE - CV NONDISCLOSURE FEES '..0. JUROR DONATIONS JUSTICE CRT. INDIG FILLING FEES STAT PROB CRT INDIG FILING FEES STAT PROS CRT JUDIC FILING FEES STAT CNTY CRT INDIG FILING FEES STAT CNTY CRT JUDIC FILING FEES STAT CNTY CRT -JUDICIAL SUPPORT CONST CNTY CRT INDIG FILING FEES CNST CNTY CRT JUDIC FILING FEES DIST CRT DIV & FAMILY LAW ( 0 DIST CRT OTHER THAN DIV/FAM LAW 6I DIST CRT OTHER CIVIL FILINGS ( 9� FAMILY PROTECTION FEE JUDICIAL SUPPORT FEE L 7-:! JUDICIAL & COURT PERSONNEL TRANING FEE 9 2022 STATE CONSOLIDATED FEE 7; COUNTY DISPUTE RESOLUTION FUND TOTAL CIVIL FEES REPORT AUGUST 2022 AUGUST COUNTY STATE 24.33 0.02 0.03 218.93 0.18 0.30 34.14 3.41 30.73 185.92 18.59 167.33 $9.09 0.91 8.18 $3.57 0.36 $3.21 $0.00 - $0.00 $104.60 $62.76 41.84 $82.25 41.13 41.12 $10.79 1.62 9.17 $10.47 $10.47 $1,190.82 $ 203.78 $ 987.04 AUGUST COLLECTED COUNTY STATE $170.00 $170.00 $0.00 $0,00 $0.00 $100.00 3.00 97.00 $60.02 3.00 57.02 $253.25 $253.25 $20.01 - $20.01 $611.00 $611.00 285.00 285.00 $ 1,499.28 $ 6.00 $ 1.493.28 TOTAL BOTH REPORTS $ 2,690.10 $ 209.78 $ 2,480.32 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 420 A 44817 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Anna kabela Address: Title: District clerk City: State: Zip: Phone: ACCOUNT NUMBEReDESCRIPTION`"' "AMOUNT 7340-999-20759-999 District Clerk Monthly Collections - Distribution $12,301.81 AUGUST 2022 V# 967 TOTAL 12,301.81 r �Z_ / 7-0 Z"z Signature of Official Date 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 1/ 6 FAX COVER SHEET September 13, 2p22 FROM: JUSTICE COURT PCT. 4, CALHOUN COUNTY 103 W. Dallas Street, P.O. Box 520 Seadrift, Texas 77983 PHONE: 361-785-7082 FAX: 361-785-2179 TO: County Commissioner Court Office Attn: Mae Belle Cassel FAX: 361-553-4444 Fax Cover: _1 Pages to Follow: _ 5- Ref: AUGUST 2022—JP4 Monthly Money Distribution Report Please give me a call if you have any questions. Thank you, Patsy Spence, Court Clerk Jidge-NesCey J. Hunt 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 2/ 6 ENTER¢OURT.NAML'..;•...,...........,................,.:...., .....,:..,.:,.,.,.. JUSTTCEOF,PEACENO.A . . EWER MONTH'OFREPORT "' .. ";: ENTERYEAR OF RePORT " i r . AUGUST' 2022 '` :" �E006,�•• AMOUNT ..: CASH BONDS + REVISCO OYf02G021 ADM1IINISTFiAT10N FEE=ADMF ; EREATHALCOHOL'.TESTIN6 4AT b. CONSOLIDATEOVOURT,COSTS '.000 20602 S ''.STATC CONYOLIOATED.000RTCOSIP2020 BIM00 LOCAL OONSOLIDATGD COURTCOSY+F020 t6400 4000R7HOU8E'SECIMRYrCNS 12R0 '' '` '•'' bMLJUSTICE'DA1`ARCPOSIYOfYY FEE .GDR 022 I.CORRECTIONAL'.MANAGEMENT;WSTITU7E:;CMI CMI .. " EHILO'S1KE`TY 'CS 'CHILD 5EATOELTFEE CSOF CRIMCVICTIMS COMPENeATION CVC DPSCIFAIWRETOAPPEA I NI'pPSC' 7000 AOMINISTRATION.FEEIPTkPTP:I PMN1):2020 •' :: 'EI:GCTRONIC'FILING FEEEEF FUOffIVE'APPREHENSIONWFA'. '+GENERAI':.REVENUE•.GR '. 'CRIM?IN0;4EOAL!$VCS.SUPPORTJIDF. BAD ;:JUVENKE'CRIME &DECINOUENOY-3CO ' 'JUVENILE;CASE.MANAGERFUND.JCMF E00 'JUSTICC COURT.PER60NNE0'.TRAINWG 4 JCPT i';.;NRORSERVICE FEEJSF 1200 LOCALARRESTFEES LLAF 5800 i ':a :.`i• .LENT ;:iBon PARKS&WILDLIFE ARRE5I;FEEBp411AF +•.:57ATE'ARREBT FEES•$AF SCHOOL CR0861NGICNIIA'SAFETY FEE•SCF .. UB7ITLEC• SUBC • 8002 STATE4RAFFIC'FINE&EST 0A.10. STP .'' 288.43 TABCARREST FEES-YAF + TECMNOLOGVFUNO=YF 1YB0 . SRAFFICr7C 062 1 LOCALTRAFF(CfINE•2020 1701 PAYMENUTIME : ' 3002 i 71MEPAYMENTjRE&1BURSEMERT FEE:Q020 TRUANCYPREVENTIONVIVERSIONFUND-TPDF ', 00 LOCH AbTATEWMRANT,FEES-WRN E000 'COLLECTION SERVlCE:EEE:MV2WOERV. 43000 OEF�N81VEpRIVING COORS& VOC 'OEFEKtREOFSE•OFF 23000 +ORMNO EXAM FEE• PROV,OL .: . "FlLINGFEE-FFEE ..• STATECONSOUDATED:CIVO:FEE-2022 2100 'LOfJv:CONS000ATSOCIVILFE.:FFSY 0000 FILWGFEG SMAL... .: :JURY FEE �:JF URYFEM9JF COPIESICERTIFED;COFIES r +INDIGENT KECI+CIFKOr;INOFNF ' JUDOEPAY,'RNSE FEE, PAY 10l0 •-SERWCEFEVSFEE ,' 75.00 ' OUT &RCOUNTY SERVICE FEE ELECTRONIO FILWGFEE • EEP p : EXPUENT NGEMFEE-EXPa %'EXPIRED RCNEWAL- EXPR ABSTRACT OF,RIDGEMENT+AOJ ' .ACbWRITBgWOPIWOE 601) '; OPS,FTA FNEDPSF LOCAC':FINESFINE 189008' ' LICENSEb WEIOXITFEES�LWP .AARILSa Wy;OUFE•FIPES • PWF :BEATBEITNNRCSTRNNED.CHILD FINE • SEAT . JUDICIAL&'COURT.PERSONNEU,TRAININGACPT OVERPAYMENT;(OVEREIO)-OVER + ' OVERPAYMENT (EJ0'ANO'CESS)-OVER .. ' pARKSaVNLOUFE 1NATER'SAFE'Tx flNE&WSF ,: . ,.MARINE:SAFETY PARKS B.VRIDUFC•MSO , y ': TOTAL'ACPUAL MONEY RECeVW • �AJhO.Ba � TYPE. T WARRAN FEES ..'. ..... ' ENTER LOCAL WARRANT FEES©n[coROOXTmNrioe�Mi4GWNmYroaiw.weRauwxr Ir :;;EYATEWARRANT.FEES....-,•s0aa0.aecpxOautOfNFK00V1111L6WXIRY90Ftt/NO m%REIgRT DUETOOTMCRS.:' AMOUNT DUE TO CCISD•507A Or;P100 M'3V:00000,x:;;;;, �;,;,.y., 400 RGNIXCaRF D.AN:OukeiwoaeewwENLxT OUEYOOARGSTIMION'FUND*'::(:i;:r:::;�5:;:? :: •: 7:':K 1 �;';AOO; KOMINCINOG 0.0. PTAUEBIwopE0w1a;14M ivi.f r'-.::.: >:;ii,7:,.1.:;';:ba0: .•;; ..lye: . w.eowquce 0Aa0aucminOaRouRacruRr OUhOW000NTY;SERNCE FEE;:;;'.+:,j;,�,;::;a';:'?;�;'.• j:i,:•;',;::''^0,00 nMgwnwE o,E.RECuocilxOaWVnaukM CASH BONDS : ' '' ROse.iNa . 9XIMUEBRmallauRorJXMN'NAYMM •�. ..' ';� ':..TOTAL OUE'TOOTNERS ., ': 0a , REASURERS'RECEIpIS FORMONTH � AMOUNT ns •� CASH CNE RS M F4 R1410 GlEmtle lNwAR11AlTrvREurvh Ra:eORe :;"".'CREOI7CARDS ;TOTAE:TREAS: ReCmPTS ..-•K O1M0 •'>�.-' "". ... '•. 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 3/ 6 MONTHLY REPORT OF COLLECTIONS AND morm8UT/ONS 9/13/2022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: AUGUST YEAR OF REPORT: 2022 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45014 FINES 1.696.35 CR 1000-001.44190 SHERIFF'S FEES 108,00 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 24.53 ADMINISTRATIVE FEES 239.00 EXPVNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR CR 1000-001-44364 1000-001-44010 TOTAL ADMINISTRATIVE FEES 263.63 CONSTABLE FEES -SERVICE 80.00 CR 1000-001-44064 JP FILING FEES 0.00 CR 1000-001.44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR IOONS99.20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-998.20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 438.60 TOTAL FINES, ADMIN. FEES & DUE TO STATE $2,586.49 CR 2670-001-M064 COURTHOUSE SECURITY FUND $63.50 CR 2720-001.44064 JUSTICE COURT SECURITY FUND $3,20 CR 2719.001.44D64 JUSTICE COURT TECHNOLOGY FUND $56.80 CR 2699-001-41D64 JUVENILE CASE MANAGER FUND $5.00 CR 2730-001-44064 LOCAL TRUANCY PREVENTION & DIVERSION FUND $55.00 OR 2669-001-44064 COUNTY JURY FUND $1.10 CR'i 272&OOt 44084 . JUSTICE'C.OURT SUPPORT FUND' $25.00 CR?%2677,-001-44084 COUN7Y:DISPUTERESOGUTION•FDND $5,00 CR2725�001-04064 ,. LAN'GUAGEACCESSFUND $3.0D STATEARRESTFEES DPS FEES 13.00 P&W FEES 0.00 TABC FEES 0.00 CR 7020 999 20740 TOTAL STATE ARREST FEES 13.00 OR 7070-999-20610 CCC-GENERAL FUND 2090 CR 7070-999.20740 CCC•STAT(u 12090 88.12 DR 7070.999-10010 209.02 CR 7072-999-20610 STATE CCC- GENERAL FUND 6868 CR 7072-999.20740 STATE CCG STATE ,20 DR 7072-999-10010 682.00 680 CR 7860.999-20610 STFISUBC.GENERAL FUND 3.30 CR 7860-999.20740 STFISUBC-STATE 82 72 OR 7860-999-10010 66.02 OR 7860-999-20610 STF- EST 9/1/2019. GENERAL FUND 11.94 CR 7860-999-20740 STF- EST 9/1/2019- STATE 286.49 DR 7860-998,10010 298.43 Page 1 of 3 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 4/ 6 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 9/13/2022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: AUGUST YEAR OF REPORT: 2022 CR 795D-999-20610 TP-GENERAL FUND 15.01 CR 795D-999.20740 TP-STATE 15.01 DR 7950.999.10010 30.02 Page 2 of 3 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 5/ 6 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 911=022 OR 7480-999-20610 OR 7480499-20740 OR 786$-999.20610 OR 7865-999.20740 OR 7970-999.20610 OR 7970-999.20740 OR 7506-999.20610 OR 7505-999.20740 OR 7857.999.20610 OR 7857-999-20740 OR 785"99.20610 OR 7850-999.20740 CR 7502-999.20740 7998.999-20740 7996-999-20701 7403-999-22889 7858-999-20740 REVISED 02/02/2021 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: AUGUST YEAR OF REPORT: 2022 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480.999.10010 0.00 CRIM-SUPP OF IND LEG SVCS-GEN FUND 0.64 CRIM-SUPP OF IND LEG SVCS-STATE 5.76 DR 7865-999-10010 940 TUFTA=GENERAL FUND 23.33 TUFTA=STATE 46.67 DR 7970.999.10010 70.00 JPAY-GENERAL FUND 192 JPAY-STATE 1728 DR 7505-999.10010 19.20 JURY REIMB. FUND- GEN. FUND 1.28 JURY REIMB. FUND- STATE 11.52 DR 7857-999-10010 12.80 CIVIL JUSTICE DATA REPOS,- GEN FUND 0.02 CIVIL JUSTICE DATA REPOS: STATE 0.20 DR 7855-999-10010 „ in DR 7502-999.10010 DR 7998-999-10010 DR 7403-999-22889 PREVENT/DIV FUND - STATE 2.20 TOTAL (DWrib Req to Oper Acc!) $4� 23B.60 DUE TO OTHERS (D/stribRegAttehCp CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT: , 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 00 0.00 WATER SAFETY FINES , Page 3 of.3 v l ^r uva 7 v V l rltKS $0.00 TOTAL COLLECTED -ALL FUNDS $4,236.60 SS: TOTAL TREASUER'S RECEIPTS $ 914.10 OVER/(SHORT) $677.50 09-13-22;14:36 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 6/ 6 S,[pYP Og �,• �CALHOUN I I , COUNTY 201 West Austin PAYEE Name: Calhoun County Oper. Acct. Address: City: State: Zip: Phone: Stgnature of %'T DISTRIBUTION REQUEST DR# 450 A 44818 PAYOR Official: Wesley Hunt Title: Justice of the Peace, Pct. 4 09/1212022 08:01 CALHOUN CO AUDITREAS (TA)03615534614 P.0011004 CALHOUN COUNTY, TEXAS COUNTY TREASURER'S REPORT MON HOT. MARCHW22 890INNIIVG ENDING FUND FUNDBALANCE RECHIPTS DISBURSEMENIS FUNDBAIANCE PERA2Try FUNDS: GENERAL S 39,081.409.75 S 1.012.N2.28 S 2,575.351,41 S 37,516.550.62 AIRPORTMAINTENANCE 71.675.36 112.63 3.11831 58.670.18 APPELLATE RIDICIALSYSTEM 215.53 150.04 - 365.57 COURTFACILITY PRE FUND 490.00 60D40 I I.M.00 COASTALPROTECITON FUND 1,996.925.10 351.95 - 1,997.277.05 COUNTS' AND OISTCOURTTECH FUND U6356 103.64 - 8,367.2D COUNTY CHILD ABUSE PREVENTION FUND 715.70 0.41 - 736.11 COUNTY CHILD WELFARE BOARD FUND 1.041.25 56.13 - 1,109.43 COUNTY JURY FUND 691.60 172.96 - OK46 COURTHOUSE SECURITY 276,998.98 1,815.94 278.784.92 COURT INITIATED GUARDIANSHIP FUND 13,3140 24236 13,626.99 DISTCLK RECORD PRESERVATION FUND 40,98L98 47.22 41,030.20 COURT REPORTERS SERVICE FUND 640.45 60,30 709.75 00 CLK RECORDS ARCHIVE FUND 334.576.07 4.648.97 339.223.94 COUNTY SPECIALTY COURTFuno 5,355,76 484.28 5.540.04 COUNTY DISPUTE RESOLUTION FUND 454.26 345.74 1,000.00 DONATIONS 119.028.49 1.10756 3,097.07 117.039.39 DRUGIDWI COURT PROGRAM FUND -LOCAL M.221.75 79.21 26,301A3 JUVENILE CASE MANAGER FUND 16,477.99 54.90 526.73 16.006.16 FAMILY PROTECTION FUND 14.493.79 2.55 - 14,496.33 JUVENILE DELINOLE Cy PREVENTION FUND 0.269.93 1.63 9,270.56 GRANTS 423.834.13 240,004,53 242,296.16 421,543.20 JUS77CB COURTTECHNOIAOY 9D,305.60 443.67 90,749.27 JUSTICE COURT BUILDING SECURITY FUND 6.6MJD7 14.00 27SSD 6,365.07 LATERAL ROAD PRECINCT#1 4240.92 0,77 - 4,341.39 LATERAL ROAD PRECINCT62 4340.82 0.77 - 4.341.39 LATERAL ROAD PRECINCT#) 4,340.92 0.77 - 4.34139 LATERAL ROAD PRP.CINCT#4 4.340.82 0.77 - 4,341.99 LANUAOE ACCESS FUND 128.36 147.44 - 276.00 JUROR DONATIONS -HUMANE SOCIETY 1,064.It 65.00 - 1,13D.16 JUROR DONATIONS VETERANS SERVICES 192.I3 59.40 - 750.15 JUSTICE COURT SUPPORTFUND 471.30 479.70 - 950.00 PRETRIAL SERVICES FUND 86.655.90 415,27 87.071.17 LOCAL TRUANCY PREVENTIONIDIVERSIONFUND 16.201.61 473A0 16,475.01 LAW LIBRARY 212,859A5 1,08752 2,208.30 211,643.67 LAW RNP OFFICERS SM. EDUC. GEOSE) 29.457.16 S.19 29.462.73 POC COMMUNITY CENTER 28.437.85 3,400.71 10,2SSAl 23.513.15 RECORDS MANAGEMENT -DISTRICT CLERK I.845,03 40.88 1.155.91 RECORDS MANAGEMENT -COUNTY CLERK 223.955A3 4,659,47 1.71 228.613.19 RECORDS MONT 4 PRESERVATION 41.144.07 1,445.82 - 4L589,89 ROAD k BRIDGE GENERAL 1353.161.66 90.501.23 1.45L662.89 6MILE PTERIBOAT RAMP INSURIMAINT 34.393,61 6.06 - 34.399.67 CAPITAL PROD- BOGGY BAYOU NATURE PARK 199,731.90 11,550D0 187.183.80 CAPITAL PROI. AMERICAN RESCUE PLAN ACT 2021 217,203.03 72048 216.452.15 CAPITAL PROS. KING FISHER BEACH PARK 60,000.00 101110.00 56.60000 CAPITAL PRO) MAOJNDIANOLA BEACH PAVILIONS 316,010.00 - 316.010.00 CAPITAL PROI- CDBG OR INFRASTRUCTURE 63,111.61 - - 63,U1.61 CAPITAL PRO! CHOCOLATE BAYOU BOAT RAMP 232.525.01 - - 232.925.01 CAPITAL PROJ- ELECTION MACHINES 0.21 - _ 0.21 CAPITAL PRO! -RB INFRASTRUCTURE S6S.14959 - 13,477.78 354,671.91 CAPITALPROJENERGYTRZ01 156.599.49 - 156,338,19 CAPITAL PROI AIRPORT RUNWAY IMPROVEMENTS 14,972.11 - - 14.972.13 CAPITAL PROI MAGNOLIA BEACH EROSION CONT 175.000.00 175.000.00 CAPITAL PRO) EVENT CENTER 125.921.09 175,927.09 CAPITAL PRO) FIRE TRUCKS R SAFETY EQUIP 6,441.68 • 6,44868 CAPITAL PROI-GREEN LAKE PARK 7,160.74 27.185.08 35,045.82 CAPITAL PROI HATERIUS PARKJBOAT RAMP 13.24SA9 - SA20.62 7.124.17 CAPITAL PROI PORT ALTO PUBLIC BEACH 1,484.78 - - 1.494.79 CAPITAL PRO] HURRICANE HARVEY PENA K914,61 - 54.914.69 CAPITAL PRO) IMPROVEMENTS PROJECTS 344369.10 - - 3".169.10 CAPITAL PROJ HOSPITAL IMPROVEMENTS 2,490.852.6E - - 2.490,85L66 CAPITAL PROJ-MMCLOANS 4,000000.00 - 4.000,000.00 ARREST FEES 63143 14L98 - 781.81 BAIL BOND FEES (HE 1940) 295.00 190.90 - 973.00 CONSOLIDATED COURT COSTS (NEW) 039.15 1.06534 - 2,403,49 CONSOLIDATED COURT COSTS 2020 0580,60 9,65449 19.235A9 DNA TESTING FUND 250A1 14.79 - 263.19 DRUG COURT PROGRAM FUND -STATE 35,75 74IIQdLj S 53 W.441.39 3 1417 291.84 S 2 869 799.38 5 5 193 933.95 SUATUALS! Page 1 of 0911212022 08:01 CALHOUN CO AUD/TREAS O:A1g3615534614 P.0021004 COUNTY TREASURER'S REPORT MONTH On MARCH2D22 BEGINNING ENDING FUND FEINDRAIANCE CRIPTS DISBURSEMENTS P ND B.lL4N OPERATING FUN -BALANCE FORWARD S 33,646.441.39 S 1A17,291.04 21169,799.38 f 52,193,933.85 ELECTION SERVICES CONTRACT S 92.755.03 316.53 - S 83,071.5E ELECTRONIC FILING FEE FUND $ 32635 121.06 S 447.61 EMS TRAUMA FUND 957.79 688.98 L546.77 FINES AND COURT COSTS HOLDING FUND 7,84T31 - 7.94731 INDIGENT CIVIL LEGAL SERVICE 7330 - - 75.30 JUDICIAL FUND (ST. COURT COSTS) JUDICIAL& COURT PERSONNELTRAININO FUND JUDICIALSALARIPS FUND "OR DONATION•TX CRIME VICTIMS FUND JUVENILE PROBATION RESTITUTION LIBRARY GIFT AND MEMORIAL MISCELLANEOUS CLEARING 15.00 64A9 610.97 369.00 62.57 40,691.01 11,064.34 15.00 27136 - 0.35 776.92 - 1.494.32 15-M WAS 19233 368,00 6267 4D,691.36 10.296.94 REPUNDABLEDP.POSITS STATE CIVIL FEE FUND C1VH,NSTiCEDATA REPOSITORY FUND 2.000.00 6I9.20 0.92 386,60 0.62 - - - 2,M9BD 1,275.90 1.44 JURY REIMBUR$BMENTPEB STATE CONSOLIDATED CIVIL FEE FUND SUBTITLE C FUND $UPPOP CRIM INDIGENT DEFENSE TIME PAYNEUM TRAFFIC LAW FAILURE TO APPEAR UNCLAIMED PROPERTY TRUANCY PREVENTION AND DIVERSION FUND BOOTCAMPJIIAEP JUVENILE PROBA77ON SUBTOTALS TAXES IN ESCROW 90.66 3,07152 3.472.36 67.44 120.29 292.98 12,785.91 149.31 147A3 447 68.92 1.516.12 3.210.00 54.46 15S.13 273.15 0.19 25.26 71078.59 - - - - 52571.57 159.38 4,69,1 0 6,691.36 121.90 278.41 566.13 12,786.10 17457 147.43 465.6139.20 - 54.741,293.70 0.00 S 1.496.563.08 3 2.923.872.27 0.00 S2.233.194.11 0B0 54,261.M.705 m3min. 5 531833.194,61 TOTAL OPERATING FUNDS OTHER FUNDS D A PORPEITED PROPERTY FUND SHERIFF NARCOTIC FORFEITURES CERT OFOR-CRTHSE HER SERIES 2010 CERTOFOB•CATHOUIS 1&$ SERIES 2012 CAL, 00. PEES & PINES 21,341.68 31.W337 499.943.57 662,935.93 107 049.75 210.36 4.07 6,357.44 9.265.51 I 1.697.70 - 21,62154 30.209.94 496.231.01 671.231.74 132441.10 MEMORIAL MRDJCALCENTER OPEM71NG MONEY MARKET INDIOENTHEALTHCARE PRIVATE WAIVER CLEARING FUND CLINIC CONSTRUCTION SERIES 2014 NH ASPORD NH BROADMOOR NH CRESCENT NH FORT BEND NH SOfERA NH GOLDEN CREEK NH SOLERA DACA NH ASHFORD DACA NH BROADMOOR DACA NN GULP POINTS -PRIVATE PAY MI CULF POINT PLAZA MEDICARE/MEDICAID NN BESHANY SENIOR LIVING NH TUSCANY VILAOB TOTAL MEMORIAL MEDICAL CENTER FUNDS 6,172.099.45 1.109.779.55 13.103.57 431.66 536.19 386.558.09 256,540.29 215,979.19 116,407.44 396,301.48 319.269.19 O.m 0.00 MOD 66.339.14 25Z622.55 343241.77 294500.94 S 5,073,019.81 $ 235.64 47,241.76 045 0B7 512,455.63 282,9346I 50.14152 157.5764) 570.250.91 357.477.26 0.00 0.00 0.00 5A96733 328,480.13 839,01L42 fiS9.340.0S S 5.373.951.39 S 10,16435 0.00 0.00 869,243.23 491,667.93 715,608.44 26605632 912,89732 631,742B0 0.00 0.00 0.00 117.743.70 511,767.99 1^263.63 847853.39 S 5.871.255.67 S 1.110.015.19 52,2W.98 431.71 936.26 29,710.43 47,064.92 62,112.27 7,927.45 3;635.07 45E03.05 0.00 0.00 O.m 5,461.77 29.334.70 92,99256 69.094.30 s 9402AOUD $ 9,454,094.32878864.18 5 7 7 2S3 DRAINAGE DISTRICTS NO.6 NO.9 NO. 10-MAINTRNANCE NO. 11-MAINTENANC&OPERATINO NO. II -RESERVE TOTAL DRAINAGE DISTRICT FUNDS 33,280.59 IS1,366.60 213.787.79 243,923.01 225 8.11 134.99 619.35 100.53 8.066.93 22.75 - - 29.325.90 44.279.36 - S 72,605.16 3 33A15.52 151.983.05 107AS1,52 207.710.18 225716.96 S SNAM.49 s mmue CALHOUN COUNTY WCm 61 OPERATING ACCOUNT PAYROLL TAX $ 416.948.24 29. 432.84 DOD 42,762.99 178.10 $ 374,632.09 450.33 TOTAL WCID FUNDS CALHOUN COUNTY PORT AU7RORITY 17 7.17 7 MAINTRNANCISANDOPBRATING S 66 39.6t $ 723,62 L_91.38 S 66076.63 CALHOUN COUNTY FROST BANK 3.57 S 5.00 1 0.97 S 11 9A64,31133 ll 994 IL 1 8 72 169.66 TOTAL MMC, DR. DIET., NAY. DIRT, WCm & FROST $ 66882,69S34 S 11,1I0,75L69 $ 15,929,632.33 TOTAL ALL FUNDS i 62.013,819.10 Page of 3 09/12/2022 08:02 CALHOUH CO AUDITREAS (FAX)3615534614 P.0031004 COUNTY TREASURER'S REPORT I MONTHOR MARCH 2O22 BANK RECONCILIATION L99S:CR1I70PDRP1 POND ODTSrNDGDEF/ FIRS: CHECKS SANK FOND BALANCE OTHER ITEMR 00757ANDLNG BALANCE OPERATING • S M",894.31 15,122,011,16 2W.260.53 6 37,917,144.18 OTHER D A FORPEITED PROPERTY FUND 21.621.94 21.621.24 SIWIWNARCOTICPORFEOTIIPS 30.209.94 751.10 30,067.64 CERT OPOB-CRTHSE REFSERES 2010 496.231.01 2.94155 - 493.380.43 CBRTOPOB.CRTHOUSE LAS SERIFS 2012 671,251.74 3.673E3 667.577.91 CAL. CO FEES &PINES 132.441.10 9.244.56 17.119.52 140,31636 MEMORIAL MEDICAL CENTER OFERAMNot 5,871,20.87 - 363.223.61 6,434A89.43 MONEY MARKET 1,110,015.19 1,110,013.19 INDIGP.NTHPALTHCARE 52,2W.98 47,220.31 41334 SAt4.01 PRIVATE WAIVER CLEARING FUND 431.71 - - 431.71 CLINIC CONSTRUCTION SERIES 2014 536.25 - - 516.26 NH ASPORD 29,720.43 - - 29.780.43 NH BROADMOOR 47.164.92 - 47.864.92 NH CRESCENT 62,11227 - 6ZIIL27 NW FORT BEND 1.927,45 - 7,927.45 NH SOLERA 52,655.07 - 52455A7 NH GOLDEN CREEK 45,005.05 45,005D5 NH ROLERA DACA 0100 - - 0.00 NH ASHFORn DACA 0.00 0.00 NN BROADMOOR DACA 0.00 - 0.99 NH CALF POINT PRIVATE PAY 5A61.71 - 5.461.77 NH GULP POINTE PLAZA MEDICARE MEDICAID 29,334.70 - 29,33C70 NH BETHAN SENIOR LIVING 92992.56 - - 92,992.56 NH TUSCANY VILLAGE 69.994.30 - - 69.994.30 DRAINAGE DISTRICT: No 33,415.59 107.70 - 33,307.88 NO 111.981.91 - 151,985.95 NO, 10 MAINTENANCE 187,051.12 146.58 - 157,502.94 NO.11 MAINTINANCEMPERATING 207.71038 4,109.49 293.40LI0 NO. 11 RESERVE 225.716.86 - 225,71686 CALHOUN COUNTY WCID aI OPERATING ACCOUNT 374,63249 - 374.632.09 PAYROLLTAK 450.13 - 450.81 CALHOUN COUNTY PORT AUTHORITY MAINIENANCPKIPERATNG•••• 66.W685 - - 66,976.85 CALHOUN COUNTY FROST BANK t990.87 - 1.99D.87 ALS 8 6L913.819.80 S I&IAQjM.2fi A 216.77510 S 4SX1,9311,99 •••• THE DEPOSITORY FOR CALHOUN COUNTY WCID IS INTERNATIONAL BANK OF COMMRCE-PORT LAVACA •••• THE DEPOSITORY FOR CALHOUN Co. NAVIGATION DISTRICT IS FIRST NATIONAL BANK -PORT LAVACA •••• THE DEPOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK - AUSTIN, TEXAS •••• EASTWEX BANK CDs -OPERATING FUND f15.013A19.67 THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS PROSPERITY BANK, PORT LAVACA Court costs and fees collected and reported may not be current and up-to-date due to non -comp) iance by other county offices. hereby certify that the current balances are correct to all monies that have been received by the County Treasurer as of the date of this report r—^ I I 4 1 Page 3 of3 0911212022 08:02 CALHOUN CO AUDITREAS TAXp615534614 P.0041004 W ca IE m » » 8"W"3It 08x8AR8ffi i . iBRRvR£RCC S 8 » M M x x D4 NA A oaaat0-92RgARpD]lz4bla8ast:2IMdyl%IaIts a�J22pi�sevQ8SIR g5gg6g%6e C! Av1"E1'9 °1f06(�fr1^G``i'�m ^^q 1j N ^ TI �f 7i M 8R.8$8n8 „g,m8Ri�88�8,$Sl8888R III Md �9R p la r » x x ^"'88BR8me6RffimsffigG, ��sa��e-a � RUN � � w x �qv 1�0p • w a�� » w w 0 a obId Inn x00 OC2� SNe »oo. IRs�uc�zz 4 1SIR R409 $S GC , ul.R 99 ^ x Ra e 91all M S 0 n M 0911212022 08:03 CALHOUN CO AUD17REAS ITAM0155341514 P.0011001 T COUNT TECH FUND ABUSE PREVENTION FUND WELFARE BOARD FUND FUND SECURITY N FUND FUND -LOCAL LAW ENFOFFICERS ETC, EDUC. (LEOSE) POCCOMMUNITYCENTER RECORDS MANAGEMENT•018TRICT CLERK RECORDS MANAGEMENT -COUNTY CLERK CAPITALPROJ CAPITAL PROD CAPITAL PR01 CAPITAL CAPITAL CAPITAL COURT CALHOUN COUNTY TREASURER'S OFFICE RUNWAY IMPROVEMENTS REACH EROSION OONT LATER KS 6 SAFETY EQUIP 1KE PARK PARWBCAT RAMP ITS HOLDING FUND SERVICE 1.OdGoo 1,907,277.05 6,567.20 736.11 ';I'- - 1.1T R64N6UR6EMENT FEE 13.628.92 STATE CONSOLIDATED CIVIL FEE FUND 41.030.20 SUBTRLECFUND 799.75 SUPP OF CRIM INDIGENT DEFENSE 330,US.04 TIME PAYMENTS 6,840,04 TRAFFIC LAW FAILURE TOAPPEAR 1,000,00 UNCLAIMED PROPERTY 117,039.35 TRVANCY PREVENTION AND DIVERSION FUND 29,001.03 BOOT CAMWJJAEP 1g008,15 JUVENILE PROBATION 14,488.33 9.270.66 421,648.20 90.749.27 Sms.o7 TOTALOPERATING 4.341.39 4,341.09 DA FORFEITED PROPERTY FUNDS 4.241.60 SHERIFF NARCOTICS FORFEITURES 4,341.59 CENT OF 00-CRTHOUSE ME SERIES WI 276.00 CERT OF 094RTHOUSE MS SERIES gold 1.180.10 CAL CO FEES a FINES 260.1a TOTALOTHERCOUNTY 960.oa . 87.071.17 MEMORIAL MEDICAL CENTER 10,076.01 OPERATING 211,6411ST INDIGENT HEALTH CARE 29,412.76 PRIVATE WAIVER CLEARIND FUND 23.665.15 CLINIC CONSTRUCTION SERIES 2014 1.885.91 NHASHFORD 22g613.10 NHBROADMOOR 42,589,09 NH CRESCENT 431,682.69 NHPONTBEND 187,183.00 NH GOLDEN CREEK 210,482.15 IN SOLERA DACA 311,50D.00 NHASHFORODACA 018-010.00 NM BROADMOOR DACA 83,111.61 I IN GULF POINT. PRIVATE PAY 232,823.01 NH GULF POINT PLAZA MEDICA 0.21 NH BETHANY SENIOR LIVING 064A71.81 NN TUSCANY 166,Sa6A9 MONEY MARKET a,44a,e8 N0� 6 85,046.62 N0.6 7,624,1 ND. 10-MAINTENANCE 1,484.iB NO.11-MAINTENANCEJOPERATING 54,019.e6 NO.11MESERVE 4/,969.10 TOTALDRAINAGE 882.01 3OB.01 81 40,601.38 1,44 147.43 406,Bm,80 SAIIA9N.a1 21.021.84 30,200,94 496,231.01 071.251,74 132,441.10 1,361,756.02 62,Z60A8 431.71 6.461.77 29,93d,70 B;9B238 89.194.00 6 ,110,015./9 f 7A77,63u9 a3,415.66 161,006.96 167,051.62 207.710.61 225,719.88 8 B00A00.49 761.01 OPERATINOACCGUNT 75,00 PAYROLL TAK 371 Bat O9 2,403.40 11,235.41 TOTAL WCIO 160.93 378,OB2,B8 206.10 CALHOUN COUNTY PORT AUTHORITY 110.43 MAINTENANCEAND OPERATING 63,071, f 16,976.61 4647.e CALHOUN COUNTY /snn.a PROBT BANK d 1.290.87 V+wav em.ommmsronenmelmmr Cal nCwn T-4 heraby"I'my that "have made an elnminetlml of M, Coun Qua ngnd,BNdut11 Dean mm deyentlhave muntl Me earllnm Coined ;IntlweMer. b7remumye Wr, unty ud0e DON e,Ilq, Cqe Col emnerP 1 Vein LWay,CemmlMlelMr Jeele hmm,CClommillhuterfta Da.R...74IulonNPm4 8WORNTO AND SUBSCRIBED BEFORE ME, County Judge, and County CommleebneN of mid Calhoun County each neepeebvaN, en Ole day of .2022 BEFORE ME the undeNlgned aumordy. on lNe day P6NONIsfy appeared Rh g.Kobem, nr�uJ�T�meeu"rer.A�,��CppIt nCeu YAee mallbee4mlhand and moonedaONabw entl CoOap ntlmunalo ue mom Pffm4ed Mien County N,m eRm2 de�rpllsN Rea�ver,Fouliml and NpeAetl may net baComnland up4aaeta tlusm nOrvpJmpllanCo ether d // le antl men dollseutl FILED FOR RECORDAND RECORDED TH M __ dayal 2A" Anna Oaadmen, countyCION #13 NO ICE Ol= MEETING- 9/2.1/2022 13. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS]'' MOVER: Gary Reese, Commissioner Pct`4 SECONDER: Joel Behrens, Commissioner Pet 3 AYES:, Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 11 AN IN a §§aa § \■ a §aaa §� a §�aa e § ■ ■ � � ■ ■ w B �\ ; .e■ \ a :z :§ :L :§ §ae § § §§ §§ Lai §- ■ § � Z : § k :§ IL �lu : :z :z :k � ■ L ■ $ § §ju - , e @ . z .L k ■ . ■ ; § § _ ewe~ � §��\ §§a ;§ �- 2 , � � ■ e §& t ' \ W - B� � ■ § | �§ ■ §§ ■< § .�; |�§ _ / �BC3} §■■ �§2 | 2 2 § �kwa f §§ � .� §� ■ z \ §\ \ )Z �B §z ■z §LU k ; §wa a §§ § )§ § § B §� )& )&LU /o § as § a fo § §§ B 2 § ) 2 § ■ ; / / $ k ' � U LU § § �§0 �eIR I § § � § § ■e § § § §m § ■` ; % § � o § ■ $LU ■ _ A � � z ) � ■ , 77 y e z z d wax V W C i7 G Ul Ul ra W Z Z '0 W i Y1 LLII a iZ : LUC b 0 y d' C H ;F :L W Z C W z ;C 2 s o 0 0 J Q 0 W 0 z2 0 0 U 1 I 1 �$j I 1 I 1 1 � 1 ' 1 U W � w C O b I � F z zz U' (7 F z z V crnrn Y: Z m W O a In A` W W Z 0 W C z o W w ON O I N W J Q 0 rc 0 U J J 0 Ux F Z z 0 0 U :" :o :z ;z :§ .L �§ z k @ § §ee&& §2»J 0000 ;;;2 ■,___ ■`mmm ■° :$ m ;o :z ;z �§ .L �2 ` � ■ U) �2 & § § 0 0 �§UA .�l . z § . ■ u �( § § ` cc ■ - § CD z ` § § w �� ■ - k ) 0 w } k I I III I C m W W z rr O1 W a w M U 6 Q z Z 0 J F uj W U LU w -j J U O w U Z W LU W LU W N w N C OC z 0 O � � r Olyp N f, s Z a LLI a d W W >. o 0 mS 2 F- W U N Z t L Z W O a ig U O z W g� 1L $ o Z 4 rn 0 W rn H W zZ W W F W H W W w U Z Q V. we w of Z b O D a z Z W W M Z w W O a o W ON v Q N NO m a n C m y W 19 0 N a 0 0 w U ui W N z O 75 z F W ;O ;N :Z z ;CWC �G :IL iW iG O J a �3 zz 2 Q Z Z e 6 O m emo uj w z z w a ~¢ aw w a O Li w U a > =1 w toh 6 � � 0 M O N I t 6 Z z W W W U aOf co z a 0 0 of i O era rn 6 N 0, BB :k )o :z :z )§ )L (§ � § � & ) :w § § ■ 0 :w § :� § � iz B , . Z � . ■ , « § © o ■ �§( §!m § § /\ $ [ § L LU -\ @ LU �®° §®\ ■ k| \| a| al k tu ) k :§ ;a ;z ;z �§ :L 2 Itm ir § §e ro � § § § ) k 2 2 � � » z 2 � � 2 � I IN § ■ A ( )) Elu / /m . ■ �\ 0 $ =z ) @ § ! § § ■§ § % ■§ ■ 9 §§ k � » z 2 � � 2 111 ;§k i§U. '■§ LU .�z 0 � § §e B u BLu �o ■\ � ;k ;o :z ;z �§ AL �§ § B m LU @ � k ± \ 2 0 k ( ) ( z 0 w :o :z :z :§ :9L ;§ § �e k k §d _/ °z J cr Z uj g Z Z LL 4-14 H Z t d O 0 O W W� W C �J lu W S z Fe W W a to N W W z �` O m y W z � W 0 � lu � 0 w 1 7 n e 0> e 0> eO1 :0 Ez 3W EF Ed' iL iW z !W W W � W to h oa. °a ;W ;0 W O z Z W J z O 0 W z z H z W 0 � � w r z w U W Z D z� 0 C U 0 a a w i N w 6 N f9 I tq, 6q #14 NOTICE OF MEETING:; — 9/21/2022 14. Approval of bills and pavroll. (RHM) MMC Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct2. AYES: i Judge Meyer, Commissioner Hall, Lyssy,; Behrens, ;Reese " Indigent. Healthcare RESULT: APPROVED [UNANIMOUS], MOVER: David Hall, Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct2 AYES: Judge Meyer, Commissioner Hail, Lyssy, Behrens, Reese County Bills RESULT:" APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned:10:29 a.m. Page 11 of 11 M O N OJ 61 O 'i M coonocm H O C O 1(1 1f1 O O of O H n W H N 'i 10 sX 01 W W ry C W M W M N b H if1 H M H N N aaaaaa � \ \ \ \\ \ a a a a a a m w N N N N N U N N N N N 00000 (� N N N N N pR5 10 1p 10 �O 1O V rl rl 'i rl H \ \ \ \ \ E 01 OI Oi OI O1 H 00000 (] aaaaaa aaaaau 00000 N ia+ DW+ a a a a a a a E+ a 0 a a D m A a H x V z O H E W az aW ou m r N �yW W £ 0 W E H E E W W ax E W W WH O X 9 ROFU� µ H H H H V A E W E a£a'T-0u b N b N N N MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST F.OR - = Seotember 21.2032` INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES Citizens Medical Professional Michelle M. Cummins MD HEB Pharmacy (Medimpact) Pharmacy Reimbursement MMCenter (in -patient $15,2a4.721 Out -patient $7,355.701 ER $o) Memorial Medical Clinic MMC Professional Fees Singleton Associates, PA SUBTOTAL Memorial Medical Center (indigent Healthcare Payroll and Expenses) Co -pays adjustments for August 2022 Reimbursement from Medicaid by:CT 135.06 353.85 62.12 22,640.42 200.00 76.45 69.77 23,537.67 4,166.67 Subtotal 27,704.34 (70,00)`, 0.00 COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES QUANTITY UNIT PRICE TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $27,634.34 approved by Commissioners Court on"09/21%2022 1000-001-46010 ugust 31,• 2022 4IiteYe6t ($2.18) m h $27,632.16 COUNTY AUDMOR 2 AP VAL 05ilY y- THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD CON ON AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE IGATION. l BY: 9/21/2022 02 €SU .A„ Z wo I (ii 0 0 Q LLLi Z G� © � DEPARTMENT HEAD DATE u ©IHS Source Totals Report Issued 09/01/22 Calhoun Indigent Health Care Batch Dates 08/31/2022 through 09/01/2022 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 3,255.80 500.07 01-2 Physician Services -Anesthesia 595.00 135.06 02 Prescription Drugs 62.12 62.12 ,/ 08 Rural Health Clinics 200.00 200.00 / 13 Mmc - Inpatient Hospital 17,369.00 15.284.72 14 Mmc - Hospital Outpatient 16,346.02 7,355.70 ✓ Expenditures 37,909.88 23,619.61 Reimb/Adjustments -81.94 -81.94 Grand Total 37,827.94 23,637.67 EXPENSES 4,166.67 COPAYS <70.00> TOTAL 27,634.34 APPROVED ON a i 2t 2 By cA�.Hots%cour rt t rs t1 ©iHS Source Totals Report Issued 09/01/22 Calhoun Indigent Health Care Batch Dates 02/01/2022 through 09/01/2022 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 15,567.80 1,557.60 01-2 Physician Services -Anesthesia 1,729.00 395.64 02 Prescription Drugs 552.26 546.92 08 Rural Health Clinics 3,976.00 3,244.43 13 Mmc - Inpatient Hospital 74,997.82 44.807.79 14 Mmc - Hospital Outpatient 59,227.03 24,688.61 15 Mmc - Er Bills 43,353.00 17,490.54 Expenditures 199,681.36 93,009.98 Reimb/Adjustments -278.45 -278.45 Grand Total 199,402.91 92,731.63 EXPENSES 60,967.70 COPAYS <440.00> TOTAL 163,259.23 U Calhoun County Indigent Care Patient Caseload 2022 Approved Denied Removed Active Pending January 1 0 0 7 5 February 1 0 1 7 4 March 0 0 0 7 6 April 0 1 0 7 3 May 0 0 0 7 3 June 1 0 1 7 3 July 0 1 0 7 2 August 0 1 1 6 1 September October November December YTD Monthly Avg 0 0 0 7 3 December 2021 Active 6 Number of Charity patients 192 Number of Charity patients below 50% FPL 71 Number of Charity patients who meet State Indigent Guidelines 45 Calhoun County Pharmacy Assistance Patient Caseload 2022 Approved Refills Removed Active Value January 2 6 0 28 $16,676.00 February 2 5 0 30 $14,616.00 March 12 7 0 42 $34,978.00 April 5 7 0 47 $42,159.00 May 8 3 0 55 $21,252.00 June 2 3 0 57 $12,186.00 July 7 3 0 64 $18,666.00 August 2 8 0 59 $16,358.00 September October November December YTD PATIENT SAVINGS $176,891.00 Monthly Avg 5 5 48 $22,111.38 0 December 2021 Active 26 al NVAG-DI r MOWN 0 Lem 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Bill To: Calhoun County Funds to cover Indigent program operating expenses. WILLIAM LITTLE CFO Date: 9/8/2022 Invoice # 373 For: Aug-22 $ 4,166.67 Total $ 4,166.67 APPROVED ON � c otp SY CALHOUN COUN7Y AU011'Om 50240.000 08/04/22 636535 10.00 00/00/00 BAN 50240,000 08/02/22 636174 10.00 00/00/00 PLB 50240.000 08/08/22 636810 10.00 00/00/00 PLB 50240.000 O8/11/22 637043 10.00 00/00/00 PLB 50240.000 08/11/22 637203 10.00 00/00/00 PLB 50240.000 08/18/22 638004 10.00 00/00/00 PLB 50240.000 08/25/22 638658 10.00 00/00/00 PLB **TOTAL** 50240.000 COUNTY INOIGBNT COPAYB 70.00 kk 'PROSPERITY BANIC THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13441 08/01/2022 'Beginning Balance 3 Deposits/Other Credits 5 Checks/Other Debits O8/31/2072 Ending Balance Total Enclosures Statement Date Account No $9,951AM + $10,213.83 $9,743.04 31 Days in Statement Period $10,435.47 7 8/31/2022 "4551 Page 1 of 2 . •• Date Description Amount 08/09/2022 Deposit $10,141.65a2-P�o O8112/2022 Deposit $80.00 v 08/31 /2022 Accr Earning Pymt Added to Account $2.18 c Check Number Date $ Amount Check Number Date Amount Check Number Date Amount 12547 08.15 $103.63 12550' 08-31 $4,166.67 12552 08.31 $5,258.70 12548 08.12 $131.25 12551 08-31 $82.79 i Date Balance 08.01 $9,954.68 O8.09 $20,096.33 Date Balance 08-12 $20,045.08 08-15 $19,941.45 Date Balance O8.31 $10,435.47 Below is an itemization of the Earnings paid this period. '• Interest Paid This Period $2.18 Annual Percentage Yield Earned 0.15 % Interest Paid YTD $18.83 Days in Earnings Period 31 Earnings Balance $17,082.52 MEMBER FDIC NYSE Symbol "PB" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---September 21, 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 353,269.38 TOTAL TRANSFERS BETWEEN FUNDS $ 145,091A1 V TOTAL NURSING HOME UPLEXPENSES' $ 898,2501 '/ TOTAL INTEWGOVERNMENT TRANSFERS $ 483,628.58+ GRAND TOTAL DISBURSEMENTS APPROVED September 21, 2022 $ 1'1880;243A0•" MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---September 21, 2022 PAYABLES AND PAYROLL 9115/2022 Weekly Payables 9/19/2022 Citibank Credit Card -see attached 9119/2022 American Construction -unit removallinstall 911912022 Amazon -supplies 9/1912022 ITA Resources Inc. -respiratory service 9/19/2022 Medline-supplies 9/19/2022 McKesson-340B Prescription Expense 9/1912022 Amedsource Bergen-34013 Prescription Expense Prosperity Electronic Bank Payments 9/12-9/15122 Credit Card & Lease Fees 9/19/2022 Sales Tax for August 2022 9112-9116122 Pay Plus-Patlent Claims Processing Fee 9116/2022 ExpertPay child support 'TOTAL PAYABLES, PAYROLL AND ELECTRgNfCi ANK PAYMENTS. TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 9115f2o22 MMC Operating to Solera-correction of NH insurance payment deposited into MMC Operating 9/15/2022 MMC Operating to Broadmoorcomection of NH Insurance payment deposited into MMC Operating 9/16/2022 MMC Operating to Crescent -correction of NH insurance payment deposited Into MMC Operating in error 9115f2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment deposited into MMC Operating 9115/2022 MMC Operating to Tuscany Village -correction of NH insurance payment deposited into MMC Operating 9/15/2022 MMC Operating to Bethany -correction of NH insurance payment deposited Into MMC Operating in error TRANSFER OF FUNDS BETWEEN NURSING HOMES/MMC 911912022 Crescent to Tuscany -correction of Tuscany insurance payment deposited into Crescent in error TOTAL TRANSFEJAM6ETWEEN,FUNDS NURSING HOME UPL EXPENSES 9/19/2022 Nursing Home UPL-Cantex Transfer 9/19/2022 Nursing Home UPL-Nexion Transfer 9/19/2022 Nursing Home UPL-HMG Transfer 9/19/2022 Nursing Home UPL-Tuscany Transfer 9/19/2022 Nursing Home UPL-HSL Transfer TOT;A NURSING;'NOME UPL?EXPENSES; INTER -GOVERNMENT TRANSFERS 9/1912022 IGT UC Year 11 to be paid September 30, 2022 T,OTALINTER-GOYERNMENTTRANSFERS 281,690.27 525.90 14,550.00 127.72 26,360.50 12,554.29 5,978.59 1,319.09 6,190.08 1,561,88 121.05 2,290.01 $ _3b3,269.W 4,605.51 5,750,50 4,095.00 20,235.86 42,363.40 61,003.14 7,038.00 535,677.82 85,820.17 75,795.45 48,714.86 152,245.74 $ 8$8,Z54:03' 483,628.58 $ 483,¢28,58•= ORANO TOTAL OISBURSEMENTSAPPROVED Seplafribei 24, 2022$ 1;$8ON140 Page I of 16 UYUTCONTAIOR ON 50142&iU22 MEMORIAL MEDICAL CENTER 10.93:49 AP Open Invoice List CALHOUN COUNTY, TEXAS Due Dates Through: 10/08/2022 Vendor# Vendor Name Class Pay Cade 11283 ACE HARDWARE 15521 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 083122 09/15/20 08/31/20 09/30/20 943.20 SUPPLIES Vendor Totals Number Name Gross 11283 ACE HARDWARE 15521 943.20 Vendor# Vendor Name Class Pay Code 10950 ACUTE CARE INC L// Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross INV913 09/15/20 09101120 09130/20 1,400.00 0 ap_open_invoice.tempiate Discount No -Pay Net 0.00 0.00 943.20 try Discount No -Pay Net 0.00 0.00 943.20 Discount No -Pay Net 0.00 0.00 1,400.00 Li RFID FEE Vendor TotalENumber Name Gross Discount 10950 ACUTE CARE INC 1,400.00 0.00 Vendor# Vendor Name Class Pay Code 14028 AMAZON CAPITAL SERVICES / Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount / 1HPDF4QN7KK9 , OW4/200W1712010101120 37.99 0.00 SUPPLIES 1YLM9Y938PYN Owl/2008/1e/201o/01/20 -39.72 0.00 CREDIT/ 1393LMHKHGDP L/ 09/01120 08/25/20 09/24120 29.39 0.00 SUPPLIES 130XQT1TV4LN ✓ 09/14/2008/25/2009/24/20 36.99 0.00 SUPPLIES Vendor Total:Numbor Name Gross Discount 14028 AMAZON CAPITAL SERVICES 64.65 0.00 Vendor# Vendor Name Class Pay Code 12800 AUTHORITYRX J / Invoice#Comment Tran Dt Inv Dt Due Dt Check O Pay Gross Discount 1433 L// 09/15/20 07/01/20 07/02/20 11,748.00 0.00 340E 1499 09/15/20 09/02/20 09/03/20 13,809.00 0.00 3408 Vendor TolaN Number Name Gross Discount 12800 AUTHORITYRX 25,557.00 0,00 No -Pay Net 0,00 1,400.00 No -Pay Net 0.00 37.99 ..� 0.00 -39.72 0.00 29.39 y i 0.00 36.99 No -Pay Net 0.00 64.65 No -Pay Net 0.00 11,748.00 v 0.00 13,809.00 4� No -Pay Net 0.00 25,557.00 Vendor# Vendor Name Class Pay Code 81150 BAXTER HEALTHCARE +.% W Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 76259986 r/' 09/14/20 08/25/20 09/19/20 803.12 0.00 0.00 803.12 SUPPLIES 76286673✓ / 09/14/20 08/29/20 09/23/20 338.31 0.00 0.00 338.31 SUPPLIES 76331360 ,/ 09/14/20 09101 /20 09/26/20 752.93 0.00 0.00 752.93 SUPPLIES Vendor TotalENUmber Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 1,694.36 0.00 0.00 1,894.36 Vendor# Vendor Name Class Pay Code file:///C:/Users/Itrevinolepsi/memmed.cpsinet.cotn/u8 8125/data_5/tmp_cw5 report26O355... 9/15/2022 Page 2 of 16 B1220 BECKMAN COULTER INC ✓� M Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross Discount No -Pay Net 110108806 09/14/20 08/29/20 09/23/20 566.14 0.00 0.00 566.14 v'~ SUPPLIES 110119639 ✓l 09/14/2009/02/2009/27/20 e04.90 0.00 0.00 604.90 SUPPLIES 110119479 �'l 09/14/20 09/02/20 09/27/20 856.82 0.00 0.00 856.82 ✓- 110129231 09/14/20 09/08/20 10/03/20 118.86 0.00 0.00 118.86 v' SUPPLIES 110121194 ✓� 09/15/20 09106120 10101120 549.00 0.00 0.00 549.00 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 2,696,72 0.00 0.00 2,695.72 Vendor# Vendor Name Class Pay Code 10024 BECTON, DICKINSON & CO (BD) .// Invoice# Cornmeal Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 91102155" ✓ 09/01/2008/30/2009/29/20 256,00 0.00 0.00 256,00 ✓' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10024 BECTON, DICKINSON & CO (BD) 256.00 0.00 0.00 256,00 Vendor# Vendor Name Class Pay Code B1655 BOSTON SCIENTIFIC CORPORATION v' M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 986848094,i 09h,1120 08/23120 09114120 394.00 0.00 0.00 394,00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 61655 BOSTON SCIENTIFIC CORPORATION 394.00 0.00 0.00 394.00 Vendor# Vendor Name Class Pay Code 14120 CALHOUN COUNTY EMS ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net 22080008 ✓ 09/15/2009/01/2010/01/20 6.600.00 0.00 0.00 6,600.00 TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 14120 CALHOUN COUNTY EMS 6,600.00 0.00 0.00 6,600.00 Vendor# Vendor Name Class Pay Code 11295 CALHOUN COUNTY INDIGENT ACCOUN u Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 090822 09/15/20 09/08/20 09/09/20 70.00 0.00 0.00 70.00 v' INDIGENT Vendor Totals Number Name Gross Discount No -Pay Net 11295 CALHOUN COUNTY INDIGENT ACCOUN 70.00 0.00 0.00 70.00 Vendor# Vendor Name Class Pay Code 14236 CARRIER CORPORATION ✓ invoice# 9amment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 90219286 ✓ 09114/20 08/30120 09/30120 12,830.00 0.00 0.00 12,830,00 CHILLER RENTAL(-IIt `{-8 FII ---) Vendor Totals Number Name Grass Discount No -Pay Net 14236 CARRIER CORPORATION 12,830.00 0,00 0.00 12,830.00 Vendor# Vendor Name Class Pay Code 1 13028 CAVALLO ENERGY TEXAS LLC V fi le:///C:/Users/ltrevino/epsi/memmed.cpsinet.com/ug8125/data_5/tmp_cw5report260355... 9/ 15/2022 Page 3 of 16 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 18054673 f 09/14/20 08119/20 09/22/20 10.17 0.00 0.00 10.17 ELECTRICITY Vendor Totals Number Name Gross Discount No -Pay Net 13028 CAVALLO ENERGY TEXAS LLC 10.17 0,00 0.00 10.17 Vendor# Vendor Name Class Pay Code C1992 CDW GOVERNMENT, INC. M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net CH10739 ,// 09/1412008/22/2009/21/20 467.83 0.00 0.00 467.83 .� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1992 CDW GOVERNMENT, INC. 467.83 0.00 0.00 467.83 Vendor# Vendor Name Class Pay Code 11202 CFI MECHANICAL INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net SD17489 ,� 09/14/2009/00/2010/06/20 1,007.50 0.00 0.00 1,007.50 LABOR/MATERIAL Mi24 AIM , Vendor Totals Number Name Gross Discount No -Pay Net 11202 CFI MECHANICAL INC 1,007.50 0.00 0.00 1.007.50 Vendor# Vendor Name Class Pay Code 10105 CHRIS KOVAREK ✓/ Invoice tj Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 66 09/15/20 09/06/20 09/16/20 80.00 0.00 0.00 80.00 SOCIAL SERV Vendor Total:Number Name Gross Discount No -Pay Net 10106 CHRIS KOVAREK 80.00 0.00 0.00 80.00 Vendor# Vendor Name Class Pay Cade 1 10212 CLINICAL PATHOLOGY LABS v CID Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net i 202208 09/15/20 OW31/20 09/30/20 14,481.53 0.00 0.00 14,481.53 LAB SERV Vendor Totals Number Name Gross Discount No -Pay Net 10212 CLINICAL PATHOLOGY LABS 14,481.53 0.00 0.00 14.481.53 Vendor# Vendor Name Class Pay Code C1166 COASTAL OFFICE SOLUTONS W Invoice# Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net }Comment OE354701 ✓ 09/14/2008/31/2009/10120 62,50 0.00 0.00 62.50 e✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1166 COASTAL OFFICE SOLUTONS 62.50 0.00 0.00 62.50 I' Vendor# Vendor Name Class Pay Code 11029 COASTAL REFRIGERATION I/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5114511 �/ 09115/20 08/10/20 09/10/20 412.45 0,00 0.00 412.45 LABOR 5114717 1/ 09/15/20 08/10/20 09/10/20 394.95 0.00 0100 394.95 LABOR Vendor Totals Number Name Gross Discount No -Pay Net 11029 COASTAL REFRIGERATION 807.40 0.00 0.00 807.40 Vendor# Vendor Name / Class Pay Code C1860 CODONICS INC ✓ M file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u8 8125/data_5/tmp_cw5report260355... 9/ 15/2022 Page 4 of 16 I Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 270152 J 09/15/2009/09/2009124120 604.13 0.00 0.00 604.13 SUPPILES ,/' Vendor Totals Number Name Gross Discount No -Pay Net 01850 CODONICS INC 604.13 0.00 0.00 604.13 Vendor# Vendor Name Class Pay Code C1970 CONMED CORPORATION ,,,� M Invoice# Comment Tran or Inv or Due Dt Check D Pay Gross Discount No -Pay Net s 972120 f 09t14120 OW25/2009/15120 215,06 0.00 0.00 215.06 f' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1970 CONMED CORPORATION 215.06 0.00 0.00 215.06 Ventlor# Vendor Name Class Pay Code C2157 COOPER SURGICAL INC ,� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6358030 ✓/ 09/14/20 08/25/20 09/14/20 256,35 0.00 0,00 256.35 SUPPLIES 6361785 y+`- 09/14/20 08/30/20 09/14/20 369.98 0.00 0.00 369.98 SUPPLIES 6368557 09/14/20 09/02/20 09/14/20 379.05 0.00 0.00 379.05 .% Vendor Totals Number Name Gross Discount No -Pay Net 02157 COOPER SURGICAL INC 1,005.36 0.00 0.00 1.005.38 Vendor# Vendor Name Class Pay Code 10006 CUSTOM MEDICAL SPECIALTIES .o Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Grass Discount No -Pay Net 298498 09/14/20 09/07/20 09/14/20 532.73 0.00 0.00 532.73 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10006 CUSTOM MEDICAL SPECIALTIES 532.73 0.00 0.00 532.73 Vendor# Vendor Name Class Pay Code 10060 DETAR HOSPITAL �`I ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net DTR2208023 ✓/ 09/15/20 0910112G 10/01/20 396.69 0.00 0.00 396.69 LAB SERVICES , Vendor Totals Number Name Gross Discount No -Pay Nei 10060 DETAR HOSPITAL 396.60 0,00 0100 396.69 Ventlor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON / Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6919910 ,J 09/14/20 08/25/20 09/19/20 482.51 0.00 0.00 402.51 ' SUPPLIES 6924620 ✓'� 09/15/20 09/01/20 09/26/20 69.68 0.00 0.00 69.68 SUPPLIES 6930560 �/� 09/15/20 09/07/20 10/02/20 113.27 0.00 0.00 113.27 /SUPPLIES 6932350 ,J 09/15/20 09/08/20 10/03/20 99.76 0.00 0.00 99.76 -' SUPPLIES . 6932351 ✓ 09/15/20 09/09/20 10/04/20 26.53 0.00 0100 26.53 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net file:///C: /Userslltreviiiolepsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5repoil260355... 9/15/2022 Page 5 of 16 10368 DEWITT POTH & SON 791.75 0.00 0.00 791.75 Vendor# Vendor Name Class Pay Code 11D11 DIAMOND HEALTHCARE CORP �✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net IN20055446✓ 09/15/20 09/01/20 09126/20 31.144.58 0.00 0.00 31,144.58 BEHAV HEALTH IN20055447✓ 09115/20 09/01/20 09126/20 19,166.57 0.00 0.00 10.166.67✓ AUG CPR Vendor Totals Number Name Gross Discount No -Pay Net 11011 DIAMOND HEALTHCARE CORP 50,311.25 0.00 0.00 50.311.25 Vendor# Vendor Name Class Pay Code / 11291 DOWELL PEST CONTROL I Invoice# r Comment Tran Dt Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 11681P( 09/15/20 08/26120 09/20/20 260.00 0.00 0.00 t 260.00✓ PEST CONTROL Vendor Total*Number Name Gross Discount No -Pay Net 11291 DOWELL PEST CONTROL 260.00 0.00 0.00 260.00 Vendor# Vendor Name Class Pay Code 12044 DRIESSEN WATER INC. (CULLIGAN) ✓ Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 1430270308312022 ✓ 09/15/2008/31/2009/22/20 475.65 0,00 0.00 475.65 ri "J WATER Vendor Totals Number Name Gross Discount No -Pay Net 12044 DRIESSEN WATER INC, (CULLIGAN) 475.65 0.00 0.00 475.65 Vendor# Vendor Name Class Pay Cade 10689 FASTHEALTH CORPORATION y: Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 09A22MMC y/ 09115120 09101120 09/16/20. 495.00 0.00 0.00 495.00 WEBSITE Vendor Totals Number Name Gross Discount No -Pay Net 10689 FASTHEALTH CORPORATION 495.00 0.00 0.00 495.00 Ventlor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP. ✓ W Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 785510510 ✓1 09/15/20 08/18/20 09/12/20 71.29 0.00 0.00 71.29 FREIGHT 786211632 09/15/20 08/25/20 09/19/20 27.85 0.00 0.00 27.85 ..-� FREIGHT 786988818 .// 09115120 09/01/20 09/26/20 91.44 0,00 0,00 91,44 ✓' FFPEIGHT , 787713263 ! 09/15/20 09/08/20 10/03/20 66.05 0.00 0.00 66.05 FREIGHT Vendor Total* Number Name Grass Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 256.63 0.00 0.00 256.63 Vendor# Vendor Name Class Pay Code 14336 FIRETRON, INC ✓ Invoice# Comment Tran Dt Im Dt Due Ot Check D Pay Gross Discount No -Pay Net 204261 ✓ 08/11/20 07131/20 10/01/20 358.40 0.00 0.00 356.40 REPAIR Vendor Totals Number Name Gross Discount No -Pay Net 14336 FIRETRON, INC 356.40 0.00 0.00 356.40 file://C:/Users/]trevitio/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report260355... 9/ 15/2022 Page 6 of 16 Vendor# Vendor Name Class Pay Code 10599 FORVIS Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net SK01645121 09/15/20 08/29/20 09/23/20 4,725.00 0.00 0.00 4.725.00 1i MEDICARE COST REPORT , Vendor Totals Number Name Gross Discount No -Pay Net 10599 FORVIS 4,725.00 0.00 0.00 4,725.00 Vendor# Vendor Name Class Pay Code I 11183 FRONTIER ''� , Invoice# Comment Tran Ot Inv or Due Dt Check D Pay Gross ❑iscount No -Pay Net 090222 09114/20 09102120 09126120 1,205.91 0.00 0.00 11205.91 552.0338 PHONE Vendor Totals Number Name Gross Discount No -Pay Net 11183 FRONTIER 1,205,91 0.00 0,00 11205.91 Vendor# Vendor Name Class Pay Code 12948 GREAT AMERICA FINANCIAL SVCS . r Invoice# Comment Tran Dt Inv Dt Due Ot Check Pay Gross Discount No -Pay Net ' 67/ 323 095 ,/ 09115/20 09/05120 09130/20 10,108.24 0.00 0.00 10,106.24 f' COPIER Vendor Total -Number Name Gross Discount No -Pay Net 12948 GREAT AMERICA FINANCIAL SVCS 10,108.24 0.00 0.00 10,10824 Ventlor# Vendor Name Class Pay Code 11984 GUERBET, LLC „/ Invoice# Comment Tran Dt Inv of Due Dt Check D Pay Gross Discount No -Pay Net 18834240 / 09/14/20 08/22/20 09/14/20 700.00 0.00 0100 700.00 ✓` SUPPLIES 18638252 �// 09/14/20 09/01/20 09/14/20 350.00 0.00 0100 350.00 ✓' SUPPLIES . Vendor Total- Number Name Gross Discount No -Pay Net 11984 GUERBET, LLC 1,050.00 0.00 0.00 11050.00 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY r/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2277926 09/14/20 08/26/20 09/25/20 462.84 0.00 0.00 462.84 fSUPPLIES 2279526 ✓ 09/15/20 08/30/20 09/29/20 88.26 0.o0 0.00 $8.26 1z SUPPLIES 2279527 ✓J 09/15/20 08/30/20 09/29/20 805.61 0.00 0.00 805.61 ✓` SUPPLIES 2282549 09/15/20 09/06/20 10/06/20 72.9a 0.00 0.00 72.981/ SUPPLIES Vendor Total- Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 1,420.69 0.00 0.00 1,429.69 Vendor# Vendor Name Class Pay Code 11562 HEALTHCARE FINANCIAL SERVICES Invoice# Comment Tran Dt Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 1006558D$ ✓ 09116/20 08127/20 10/01/20 4.610.52 0.00 0.00 4.610.52 LEASE Vendor Totals Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 4,610.62 0.00 0.00 4.610.52 Vendor# Vendor Name Class Pay Code file:///C:/Userslttrevinolcpsilmemmed.cpsinet.com/u88l25/data_5/tmp_cw5report260355... 9/15/2022 Page 7 of 16 H0031 HEB CREDIT RECEIVABLES DEPT308 •/. Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 093122 09/15/2006/31/2009125/20 1,022.42 0.00 0.00 i 1,022,42 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0031 HEB CREDIT RECEIVABLES DEPT308 1,022.42 0.00 0.00 1,022.42 . Vendor# Vendor Name Class Pay Code 14140 HELMER, INC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0000426685 ✓ 09/14/20 08/31/20 09/14/20 233.87 0.00 0.00 233.87 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14140 HELMER, INC 233.87 0.00 0.00 233.87 Ventlor# Vendor Name Class Pay Code H1399 HILL -ROM COMPANY, INC i; M Invoice# Comment Tran Dt Inv Ot Due Ot Check D Pay Grass Discount No -Pay Not P898957 ✓ 09/14/20 08131120 09/14120 69.84 0.00 0100 69.84 ..� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H1399 HILL -ROM COMPANY, INC 69.84 0.00 0.00 69.64 Vendor# Vendor Name Class Pay Code H0416 HOLOGIC INC r/ Invoice# Comment Tran Dt Inv Dt [)us Ot Check 0 Pay Gross Dlseount No -Pay Net 10244756 ,/ 09/14/20 08/29/20 09/14/20 50.00 0.00 0.00 50.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 50,00 0.00 0.00 50.00 Ventlor# Vendor Name Class Pay Code 10922 HUNTER PHARMACY SERVICES ✓ Invoice# Comment Tran Dt Inv 01 Due Dt Check D Pay Gross Discount No -Pay Net 5066 / 09/15120 08/31/20 09120/20 14,864,78 0.00 0.00 14,864.78 ✓ SALARY Vendor Totals Number Name Gross Discount No -Pay Net 10922 HUNTER PHARMACY SERVICES 14,864.78 0.00 0.00 14,864.78 Vendor# Vendor Name Class Pay Code 11260 INTOXIMETERS INC ,Z M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 715313 ✓ 09/14/20 09/01/20 09/26/20 56,00 0.00 0.00 56.00 -" SUPPLIES 715572 ,/ 09/14/20 09/07/20 10/02/20 489.00 0.00 0,00 489.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11260 INTOXIMETERS INC 545.00 0.00 0100 545.00 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC �/ Invoice# Comment Tran Dt Inv Dt Due 01 Check D Pay Gross Discount No -Pay Net 930812835 v 09/14120 08/31/20 09/30/20 330.00 0.00 0.00 330.00 " SUPPLIES 9308568681/ 00/14/2009/06/2010/06/20 3,713.48 0.00 0.00 3,713.48 ✓ SUPPLIES 930876457 ✓ 09/14120 09/06/20 10/06/20 1.128.00 0.00 0.00 1,128.00 ✓' file://1C:/Users/ltrevino/epsi/memmed,cpsi net.com/u88125/data_5/tmp_cw5report2603 55,.. 9/15/2022 Page 8 of 16 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net J0150 J & J HEALTHCARE SYSTEMS, INC 5,171.48 0.00 0.00 5.171.48 Vendor# Vendor Name Class Pay Code 11812 JACOB HAMILTON, PT, DIRT Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 090722 09/14/20 09/07/20 09115/20 1.432.30 0.00 0.00 1,432.30,f, REIMBURSE PN Nt, in.3 Lal4-�a(y(aY) Vendor Totale Number Name Gross Discount No -Pay Net 11812 JACOB HAMILTON, PT, DPT 1.432.30 0.00 0.00 1,432.30 Vendor# Vendor Name Class Pay Code 14540 JINDALXLLC ✓' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 202223007 ✓ 09/15/20 09/08/20 09/15/20 9,000.00 0.00 0.00 91000.00 REVENUE CYCLE Vendor Tola4 Number Name Gross Discount No -Pay Net 14540 JINDAL X LLC 9,000.00 0.00 0.00 9,000.00 Vendor# Vendor Name Class Pay Code L0700 LASCORP OF AMERICA HOLDINGS ,/ M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 73992418 1/ 09/15/20 08/27/20 09/21/20 1.29 0.00 0.00 1.29 LAB SERV 74074851 09/15/20 08/27/20 09121120. 16.00 0.00 0.00 16.00 LAB SERV Vendor Total$ Number Name Gross Discount No -Pay Net L0709 LABCORP OF AMERICA HOLDINGS 17.29 0.00 0.00 17.29 Vendor# Vendor Name Class Pay Code L1001 LANDAUER INC ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101038282 ✓ 09/15/20 08/22/20 09/21/20 766.15 0.00 0,00 766.15 DOSIMETER Vendor Totale Number Name Gross Discount No -Pay Net L1001 LANDAUER INC 766.15 0.00 0.00 766.15 Vendor# Vendor Name Class Pay Code L1288 LANGUAGE LINE SERVICES ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 106347201/ 09/16/20 08/31 /20 09/25/20 452.36 0.00 0.00 452.36 INTERPRETATION Vendor Totale Number Name Gross Discount No -Pay Net L1288 LANGUAGE LINE SERVICES 452.36 0.00 0.00 452.36 Vendor# Vendor Name Class Pay Code 11600 LEGALSHIELD✓ Invoice# Comment Tran Dt Inv or Due Ot Check D Pay Gross Discount No -Pay Net 090122 09/14/20 09/01/20 09/15/20 479.55 0.00 0.00 479.55 PAYROLLDEDUCT Vendor Totale Number Name Gross Discount No -Pay Net 11600 LEGAL SHIELD 479.55 0.00 0.00 479.55 Vendor# Vendor Name Class Pay Cede L1640 LOWE'S BUSINESS ACCT/SYNCB .�/ W Invoice# Comment Tran Dt Inv Ot Due Dt Check DPay Gross Discount No -Pay Net 083122 09/15/20 08/31/20 09/28/20 24.69 0.00 0.00 24.69 ✓� file:///C:/Userslltrevinolopsi/memmed.cpsinct.com/u88125/data_5/tmp_cw5report260355... 9/15/2022 Page 9 of 16 SUPPLIES Vendor Totale Number Name Grass Discount No -Pay 1 Net L1640 LOWES BUSINESS ACC71SYNCB 24.69 0.00 0.00 24.69 Vendor# Vendor Name Class Pay Code 10972 M G TRUST ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 000822 09/15/20 09/08/20 09115120 640.86 0.00 0.D0 640.86 ✓� PAYROLL DEDUCT Vendor Totals Number Name Gross Discount No -Pay Net 10972 M G TRUST 640.86 0.00 0.00 640.86 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC.,/ A/P Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 30565705 ✓ 09/15/20 09/02/20 09/22/20 37.28 0.00 0.00 37.28 INDIGENT Vendor Totals Number Name Gross Discount No -Pay Net 10613 MEDIMPACT HEALTHCARE SYS, INC, 37.28 0.00 0.00 37.28 Vendor# Vendor Name Class Pay Code M2827 MEDIVATORS ,% M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 91218347 ✓ 07M 1120 02/01/20 10101 /20 34.00 0.00 0.00 34.00 ` SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2827 MEDIVATORS 34,00 0.00 0.00 34.00 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC Vr M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2227069061 09/13/20 09/02/20 09/27/20 200.15 0.00 0.00 200.15 SUPPLIES , 1960604039 09/14/20 07/29/20 08/23/20 33.15 0.00 0.00 33.15 SUPPLIES 1961186080 ✓ 09/14/20 08/04/20 05/29/20 446,40 0.00 0100 446.40 SUPPLIES 1961866841 f' 09/14/20 06/10/20 09/04/20 334.94 OAo 0.00 334.94 SUPPLIES 1962748739 ,�/�! 09/14/20. 08/17/20 09/11/20 207.61 0.00 0.00 207.61 SUPPLIES 1968119891 09/14/20 08/29/20 09/23/20 27.89 0.00 0.00 27.89 SUPPLIES 1964498972 ✓ 09/14/20 08/31/20 09/25/20 6.45 0.00 0.00 6.45 u / SUPPLIES 1964498967 ✓ 09/14/20 08/31/20 09/25/20 427.87 0.00 0.00 427.87 �,.•" SUPPLIES 1964498970 ,% 09/14/20 08/31/20 09/25/20 288.60 0.00 0.00 288.60 SUPPLIES 1964498969 ,,/ 09/14/20 08131/20 09/25/20 288.60 0.00 0.00 288,60 SUPPLIES 1964498971 ✓ 09/14/20 00/31/20 09/25/20. 144.30 0.00 0.00 144.30 SUPPLIES 1964498968 ff 09/14f20 08/31/20 09/25/20 288.60 0.00 0.00 286.60 SUPPLIES file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp gw5report260355... 9/15/2022 Page 10 of 16 1964785481✓ 09/14/2009/01/2009/26/20 SUPPLIES 1966073720 y� 09/14/20 09114120 10109/20 SUPPLIES 1967472724 ✓/ 09/14/20 0912=0 10/18/20 SUPPLIES 1967412887,�� 09/14/20 09/23/20 10/18/20 SUPPLIES 1967647787,% 09/14/20 09/24/20 10/19/20 SUPPLIES 1968000462✓ 09/14/20 09/28/2010/23/20 SUPPLIES 1968000463 ✓ f 09/14/20 09/28/20 10/23/20 S/UPPLIES 1966119888 ✓ 09/14/20 09/29/20 10/24/20 SUPPLIES 19681198881/ 09/14/20 09/20/20 10/24/20 SUPPLIES 1968119897 ,// 09/14/20 09/29/20 10/24/20 SUPPLIES 1968119894 ✓'. 09/14/20 09129/20 10/24/20 SUPPLIES 1968119893 � 09/14/20 09/29120 10124/20 SUPPLIES 1968119899 ,„/ 09/14/20 09/29/20 10/24/20 SUPPLIES 1968119884 ,// 09/14/20 09/29/20 10/24/20 SUPPLIES 1968268861 ✓ / 09/14/20 (19/30/2010/25/20 SUPPLIES 1968560985 ✓'- 09/14120 10/01/20 10/26/20 SUPPLIES 1968846049 �/- 0911412010/05/201MOM SUPPLIES 1980672692. = 09/14/2D 12/31/20 01/26/20 SUPPLIES 1988310766 /` 09/14/20 02/18/20 03/15/20 1988310757 ✓ 09/14/20 02/18/20 03/15/20 SUPPLIES 1989180727A,f 09/14/20 02126/20 03/22/20 SUPPLIES 2211077187 �/ 09/14/20 05/12/20 06/06/20 SUPPLIES 2214616833 f- 09/14/20 06/09/20 07/04/20 SUPPLIES 2225829055 ,f 09/14/20 08/24/20 09/18/20 SUPPLIES 2227282391 ,/ 09/14/20 09/03/20 09/28/20 SUPPLIES 2227474492 1/ 09/14/20 09/05/20 09/30/20 1.212.00 0.00 86.60 0.00 1.250.76 0.00 119.31 0.00 32.55 0.00 2.044.40 0.00 234.65 0.00 800.01 0.00 61.20 0.00 852.18 0.00 57.14 0.00 149,89 0.00 0.00 207,01 0.00 0.00 0.00 0.00 0,00 385.10 0.00 93.56 0.00 75.38 0.00 94.17 0.00 163.21 0.00 785.95 0.00 1.255.21 0.00 125.85 0.00 183.54 0.00 3,862.27 0,00 23.72 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 209.88 0.00 0.00 35.43 0.00 0.00 1,212.00 86.60 1,260.76 �. 119.31 32.65 2,044.40 234.65 -,- 800.01 61.20 I 852.18 57.14 149.89 4 i 207.61 385.10 93.56 ✓ 75.38 94.17 / 153.21 V, 785.95 1,255,21 125.86 s 103.54 �^ 3,862.27 23.72 209.88 35.43 i. file:///C:/Users/ltrevinolcpsi/memmed.cpsinet.conl/u881251data 5/tmp_cw5report260355... 9/15/2022 Page 11 of 16 SUPPLIES 2227474491 09/14/20 09/05/20 09/30/20 62.64 0.00 0.00 62.64 SUPPLIES 2227538484 4,i 09/14/20 09/05/20 10/01/20 391.58 0.00 0.00 391.58 ,! SUPPLIES 1965390291 09/14/20 09/00/20 10/03/20 ✓ 669.88 0.00 0.00 669.88 w SUPPLIES L✓ 1960604038 109/15/20 07/29/20 08/23/20 531.48 0.00 0.00 531.48 SUPPLIES 1965349903 ✓� 09/15120 09107/20 1 OM2120 30.00 0.00 0.00 30.00 REFRIG FEE 1965349901. 09/15/20 09/07/20 10102/20 30,00 0,00 0.00 30.00 REFRIDG FEE , 1965349902 09/16/20 09/0712D 10/02/20 30.00 0.00 0.00 30.00 u„% REFIDGE FEE , Vendor Totals Number Name Gross Discount No -Pay Net I M2470 MEDLINE INDUSTRIES INC 18.831.81 0.00 0.00 18,831.81 Vendor# Vendor Name Class Pay Code 10963 MEMORIAL MEDICAL CLINIC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 090822 09/15/20 09/08/20 09/15/20 280,00 0.00 0.00 280.00 PAYROLLDEDUCT , Vendor Total: Number Name Gross Discount No -Pay Net 10963 MEMORIAL MEDICAL CLINIC 280.00 0.00 0.00 280.00 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, U.G „/ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0, Pay Gross Discount No -Pay Net 8607744 09/14/20 09/01/20 09/11/20 704.63 0.00 0.00 704,53 INVENTORY 3612704 ,% 09/14/20 09/02/20 09/12120 1,177.77 0.00 0.00 1,177.77 INVENTORY , 8618461 09/14/20 09/05/20 09/15/20 1,310.67 0.00 0.00 11310.67 ;1 INVENTORY v , 8615875 ✓ 09/14/20 09/05/20 09/15120 3$0.03 0100 0,00 330.03 .! )NVENTORY - 8618460 �f/� 09/14/20 09/05/20 09/15/20 134.64 0.00 0.00 134.64 INVENTORY 8615877 ,,r' 0911412009/05/2009/15/20. 252,20 0,00 0.00 252.20�' INVENTORY , 8622731 f 09114/20 09106120 09/16/20 1,389.14 0.00 0.00 1,389.14 INVENTORY 8622569 "� 09/14/20 09/06/20 09/16/20 432.32 0.00 0.00 432.32 �f INVENTORY 8622568 ✓� 09114/20 09/06/20 09/16/20 2,176.77 0.00 0100 2,176.77✓� INVENTORY _ 8619977 �/ 09/14/20 09/06/20 09/16/20 74.69 0.00 0.00 74.69 )INVENTORY 8822567 ✓ 09/14/20 09/06/20 09/18/20 220.22 0.00 0.00 220.22 s� INVENTORY 8628447 �/ 09/15/20 09/07/20 09/17/20 86.44 0.00 0.00 86.44 INVENTORY i file:///C:/Userslitrevinolcpsilmemmed.cpsinet.com/u88125/data 5/tmp_pw5report260355... 9/15/20�2 1 Page 12 of 16 8628446 ✓ 09/15/20 09/07/20 09/17/20 433.98 0.00 0.00 433.98 INVENTORY 1 8625171 �,/ 09/15/20 09/07/20 09/17/20 27,21 0.00 0.00 27.21 INVENTORY 0115 �j 09/15/20 09/07/20 09/17/2D -886.86 0.00 0.00 -686.86 * f CREDIT 8625166 09/15/2009/0712009/17M 449.07 0.00 0.00 449.07 ✓ /INVENTORY 8625163 J 09/15/20 09/07/20 09/17/20 48.53 0.00 0.00 48.53 INVENTORY , 8625170 /� 09/15/20 09/07/20 09/17/20 446.55 0.00 0.00 446.55 ,,,.•' INVENTORY 8625164 „/� 09/16/20 09/07/20 09/17/20 74.69 0.00 0.00 74.69 .i INVENTORY , i 8633194 .r 09/1612009/08/2009l18/20 6,599.44 0.00 0.00 6,599.44 ./ INVENTORY 8633193 v� 09/15/20 09/08/20 09/18/20 27.08 0.00 0.00 27.08 ✓ INVENTORY 8630203 ✓ 0911$120 09/08/20 09/18/20 74.69 0.00 0.00 74.69 ✓- INVENTORY 8630204 ,,/ 09/16/20 09/08/20 09/18/20 45.33 0.00 0.00 45.33,. INVENTORY 0612 J 09115/20 09/08/20 09/18/20 -1,315.11 0.00 0,00 , -1,315.11 CREDIT / 0676 J 09/15/20 09/08/20 09/18120 -50.65 0.00 0.00 -50.65 CREDIT $633192 ,% 09/15/20 09/08/20 09/18/20 22.51 0.00 0.00 22.51 INVENTORY Vendor TotatENumber Name Gross Discount No -Pay Net 10536 MORRIS $ DICKSON CO, LLC 14,285.88 0.00 0.00 14,285.88 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 8800936386 f 09/14/20 08/23/20 09/22120 367.40 0.00 0.00 367.40 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2659 MXR.IMAGING, INC 367.40 0.00 0.00 367.40 Vendor# Vendor Name Class Pay Code 13548 NACOGDOCHES TRANSCRIPTION ; � v Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 7816 09/15/20 09112/20 09/22/20 295.96 0.00 0.00 295.96 TRANSCRIPTION 1.$l9a- qj$4 LY) Vendor Totals Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 295.96 0.00 0.00 295.96 Vendor# Vendor Name Class Pay Code 00920 OFFICE DEPOT Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 249564890001 / 09/13/20 06/20/20 07/24/20 240.34 0.00 0.00 240.34 / SUPPLIES / 249554892002 ✓ 09/13/20 06/20/20 07/24/20 579.98 0.00 0,00 579.98 ,f SUPPLIES file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.cone/u88125/data_5/tmp_cw5report260355... 9/15/2022 Page 13 of 16 249529502001 w/` 09/13/2006/24/20 07/24/20 162.99 0.00 0.00 162.99 / SUPPLIES 249529502002 / 09/13/20 07/27/20 07/31/20 162.99 0.00 0.00 162.99 SUPPLIES 261280626001 09/13/20 08/16/20 09N 8/20 25.98 0.00 0.00 25.98 SUPPLIES 262275722001 -/ 09/13/20 08/171PO 09/18/20 20.33 0.00 0.00 20.33 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 00920 OFFICE DEPOT 1,192.61 0.00 0.00 1,192.61 Vendor# Vendor Name Class Pay Code 14288 PADRON WELDING SERVICE ✓ Invoce# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Not 090222 09/15/20 09/02/20 09/15/20 85.00 0.00 0.00 85.00 .f / HAND RAIL REPAIR Vendor Totale Number Name Gross Discount No -Pay Net 14288 PADRON WELDING SERVICE 85.00 0.00 0.00 85.00 Vendor# Vendor Name Class Pay Cade 11155 PARA ,'/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 11997 -'� 09/15/20 09101/20 10/01120 950.00 0.00 0.00 950.00 OTRLY PROCESSING v 11914 09/15120 09101/20 1 O/OMO 3.084.00 0.00 0.00 3,084.00 ,% REVENUE INTEGRITY PROGR Vendor Totals Number Name Gross Discount No -Pay Net 11.155 PARA 4,034,00 0.00 0.00 4,034.00 Vendor# Vendor Name Class Pay Cade 12544 PATRICK OCHOA Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 901228 09/15/20 09/01120 09/02l20 380.00 0.00 0.00 380.00,i ' LAWN MAINT 090122A 09/15/20 09/01/20 09/02/20 520,00 0.00 0.00 520.00 LAWN MAINT M' 090122 09/15/20 09/01/20 10/01120 200.00 0.00 0.00 200.00 LAWN MAINT Vendor Tolel:Number Name Gross Discount No -Pay Net 12544 PATRICK OCHOA 11100.00 0.00 0.00 1.100.00 Vendor# Vendor Name - Class Pay Code 11932 PRESS GANEY ASSOCIATES, INC. Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net IN000548203 ✓/ 08/31/2008131/2009130/20 2,624.74 0.00 0.00 2,624.74 CONTRACTFEES Vendor Totals Number Name Gross Discount No -Pay Net 11932 PRESS GANEY ASSOCIATES, INC. 2,624.74 0.00 0.00 2,624.74 Vendor# Vendor Name Class Pay Code i 14544 PRINT RITE INC. f Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 22593 ✓/ 09/14/20 09/02/20 09/22/20 148.14 0.00 0.00 148.14 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14544 PRINT RITE INC. 148.14 0.00 0.00 148.14 file:///C:/Userslitrevinolcpsi/memmed.cpsinet.com/u881251data_5/tmp_cw5report260355... 9/15/2022 Page 14 of 16 Vendor# Vendor Name Class Pay Code 10896 OIAGEN INC J,. Invoice# Comment Tran Dt Inv D1 Due Dt Check D Pay Gross Discount No -Pay Net 998459177 ✓ 09/14/20 08/29/20 09/28/20 359,28 0.00 0.00 359.28 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net 10896 OIAGEN INC 359.28 0,00 0.00 359.28 Vendor# Vendor Name Class Pay Code 11240 REMI CORPORATION 1 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1032370 09115/20 06/30/20 07/12/20 13,624.25 0.00 0.00 13,524.25 ANNUAL SERV AGREEMENT , Vendor TolalENumber Name Gross Discount No -Pay Net 11240 REMICORPORATION 13,524.25 0.00 0.00 13,524.2E Ventlor# Vendor Name Class Pay Code 11252 RX WASTE SYSTEMS LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3817 ✓ 09/15/20 09/07/20 10/02/20 698.00 0.00 0.00 696.00 FIX DESTROYER Vendor Tolal: Number Name Grass Discount No -Pay Net 11252 RX WASTE SYSTEMS LLC 696.00 0.00 0100 696.00 Vendor# Vendor Name Class Pay Code / 10886 SHANNON JACILDO Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 091222 09/16/20 09/12/20 09/19/20 34.99 0.00 0.00 34.99 , REIMBURSEMENT Vendor TotalE Number Name Gross Discount No -Pay Net 10886 SHANNON JACILDO 34.99 0.00 0.00 34.99 Vendor# Vendor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES Invoice# Comment Tian Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 56382200055638 �% 09/15/20 09/03/20 09/23/20 4,038.24 0.00 0.00 4,038.24 / v LEASE Vendor Totale Number Name Gross Discount No -Pay Net 10936 SIEMENS FINANCIAL SERVICES 4,038.24 0.00 0,00 4,038,24 Vendor# Vendor Name Class - Pay Code 12472 SOMETHING MORE MEDIA, INC. „✓ Invoice# , Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1842 „✓ 09/15/20 08131/20 09115120 2,225.00 0.00 0.00 2,225.00 ADVERTISING Vendor Totale Number Name Gross Discount No -Pay Net 12472 SOMETHING MORE MEDIA, INC. 2,225.00 0.00 0.00 2,225.00 Vendor# Vendor Name Class Pay Cade T2539 T-SYSTEM, INC ✓ W Invoice# Comment Tran Dt Inv DI Due Dt Check D• Pay Gross Discount No -Pay Net 758135 08131/20 08/31120 09/30/20 6,130.42 0.00 0.00 6,130.42 ER TRACKING Vendor Totals Number Name Gross Discount No -Pay Net T2539 T-SYSTEM, INC 6,130.42 0.00 0.00 6,130.42 Vendor# Vendor Name Class Pay Code T2204 TEXAS MUTUAL INSURANCE CO ,✓-- W file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report2603 55... 9/15/2022 Page 15 of 16 Invoice# Co mant Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1003985989 09/14120 09/07120 09/27/20 4,575.OD 0.00 0.00 4,575.00 PAYROLL REPORT Vendor Total; Number Name Gross Discount No -Pay Net T2204 TEXAS MUTUAL INSURANCE CO 4,575.00 0.00 0,00 4,675.00 Vendor# Vendor Name Class Pay Code U1064 UNIPIRST HOLDINGS INC' Invoice# Comment Tran Dt Inv of Due Dt Check D Pay Gross Discount No -Pay Net 8400402516 09/14/20 08/25/20 09/19/20 221.42 0.00 0.00 221.42 v/ LAUNDRY 8400403040.E 09/14/20 09/01/20 09/26/20 26.76 0.00 0.00 28.76 -� LAUNDRY 8400403044 ✓ 09/14/20 09/01/20 09/26/20 208.13 0.00 0.00 208.13 LAUNDRY 8400403068 �/ 09/14120 09/01120 09/26/20 1,761.47 0.00 0.00 1,701.47 LAUNDRY 8400403059 t% 09/14/20 09/01/20 09/26/20 159.89 0.00 0.00 159.89 �..= LAUNDRY 8400403041 ,/ 09/14/20 09/01/20 09/26/20 201,59 0.00 0.00 201.59 LAUNDRY 8400403042 ✓ 09/14/20 09/01/20 00/26/20 176,55 0.00 0.00 176.55 ✓ LAUNDRY 8400403043 / 09/14/20 09/01/20 09/26/20 190.01 0.00 0.00 190.01 ✓' LAUNDRY 8400403251 ✓ 09/14/20 09/05/20 09/30/20 48.15 0.00 0.00 48.15 ,,11 LAUNDRY 8400403271 �' 0911412009105/200913OY20 2,362.96 0.00 0.00 2,362.95 LAUNDRY 8400403252 f 09/14/20 09/05/20 09/30/20 57.12 0.00 0.00 57.12 .% LAUNDRY 8400403598 ✓ 09/14/20 09/05120 10/03/20 1,690,06 0.00 0.00 1,690.06 LAUNDRY 8400403591 ✓ 09/14/20 09/08/20 10/03/20 64.50 0.00 0.00 64.50 ✓� LAUNDRY 8400403574 ,/� 09/14120 09/08/20 10/03/20 190.01 0.00 0.00 190.01 ✓ y LAUNDRY B400403613 09/14/20 09/08/20 10/03/20 124.22 0.00 0.00 124.22 LJ' LAUNDRY 8400403575 ✓ 09/14/20 09/08/20 10/03/20 211.12 0.00 0.00 211.12 LAUNDRY 8400403573 ✓/ 09/14/20 09/08/20 10/03/20 243.27 0.00 0.00 243.27 ,✓ LAUNDRY 84004D3083./ 09/14/20 09/08/20 10/03/20 118.41 0.00 0.00 118.41 LAUNDRY 8400403572„/ 09/14/2009/011/E010/03120 191.69 0.00 0.00 191.69 ✓ LAUNDRY 8400403571 09/14/20 09/08/20 10/03/20 37.32 0.00 0.00 37.32,% r LAUNDRY Vendar Totals Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 8,224.64 0.00 0.00 8,224.64 Vendor# Vendor Name Class Pay Code file:///C:lUsers/ltrevinolcpsi/memmed,cpsinct.com/u88125/data_5/tmp_cw5report260355... 9/ 15/2022 Page 16 of 16 U2000 US POSTAL SERVICE / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 090922 09/14/20 09/09/20 09/15/20 2,200.00 0.00 0.00 POSTAGE Vendor Totals Number Name Gross Discount No -Pay U2000 US POSTAL SERVICE 2,200.00 0.00 0.00 Vendor# Vendor Name Class Pay Code 10793 WAGEWORKS, INC. , / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 090822 09115120 09108/20 09/15/20 3,243.15 0.00 0.00 PAYROLL DEDUCT Vendor Totals Number Name Gross Discount No -Pay 10793 WAGEWORKS, INC. 3,243.15 0.00 0.00 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay, 9111210789 -/ 09/14120 09/07/20 10/02/20 9,900.00 0.00 0.00 SUPPLIES Vendor Total: Number Name Grass Discount No -Pay 11110 WERFEN USA LLC 9,900.00 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 281,690.27 0.00 0.00 APPROVED ()M SEP 15 2022 BY COUNTY AUDITOR CA_tiCUO Ci�l to i i Y, T-;,AS Net 2,200.00 ✓ Net 2,200.00 Net 3,243.16 ✓ Net 3,243.15 Net 9,900.00 �✓ Net 9,900.00 Net 281,690.27 file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5 report260355... 9/ 15/2022 r�iCCE1VED 13y THE (V n nuD ro�ov CITIBUK CORPORATE CARD C;ALHDUAN COUNn', ±`XAfi Account Statement COmMMIJIUMAccount ROSNANOASTHOMAS Account Inquiries: Toll Free: 1-(800)-248.4553 Intarnatlorlai: 1-(90q)-B54-7314 Account Number: XXXX-XXXX-XXX; TDDfTTY: 1-(877)-505-7276 .... ... _.. ..._ Send Notice at Billing Errors and Customer Service Inquiries to: Cash Advance Limn CITIBANK, N.A., PO SOX 6125, SIOUX FALLS SD 57117-6125 Statement Clgsing Dafe Q Gays la Bilhn9 Penod -_- Transactions Post Tans_.._- Oale Oats MCC Reh�ne y1re Numbgr„_ _. _._,,......___..... Doser(ptisn/Loatian moon! ""•""•"'^'•'••' NOTICE MEMO ITEMS) LISTED BELOW •••••••••••••••••••• 09110 08109 099 05134372222600037916749 1 NPDB NPDB.HRSA.GOV S00.767-6732 VA 22033 USA tSO N86105085 08/10 Will 8999 55432862222200909839349 2 AWN•CREDENTUWNG SOM1413351L soil USA 4p0 09/02 Oar31 BM763GS372244164501783779 3 TPTA AUSTIN TX 78701 USA .,.%4f5A0 ✓ 000000075434478 09102 09101 5734 82711182244000021059011 4 SP SWEEPSCRUB.COM NORTHUTTLEAR 72117 USA �64AO ' ._.....__._... .nu••.w^•..•u• TnTL1 A1A^I IlrT n. U.1 1n .re.uc....... "`( !�:iUpl I`1' 15I II�ll1 A�II i�'Ai J1(7LII'Ifa;tsl+'r r, ;AS NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Pagel of2 _.._. _.. ............. ... ... — . ........ ., ...... _.. _.. .... ..... ... -"'p�a•,`s CITIBANK, N A CI POBOX61ii •s e S OUX FALLS SD 57117-6725 ROSHANDA S THOMAS 202 S ANN ST PORT LAVACA TX 77979-4204 Account Number XXXX-XXXX-)O= Statement Closing Date September 03, 2022 00007905040 Not an invoice. Foryouriecords only. ye-Y..Irh,;e.r , 't.l.ne o,Jl 19 ' :. I, l.•I •L .q ., .... m.�n • 24 how Lasfm6MMn CanlMmadlafaly CurtUepMnalmware aeon Rary Cuy. teeth a dyy. dglho GGabar`An cM hlN'hpne moth¢ too AA NOI=1 . NOokohs:�YOU mayneaka a paymem MyadlN uallyww=wa ntanlho th A" of maat3bmeRMrepad ellatarstden LSUCGIpaAledM. mNgpuMaWgec Pfmm AWA Nm mote aganlLdmn de Met none me CIPArfagar dnlna payment fmbm mubled la namhGdes.. II AWN by neik pt®se aAm sU Pleam Mane erallM ho^tafe b1h • CVedharder CrtdlL Llne Beth Grdhordee has an lndMdualC uN'rh —Y M UM far Cdsb wA nAh4l Nfik111, Ne maNmum emouM that No lnw venttfty be.1. W Send an A Awj percenhelOWdv eaa.0veembaaura M woad" Company, aheckmn, Iaw GI Gr!}dder Ealenos. uve ua#e ywr umaed paymenlNProper farm atwr emdn Lim (end Lnnk. Y a OftalldMAVIAt,doo V ny% he do wny tl nj The M, Pt mN on he 0 N debrmlRy try the Canlary aM k Of Int MAY. Poyl rent, can alm�W made byeleLtrartc NndM Bell mhenstar, vbe ft,,o , ,,, lrw,,, pee, a palm CI the loMa Wroj dmpanY hedlt LNw Lin Meeft deblk awl alher mamma- dot the number on am not G Nk Ge ona.1 In, dale. • T. mere.. Me Reallewla a CampanY cr 4lydholda Craig( unho'BA, Campamy mMY reA"G deng" b med%M, by mnbKfing CXI Carmab Card Cuao AV dCe 1CAAAAews • ramma"�Y RffiR6agm. by US PAY'Amof any aRune durgod b tie Axaenk Me Mv' m mEAP' Me RI hat Apa¢kadon Mr the Atteunf aM the autlwMy of all semis. Cul Whephane lees Cm dpM eery day, 2a a ayat wmbnraP-doodon Nd 1011-Meselemml Phan° pelmnsat the dote of NeBa�nhgslxhnpptlmlbn• and(h) ouNadanstha bonego e 0 the nufar t use G me Aaaunt Under the teem of The C01porGo db Agl¢ement by OR d0 IaMfum ¢Raped. •"Wenal Cerdlhodae: the dMpanY May reque6L epPli"tivA far adlillaw • spmfd mr ho"Al w Cadh A (make: CaMMGdels may gal a Cmh UoaM. at Rpt 16g,C00wadaot6 dry¢. CaMholdeR by contlGNg CYO MT."m Cans g¢mda, purNfep110nelNafiare open Onoy day, 24 hove a day At Me ws¢pb4ro number apedpatl en No not d tie fi¢Waaldobd 0.hanee want a portal Na ZaNndeh Tohl smbment llmdone ChlCA WAU dM padhlhdd, Credo Llm.It b ratan eddaicmlfnanlonak . For ash Mae not Al a sepal le f erne hfemtrlalk, • LYphWageaO online Tea Yap"n ews¢ymAmgeyourCme:aR+aRb drd anAm Number(PIN)RrequYadfarseemiyypw. Msa. uonly Nd CNMaraga anlhe Imo. CNmanager ambles yvu b maiage Uudnem aHsw vullgldM fum yebmmpubr ormobie dRke; yw . 0.vinamney Yic; My Mearnt still be dtlYqum! YnIeR N0 Bonk maebms the amount AwAn 0n Ise halblp setmlent as pu been" due, be. aNlanenis enlNeuu m mnfum a"apa Wallace. To reg'0for for CilpAmmgeA poem hog o, to Irtm any disown Budges, by the payment due den the Bank tit shm MAY unpaid padan a( Ole yew samlbWn mN afar on N0 SellAnt k.colunt, Mr dbholdere"link Fmm Neln MlbvNo plempfsMeshblRM1 your kaemada¢aca paGdue[rtenaen mbsal"neM9hgsbMnlal@Raaypadmof we past on batone,a,AAM mtomr AAAMft W16V emmmm(Appae, ly 66ag doge elbr Me NOW ryda cla's), 1 agrm to pry a kohn amry lee rnoAN, based we pemmageofineerWm paAMmOalarte UAW mypaymmrIn Anal b/ Ole Bank A lab fm may elm be nabbed lmM AN ea a pylmmt far Ne PAR due ba."a llremNad by tie Bank • In COse olErmaOY Clrerlbro Pbaut Yam BI1l: Vou art tmporePola brinadlRp medtsfade.RmlypmpmamIV maPnenjew who Oak w aAflp,w p, An see a(bVNpILM, Nmnea, IV melNalgl9a tlpl IRS eel MM IeCOAM, ar jot reametl memlamlm. YaluahwW0lm MNab Nepmeess YyWrnamn[SMlemanl InaamnlY lake oak es a ah¢rge a N a ereae, IselMth you hale been Iaaue0 a aatl4 lelp. N no .shone. Ta bagUl me niapne no lUlbn plamu, WY eimvmncrmmrtmm • Vau may also dRppb h eaPmcthn by hang M C, You may M, b m on a Ym dtneb tMe malRn Page2&2 MEMORIAL MEDICAL CENTER PURCHASF ORDER 'Bill To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (361) $322-03�122 Vendor Name: Vendor Address: Vendor Phone #: Vendor Fax #: Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 -. PHONE: (361) 552-6713 FAX: (361) 552-0312 Date: 9 1 1 -3 Zo &-,I- P.O. # Account # Initiated By: Dale Required Expens¢# Department Deliver To Form#Mi her D ipuon Unit Cost Unit Meal. Extended Coat• i) i_, I'�/y�,� � � ,Q ✓ lv'Y I, t-'i./f '/l k. r/�,,, �. J i� 6 ,���, y"• OV�B'/�,L �,•Aa p q A 4 d' 1. a t+� r rvvY l�r-�6'�I 5 TA " � �' ��n '� 4 as va t �P `' S10 - s 9q.Wo B - to Est. Freight Contact: Date: Quoted By: Buyer: E.T.A. Est. Total Cost Dept. Director Dir. Nursing Dir. Clinical Service TOTAL COST elr i' 71 JAI__ RECEIVED BY THE COUNTY AUDITOR ON SEP 19 2022 09/19/2022 CALHOUN CQMYTY, TEXAS MEMORIAL MEDICAL CENTER 0 AP Open Invoice List aP_opon_involce.templale Dates Through: Page 1 of 1 Vendors Vendor Name Class Pay Code 11632 AMERICAN CONSTRUCTION Invoices / Comment Tmn Dl Inv Dt Duo DI Check D Pay Gross Discount No -Pay Net i1 1753 ,/ 09116/20 08118120 08119120 12,260.00 0.00 0.00 12,250.00 / UNIT REMOVAL /INSTALL 610n FaLKR L. U-m r 3 pknac. qUO J 14 see Iz f owy , 1759 {/ 09/16/20 08/24/20 08/25/20 2,300.00 0.00 0.00 2,300.00 LABOR WARRANTYIINSTALL Vendor Totah Number Name Gross Discount No -Pay Net 11632 AMERICAN CONSTRUCTION 14,550.00 0.00 0.00 14,550.00 Report Summary Grand Totals: Gross Discount No -Pay Net 14.550.00 0.00 0.00 14,550.00 APPROVED ON SEP 19 2022 BY COUNTY AUDITOR cA1_HciINcoLtN)Ty T=;A file:///C:/Users/Itrevinotcpsi/memmed.cpsinet.com/tt88125idttta_5/tmp_cw5report659843... 9/ 1 RECEIVED BY THE Page I or COUNTY AUDITOR ON SEP 19 2022 MEMORIAL MEDICAL CENTER O9/t9/2D22.r. TEXAS AP Open Invoice List 0 CAU i 807 ap_opon_involco,templato Duo Datas Through: 10/06/2022 Vendor# Vendor Name Class Pay Code 14028 AMAZON CAPITAL SERVICES Invoiced Comment Tran Dt Inv Dt Due D1 Check D Pay Gross Discount No -Pay Net -1-HPBF40NMK9- 00124/20 08117120 10101120 37.99 0.00 0.00 —8409- SUPPLIES OYlbylyinul lis+ 1.y1M9y83tiR`1N 08131/20 08116120 10101/20 •39.72 0.00 0.00 .:99172. CREDIT It 'I 1GWOPRG47W73 // 09/01/20 08/16120 09115120 39.72 0.00 0.00 3972,,/ SUPPLIES T8986MHKHGDW 09101/20 08/25/20 09124/20 29.39 0.00 0.00 _29.39_ SUPPLIES I' `r t5QX6T-IW4*N 09/14/20 OB125/2009124/20 36.99 0.00 0.00 --38:99' SUPPLIES I t " iXRXPN6M9P7G ✓ 09116/200711312DOBI13/20 B8.00 0.00 0.00 88.00✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Not 14028 AMAZON CAPITAL SERVICES 192.37 0.00 0.00 192.37 Roport Summary Grand Totals: Grass Discount No -Pay Nei .. / 1920.00 0.00 192,137 1 9-7:1-2- Ia'.-1,v APPROVED ON SEP 19 2022 By COUNTY AUDITOR CALHOUN COUNTY, T,--`SAS tilc:lllC:lUsers/ltrex,ino/cpsi/memnted.cpsinet.com/u88125/data 5/tmp_cw5repor(3G30OI... 9/19/2022 Page 1 of 1 RECEIVED BY THE COUNTYAUDITOR ON SEP 19 2022 MEMORIAL MEDICAL CENTER 09/19/2022 0 AP Open Invoice List CALHOUN4TOUNTY, TEXAS ap_open invoice.template Dates Through: Vendork Vendor Name Class Pay Code 11285 ITA RESOURCES INC Invoice# Comment Tian Ot Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net MMC092022 ✓ 09119120 09/12120 09/21120 26,360.50 0.00 0.00 26,360.50 RESPIRATORY SERV Vendor Totals Number Name Gross Discount No -Pay Net 11285 ITA RESOURCES INC 26,360.50 0.00 0.00 26.360.50 Report Summary Grand Totals: Gross Discount No -Pay Net 26,360.50 0.00 0.00 26,360.50 %PPROVED ONO SEP 19 2022 By COUNTY AUDITOR CALHOUN COUNTY, TEXAS tile:///C:/Users/Iti-evino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report553530... 9/ 19/2022 Page I of 3 COUNTY AUDITOR On SEP 19 2022 MEMORIAL MEDICAL CENTER 09/19/2022 0 CAYAQYN COUNTY, 7g?(gg AP Open Invoice List ap open Invoice,tcmplate Due Oates Through: 10/06/2022 Vendorll Vendor Namo Class Pay Code M2470 MEDLINE INDUSTRIES INC M Invoicad Comment Tran Ot Inv DI Due Dt Check D Pay Gross Discount No -Pay Net 2220201072 09101/90 07110/20 08/12120 54.39 OAO 0.00 54;30 .y SUPPLIES 2222807940 09/01;2000/0312008128120 2,888.67 0.00 0A0 ,2:888.67 SUPPLIES 2222758922 09/0112008/03/2006/28120 26,62 0.00 0.00 26,62.E SUPPLIES 2222758905 0910112008/0312008128/20 1,730.17 0.00 0.00 1,730.17 SUPPLIES 2222758906 09/0 1120 08103120 08/28120 31914 0.00 0.03 319.14 a SUPPLIES 2222758904 09101/20 08103/20 08/28/20 348,32 0.00 0.00 - 348:32 P SUPPLIES 2223886618 09101/2008/1012009/04120 12.29 0.00 0.00 -12,29. e SUPPLIES 2225829060 09/01120 08124/20 09118120 313,40 moo 0.00 ,3W.404 SUPPLIES 2226829066 D9101/2008124/2009/18120 3,223.28 0.00 Oleo 3,223,28 SUPPLIES 2225829062 0910112U 08124/20 09/18/20 3,638,01 0.00 0,00 3,638..01 SUPPLIES 2227089061 OV1 p(LN I13`20 9/02/2009127120 200,15 0,00 OAo 200.16 I SUPPLIES I ] ��---- . 1960604039 ,09114/2007129i2008120120 33.15 0,00 Oleo 33,1 SUPPLIES ' 19611360BG 0911412008/0412008/29120 446,40 oleo 0.00 446, 0 SUPPLIES 1961866841 i 09/14/20 08110i20 09iO4/20 334.94 0.00 0.00 334. 4 ( SUPPLIES 196274039 09/14120 08117/20 09111120 207,61 0.00 0.00 207 1 1 SUPPLIES 196811989/ 09114/20 08/20120 09/23/20 27.89 0.00 0.00 27, 9 7I SUPPLIES 28.60 19644B8969 09/14/20 08/3V20 09125/20 288.60 OA9 Q00 SUPPLIES 1964498971 0911,1120 08/31120 09125120 14,130 0.00 0.00 14.30 SUPPLIES 1964496970 09/14/20 08/31/20 09/25/20 288.60 0.00 0.00 2 8.60 SUPPLIES 1964498968 09114/20 08/31120 09J25120 2880 Oleo Doe 2 8.60 SUPPLIES 1964488987 09/141200613112009125/20 427,87 0.00 0.00 4 7.87 SUPPLIES 19644198972 09/14/200813 V2009/25120 6,45 0.00 0.00 45 r SUPPLIES 1. 196411 5461 09/1412009/0112009/26/20 1,212.00 0.00 0,00 1212.00 . rite:///C :/Users/Itrevino/cpsi/memmed.epsinet.eoinhi88125/data_5/tmp___cw5report695890... 9/19/2022 Page 2 or 3 19681 19681 19691 19601 19681 19681 221 221 SUPPLIES O9tl4/20 09/14/20 10/09/20 SUPPLIES 09114/20 09/23120 10/18/20 SUPPLIES 09/1.1120 09/23/20 10/18/20 SUPPLIES 09/14/20 09/24/20 10/19i20 SUPPLIES 09/14/20 09/28/20 10/23/20 SUPPLIES 09/14/20 09/28120 10/23/20 SUPPLIES 09/14/20 09/29/2010124120 SUPPLIES 09/14/20 OW291201012020 /20 SUPPLIES 09/14/20 00/29/20 10/24/20 SUPPLIES 09/14/20 09/29120 10/24/20 SUPPLIES 09/14/20 09/29/20 10/24/20 SUPPLIES 09/14/20 09/29/20 10124/20 SUPPLIES O9fi 4120 09/29/20 1Oi24/20 SUPPLIES 09/14/20 09/30/20 10/25/20 SUPPLIES 09/14/20 10/01/20 1W26/20 SUPPLIES 09/14120 10/05/20 10130120 SUPPLIES 09/14/20 12/31120 01/25/20 SUPPLIES 09/14/20 02/18120 03/15/20 09/14/20 02/18/20 03/15/20 SUPPLIES 09/14/20 02/25/20 03/22/20 SUPPLIES 09/14/20 05/12•!20 06/06/20 SUPPLIES 09/14/20 06/09/20 07/04/20 SUPPLIES 09/14/20 08124i20 09/18/20 SUPPLIES 09114120 09103i20 09/28120 SUPPLIES 0911420 09105/20 09/30/20 SUPPLIES 86.60 0.00 1,250.76 0.00 119.31 0.00 32.05 0.00 2,044.40 0.00 234.65 0.00 800.01 0.00 57.14 0.00 852.18 0.00 149.89 0.00 385.10 0.00 207.61 0.00 61.20 0.00 93.56 0.00 75.38 0.00 94.17 0.00 153.21 0.00 785.95 0.00 1,255.21 040 125.85 0.00 183.54 OM 3,862.27 0.00 23.72 0.00 209.8B 0.00 62.64 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 o.0o 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,25 .70 119131 14 618 1.89 L10 .61 m 1 17 t i le:///C:/Users/ltrevino/epsi/nlemmed.cpsinet.coin/t188125ldata_5/Unp_cw5 report695890... 9/19/2022 22274�4492 09/14/20 09/05/20 09/30/20 35.43 0.00 0.00 SUPPLIES 2227838484 09/1 1120 09106/20 1010 1120 391.58 0.00 0-00 SUPPLIES 1965390291 09/14/2009/08/2010/03120 669.88 0.00 0.00 SUPPLIES 1960604038 09/15/20 07/29/20 08/23120 531.48 0.00 O.OD SUPPLIES 19653�9901 O9/15/20 09/07/20 10/02/20 30.00 0.00 0.00 I REFRIDG FEE 1965346903 09/15/20 09/07/20 10/02/20 30,00 0.00 0.00 REFRIG FEE 1965349902 09/15/20 09/07/20 10/02120 30.00 0.00 0.00 REFIDGE FEE Vendor Total; Number Name Gross Discount No -Pay Fd2470 MEDLINE INDUSTRIES INC 31,38 .10 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay / 31.38v0 0.00 0,00 rt1PPROVEDOny SEP 19 2022 BY COUPITI AUDITOR CA1"HOUA' COON liY. TEXAS Page 3 of 3 .48 Net 31,3�0 Net� 31138,8,0 qj�q Cl file:///C:lUsers/itrevino/cpsi/ntenmled.cpsinet.com/u88125/dtita_5hmp_cw5repart695890... 9/ 19/2022 STATEMENTAs of:09/16/2022 pa"; Toenverepropercretlbtoyour assonant, dieted, and reform this te r: asss slab with your handsome DC: 8415 As of: 09/16/2022 Page: 002 MEAORIAL MEDICAL CENTER AMT DUE REAITED VIA ACH DEBIT Territory! mp; Mall to: Co8000 AP Statement for information only ANT DUE REMIT® VIA ACH DEED 8 5 N VIflOINIA STflFYT Coal 632536 Mademenl for Information only PoW IAVACA TX 77878 Date: 09/1712022 Cos: 632536 PIFASE CHECK ANY DMe: 09/1]/2022 (TEAS NOT PAID (. ), Deis," Due Dsa DMe Ncelvabl�mnt 59M2g lonal Attoa36 Number Cast Amount P Am t P Nceivabk Ibfere roo Description Discount (gross) F (rot) F Number PF column Iegentl; P - Net 0. It... F = FMuro Oue Item, blank = Current Ow Item TOTAL- National At 632536 MEAOHAL MEDICAL CENTED SaMMsla: 6.100.60 U30 FMu s Due; 0.00 Due U Nltl On TMs: � It NItl By 09/2012022, USD �,9]6.6B NO Due: 0.00 Ny This Amount: 6,978.59 USD Of. load K pstl late: Lsat Payment 2,951.97 If Paid After 08/20/2022, pus II Nitl late: 22.01 0810712017 Pay this Amount: 6.100.60 USD USD 6.100.60 S, L. 6U^&7 = 151•bi U (APPROVED ON SEP ] 9 2027 BY COUNTY AUDITOR CALSi-,UN rill>;N. TI AS For AR Inquiries please contact 800-867-0333 MSKESSaN STATEMENT As al: 09/16/2022 Page: Out To elmum Poem med0 to year acwuiA, dabch and rehire this coma,..v: rose dub with your mmNlenee OC: B115 As of: 09/16/2022 Page: 001 HEB PHCY 04341MW MED PHS ANT DUE REMITTED VIA ACM DEBIT TeMtory: T001 Mall to: Camp: B000 AL MEDICAL CENTER Statement for information Only AMT DUE REMITTED VIA ACH DEBIT VICKYMEMO KIRGINI Customer. 190813 Statement tat infommtisn only 815 N 815 N IA ST Oa1e: 08/1 ]/2022 PoFR LAVACA TX 77979 AVAC Cost: 19D813 PLEASE CHECK ANY Dab: 09/17/2022 R@4S NOT PAID (s) BlIlnDue Receivitlod Acoount PG cash Amount P Amount P P4oeivable Dal. Deb Number Reference Description Discount (grass) F (.0 F Number Customer Number 190813 HEM PHCY 0434/MEM MED PHS 09/14/2022 09/20/2022 7366024599 2017061353 1151nvoice 1.36 68.16 66.80 17366024599 O PF column legend: P e Past Due Item, F = Rouse Use ae s. dank = Current Due Gem TOTAL Cudanler Number 190813 HIM PHCY 04341MEM MED PHS Sudolala 68.16 USD Future Orse 0.00 Due I1 Pdd On Time: If P4M By 0912012022. USD 66.B0 � Pad Due: 0.00 Pay This Amount: 66.80 USD Disc lost K Paid late: 1.36 lad Payment 8,992.97 If Aeld After (HIMOV2022, Due If Pent lab: 09/05/2022 - Pay this Amount: 68,16 USD USD 68.16 APPAOYEp ON SEP 19 2022 AY COUNTY AUUrrOR CAI}IOUN Colls)Ty, Try,Ag For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT An of: 09/16/2022 Page: 001 To eneun pmpar 4mdA to your acc na, detach and ralum we �mp�m esss alub with your nmKlana WALMART 1098IMEM MED MS pMT DUE MCKY AL MEDICAL CENTER Statement D nl 815 N KAUSIX 615 N AVACViRGIM ST PoW LAVACA T% ]78]8 RFMRTEO VIA ACH DEBIT for lITTE information only OC: 0115 Territory: ary• 400 Cuatamac 256342 Data: 09/1 ]/2022 As W: 09/16/2022 Page: 001 Mall to: Comp: 8000 AMT DUE REMITTED VIA ACH D®IT Statement for information only coal 256342 PLEASE CHICK ANY Date: 09/17/2022 IT MS NOT PAIIDDi(-r-)I Wing Data Due Dale gapayvapla<'lollonel Account .utb21pe Numra ber Reform De rlptlon cash Olxounl Amount P (gloat F Arnount P (net) IF Raaaw. Number I Customer Number 256342 WALMART 181HUNI t MED PHS 09/10a(122 09/20/2022 7366539371 46019108 1151nvoice 1.02 50.93 49.91 v 7365539371 09/12/9022 09/20/2022 7365626352 46092068 1951nvoice 7.05 352.53 345.48 - 7365626352 09/13/2022 09/20/2022 7365909789 46244517 1951nvolce 0.02 0.95 0.93. 7365909789 09/13/2022 00/20/2022 7365909790 46262732 1951nvace 2.62 131.00 128.38- 7365909700 09/14/2022 09/20/2022 7306025341 46399343 11W voice 11.66 577.96 566.40� 7366025341 09/14/2022 09120/2022 7366026344 46464573 1151nvoke 5.32 266.19 260.87, 7366028344 09/14/2022 09/20/2022 7366025346 46464573 11510veice 0.04 1.90 1.86 ✓ 7366025346 09/14/2022 09/20/2022 7066210312 46410076 1151nvoka 2.50 124.69 122.39,; 7366210312 09/15/2022 09/20/2022 7366313215 46529822 1151nvoice 1.28 63.88 62.60 �' 73663132t5 09/15/2022 09/20/2022 7366313217 46610035 1151nvoice 7.95 397.32 389.37 - 7366313217 09/15/2022 09/20/2022 7366474329 46548731 1951nvoice 0.02 0.77 0.75 , 7366474329 09/16/2022 09/20/2022 7365446300 46009097 1151nvolce 5.32 266.12 260.80 = 7365448300 09/16/2022 09/20/2022 7365448301 46046074 1151nvoice 0.06 0.00 7365448301 09/16/2022 09/20/2022 7365448302 46046074 115lnvolce 0.01 0.63 0.62 i 7366448302 09/16/2022 09/20/2022 7365448303 46059127 1151nvofce 0.01 0.63 0.62 / 7365446303 09/16/2022 OSJ20/2022 7365448304 46120557 1151nv01ce 31,78 1,589.18 1,557.40 7365448304 09/16/2022 09/20/2022 7365446305 46215599 1151nv01ce 1327 663.40 650.13✓ 7365446305 09/16/2022 09/20/2022 7366565510 46645774 115lnvoice 13.65 682.48 668.83 + 73665GS510 09/16/2022 09/2012022 7366565513 46716660 115lnvolce 7.95 397.30 389.35 7366565513 09/16/2022 09/20/2022 7366566515 46713542 11lumidce 0.09 0.09 ", 7366565515 09/16/2022 09/20/2022 7366706358 40652135 195lnvoice 0.64 32.05 31.41 ' 7366106358 09/16/2022 09/20/2022 7306706359 46656625 1151m,de. 0.01 0.32 0.31 7386706359 For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: 09116/2022 Page: 002 To ensure proper credM to your account, detach antl mtum this Cr wv! face dub with your mmhtence DC: 8115 As of; 09/16/2022 Page: 002 WALMART 109811AW MED PAS ANT DUE RHu11TT® VIA ACH DEBIT Territory: 000 Men to: Comp: 8000 MEMORIAL CBJT91 Statement for information only AMT DUE REMITTED VIA ACH DEBIT KAL SEK KALISIX 258342 Statement for information only 815 N 815 N Iq ST Gudomar: Oda: 09/1 ]/2022 PDin LAVACA T% A9]8 AVAC CUM: 256342 PLEASE CHECK ANY Data: 09/tt2022 ffMS NOT PAID (a) Nil m3 am Receivabllatkvl Account move Cash Amamd P Amount P Receivable I Date Date Number �lemnca Dexdpllan Discount (grew) F (net) F Number PF column legend: P = Pad Due Item, F = Fdure Due Item, blank = Cunnt Due Item TOTAL Cudemd Named 256342 WALMARy 1098IMEM MED PHS Subtalde: 5,600.58 USD Futter, Due: 0.00 If Petal By 09/20/2022, Duo 11 PaM On Time: Pest Me: 0.00 Pay This Amount: 5,488.56 USD USD 5.488.56 DI. last 9 field late: tad Paym 5,28].62 If Paid After2022, 12.02 Due H Paid late: 09/12/2022 Pay this Amount: 5,800.68 USD USO 51600.58 APPROVED ON SEP 19 2022 BY COUNTY AUDITOR CALHOUN CDUnITY,'fFXAS For AR Inquiries please contact 800-867-0333 m=RCD,VIV STATEMENT A. at: 09/16/2022 Page: 001 To ensure proper cmdf to your account, detach and return this �mwev: e... gun with your remOtanco OC: 8115 A. of: 09/16/2022 Page: 001 HIM PHY FC 490/MBA MC PHS ANT DUE RBdlT 51) VIA ACH DEBIT Temtow: 400 No to: Comp: 5000 NIMORIAL MEDICAL CE4TBi Statement for information only AMT DUE REAITTED VIA ACH DEBIT VICKY KALISW Cushman, 464450 Statement for information only 816 N VIRGINIA ST PORT LAVACA T% 77979 Date: 09/17/2022 Cug: 464450 PLEASE CHECK ANY Date: 09/17/2022 OBAS NOT PAID (✓) BilR Due Receivabjallonal Account MIPS Dgg1 Amount P Amount P hceWede OaU Oata Number We...Dextlptlon Discount (gross) F (nop F Number Customer Number 464450 H® MY FC 490/MEa1 MC PHS 09/12/2022 09/20/2022 7365433065 8220"55-100210 1151nvoice 1.01 60.44 49.43 1/ 73GE433065 09/14/2022 09/20/2022 7366003607 B220"55-000511 1151mmice 2.74 137.23 134.49 ✓ 7366003607 09/15/2022 09/20/2022 7366273908 B2209-055.100583 1151nvolce 1.57 70.50 76.93 7366273908 PF eoiumn legend; P = Paul Duo Item, F = Future Due hem, blank c Current Due Item TOTAL Customer Number 404450 HIM MY PC 490IMEM MC PHIS Subtotal.: 268.17 USD Future Due: 0.00 Due ll Paid On Tama: N Pam By 0912012022, USD 26D.65 Peg Due: 0XI) Pay This Amount: 260.85 USD Dix log If paid late: lag Payment 8.992.97 If Paid After 2022, Duo N Paid late; 5.32 DsroreO szz Pay (ante amount: nerd: 266.17 USD usD 266.17 APPROVEOON SEP 19 ?v DY COUNTY AUDITOR CALHOUN COUniTy, Tc AS For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT Company: seen CVS PHCY 8923/ME.1 MC PIS AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for information only VICKY KALISEK 815 N VIRDINIA ST PORT LAVACA TX 77979 As of: 09/16/2022 Pate: 001 To arson proper eralk to your Resound, coach seat mum thla etas NNh your trmittence DC: 8115 As of: 09/16/2022 Page: 001 Mail to: Comp: 8000 Tenitory: 900 AMT DUE REMITTED VIA ACH DEBT Customer 835434 Statement for Information only Date: 09117/2022 Cost: 835434 PLEASE CHECK ANY Dme: 0911712022 ITEMS NOT PAID (v) alin9 Due Reeela nid"allonel Amount gaps Cash Amount P Amount P Racehmble Data Data Number Reforeneo Desecpllon Discount (gears) F (eat) F Number Customer Number 835434 CVS PHCY 89231MEM Me PHS 09114/2022 09/20/2D22 7366038147 1876969 Illiterates 3,09 154.72 151.63 7368038147 O PF autumn legend: P = Pays Due Item, F e Foam Due Item, blank = Cement Due Item TOTAL Cusomer Number 835434 CVS PHCY 89231MEM MC MS SaMutBN: 164.72 USD Fmum Due: 0.00 Due If Paid On Time: 11 Paid By 09/20/2022, USD 151.63 Red Doe: 0.00 Pay This Amount: 151.63 USD Disc IOW B pald his. Las3.09 Payment20228,992.e7 It After 2022, Due 11 Poitl 181e: 09/OS/2022 091 yth Amount: Pey this Amount: 154.72 USD USD 154.72 APPR0VE00A1 SEP 1 9 2919 DY COUNTY AUDITOR CALHOUN COUNiY, TEY,AS For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT A. of: 09/16/2022 Page: 001 To andure proper weal to your summed, aimed, and realm this cis... eos4 dub whh your remhta um DC: 8145 As 9/18/2022 CVS MCY ]4i5/MP]61 MC PHIS AMT DUE RBdITT® VIA ACH DEBIT Territory: 400 Mal�� Camp 8000 MEMORIAL MEDICAL GMTM statement for inlormalion only AMT DUE VIA ACH DEBIT KAUSVIMINI( Customer: 835438 VIC815 ]or h nn Statement for inlormalion Dory N IA ST N Date; 09/1 ]/2022 PON/ IAVACA T% 77979 M AVAC Cud: 835438 PIFASE CHECK ANY Dale: 09/17/2022 ITEMS NOT PAID (�) ailing Due N N.&MIdel Account b3ntp45pfi Ceeh Amount P Amount P Receivable Ode Date Number liehrenee Description Cleared (gross) F (n t) F Number Customer Number 835435 CVS MCY ]4]5/MEM MC PHI 09/14/2022 09/20/2022 7366226560 1876518 11 Slnvoice 0.22 10.97 10.76 ✓ 7366226560 O PF column "end: P = Post Due Item, F = fldum Doe Item, bled = Current Due Item TOTAL• Cudomar Number 835438 CVS MCY ]4]6/M@d MC PIS Summab: 10.97 USD Fotum Due: 0.00 Due It Paid On Time: If BY 2022, USD tOJS Pad Due: 0.00 Payy Thls Amount: 10.75 USD Dieu lad M pent late: tad Payment 5,2W.62 11 Paltl Ater 09/110/2022, Due If Peitl late: 0.22 09/12/2022 Pay this Amount: 10.97 USD USD 10.97 APPROVE) ON SEP 19 y", BY COUNTY AUDITOR CN H0t %1I CCG*RY -•AS For AR Inquiries please contact 800-867-0333 AmerisourceBe err STATEMENT Statement Number. 63750521 Date: 09-16-2022 1 or 1 AMERISOURCEBERGEN DRUG CORP WALGREENS 012494 340E 1001352841037026186 12n7 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER SUGAR LAND TX 7747"101 1302 N VIRGINIA ST PORT LAVACA TX 779792509 DEA: RA0289276 Sat- Id Due in ] days 866A51-9655 AMERISOURCEBERGEN PO Box 90=3 CHARLOTTE NC 28290.5223 Not Yet Due: Not Yet: p,0p 1,J10.00 Past Due: 0.00 Ta141 Due: 1.319.09 Ao.n!Belsaw: 1.319.09 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 09-12-2022 09.2&2022 31058T90T1 181492 Involve 7].1B 010D 77, 88• 09-12-2022 09.23-2022 3105679872 167493 Invoice 23.60 000 09.12-2022 W-232022 31D5679873 167494 Invvitt 2.35 23.60 09.12-2022 09-23.2022 3105715657 167UI Involve 167.54 0.00 0.00 2.35- 167.54..' 09.13-2022 09.23-2022 310 80247 167550 Invoice 4A2 0.00 4A2 " 09-14-2022 09.232022 3IM006971 167550 Involce 5.73 0.00 09-16.2022 W-232022 3IM292614 167679 Involve 1.026.37 0.00 5.73 1,026.37 09-162022 09-23.2022 3106282615 167580 h.iva 0.09 0.00 09-16-2022 09.23.2022 3IM292016 167MI Invoce 11.81 0.0 0.00 11el Current 1-16 Days i8J0 Days 31.60 Days 61-90 Days 91-120 Days Over 120 Days 1,319.09 D.0D 0.00 0.00 0.00 0.00 0.00 Thank You for Your Payment Reminders Data Amount Due Date Amount 09-18-2022 (US.80) 09-23.2D22 i" 1,319.09 ` Total Due: ''? 1,319.09 APPROVED ON SR 19 2022 CMG {F Soi)3 WCOUNTY AUOITOfl cALrlotmlcou.rrv.Tt. R 0•L. Gt k*s sIz•LI, MEMORIAL MEDICAL CENTER J91 r4 PROSPERITY BANK 7'i- ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT —September 12, 2022 -September 18, 2022 I LiUY CP 't z, Date Beni, Descdotlon MMCNOtm Am4en 411 • '+4 ' 9/12/2022 TRANSFIRST LLCVMC SETTLE 41399801332385611 Credit Card Processing Fee 912.00 9/12/2022 PAY PLUS ACNTRAN54525792911010OG94993266 - 3rd Party Payor Fee �l %I cl 1_. 9/12/2022 TSYS/TRANSFIRST DISCOUNT393009825416366110 - Credit Card Processing Fee 59N I. 9/12/2022 TSYS/MAOSFIRST DISCOUNT 42399NI3323896110 - Credit Cord Processing Fee 277.20 9/12/2022 TSYS/TRANSFIRST DISCOUNT 413998013324016110 Credit Card Processing Fee 1,0pG.15 1[Y-4r 9/12/2022 TSYS/TRANSFIRST DISCOU NT 4139980135IB376110 - Credit Card Pmcessing Fee 72.56 9/12/2022 TSY5/MANSFIRST DISCOUNT 413990013324196110 - Credit Card Processing Fee 457.84 1CII, 9/12/2022 TSYS/TRANSFIRST DISCOUNT 413998013323936110 - Credit Card Pr..mg Fee 2p00.90 ti II I)r 9/12/2022 TSYS/TRANSFIRSTOISCOUNT4139980136839761W -Credlt Cord Punes6ing Fee 495.01 41I 9/12/2022 TSYS/MA,NSFIRST DISCOUNT 393009825899466110 Credit Cord Processing Fee 129.00 9/13/2022 PAY PLUS ACHFRAN54525J92911010006957003]3 - 3rd Party Payor Fee '49dT7,• G + I y(; �.•. 9/13/2022 MCKESSON DRUG AUTO ACH ACH05175GI 910DD0129 -34080rug Program Expense S.%761+�- v( U� 9/15/2022 PAY PLUS ACHTRAN5452579291101000697654508 -3rd Party Payor Fee .19,0¢` A,. 9/IS/2022 PAY PLUS gCHTMN54525]929110ID0069]654508 -3M Pony Foyer Fee 2,55 4'/ 6:> 9/15/2022 TEXAS COUNTY DRS RECEIVABLE 041921000023199 - Retirement Funding 192,630.00 je. 9/15/2022 FOMS FOMS PYMT 052-1737276.OW 4100012348252 - Credit Card Processing Fee 120.09 49 U / 9/15/2022 FOMS FOMS PYMT 052-1745548.00041UO012351MG - Credit Card Processing Fee 80,06 19 9/15/2022 FOMS FUMS PYMT 052-1743547-0004100012349165 - Credit Card Processing Fee 40.03 9/16/2022 PAY PLUS ACHrRANS 452579291301000698MB273 - 3rd Pen, P.,, Fee ^�°�:i4^ 2 a 7 S ` 9/16/2022 EXPERTPAYEXPERTPAY24600341191000014259122 {Rlltl Support Payment r2F2 0}+# J . J p , 9/16/2022 AMERISOURCE BERG PAYMENTS DIM0W]fi82100002 - 3408 Drug Program Expense 2258U:t( 9/16/2022 MEMORIAL MEDICAL PAYROLL]46W3411113122650 -Paymll 31575517= 1 � I. U7 9-1 �t 1`0!% September 19, 2022 WILLIAM LITTLE, CFO �¢ Memmlol Medical Center p �p19Je:i. 1 IL �2 rj PROSPERITY BANK ELECTRONICTRANSFERS FOR OPERATING ACTAUNT-ESTIMATED ACHS +1 )U III r Date Description MMCN4tes Amount Y 60 - e 9/20/2022 SALESTAX -Sales Tax 1,561.88 9/30/2022 UC IGT IGT 463,618:58.- 7 h'. APPiOVEO 486.Y90.46 September19,2022 pA, WILLIAM LITTLE, CFO Memorial Medical Center SEP 19 2022 - FIY COUNTV AURITO , N ij U 1 1 1? s%.<ILNOUA2 COUa(Ty. T� XNg QQ Confirmation: You Have Filed Successfully Sales and Use Tax Period Ending 08/31/2022 (2208) TaxpayerlD Taxpayer Name: Entered By: User ID MEMORIAL MEDICAL CENTER Email Address: Reference Number Taxpayer Address: Date and Time of Filing: 815 N VIRGINIA ST PORT LAVACA, TX Telephone Number. (361) 552-0342 09/121202Z 02:25:32 PM 77979-3026 IP Address, PAYMENT SUMMARY Electronic Check Payment Reference Number Type of Bank Account: Checking State Amount: $1,183.24 Trace Number: 70008511 Accountholder Name: Local Amount: $378.64 Bank Routing Number Amount to Pay: $1,561.88 Bank Account Numbe, Electronic Check: $1,561.88 Payment Effective Date: 09/20/2022 CREDIT SUMMARY Credits Taken Are you taking credit to reduce taxes due on this return? No Licensed Customs Broker Exported Sales Did you refund sales tax for this filing period on items exported outside the United States based on a Texas Licenced Customs No Broker Export Certifications? LOCATION SUMMARY Loc# Total Texas Taxable Sales Taxable Subject to State State Tax Due Subject to LOC81Tax Rate Local Tax Due Sales Purchases Tax lRate.0625) Loral Tax 00004 19027 19027 0 19027 1189.19 19027 0.02 380.54 SubTotal 19027 19027 0 29027 1189.19 19027 380.S4 Total Tax for Locations $1,569,73 Total Tax Due; S1,569,73 Timely Filing Discount: • $7.85 Balance Due: $1,561.88 Pending Payments: -$0.00 Total Amount Due and Payable: $1,561.88' ( State amount due is $1,183.24) ( Local amount due is $378.64 ) Transaction Summary Transaction Complete Trace # Texas Health and Human Services Commission Memorial Medical Center Operating County Payment Total $483,628.58 9/30/2022 Bank Routing and Account Number Settlement Date UC Hospital Amount $483,626.58 Entered By Moehri Page No: t or t Run Date: 9/13/2022 Run Time:11:oe:o2 Marley ODonnell From: Texas Health and Human Services Commission <txhhs@public.govdelivery.com> Sent: Tuesday, September 13, 2022 10:26 AM To: Marley ODonnell Subject: Uncompensated Care Program IGT Notification Demonstration Year 11— Final Payment CAUTfON: 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. RCY,�y ETEXAS Sw>„ 0 �� Health and Human Services Uncompensated Care Program IGT Notification Demonstration Year 11 - Final Payment HHSC is providing notification of the Intergovernmental Transfers (IGT) call for the Uncompensated Care (UC) Demonstration Year (DY) 11 Final Payment. This file has been updated today, September 13th, 2022, and can be found under the UC IGT Final Calculation Files heading on the Provider Finance website located here: Uncompensated Care Payments I Provider Finance Department (texas gov). • State Hospitals will need to submit a journal entry for the All Funds amount located in Column Z on the tab labeled "2. State Hospitals". This journal entry should be submitted no later than Oct. 3, 2022. • A!l of her IGT amotknts can be found iI1 co Mt1,5K on the "3. UC Cafct�l"i��toris ^by Hospital" tads of the Suggestetl ZG°l3. • The total IGT amount needed to fully fund each SDA is summarized in column C of the "Payment and IGT Summary by SDA" tab. The IGT must be entered into TexNet no later than close of business September 29, 2022 vvlth a,settlement date of September 30, 2U22 • This settlement date is non-negotiable. • The funds need to be placed in the ' Up 6 cket Please transfer funds through TexNet. TexNet instructions are 51160'i'TThis form can be found under the Additional Information heading on the same webpage: Uncompensated Care Payments I Provider Finance Department (texas goy). Please submit the trace sheet and IGT allocation as two separate documents. Please email any general questions regarding the calculation to the Hospital Services Team. You have subscribed to get updates about Texas Health and Hunan Services (HhiS). For more information about HFIS, please visit our ebsite. "— Stay Connected �• (en espanap 6 SHARE Subscriber Services Manage Preferences i Unsubscribe j Helo This amsi! :vas cant to rrn;mm=.I!t3rcnr;;a:!la�:=aa.co�n usury ycv e!iv6ry Cmm�',u:�i<: !inra CI'Mi ^n =hr:i of 7� 9Ea HeaIIh end ivnr,en Ssrdcas f)amloisoian M7 ! %tti S:. Sin!e di:'ue� �e :per. CC: eG'n^ (JUVDEi.WERY� 2 Application Application Application Hospital is in the 2. State Hospitals tab, the value is Yes, othenais e it is Calculated: Unins SF - Calculated: If DSH PMT > DSH only costs (Medicaid SF + DSH-Only Uninsured SF) then DSH PMT- Medicaid SF - DSH- uon catcwauon uaa on1V w-. else u Calculated: If UC Schedule 3 - DSH PMT attributable to Charity >0, UC Schedule 3 - DSH PMT attributable to Charity, else 0 Data Application Data Calculated: Sum of Schad 1, Schad 2, Schad 1 AdL Schad 2 Application Data Application Data Application Data Adj, and Sched 3 Adj DSH calculation data Calculated: If on State Tab, Other UC Cost (Nan-S-10) Schad 3 Adj; otherwise, UC Charity Cost Remaining after DSH offset + Other UC Cost (Non-S-10) + DSH IGT for Large Public Calculated: Rural hospitals get UC cost, Other Hospitals get an amount equal to % of total cost times remaining pool (Total UC Pool - Non - Hospital - State & Rural Set Aside); physician groups get % to total times physician poo Calculated: If Large Public, ensures payment does not exceed UC cost excluding the IGT amount; If First Pass > Eligible UC Cost - DSH IGT, then First Pass - (UC Cost - DSH IGT), Calculated: If there was a reduction, there are no remaining UC Costs, otherwise UC cost - Large Public IGT - Calculated: Allocation reductions are distributed based on remaining UC costs as a % to total; (Remaining UC Costs after First Pass)/(Sum of Ali Remaining UC Costs after First Pass)"(Sum Allocation Reduction for Calculated: UC costs remaining after first pass minus second Calculated: First pass payment minus initial reduction plus second pass payment Calculated: Payment after Second Pass times State Match From UC Advance Calculated: YTD UC Payments*State FMAP % Calculated: Total Eligbie Calculated: State Placeholder for future Calculated: YTD UC Cost - DSH IGT for Match' Max Total years; for now 0 Payment"State Match Large Public Payment 2"+`"� `��'.f ��i?a�F�'Yf a,}�iY x Fh. h S�'�'4r5 ";'Y hs✓. < :{ y .�yr, v �,��i ���; State Hospitals: YTD UCr Payments Remaining after Sehed 3 $2,674,506 $ $882,597-02 Calculated: If provider is in State Tab, Max total payment minus YTD UC after Schad 3; otherwise Max total payment minus YTD UC payment Calculated: If in State Tab, max total IGT minus YTD IGT after Schad 3; otherwise, max total IGT minus YTD IGT Update with new IGT amounts Bexar Pool Dallas Pool El Paso Pool Hidalgo Pool Reallocation or Reallocation or Reallocation or Harris Pool Reallocation or (Reduction) '(Reduction) (Reduction) Reallocation or (Reduction) Based on IGT Based on IGT Based on IGT (Reduction) Based Based on IGT Survey as Survey as Survey as on IGT Survey as Survey as Described in 1 Described in 1 Described in 1 Described in 1 TAG Described in TAG 355.8212 TAG355.8212 TAG 355.8212 356.8212 (f)(3) TAG 355:8212 (f M (f)(3) (f)(3) (f)(3), Jefferson Pool Reallocation or (Reduction) Based on IGT Survey as Described in 1 TAG 365.8212 Lubbock Poor Reallocation•or (Reduction) Based on IGT Survey as Described In 1 TAC 356.8212 (f)(3) MRSA Central Poor Reallocation or (Reduction) Based on IGT Survey as Described in 1. TAC-355.8212 (f)(3) MRSA Northeast Pool Reallocation or (Reduction) Based on IGT Survey as Described in 1 TAG 355.8212 (f)(3) MRSA West Poo Reallocation or (Reduction) Based on IGT Survey as Described in 1 TAG 355:8212 (()(3) Calculation: Sum of Pink Columns (Reallocation/Red uction by SDA) Calculation: UC Payment After Second Pass plus Reallocation/Reduction Nueces Pool Tarrant Pool Travis Pool Reallocation or Reallocation, or Reallocation or (Reduction) (Reduction) (Reduction) Based on IGT Based on IGT Based on IGT Total DY 11 Payment Survey as Survey as Survey as , (State Hospitals - Non- Described in 1 Described in 1 Described In 1 P SAO Only TAC 355.8212 TAC 355.8212 TAC 355 8212 *� Calculation: if in State Tab, Total DY9 Payment minus YTD IGT after Schedule 3; otherwise, Total DY9 Payment minus YTD IGT Total DY 11 IGT Calculation: State Match " Final Payment or Recounmant Final IGT Required Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON MEDICAL CENTER NP0MEMORIAL 17 2�22 0 AP Open Invoice List 11:44 1:44 ap_open_Invoice.template Dates Through: CALONA00rMW Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 090222 09/1412009/0212010/07/20 4,605.51 0.00 0.00 4,605.51 TRANSFER WJ1 jytSl)Y4lKlG v t1 clr.�9hr"�a1 IK-b MI'h(- Dp1.vnkin , Vendor Totals Number Name Gross Discount No -Pay Net 11828 SOLERA WEST HOUSTON 4,605.51 0.00 0.00 4,605.51 Report Summary Grand Totals: Gross Discount No -Pay Net 4,605.51 0.00 0.00 4,605.51 APPRUV€D( SEP 15 2022 BY COUNTY AUDITOR CA(.1-I^Ui i CO! iPir/, T =XAS file:!//C:fUsers/Itrevino%psi/memmed.cpsinet.com/u8 8125/data_5/tmp_cw5report702264... 9/ 15/2022 Page I of 1 RECEIVED BY THE COUNTY AUDITOR ON SEP 15 2022 09/15/2022 CALH011iftouNTY, TEXAS MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: 0 ap_open_invoice.template Vendor# Vendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount 090922 09/14/20 09109/20 10109/20 5,750.50 0.00 TRANSFER Nli t,p1lVLV((.t. V*4 &PZi'fecl in'h Yl WL 0pct,L-i'inj Vendor Total: Number Name Gross Discount 11832 RROADMOOR AT CREEKSIDE PARK 5,750.50 0.00 Report Summary Grand Totals: Gross Discount No -Pay 5,750.50 0.00 0.00 APPROvEI) ON SEP 15 7r2, BY COUNTY AUDITOR CAI_HOt*l CCtJ,rry, � No -Pay Net 0.00 5.750.50 No -Pay Net 0.00 51750.50 Net 5,750.50 file:///C:/Userslltrevino/cpsilmemmed.cpsinet.comlu88125/data_5/tmp_cw5report701390... 9/15/2022 Page 1 of I RECEIVED BY THE COUNTY AUDITOR ON SEP 15 2022 MEMORIAL 09/15/2022 MEDICAL CENTER £ALHOUN7 tA€(1N77, TEXAS AP Open Invoice List 0 ap_open invoice.template Dates Through: Vendor# Vendor Name ClasS Pay Code 11824 THE CRESCENT Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay 090922 09/14/20 09/09/20 10/09/20. 4,095.00 0.00 0.00 TRANSFER NO IYISUVILAU P�"� �cl7o5i�cc 'In-�, Vy KL Opt,t1.-},k Vendor TotalE Number Name Grass Discount No•Pay 11824 THE CRESCENT 4,095.00 0.00 0.00 Report Summary Grand Totals: Gross Discount 4.095.00 0.00 APPROVED SEP 15 H22 6Y CCU Iry AUDITOR Net 4,095.00 Net 4,095,00 No -Pay Net 0.00 4,095.00 file:///C:/Users/ltrevino/epsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report760127... 9/ 15/2022 Page 1 of 1 :6ECEIVED 6Y THE (,,O UCt,M AUDITOR ON '51IA22022 MEMORIAL MEDICAL CENTER AP Open Invoice List 11:44 0 titt.fiOUN COUh1TY,�lEl%$ Dates Through: ap_open invoice.template Vendor# Vendor Name Class Pay Code 12696 GULF POINTE PLAZA , Invoice# Comment Tran Dt Inv Dt Due Dt Check U Pay Gross Discount No -Pay Net 090622A 09t14/20 09/06/20 10/07/20 5,290.58 0.00 0.00 5,290.58 ✓ TRANSFER t N"J"CUM-h.LL pDV%_A dtfoYiLL ct1 Ikb V Wtt- 0�' 090622 09/14/20. 09/06/2010/07/20 3,501.00 D.00 (J 0.00 3,601.00 , TRANSFER tL tt D90722 09114/20 09/07120 10/07/20 10,630.13 0.00 0.00 10,630.13 ,1'J TRANSFER It 4 090822 09/14/20 09/08/20 10/08/20 814.15 0.00 0.00 814.15 TRANSFER " 11 Vendor Totals Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 20.235.86 0.00 0.00 20,235.86 Report Summary Grand Totals: Gross Discount No -Pay Net 20,235.86 0.00 0.00 20,235.86 aPPRGVEG ON' SEP 15 2022 By COMM AUDi i OR file:///C:/Users/Itrevino/epsihnemmed.cpsinet.com/tt88125/data_5/tmp_cw5report768542... 9/15/2022 Page 1 of 1 RECEIVED COUNTY ON SEP 15 2022 MEMORIAL MEDICAL CENTER 09/15/2022 0 AP Open Invoice List CA1L4i &N COUNTY, ila(AS ap_open-invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 090122 09/14/20 09101120 10/07/20 1,625,00 0.00 0.00 1,625.00 1� TRANSFER V, ltjl UV1RUpt wo aC(V�.!Jta Irliv INWU, Oft^ 090122A 09114/2009/01/2010/07/20 2,644.46 0.00 0.00 2,644.46,/ TRANSFER " I, 090222 09/14120 09/02/20 10107120 11,444,36 0.00 0.00 11,444.36 ✓ TRANSFER " q 090622A 09/14/2009/06/2010/07/20 2.644.10 0.00 0.00 2,644.10 TRANSFER it 1 09D622 09/14/20 09/06/20 10/07/20 2,600.00 0.00 0.00 2,600.00 TRANSFER 090722 09/14120 09/07/20 10/07/20 12,196.80 0.00 0.00 12,196.80 ✓ TRANSFER 090822 09/14/20 09/08/20 10/08/20 6,474.00 0.00 0.00 6,474.00 TRANSFER IL 090922 09/14/20 09/09/20 10/09/20 920.60 0.00 0.00 920.60 ✓' TRANSFER O9D922C 09/14/20 09/09/20 10/09/20 307.25 0.00 0.00 307.25 TRANSFER .L to 090922A 09114120 09/09120 10/09/20 716.92 0.00 0.00 716.92 TRANSFER I` It 090922B 09/14/20 09/09/20 1 D/09/20 789.91 0.00 0.00 789.91 TRANSFER wL �� Vendor TotalE Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 42,363.40 0.00 0.00 42,363.40 Report Summary Grand Totals: Gross Discount No -Pay Net 42,363.40 0.00 0.00 42,363.40 APPROVED ON SEF 1,5 2022 BY COUNTY AUDITOR file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report554174... 9/ 15/2022 Page 1 of 1 RECEIVED BY THE COUNT/ AUDITOR ONI SEP 15 2022 09/15/2022 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List CALHOU14ftUNTY, TEXAS ap_open_invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 090122 09114120 09101/20 10107/20 10,563.67 0.00�-.. 0.0D 10,563.67 L TRANSFER t'JH j" UVk VtLj, p15MI &prYai"tul � N-b 1hIV�[- tl)�11.n-• X , 090222 09/14/20 09/02/20 10/07/20 9,257.71 0.00 0.00 9,257.71 TRANSFER t` tt 090622 09/14/20 09/06/20 10/07/20. 31,925.12 0.00 0.00 31,925.12 TRANSFER it it 090822 09/14/20 09108/20 10/08/20 305.42 0.00 0.00 305,42 TRANSFER n 0 090922 09/14/20 09/09/20 10/09120 8,951.22 0.00 0.00 / 8,951.22 TRANSFER " n Vendor TotalE Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 61.003.14 0.00 0.00 61,003.14 Report Summary Grand Totals: Gross Discount No -Pay Net 61,003.14 0.00 0.00 61,003.14 APPROVED ON SEP 15 2022 BY COLINI' AUDITOR G+U'10,;N COUPfrY. TEXAS n file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.coin/ug$125/data_5/tmp_cw5report347057... 9/15/2022 FROM CRESCENT TO TUSCANY 9/19/22 AppRo'ljEE) tINl SEP 1 2072 By COUNTY AUDITOR CALHOUN I —1Y, Tl—=YAS AMIDLINT USE -"TD-!!7 Imp, est Clsi, E]A/P Chec�. DEVOTED PAYMENTS MADE TO CRESCENT, OUT BELONGS TO TUSCANY Mayra Martinez L Memorial Medical Center Nursing Home UPI. Weekly CantexTransfer Prosperity Accounts 9/19/2022 oxYlnua Awum eednnln{ ;N N H onuu — y4rcC e Aw Pmdb3 eabnbe Amwel tna.mmnn.6lem,mme I.ztrY t 331710.31 ✓ 33,653.BC 116,s"n.00 "' c. - r_yMFP 55.511.39 ✓ 55.3)6,I1a/ 119.851 W v. E1.356.64a' E3.13i 1B �E9,106.96. qy'�AC�B ma�Mdl 74,316J14 9) 3I693Cf1a0A36A1 V i �C, b I j nne eemr edewmmbwm9ra9unr 1:\XN WeeaNRemlen\NN UPILmIfer SummaMlEOl1Ve01embe,\XNURinmlx fummaryM,l933nu 1C),)b.SB Bank BNann 19],3B9.SB Vatlanae laavain Nlmh 1W.fA IeNlntaveal E9.39 AuBYmm�rnl SOW ./! SlOtemhmintertst hElun OabneC/TRnahrNnt 1C], N9.W ! - 105,908.47 oanl Balance 105.409.47 V Vanancn laiYCln Bilann ]00.00 '.IYlnhmn ujs AYNrc lnlerml IIa3 v' September lnnrml Adlmt Bala^n/Rannar Amt iwnz.w 119,911.35 NM Balanre Id.— E19.989JBry team In babnh 100.90 CW WPAYMFMTOTUSG ]p3800 y� 3ulYl^hren 15.3] v' AYeen uhhrc 33.01 ✓ Semember 1nlerm3 Ad1Yal Belen[e/rmfler Aml ] .1107 29.336.40 / Bmk Balann 39d3640 wmnm learn In eabme SWco luNlntenn 5.751 AY3uatlnlmM 0.71 s� Saptembnblermt Mlun Balane/tnmf., 391106.9e y 1C0.96e.59 Benk Balance 1019W.59 Y/ Van.. U.-m Sebnee 100.00 105,77210 112,813.W 29,106.90 140,936.01 APPROVED iTIVI 5EP 19 202`L 391,lnleren 17.5e ✓" BN( COUNTY AUDITOR AYWflnt ,mt 3144 Se9eembvlmnm V C.`\lH0Uh1 GOUN'fY, TEXAS Mlun Babnm/rnnaba Amt t10.B3B01 r' TOTAITBAXSr6n9 5116 13 A9prwed: WIWAM WTIE CPO 9119/EO13 F., I 9/I]/]0l3 MWnL MCaL1XNCCIAIMPMLPNGlGl61WgW � �� 9/1y10]) M.1NtaFIJIVMCTI)IB MM PMMO10Wpp4l 9/13p03] .Vn(RyoYPD19CMC[WMPM)31P910A1) IIIDp 9/IS/IpiS VNCfOMMUNIIYILMf[WMpM(1fLWM1l91Pa0 9/{3/]O]] VX[mMMUN11Ypl M(WMpM]>1lvlLl{9IBW) 9/t}/3p)3 UHCCOMMUXm•PLXC(WMPMI)IEY'Lil9}ZW 9/NGPR UNC WMMUNIIYPLMCCLVMPMIIIW]H1191Otm 9/19/]Dif [nN3neHAm1)YSD� WISIM)i WIREOMAWCHCQMMO CMEKNCPn,U 9/1190ll 3unerlpeuP 11UC X[C W MPM] 31M[011lp yyYL VILSM31 UNC-ECKDH M MPMT7 MPM]](6WaMUUyjp 1111021 NNB'E(Np NCLWMPMWMVMI?WaaL M3 9/3P/IM) VM[CnMMVXIry PLNKWMOM[146OIIg191M 91l6/10t3 H(6LIM MUMPNSYCXfCWMPMi t](WYnIMp] 1 ,4< 9/M/Mb XNL-ECHO NCGAIM9M6)}6WHBI61ry[O1}60ifi 9/1}R0}] UN[NMMVNmILIKCWMPM)14[014I191NM 9/1 L101] NUMRX41mmXlLWMRR 3906I13DJm6})]G 9/!}/}0}} NUIMNRCNRtlR0N4MIMPML3fW61 GfAWl6.1A IMAM} YMCCOMMVNIM1PLNLYLJMfM6]L(pJNLL9ltlro 9/Le/}M3 uNCmMMYNRYAINCpNMIME )4WA6LL91[NB 911/M4 NYMMMCXI,BR}XUWMIMI3AB1QWN1Wf 9111/l0II NiM1N NUMR116vLMCfWM0M6I11WLIL'Cpl 1114 M}[ YNCCOMMUMMPLX[CWMPMI)4(WNiI fIMW 9/N/}OII IIf.LLM XYMIR WENCCWMIMI1NMg311130%2 9/t4p0i} CIORMMC(NIMPMEIMfE10A1191MWIWAM90 iUMll 3Mo fYPf4mmlr NCCWMPM])}fMyl11Ul8E Wilma SIVW02 UHC COOMMMUNUVft N=UWMl MCEWaLMl119ro 9/36/1. NVMf11ACMf od Cf111MPMTb01610 M=H7M 9/3R/}W]NUMPIIp(N4pR8 NflWMIMl9p d14)pq]1}6S WIUN22 UXLCOMMDNT'PLXKWIMOMT)d6op311t9IWW a W12I1012 MUMMA INSCD NCLIAIMMP0WBGaWWA WA0)AI 9/ll/loll DWOTEO L AITH PHCCLUMPMT 121103MWp1135 9/ll/M3l DCVOTCDAMTH PNCCWMPMT 121140IM21A83] 9/li/2022 OFVOIEOHfgLTN DNCCUIMPM)11114M992]%3D W13/M22 HOE-E 9/M/Mii UHCCO HDNKWIMPMF]bOMflle1Mp01M)92 WIL12Ull DHCCOMCHAM$5LHClAJMPWT14Mp30I1 ,,, WI3/10i1 NUMPNACUPO PH=lAM,p T32IM191 W3605 P/IQ2022 UHCCOOMFALIHPHM 1 MPMI3lIld039M9B032 9/R/3022 UNCCOMMVXIry PLIIKWMPMIA60W41I91WW 9/1S/1031 pEVOTFONFALMPH[[WIMPMT 321340394RWb 9/15fM11 O3BO260MMINW NKW MPM) a,jj 9M9MJ2 9/16/202} MPWN ADMINIMNCMIMPMTl<9963110Wp]69 9/16/2011 NH9-[[HOALTHPHPM(2d6003412114 116534 9/16/1011 0[VOTFDN56LTH PHCCUIMPRn $11103%Y3]663 Ifl0lii2J ISEOow MPP/Gmpl Qwpl6.P3 y9P/(am 3 OMP/0mp(RMP g"n I NNPORTIDN ' 2L]M.49 S1.SG.69 - &366.W 6iE650 3Lfn.4P y13Q,(0 1.76.19 21.ISa26 m.9W.93 • 10,99&B) - f}, - 41,60,,47 �60.Si L:M19&N &30 4,49&30 LG9.M SAl0F6 ' 91121 813,P ' "0.99 a36999 ' .1,22 1.94 31.1).33 • 3 4e I 14)A31.11 MMCPORMS T..O.lwt I@yhPjp QVPIQAP CJPP/fampi oppl/ mp3 glpp/Ccmp Lvle Qlppm NHpOD11OX f1X]6 - 5,42B76 ll,911.G 13.91LH - 11M. 3)WW a935.0 1..1M96 3.]L3W • 2L9A.39 • 6,332.96 W3SJW - 21,95838 L11&53 ' 30,39D.00 • 9F96.61 l,L]R53 � 5,9%fit lAa. _ Iab7.ro S.M0.49 RI69W 11167.90 33.653.10 91169.0 365A3 691000 ' j 1.IIP.W ' ],140,W 455J6 1 9p J - ]Jq MMCMMIGN .7n HwAu! Im,.H...ln qRP/Gm01 QIPq(pmp} gIPP/fampl QPP/Cv pµG W NH PoRnON - ).4b.10W..00 W 3abp.4] - )A90A0 9,W9.00 S,mm ' 6,WS.W .,510.00 apW.W 16A69,03 4.610.W SA96.92 16.663.03 11593.39 ,076. • 6.975.LV - 13. 155. ' te.29158Wou - - 1,L93.SR II.BN'00 4,mm 15A16.11 11193.50 W3,W a6W,M 691.00 4.10. 0 - LVION "mu 4,IN.00 LOOM 5.W6.92 SFW,W - MMCP0Rn4XN :•� �H QYJ TIRD)?5C1p NIP/COmPl D19P/famP2 QH'P/[PmOI CUPOOMM NI[ le NM/[Oil 0e9eY1 -� 1.1[eW P P NPPTI NM PoILIION MWIO)I VMf COMRWMX1Pl ML[NIMIM[)<I0Yt191¢W - 21]1RU LI(8W 9(11/1WI YNCMMMYXIrypL HCCWMIMC)[NOGtl91Kro 17W." 23.178,17 'IMP [ WIR[OMGXIE9XLPLTIGVIF[[M1M91 ]1,13).l9 AM71 3L13].L / b106.90 b 1069 JM. W.M, W.NM.e Mn-22 mr„W.Y]o]J.ry 9/IUM2 MOIMa MCarTIXCCUIM9M69N1(9)Y915]IW ItCU SS M91M9NCe1 ttNCCWM SIMNT 91163339S11p 9/Y/NI3 NJ.X4D[.9XDXlf I)IL MX6 tMM)OOH6141 IIW2Mi UXC(OMMYMNY ILKKMIMIM)66WY13914W 9/1L]Mi NIIMMM CMII p6BMfCWMIM133p65lYDLY]5 1/111=2 VHCCOM916Mn CLHUJWMf)66NL1111i9Y 9/U/ UNf COMMUNM9LMCCWM9M)JSi0A611910M 9/111MI HOVrtIiSOIU)pNN([WMIMI>6l iW(I(W01)9 9/131IDEE NUM4wIMi[O H[fWMIM11Y16i 61[(N56JS96 9111IM2S HUM4N.(<IYD6BHCCWMOM]IpYS(+p%V . 9/EM22 HUMCCUIROH CH.(p138N(CWM9M]IWYi 61u". 9/YR012 U1111YMl6INYtt MCCU1MIM6JIgB36111](3Y 91W k WIRIMTMUXMIINQWMOMr>(6p)361191D%O 9/IS/]D]] Do W)GM[ItNGl1NfAM [FMfY 111 9/1 =/ ppa)il 9/19(]Wi MMM4GXOX[LI7YMN51MMT00L I4g41 8A5/2D]] XU.WXR INSCp XCCWMIM))NN6]iYHL9(IBS) 9/IS/W]] NYM414f1UD66MfCWMIMf 3NYi41YC]1s19 9/16IM22 HUMAHA OXCCUIMIM WW3114M1D 11E 9/16IMN] HUM1X1[IU DLtBNC[WAVMilg1Y(SN0]t)63 MMCFGRTION T •O.LJ3M9e1 SppS(l•.J! o�rv/memos 41-1Rm9E afro/mm9l yrr/fomWsbpv m91TI 6.41if1 5J1335 1.021W s Em.vi , a(59.n 3 2M. s M W9 1.356.13 _ YBW 5.91 1.91M1N A 9.1S L fiN39 8JA 00 Owm 0.666W (A60.BJ 158R 930.W NX90RMM 6,4JNq 9.)]3 39 9.039 W M939 30A4U I; 6935,W 533100 10.95 "Xi 860.. 5.925..0 2,911.00 SAWN 9R 35.366.65 6.39060 10,66900 a,a6om 15,160+6 910.W 74.IfR.3(Y 1108]6Al ✓ ' 60 TWAM 333.11168 542.IMl6 BG.Y 9/19/2022 Quick View Select Quick View Accounts Account Number Name Account Type v Search All DDA Account Number Current Balance Number of Accounts: l5 $5,187,088.61 '4551 CAL GO INDIGENT $12.352.40 HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $85,95D61 HEALTHCARE •4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.61 2014 '4357 MEMORIAL MEDICAL 53,971,477.70 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $431,99 WAIVER CLEARING '4381 MEMORIAL MEDICAL 514T288.58 CENTER I NH ASHFORD '4403 MEMORIAL MEDICAL CENTER INH g105.908.47 BROADMOOR '4411 MEMORIAL MEDICAL S119,988.35 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL 529.226.40 CENTER INH FORT BEND '4438 MEMORIALMEDICAL CENTER ISOLERA AT 5140,984.59 WEST HOUSTON '2998 MMC -MONEY MARKET 5295.703.93 FUND 15506 MMC -NH BETHANY $152,399.33 SENIOR LIVING 'S441 MMC -NH GULF POINTE PLAZA- 540,845.92 MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE $35,178.88 PLAZA- PRIVATE PAY '3407 MMC -NH TUSCANY 548.814.85 VILLAGE https://presperity.albanking.com/onlineMessenger Treasury Center Select Group Groups Add Group Data reported as of Sep 19 202: Available Balance Collected Balance Prior Day Balanc $5,344,929.60 $5,187,088.61 $5,474,601.7 $12.352.40 $12,352.40 $12.352.4 $85,950.61 $85,960,61 $116,565.2 $536.61 $536.61 $536.6 54,070,170.03 $3,971,477,70 $4,291,915.E 5431.99 $431.99 5431 c $149,003,76 5147,288.58 5137,579.7 $117,898.23 5105.90847 $91,958A 5135.578.35 5119,988.35 $105.211.4 $44,591.90 $29.226.40 $29,226.4 5146,514.59 5140,984,59 $124,896.1 5295,703.93 5295.703.93 5295,703.5 5158.308.84 5152,399.33 S1S2.399.E S42,453.40 $40,845.92 540.845.E 535.178.88 535,178.88 546.935.2 S%256.08 $46.814.85 528.043.,E r v1 Memorial Medical Center Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 9/19/2022 P.moua Account 8g1nnln9 76,400.9E Note: Only bobncea of.. 55,v00 uJobetFanaj ned ra he onoIn9 home. Nate YEach account hm v bare bobncoaJsloo rhw MMC deawlled noun, a[[vanT. P'�E'r�VV�O t�'Itl SEP 19 2022 By COUNTY AUDITOR CALHOUN COUNTY, Ttty 1:\NH Weekly T,.tnh,\NH UPI ironer Summary%2DZAS PNmbeANH UPLTranaler 5ummam 0.193I.rNe Today. 9a91nnin9 Ann aunl to Be TnnAerred to Nunn, �950.61 Sank BalmM s 69,950.91 Vadtnw Leave in Balanae 100.00 lulylnwou, am / Pusan lnceraet 5eptemberintareat 9003 AdluriBalance/TranSferAmt BSdE0:1F J ,! WIWAMLrrnE,CFO 11.w OT9 9/11/t@} DOIOFX[PffXXFpLTMFP[OFI4E035693WMISTO m �� �f MEAN?pMMHIEMFM RCCI<3059}963MW3491351 9/lJ/10}2 HGWI M UIM M, MCCUIMPMFIOwIn 1125 9l="12E N"IXCF1AIMiMF 15BW359519IMN1139m15 9/la/d22 WIRE �SFVIMMOMIALPICO l- MT5639N555BJ691J9 9/15/MU TSYS OUNSF%IONXGMXp 5416E CREIK 555076 9/15j"22 TOVItAS LW NHCCBXCO WPWON9556J6N)9 9/I5/ME3 XOYRp5501UTWN HCfLUMPMT6MmJ <30W016) 91161203E 9/16120}} T96/iRG113BP51 BXFO5RMi51lFN5558169O9 mmcponnon QIPP/O m T,,O w QIP9/fem 1 QRP/C9mp1 QIM/Cem i4959 QIPPn X1490P31OY - 3,675.31 3.675.31 11129.00 2131900 2M.12 ;34963 65.951.69 65,9616f I.M..00 I,N000 45,612.16 . i,S50-06 i,550.16 7431.E 7.m1.1t 30,71B6fi I13.90 111.96 ]6.4W.13 669M1) Y0p 9/19/2022 Quick View Select Quick View Accounts Account Number I Name Account Type IF Treasury Center Select Group Groups Atld Group Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: l5 $5.187,088.61 $5,344,929.60 $5,187,088.61 $5,474,601.7 •4551 CAL CO INDIGENT HEALTHCARE 512.352.40 $12.352.40 $12.352.40 $12,352.4 '4454 MEMEDICAL! NH GOLDENOLDEN CREEK 9 $85.50,61 .' 585,950.61 585,9%61 $116,565.e HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.61 $53fi.61 $536.61 5536.E 2014 '4357 MEMORIAL MEDICAL CENTER -OPERATING $3,971,477,70 54,070,170.03 $3,971,477.70 S4,291 ,91 5.1 '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.99 5431.99 $431.99 5431 WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD $147.288.58 5149,003.76 5147,288.58 513T579.7 '4403 MEMORIAL MEDICAL CENTER! $105,908.47 $117,898.23 S105,908.47 591,958.4 BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT $119,988.35 5135.578.35 $119,988.35 S105,211A '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND $29.226.40 $44.591.90 529,226.40 529.226.4 '4438 MEMORIAL MEDICAL CENTER /SOLERA AT $140.984.59 5146,514.59 5140,984.59 5124,896.1 WEST HOUSTON 12998 MMC -MONEY MARKET FUND $295,703.93 5295,703.93 $295,703.93 5295,703 '5506 MMC -NH BETHANY SENIOR LIVING 5152,399.33 6158,308.84 5152,399.33 $152,399.3 '6441 MMC -NH GULF POINTE PLAZA, - 540,845.92 542,453.40 $40,845.92 $40,845,£ MEDICARE/MEDICAID '5433 MMC-NH GULF POINTE PLAZA - PRIVATE PAY $35,178.88 $35.178.80 535,178.88 546,935.e '3407 MMC -NH TUSCANY VILLAGE 548,814.85 550,256.08 548,814.85 $26,043.: htlps:/Iprosperily,olbenking.com/onlineMessenger r 111 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 9/19/2022 r.nNna Amaum wee atwunl Be{imdn[ venNn[ rnntmea,u K.M Nome35.17.0 15,072.77 Xun.A.. &6nn Tnmlendtt rt @,.In .fx[Mna aelu Tatla eBe InnN 4Nae X Xwne ([ 19.995.13 33.en.]a ll.e]9.69y Nn3e,l,nn ss,l)Bdef/ ve,u LeavemeBalann I0.00 ssmunt Nwfln H y_�iMtia'A&$IgBAtSAwi _�I IufylnYen,t :.]: Aulutlnlmn ].M x9mmeeelnunu agnummepnml.vamt 9s,man f,/". vrcvbuY Amoum mae ee9lnnMB 9entlN{ rnn,lerredro aNme ,inn3lervOm . mnnwln cY,cleand gva,1H e4J M9 n,iursi B3.O13.00y ,0.4Y.9] Q,nz.w Bank Wlan<e <O,B6.9] ✓ Vvlanw keave In B.Hnn ion rvorc: onh OWvnme)am$s,000 mnbrven]kuNro menwnnq Nerve. Nole};[v<b K(aunfAGObOlebelunnaf$1W aMl MMC tl99uliledloopeno[mW(. APPROVED Mi!! SEP 19 2' 22 BY COUNTY AUDITOR CALHOUN COUNTY, ?T_/AS F.Ixxweekhn.nnmVlx uvl[nmla summ.M10E3Veonmeegxxuvuxnrtersumm.n M.L9.]v.h. IuMlnlenn 9J3 Au9mllnlenal 13.39 xmemwamemk Adjml Llame/rnnXa Aml M,]1].H / rmnr[u3ulu uasu' y A9n—& WIW.W I9rrti, CFO 9f19lean ,..4 9/13/2022 YX HUMANA CHACH261 E300002)3E2498242W PR 9/13/10E2 HUMA A CNA OISN MPMT 19Z20 63896E E1800O2606 9p3/2022 AETNNNE- ECHO HCCIAIMPMT 4MUll 453000U15820 9J1612022 CNN • ECHO NCCUIIMPMT Td6003011 E10000E91136 9/1/22 CNE 9/15422 NNES -ECHO HCCIFIMPMT 706003E111E0000229106 9/]81=(2022 MINE ECHO HCCIAIMPMi 7E6003911 EE0000226700 Mi1C PORTION QIPP/temp QIPP/Campo SrenslenOut T n nl QIP%COmP1 2 QIPPJCOmp3 ibpse QIPPTI NH PORTION 11,573.06 - 13,373.26 13A78J1 - 23,678.71 31950.00 - 3,850.00 81.N1 - 87.81 13,606.2E 9]3.11 91].80 9)2.21 91].80 19,846.2I. / 33.BM.69 - 3289fi9 MMCPORTION li QIPP/Camp gIPP/CPmp1 -•, _ 4an3Ter�ut Tr.nrfw. QIPP/ComPl 2 QIpP/CPmpd ibpse QIPPTI NHPOR}ION 9112IM22 MERCHANT NANRm OBPOSITe9M)851888991p 1 2.03371 2,035J1 9p3/3023 OepoH[ 9/15/2022 WIRE OUT HMO SERNCE9, 0[ 01,033.00 38,686.97 - 38,686.97 / 81,023.00 J, OO.TE3.fi8 - RO ]2366 901569.24 73. 02 37 73.60Z.37 9/1912022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number I Name Groups Add Grnup Account Type `DUA Oala reposed as m Sap 19 202 Account Number Current Balance _ Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $6.187.088.61 $5,344,929.60 $5,187,088.61 $5.474,601.7 '4551 CAL CO INDIGENT $12,352.40 $12,352.40 $12.352.40 $12,352.4 HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK 585,950.61 $85,950.61 $85,950.61 $116,565.2 HEALTHCARE -4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.61 5536.61 $535.61 5536.E 2014 '4 7 MEMORIAL MEDICAL S3,971,477.70 54,070,170.03 53,971,477.70 54,291,915.2 CENTER -OPERATING -4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.99 $431.99 $431.99 5431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD 5147.288.58 5149,003.76 5147,288.58 5137,579.7 '4403 MEMORIAL MEDICAL CENTER/NH 5105,908.47 S117,898.23 5105,908.47 $91,958.4 BROADMOOR '4411 MEMORIAL MEDICAL $119.988.35 S135,578.35 5119,988.35 5105.211.4 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $29.226.40 $44.591.90 $29.226AG 529,226A CENTER / NH FORT BEND '4438 MEMR I SOLEEDICAL CENTERISOLERA AT $140,984.59 $146,514.59 $140.984.59 5124,895.1 WEST HOUSTON '2998 MMC -MONEY MARKET $295.703.93 5295,703.93 5295.703.93 5295,703.9 FUND 'S506 MMC -NH BETHANY SENIOR LIVING $152,399.33 $158.308.84 5152.399.33 5152,399.2 '5441 MMC -NH GULF POINTE PLAZA- 540,845.92 S42A53.40 540,845.92 540.845.E MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE 535,178.88 535.178.88 $35.178,88 546.935.i PLAZA - PRIVATE PAY 2407 MMC-NH TUSCANY $48.814.65 $50,256.08 $48,814.85 528.043.E VILLAGE r https://prosperity.albanking.com/onlineMessenger ift Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 9/19/2022 PmMna aavam aegnwH Hun wa, N ..t0 W FN—u/vnss.aaev ubenen./s eem ena.unnanwne Nor. 3: fv[FO[<aunrhOr 1 b0r[Lvlmao/$IM rh. M.CAWI"w re Ppm v[[ounr. APPRovEf) 00 SEP 1 BY COUNTY AU6;TOR CA LHOUN COUNny.1EXAS 0.)l1.35 A nmlrnedm th—cle. ems e,im[v .esuss s.nNn a.Imn 3opga /r mrvn en.nw/rnv,(s[e j/ _i uasass L� •norame: / -/i:' vssn wwANtrrnf,uo i 9113/2022 Oep9sit 911312022 HNR-ECHO HCCt QA MT 74600341144W00220742 9/15/2022 WIRE OUT UNBAR 614TERPR6ES, 0.0 9/16/2022 HNS- ECHO HCCWMPMT 746003411440000228671 9/16/2022 HN9-ECHO HC0AIMPMT 746003411440W0228849 MMCPORTION CI IPP/Comp gIPP/Camp gIPP/Comp Transfer -out Transfer•In 1 QIPP/Comp2 3 48Wpie QIPP71 NHPORTION - 25,465.39 - 25,455.39 - 2.478.26 - 2,478.18 8,937.26 20,222.40 548.88 20,222.40 548.80 8,93736 48,714.85 / 4871485 9119/2022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number / Name Grou s Accnunf Type Adtl Grcup LDDA Data reported as of Sep 19 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $5,187,088.61 $5,344,929.60 $5,187,088.61 $5,474,601.7 '4551 CAL CO INDIGENT $12.352.40 $12.352.40 $12,352.40 $12.352.4 HEALTHCARE '4454 MEMEDICAL/ NH GOLDENOLDEN CREEK 585.950.61 $85,950.61 $85.950.61 $116.565.2 HEALTHCARE •4365 MEMORIAL MEDICAL CENTER •CLINIC SERIES $536.61 5536.61 $536.61 5536.E 2014 '4357 MEMORIAL MEDICAL 53,971,477.70 54,070,170.03 53,971,477.70 54,291,915? CENTER -OPERATING •4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.99 5431.99 5431.99 5431.E WAIVER CLEARING •4381 MEMORIAL MEDICAL 5147,288.58 5149,003.76 $147,288.58 S137,579.7 CENTER I NH ASHFORD •4403 MEMORIAL MEDICAL CENTER /Nhi $105,908.47 $117,898.23 5105,908.47 $91,958.4 BROADMOOR '4411 MEMORIAL MEDICAL $119.988.35 5135.578.35 $119,988.35 $105,211.4 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $29.226,40 $44.591.90 $29.226.40 $29226 4 CENTER/NH FORT BEND '4436 MEMORIAL CENTER I SOLESOLERA AT 5140.984.59 5146,514,59 $140.984.59 $124,896A WEST HOUSTON '2998 MMC -MONEY MARKET FUND $295.703.93 $295,703.93 5295,703.93 5295,703.E 'S506 MMC-NH BETHANY SENIOR LIVING $152,399.33 S158.308.84 S152,399.33 5152.399.1 '5441 MIMIC •NH GULF POINTS PLAZA- $40.845.92- $42.453.40 540.845.92 540,845.E MEDICAREIMEDICAID 'S433 MMC-NH GULF POINTE PLAZA - PRIVATE PAY $35,178.88 $35.178.88 $35.178.88 $46,935.F ,3407 MMC-NH TUSCANY VILLAGE $48.814.85 $50,256.08 $48,814.85 $28,043; htlpsa/prosperity.clbanking.com/onlineM11essenger 1:1 Memorial Medical Center Nursing Home UPI. Weekly HSLTransfer Prosperity Accounts 9/19/2022 PervbYl •ttnYnl XYRIn N Number B� a1dklNr W.: onNeehnmg/eWrSS.WPMebelrav/urtdrelhenunb9b�Yne. Ngu L EeM ccua-aNu a cme b0catt 01SIW that MMCdePomedmopm Y¢mm. ,NppROVE6 ON SEP 19 2022. By COUNTY AUDITOR CALHOUN COUNTY-IT-wAs 1.%NXWftw irgnlfaMw UPI i ,aru SUMMIMMASVIWM INN uh 9ranrlw tgg, 09r9.linln lmduy Metlltxe 8..Y Bunn, WtlllX, IIiYIIII Bebn[e low mnt Igor rnmlemdm rYgbla.n loos FYlntlntvnt t ]1.16�/ se9lelnbameerm / adlua!&bnvffrwle�lo].HS.)i �rwH: wnwrb mns,ao 9/upwa MMC POATION nj3tylw-hut 3nntl�r.ln OIPP/Pumpl gIPP/COmP] y0P/Cramp] gIPP/4mpKI1M! DIPPII NH"UON 13,501.07 - 13,50307 3,439.16 3,<39<6 - 26,402N - 20.4Pxfia ]oaea el 0,IW 61 31. - 1,331.12 IE 31 - 3,33t131x ]6,813.6) =It ZI 202A Oepeslt 9/13/2022 0.p. R 91l3/2022 DepuN1 9/13/2022 DlpeNt 9/13/x@3 DlpOpt .=] -II NOVITAI WIW IOHNCWPMPMT6]66PI610[0p163 9/102022 NEALT HUMAN SWHMWMPMTI34600341130163 9/15/2022 WIREOUTPOMIAVAC NKLLC 9/IS/3022 NWITA15IIIVTION NCCWM9Mf6)6fP1@M00I6J i 10.1958E i - I0.195.83 9/1912022 Treasury Center Quick View Select quick View Accounts Select Group Account Number Name Grou s A[Itl Group Account Type Y LDDA Dal. reported as of Sep 19 2021 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $5,187,088.61 $5,344,929.60 $5,187,088.61 $5,474,601.7 '4551 CAL CO INDIGENT 512.352.40 $12.352.40 $12.352,40 512,352.4 HEALTHCARE '4454 MEMORIAL MEDICAL 1 NH GOLDEN CREEK $85.950.61 S85,950.61 $85,950.61 $116,565.2 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER -CLINIC SERIES $536,61 $535,61 S536.61 S536.E 2014 '4357 MEMORIAL MEDICAL S3.971,477.70 S4,070,170.03 $3,971,477.70 S4,291,915.2 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE S431.99 5431.99 $431.99 S431 c WAIVER CLEARING '4381 MEMORIAL MEDICAL S147,288.58 S149,003.76 S147,288.58 $137.579.7 CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH S105,908.47 $117.898.23 S105,908.47 $91,958.4 BROADMOOR '4411 MEMORIAL MEDICAL $119.988,35 S135,578.35 S119,988.35 $105.211.4 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $29.226.40 S44,591.90 S29.226A0 S29,226.4 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER ISOLERA AT $140.984.59 S146,514.59 S140,984.59 S124,696.1 WEST HOUSTON '2998 MMC -MONEY MARKET S295.703.93 S295,703.93 S295.703.93 S295.703.E FUND '5506 MMC -NH BETHANY S152,399,33 .- S158,308.84 S152,399.33 S152.399? SENIOR LIVING •5441 MMC -NH GULF POINTE PLAZA - S40.845.92 $42,453,40 $40,845.92 S40,845S MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE $35,178.88 935,178.86 S35,178.88 $46,935,2 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY S48.814.85 S50.256.08 S48,814.85 528,043.: VILLAGE r https://prosperity.olbanking,com/onllneMessenger i/1 z� m m �� n z� m y� zn z z m m o o = � o � y N e n 0 C y> O [n p m � a n y b r m N a N U Vi U U U U U U U U U U U U U O O O O O O O O O O O O O O O N N p m Sn Sn Sn xn za Sn xa xn Sin rb W wZ wx < pr+f O'r'i O�nO ZmZ <m <m c G� O'r'i p+ri p+ri <m <m ma mn m0 mo ' m z z m a m m m r r K w W W y w u VPi P w P A W W N N W N W O O W W A O W �a gnz� °a �? v> a �? b> C�m� 3 z> z> r� mA-1 y-zi ry �' �-Z-I rH E Z-] r zi W-Zi -i -zi Z 0.2-7 y m A d m m w y m y w y w m m y p y w m = N N m Fcr mz rD D 7� P DN �b y y -i S H y y Ri i§ R A ti yr K S 'q -i (P K a w a z C mA C O m n A P A N N W � Ce N J VNi b b P b VNi 0 0 0 y a O a n y � m =i � y F m Z C N ro Or C w A H T O c N m P N N N N N N N U U N U N N U N U A O O O O O O p O O O O O O O O O p n N< Ny gn nr Zn nr 9 C a C n O Tn ACrtC' n yTyn yn Ar Sn ACC" S° F[C" Sn AcC- Sa At°- Sn ACC" yTn ACC- SO a m Ham' 'n -n m Om O'9 3/� O'^ C7 '� O"� O"� 0m pm p•n pm �m y o wC O O m m n a0 a fn a° n ° n D° gn a° gn a0 fn �n En aa° m t„3n awl 7m� a „Dv',� mA y n n n n n n n n n n n .ro F 0 0 J Q u W n P Y O. 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