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2022-10-26 Final PacketAll Agenda Items Properly Numbered / Contracts Completed and Signed I/ All 1295's Flagged for Acceptance (number of 1295s Z ) All Documents for Clerk Signature Flagged (All documents needing to be attested to need to be signed day of Commissioner's Court.) On this) day of 0r 2022 a complete and accurate packet 2O4 for f 2022 Commissioners Court Regular Session Day Month was submitted from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoun County Judge/Assistant C:\Users\Maebelle.Cassel\Appdata\Local\Microsoft\Windows\Inetcache\Content.Outlook\3 CU9II QW\PACKET COMPLETION SHEET.Docx AGENDA Rich2rd H. Meyer County judge David ]Full, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, October 26, 2022 at 10:00 a.m, in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: AT FILED 4� Call meeting to order. OCT 2 j 2Oa2 t2 Invocation. ?UN nAPN BY: /Pledges of Allegiance. e rf. General Discussion of Public Matters and Public Participation. 5. Hear report from Memorial Medical Center. Consider and take necessary action on the sale, Bill of Sale, and Utility Easement with the South Central Calhoun County Water Control Improvement District #1 and authorize all the appropriate signatures. (DEH) 0 mConsider and take necessary action to declare the attached list of items from R & B /Precinct 3 as Surplus/Salvage to be sold at auction. (IMB) e Consider and take necessary action to authorize the District Clerk to sign Kofile's revised proposal for the preservation and archival imaging of historical records. The dollar amount of the proposal has not changed. The only change is the removal of the TXMAS contract. (RHM) 49. Consider and take necessary action to approve the Calhoun County E9-1-1 Emergency Communication District Proposed FY 2023 budget. (RHM) Page 1 of 2 03 Consider and take necessary action to approve the first extension of three — one year periods for the Delivered Fuel Contract between Calhoun County and New Distributing Company, Inc. for the period January 1, 2023 through December 31, 2023 and authorize the County Judge to sign all necessary documents. (RHM) Ti. Consider and take necessary action to award the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08. (DEH) 12. Consider and take necessary action to declare the attached list of items from the County Clerk's Office as Waste. (RHM) I3. Accept Monthly Report from the following County Office: 7- Tax Assessor -Collector — September 2022 14. Consider and take necessary action on any necessary budget adjustments. (RHM) t Approval of bills and payroll. (RHM) Richard H. Meyer, Cou6iKjudge 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.ora under "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 NOTICE OF MEETING - 10/26/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney Kaddlne Smith, Deputy Clerk REGULAR TERM 2022 § OCTOBER 26, 2022 BE IT REMEMBERED THAT ON OCTOBER 26, 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 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Happy Birthday to Sheriff Bobbie Vickery and Treasure Rhonda Kokena! Russell Cain with the Republican Party and Brandelyn Wiser with the Democratic Parry explain they would like Commissioners to reconsider the ban placed on campaign signs outside of the Courthouse. 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report. Page 1 of 3 NOTICE 01- MEETING-10/26/2022_ 6. Consider and take necessary action on the sale, Bill of Sale, and Utility Easement with the South Central Calhoun County Water Control Improvement District #1 and authorize all the appropriate signatures. (DEH) RESULT: APPROVED [UNANIMOUS]; MOVER: David Hall, Commissioner Pct l SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to declare the attached list of items from R & B Precinct 3 as Surplus/Salvage to be sold at auction. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pet 3 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to authorize the District Clerk to sign Kofile's revised proposal for the preservation and archival imaging of historical records. The dollar amount of the proposal has not changed. The only change is the removal of the TXMAS contract. (RHM) Anna Kabela explained the change. RESULT: APPROVED [UNANIMOUS]' MOVER: David Hall, 'Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve the Calhoun County E9-1-1 Emergency Communication District Proposed FY 2023 budget. (RHM) Rachel Morales explained upgrades to come. RESULT: APPROVED [UNANIMOUS]' MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER:Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to approve the first extension of three — one year periods for the Delivered Fuel Contract between Calhoun County and New Distributing Company, Inc. for the period January 1, 2023 through December 31, 2023 and authorize the County Judge to sign all necessary documents. (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 2 of 3 NOTICE OE MEF rING—10/26/2022 11. Consider and take necessary action to award the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct1 SECONDER: Gary Reese; Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to declare the attached list of items from the County Clerk's Office as Waste. (RHM) RESULT: ' APPROVED [UNANIMOUS] MOVER: Gary Reese; Commissioner Pct 4 SECONDER: David Hall,Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Accept Monthly Report from the following County Office: I. Tax Assessor -Collector — September 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pet 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Approval of bills and payroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hail, Commissioner Pct I 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 10:38 a.m. Page 3 of 3 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) you wish to address are discussed before the Court. Fill out all appropriate blanks. Please print or write legibly. NAME: / %6 A/Ip/P/V✓1 ADDRESS: TELEPHONE: PLACE OF EMPLOYMENT: EMPLOYMENT TELEPHONE: 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: x, 'C, l�GV J Which agenda item (or items) do you wish to address? In general, are you for or against the agenda item (or items)? S )" 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: 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) you wish to address are discussed before the Court. Instructions: Fill p6Yall app NAME: ADDRESS: TELEPHONE: PLACE OF EMPLOYMENT: EMPLOYMENT TELEPHONE: Please pri4 or write legibly. 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 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 OF MEETING - 10/26/2022 Richard H. Meyer County judge David Hall, Commissioner, Precinct l Venn Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney Kaddie Smith, Deputy Clerk REGULAR TERM 2022 § OCTOBER 26, 2022 BE IT REMEMBERED THAT ON OCTOBER 26, 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 a.m. by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag- Commissioner Gary Reese Texas Flag- Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Happy Birthday to Sheriff Bobbie Vickery and Treasure Rhonda Kokena! Russell Cain with the Republican Parry and Brandelyn Wiser with the Democratic Party explain they would like Commissioners to reconsider the ban placed on campaign signs outside of the Courthouse. 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report. Page 1 of 11 • 1: NOTICE OF MEETING — 1.0/26/2022 6. Consider and take necessary action on the sale, Bill of Sale, and Utility Easement with the South Central Calhoun County Water Control Improvement District #1 and authorize all the appropriate signatures. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy,`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 October 26th, 2022. Consider and take necessary on the sale, Bill of Sale, and Utility Easement with the South Central Calhoun County Water Control Improvement District #1 and authorize the appropriate signatures Si erel , David E. Hall D EH/apt ®m UTILITY EASEMENT STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF CALHOUN This Agreement (this "Agreement") is made on thglday of&1�22, at Port Lavaca, Texas, between The County of Calhoun, whose address is 211 S. Ann Street, Port Lavaca, Calhoun County, Texas 77979 (hereinafter referred to as "Grantor"), and the South Central Calhoun County Water Control and Improvement District No. 1, a State of Texas Water District, whose address is P.O. Box 833, Port Lavaca, Calhoun County, Texas 77979, Attn: Tamera Atkins (herein referred to as "Grantee"). 1. For the good and valuable consideration described in Paragraph 2 below, Grantor hereby GRANTS, SELLS and CONVEYS to Grantee, its successors and assigns, an exclusive easement and right-of-way (the "Easement") for the placement, construction, operation, repair, maintenance, replacement, upgrade, rebuilding, relocation and/or removal of a water well and related facilities (collectively, the "Facilities") on, over, under, and across the following described property of the Grantor, to wit: Being all that certain tract, piece or parcel of land lying and being situated in the County of Calhoun, State of Texas, being more particularly described by metes and bounds in Exhibit A and by survey in Exhibit B attached hereto and made a part hereof for all purposes (herein sometimes referred to as the "Easement Area" or the "Property"). 2. The Easement and the rights and privileges herein conveyed, are granted for and in consideration of the sum of One and No/100 Dollars ($1.00) and other good and valuable consideration to Grantor in hand paid by Grantee, the receipt and sufficiency of which is hereby acknowledged and confessed. 3. The Easement, with its rights and privileges, shall be used only for the purpose of placing, constructing, operating, repairing, maintaining, rebuilding, replacing, upgrading, relocating, and/or removing the Facilities. 4. The duration of the Easement is perpetual. 5. Grantor and Grantor's heirs, personal representatives, successors, and assigns are and shall be bound to WARRANT and FOREVER DEFEND the Easement and the rights conveyed in this Agreement to Grantee and Grantee's successors and assigns, against every person lawfully claiming or to claim all or any part thereof. 6. The Easement, and the rights and privileges granted by this Agreement, are EXCLUSIVE to Grantee, and Grantee's successors and assigns, and Grantor covenants that Grantor shall not convey any other easement, license, or conflicting right to use in any manner, the area (or any portion of the area) covered by this grant. 7. This Agreement contains the entire agreement between the parties relating to its subject matter. Any oral representations or modifications concerning this Agreement shall be of no force and effect. Any subsequent amendment or modification must be in writing and agreed to by all parties. 8. The terms of this Agreement shall be binding upon Grantor, and Grantor's heirs, personal representatives, successors, and assigns; shall bind and inure to the benefit of the Grantee and any successors or assigns of Grantee; and shall be deemed to be a covenant running with the land. ��// J, �0� T SS WHEREOF, Grantor has caused this instrument to be executed on this! W f -� day ot���{ , 2022. ti UTILITY EASEMENT Page 1 of 4 3827219.0 EXHIBIT "A" 0.243 ACRES THE STATE OF TEXAS) THE COUNTY OF CALHOUN) BEING a 0.243 acre tract of land situated in the Narciso Cabazos Survey, Abstract No. 3, Calhoun County, Texas and being a portion of the right-of-way of East Dowling Street between Block 95 and Block 98 of Alamo Beach Townsite according to the established map or plat thereof recorded in Volume Z, Page 13 of the Plat Records, Calhoun County, Texas, said 0.243 acre tract of land being more fully described by metes and bounds as follows: BEGINNING at a found bent 5/8" steel rebar marking the intersection of the southeast line of East Dowling Street (apparent 70-foot Right -of -Way) with the southwest line of Alamo Beach Avenue (60-foot Right -of -Way) same being the north corner of Lot 7, Block 98 of said Alamo Beach Townsite, for the east corner ofthe herein described tract; THENCE, South 55'05'07" West, with the southeast right-of-way line of said East Dowling Street along the northwest line of said Lot 7, Block 98, a distance of 150.27 (150.00) feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the west corner of said Lot 7, Block 98 for the south corner of the herein described tract; THENCE, North 35'10'14" West, over and across said East Dowling Street, a distance of 70.29 feet to a set 5/8` steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the south corner of Lot 28, Block 95 of said Alamo Beach Townsite for the west corner of the herein described tract; THENCE, North 55'05'07" East, with the southeast line of said Lot 28, Block 95 and the northwest right-of- way line of said East Dowling Street, a distance of 150.30 (150.00) feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the east corner of said Lot 28, Block 95 and being along the southwest line of said Alamo Beach Avenue for the north corner of the herein described tract; THENCE, South 35'09'04" East, with the southwest right-of-way line of said Alamo Beach Avenue over and across said East Dowling Street, a distance of 70.29 (70.00) feet to the POINT OF BEGINNING, CONTAINING within these metes and bounds a 0.243 acre tract of land, more or less. Bearings are based on the Texas State Plane Coordinate System (NAD83), South Central Zone (4204). This survey was adjusted using a combined scale factor of 1,00004S25449716 (GEOID32 B). UTILITY EASEMENT Page 3 of 4 3827219.vl EXHIBIT "B" BOUNDARY SURVEY % N , �' ,ADMIx Y, \ BEING A 024' ACRE TRACT OF LAND SITUATED IN THE NARCGO CABAZOS TJ. SURVEY. ABSTRACT NO. 3. CALHOUN COUNTY. TEXAS AND BEING A �• $ TE/ PORTION OF 'HE RIGHT-OF-WAY OF EAST DOWLING STREET BETWEEN BLOCK 95 AND BLOCK BB OF ALAMO BEACH TOWNSITE ACCORDING TO THE �1 ESTABLISHED MAP OR PLAT THEREOF RECORDED IN VOLUME Z. PAGE 13 - ¢. I OF THE PLAT RECORDS. CALHOUN COUNTY. TEXAS. / VICINITY MAP L11111,11 "A' IN III ro LILT., T OI LOXT 3 NLCCF FILLLF, 9 �.. / LDT 1.7 IS �Op (POINT OF I p50O g `v:, � BEOINNING� � Qi 9'Fk 0.243 Acres DA X,,Bs Lc LOT o / G � 9 ,IL �G F GI. I / LEGEND o ` NL . .b.,I.N NICOE. tIL� E GIG ABOVE PNt AND ACCOMPANYING LEGAL DESCRIPTION MIENS PNEPARED FHWI AN IN Urrri UG . OFF) PIcmOOEMmGe SAGASTE ACTUAL CURVET MADE ON THE GROUND UNDER MY SUPERVISION IN MAY, 2022 AND ARE TRUE AND CONTACT TO HE BEST OF MY XNOWLEOGE AND GOLD 0 60 120 ACCORDING TO THE GTOOINSUGI RATE MAR VFIRMI FOR CA ROUN COUNTY. TEXAS. COMMUNITY LABEL NUMEEA 20 4GRG 05E M REVISED OCTOBER 10, 20M, tHE SUBJECt PROPERTY IS LOCATED IN ZONE F19NA0E01. VMICII ISAMOOE1NlE FLOOD GRAPHIC SCALE INFEST HA2MO AREA FOR AREAS OF 02% ANNUAL CHANCE FL000: AREAS OF 11 FINANCE FLOOD IMHI AVERAGE DEPTHS OF LESS IRAN 1 FOOT OR WITH DRAINAGE AREAS OF LESS MAN I SOUARE MILE'. AND AREAS PRO( OY LEVEES FgOM 11 �; ANNUAL C1uNCE FLWU. OF 'l ........... f 4P: •�)srEq:; Fy LBRR Gurvoyin9.AeADl lnwpII r - e ,...I �'MS _O6I0&202Z,_ MICNA[L R. WIWAMS cA.M CI.0 MONnbmsl ruRMI0.1 1 vgtlAx SURVEYING. irvc. 6616 ' BY'.MICINELHWILLIAMS '•: SnxnxTOAq, TEVA5 r210126266N HPMa IOIN.uM TEXAS( EREOPROFEEEIOTNL IAXUSUXVEYOR �•' OnES510�•'Q� TEXAS xo. 601G STUD., y PRAWN BY: MMB , JOB NO.: 52523300 v UTILITY EASEMENT page 4 of 4 3827219.v1 BILL OF SALE AND ASSIGNMENT (for Utility Facilities) Date: (JK".t r tJ 26 2022 Grantor: Calhoun County Grantor's Mailing Address: 211 S. Ann Street Port Lavaca, Calhoun County, TX 77979 Grantee: South Central Calhoun County Water Control and Improvement District No. 1 Grantee's mailing address: P.O. Box 833 Port Lavaca, Calhoun County, TX 77979 Consideration: Ten Dollars ($10.00) and other good and valuable consideration in hand paid by Grantee Property: See Exhibit "A" and Exhibit "B" attached hereto and incorporated herein Grantor, for the consideration herein expressed quitclaims to Grantee all of Grantor's right, title, and interest in the Utility Facilities described in Exhibit A and any other similar property (even though not listed on Exhibit A) related to and utilized in connection with the Utility Facilities which are being sold and transferred to Grantee. This quitclaim bill of sale and assignment is made without warranty of any kind, express, implied or otherwise. When the context requires, singular nouns and pronouns include the plural. Executed effective 2-6 2022 GRANTOR: ACCEPTED: GRANTEE: Calhoun County South Central Calhoun County Water Control and Improvveeme�nt District No. 1 By: LiNn2+IIc 3774438A GRANTOR: �Lp'Gyh.i STATE OF TEXAS COUNTY OF CALHOUN '/ �Ihis_y_'pstrument s aGkowledged before me on thin-10-4 of ( ECI;4�2022, MAE BELLE CASSEL Notary Public, State of Texas °> My Notary ID # 132012m EXPlres May 14, 2023 AFTER RECORDING, RETURN TO: Graves, Dougherty, Heaton & Moody Attn: Natasha J. Martin 401 Congress Ave, Suite 2700 Austin, Texas 78701 UTILITY EASEMENT Page 2 of 4 3827219.0 EXHIBIT "A" 0.243 ACRES THE STATE OF TEXAS) THE COUNTY OF CALHOUN) BEING a 0.243 acre tract of land situated in the Narciso Cabazos Survey, Abstract No. 3, Calhoun County, Texas and being a portion of the right-of-way of East Dowling Street between Block 95 and Block 98 of Alamo Beach Townsite according to the established map or plat thereof recorded in Volume Z, Page 13 of the Plat Records, Calhoun County, Texas, said 0.243 acre tract of land being more fully described by metes and bounds as follows: BEGINNING at a found bent 5/8" steel rebar marking the intersection of the southeast line of East Dowling Street (apparent 70-foot Right -of -Way) with the southwest line of Alamo Beach Avenue (60-foot Right -of -Way) same being the north corner of Lot 7, Block 98 of said Alamo Beach Townsite, for the east corner of the herein described tract; THENCE, South 55'05'07" West, with the southeast right-of-way line of said East Dowling Street along the northwest line of said Lot 7, Block 98, a distance of 150.27 (150.00) feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the west corner of said Lot 7, Block 98 for the south corner of the herein described tract; THENCE, North 35'10'14" West, over and across said East Dowling Street, a distance of 70.29 feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the south corner of Lot 28, Block 95 of said Alamo Beach Townsite for the west corner of the herein described tract; THENCE, North 55'OS'07" East, with the southeast line of said Lot 28, Block 95 and the northwest right-of- way line of said East Dowling Street, a distance of 150,30 (150.00) feet to a set 5/8" steel rebar with yellow plastic cap stamped "URBAN SURVEYING, INC." marking the east corner of said Lot 28, Block 95 and being along the southwest line of said Alamo Beach Avenue for the north corner of the herein described tract; THENCE, South 35°09'04" East, with the southwest right-of-way line of said Alamo Beach Avenue over and across said East Dowling Street, a distance of 70.29 (70.00) feet to the POINT OF BEGINNING, CONTAINING within these metes and bounds a 0.243 acre tract of land, more or less. Bearings are based on the Texas State Plane Coordinate System (NAD83), South Central Zone (4204). This survey was adjusted using a combined scale factor of 1.00004525449716 (GEOID126). 2 3774438.v1 EXHIBIT i ARY SURVEY BEING A 0.243 ACRE TRACT OF LAND SITUATED IN THE NARCISO CAICCROS SURVEY ABSTRACT NO 3, CALHOUN COUNTY, TEXAS AND BEING A PORTION OF THE RIGHT-OF-WAY OF EAST DOWLING STREET BETWEEN BLOCK 95 AND BLOCK 90 OF ALAMO BEACH TOWNSITE ACCORDING TO THE ESTABLISHED MAP OR PLAT THEREOF RECORDED IN VOLUME Z PAGE 13 OF THE Pill RECORDS CALHOUN COUNTY, TEXAS. VICINITY MAP il `17 1AIF .1 I"i, VAI Ill I,, �11 Al "Iii A "I illn, 11, 'All I . i 'I 1Ii1I1'1rI. I I'111�A PIL11ii1l; -1 11) 1',TBk TI I'II1,AAil ll, CIA1.111 "'FL, TA� I, "LIT, A ' III>l A1111,11,i .- A �UIFI,il ',%IT I.T'1 Ir I TV, 4 i I I Ia L 1 21F LDT _l, CIT 3L "I UT IT LOi Or 0 f OINT 6 GINNING t 0.24.3 Acres A, V, I"Foo Ix ,F -p 4v 0 V I,)T I IT, A LEGEND TF .-A AI HU—THI., O FAINTABILAINAGWARHALUP •FOGINSUAVATITILLPIPAR IMNITARYFEWORMANBLI ITINT, HE ABOVE FLAT AN. ACC.111PAGGING LEGAL CRAGIBITURT. ISHE IFFSPAREG INC. AN iN ^VL,11 . BACTIBIGRATINF.CGIANIS ACTUAL MUNI MADE ON THE GROUND UNDER My SUPERVISED" IN MAY, 2022 AND ARE TRUE AND CORRECT TO I HE BEST OF My KNONALOVE AND BELIEF 0 60 120 ACCORDING 70 THE ROOM INSURANCE KATE MAP FISH) FOR CALHOUN COUNTY. TEXAS COMMUNITY PANNUMBER WIBS�C GAS. MAP REVISED OCTOBER 16 20" THE 6z%ii2!T!n SUBJECT PROPERTY IS LOCATED IN ID11 il ISFACRIN, WHICH IS A MOOPRATE Hil GRAPHIC SCALE IN FEET PAGANS AREA FOR AREAS OF Il ANNUAL CHANGE FLOOD AREAS OF 1% ANNUAL CHANCE FLOOD WITH AVERAGE DEPTHS OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS OF LESS IRAN I SQUARE MILE ARE AREAS PROT By LEVEES FROM 1% ANNUALCINANCE FLOOD OF ...... Ausl ET, V LAGBI 3.1.,in, . AGNd Imuft, X. WILLIAMS �.Ml�-.A ITIFA�A= 1. FRE, S VEIBAG BIG ............. CISN, PA. N B 'A 21 All 1. ."A' By M"GAILP Will 6616 I.V SAN .... FAN,1 INA All. ING A GIBOR REGISTERED PROFESSIONAL LAND SURVEYOR SO TEASE NO IS ... �! .......... DRAWNBY MMB SUR JOB NO. 52523300 3 3774438.vt # 07 ' NOTICE OF MEETING -.. 10/26/2022 7. Consider and take necessary action to declare the attached list of items from R & B Precinct 3 as Surplus/Salvage to be sold at auction. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 skor4DER:"1 David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 11 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 — Fax (36I) 893-5309 Email: icel.behrens(a)calhouncomors Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for October 26, 2022. • Please Consider and Take Necessary Action to declare the attached list of items from R & B 560 as Surplus/Salvage and to be sold at Auction. Sincerely, Joel Behrens Commissioner Pet. 3 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Road & Bridge 560 Pct. #3 Requested By: Commissioner Joel Behrens Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration RCP CULVERTS OLD/ NO LONGER USEABLE (VARIOUS LENGTHS TO BE SOLD AT AUCTION AND SIZES) • 1: NOTICE OF MEF_TING—10/2E/2022 8. Consider and take necessary action to authorize the District Clerk to sign Kofile's revised proposal for the preservation and archival imaging of historical records. The dollar amount of the proposal has not changed. The only change is the removal of the TXMAS contract. (RHM) Anna Kabelaexplained the change. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct2 AYES: Judge Meyer, Commissioner Hall, Lyssy,;Behrens, Reese Page 4 of 11 Mae Belle Cassel From: anna.kabela@calhouncotx.org (Anna Kabela) <anna.kabela@calhouncotx.org> Sent: Wednesday, October 19, 2022 9:21 AM To: 'Mae Belle Cassel' Subject: KOFILE'S REVISED PROPOSAL Attachments: REVISED PROPOSAL FOR THE PRESERVATION AND ARCHIVAL IMAGING OF HISTORICAL VOLUMFS.pdf; FORM 129510-19-2022 09.14.22 722080 B555896B-FC71-4A8B-ABOF-A17D2046EFE7.pdf Categories: Red Category Good morning, Mae Belle, Will you please place the attached revised proposal and form 1295 on the October 26th, 2022, Commissioners' Court's agenda. I am asking the commissioners to consider and take necessary action to authorize District Clerk Anna Kabela to sign Kofile's revised proposal for the preservation and archival imaging of historical records. The dollar amount of the proposal has not changed. The only change is the removal of the TXMAS contract. Thank you! ANNA KABELA District Clerk Calhoun County District Clerk's Office anna.kabela@calhouncotx.org (361) 553-4631 Phone (361) 553-4637 Fax 211 S. Ann - Courthouse, Suite 203 Port Lavaca, Texas 77979 Calhoun County Texas Honorable Anna Kabela Calhoun County District Clerk Port Lavaca, Texas FOreservation a r,41 This proposal addresses Calhoun District Clerk's historical records, and is presented by Kofile Technologies, Inc. (Kofile). Quoted services include conservation treatments, rehousing, and imaging. Archival rehousing includes encapsulation and loose-leaf binding into Archival Recorder Binders. Note that prices for the inventory herein are good for 90 days from the date of this assessment. Kofile is uniquely qualified to complete Calhoun District Clerk's modernization goals by taking an innovative approach to this project to ensure a successful outcome. Kofile's basis for success is decades of experience, realistic solutions, and professional analysis and each project is unique and deserves special attention. Our team provides realistic solutions, professional analysis, and innovative archival products to equip records stewards with the information and resources needed to preserve collections. Kofile performs all services in accordance with the Code of Ethics & Guidelines for Practice of the American Institute for Conservation (AIC). PROJECT PRICE QUOTE Without a signed agreement, prices are good for 90 days. All pricing is based on estimated page counts. Final billing occurs on actuals per mutually agreed upon pricing; not to exceed the P.O. without written authorization. LEVEL OF RECORD SERIES VOLUME DATE VOLS. PAGES BINDING FORMAT SERVICE I PRICE QUOTE District Court A -D, 5 2,346 Sewn Manuscript II Preservation/ $20,553.99 Minutes D Imaging Petition of - 1908- _ 1 190 Loose Manuscript/ I Preservation/ $2,034.90 Naturalization 1912 Leaf Typescript Imaging Naturalization 1 1 192 Loose Manuscript/ ' Preservation/ $2,482.56 Records Leaf Typescript I Imaging PROJECT TOTAL $25,071.45 PROPOSAL ACCEPTANCE Payment Terms: 56% upon executed agreement withthe balance due upon project completion. Signature/Title of Authorized Offcial Date SCOPE OF SERVICES General treatments and services are outlined in the following. Services are tailored to the needs of the specific item. Preservation —Conservation Treatments, Deactdify, Encapsulate, & Bind • Kofile creates a permanent log (noting condition, page order, characteristics, and treatments) for each item upon receipt. Items are inspected and control numbered as necessary. A final quality check references this log. CAL; (0UN COLON i Y DISTRICT CLERK P .'.SERVATION & ARCHIVAL IMAGING OF �tl$TORICAL.PECCRDS October 1Z 2022 PAGE 2 1 n • Dismantle volumes by hand (if applicable). • Surface clean sheets. Tools include a microspatula, soft dusting brush, latex sponge, powdered vinyl eraser, or soft block eraser. Surface cleaning removes materials and deposits--e.g., dust, soot, airborne particulate, sediment from water damage, mold/mildew residue, active micro -organic growth, insect detritus, or biological or mineral contaminants. • Remove any non -archival repairs, adhesives, residual glues, or fasteners to the extent possible without causing damage to paper and inks. • Mend tears and guard burns on back side of sheets with acid free and reversible mending materials. • Deacidify sheets (each side of each sheet) after careful testing with Bookkeepers& This commercial solution of magnesium oxide, which neutralizes acidic inks and paper by providing an alkaline reserve (after pH and compatibility testing). Random testing ensures an 8.5 pH with a deviation of no more than ±.5. • Encapsulate each sheet in a Lay Flat Archival Polyester PockefTM. Each custom envelope is composed of Skyroll SH72S® Mylar and includes a patented lay flat design. Dimensions match the "book block" dimensions, with a 1'/4" binding margin. • Re -bind in custom -fitted and stamped archival quality binder. Each binder is manufactured on a per -book basis and sized to 1 /4" incremental capacities. This binder is available with four hubs, a gold -tooled spine, and is roller shelf -compatible. A volume may return split due to the added weight of the Mylar, depending on page count. • A dedication/treatment report is included in each binder. Imaging —Archival Image Capture, Image Processing, Clean Up, & Enhancements • Capture images at a minimum of 300 dpi at 256 gray levels, ensuring the highest quality for poor contrast and legibility. Gray -scale ensures optimum resolution for each page. • Images accumulate as Group IV bi-tonal images in a standard PDF or TIFF format. • IMAGE PERFECT, Kofile's proprietary software, ensures the optimum image quality with custom image clean up and enhancements such as deskew, despeckle, character repair, polarity reversal, and zonal processing. • Crop excess blank space around image. This may involve manual cropping to ensure best quality image. • Images are named (tagged for the directory file structure) by book, volume, and page (or other requested fields). • Images are grouped (stapled) together to form documents. • Page Validation (automated PG. numbering for validation). • If applicable, images are optimized and scaled for system output. • If requested, annotations are supported to enable the electronic addition (either custom or Book/Volume/Page) on the digital image to assist in recording keeping. • When multiple documents (Deeds, Birth Record, etc.) exist on a single page, images are split so that each document is viewable individually. • Calhoun District Clerk receives a MASTER (e.g., CD, DVD, ftp, flash drive) in a medium suitable to the project size. • If requested, Kofile can hold a security copy of all images for safekeeping. �d CALi;OJN COUNTY L'ISTRICICLERK PAGE 31 4 PRESERVAI ION & ARCHIVAL U'AAG!NG OF HISTORICAL RECORDS OC'Jber 17, 2022 PROJECT TIMELINE Kofile is highly capable to successfully and timely complete this project. Kofile does not seek work that it cannot professionally complete within a reasonable and agreed -upon schedule. Kofile works with its client's budget or timing constraints to ensure that the project is completed to satisfaction. Projects run along 14 to 18 weeks (per batch, if needed). Pickup and delivery are pre- arranged with prior to the project start. Preservation projects are unique in that the work determines the schedule, response times, and completion date. Each job is individual and unique. The condition of the record determines how quickly it moves through the preservation process. Usually, older records suffer from extreme deterioration and require more attention. As the collection is processed in controlled batches and the age of the records decreases, production rate increases. ACCESSIBILITY OF RECORDS Records held at Kofile are maintained as private and confidential material. The Calhoun District Clerk is guaranteed access to records via email or toll -free fax at our expense. Upon receipt of a records request, Kofile will flag the requested record and verify inventory control, pull supporting paperwork, and email/fax a response to the approved requester or alternate. The turnaround time for a records request will meet or exceed requirements. OWNERSHIP OF RECORDS Please note that all records (including volumes, documents, digital images, metadata, or microfilm) serviced by Kofile shall remain the property of the County. This policy is applicable to any agreement, verbal or written, between the County and Kofile. • The records are not used by Kofile other than in connection with providing the services pursuant to any agreement between Kofile and the County. • The records are not commercially exploited by or on behalf of Kofile, its employees, officers, agents, invitees, or assigns, in any respect. Please let me know if you have any questions. We look forward to serving Calhoun District Clerk and to working together for the preservation and access of its public and historical assets. Sincerely, , Billy Gerwick Account Executive billy.gerwick@kofile.com (832) 373-9124 rac/sgr 1®G CALPOUN COunriY DIS(RICT C: [."K PAG_ 414 PR"e$ERVA': ION & ARCHIVAL IMAGING OF HISTGRICP.L RECORDS Oc'ober 1:. 2092 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lafl Complete Nos.1-4 and 6 if there are interested ponies. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2022-945765 KoFfle Technologies, Inc. Dallas, TX United States Date Filed: 10/1812022 2 Name of govemmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, Texas District Clerk Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2022-1018 Calhoun District Clerk's historical records conservation, rehousing, and imaging. 4 Name of Interested Party City, State, Country (place of business) Nature of Interest (check applicable) Controlling Intermediary Kofile, Inc. Dallas, TX United States X Crosno, Michael Dallas, TX United States X Mohn, Jonathan Dallas, TX United States X Sloneker, Sharon - Dallas, TX United States X Williams, George Dallas, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is Jonathan Mohn and my date of birth is My address is 6300 Cedar Springs Road Dallas TX , 75235 USA (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Dallas County; State of TX , on the 18 day of October , 2022 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V3.5.1.8b4250fl # 09 I NOTICE 01- MEETING — 10/2.6/2022 9. Consider and take necessary action to approve the Calhoun County E9-1-1 Emergency Communication District Proposed FY 2023 budget. (RHM) 31rales explained upgrades to come. APPROVED [UNANIMOUS] Page 5 of 11 o ��z F vl d C O O O O O O O O m o.nv .n .n 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 l0 N 'i •i O O O o 0 0 O O O o 1 o ri o 6 o of F �z �j o0000 0 w a O o 0 0 00 0 0 n ao m o o w of kc O O N "I M w w Qm w O O O O M 00 O O O O O to O O O O t- o O O�o — O O O �o O O O O r CN O O O m O1 00 O �o O N �O O O O \d M O O 00 �O <h M N 0 7 kn O I Vn V) y. O a vi O �o 0 0 an m Itm0� N r �i vi M ,--i W 01 N W 69 6s &I 69 69ON O I 69 69 69 s9 s9 69 rl F us O O O O O O O O O O O O O O O O O O O O O O r r 0 01 Ln 01 00 iA �o 0 .--i d." M 000 rl &S r- N r-� 69 7 6s O, l0 49 7 R v ss ss v� ss r ds O O O kn 0 r 0 0 0 0 lO 0 0 0 0 W 00 Cl O ON V — Vl O O O O O O O O\ Q\ O O �O N ,-. 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Consider and take necessary action to approve the first extension of three — one year periods for the Delivered Fuel Contract between Calhoun County and New Distributing Company, Inc. for the period January 1, 2023 through December 31, 2023 and authorize the County Judge to sign all necessary documents. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct SECONDER: h Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 11 Mae Belle Cassel From: peggy.hall@calhouncotx.org (peggy hall) <peggy.hall@calhouncotx.org> Sent: Thursday, October 20, 2022 8:21 AM To: MaeBelle.Cassel@calhouncotx.org; Richard H Meyer Cc: Cindy Mueller; Candice Villarreal, demi.cabrera@calhouncotx.org; Erica Perez Subject: Agenda Item for October 26, 2022 Attachments: 2022.10.26 Court to approve 1st of 3 one year extensions.pdf Mae Belle, Please place the following item on the Commissioners Court Agenda for Wednesday, October 26, 2022: • Consider and take necessary action to approve the first extension of three —one year periods for the Delivered Fuel Contract between Calhoun County and New Distributing Company, Inc. for the period January 1, 2023 through December 31, 2023 and authorize the County Judge to sign all necessary documents. Thanks! Peggy 3Va_ 1T Assistant Auditor Calhoun County 202 S. Ann St., Ste B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 Calhoun County Texas October 20, 2022 To: Judge Meyer From: The office of the County Auditor Peggy Hall, Assistant Auditor Please place the following item on the Commissioners Court Agenda for Wednesday, October 26, 2022 Consider and take necessary action to approve the first extension of three — one year periods for the Delivered Fuel Contract between Calhoun County and New Distributing Company, Inc. for the period January 1, 2023 through December 31, 2023 and authorize the County Judge to sign all necessary documents. CONTRACT EXTENSION AGREEMENT FOR THE ANNUAL SUPPLY CONTRACT FOR DELIVERED FUEL Original Contract (Award) approved by Commissioners Court on November 24, 2021 First Extension of three — one year periods Beginning January 1, 2023 and Ending December 31, 2023 Approved by Commissioners Court on 2022 Calhoun County, 211 South Ann Street, 3,d Floor, Suite 301, Port Lavaca, Texas 77979 CONTRACT EXTENSION AGREEMENT FOR THE ANNUAL SUPPLY CONTRACT FOR DELIVERED FUEL THE STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County hereinafter called "COUNTY" and New Distributing Company, Inc. hereinafter called "NEW DISTRIBUTING" did enter into a CONTRACT awarded on November 24, 2021 for the CONTRACT beginning January 1, 2022 and ending December 31, 2022. In the CONTRACT, the COUNTY did grant unto NEW DISTRIBUTING the option to extend for an additional three — one year periods upon Commissioners Court approval prior to the end date of the preceding CONTRACT and both the COUNTY and NEW DISTRIBUTING agree to said extension. THEREFORE, the CONTRACT term shall be extended for the first of three — one year periods, the first additional year beginning January 1, 2023 and continuing through December 31, 2023. COUNTY and NEW DISTRIBUTING agree that during the first additional year extension, the CONTRACT will continue as follows: The ORIGINAL CONTRACT, which is attached hereto (Attachment A) as a part of this CONTRACT EXTENSION AGREEMENT, will end on December 31, 2022. The COUNTY and NEW DISTRIBUTING agree to extend the ORIGINAL CONTRACT for an additional one year period, which will begin immediately upon the expiration of the original time period and will continue through December 31, 2023. This CONTRACT EXTENSION AGREEMENT binds and benefits both the COUNTY and NEW DISTRIBUTING. Any successors or assigns shall be agreed upon by both the COUNTY and NEW DISTRIBUTING. This CONTRACT EXTENSION AGREEMENT, including the attached ORIGINAL CONTRACT (Attachment A), is the entire agreement between the COUNTY and NEW DISTRIBUTING. All other terms and conditions of the ORGINAL CONTRACT (Attachment A) remain unchanged. Page I of This CONTRACT EXTENSION AGREEMENT documents shall include the following documents, and this CONTRACT EXTENSION AGREEMENT does hereby expressly incorporate same herein as if fully set forth verbatim in this CONTRACT EXTENSION AGREEMENT: 1) Original Contract (Award) (Attachment A) 2) Original Invitation to Bid, Bid Number 2022.01; 3) Revised Specifications to Bid Number 2022.01; 4) General Conditions included in Bid Number 2022.01; 5) Invitation to Bid Form for Bid Number 2022.01; 6) This instrument; and 7) Any addenda or changes to the foregoing documents agreed to by the parties hereto. This CONTRACT EXTENSION AGREEMENT shall be signed on behalf of COUNTY by Honorable Richard H. Meyer, Calhoun County Judge, and on behalf of NEW DISTRIBUTING by y-pe"IrJ Prim ,yl� P05lDG'j Print Authorized Representative for New Distributing Print Title of Authorized Representative for New Distributing a��fh EXECUTED this the day of 2022. COUNTY: CALI U H .OUNTY, TEXAS I'lnorable Richard H Mey CALHOUN COUNTY JUDGE CALHOUN COUNTY COURTHOUSE 211 SOUTH ANN STREET 3111) FLOOR, SUITE 301 PORT LAVACA TX 77979 NEW DISTRIBUTING: NEW DISTRIBUTING COMPANY, INC. Signature off Authorized Representative of Now Distributing }7Gyt.1 Oaxl -yic TprStae-ji Printed Name and Title NEW DISTRIBUTING COMPANY INC PO BOX 1247 VICTORIA TX 77902 ATTEST: ATTEST: No"Q (' Page 2 of 2 ATTACHMENT A ORIGINAL CONTRACT Awarded November 24, 2021 by Calhoun County Commissioners Court Im PECCTHALL CRISTINAPTUAEON 202 SANNST,STEH OEMICASHERA CANDICEVILLARREAL PORT LAVACA,TEAMS77979 ERICAPEREE 1"ASSISTANTAUOITOR TELEPHONE 13 611553-4610 FAX 13 6115534614 ASSISTANT AUDITORS December 31, 2021 NEW DISTRIBUTING CO., INC. PO BOX 1247 VICTORIA TX 77902-1247 RE: AWARD ANNUAL SUPPLY CONTRACT DELIVERED FUEL— JANUARY 1, 2022 thru DECEMBER 31, 2022 We wish to thank you for your bid and to advise you that your company's bid for the Delivered Fuel Annual Supply Contract was accepted and awarded during Commissioners' Court on Wednesday, November 24, 2021. Fuel deliveries covered by the bid must be delivered and invoiced in accordance with the bid specifications. Enclosed you will find the following: • Copy of your Invitation To Bid Forms • Contact and Billing Information and Location of Fuel Tanks and Generators • Sales Tax Exempt Form for Calhoun County (covers all County Departments) • Sales Tax Exempt Form for Memorial Medical Center (also covers MMC Clinic) • Bid Tabulation Award If there are any Forms or other Tax Exempt Forms you need the County to fill out, please mail or email to: Calhoun County Auditor Attn: Peggy Hall, Assistant Auditor 202 S Ann St, Ste B Port Lavaca, TX 77979 EMAIL: peesy.hall@calhouncotx.ora Please send me your Certificate of Liability Insurance listing Calhoun County Texas as an additional insured. If you have any questions, please contact our office. Thank you, Peggy Haff Peggy Hall Assistant Auditor NEW DISTRIBUTING CO, INC. ANNUAL SUPPLY CONTRACT BID NUMBER: 2022.01 BEGINNING JANUARY 1, 2022 AND ENDING DECEMBER 31, 2022 With an option for renewal for an additional three —one (1) year periods, if agreeable with both the successful bidder and Calhoun County CALHOUN COUNTY TEXAS INVITATION TO BID FORM AMENDED WITH ADDENDUM NO. 1 Approved by Commissioners Court October 20, 2021 Annual Supply Contract for Delivered Fuel Bid Number: 2022.01 January 1, 2022 thru December 31, 2022 With an option for renewal for an additional three -one (1) year periods, if aggreeable with both the successful bidder and Calhoun County BIDDER'S NAME AND ADDRESS: New Distirbuting Co., Inc. 4102 US Hwy. 59 N. Victoria, TX 77905 • Please type or print in ink. If handwritten, must be legible. • White out is not acceptable. • This is a bid form only and does not represent an order for a purchase by Calhoun County. • Acceptance of the successful bid shall obligate the bidder to provide up to the amount bid at the bid terms and conditions stated herein. Acceptance of the successful bid shall only obligate Calhoun County to purchase some of the items from that bidder. Calhoun County reserves the right to require any successful bidder to enter a separate written contract containing the terms herein and other reasonable conditions. The Invitation to Bid packet, in its entirety, will be the binding contract between Calhoun County and the successful bidder. • SEE SPECIFICATIONS FOR DELIVERED FUEL AND GENERAL CONDITIONS FOR COMPLETE REQUIREMENTS • Estimated quantities are not guaranteed for the year. Amounts will vary by need. • ALL Transportation Costs and Other Fees must be included in the laid pltl ef: rfrir+rts mark-up per gallon or clearly stated on the bid • Delivery in 24 hours from receipt of order. • Calhoun County is Exempt from all Federal Excise Taxes and Sales Tax (county, city and state sales tax). • Calhoun County is Not Exempt from: Texas State Excise Tax on Gasoline and Clear Diesel • ALL OTHER FEES NOT INCLUDED IN ^"" rsv^ s�.R M1151511:1`i THE MARK-UP PER GALLON MUST BE LISTED AND CLEARLY STATED ON THE INVITATION TO BID FORM. If extra space is needed to list Other Fees, attach a separate page stating the fee and amount of the fee. This separate page must be signed and dated by an authorized respresentative. Make note of this separate page under the Other Fees column. Only Fees listed on the bid returned by the bidder and awarded as such to the successful bidder will be allowed to be included on the invoice when the awarded bidder submits the invoice for payment. List Method or Source that will be used throughout the bid period and provide a copy: OPIS Victoria Citgo Unbranded / Corpus Citgo Branded for Ethanol -Free ONLY Page 1 of 7 Invitation to Bid Form -Annual Supply Contract for Delivered Fuel --Continued OTHER FEES NOT INCLUDED IN nr r IC OR K US THE MARK-UP PER GALLON If No C1targe OR Not Applicable, Mark A'A PftFS OF Texas List Any Other M!"Us- Environmental Feels) AND Mark-U P Texas OSLTF- Fee Per Delivery Isee Texas Petroleum Amount of Per State LUST Federal oil Ptoduats ealieary Fee Fee(s) Sthedule for 5,013a Gallons Fs: After flours call out Department Fuel Type Galion Excise Tax FEE Spill Fee or mare) service Fee Gasoline Less than 2,500 Precinct 1 Gallons the Fee is Unleaded $ .0012 Fuel Tank(s) Location: 87 Octane $ •07 $0.20 .001 .00193 2,500 Gallons but N/A 305 Henry Barber Way Brand Name: Less than 5,000 Port Lavaca TX 77979 Citgo UNB Gallons the Fee is $ .0012 Gasoline Less than 2,500 "aT colon° Ol ea uiNwe vo lh'Pvt available" Unleaded Gallons the Fee is $ Iwcigo basis MI 93 Octane $ .14 $0.20 .00193 .0012 2,500 Gallons but N/A carpus chdsu•, Non -Ethanol .001 Less than 5,000 Brand Name: Gallons the Fee is Citgo Branded $ .0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur $ .0012 (Clear Diesel) $ .08 $0.20 .001 .00214 2,500 Gallons but N/A Brand Name: Less than 5,000 Citgo UNB Gallons the Fee is $ .0012 Gasoline Less than 2,500 Precinct 2 Gallons the Fee is Unleaded $ .0012 FuelTank(s) Location: 87 Octane $ .07 $0.20 .001 .00193 2,500 Gallons but N/A 5812FM 1090 Brand Name: Less than S,ODD Port Lavaca TX 77979 Citgc UNB Gallons the Fee is $ .0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur $ .0012 (Clear Diesel) $ .08 $0.20 .001 .00214 2,500 Gallons but N/A Brand Name: Less than 5,000 Citgo UNB Gallons the Fee is $ .0012 Page 2 of 7 Invitation to Bid Form -Annual Supply Contract for Delivered Fuel ..Continued OTHER FEES NOT INCLUDED IN P16US ORMINUS THE MARK-UP PER GALLON If No Charge OR Not. Applicable., No& NA Plus OF T Texas List Any Other Minus Environmental Fee(s) AND Mark-UpTexas OSLTF- Fee Per Delivery (See Texas Petroleum Amount of Per State LUST Federal Oil PmductsoenverFFee Fee(s) Department Fuel Type Gallon Excise Tax FEE Spill Fee Schedule far 5,000 Gallons armPre) Er: After Henn Call Out serelce Fee Precinct 3 Gasoline Less than 2,500 Gallons the Fee Is Fuel Tank(s) Location: Unleaded $ .0012 24627 State Hwy 172 87 Octane $ .07 $0.20 .001 .00193 2,500 Gallons but N/A Port Lavaca TX 77979 Brand Name: Less than 5,000 (Precinct 3 is in Olivia) Cltgo UNB Gallons the Fee is $ .0012 Gasoline Less than 2,500 ••arooMO Unleaded Gallons the Fee is ENandFtcc is ml we na.e s,anama•' Pd6n00asiswlll 93 Octane $ .14 $. 0012 6clpus COdsiO Non -Ethanol $0.20 .001 .00193 ?,Soo Gallons but N/A Less than 5,000 Brand Name: Gallons the Fee is Citgo Branded $ .0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur S .0012 (Clear Diesel) $ -08 $0.20 .001 .00214 2,500Gallons but NIA Brand Name: Less than 5,000 CItgO UNB Gallons the Fee is $ .0012 Precinct Gasoline Less than2,500 (Port O'Connor) Unleaded Gallons the Fee is $ ,0012 Fuel Tanks) Location: 87 Octane $ .07 $0.20 001 2,500 Gallons but N/A 93 Trevor Street Brand Name: . .00193 Less than 5,000 (off of Hwy185) CIY9 o UNB Gallons the Fee is Port O'Connor TX 77982 S .0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur S.0012 (Clear Diesel) $ .08 $0.20 .001 .00214 2,500 Gallons but N/A Brand Name: Less than 5,000 Cit90 UNB Gallons the Fee is $ .0012 Page 3 of 7 Invitation to Bid Form -Annual Supply Contractfor Delivered Fuel --Continued OTHER FEES NOT INCLUDED IN PLUS GR MINUS THE MARK-UP PER GALLON !J'No Charge OR Not Applicable, bfark NA Plus ar Texas List Any Other Mines Environmental Fee(s) AND Mark-UpTexas OSLTF- Fee Per Delivery Isee Tees Petroleum Amount of Per State LUST Federal Oil Pradmt, Oellme Fe. Feels) Department Fuel Type Gallon Excise Tax FEE Spill Fee Schedule for 5.000 Gallons armor.) E.: Alter Hours call out Service Fee Precinct 4 Gasoline Less than Gallons thea Fee Fee is (Seadrift) Unleaded $ .0012 Fuel Tank(s) Location: 87 Octane $ .07 $0.20 .001 .00193 2,500 Gallons but N/A 104 E Dallas Brand Name: Less than 5,000 Seadrift TX 77983 Citgo UNB Gallonsthe Feeis 5 .0012 Gasoline Less than 2,500 "fooet.n. Unleaded Gallons the Fee is CmanW-Frou is all we hava a" enable" Fddeg basis w0l 930ctane $ .14 $0.20 $0012 2,500 Gallons but N/A 10 ccoonf scans d¢° Non -Ethanol .001 .00193 Less than 5,000 Brand Name: Gallons the Fee is Citgo Branded g .0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur s .0012 (Clear Diesel) $ 'Oa $0.20 .001 .00214 2,500 Gallons but N/A Brand Name: Less than 5,000 Citgo UNB Gallons the Fee is $.0012 Precinct Gasoline Less than Gallons theeFee Fee is (Seadrift) Unleaded $ .0012 Fuel Tank(s) Location: 87 Octane S .07 $0.20 .001 .00193 2,500 Gallons but N/A 448 Harbor Road Brand Name: Less than 5,000 Seadrift TX 77983 Citgo UNB Gallons the Feels 5.0012 Diesel Less than 2,500 Gallons the Fee is Low Sulfur S .0012 (Clear Diesel) $ .08 $0.20 .001 .00214 2,500 Gallons but N/A Brand Name: Less than 5,000 Citgo UNB Gallons the Fee is s .0012 Page 4 of 7 Invitation to Bid form -Annual Supply Contract for Delivered fuel --Continued OTHER FEES NOT INCLUDED IN PLUS OR MINUS THE MARK-UP PER GALLON If No Charge OR Not Applicable, Mark NA Plus of Texas List Any Other Minds- Environmental Fee(s) AND Marls -Up Texas OSLTF - Fee Per Delivery (See Texas Petroleum Amount of Per State LUST Federal Oil PmdumSDella.gFee Feels) Department Fuel Type Gallon Excise Tax FEE Spill Fee Schedule for 5,00D Gallons ormom) Er: After Hours Coll out Servlee Fee Skid Fuel Tank Skid Location for Fuel Diesel Less than Delivery: Low Sulfur Gallons thee Fee ee Is $ .0012 Within Close Proximity (Clear -Diesel) $ .21 $0.20 .001 2,500 Gallons but N/A to the Calhoun County Brand Name: .00214 Less than 5,000 Courthouse Citggo UNB Gallons the Fee is 211 S Ann Street 5.0012 Port Lavaca TX 77979 Generator - Calhoun County Diesel Less than 2,500 Courthouse Low sulfur Gallons the Fee is $ .0012 Generator Fuel Tank (Red Diesel) $ •21 NA .001 .00214 2,500 Gallons but NIA Location for Fuel Brand Name: Less than 5,000 Delivery: Citgo UNB Gallons the Fee is 211 S Ann Street $ .0012 Port Lavaca TX 77979 Generator - Calhoun County Diesel Less than 2,500 Adult Detention Gallons the Fee is Center (JAIL) Low Sulfur $ .0012 (Red Diesel) $ .21 NA .001 .00214 2,500 Gallons but NIA Generator Fuel Tank Brand Name: Less than 5,000 Location for Fuel Citgo UNB Gallons the Fee is Delivery: $ .0012 302 W Live Oak Port Lavaca TX 77979 Page 5 of 7 Invitation to Bid Form - Annual Supply Contract for Delivered Fuel -- Continued OTHER FEES NOT INCLUDED IN PLUS OR Mill THE MARK-UP PER GALLON Lf No Charge DR Not Applicable, Mork NA PINS-eF Texas List Any Other MIRbIs Environmental Fee(s) AND Mark -Up Texas OSLTF- Fee Per Delivery (See Texas Petroleum Amount of Per State LUST Federal Oil Products Gell.eryFea Feels) Department Fuel Type Gallon Excise Tax FEE Spill Fee Schedule for 5,000 Gallons ormorel Ex: After Hours Call out Service Fee Generator - EMS Central Station Diesel Less than 2,500 (Emergency Gallonsthe Fee is Low sulfur $ .0012 Management (Red Diesel) $ 21 NA .001 .00214 2,500 Gallons but N/A Services) Brand Name: Less than 5,000 Generator Fuel Tank CItgo LING Gallons the Fee is Location for Fuel $ .0012 Delivery: 705 Henry Barber Way Port Lavaca TX 77979 Generator - EMS South Station Diesel Less than 2,500 (Emergency Gallons the Fee is Management Low sulfur $ .0012 (Red Diesel) $ •21 NA .001 2,500 Gallons but N/A Services) Brand Name: .00214 Less than 5,000 Generator Fuel Tank Citno UNB Gallons the Fee is Location for Fuel $ .0012 Delivery: 6084 State Hwy 185 E Seadrift TX 77983 Page 6 of 7 Invitation to Bid Form - Annual Supply Contract for Delivered Fuel --Continued OTHER FEES NOT INCLUDED IN P1616159R MINUS THE MARK-UP PER GALLON !f No Charge OR Not. Applicable, Mark NA Plus _„ Texas List Any Other Minus Environmental Fee(s) AND Mark -Up Texas OSLTF- Fee Per Delivery (See Texas Petroleum Amount of Per State LUST Federal Oil P'oauetsoelf"Fee Fee(s) Department Fuel Type Gallon Excise Tax FEE Spill Fee Schedule for 5,000 Gallons or morel Ex: After Noun Coll out Servlee Fee Generators - Memorial Diesel Less than 2,500 Medical Center Gallons the Fee is (Hospital) Low Sulfur OB $.0012 (Red Diesel) $ NA .001 00214 2,500 Gallons but N/A Generators Fuel Tank Brand Name: Less than 5,000 Location for Fuel Citgo UNB Gallons the Fee is Delivery: $ .0012 815 N Virginia Street Port Lavaca TX 77979 Generator - Memorial Diesel Less than 2,500 Medical Clinic Low Sulfur Gallons the Fee is $ .0012 Generator Fuel Tank (Red Diesel) $ •21 NA .001 .00214 2,500 Gallons but N/A Location for Fuel Brand Name: Less than 5,000 Delivery: Cltgo UNB Gallons the Fee is 1016 N Virginia Street $ .0012 Port Lavaca TX 77979 The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership or individual has not prepared this bid in collusion with any other bidder, that the contents of this bid as to prices, terms or conditions of sold bid have not been communicated by the undersigned nor by their employees or agents to any official, employee or agent of Calhoun County or any other person engaged in this type of business prior to the official opening of this bid. The undersigned affirms that they have not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment gift loon, gratuity, special discount, trip, favor, or service to any official, employee, or agent of Calhoun County in connection with this bid. The undersigned affirms that they have read the entire Invitation to Bid Packet and fully understands and has followed oil requirements. FAILURE TO SIGN BELOW SHALL DISQUALIFY THE BID Date: 10111/2021 Authorized Signature & Title: Vice President Printed Name & Title of Authorized Signature: Devin New - Vice President Phone Number: (361) 575-1981 Email: devin a( -newdistributino.com REMARKS: Page 7 of 7 10/11121, 9:30 AM Customized OPTS City Rack VICTORIA/PLACEDO, TX 2021-10-11 10:eO:12 EDT **OPIS CONTRACT DENCH14ARK FILE** **OPIS GROSS COOS E'THANOL(10%) PfIICES** 9.0 RVP Move Terms Unl Have Mid Move Pre Move Date Time Valero b 1-20 245.38 + 1.01 262.34 + .80 295.47 + .40 10/08 18:00 Citgo u 1-10 247.25 + 2.52 262.40 + 2.S2 294.73 + 2.53 10/08 18:00 76-Mot b 125-3 247.69 + 2.74 262.88 + 2.74 296.80 + 2.73 10/08 18:00 Shell -Mot b 125-3 247.83 + 2.74 266.06 + 2.74 380.49 + 2.74 10/08 18:00 Citgo b 1-10 247.93 + 3.eO 263.59 + 3.00 29S.40 + 3.00 10/08 18:00 Cenex b 1-10 249.60 + 3.15 -- -- -- -- -- -- -- -- 10/08 18:00 PSX b 1-10 249.79 + 3.00 264.94 + 3.00 297.26 + 3.00 10/08 18:00 XOM b 125-3 249.83 + 3.11 267.05 1. 3.11 B00.47 + 3.11 10/08 19:00 LOW RACK 246.38 262.34 294.73 HIGH RACK 249.83 267.05 300.49 RACK AVG 248.29 264,18 297.23 OPIS GULF COAST DELIVERED SPOT (SRI) FOB VICTORIA/PLAC 239.17 -- -- 251.77 BRD LOW RACK 246.38 262,34 295.40 ORD HIGH RACK 249.83 267.05 300.49 BRD RACK AVG 248.44 264.48 297.65 USD LOW RACK 247.25 262.40 294.73 USD HIGH RACK 247.25 262.40 294.73 USD RACK AVG 247.25 262.40 294.73 CONT AVG-10111 248.29 264.18 297.23 CONT LOW-2e/11 246.3E 262.34 294.73 CONT HIGH-10/11 249.83 267.05 300.49 VICTORIA, TX LOW RETAIL 279.48 AVG RETAIL 287.55 LOW RETAIL 6X-TAX 240.71 AVG RETAIL EX -TAX 248.79 VICTORIA/PLACEDO, TX 2021-10-11 10:00:12 EDT **OPIS CONTRACT BENCHMARK FILE** **OPIS GROSS ULTRA LOW SULFUR LED DISTILLATE PRICES•* Have Terms No.2 Move No.1 Move Pre Move Date Time Cenex b 1-10 262.29 + .65 -- -- -- -- •- -- -- -- 10108 18:00 PSX b 1-10 263.13, + 1.08 -- -- -- -- -- -- -- -- 10108 18:00 Citgo b 1-10 263.19 + 1.50 -- -- -- -- -• -• -- -- 10/08 18:00 Citgo u 1-10 253.29 + 1.50 -- -- -- -- -- -- -- -- 10/08 18:00 Valero b 1-10 263.35 + 1.70 -- -- -• -- -- -- -- -- 10/08 18:00 Motiva b 125.3 263.64 + 2.46 -- -- -- -- •• -- -- -- 10/08 18:00 76-Mat b 125-3 263.80 + 2.47 -- -- -- -- -- -- -- -- 10/08 18:00 Shell -Mot b 125-3 263.85 + 1.47 -- -- -- -- -- •• -- -- 16/08 18:00 LOW RACK 262.29 -- -- •• •- HIGH RACK 263.85 -- -- •- -- RACK AVG 263.30 -- -- -- •- OPIS GULF COAST DELIVERED SPOT (SRI) FOB VICTORIA/PLAC 245.99 -- -- -- -- SRO LOW RACK 262.29 -- -- -- -- BRD HIGH RACK 263.85 -- -• -- -- BRD RACK AVG 263.32 -- -- -- -- UBD LOW RACK 263.19 •• -- -- -- USO HIGH RACK 263.19 -- -- -- -- UBD RACK AVG 263.19 -- -- -- -- CONT AVG-10/11 263.30 -- -- -- -- CONT L014-10/11 262.29 -- -- -- -- CONT HIGH-10/11 263.85 •- -- -- -- https:/lyiebracks.opisnet.com/Ontau!t.aspx 112 10111121. 9:30 AM Customized OPTS City Rack._ --- -- VICTORIA/PLACEDO, TX 2022-10-11 10:00:12 EDTY **OPTS CONTRACT BENCHMARK FILE** **OPTS GROSS ULTRA LOW SULFUR RED DYE LED DISTILLATE PRICES*; No.2 No.1 Pro Move Terms RD Move RD Move RD Move Date Time Cenex b 1-10 262.69 + .65 -- -- -- -• -- -- •- -- le/08 18:00 Citgo b 1-10 263.59 + 1.50 -- -- -- -- -- -- -- -• 10/08 18:00 Citgo u 1-10 263.59 + 1.50 -- -- -- -- -- -- -• •- le/08 18:09 PSX b 1-10 264.12 + 1.00 -- -- -- -- -- -- -- -- 10/08 18:00 LOW RACK 262.69 -- -- -- -- HIGH RACK 254.12 -- -- -- -- RACK AVG 263.50 -- -- -- -- OPIS GULF COAST DELIVERED SPOT (SRI) FOB VICTORIA/PLAC 246.34 -- -- -- -- BRD LOW RACK 262.69 -- -- -- -- BRO HIGH RACK 264.12 -- -- -- -- 8RD RACK AVG 263.47 -- -- -- -- UBD LOW RACK 263.59 -- -- -- -- UBD HIGH RACK 263.59 -- -- -• •- UBD RACK AVG 263.59 -- -- -- •- CONT AVG-10/11 263.50 -- -- -- -- CONT LOW-10/11 262.69 -- -- •• -- CONT HIGH-10/11 264.12 -- -- -- -- VICTORIA/PLACEDO, TX 2021.10-11 10:00:12 EDT **OPIS CONTRACT BENCHMARK FILE** **OPIS GROSS WHOLESALE BS SME BIODIESEL PRICES** ULS2 UL520 Move Terms LED LED Date Time XOM b 125-3 260.75 -- -- 10/08 19:00 PSX b 1-10 263.11 -- -- 10/08 18:00 Citgo b 1-10 263.19 263.59 10/08 18:00 Citgo u 1-10 263.19 263.59 10/08 18:00 Valero b 1-10 263.35 -- -- 20/08 18:00 Motive b 125-3 263.64 -- -- 20/08 18:09 76-Plot b 125-3 263.80 -- -- 10/08 18:00 Shell -Mot b 125-3 263.85 -• -- 10/08 18:00 LOW RACK 260.75 263.59 HIGH RACK 263.85 263.59 RACK AVG 263.11 263.59 ROD LOW RACK 260.75 263.59 BRD HIGH RACK 263.85 263.59 BRD RACK AVG 263.10 263.59 UBD L014 RACK 263.19 263.59 UBD HIGH RACK 263.19 263.59 UDD RACK AVG 263.19 263.59 CONT AVG-10111 263.11 263.59 CONT LOW-10/11 260.75 263.59 CONT HIGH-10/11 263.85 263.59 Copyright, Oil Price Information Service https:Ihvabmcks,opisnet.comiDefault.aspx 212 C07GO .. . . ...... 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IM 211" CALHOUN COUNTY, TEXAS CONTACT AND BILLING INFORMATION AND LOCATION OF FUEL TANKS AND GENERATOR FUEL TANKS Calhoun County Precinct 1 Commissioner David Hall 305 Henry Barber Way (by the County Fairgrounds) Port Lavaca, TX 77979 Office Manager: Angela Torres Office: 361-552-9242 Fax: 361-553-8734 Location of Fuel Tanks: 305 Henry Barber Way, Port Lavaca, TX Calhoun County Precinct 2 Commissioner Vern Lyssy 5812 FM 1090 (Six Mile) Port Lavaca, TX 77979 Office Manager: Lesa Jurek Office: 361-552-9656 Fax: 361-553-6664 Location of Fuel Tanks: 5812 FM 1090, Port Lavaca, TX Calhoun County Precinct 3 Commissioner Joel Behrens 24627 State Hwy 172 (Olivia) Port Lavaca, TX 77979 Office Manager: Lynette Adame Office: 361-893-5346 Fax: 361-893-5309 Location of Fuel Tanks: 24627 State Highway 172, Olivia TX Calhoun County Precinct 4 Precinct 4-P (Port O'Connor) Commissioner Gary Reese Trevor St off of Hwy 185 Port O'Connor, TX 77982 Office Manager: April Townsend Use same numbers as Seadrift (4-S) Location of Fuel Tanks — Pct 4-P Barn #3: 93 Trevor Street off of Highway 185, Port O'Connor, TX Page 1 of 3 CONTACTAND BILLING INFORMATIONAND LOCATION OF FUEL TANKS AND GENERATOR FUEL TANKS, Continued Calhoun County Precinct 4 Precinct 4-S (Seadrift) Commissioner Gary Reese 104 E Dallas St PO Box 177 Seadrift, TX 77983 Office Manager: April Townsend Office: 361-785-3141 Fax: 361-785-5602 Location of Fuel Tanks — Pct 4-S Barn #1: 104 E Dallas, Seadrift TX Location of Fuel Tanks — Pct 4-S Barn #2: 448 Harbor Road, Seadrift TX Skid Fuel Tank: Calhoun County Attn: Commissioner David Hall 305 Henry Barber Way Port Lavaca, TX 77979 Office: 361-552-9242 Fax: 361-553-8734 Storage Location when not in use: Calhoun County Recycle Center, 900 Landfill Rd, Port Lavaca TX Location for Fuel Delivery: Within close proximity to the Calhoun County Courthouse, 211 S Ann St, Port Lavaca TX Calhoun County Courthouse - Generator Calhoun County Maintenance Attn: Everett Wood, Maintenance Supervisor 211 S Ann St Port Lavaca, TX 77979 Contact Person: Everett Wood, Maintenance Supervisor Office: 361-553-4499 Fax: 361-553-4497 Location of Generator: 211 S Ann St, Port Lavaca, TX Calhoun County Adult Detention Center (Jail) - Generator Calhoun County Maintenance Attn: Everett Wood, Maintenance Supervisor 211 S Ann St Port Lavaca, TX 77979 Contact Person: Everett Wood, Maintenance Supervisor Office: 361-553-4499 Fax: 361-553-4497 Location of Generator: 302 W Live Oak, Port Lavaca, TX (Corner of Live Oak and San Antonio St) Page 2 of 3 CONTACT AND BILLING INFORMATION AND LOCATION OF FUEL TANKS AND GENERATOR FUEL TANKS, Continued EMS Central Station (Emergency Management Services) - Generator Calhoun County EMS Central Station Attn: Accounts Payable 705 Henry Barber Way Port Lavaca, TX 77979 Office: 361-552-1140 Fax: 361-552-6552 Location of Generator: 705 Henry Barber Way, Port Lavaca, TX EMS South Station (Emergency Management Services) - Generator Calhoun County EMS South Station Attn: Accounts Payable 705 Henry Barber Way Port Lavaca, TX 77979 Office: 361-552-1140 Fax: 361-552-6552 Location of Generator: 6084 State Hwy 185 East, Seadrift, TX Memorial Medical Center (Hospital) — Generators (2 Generators) Memorial Medical Center Attn: Accounts Payable 815 N Virginia St Port Lavaca, TX 77979 Accounts Payable: Ellen Heiman — Office: 361-552-0256; Fax: 361-551-4504 Order Contact: Bethann Diggs, Plant Services Dept. Asst. — Office: 361-552-0392; Fax: 361-552-0312 Location of Hospital Generators: 815 N Virginia St, Port Lavaca, TX Memorial Medical Clinic - Generator Memorial Medical Clinic c/o Memorial Medical Center Attn: Accounts Payable 815 N Virginia St Port Lavaca, TX 77979 Accounts Payable: Ellen Heiman —Office: 361-552-0256; Fax: 361-551-4504 Order Contact: Bethann Diggs, Plant Services Dept. Asst. —Office: 361-552-0392; Fax: 361-552-0312 Location of Clinic Generator: 1016 N Virginia St, Port Lavaca, TX Page 3 of 3 CERTIFICATE OF INTERESTED PARTIES FoRM 1295 loft Complete Nos. 1.4 and 6 it there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2022-944849 1 Name of business entity filing form, and the city, state and country of lire business entity's place of business. New Distributing Co., Inc. Victoria, TX United States Date Filed: 10/16/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form Is being filed. Calhoun County Date Acknowledged: 3 Provide the Identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2023 1st of 3 - One Year Extensions Annual Supply Contract for Delivered Fuel January 1, 2023 through December 31, 2023 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary New, Jon Victoria, TX United States X New, Davin Victoria, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is "D Vt0 r a� date My address is _ _M11W111ff (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing Is true and correct. Executed In ✓tr,Ci mA- County. State of "t-'SXkr , on the I�"day of Derrata- E0 ZY (month) (year) Signatu of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission unnnm_athlrsstatatx uc W. I— v� c I ar,e ocna A� CERTIFICATE OF LIABILITY INSURANCE ° T THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURA14CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: II The Certificate below Is an ADDITIONAL INSURED, the pollcyfles) must have ADDITIONAL INSURED provisions Or he endorsed. If SUBROGATION 13 WAIVED, subject to Hie (elms and condlliDns of tits policy, Certain policles may require an endorsement. A slnlement an this Certificate does not writer rights to the COMECON, holder In lieu of such eni arsocCRECUS1. PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 MIME!" CLIENT D E PNWito EKI : 888•3334949 E Ild :507�146 46M 111,216 I E NT 00 N TACTCENTER 3 OWATONNA, MN SSOSO INSURERCI AFFORCHIO COVERAGE IAIC nlsun ltA: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 034.113.1 INSURERM NEW DISTRIBUTING CO INC PO BOX 1247 111SUAIRC: INSURER°: VICTORIA, TX 77902.1247 INSURER Or INSURER P. 61 THIS 16 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMURIT, TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUES OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, I`ie WPEOFINSURNICE II IR YUND PO POrRUMBER 'all EEE IAAVOOY EIIP UAlgs A X COMMEgCLLLOEIIEPPLUABNIY CWAISd1ADE LOCCUR Y N 04/01/2D22 0001/2823 EACII OCCURREIICE SI,000.000 O IAOEISE,TORIr,EmED MEDEXP(MSengenm) S100,000 EXCLUDED PERMIPLAADVIiIAIRY $1.000.000 "Bill. XOUCY A00RL0J6WCATIT APPLIES PER: OSNER: OENERALMOREOATE $2.000.00 PRODUCTS •COMPI°P A00 S2.BOO.000 A ACTRMOBILELIABILNY X MIVAUw OWIIED AVYOSOBLY 6°HwTLEO Autos IIIRED AUEOS OIILY Anne AUTOS ONLY N N 04/01/2022 O4l01/2023 OMS IEOSIIIOIEUMIT S1.0gg.000 BODILY 111MRY(Perpenml BODILY IIINRY IPeenflRnO TQPEI, NA0.0E A X UAIBRELLA LIAR EXCESS LIAR X "CUR OWMS-NME N N NEW 04/0112022 D4/01/2D23 EACNOCCURRENCE $10.001),00 RoSiaoATE SIQOaocoo DED I IFIETICIN-11 A WORKERS COMPENSATION YE Alin EMPLORS• LIADILITY 1 ANY PR°PRIETORIPARTHERIEXECUTIVE ORICERINEMBfRinvownEm (Mmaelnrylnllxl HIRLdnNl4eund:r DESCRIPTION OF OPERATIONS Atlew ILIA N 04/01/2022 0410112M X PERSTATUTE OTN. ER LL EACH ACCIDENT $1,000,000 DISEASE • EAEMPLOTEE E.L.51.000.0a0 E.L DISEASE- POLICY UNIT S1,000,0g0 I. INSURED flON GENERALmryW LIABILITY CERTIFICATEHOLDER IS161 VEHICLES ADDITIONALINSURED ON GENERAL LIADILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL JECbeTO T THE CERTIFICATE HOLDER IS AN R ORGANIZATION INSURED -DESIGNATED PERSON OR ORGANIZATION EIBIORSEHENT. 034-113-0 CALHOUN COUNTY 202 S ANN ST STE B PORT LAVACA. TX 77919i2D4 610ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. G K&, CORPORATION. All AGEING 26 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: . a THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: A. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE ioun County S Ann St Ste B Lavaca, TX 77979-4204 Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising Injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However., 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured Is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Any Coverage Provided by This Endorsement Applies Only to Delivery of Fuel to All of the Carl Holders Locations in Texas. B. With respect to the insurance afforded to these additional insureds, the following Is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Insured: New Distributing Co Inc PO Box 1247 Victoria, TX 77902-1247 © Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number: 0700621 Transaction Effective Date: 04/01/2022 #11 NOVICE OF MFE-rING—10/26/2022 11. Consider and take necessary action to award the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08.(DEH) RESULT: APPROVED [UNANIMOUS]; MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner PctA AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 11 October 19, 2022 To: Judge Meyer From: For Commissioner David Hall Please place the following item on the Commissioners Court Agenda for October 26, 2022: Consider and take necessary action to award the Request for Qualifications for Engineering, Architectural and Surveying Services for the Combined Dispatch Building, RFQ 2022.08. Calhoun County, Texas RATING SHEET SCORES RFQ 2022.08 Engineering, Architectural and Surveying Services for the Combined Dispatch Building RFQs were opened at 2:00:00 PM, Wednesday, October 19, 2022 in the County Judge's Office. 3 RFQs were received G & W Engineers, Inc. (Port Lavaca) Gignac & Associates, LLP (Corpus Christi) Rawley McCoy & Associates, PLLC (Victoria) The 3 RFQs were rated by a committee consisting of: David Hall, Commissioner Precinct 1 Richard H. Meyer, County Judge Cindy Mueller, County Auditor Vendor Rating Score Average of Total Points G & W ENGINEERS, INC. 98.67 GIG NAC & ASSOCIATES, LLP 87.33 RAWLEY MCCOY & ASSOCIATES, PLLC 94.00 CALHOUN COUNT), TEXAS RATING TOTALS FOR EACH COMMITTEE MEMBER RFQ 2022.08 Engineering, Architectural and Surveying Services for the Combined Dispatch Building G & W ENGINEERS, INC. Experience Work Performance Capacity to Perform Total Points DAVID HALL 60 25 15 100 RICHARD H. MEYER 60 25 15 100 CINDY MUELLER 59 24 13 96 TOTAL 296 =3 AVERAGE 98.67 GIGNAC &ASSOCIATES, LLP Experience Work Performance Capacityto Perform Total Points DAVID HALL 55 10 15 80 RICHARD H. MEYER 58 24 15 97 CINDY MUELLER 52 19 14 85 TOTAL 262 =3 AVERAGE 87.33 RAWLEY MCCOY &ASSOCIATES, PLLC Experience Work Capacity to Perform TotalPerformance Points DAVID HALL 57 10 15 82 RICHARD H. MEYER 60 25 15 100 CINDY MUELLER 60 25 15 100 TOTAL 282 =3 AVERAGE 94.00 #12 ' NOTICE OF MEETING— 1.0/26/2022 12. Consider and take necessary action to declare the attached list of items from the County Clerk's Office as Waste. (RHM) RESULT:.. APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 ' SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 11 Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: Calhoun County Clerk Requested By: Anna M Goodman Commissioners' Court: 1012612022 Inventory Number Description Serial No. Reason for Waste/Disposal N/A PLL22tOW PLANAR MONITOR PL504LT501341 DOESN'T WORK NA/ PLL22IOW PLANAR MONITOR PL504LT501299 DOESN'T WORK y 2r S' 1 WtUl-C Dil[e S:\AFnodnaw\AGENDA ITEMS\Waste Declaration F'orm.102622.Doc Page 1 #13 NOTICE OF MEETING—10/2.6/2022 13. Accept Monthly Report from the following County Office: i. Tax Assessor -Collector — September 2022 RESULT: APPROVED[UNANIMOUS] MOVER; Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pet 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, behrens, Reese Page 9 of 11 SUMMARY TAX ASSESSOR -COLLECTORS MONTHLY REPORT SEPTEMBER2022 COLLECTIONS DISBURSEMENTS Title Certificate Fees $ 6,769.00 Title Fees Paid TXDMV $ 3,594.00 Title Fees Paid County Treasurer Salary Fund $ 2,166.00 Motor Vehicle Registration Collections $ 133,126.28 Disabled Person Fees $ 5.00 Postage - $ - Global Additonal Collections $ 1.80 Paid TXDMV $ 108,471.33 Paid TXDMV SP $ 17,984.28 Paid County Treasurer $ - Paid County Treasurer Salary Fund $ 4,868.55 DMV CCARDTRNSFEE $ 1,807.12 $ - GLAdditonalCollections $ 1.80 $ - GLOBAL (IBC) Credit/Debit Card Fees $ 1,596.67 GLOBAL Fees In Excess of Collections $ 212.35 MERCH SERVICES STATEMENT $ Additional Postage -Vehicle Registration $ - Paid County Treasurer - Additional Postage $ - Motor Vehicle Sales & Use Tax Collections $ 638,878.66 Paid State Treasurer $ 638,978.66 Special Road/Bridge Fees Collected $ 18,850.00 Paid County Treasurer - R/B Fees $ 18,850.00 Texas Parks & Wildlife Collections $ 3,197.00 TPW GLOBAL CC TRANSACTION FEES $ 291.82 GLOBAL ADDITIONAL COLLECTIONS $ - Paid Texas Parks & Wildlife $ 2,877.30 Paid County Treasurer Salary Fund $ 319.70 P&W CCARDTRNSFEE $ 291.82 GLOBAL Additonal Collections $ - GLOBAL (IBC) Credit/Debit Card Fee's $ 358.16 GLOBAL In Excess/Shortage of Collections $ (66.34) Boat/Motor Sales & Use Tax Collections $ 43,671.72 Paid State Treasurer $ 41,488.13 Paid County Treasurer, Salary Fund $ 2,183.69 TABC 6% CO COMMS FOR MONTH OF $ - TABC 6 % CO COMMS FOR MONTH OF $ - Paid County Treasurer, Salary Fund. $ _ County Beer& Wine Collections $ 295.00 Paid County Treasurer, County Beer & Wine $ 280.26 Paid County Treasurer, Salary Fund $ 14.75 INTEREST EARNED ON OFFICE ACCOUNT $ 22.99 Paid County Treasurer, Nev. East $ 0.01 Paid County Treasurer, all other districts $ 22.98 INTEREST EARNED ON PARKS AND WILDLIFE ACCOUNT $ 6.65 Paid County Treasurer, interest on P&W Acc $ 5.66 INTEREST EARNED ON REFUND ACCOUNT $ 0.03 Paid County Treasurer, Interest on Refund Acc $ 0.03 Business Personal Property - Misc. Fees Paid County Treasurer Excess Funds Paid County Treasurer Overpayments Current Tax Collections Penalty and Interest - Current Roll Discount for early payment of taxes Delinquent Tax Collections Penalty & Interest - Delinquent Roll Collections for Delinquent Tax Attorney Advance - FM & L Taxes Advance - County AdValorem Taxes Paid County Treasurer - Nev. East Paid County Treasurer - all other Districts Paid County Treasurer - Delinq Tax Atty. Fee Payment in Lieu of Taxes Paid County Treasurer.- Navig. East Paid County Treasurer - All other Districts Special Farmers Fees Collected Paid State Treasurer, Farmers Fees $ 30.26 $ 30.26 $ 84,490.56 $ 4,664.47 $ 7,330.17 $ 3,616.01 $ 7,980.17 $ 10.63 $ 99,132.97 $ 62.30 $ 895.30 $ 7,980.17 $ 55.00 $ 55.00 Hot Check Collection Charges $ - Paid County Treasurers, Hot Check Charge $ - Overage on Collection/Assessing Fees $ - - Paid County Treasurer, overage refunded $ - Escheats $ - Paid County Treasurer -escheats $ - TOTAL COLLECTIONS $ 952,371.57 TOTAL DISBURSEMENTS $ 952,371.57 TOTAL OF ABOVE RECEIPTS PAID TO STATE AND COUNTY $ 962,371.57 ! U(A KERRIBOYD ic' Tax Assessor -Collector aR. C Z.A IS M R CountyJu e M[! NOTICE OF MEETING— 1.0/2.6/)022 14. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: - APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct4 SECONDER: Joel Behrens, Commissioner Pet 3, AYES: Judge Meyer, Commissioner Hall, Lyssq, Behrens,, Reese Page 10 of 11 ft ly O A z a � 3 z m m m r m m m z NIn 0 m a m z z N V O O I 0 M t0 O m m O O �D mz O <-0 m N it pi m z g -1 Z � a < m m n o O 3 � 3 z y n Q z 1 y cn n 1 m Z v n 3 m m m c v § z CA § k ) § § \000 a_§§§ \)kC3 } j v a � s z I z @ ) k 0 2 A q A 2 'n § E., § � ME m; a■ ° — § � no s �) 0 ; ■. k§ M�� ` k; cn z! ; z: s;m cn m= : r m: § ■ �: 0= » �) m P: z) § o. ■; ,,,§ � §) &222■ ; m\ 266E % ■000 �) §2§§ M) z§ § 2 �k § § � --■ M/ M; ■§ ■! m= s , , m� z= z: �■ s § �; z■ z; g| , _/m§ A: 0= c. ) 0 §§ | § §«§m�■ | _ _k\0C3 ; 0,9 0 . / § 2 m N q 2 § § m m n r c O 0 n A O m m n z n c� m m m z 1 0 a r 0 a = N N N v= m m N N N N N N N j m m= O) W t0 N N N N .(OAp�1 N O O C v P= aO O N O O O O m O a a = m -�j= c»Kv-4 v D A D vr(nv cDiT i 3= �cmivmNmc��� xn m= 3>� 0cn x�v mcn m Z= �rnm zzmEX A c-0 H �_ WI mvAmz v O <_ 3 g�{ m< p m z a= m Cl) 0 w D v a cnM mMXi wig O M > m vim 3 m !! m ti rT1 v X i= 0 m v r p a= N D r m yap y = m 0 i= m m X m= ;a z _ °n a€ z 0 C A z z 1 m= o m z z z z z z z z z 00 to Q 3= °m/000000000 O O ii Av 3 0 0 0 O O O O O O z z= m 2 z z z z z z z z z y Z Z Z Z Z Z Z Z Z n z S a 3 = w T ti s m = s oo�^ s v= o 0000000000m PIN IRIS FAN T �= N NNNNNNNNNN T 0 0 m= O 0 0 0 0 0 0 0 0 0 0 T (per N N N O N N N A eu CS 0 0 w= Af N O O O O N O O (WO T �^ C = O J J R FA _ O N T = A A N N N N O N N W N T i m 3 z on m 1 O 0 oc X 9 m z N! m J c IN m m m a r C 0 C 0 0 z O 0 m n m m 2 0 D r nnQ 0 C) D D D D D D D D D D r r r r 0 0 0 O O cccc D s v v v v v z V V 0 0 v 7 o 0 0 :O t0 f0 (O f0 Zs Ll f0 f0 f0 f0 y O z z z z z DO000 7 0 0 0 0 u z z z z z s� O o 0 0 0 0 0 T M fA fA fA EA EA EA 0 0 0 0 0 0 0 a O O a a W 0 Z 3 ai m; 'U: $ a li Mi m: • z Zi 3€ 0i G? m: A 70 i C c v n m C m n O y m Z 2 Y/ C O N W0 N 4 O O N C COO, 0F= o21� K Z N O D C m -4 v z D m D 55 w m N n m a n000z mzzz O 0 0000 o m gc)c>c> 2 z ?z z ? -4 m 0 O Z z w y z 1 w 1 y n a a r r a� a wF»vi Fn �ii� O O O O O O o 0 0 0 W T N N O 0 T T 11� N N 0 0 O O N � v �•a m N 0 Z 0 c N m Z m o Z I �a 0 v m a m Z z so V N �Wm W N A ti N O N p 0o> m � c m m v m D C m R Z mC/)o� Z m z cn 0 m z Z D f0 (p f0 mzzz e 0 OAo opo 9 2 D D D Ai 2?��� m 0 w � w a n r r lolo o 0 0 IfA [N fA � m N A J M d1 J (D Oo O O <O f0 O m z I z a m m z O i m z a z z CAA p a m a m Jz l to to to M m z m rn 0 a r N 0 o o � N Ol m W O m O (T A W N Z m m m m m m m m m m m m m m m Zcp cn co n L L LL LL L Lccccc cnrnrnCl) Cl) tn -100000 n m m m m m m00000esv N mmmmmeya < v v _0 v v m 0 0 0 0 0 m m m m m m vvv-ov x;o AAA m m m m m 00000 Z Z Z Z Z 00000 :O f0 f0 fp (O (O y e zzzzzz 0 0 0 0 0 0 7 A0 A0 0 0 p0 zZ zzzzz w 1 N W (P W W Eq W ER E9 EA EA EA EA EA T o 0 0 0 0 0 0 0 0 T Z sCA N CO T O O O O O O O O O fR fA fA f9 i � a CI 0 fA f _ EAR �T F O O O) N W— w W m 3 m'' z �"' m z 3! m Z! Al H �! ,z°, Z H a; 3; o m c p? m; N m; c z: m C? m m: O o N m c J O O,O #15 NOTICE OF MEETING — 10/26/2022 I...Ina 11R7T ., 6I1111517:Iu11 MMC 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, CommissionerHall, Lyssy, Behrens, Reese Adjourned 10:38 a.m. Page 11 of 11 b N O r M M M C QI ti O O r M O O N M O O O M N N VOi '+ N 69 b9 Vi fA MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---October 28, 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONICBANK PAYMENTS $ 1,226,97tS7 TOTAL TRANSFERS BETWEEN FUNDS' $ 86,W;281' TOTAL NURSING HOME UPL'EXPENSES $ 1,144,46144 V TOTALINTER-GOVERNMENTTRANS,FER5 $ 50,509.94 GRAND TOTAL; DISBURSEMENTS APPROVED October 26,,2022 $ 2,587;956.28 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR --October 26, 2022 PAYABLES AND PAYROLL 10120/2022 Weekly Payables 654,339.84 1012012022 Patient Refunds 2,555.78 10124/2022 Evident -consulting services and monthly subscriptions 36.869.71 10/24/2022 Aqua Beverage Company -water 41.97 1012412022 Texas Bruner and Boiler Services -labor and materials - 16,013.75 10124t2022 Beyer Mechanical4nstall of air handler unit 10,061.82 10124/2022 Elitech Group Inc. -supplies 1,106.00 t012412022 McKesson-34013 Prescription Expense 4,144.87 10/24/2022 Amerisource Bergen-340B Prescription Expense 2,320.43 10/2412022 Payroll Liabilities -Payroll Taxes 123,408.42 1012412022 Payroll 373,600.13 1012412022 Payroll Liabilities for supplemental payroll -Payroll Taxes 387.84 10/24/2022 Supplemental Payroll 1,375.79 Prosperity Electronic Bank Payments 10/17/2022 Credit Card & Lease Fees 240.18 10117-10/21/22 Pay Plus -Patient Claims Processing Fee 511.04 TOTAL=PAYAE;LE4,,PAYROLL AN0 ELECTIRONICrSANK PAYMENTS $ 1 226,971.57- TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 10120/2022 MMC Operating to Ashford-corredion of NH QIPP payment deposited into 5,030.92 MMC Operating 10/20/2022 MMC Operating to SOlera-correction of NH insurance and QIPP payment 5,084.06 deposited into MMC Operating 10/2012022 MMC Operating to Fort bend -correction of NH insurance and QIPP payment 2,214.95 deposited info MMC Operating 1012012022 MMC Operating to Broadmoor-correction of NH QIPP payment deposited into 722.34 MMC Operating 10120/2022 MMC Operating to Crescent -correction of NH QIPP payment deposited into 1,654.16 MMC Operating in error 101202022 MMC Operating to Golden Creek -correction of NH insurance and QIPP 14,904.56 payment deposited into MMC Operating in error 10/20/2022 MMC Operating to Gulf Pointe Plaza-cmredion of NH insurance and QIPP 11.774.65 payment deposited into MMC Operating 10120/2022 MMC Operating to Tuscany Village -correction of NH insurance and QIPP 4,899,98 payment deposited into MMC Operating 1012012022 MMC Operating to Bethany -correction of NH insurance payment deposited into 39,719.67 MMC Operating in error TOTAL TRANSF.EWBETWEEN.FUNDS. $. 86,005.28 ; NURSING HOME UPL EXPENSES 10/24/2022 Nursing Home UPL-Canlex Transfer 322,953.00 1012412022 Nursing Home UPL-Nexion Transfer 103,576.23 10124/2022 Nursing Home UPL-HMG Transfer 108,044.02 10124/2022 Nursing Home UPL-Tuscany Transfer 274,823.53 10/2412022 Nursing Home UPL-HSL Transfer 335,066.66 ,,,TOTAL` NURSING HOME UPIL EXPENSES $ 1044,483.44; INTER -GOVERNMENT TRANSFERS 1012412022 IGT DSH 2O23 Advance 2 Payment to be paid November 02, 2022 50,509.91 TOT AL`,INTER=GOVERNMENT TRANSFERS $ GRAND TOTAL DISBURSEMENTS APPROVED October, 26,,,20221 $ 2 $07,950:10 Page 1 of 16 RECEIVED BY THE COUNTYON MEMORIAL. MEDICAL CENTER pUNTY2AUDITOR 7 0 1jr Q Z�z� AP Open Invoice List 1 t:38., ap_open_Invoice.templale Due Dates Through: I Ill0/2022 CA1+wbli# (W [ M,1TW Class Pay Code A1705 ALIMED INC.7 M Invoice# Comment Tran Dt Inv Dt Due Dt Check D-Pay Gross Discount No -Pay Net RPSVO3904739 ✓ 10/19/20 10/1 MD 10/26/20 958.99 0.00 0.00 958.99 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1705 ALIMED INC. 958,99 0.00 0,00 958,99 1 Vendor# Vendor Name Class Pay Cade I 14028 AMAZON CAPITAL SERVICES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 19JVCDNVJMNF✓ 10/19/2009/20/2010120/20 117.84 0.00 0.00 117.84 yr' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14028 AMAZON CAPITAL SERVICES 117.84 0.00 0.00 117.84 1 Vendor# Vendor Name Class Pay Code 14592 AMERICAN HEART ASSOCIATION INC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 545260 f 10118/2010111/2010/31/2o 5,000.00 0.00 0.00 5,000.00 S22 VICTORIA HW PLEDGE Vendor Totals Number Name Gross Discount No -Pay Net 14592 AMERICAN HEART ASSOCIATION INC 5,000.00 0.00 0.00 5,000.00 Vendor# Vendor Name Class Pay Code A2150 ANNOUNCEMENTS PLUS TOO AGAIN „z W Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 779 ✓ 10117120 09/28/20 10/08/20 18A0 0.00 0.00 /8.00 TJ3012HIES UAfG fvr-Tjt, dtspimjaA tit'IY.mt_ Vendor Totals Number Name Gross Discount No -Pay Net A2150 ANNOUNCEMENTS PLUS TOO AGAIN 18,00 0,00 0,00 18.00 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 2770291 ✓ 10/20/20 10/03/20 11/02/20 3,400.00 0.00 0.00 3,400.00 r.+` LAB STAFFING 01W- 9I Z4 zz-) $,W-lsy Vendor Totals Number Name Gross Discount No -Pay Net A0400 AUREUS RADIOLOGY LLC 3,400.00 0.00 0.00 3,400.00 Vendor#Vendor Name Class Pay Code 12800 AUTHORITYRX t% Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 1549 ✓ 10/18/20 10/05/20 10/06/20 455.00 0.00 0.00 455.00 CLAIMS Vendor Totals Number Name Gross Discount No -Pay Net 12800 AUTHORITYRX 455.D0 0.00 0.00 455.00 Vendor# Vendor Name Class Pay Code 81150 BAXTER HEALTHCARE f W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 76704235 ✓' 10/19/20 10/03/20 10/28/20 278.83 0.00 0100 278.83 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net file:l//C:/Users/ltrevino/epsi/memmed.cpsinet.com/u88125/data 5/trnp_cw5report62936.., 10/20/2022 Page 2 of 16 B1150 BAXTER HEALTHCARE 278.83 0,00 0.00 278.83 Vendor# Vendor Name Class Pay Cede M2485 SAYER HEALTHCARE ✓ M Invoice# Comment Tran Dt Inv Ot Due Dt Check DPay Gross Discount No -Pay Net 6010209129 ✓ 10/19/20 09/30/20 10/19/20 678.40 0.00 0.00 678.40 f SUPPLIES ' Vendor Totals Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCARE 678.40 0.00 0.00 678,40 Vendor# Vendor Name Class Pay Code 61220 BECKMAN COULTER INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 110187636✓ 10117/20 10/04120 10129120 2,786.72 0.00 0.00 2,786.72 SUPPLIES 110203574 1/ 10/17120 10/07/20 11/01/20 249.95 0.00 0.00 J 249.95 r! SUPPLIES 110177530 ✓ 10/20/20 09/30/20 10/25/20 3,874.83 0.00 0.00 3,874.83 ✓ SUPPLIES 110183225 ✓ 10/20/20 10/03/20 10/28/20 2,806.41 0100 0.00 2,806.41 ✓' SUPPLIES 110182686 Jf 10/20/20 10103/2010/28/20 180.96 0.00 0.00 180.96 arm SUPPLIES 7325872 ✓' 10/20/20 10/03/20 10/28/20 6,698.93 0.00 0.00 6,698.93 SUPPLIES 1101837921/ 10/20/20 10/04/20 10/29120 16,178.46 0.00 0.00 16,178.46 ✓+ SUPPLIES 110185789 10/20/20 10/04/20 10/29/20 471.08 0.00 0.00 471.08 5 PPLIES 110185372 10/20/20 10/04/20 10/29/20 6,861.90 0.00 o.00 5,851.90 ✓ 110188610 1OP2012010/05/2010/30/20 154.50 0.00 0.00 154.50 ✓�, SUPPLIES 5464007 10/20/20. 10/05/2010130/20 6,249.42 0.00 0.00 6,249.42 ✓ LEASE / U 0188525 1W20/201010512010/30/20 226,80 0.00 0.00 226.80 r X SUPPLIES 5464324 ✓ 10/20/20 10/13/20 11/07/20 5,016.58 0.00 0.00 5.016.58 r� LEASE Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 50,746,54 0.00 0.00 50,746.54 Ventlor# Vendor Name I Class Pay Code 12324 BLUE CROSS BLUE SHIELD V/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101822 10/20/20 10/18/20 11/01/20 224,036.86 0.00 0.00 224,036.86 v'� PAYROLL DEDUCT INS Vendor Totals Number Name Grass Discount No -Pay Net 12324 BLUE CROSS BLUE SHIELD 224,036.86 0.00 0.00 224.036.86 Vendor# Vendor Name Class Pay Code 13892 BLUE CROSS BLUE SHIELD REFUND Invoice# Comment Tran Dt Inv or Due Or Check D Pay Gross Discount No -Pay Net 100322 10120/20 10/03/20 11103/20 1,587.60 0.00 0.00 J 1,587,60 file:///C:/Users/ttrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 3 of 16 Vendor Total: Number Name Gross Discount No -Pay Net 13892 BLUE CROSS BLUE SHIELD REFUND 1,587,60 0.00 0.00 1.587.60 Ventlor# Vendor Name Class Pay Code B1650 BOSART LOCK & KEY INC ✓, M Invoice# Comment Tran DI Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 125047 ,l' 10/12/2010/0712011106/20 264.90 0.00 0.00 264,90✓/ SUPPLIES Vendor TotalENumber Name Gross Discount No -Pay Net B1650 BOSART LOCK & KEY INC 264.90 0.00 0.00 264.90 Vendor# Vendor Name Class Pay Code 11224 CABLES AND SENSORS /J' Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 137804 ✓ 10l01/20 09/23/2010/23120 303.00 0.00 0.00 303.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11224 CABLES AND SENSORS 303.00 0.00 0.00 303.00 Vendor# Vendor Name Class Pay Code 13264 CERVEY, LLC ✓! Invoice# Comment Tran Dt Inv Dt Due Ol Check D Pay Gross Discount No -Pay Net 18409 ✓ 10/18/20 10/05120 10/30120 1,699.00 0.00 0.00 1,699.00 i LICENSE Vendor TolalE Number Name Gross Discount No -Pay Net 13264 CERVEY, LLC 1,699,00 0.00 0.00 1,699.00 Vendor# Vendor Name Class Pay Code 12768 CHEMAOUA/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 7969201 ✓/ 10/20/20 10/10/20 10/20/20 565A3 0.00 0.00 565.43 ✓� WATER TREATEMENT . Vendor Totals Number Name Gross Discount No -Pay Net 12768 CHEMAOUA 565.43 0.00 0.00 565.43 Vendor# Vendor Name Class Pay Code C1600 CITIZENS MEDICAL CENTER ,/ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 092122 10/1812009/21/2010121/20 80.00 0.00 0.00 80.00 v` BLS RECERT 092222 10/18/20 09/22/20 10/22/20 25.00 0,00 0100 25.00 ✓' 5 BLS CARDS 092922 10/18/20 09/29/20 10/29/20 60.00 0.00 0.00 60.00 12 BLS CARDS Vendor TetalE Number Name Gross Discount No -Pay Net C1600 CITIZENS MEDICAL CENTER 165.00 0.00 0.00 165.00 Vendor# Vendor Name Class Pay Coda C1730 CITY OF PORT LAVACA ,%� W Invoice# Comment Tran Dt Inv Ot Due Dt Check D, Pay Gross Discount No -Pay Net 101422E 10/20120 10/14/20 11/05/20 64.17 0.00 0.00 64.17 V/ WATER 101422A 10/20/20 10/14/2011107/20 28.92 0.00 0.00 28,92 ; WATER 101422C 10120120 1011412D 11/07/20 67.37 0.00 0.00 67.37 WATER 101422 10120120 10114/20 11/07/20 - 6,755.21 0.00 0.00 6,755.21 file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u8g125/data_5/tmp_ew5report62936.., 10/20/2022 Page 4 of 16 WATER , Vendor Total: Number Name Gross Discount No -Pay Net C1730 CITY OF PORT LAVACA 6.915.67 0.00 0.00 6,915,67 Vendor# Vendor Name Class Pay Code 10212 CLINICAL PATHOLOGY LABS v ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 176562022090 �/ 10/20/20 09130/20 10130/20 14,973.75 0.00 0.00 14,973.75 Jl LAB SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 10212 CLINICAL PATHOLOGY LABS 14,973.75 0.00 0.00 14,973.75 Vendor# Vendor Name Class Pay Code C1166 COASTAL OFFICE SOLUTONS f W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net OEOT213241 y 10/19/20 10103/20 10/13120 226.32 0.00 0.00 226.32 SUPPLIES Vendor Totale Number Name Gross Discount No -Pay Net C1166 COASTAL OFFICE SOLUTONS 226,32 0.00 0.00 226.32 Vendor# Vendor Name Class Pay Code 11029 COASTAL REFRIGERATION invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 5114284 10/18/20 10/03/20 10/31/20 447.42 0.00 0.00 447,42 LABOR EVAPORATOR Vendor Total: Number Name Gross Discount No -Pay Net 11029 COASTAL REFRIGERATION 447.42 0.00 0.00 447.42 Vendor# Vendor Name Class Pay Code 13572 COMMUNITY INFUSION SOLUTIONS Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net IC20220316 ✓ 10118/20 03/03120 03113120 9,336.52 0.00 0.00 9,336.52 INFUSION SERV , Vendor Total: Number Name Gross Discount No -Pay Net 13572 COMMUNITY INFUSION SOLUTIONS 9,336.62 0.00 0.00 9,336.52 Vendor# Vendor Name Class Pay Code 14080 CORROHEALTH, INC. Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 890566 ✓/ 10/19/20 09130/20 10130/20 2,124.00 0.00 0.00 2,124.00 f'l SEPT 2022-DIAGNOSIS Vendor Totale Number Name Gross Discount No -Pay Net 14080 CORROHEALTH, INC. 2,124.00 0.00 0.00 2,124.00 Vendor# Vendor Name Class Pay Code 14400 CULINARY CONCESSIONS LLC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net INV00000133 / 10118120 09130/20 10/30/20 33,011.53 0.00 0.00 33,011.53 CONTRACT FEES SEPT 22 Vendor Totals Number Name Gross Discount No -Pay Net 14400 CULINARY CONCESSIONS LLC 33,011.53 0.00 0.00 33,011.53 Vendor# Vendor Name Class Pay Code 14292 DEARBORN LIFE INSURANCE COMPAN „, Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 101322 10/18120 10/13/20 11101120 3,738.33 0.00 0.00 3,733.33 INSURANCE Vendor Total: Number Name Grass Discount No -Pay Net file:///C:(Users/ltrevino/cpsihnemmed.cpsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 5 of 16 14292 DEARBORN LIFE INSURANCE COMPAN 3,733.33 0.00 0.00 3,733.33 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6951470Vr 10/01/2009123/201 Ott 8/20 503.39 0.00 0.00 503.39✓� SUPPLIES 6932352„/ 10/19/20 10111/20 11105120 8.88 0.00 0,00 8.88 SUPPLIES 6969060 ✓/ 1Oil 9/2010/12/2011106120 7.46 0.00 0.00 7,46 ✓� SUPPLIES 6968800 ✓` 10/19/2010/1212D 11/06/20 213.29 0.00 0,00 213.29 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 733.02 0.00 0.00 733.02 Vendor# Vendor Name Class Pay Cade 10789 DISCOVERY MEDICAL NETWORKING Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net MMC101522 10/18/20 10115/20 1 D/16/20 151,997.33 0.00 0.00 151,997.33 ✓' PHYSICIAN SERVICES (t-19� . Vendor Totals Number Name Gross Discount No -Pay Net 10789 DISCOVERY MEDICAL NETWORK INC 151,097.33 0.00 0.00 151,997.33 Vendor# Vendor Name Class Pay Cade 11291 DOWELL PEST CONTROL ,. f Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 12658 ✓ ` 10/18/20 10/12/20 11/05/20 160.00 0.00 0.00 160,00 b,r` PESTCONTROL , Vendor Totals Number Name Gross Discount No -Pay Net 11291 DOWELL PEST CONTROL 160.00 0.00 0.00 160,00 Vendor# Vendor Name Class Pay Code 12044 DRIESSEN WATER INC. (CULLIGAN) Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 09302022 ✓' 10/19/20 09/30/20 10/22/20 510.30 0.00 0.00 510.30 WATER t Vendor Totals Number Name Gross Discount No -Pay Not 12044 DRIESSEN WATER INC. (CULLIGAN) 510.30 0.00 0.00 510,30 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE ,% M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6107237 ,/ 10/01/20 09/02/20 09/27/20 113.83 0.00 0.00 113.83 ✓ SUPPLIES 6528002 10/01/2009/19/2010/14/20 1,462.49 0.00 0.00 1,462.49 s/ SUPPLIES 5946321 ,/ 10119/20 10103/20 10/28(20 236.50 0.00 0.00 236.50 SUPPLIES 6946322 10119/20 10/03120 10/28/20 1,212.00 0.00 0.00 1,212.00 ✓� SUPPLIES 6986195 „i 10/19/20 10/04/21) 10/29/20 - 204,01 0.00 0.00 204.01 ,SUPPLIES 6986196 ✓ 10/19/20 10/04/20 10/29/20 224.92 0.00 0.00 224.92 SUPPLIES 7028075 „, 10/19/20 10/05/20 10130/20 39.58 0.00 0.00 39.58 ✓� file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_ew5report62936.., 10/20/2022 Page 6 of 16 / SUPPLIES 7028076 ✓ 10/19/20 10/05/20 10/30/20 39.58 0.00 0.00 39.58 ✓ v 3 SUPPLIES 708906V 10/19/20 10/06/20 10/31/20 -213.83 0.00 0.00 -213.83 ✓f CREDIT 7069064✓ 10119120 10106120 10131/20 541.07 0.00 0,00 541,07 y` SUPPLIES f 7109708✓ 10/19/20 10107120 11/01/20 93.08 0.00 0.00 93.08 V' , / SUPPLIES 7149941✓ 10/19/20 10110/20 11/04/20 36.46 0.00 OAO 30.46 SUPPLIES 7149942 / 10/19/20 10/10/20 11/04/20 406.01 0.00 0.00 406.01 ✓ SUPPLIES 6654422 ,i` 10/20/20 09/22/20 10/17/20 15.20 0.00 0.00 15.20 ! ,SUPPLIES 6780651 10/20/20 09/27/20 10/22/20 262.40 0.00 0.00 282.40 ✓'F SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 4,693.30 0.00 0.00 4,693.30 Vendor# Vendor Name Class Pay Code 13960 G & S MANAGEMENT GROUP LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 340386213 f 10/18/20 10/10/20 10/20/20 260.55 0.00 0.00 260.55 WASTE / 340386211 10/1812010/10/2010120/20 1,827.89 0.00 0.00 1,827.89 DISPOSAL 340386212✓ 1011B/2010/10/2010120120 373.08 0.00 0.00 373.081/ DISPOSAL Vendor TotalENumber Name Gross Discount No -Pay Net 13960 G & S MANAGEMENT GROUP LLC 2,461.52 0.00 0.00 2,461.52 Vendor# Vendor Name Class Pay Code G1001 GETINGE USA Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6992012951 ✓i 10/04/20 09/21/20 10104/20 47.98 0.00 0.00 47.98 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net G1001 GETINGEUSA 47,98 0.00 0.00 47.98 Vendor* Vendor Name Class Pay Code 13148 GRACE FLOORING AND GLASS ✓ Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 1579 ,/ 10/18/20 10/11/20 10/31/20 103.26 0.00 0.00 103.25 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 13148 GRACE FLOORING AND GLASS 103.25 0.00 0.00 103.25 Vendor# Vendor Name Class Pay Code / W1300 GRAINGER ✓ M Invoice# Comment Tran Dt Inv Dt Due of Check D Pay Gross Discount No -Pay Net 94666BB232/ 10/19/20 10/04/20 10/29/20 65.00 0.00 0.00 65.00✓ SUPPLIES 9467081197 ✓'� 10/19/20 10/04/20 10/29/20 125.40 0.00 0.00 125.40 J` SUPPLIES file:///C:/Users/ltrevinolepsi/memmed.cpsinet.com/u88125/data_5/tmp_ew5report62936.., 10/20/2022 Page 7 of 16 9468732541 ,/- 10/19120 10/05/20 10/30120 286.98 0.00 0.00 286.98 SUPPLIES 9468242186 ✓f 10/19/20 10/05120 10/30/20 -70.52 0.00 0.00 -70.52 � CREDIT 9468242178 i 10/19/20 10/05/2010/30/20 -70.52 0.00 0100 -70.52 SUPPLIES 9468597704 10119/20 10/06/20101311PO -70.52 0.00 0.00 -70.52 „% ,! CREDIT 947073893P 10119120 10/07120 11/01/20 126.98 0.00 0.00 126.98 w`1 SUPPLIES , Vendor Totale Number Name Gross Discount No -Pay Net W1300 GRAINGER 392.80 0.00 0.00 392.80 VendoNt Vendor Name Class Pay Cade G1210 GULF COAST PAPER COMPANY �:' M Invoice# Comment Tran Ot Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 2288302 v,�'10/01/2009/1612010/16120 158.28 0.00 a00 158.28 ✓.-r SUPPLIES 2290025 ,% 10/01/20 09/20/20 10/20/20 934.18 0.00 0.00 934.18 ✓� SUPPLIES 2293408 1% 10/01/20 09/27/20 10/27/20 610.06 0.00 0.00 610.96 ✓ SUPPLIES 2275849A ,/ 10/17/20 08123120 09/22/20 66.13 0.00 0.00 66.13 ✓l, i 2278903 10/17/20 08/29/20 09/28/20 26478 0-00 0.00 264.78 SUPPLIES , Vendor Total¢ Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 2,034.33 0.00 0.00 2,034.33 Vendor# Vendor Name Class • Pay Cade H/100 HAYES ELECTRIC SERVICE ✓ W Invoice# q Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net A222091901 v'/ 10/18/20 09/19/20 09/29/20 180.00 0.00 0.00 180.00 /1 LABOR-felrcr-I.yjG WV-- ✓, Ventlor Totals Number Name Gross Discount No -Pay Net 1­11100 HAYES ELECTRIC SERVICE 180.00 0.00 0.00 180.00 Ventlor# Vendor Name Class Pay Code 10804 HEALTHCARE CODING & CONSULTING,/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 13023./ 10/18/20 09/30/20 10130/20 450.50 0.00 0.00 450,50 CHARTS Vendor Totale Number Name Grass Discount No -Pay Net 10804 HEALTHCARE CODING & CONSULTING 450.50 0.00 0.00 450.50 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES / Invoice# Comment Tram Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 100670341 10110/20 10101/20 10/01120 89,87 0.00 0.00 89.87 LATE FEE ` 100670338,/ 10/19/20 10101/20 10/01/20 245.98 0.00 0.00 245.98 ✓'! LATE FEE 100670340 ,/ 10119/20 10/01/20 10/01/20 372.39 0.00 0.00 372.39 „•r LATE FEE 100670339 ✓ 10/19/2010/0112010/01/20 357.71 0.00 0.00 357.71 s' file:///C:/Users/ltrevino/cpsi/menimed.cpsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 8 of 16 LATE FEE 100673875,/ 10/19120 10/07/20 11/01/20 1,797.44 0.00 0.00 1,797.44 LEASE 100673874 / 10/19/20 10/07/20 11/01/20 7,447.86 0.00 0.00 7,447.86 r' LEASE 100673873 10119120 10/07120 11101/20 7,154.15 0.00 0.00 7,154.15 LEASE .I Vendor Totale Number Name Gross Discount No -Pay Net ` 11652 HEALTHCARE FINANCIAL SERVICES 17,465.40 0.00 0.00 17,465.40 Vendor# Vendor Name Class Pay Code H0416 HOLOGIC INC i/ Invdce# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay 10326460 10/19/20 10103/20 10/19120 472.50 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount H0416 HOLOGIC INC 472,50 0.00 Vendor# Vendor Name Class Pay Code 10530 HUMANA HEALTHCARE PLANS J Involce# Comment Tran or Inv of Due Dt Check D Pay Gross Discount 092522 10/20/20 09/25/20 10/25/20 65.00 0.00 REFUND BRICE CAUGHRON Vendor Totals Number Name Gross Discount 10530 HUMANA HEALTH CARE PLANS 65.00 0.00 Vendor# Vendor Name Class Pay Code 10922 HUNTER PHARMACY SERVICES ✓ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount 5108 f/ 10/18/20 09/30/2010/20120 14,828.67 0,00 PAYROLL Vendor Total: Number Name Gross Discount 10922 HUNTER PHARMACY SERVICES 14,828.67 0.00 Vendor# Vendor Name Class Pay Code 11285 ITA RESOURCES INC „% Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount MMC102022 ,/ 10/4/20 10118/20 11/07/20 26,593.30 0,00 PROFSERV Vendor Total; Number Name Grass Discount 11285 ITA RESOURCES INC 26,593.36 0.00 Vendor# Vendor Name Class Pay Code 14580 Involce# Comment Tran Ot Inv Ot Due Ot Check D, Pay Gross Discount 092922 10120120. 09/29/20 10/29/20 63.00 0.00 REFUND Vendor Totale Number Name Gross 14580 63.00 Vendor# Vendor Name Class Pay Code L0700 LASCORP OF AMERICA HOLDINGS ,% M Invoice# gomment Tran Dt Inv Dt Due Dt Cheek D Pay Gross 74412363 v 10/20/901010112G 10/20/20 26.29 AB SERVICES 74406846 10120120 10/01120 10126120 772.75 LAB SERVICES Net 472.50 No -Pay Net 0.00 472.60 No -Pay Net 0.00 65.00 No -Pay Net 0.00 65,00 No -Pay Net 0.00 14,828.67 •' No -Pay Net 0.00 14,828.67 No -Pay Net 0.00 26.593.36 Vi No -Pay Net 0.00 26.593.36 No -Pay Net 0.00 63.00 Discount No -Pay Net 0.00 0.00 63.00 Discount No -Pay Net 0.00 0.00 26.29 0.00 0.00 772,75 1 file://!C:/Userslltrevino/epsi/memmed.cpsinet.conl/u88125/data 5/tmp_cw5report62936... 10/20/2022 Page 9 of 16 Vendor Total: Number Name Gross Discount No -Pay Net L0700 LABCORP OF AMERICA HOLDINGS 799.04 0.00 0.00 799.04 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC f M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2228933688 ,i "" 10/01/20 09/15/20 10/10120 292,91 0.00 0.00 292.91 f ' SUPPLIES 2229843105 f 10101/2009/22/2010/17/20. 514.37 0.00 0.00 514.37 f SUPPLIES 2230484030.1/' 10/01/2009/27/2010/22/20. 2,058.30 0.00 0.00 2,058.30 �= SUPPLIES 2231632956f 10/19/20 10/04/20 10/29120 1,514.60 0.00 0.00 1,514.66 ' SUPPLIES 2231748748 v' 10/19/2010104120 10/29/20 53.30 0.00 0.00 5$.30 ' SUPPLIES 2231897630 ,,' 10/19/20 10/05/20 10/30/20 476.24 0.00 0.00 476.24 rr'` SUPPLIES 2232033017 f' 10/19/20 10/06120 10/31/20 22.20 0,00 0,00 22.20 "` ✓ SUPPLIES 2232860977 ✓,% 10/19/20 10/10/20 11/04/20 70.48 0.00 0.00 70.48 SUPPLIES 2232967390 f 10/19/20 10/11/20 11/05/20 31,30 0.00 0.00 31.30 4 r' SUPPLIES 2232967389 ✓/ 10/19/20 10111121) W05/20 0.49 0.00 0.00 0.49 ,,r SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 5,034.25 0.00 0.00 $,03425 Vendor# Vendor Name Class Pay Code M2621 MMC AUXILIARY GIFT SHOP r,r'' w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 101322 10/18/2010/13/2010125/20 320.77 0.00 0100 320.77 PAYROLL DEDUCT , Vendor Totals Number Name Gross Discount No -Pay Net M2621 MIMIC AUXILIARY GIFT SHOP 320.77 0.00 0.00 32037 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC ✓r Involve# Comment Tran Dt Inv Dl Due Dt Check D Pay Gross Discount No -Pay Net 8752251 /' 10118/2010/11/2010/21120 2.34 0.00 0.00 2.34 INVENTORY 8752252f 10/18/20 10/11120 10/21/20 3.97 0.00 0.00 3.97 INVENTORY 8753840 f� 10/18/20 10/11/20 10/21/20 27.11 0.00 0.00 27.11 INVENTORY 8750555 f 10/18/20 10/11/20 10/21/20 - 193.49 0.00 0.00 193,49 ''� INVENTORY 8753841�� 10118/20 10/11/20 10/21120 1,638.43 0.00 0.00 1,638.43,/r INVENTORY ✓ 8750556 10/18/20 10/11/20 10/21/20 0.39 0.00 0.00 0.39 INVENTORY 8751721 v� 10118120 10/11/20 10121/20 330.03 0.00 0.00 330.03 ✓.. INVENTORY t• file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/tt88125/data_5/tmD-cw5report62936... 10/20/2022 Page 10 of 16 CM73332 v / 10/18120. 10/12/20 10/22/20 -94.09 0.00 0.00 -94.09 r CREDIT 8758100 0% 1011812010/i212010122/20 272.56 0.00 0.00 272.56•_` ,INVENTORY B755742 10/18/20 10/12/20 10/22/20 $68.02 0.00 0.00 868.02 INVENTORY 8758101 10/18/20 10/12/20 10/22/20 499.09 0.00 0.00 499.09�, INVENTORY 8760628 10/1812010/13/9010/23/20 56.97 0.00 Mo 56.97 „! INVENTORY 8762614 of 10/18/20 10/13/20 10/23/20 78.36 0.00 0.00 78.36 INVENTORY CM73598 f` 10118120 10/13120 10/23/20 -204.58 0.00 0.00 -204.58 w` CREDIT CM73597 / 10118120 10/13/20 10123/20 -236.91 0.00 0.00 -236.91 CREDIT 8762613 w,% 10118120 10/13120 10/23/20 26.95 0.00 0.00 26.95 ✓`. INVENTORY 6760629 YF. 10/18/20 10/13/20 10/23/20 396.62 0.00 0.00 396.62 INVENTORY 7639416E 1/ 10/1912012/1212012/22/20 10.00 0,00 U0 10.00 INVENTORY CM98621y 10/1912012/30/2001109/20 60.23 0.00 0.00 60.23 INVENTORY CM51999 v'r 10/19/20 07/11/20 07/21/20 -419.56 0.01) 0.00 -419.56 CREDIT CM51998 �' 10l19l2007/11/2007/21/20 -3,106.27 O.OD 0.00 -3,106.27 CREDIT 8556441 A �/ 10/19/20 08/18/20 08/28/20 -200.00 0.00 0.00 -200.00 CREDIT 8564325,r/ 10119/2008/2112008131/20 18D.95 0.00 0.00 180.95 INVENTORY 8569723,'/ 10/19/2008/22/2009101/20 2,693.81 0.00 0.00 2,593.81 INVENTORY 8569722 ✓- 10/19/20 08/22/20 09/01/20 818.87 0.00 0.00 818.87 / ., INVENTORY 9747 1/ 10/19/20 10/13/20 10/23/20 -26,16 0.00 0.00 -26.16 ..� CREDIT 9725,,/ 10/19120 10/13/20 10/23/20 -0.47 0.00 0.00 .0.47 CREDIT 9673'` 10/19/20 10/13/20 10/23/20 -407.93 0.00 0.00 -407.93,/ CREIDT 8769648V 10/19/20 10/16/20 10/26/20 920.75 0.00 0.00 920.75v' ' ,INVENTORY 6769847 / 10/19/20 10116120 10/26/20 670.86 0.00 0.00 670.86 .INVENTORY 8767734,// 10/19120 10/16120 10126120 74.69 0.00 0.00 74.69 INVENTORY 87705461 10/19/20 10/17/20 10/27/20 733.27 0.00 0.00 733.27uj .INVENTORY 8772830 10/19/20 10/17/20 10/27/20 619.83 0.00 0.00 619.831Z tile:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 11 of 16 INVENTORY 8772831 ,/ 10119/2010/17/2010/27/20 5,281.50 0.00 0.00 , 5,281.5q,,% INVENTORY 8772709 ,�"� 10/19/20 10/17/20 10/27/20 11.19 0.00 0.00 11.19 INVENTORY 0693 10/19/20 10118/20 10128/20 -815.48 0.00 0.00 •815,46 /CREDIT 8778995 ,/ 10/19/20 10118/2010128/20 4.31 0.00 0.00 ± 4.31' .7' INVENTORY 8775597 ,i' 10/19/20 10/18/20 10128/20 4,249.17 0.00 0.00 � 4,249.1-(- INVENTORY ° 0811 r% 10/19/20 10/18/2010/28/20 -25.40 0100 0,00 -25.40 yam' :CREDIT r r , 8776098 ,;' 10/19/20 10/18(20 10/28l20 122.56 0.00 0.00 i 122.56 INVENTORY 8776095 10/19/20 10/18/20 10/28/20 44.39 0.00 0.00 .44.39 � INVENTORY 8778996 ✓ 10/19/20 10/18/20 10/28/20 211.82 0.00 0.00 211.82 INVENTORY B778529 f 10/19/20 1011812010128120 24.61 O.OD 0.00 24.61 INVENTORY , Vendor Totals Number Name Gross Discount Na-Pay Net 10536 MORRIS & DICKSON CO, LLC 15,490.29 0.00 0.00 15,490.29 Vendor#Vendor Name Class Pay Code M4250 MORTAN INC .� M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 282344 ✓ 10/19/2010/11/2010119/20 333.30 0.00 0.00 333.30 SUPPLIES I , Vendor Total: Number Name Gross Discount No -Pay Net M4250 MORTAN INC 333.30 0.00 0.00 333.30 Vendor# Vendor Name Class Pay Code M2659 MXR IMAGING, INC r.%` M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8800952070 ✓/ 10/19/20 10/03/20 11/02l20 402.85 0.00 0.00 402.85 ✓'� SUPPLIES 8800952069,// 10/19/2010/03/2011/02/20 205.17 0.00 0.00 205.17,,' S PPLIES 8800953361 10/19/20 10106/20 11/05/20 215.17 0.00 0.00 215.17 ./ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay, Net M2659 MXR IMAGING, INC 823.19 0.00 0.00 823.19 Vendor# Vendor Name , Class Pay Code 13624 NEXION HEALTH AT NAVASOTA INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net TELEMED20221002 / 10118/2010/06/2011/01/20 1,000.00 0.00 0.00 1,000.00 TELEMED REIMBURSEMENT Vendor Totals Number Name Gross Discount No -Pay Net 13624 NEXION HEALTH AT NAVASOTA INC 1,000.00 0.00 0.03 1 1,000.00 Vendor# Vendor Name / Class Pay Code 01500 OLYMPUS AMERICA INC r,! M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net file:///C:/Users/ltrevino(cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 12 of 16 33354605 ✓ 10/19/2010107/20. 11/01/20 1,125.00 0.00 0.00 # 1,125.00 V . CONTRACNT 33356236 10/19/2010/10/2011/04/20 114.66 0.00 0,00 114.66 SUPPLIES C,,. Vendor Totals Number Name Gross Discount No -Pay Nei 01500 OLYMPUS AMERICA INC 1,239.66 0.00 0.00 1,239.66 Ventlor# Vendor Name Class Pay Code 01416 ORTHO CLINICAL DIAGNOSTICS ..' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Nei 1852628810 / 10/19120. 10/05/2011/04120 283.61 0100 0.00 283.6t SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 01416 ORTHO CLINICAL DIAGNOSTICS 283.61 0.00 0.00 283.61 Vendor# Vendor Name Class Pay Code 10162 PARTSSOURCE, LLC Nr" Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 04523343 10/19/20 09/29/20 10/29/20 267.14 0.00 0.00 267,14 4/r Y fi SUPPLIES 04529681 10/19/2010105/20 11/04/20 733.65 0.00 0.00 733.85 �% SUPPLIES 04529684 % 10/19/20 10105/20 11104/20 199.42 0.00 0.00 199.42 ..•'� SUPPLIES 0133587 10/19/20 10/07/20 11/06/20 222.21 0.00 0.00 222.27 SUPPLIES 04535656 ,rt 10/19/20 10/10/20 11/09/20 84.42 0.00 0.00 84.42 �. SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10152 PARTSSOURCE, LLC 1,507.04 0.00 0.00 1,507.04 Ventlor# Vendor Name Class Pay Code P1800 PITNEY BOWES INC f W Invoice# Commentv Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 1021620164 10/18/20 09/26/20 10/26/20 207.00 0.00 0.00 207.00 POSTAGE Vendor Totals Number Name Gross Discount No -Pay Net P1800 PITNEY BOWES INC 207.00 0.00 0.00 207.00 Vendor# Vendor Name Class Pay Code P2100 PORT LAVACA WAVE W Invoice# Comment Tran Dt Inv DI Due DI Check DPay Gross Discount No -Pay Net 093022 10/18/20 09/30/20 10/25/20 700.00 0.00 0.00 700.00V ADVERTISING Vendor Totals Number Name Gross Discount No -Pay Net P2100 PORT LAVACA WAVE 700.00 0.00 0.00 700.00 Vendor# Vendor Name Class Pay Code 12480 PRO ENERGY PARTNERS LP „✓' Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 22090600 y� 10118120 09130/20 10115/20 1,545.31 0.00 0.00 1,545.31 yr GAS Vendor Totals Number Name Gross Discount No -Pay Net 12480 PRO ENERGY PARTNERS LP 1,545.31 0.00 0.00 1,545.31 Vendor# Vendor Name Class Pay Code 14060 RADCOM ASSOCIATES, LLC // file:/I/C:IUsers/ltrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report62936... 10/20/2022 Page 13 of 16 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross INV000908 V/ 10/18/20 07/29/20 08/28/20 900.00 MEDICAL PHYSICS Vendor Totals Number Name Gross 14060 RADCOM ASSOCIATES, LLC 900.00 Vendor# Vendor Name Class Pay Cade 11080 RADSOURCE Invoice# Comment Tran Of Inv Dt Due Dt Check D Pay Gross SC32091122 10/18/2010/12/20 it/06/20 1,791.67 V/ SERV AGREEMENT SC32691122 1>` 10/18/20 10116120 11/10/20 1.708.33 SERV AGREEMENT Vendor Total:Number Name Gross 1108D RADSOURCE 3.500.00 Vendor# Vendor Name Class Pay Cade 13272 RAPID -AIR llr pid polk-±inra V,/ Invoice# Comment Tran Of Inv Of Due Dt Check DPay Gross 15429 10/t8/2010/1212010/22120 53.00 V, BUSINESS CARDS Vendor Totals Number Name Gross 13272 RAPIDAIR 53,00 Vendor# Vendor Name Class Pay Code 10625 SARA RUBIO ,/ Discount No -Pay Net 0.00 0.00 000.00V / Discount No -Pay Net 0.00 0.00 900.00 Discount No -Pay 0.00 0.00 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Invoice# Comment Tran Dt Inv Dt Due Of Check D Pay Gross Discount 101422 10/18120 10114/20 10125/20 68.00 0.00 REIMBURSEMENT-1(6vzi �oiltt,A C4,ALL J I0112-- amrd '114 Vendor Totals Number Name Gross Discount 10625 SARA RUBIO 6B.00 0.00 Vender# Vendor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES ./ Invoice# Comment Tran Dt Inv Of Due Dt Check D Pay Gross 56382200060184 f 10118(20 09/29120 10/19/20 1,333,33 RENTAL Vendor Totals Number Name Gross 10936 SIEMENS FINANCIAL SERVICES 1,333.33 Vendor# Vendor Name Class Pay Code S2001 SIEMENS MEDICAL SOLUTIONS INC f' M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 116267158 V! 10/18120 09/16/20 10111/20 2,193.83 CONTRACT Vendor Totals Number Name Gross S2001 SIEMENS MEDICAL SOLUTIONS INC 2,193.83 Vendor# Vendor Name Class Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE CENT', Invoice# Comment Tran Of Inv Dt Due Of Check D Pay Gross 107025077 10120120 10/15120 11/09/20 3,081.00 SUPPLIES CM8006 V!` 10/20/20 10/15/20 11/09/20 -1,659.00 No -Pay 0.00 No -Pay, 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 0.00 0.00 a Net 1,791.67 V 1,708,33 Net 31500.00 Net $3.00 Net 53.00 Net Net 68.00 Net 1,333.33 J Net 1,333.33 Net 2,193,83 M,/ Net 2,193.83 Net 3,081.00 ✓/ -1,659.00 CREDIT Vendor Totals Number Name Gross Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 1,422.00 0.00 0.00 '1,422,00 file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report62936... 10/20/2022 Page 14 of 16 Vendor# Vendor Name Class Pay Code t 10094 ST DAVIDS HEALTHCARE / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMCPU0227 „% 10/20120 10120120 11/01/20 420.00 0.00 0,00 420.00 JULY 22 CONNECTIVITY FEE MMCPL20228 10/20120 10/20/20 11/01120 520.00 0.00 0.00 520,00 AUG 22 CONNECTIVITY FEE Vendor Totals Number Name Gross Discount No -Pay Net 10094 STDAVIDS HEALTHCARE 940.00 0.00 0.00 940.00 Vendor# Vendor Name Class Pay Code 11672 STANLEY ACCESS TECH LLC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0906666103 / 10/18/20 0912PJ20 10/22/20 1,731.42 0.00 0.00 1.731.42 f LABOR/MATERIAL � , Vendor Totals Number Name Gross Discount No -Pay Net 11672 STANLEY ACCESS TECH LLC 1,731.42 0.00 0.00 1.731.42 Vendor# Vendor Name , Class Pay Code 11136 SUSAN DOUGLASS, MSN, RN, CEN I/ I Invoice# Comment Tran Dt Inv Dt Due of Check D Pay Gross Discount NaPay Net 101922 10119120 10/19120 11101/20 425.00 0.00 0.00 425.00 1 TRAUMA NURSING COURSE- Gquiy'd twits Vendor Totals Number Name 0W14 "PunS'y" Gross Discount No -Pay Net 11136 SUSAN DOUGLASS, MSN, RN, DEN 425.00 0.00 0.00 425.00 Vendor# Vendor Name Class Pay Code T2204 TEXAS MUTUAL INSURANCE CO w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Not 1004052493 10/18/201010S/2010/25/20 6,805.00 0.00 0.00 6.665.00 ,f PAYROLL DEDUCT t411-Ieiel 171) 1004031115 10/19/20 10/10/20 10/30/20 6,865.00 0.00 0.00 6,865.00, INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net T2204 TEXAS MUTUAL INSURANCE CO 13,730.00 0.00 0.00 13,730.00 Vendor# Vendor Name Class Pay Code 11908 TMS SOUTH /' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV61139 f 10/17/20 10/06/20 11/05/20 102.76 0.00 0.00 102.76 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net 11908 TMS SOUTH 102.76 0.00 0.00 102.76 Ventlor#Vendor Name Class Pay Code 14372 TRIAGE, LLC f Invoice# Comment Tran Dt Inv Dt Due Of Check 0 Pay Gross Discount No -Pay Net INV1796602535 // 10/18120 10/07/20 11106/20 3;888.0D 0.00 0100 3,888.00 RADIOLOGY STAFFING Vendor Totals Number Name Gross Discount Na-Pay Net 14372 TRIAGE, LLC 3,888.00 0.00 0.00 3,888.00 Vendor# Vendor Name Class Pay Code 13616 TRIOSE, INC Ij Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net TRI134753 10/1912U 10/13/20 10/28/20 112.23 0.00 0.00 112.23 L FREIGHT file:///C:Nsers/ltrevino/epsi/memmed.cpsinet.comlu88125/data 5/tmp_ew5report62936... 10/20/2022 Page 15 of 16 Vendor Totals Number Name Grass Discount No -Pay Net 13516 TRIOSE, INC 112.23 0100 OAO 112.23 1 Vendor# Vendor Name Class Pay Code 11001 ULINE ,/ Invoice# pomment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 154695241 v/ 10/1912010/04/2011/03/20 63.00 0.00 0.00 63.00 ✓�F SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11001 ULINE 63.00 0.00 0.00 83.00 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC / Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 10/18/20 10/10/20 11/04/20 a4004O5900 v'1 61.30 0.00 0.00 61.30 ✓' LAUNDRY 8400405899 Vf 10/18/20 10/10/20 11/04/20 48.15 0.00 0.00 46,15 LA LAUNDRY 8400405921 , 1 10/18/20 10/10120 11/04/20 2,432.99 0100 0.00 2,432.99 f/ LAUNDRY 8400406257 4ri 10/1812010/13/2011/07/20 114.02 0.00 0.00 114.02 LAUNDRY 8400406217 �/ 10/18/20 10113/20 11/07120 233.96 0.00 0100 233.96 LAUNDRY Vendor Totals Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 2,890.42 0.00 0.00 2,890A2 Vendor# Vendor Name Class Pay Code U1056 UNIFORM ADVANTAGE W �' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net j SIV12611250 / 10114/20 07/26/20 11105/20 245.90 0.00 0.00 245.90 UNIFORM Vendor Totals Number Name Gross Discount No -Pay Net U1056 UNIFORM ADVANTAGE 245.90 0.00 0.00 245.90 Vendor# Vendor Name Class Pay Code 11280 VICTORIA ADVOCATE V . Invoice# Comment Tran Ot Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 0252335 %" 10/18/20 05/31 /20 06/30/20 48.50 0.00 0.00 48.50 NEWSPAPER 0256719 ,f 10/18/20 06/20/20 07/30/20 46.60 0,00 0.00 46.60 �. NEWSPAPER 0260570 •,!'� 10/18/20 08/01/20 09/01/20 50.00 0.00 0.00 50.00 •,,✓ NEWS PAPER 0268474 ij 10/18/20 08131/20 09130120 36.10 0.00 0.00 36.10 NEWS PAPER 0272344 10/18/20 10/01/20 11/01/20 27.10 0.00 0.00 27.10 �/ NEWSPAPER Vendor Totals Number Name Gross Discount No -Pay Net 11280 VICTORIA ADVOCATE 208.30 0.00 0.00 208.30 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC J Invoice# Comment Tran Dt Inv Ot Due Ot Check D Pay Gross Discount No -Pay Net 9111227001 10/19/2010/1112011105/20 2,478.00 0.00 0.00 2.478.00 ✓/ SUPPLIES file:///C:lUsers/ltrevino/cpsi/memmed.opsinet.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 Page 16 of 16 Vendor Totals Number Name Gross Discount No -Pay 11110 WERFEN USA LLC 2,478.00 0.00 0.00 Vendor# Vendor Name Class Pay Code 10556 WOUND CARE SPECIALISTS Invoice# Comment Tran'6t Inv Dt Due Dt Check D Pay Gross Discount No -Pay WSC00005528 10118l2010101/2010/30/20 4,475.00 0.00 0.00 WOUND CARE SERV Vendor Totals Number Name Gross Discount No -Pay 10556 WOUND CARE SPECIALISTS 4,475.00 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 654,339.84 0.00 0.00 PROVE OM OCT 26 2022 BY COUININ AUDITOR CALHOUN COUNTY, TEXAS Net 2,478.00 Net 4,475.00 Net 4,475.00 Net 654,339.84 file:/!/C:/Users/ltrevino/epsi/memmed.cpsinct.com/u88125/data_5/tmp_cw5report62936... 10/20/2022 RUN 10/20/22 MEMORIAL MEDICAL CENTER PAGE 1 �DATE:� EDIT LIST FOR PATIENT REFUNDS ARID=0001 APCDEDIT C&&EgWnBYTHE AUDI7'OA ON PATT 2� n �n„ E PAY PAT NUM YE MEWE DATE AMOUNNT CODE TYPE DESCRIPTION CL NMI --------------------------- .../.,_._.____._______.......... C ........ ._..____r___________.. ------------------------ ------------- / 102022 459.98✓ 3 REFUND FOR 102022 82.60✓ 2 REFUND FOR . 102022 547.80 ✓' 2 REFUND FOR 102022 95.89 2 REFUND FOR 102022 189.41 % 2 REFUND FOR 102022 167.88 / 2 REFUND FOR 102022 543.91,/ 2 REFUND FOR :✓ 102022 103.00 3 REFUND FOR 102022 347.10/� 2 REFUND FOR / ________c_______________—_____________._______-___-____-___________-_______-___•_---------____.._________________.____...._;....... 102022 18.71 ,% 2 REFUND FOR ARID=0001 TOTAL 2555.78 ............ _-------------------- _----------------------------------------------------------------------- ....... .------------------- ry`. TOTAL 2555.78 ! APPROVE —DO 9 OCT 2 0 2022 BY COUNTY AUDITOR CALHOUN COUNiV,T'EYAS r 1 e RECEIVED BY THE COUNTYAUDRORRON OCT z 4 202,2 MEMORIAL MEDICAL CENTER CALHOU p10C/2n4�/2�022 POUNM TEXAS AP Open Invoice List 0 i Dates Through: ap_open_involce.template Vendor# Vendor Name Class Pay Code C2510 EVIDENT M Invoice# Com0lent Tran Dt Inv Dt Due 01 Cheek D Pay Gross Discount No -Pay A221005137B ✓ 10/2412010/05/2010/30/20 17.478.00 0.00 0.00 MID HLY SUBSCRIP T2210101378 10124/2010/10/2010110120 19,391.71 0.00 0.00 CONSULTING SERV Vendor Total< -Number Name Gross Discount No -Pay C2510 EVIDENT 36,869.71 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 36,869.71 0.00 0.00 APPROM ON OCT 24 2022 ElYCOUNTYAUDROR CALHOUN COUNTY, TEXAS Page 1 of 1 Net Is / 17,478.00 V 19,391.71 Net 36.869.71 i Net 36.869.71 , file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5repoit59232,., 10/24/2022 RECEIVED BY THE COUNTY AUDITOR ON OCT 2 4 2022 CALHOUN COUNTY, TEXAS 10/24/2022 1 V22 MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Vendor# Vendor Name Class Pay Code A2218 AQUA BEVERAGE COMPANY M Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross 226523 / 101241200913012010125/20 41-97 WATER Vendor Total; Number Name Gross A2218 AQUA BEVERAGE COMPANY 41.97 Report Summary Grand Totals: Gross Discount 41.97 0.00 Page I of I 0 ap_open_Invoice.template Discount No -Pay Net 0.00 0.00 41.97 Discount No -Pay Nei 0.00 0.00 41.97 1 1 No -Pay Net ` 0.00 41.97 ti le:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report34487... 10/24/2022 RECEIVED BY THE Page I of I COUNTY AUDIFFOR ON OCT 2 4 2022 10/24/2022 MEMORIAL MEDICAL CENTER 0 CALHOUN Pg1UNTY, TEXAS AP Open Invoice List ap_epen_invoice.template Dates Through. Vendor# Vendor Name Pay Code /Class 12704 TEXAS BURNER & BOILER SERVICES ✓ Invoice# , Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 223109V 10/24/20 10/21/20 10/24/20 16,013.75 0.00 LABOR ]MATERIALS Vendor Total: Number Name Gross Discount 12704 TEXAS BURNER & BOILER SERVICES 16.013.75 0.00 Report Summary Grand Totals: Gross Discount No -Pay 16,013.75 0.00 0.00 Appnovuo ION OCT 2 4 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS l No -Pay Net t 0.00 16,013.75 ✓' No -Pay Net �I 0.00 16,013.75 t Net 16,013.75 fi le:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88 125/data_5/tmp_cw5report8I448... 10/24/2022 RECEIVEV8 V THE COUINT, Y1A'18O1Tb ON OCT 2 4 2022 10/24/2022 MEMORIAL MEDICAL CENTER CAL"WN_Ty ...w8 AP Open Invoice List Dates Through: Vendor# Vendor Name Class Pay Code 13972 BEYER MECHANICAL Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross 223950000011746 10/24/20 10/21/20 10/24/20 10.061.82 HALF DOWN AIR HANDLER Vendor Totals Number Name Gross 13972 BEYER MECHANICAL 10.061.82 Report Summary Grand Totals: Gross Discount 10,061.82 0.00 OCT 24 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEAS Page I of 1 0 ap_open tnvoice.template Discount No -Pay #y�, Net 0.00 0.00 '10,061.82 ""rRff Discount No -Pay Net li 0.00 0.00 10,061.82 ' No -Pay s Net 0.00 10,061.82 file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88l 25/data_5/tmp_cw5report59473... 10/24/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON OCT 2 4 z02z MEMORIAL MEDICAL CENTER 10/24/2022 0 d:ALNpqINrjpUNTY,TE%AS AP Open Invoice List Oates Through: ap_open invoice.template Vendor# Vendor Name Class Pay Code W1167 ELITECH GROUP INC (WESCOR) W i Invoice# / Comment Tian Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 790885 ✓ 10124120 07113/20 08113/20 286,10 0.00 0.00 286,10 W/f / V SUPPLIES / 791041 10/24120 07114/20 08114120 286.10 0,00 0.00 286.10 ,{ SUPPLIES 796782 .f 1 0/24120 09/02120 10124/20 286.10 0.00 0.00 286.10 v/ //'SUPPLIES 7972071/ 10/24/20 09/08/20 10108/20 247.70 0.00 0.00 247.70 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net W1167 ELITECH GROUP INC(WESCOR) 1,106.00 0.00 0.00 1,106.00 Report Summary Grand Totals: Gross Discount No -Pay Net /1106.00 0.00 0.00 1.106.00 file:/1lC:/Users/ltrc%,inolcpsilmemnied.cpsinet.cons!u88125%data_51tmp_c%N,5report80099.., 10/24/2022 MSKESSON STATEMENT As ol: 1012112022 Page: 002 To made prefer create to your account, c olamt arm .1. thls cwnaam: aoaa muh No your emeence DC: 6115 As of: 10/21/2022 Page: OU2 MEMORIAL MEDICAL CENTEP AMT DUE fnm VIA ACH DUST Territory: Man to: Comp: 8000 AP 6lalement faror information only VIA DEBIT ANT DUE for 615 N VIPGINIA STREET Customer. 832538 inform Statement for information only my MW LAVACA TX 77979 Date: 10/22/2022 Cum: 632536 PLEASE CHECK ANY Oat. 10122MO22 REMS NOT PAID N) Min9 Due lane"" ilivalimul Acemmt $3RgyT6 Cash Amount P Amamt P Newivabb I I Dole Date Number Iklemnce DescNplfon Deeded (gros) F (net) P Number PF column fegend: P = Not Ow Item, F = Fatue Due Item, blank = Curren Due Item TOTAL NolNkall Aom 632536 MEMOWAL MEDICAL CENYOR SuMmtals: 4,229.48 USD Future Duo: 0.00 II Paid By 10/25/2022, Poet Due: 0.00 Poy Thy Amount: 4,144.87 USO lLast Payment 2.451.97 N Paid Affair 1012512022, 08/07/2017 Pay INS Amount: 4,229.48 USD ae OtSDIEW OCT 24 2022 BYCOUNPYAUDITOA CALHOUN COUNTY, T WS For AR Inquiries please contact 800-867-0333 Due 11 PNtl On time: USD 9,144.87 OLSC lost it paid late: 84.61 Due N Pala W. USD 4,229.48 MSKESSON STATEMENT CompMy: BOae H® PHCY 0434/ME4 Mm INS AMT DUE REMITTED VIA ACH OMIT MEMORIAL MmICAL CENTER Statement for information only VICKY KALISER 815 N VIRGINIA ST PORT IAVACA TX 77979 As of: 10/2112022 Page: 001 To ensure proper cretl8 to your account, detach am ret" this stub with your smandce DID: 0115 As m: 10121/2022 Page: 001 Mail to: Comp: 8000 rertkmy: y001 AMT DUE fm VIA ACH D®IT Customer. 190813 Statement foror information only Date: 10/22/2022 Cud: 190813 PLEASE CHmK ANY Data: 10/22/2022 ABAS NOT PAID (+) oil]etlonal Account 36 r Cash Amount P nett'Due Gate Oeta Numbva Number tisierence Deealplbn Discount (gres) F Odt) F NNeoFib:"a Customer Number 190813 H® PHCY 0434/MEM Mm MS 10/19/2022 10/25/2022 7373013509 2017063236 1151nyolce 0.67 33.46 / 32.78✓ 7373013509 0 PF colume loved: P = Pawl Due Item, F = ROure Due Item, blank = Conrad Due Item TOTAL Customer Number 19ba13 H® PHOY 0434/MEd M® PH9 subtotals: 33.45 USD Future on. 0.00 Due It Paid On Time: It PeM By 1=512022, USD 32.78,/ Past Due: 0.00 Pay This Amount: 32.7e USD DNc lost if piU late: 0.67 Last Payment 4.394.69 If Pant After 10125M2022, 0. If Pent I.M. 10103/2022 Pay this Amount: 33.45 USD USD 33.45 iffROVOON OCT 24 "17 BY CQIJ"I AM CALHMCOIMTY, s ON For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: 10/21/2022 Page: 001 To anal, proper e,de to your amount, detach and ,turrt this rAmPom-. eeus Mob wbb your noulaamee DC: 8115 As of: 10121/202Y Page: 004 WALMART 10981JAW MED PHS AMT DUE SWITTED VW ACH D®IT Territory: 400 Mail to. Coll,: 8000 MEMORIAL MEDICAL CE9TM Statement for mimmmi0n only AMT DUE RWITTED VIA ACH D®IT VICK KALISEK CUMomer. 256342 Statement for Information only 816 N VIRGINIA ST Date: 10/22/2022 PORT IAVACA TX 77979 CUM: 256342 PLEASE CHECK ANY Date: 10/22/2022 nBAS NOT PAID Billing - 0. Data Date FkneWablilatlonal Amount Pays Number Refe,nm Caeb Deastiptian OlMoum Amount P (gross) F BD Amount P Roadrable I (mi) F Number Customer Number 256342 WALMART 1098IMEM MED PHS 10/17/2022 10/2512022 7372446077 49884612 1151nv0ice 0.16 0.16✓ 7372446077 10/17/9022 10/2512022 7372445078 49921595 Il Sbwoice 2.20 109.98 107.78✓ 7372446070 10/17/2022 1012SI2022 7572446079 49998459 116finnooe 6.60 329.96 323.36 ✓ 7372446079 10/17/2022 10/25/2022 7372613873 50040070 1951moice 0.01 0.32 0.31 ✓- 7372613873 10/17/2022 10/25/2022 7372613874 49966903 1951nvoice 0.02 0.95 0.93 ✓ 7372613874 10/17/2022 10/25/2022 7372613875 49890874 1951nvolco 0.03 4.27 1.24 -/ 7372013875 10/18/2022 10/25/2022 7372755175 50134607 1151m.1ce 0.01 0.63 0.62'� 7372755175 10/16/2022 10125/2022 7372755176 50203518 1151nvoice 0.16 0.18✓ 7372755176 10/18/2022 10/25/2022 7372756177 50203518 1151nvolc. 0.01 0.63 0.62 ✓ 7372755177 10/19/2022 10/25/2022 7372897298 50140924 195lnvolce 7.90 394.91 387.01 J 7372897298 10A8/2022 10/26/2022 7372897299 50145464 1151nvei`e 0.01 0.32 0.31 ✓ 7372897299 t0A912022 10/25/2022 7373005550 50362631 1151nvoioe 6.06 302.79 296.73 ✓ 7373005550 10119/2022 10/25f2022 7373005552 50362631 1151m,mce 7.90 394.91 387.01 ✓ 7373005552 10/19/2022 10/2W2022 7373187668 50302412 1951nvolce 0.03 1.27 1.24 v/ 7373187668 10/20/2022 10/25/2022 7373272240 50501531 1151rnidoa 12.05 602.46 590.41 ✓ 7373272240 10/20/2022 10/26/2022 7373430663 50444377 1151nvoice 0.02 0.95 0.93 f 7373430653 10/2172022 10/25/2022 7373521915 50624659 1151nvcico 1.13 56.60 55.37 f 7373521915 10/2112022 19/25/2022 7373693797 60560672 1951nv0ice 1.12 56.13 65.01 ✓ 7373693797 PF column N9alah P , Past Due Item. F = Future Due Item, blmlk = Current Due Item TOTAL CUM. Number 256342 WALMART 1098IMM MED MS SUMmais: 2.264,30 USD FUW, Our: 0.00 Duo If I On Time: If Paid By 1012512022, USD 2,209.20,/ Net Due: 0.00 Pay This Amount: 2.209.20 USD UNc IOM 8 pad Mte: 45.10 Laet Payment 5.720.94 If Paid Alter 10/2612022, Due If Net late: 10/17/2022 Pay this Amount: 2.254.30 USD USD 2,254.30 APPROVE171 bN 0U 1 ; 4 2022 For AR Inquiries please contact 800-867-0333 COUNTY T AL TEXAS CAlHOUN COUNTY, TEXAS COUNTY, MSKESSON STATEMENT As M: 10/21/2022 Page: 001 To annular,Minor creditto your Wormer. tlat9eh arul rate. Mlle fpmpvry: aoo0 VIA, With year remittance DC: 8115 As of: 10/21/2022 Page: 001 Mall to: Comp: 8000 H® MY FC 490/MBA MC MS AMT DUE REAITTED VIA ACH DEBIT Territory: 400 MEAORIAL MEDICAL CENTER Statement for information only REMITTEDOMIT ANIT DUEEMITTE VIA ACTI VICKY KALISEK Customer, 464450 m Statementonly 815 N VIRGINIA ST Date: 10/22/2022 PORT IAVACA TX ]]979 Cure: 464450 PLEASE CHWK ANY Data: 10/22/2022 ITERIS NOT PAID (r) filling Due Ram"abiratl9rel Amount bWP6 Caah Amount P Amount P Receivable Data Dale Number Reference Description Discount (g.m) F (�) F Number Customer Number 464450 H® MY PC 490IMEM MC MS 10/17/2022 10/25/2022 7372435230 IY2210-055-104006 1151nvoice 1.40 70.00 68.60✓ 7372435230 10/10/2022 10/25/2022 7372751077 82210.055-104209 1151nvaice 0.14 6.]] 6.63 ✓ ]3]2]StOi] 10/20/2022 10/25/2022 7373247841 R2210A55-104364 1151nvoke 0.21 10.54 10.33 ✓ 73T329T841 PF column lege0d: P = Net Dun Item, F = Feu. Due hem. blank = Current Due Item TOTAL Customer Number 464460 H® PHY PC 49D/MEM MC MS Subtotal. 87.31 USE) Future Duo: 0.00 Due If Paid On Time: It Net By 10/26/2022, USD 86.56 lj Past Due: 0.00 Pay Thie Amount: 85.56 USD Disc last H paid late: 1.]5 Dart Payment 5.720.94 If Paid After 10125nI122, 0. If Ieud late: 10/17/2022 Any Dee Amount: 87.31 USD USD 87,31 APPROVED ON OCf 242072 6Y COUNTY AUOtrOF1 CALROUN COUNT/. TEXAR For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: 1012112022 Pale: 001 To middle proper pent to your acbbunt, Eetech and mtum this con,wov: ebao pm with year ram8lence DC: 8115 A. of: 10/21/2022 Page: 001 CVS PHCY 8923/MM MC MS AMT DUE R13d ITT1� VIA ACH DEBIT Territory: 400 Mall to: Comp: 8000 MEMORIAL MEDICAL CENTER Statement for information only ANT DUE REMITTED VIA ACH DEBIT VICKY KALISEK Custome,835434 Statement for information only 815 N VIRGINIA ST Date: 10/22/2022 PORT LAVACA TX 77979 Cup: 835434 PIPABE CHECK ANY Date: 10/22/2022 D3AS NOT PAID (v) Mining Duo ReceNa0etl0rel Aoepunt r9ril B Cash Amount P Amount P RecNv°bb Data Date Number Relemrma Deseriptlen Discount (gm°°) F (nal) F Number Customer Number 835434 CVS PHCY 8923IMFM MC MS 10/19/2022 10/26/2022 7373030271 1935842 1151nvplce 36.98 1.848.76 1,811.78 ✓ 7373030271 O PF column leWnd: P = NO Due Item, F = Future Due ttem, blank = Current Due Item TOTAL' Customer Number 835434 CVS PHCY a923/M94 MC PHS Subbtalc 1,848.76 USD Futum Due: 0.00 Ous It Pald On Tit°°: If Pald By 10125/2022, USD 1.611.78 Pap Oue: 0.00 Pay rus Amount: 1.811.78 USD Dhc 1°9 If Item Mm: 36.96 Last Payment 4.394.69 11 Rem After 10n512022, 0. 11 Pam late: 10/03/2022 Pay this Amount: 1.848.76 USD USD 1.840.76 ,APPAIM ON OCT 24'a" BY COUNiYAU011'Oq CAIHOUN COUNTYJW- S For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT .mwav: soon CVS PHCY 74751MW MC MS ANT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Statement for Information only VICKY KALISEK 815 N VIRGINIA ST PORT IAVACA TX 77979 As of: 10/212022 Paga: 001 To mean prefer rndb to your account, detach and .1. this stub with your rematr2mm DC: 3115 As ch 10(21/2022 Pugs: 001 Mail to: Comp: 8000 Territory: 400 AMT DUE REMITTED VIA ACH Cf331T Cusamer,835438 Slmemml for Information only Dale: 10/22/2022 Gusto 835438 PLEASE CHECK ANY Date: 10MI2022 ITEMS NOT PAID (�) Giant, Due ReceivabluNatlone Account t3.81?6 Cosh A.1 P Amount P Reseivabie Data Date Number Reference Description Discount (grass) F (net) F Number. Cuatmnar Number 036438 CVS FNCY 747SIMEM MC Rib 10/19/2022 10/25/2022 7373195513 1935681 1151nvoice 0.11 5.66 ✓ 5.56 7373195513 O PF column IegeM: P = Pail Due Item, F = Foams Due Item, blank = Current Due Hem TOTAL Columnar Number B35438 CVS FHCY 74751MEM MC PHS Summab: 5.66 USD Future Due: 0.00 U Paid BY 1012M022, Peat Due: C,00 Pay This Amount: 5.55 USD last Payment 5.720.94 If Pant After 1012512022, 10/17/2022 Pay this Amount: 5.66 USD APPROVEDON OCT 2 i L;22 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS For AR Inquiries please contact 800-867-0333 Ous 11 Paid On Time: j USD 6.55 V Diet loin B pald We: 0.11 0. 11 pant late: USO 5,66 J17� STATEMENT Statement Number: 63943048 AmerlsourceEiergen` Date: 10-21-2022 l Of 1 AMERISOURCEBERGEN DRUG CORP WALGREENS 812494 340E 12727 W. AIRPORT BLVD, MEMORIAL MEDICAL CENTER 100135284 1037028186 SUGM1LM4DTX 774106101 1302 N VIRGINIA ST PORTLAVACATX 77979-2509 Bat- Fri Cue in 7 days ' DEA: RA0289276 866-451-9655 AMERISOURCEBERGEN PO Box 905223 Not Yet Due: 0.00 CHARLOTTE NC 28290-5223 CuaenC 2,320.43 Pastow 0.00 Total Due: 2,320.43 Account Balance: 2.320.43 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Dale Dale Number Number Type Amount 10-11.2022 10-28.2022 3109429034 167981 Invoice 2.021.47 0.00 2,021.47 10-17.2022 10.28.2022 3109429095 167982 Invoice 1.01 0.00 1.01 10-172022 10.28-2022 3109464435 168029 Invoice 73.70 0.00 757011 10-18.2022 10-28.2022 3109599"1 168036 Invoice 12.36 0.9D 12.W 1&19-2022 11148-2022 3109762494 168wil Invoice 147.0 oQD 147.65 10.20-2022 1048.2022 3109902183 158058 Invoice 52.21 QUD 52.21 / 10.21-2022 10-28-2022 3110051206 168088 Invoice 12.W 0.0D 12.03 Current lA5 Days 16-30 Days 31-60 Days 61-90 Days 91-120 Days Over 120 Days 2.320.43 0.00 0.00 0.00 O.OD 0.00 0.00 k You for Your Payment Reminders // FDate =Amount Due Date Gunt 10.29.2022 �s�i _- %�%- -2,320.43 22 Total Due: 2,320.43 ADVED ON OCT 2 4 2022 DY COUNTYAUDITOR CACHOU,, COUNTY, TENAS TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800.572-8683) F"ENTER9-DIGIT TAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" ❑"ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" FTIF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGITTAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) -Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR - 12 (DECEMBER) -Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" E_T6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER ##t<# ENTER: E3 re 0 941 # 0 $ 123,408.42 1 $ 62,823.62 $ 14,692.44 $ 45,892.36 r-HECK S CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F:WP.Payfoll FileslPayroll Taxes120221#22 R1 MMC TAX DEPOSIT WORKSHEET 10.20.22.xls 1012412022 941 REC/TAX DEPOSIT FOR MMC PAYROLL -e PAY PERIOD: BEGIN 101712022 PAY PERIOD: END 1W2012022 PAY DATE: 1012812022 GROSS PAY: S 538,886.17 DEDUCTIONS A/R 3 532.83 ADVANC SOOTS SUNLIFE CRITICAL ILLNESS S $86.18 SUNLIFE ACCIDENT S 768.72 SUNLIFE VISION SUNLIFE SHORT TERM DIS 5 1,218.27 BCSS VISION S 1,021.56 CAFE-D $ 1430.5$ CAFE-H S 22.784.08 5 S CAFE-P CANCER CHILD $ 2,3fi2.70 CLINIC S 195.0D COMBIN S 280.87 CREDUN S - DENTAL 5 DEP-LF 3UNLIFE TERM LIFE S 898.62 SUNLIFE HOSP I,NDEM 5 524.73 FED TAX $ 45,892.36 FICA-M S 7,346.22 FICA-0 S 31,411.81 FIRST C 5 - FLEX S $ 3,285,40 FLX-FE $ GIFT S S 17.87 GRP IN GTL HOSP4 LEGAL $ 968,96 OTHER 5 2,31-9,75 NATIONAL FARM LIFE 5 1.667.92 MED SURCHARGE S 340,00 PR FIN $ RELAY REPAY STONEDF S 640,86 STONE STONE 2 STUDEN TSA-R S 37.720.75 UWIHOS S TOTAL DEDUCTIONS: S 166,266.D4 $ �4KOLLCWtCKREPORT� 1l NET PAY: $ 373,600.13 S bKlIAC � W1W R65,rt+ TOTAL CAFE 126 PLAN: 6 32.225.65 Le 5 'AXABLE PAY: S 606A40.52 $ 506.040.52 "CALCULATED--- From MMC Ripon Difference 'ICA- MED (ER) ,+s+. $ 7.346.29 'ICA - MED (EE) S 7.346.29 S 7.346.22 $ 0.07 'ICA -SOC SEC (ER) :xs S 31,411.71 ICA - SOC SEC (EE) sip+, 5 31.411.71 $ 31.411.81 $ (0.10 'ED WITHHOLDING $ 4S.892.36 $ 45.892.36 REVISED 311812014 ARRMat AL CK 111 TOTALS S ) $ 538,866.17 532.33 33E I%1 58.. 2 121&27 1.021.56 1,630.58 22.7S4.08 2,362 70 19S.00 210.87 593,62 524.73 48.892.36 7,346.2^_ 31, 411.a I 3.285.40 17.87 968.96 ?,679.75 1,667.9-1 340.00 640.86 37.720,75 S - S . ( S I6a,2e6.04 e WTWREPOKT'-W„RCWTW� S S S 373,600.13 MR114D W1W I@Pag1��LgUa WIW AfPMt•' Exempt Amt: Employees over FICA -SS Cap: S S S Peycoee S - Employee Reimb.: TAX DEPOSIT: 5 123.408.W $ 123AOS 42 FICA - MEDICARE 'saw S 14.692.58 S14.692A4 FICA - SOCIAL SECURITY rz,cn S 62.823.42 $62.823.62 PREPARED BY: FED WITHHOLDING $ 45,892.36 $45,802.36 PREPARED DATE: TOTAL TAX: $ 123,408.36 $123,408.42 S (0,06) TOTAL: S Caitlin Clevenger 10/24/2022 922 R1 MMC TAX DEPOSIT YIORKSHEET 11120 2211r. TAX DEPOSIT 490RXSHEET IOC412522 Trv±: _.-:0: ?ay:o;1 ..?]is:?. __•'c'? %h' P?PFG :_v_ Sc:.:.ar •-- P a y C o d e S u i r a r T._........._...............................:. ? d u :: i e P. s S c❑ s ..J .............. .-'.............................................................. ....._....... ...._......... ._.............................. &EGTZA? PAY•51 545F.CC S '1 li YQi""<iF.:S A/?. 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W1 :IFS! 7 L1 7.11E ....... :, .. _..... 5i1?1 F!iDRiE X EL�R hce . -21 u_aY TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1.800-572.8663) E—l"ENTER 9-DIGITTAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" ETIF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGITTAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT- FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" EJ "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER Ell ENTER: 0 $ 387.84 1 $ 217.28 $ 50.82 $ 119.74 CHECK > CALLED IN BY: CALLED IN DATE: CALLED IN TIME: F:kAP-Payroll FileslPayroll Taxes12022V122 R2 MMC TAX DEPOSIT WORKSHEET 10.20.22.xis 1012412022 941 RECITAX DEPOSIT FOR MMC PAYROLL REVISED 31182014 PAY PERIOO: BEGIN PAY PERIOD: END PAY DATE: GROSS PAY: DEDUCTIONS: AIR ADVANC BOOTS SUNLIFE CRITICAL ILLNESS SUNLIFE ACCIDENT SUNLIFE VISION SUNLIFE SHORT TERM Or$ SCBS VISION CAFE-D CAFE-H CAFE-P CANCER CHILD CLINIC COMSIN CREOUN DENTAL DEP-LF SUNLIFE TERM LIFE SUNLIFE HOSP INDEM FED TAX FICA-M FICA-0 FIRST C FLEX S FLX-FE GIFT S GRP-IN GTL HOSP-1 LEGAL OTHER NATIONAL FARM LIFE IAED SURCHARGE PR FIN RELAY REPAY STONEDF STONE STONE 2 STUDEN TSA-R UW/HOS TOTAL DEDUCTIONS NET PAY: TOTAL CAFE 125 PLAN: TAXABLE PAY: $ 1,752.24 $ 1,752.24 "CALCULATED" Fran MMQR§oa Differenc! -ICA - MED (ER) , •:e $ 25.41 xICA- MED(EE) $ 25.41 S 25.41 S - :ICA - SOC SEC (ER) a:aw S 108.64 :ICA -SOC SEC(EE) am. S 108.64 S 108.84 $ - ;ED WITHHOLDING 5 119.74 S 119.74 TAX DEPOSIT: S 387.81 S 387 U FICA -MEDICARE xw* S 50.82 $50.82 FICA - SOCIAL SECURITY S 217.28 $217.28 PREPARED BY: FED WITHHOLDING S 119.74 5179.74 PREPARED DATE: TOTAL TAX: $ 387.84 $387.84 $ - TOTALS 1,762.24 119-74 25.41 108.64 72&66 376.J5 1,375.79 Exempt Amt Employees over FICA -SS Cap: S S - S Paycode S - Employee Relm6.: TOTAL: $ Caitlin Clevenger 1012412022 022 R2 MMC TAX OEPOSR WORKSHEET 10.20.22 Ms TAX DEPOSIT WORKSHEET 10124022 ..,....:2: Payroll %'_C35Ler H:-Ae>�lj 1 ,2.icG Filial _z-arf ............................... .. r - _ , ' iI::i';�e� •..... 1 CM.. _ .. - --� ..;> ..............._____._................................ .----------------- ................................................. . CnF° . .ZFE G.ifd. Cn"A•L ..it t-f M;C r. ...___ ._...._ _.E27, P_,-0 10?.54 ?aiSTC iLEt 5 FL :_ ..... _ .... _... _ Gil- _.:P.D A. L-3A. ....... NLnL_ sse .PR . .I KAY fi_..•1. K7ML•.w.u. _.i_1: KIM .. T.l 1LA 00 .i11Ji1 •--------- _------ _--- Giana Iotals: 55.0 ....... Grose: i'Z-24 Caeicticns: ?'u.,5 Net 1?75.7? 1 _....................... _--------------------------------- _----------- __----------------- __________________"------_------. �c� Far.,a?e: ir;,4 ' YZP''Ju :: }::,:5!r:r. _rt<uS.: sae _ :in -Mc -co, ., ._._..s7,0 . egncaEgrr 1375.73 MEMORIAL MEDICAL CENTER PROSPERITY BANK FOR OPERATING ACCOUNT --- October 17, 2022 -October 23, 2022 Date Bank0sectiotion 10/17/2022 PAY PLUS ACHTRANS 452579291101000698598035 10/17/2022 IRS USATAKPYMT 2702690511073496103601000011 10/17/2022 TEXAS COUNTY ORS RECEIVABLE 0419 21000024648 10/17/2022 FDMS FDMS PYMT 052-1743547-WO 4100012156952 10/17/2022 FDMS FDMS PYMT 052-1743548-000 410001215932D 10/17/2022 FDMS FDMS PYMT 052-1737276-0004100012156023 10/18/2022 PAY P LUS ACHTRAN5452579291101000699672099 10/18/2D22 MCKESSON DRUG AUTO ACH ACH05217983 910000140 10119/2022 PAY PLUS ACHTRANS 4525792911010006SD624260 10119/2022 IRS USATAXPYMT 270269200090992 6103601010251 10/20/2022 WI RE OUT CBNA INCOMING SETTLEMENT ACCOUNT 10/20/2022 WEBFILE TAX PYMT DD 902/7024739722000026971 20/20/2022 PAY PLUS ACHTRANS 452579292 101000691345121 10/21/2022 PAY PLUS ACHTRAN5452579291101000692233244 10/21/2022 AMERISOURCE BERG PAYMENTS 0100007768 2100002. MMC Notes - 3rd Party Payer Fee - Payroll Taxes - Retirement Funding -Credit Card Processing Fee - Credit Card Processing Fee - Credit Card Processing Fee - 3rd Party Payer Fee 3400 Drug Program Expense 3rd Parry Payer Fee IRS Fee -Citibank Corporate Card Payment Sales Tax - 3rd Party Payer Fee - 3rd Party Payer Fee - 3408 Drug Program Expense i October 24, 2022 WILLIAM LITTLE, 60H�Lg+rJ jU• Iq (Z LG. Memorial Medical Center ppr,''F'�' PROSPERITY BANK �iY- �•y7r4Jed 18'12-21Lo ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT —ESTIMATED ACHS Date Description MMC NoMs 11/2/2022 DSH IGT DSH IGH October 24, 2022 WILLAM LITTLE, CFO Memorial Medical Center APPROVED ON OCT 24 2022 C©!HOUR O MY, TTEXAS CPSI Amount 177.191 122,755.991,* 291,012.41 -�P 40.03 80.06 120.09 082. 5,72U.94-t 75.50, 1,756.70# 338.14* 1,631.5704 4 2.741, '.'$54li45 2,422.494 426,389.46 I _ I. n Amount , 50,509.91 I. - YSlz:t . p.uLl - Transaction Summary Transaction Cmmnipte Texas Health and Human Services Commission Memorial Medical Center Operating County Pa ment Total $50,509.91 Bank Routinq and Account Number Settlement Date 11/2/2022 DSH Amount $50,509.91 Entered By Marle Moehri Page No: t of t Run Date: 101`17f2022 Run Time: t5:ie:5o Marlev ODonnell From: Texas Health and Human Services Commission <txhhs@public.govdelivery.com> sent: Monday, October 17, 2022 2:54 PM To: Marley ODonnell Subject: DSH IGT Notification - 2023 Advance 2 Payment ICAUTION: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. `'4 ; TEXAS ��' Health and Human Services `:6w DSH IGT Notification - 2023 Advance 2 Payment HHSC is providing notification of the Intergovernmental Transfers (IGT) call for the Disproportionate Share Hospitals (DSH) 2023 Advance 2 Payment. The FFY 2023 DSH Advanced Payment 2 file was updated on 10/14/2022 and can be found under the Federal Fiscal Year (FFY) 2023 heading on the Provider Finance website. • Payment and transfer amounts for state hospitals can be found in column V of the "State" tab (UT Southwestern Medical Center is the only exception an the State tab and will need to submit the IGT amount in column W via TexNet.). • Payment amounts for non -state hospitals can be found in column AX of the "Non -State" tab and the corresponding IGT amounts can be found in column BC of the same tab. To ensure that all government entities receive this notification, HHSC strongly encourages providers to send this information to any government entity that is completing an IGT on their behalf. Below are the pertinent dates associated with the 2023 DSH Advance 2 payment: November 1, 2022: Last date to schedule transfer in TexNet • November 2, 2022: IGT Settlement Date • November 14, 2022: State Owned Hospitals submit Journal Entry • November 30, 2022: Latest DSH Advance 2 Payment Date Please be sure to select the DSH bucket in TexNet when you enter your IGT. It is imperative that you send a screen shot/PDF copy of the confirmation/trace sheet from TexNet to the Payments Team. TexNet instructions are available here. Please email Provider Finance with any additional questions. '�Gu h- v a Silbsc: 0ed IC pet upd. c dnOld lc.. t t,i a r^. 9i r CI I .an8c Serf ces lH6$. r,r MOre :ptOf IIAILpn 3L+Gut H-F OleaSe ViSIt Our website Sla "unnected 0 SHARE Subscriber Sewces Manage Preferences unsubscribg Help 2 Proposed Method for State -Owned Hospitals 5 Non -State Owned Urban Public Hospital Class 1 3 Non -State Owned Urban Public Hospital Class 2 1E Non -State Owned All Other Hospitals Texas Health and Human Services Commission April 27, 2015 322,149 949,083 738.597 68,467 372,408 130.776 1,456,585 7.268,345 1,843.054 Texas Health and Human Services Commission April 27, 2015 1.060,746 1.080.746 - 42.383,249 42.383,249 2,042.991,476 979,509,786 1.230.969,552 199,243 199,243 - 71960,966 7,960.966 264,233,136 119.949,481 214.094,433 3.299.639 3,374.862 134.84629A tad AAA 1. 1 �.o o,.., — .-. __. ___ Texas Health and Human Services Commission April 27, 2015 76.934.514 1,986,055.961 42.383,249 - 1,923,673,712 589,705 2,685,041 261,548.095 7.960.966 - 253.587.129 77,737 106.458.055 2.142,435,055 133,563,002 1.283.265 2 nnn n71 nta c.c.11 Texas Health and Human Services Commission April 27, 2015 42,972.953 22,068,599 62,780.949 127.822,501 127.822.501 1,838,234.460 8.038,703 4.128.246 - 12,166,949 12.166,949 - 249,381.146 134.178,824 6.126,082 - 140.304.906 140 am Am _ e nn, ,,., — Texas Health and Human Services Commission April 27, 2015 IMD CHECK $8.404,034 127,822,501 - - - B4,849.547 1,838.234,460 42.972,953 12,166,949 - - - 4,128,246. 249,381,146 8,038,703 140.304,906 - - - 6.126.082 2,002,130,149 134.178.824 Texas Health and Human Services Commission Apol 27, 2015 2.196659 (0037781) 127,822,501 84,849.547 12,166,949 4,128.246 140,304,906 6,126,082 280,294.356 $95,t03,875.12 $95,103,875.12 Texas Health and Human Services Commission April 27, 2015 Page 1 of 1 CRECEIVED UCNV AUDITOR ON P ,L. ®C i 12 O ZOZZ MEMORIAL MEDICAL CENTER 10/20/2022 0 AP Open Invoice List O]�y.*r�urtTY.TncAs Dates Through: ap_open_invoice.template 1 Vendor# Vendor Name Class Pay Code 11816 ASHFORD GARDENS v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 101322 10120/2010/1312011/13/20 5,030.92 0.00 0.00 OHC AUG 22 OIPP Vendor Total;Number Name Gross Discount No -Pay 11816 ASHFORD GARDENS 5,030.92 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 5,030.92 0.00 0.00 Appaovi:o cif<1 OCT 2 0 2022 BY COUNTY AUDITOR CALHOUN COUNTy, TEXAS Net f 5,030.92 P f Net 5,030.92 Net 5,030.92 file:///C:/Users/ltrevino/epsilmemmed.cpsinet.com/u88125/data 5/tmp_cw5report21681... 10/20/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON OCT 020 02202022 MEMORIAL MEDICAL CENTER 1/0 0 AP Open Invoice List CALHOI]It1'1&UNIY TEXAS ap_open_invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 101122 10/20/20 10/11/20 11/11/20 2,976.42 0.00 TRANSFER rJVJ jVU0 Vt(c- pyAtj dcpa5"JcJ Ih+ WWL Ojlttt+nlY 101322 10/20120 10113120 11/13/20 2.107.64 0.00 UHC AUG 22 QIPP Vendor Totals Number Name Gross Discount 11828 SOLERA WEST HOUSTON 5,084.06 0.00 Report Summary Grand Totals: Gross Discount No -Pay 5,084.06 0.00 0.00 &I)PROVE0 ON OCT 2 0 ?''. By COUNTY AUDITOR CALHOUN COUNTY, TKXA5 No -Pay Net / V/ 0.00 2,976.42 0.00 2,107.64 „J No -Pay Net 0.00 5,084.06 Net 5,084.06 file:///C:/[Jsers/ltrevino/epsilmemmed.cpsinet.com/u88125/data_5/tmp_ew5reporu2241... 10/20/2022 Page I of I RECEIVED BY THE COUNTY AUDITOR ON MEMORIAL MEDICAL CENTER 2Q22 ®, 8 2022 AP Open Invoice List 0 1.2 Dates Through: ap_openJnvoice.template CALHW00r/f N9QV9E a Class Pay Code 11820 FORTBEND HEALTHCARE CENTER Invoiceit Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay, Net 101322 10/20/2010/1312011113120 2,214.95 0.00 0.00 2.214.95 UHC AUG 22 QIPP ' e Vendor Totals Number Name Gross Discount No -Pay Net 11820 FORTBEND HEALTHCARE CENTER 2,214.95 0.00 0.00 2,214.95 Report Summary Grand Totals: Gross Discount No -Pay Net 2,214.95 0.00 0.00 2,214.95 OCT 2 0 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:!//C:/Users/ltrevino/cpsi/memmed.cpsinet.corn/u88125/data_5/tmp_ew5report18775... 10/20/2022 Page I of 1 RECENEDBYTHE COUNTYAUDITORON OCl/�f1/L+oi2322 MEMORIAL MEDICAL CENTER AP Open Invoice List 0 11:28 ap_open_invoice.template CALHOUN COUNTY, TEXAS Dates Through: 1 Vendor# Vendor Name Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK 4 Invoice# Comment Tran DI Inv Di Due Dt Check D Pay Gross Discount No -Pay Net 101322 10/20/20 10/13/20 11/13/20 722,34 0.00 0.00 722.34 UHC AUG 22 OIPP Vendor TotalE Number Name Gross Discount No -Pay Net 11832 BROADMOOR AT CREEKSIDE PARK 722.34 0.00 0.00 722.34 Report Summary Grand Totals: Gross Discount No -Pay Net 722.34 0.00 0.00 722.34 A"ROIFE l0XP OCT 20 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report73189... 10/2012022 Page 1 of 1 RECEIVED 6Y THE COUNTY AUDITOR ON O1�2�022 2 MEMORIAL MEDICAL CENTER 0 11:30 AP Open Invoice List ap_open_invoice.template CALK (`N1Y TEXA& %iv Dates Through: r sndor Name / Class Pay Code 11824 THECRESCENT f Invoice# Comment Tran Ot Inv Ot Due Dt Check DPay Gross Discount No -Pay 101322 10/20/2010/13/2011/13/20 1,654.16 0.00 0.00 UHC AUG 22 QIPP Vendor Totals Number Name Gross Discount No -Pay 11824 THECRESCENT 1,654.16 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 1,654.16 0.00 0.00 APPROVEamw OCT 2 0 2022 CAtLHOUN COU TFO9 S Net 1,654,16,% Net 1,654.16 Net 1,654.16 file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report l9061... 10/20/2022 Page 1 of 1 RECEIVED Eyl THE COUM1m' AUDITOR ON i�9Z2� 2022 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 11:29 ap_open_Invcice.template CAIVHOUN COUNTY,TEXAS Dates Through: endor# Vendor Name Class Pay Cade 11835 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount 101122 10/20/20 10/11/20 11 /11 /20 1,507.51 0.00 TRANSFER UWIV5tmt-LL o,4�0 dtp6 .&k )KI, kmL. 6KMll'FIML� 101222 10/20/20 10/12/20 11/12/20 10,194.55 0.00 TRANSFER tt 1' 101322 10120/20 10/13120 11/13120 3,202.19 0.00 UHC AUG 22 OIPP Vendor Totals Number Name Gross Discount 11836 GOLDENCREEK HEALTHCARE 14,904,56 0.00 Report Summary Grand Totals: Gross Discount No -Pay 14,904.55 0.00 0.00 APPROVEDriiiU' OCT 20 2022 BY COUNTY AUDFOR CALHOUN COUNTY, TEXAS No -Pay Net 0.00 1,507.81'''� 0.00 10,194.55 0.00 3,202.19 No -Pay Net 0.00 14,904.55 Net 14,904.55 file:///C:lUsers/ltrevino/cpsilmemmed.cpsinet.com/u881251data_5/tmp_cw5report41654... 10/20/2022 Page 1 of 1 RECEWIEDBYWC- COUNTYeA1�AIRMAON ®CTI M/20992 MEMORIAL MEDICAL CENTER AP Open Invoice List 0 11:29 ap_open_invoice.template CAWOUN COUNil, T Dates Through: Vendor# Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoiceft Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 101122 10/20/20 10/11120 11/11120 974.45 0.00 0.00 974.45 ✓ ` TRANSFER NP j"SUVAflU_ p�1,44 tif,�76/jlgrrA Ir1-h Wp1 , OKK+Il 101222 10/2012010/12/2011/12/20 9,328.00 0.00 0.00 9,328.00 V/' TRANSFER k4 11 101322 10/2012010/1312011/13/20 1,472.20 0.00 0.00 1,472.20 UHC AUG 22 OIPP Vendor Total: Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 11,774.65 0.00 0.00 11,774.65 Grand Totals: APPROUtp 01�9 OCT 2 0 2Q22 6Y COUNTY AUDITOR CALHOUN COUNTY, TENAS Report Summary Gross Discount 11,774.65 0.00 No -Pay Net 0.00 11,774.65 1 4 file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_ew5 report73470... 10/20/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON QCf0/2072o9P22 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 11:30 ep_open_invoice.template CACHOU# COUNTY, TEft49 Dates Through: Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check IY Pay Gross Discount No -Pay 101222 1'0120/2010/1212011/12/20 1.629.75 0.00 0.00 1 TRANSFER NN'Imu&V'0. ?yWA'K'grd jI,+ V&VL UVOr 101322 10/20/2010/13/2011113/20 3,270.23 0.00 0.00 UHC AUG 22 QIPP Vendor Total: Number Name Grass Discount No -Pay 13004 TUSCANY VILLAGE 4,899.98 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 4,899.98 0.00 0.00 OCT 20 2022 BY COUNTY ALIDYMPI CALHOUN COUNTY, TE%A€; Net 1,629.75 ✓ 3,270.23 Net 4,899.98 Net 4.899.98 f le:///C:/Users/ltrevino/cpsilmemmed.opsinet.com/ti88125/data_5/tmp_cw5report86647... 10/20/2022 Page I of 1 RECEIVED BY THE OOLINTY AUDITOR ON OCT 2 O 2022 MEMORIAL MEDICAL CENTER 10/20/2022 0 AP Open Invoice List t'At i11Z M COUNTY, TEXAS ap_open_invoice.templale Dates Through: Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 101122 10/20/20 10/11120 11/11/20 12,091.92 0.00 0.00 TRANSFER 0 ftuv 1ju- i/5I dL0(A k IKA, Mom- 9puit- nh 101222 10/20/20 10/12l20 11/12/20 27,627.75 0.00 U 0.00 TRANSFER h If Vendor Total: Number Name Gross Discount No -Pay 12792 BETHANY SENIOR LIVING 39,719.67 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 39,719.67 0.00 0.00 APPROVEDON, OCT 2 0 2022 BY COUNTY AUDUOR CALHOUN,COUNTY, TEXAS 1 Net 12,091.92 27,627.75 Net 39.719.67 Net 39,719.67 1e file:!//C:/Userslltrevinolcpsilmemmed.cpsinct.com/u88125/data_5/tmp_ew5report86089... 10/20/2022 Facility ID Facility Name Total UHC Deposits 4811 Ashford 56,027.52 105818 BroadmeeT 20,475.96 105324 Crescent 18,582.96 4628 Fort Bend 23,000.45 105006 Solera 22,218.80 102540 Golden Creek 34,624.79 100906 Gulf Pointe 15,402.19 103462 Tuscany 33,510.30 Bethany Total UHC Desosit 223,842.96 MMC PORTION QIPP/Comp1 QIPP/Comp2 QIPP/Comp3 QIPP/Comp4& Lapse QIPP TI NH PORTION 45,965.68 10,061.84 30,996.60 5,030.92 19,031.28 1,444.68 19,753.62 722.34 15,274.54 3,308.32 16,928.80 1,654:16: 18,570.56 4,429.89 20,785.51 2,214M 18,003.52 4,215.28 20,111.16 2,107.64. 28,220AG 6,404.38 32,422.59 3,202a9 12,457.80 2,944.39 13,930.001 2,47220 26,969.84 6,54GA6 30,240.07 3,270.23 184,493.72 39,349.24 1 204,168.34 19,674,62 FUNDS DEPOSITSD INTD MMOOPEMTING, NEED TO ISSUE PAYMENT&MMURSING, HOME. M$iSE CHECR,Rfigt1ES,TS FQR'F#CHNURSING HQ(v1E FDR HIGHLIGHTED _ 0200i'AMDUNTS AUGUST 56,027.52 20,475.96 28,582.96 23,000,45 22,218.80 34,624.78 15,402.19 33,530.30 223,842.96 Memorial Medical Center Nursing Home UPL Weekly Canted Transfer Prosperity Accounts 10/24/2022 na6ua ymm, Amm-1 sefnnln9 A.pwrmn6 G..sW A—t 6a Tnndamdro d—m. In Xama ru. sds.s. nnalanM TnMmin )Ce aN &lann Wme ._, �, tl9,6B1.93 )29,410d9 T..99.6P 39,66191 / 39,499.63 Banks0sus, 39,664A1 ✓ Vanansu uae In Wants 100,00 ✓ MOUNAWIAW30PI 64.74 IulYlMernt An,,01.1.11 SdptembdrlMm. Atllmt Oalame/Tnm(erAmt M,499.6T f gy. / / 99)51.27 / 93,630.99 Bahr Balanm 93,75127 J Vni.m. brveln Bdhnte 100M MOVsAVA3A013Qiq Uln AuryRinlenft 54PtembMlmnat Adrylt B.1tm./ 1m(m.1 93,61MO4 p1 -r. P - ! 101.510.031i 96.330961/ 8)s)&9] / ,/ 73.00.98 / 62,6ia.91 Bank Balance >3,05).9B ✓ Vatlante LtavelnsilMtt Iwo MOOXAYBSAW3QIPP 1907✓/ OEVOTEO PAYM[Ntt TOTUfdNY {I.O50.00✓ hi'l tdlnt Wauttlmnumat Septemberimmunt / Adjmt BVanmpnruferAmt 11.1178.91✓ 46,330.951d6,65651,/ 1$.630.60 f 4,)S).d H,63am BaNrOManm 15.75706 a% Variance 4a..In B.bnt. low RKdJMYB3AW3Q1PP 26" AuPntllnYrM 5sPItMOMlnterM / Aljm' BtlaRe/Ilanlln Amu g6 cto B/ 99.915 6S ✓ 9$)92.A ✓ll).1II01 ✓ 311,An7 / II0,332.9a BmkBtlance 3)1A35]0 J Var"mu leaveme.lann 1N-00 i_ /;. «.dNam/nnYaemdm.Ymm�dmm. Note:Onlydelpn[m 0l nasd0.V mllde trurlrv/edao ManurAnPdamr Note 2; [eA PROML An 41e1e MbnN P) 51W Net MMC It�u![tl m rym nroenl IatIN WevklY Pumlen\NN UPt Pundit Summary\}y3WneeegNN VPc 9amrer5ummary 10.2g3Yu M0VNAVB3Am301PP 22.BB APPROVrZ ON OCT 2 4 2022 n1v14m" t Ad3dmm.am By COUNTY AUDITOR sasu,sMw dlrAm CALHOUN EXAq / COUN7Y,'T Adjust BalanaRavnalm Am I12,3RY ✓ TOiALTPAPOIIW 32;9fl00 0.POt09ed• �---� 'C!' 1111AMLF 1,CP0 r MMc9Opn0N =, R; 1L:,wo.1 i,,Ilmn DIP`/WmP1 CIPP/GmP2 QW10.0 WP1Qmpf6YpM WE" NX9oRTION lal]nm2 XNP.ICMOMCWRIP 4/111100 IAMz1 CWHIPAITU IO/ppY2 uxc cOMMuxmPINCCWMPM}fiHON1S]IWA 2Jp.N U01.19 - IdH.15 10/W)YY NM6. (fNO KKCWMIMi ]N6YIIYthUEY9op 1,lo I,5]5.22 IWlAfMoD1mon YXCCOAWYMm O]4Z=IG) - loll 3a936 MCWIIMT3 IWI41022 NUMRNRCXRXNXNCURIMURICINTER LTD - JN.Y Mo. 309.G llMW29]I WIMOUTMNIORONwL)MGPEC[M[R l)0 129,51019 _ UIK(OMMVNm rI NCfWMIM))]WYIl91NL' 0.11 Do W/)0/30}2 NpVI)MSOIYIxIX NC[WM`Ml6iE]If10INIW HIM." 10121/102EVxf LPMMYNm IL MCCWMIME ]I(WN119ll3m Y652 360.H ]02U]OII XOVRR9 {OLYl10M xCCGIMPM26]HI3yRW1}6 / Gp,G 411 % IWl)/]0!} MNx-[IMUNCCGIMPMt)IElAl11l11LVW23Yll 10/T//MII UHCfOMMUNIN ILMCNMPMI11iN1Ill910.W I41]/101i NFAITINVMMJ SVCMGWMPM}IlIf00NlL1WCZ IWIUHI]1 MRPSupvlemenM X[CWMYMTM61AM11llIH1 IW1V20n DxccOxvxuxmrLMcwIMPMr144aDN1ie1D06p IW14]N2 UMC[UMMUNTPI XCfwIMPMllIN2Nl191M1M 1W1420Z1 MUMNIAINC COMICGIMIM!)9%f{p1CtlgS]IYI ID/14ZWE MUMPNRGMAOIS6NCCwM11M}3%b112[PAINO IWH/2Du uxemMMYxmnMlwMpMrnw3eu91wm 10/19pW2 NUMNIRGH4TEX HIAwWpMf ENTERS %O]U1C01 IWN/1W2 WIfEOUIGM[%N{AIiNWICCFMFM III 10]NI30II IMB-lC1N)NLCWMIM]]IW]MIIIMVVl155392 1a/]4ID)3 UXC(OMMYXmpLNC[wlNMli lli0]MI19lODW WIVAM2 wppw 10/EV)OR UKK[OMMUNm It M[[GIMPM}y2Mpp1191[fdJ 10/2UNIS2 UKK[OMMUNm PLXKAAIMPMi)fIN341191PIW M/2VNN3 REATH5 MMW XKCW W JUSE]I]Wpll3 IWZ4VN1 NFM]N HUMANSU[MCCWNDR3i 112K0Mlllipl! 10/211E932 MRISYppIUIaIp MCCGIMPMiNM0yI2 Uf)M )0/P/1M2 HMO dCNONCC1AIMVM!]46MY11 A400W]M3)0 19/17/2022 YNRFONEPt1MCMF UMMIMPMI lNW34111243M 10/l7/M21 DEMOTED HEALTN P HCCGIMMn 131140394933247 1WIIR022 HUMMAI WIIC 2 WMT31210 Rb S 10/W1022 HUMWMIMCDlIHCCVIMT3 3NM4ZWSi09M 10/14E012 MYMANACXh DIH NCCiAIMPMl3900Me]0%MB60 10/142023 DEMOTED NEALNI I HC<WMPMT E211403%9%940 m/141013 DEVDTED HMLTH P HCMI WW 321149E9599030 1011912OZZ PNCVECOMC4 PHC[74M3T]SMOL2 M69M W19/SOZ2 DEWITE DNCCGIMHCWDEVIN 121MI)M 930716 04 1W39/2011 ONOTEDHMLTNPHCMIMPW 13114D39919HM L9/H/1011 OEVOTEONML3MPHCCWMPMT 1211WMI953M IO/H/2012 WlRM0U I NMPHCC1I4Mt E TFROH9195306 EW2l/ U WIRF ODTGNIFXNGLIN GRE [ENTfB5111 EW2VM12 DRPPIII I012111M2 NOVITAISOIIIiION NCCWIMPMIM63234200p0133 1012VI011 MFMTNNUMANSVCMECWRVMT134400SEE4W03 10/11/M22 DIVTEEDNGLTHPOCCWMI49T 111140Hfl4359i 10/2V10St OEVMfDNGIiH PNCCwIMPMT 1911009fl41593 - MMCIORTHIN 1.,H1.m T.-I1f199 GIP/Umpl DIP01[Pm9i pIW}CPmP3 OWEDmp"U'l. Qmy RRPORTIDN I. - 3aat33 " Alla, IR.l9 XISEZA 3.890,10 • LAMED , - ZM.47 1LOGO 47 l. LM 412.55 - 162.55 pY ]a69 Ml 60.30 ' 2Iin15 LAD 46 89.139.15 • 252066 152R66 49W.)C 6,W6.38 - 6Lf]1.12 61,05.11 DIE 0.12 20. ]IOA4 LY9}9 1.629.29 ' ..WW" - 4.65650 - 3 IG56 l 33%50 pA9.M Ai ID14 / 11,610.94 MMCPGMIDN iT ^� TpnRenln DIIP/COmpl GPI/Umpi DIrP/CLMp3 GPP/COmpf6lRpY GPPN NN Wpi1pN - 1.539.46 1,59046 - n9aD n6.pp ' 6.000.00 6.004.00 65#O.W 6,510.00 10,691% 10,69¢00 2.100,00 - 'Amu - f.600.W lOwOa 1.600.% 4 W 00 om ..i6 a00.00 Ma.W WAp - I.i00.00 %,350.96 J,}0p.00 4,aM.DO 6,M0.9P ' I,65I]9 1.653.19 - 1,05601 1,a26.01 2AM.1 11M00 96A90.9i 618H91 IL8H.91 MMCPDRTION 7_LS([!C4YI 3f1252 /S9p GM/GTp1 GPIICOmpl DIPP/CpmP9 GII/Cemp161RpM GPPn MN WRG1 10/17/1022 YNC[OMMUNIIYPLHC[WMPML146M34119IOW0 4919.36 4.420.76 101171](IM2 40M.50 10/IP/Nll VIIC[OMMYNm PLNCCWNIMT 146MM119tMN - 0 22R2,NS.D .21 12451 10/]W1022 WIREDUCGNIF%NFAITH GPCCFNT[RS IN 44,6H.51 . - - 10/2V3021 Dl�U0VIT - 39.53 3155 10/]VIO]2 N0V1TA950WTON IIC[WMPMl6i5W3910W011i 4 EFO % a03155 11A5451._ ' R,i1QM 7 tS O06D 1011](1022 UNRCDNEMEMCANEWCWMPM!]46W34111#4351 10/1711022 UHCC0MMUNIIVPLWCWIMPME)460M4)191DC3D 10/1711011 UHCCOMMUNMPtWMIMPMTMM0141191909 10/P/EM# HUMANAINSCOHttU1MPAR3MM2H000M2f0I] HOAR IZ IWIMNR[EIPOISBHCCWIMPM]390M342WCd1916 10]I!/#ME MNMMMOUSCHEMx11MHi31AM�11N41 10/142012 HUMM u ADI HNC CUIMP 3 3H l4) I11M 10/14E012 HUMANNCMa0190NCCWIMPAn3MM321143W W IUIW2W3 U01lCENeNYYrc XCCGIMPMt M6WN11110M 101W2022 MANAN ANSM11C#8MN W OODUO 83000D014B161 10/19/2022 XUMANAINSCOXHUtM ECEMERSO90Mi9)96 LOIZW2022 WIBf EU OHC WMPMT?440MIlMSIn IW2WIW# NHB-FCxO HC<WMIMT)O6%MI144DOMISSWI IW2W10E2 01.11, CNA OISO NCCGIMPMT3AlB614]CWp1936 WE1/2022 DMTA 1/11/1#1 HUW NXRU]IOCWIMMPMT6)6]1000000t21 1U/21/E021 HUMANACHADRI IlCCWEMT390M1MpODHEMTI 10/E1/IO22 NUMANACXA 0190 NCCGIMPMI390M10I00.'011]I TMAU MMCMATION L56DV9CD.J }mYl GPPGmPI DIIP/GmP2 DRP/C9m9S GPP/COmpfR1a01< DIP PTI NHmRnm Slow slow - 650.00 65D.W - S,095.65 5,035.65 14,53S.D0 14.516.00 33.601.0D IXW" • 4.9U,E5 4,944.17 - 2011.35 IOU5 19.OSSAO 19,057A0 4.050.00 40Sow - 4153.50 0.153.50 - 55004D RSBD00 - 3,150•a3 3.154.93 Esum' 1.99}M a2 Z2 2730 - l.]n59 ,151M 51A9 1851M 4 99.1yn V ]31.31196 v millla9 441.455.59 322.913,00 MESON 10/24/2022 Quick View Select Quick View Accounts Account Number I Name Account Type Account Number Current Balance Number of Accounts: 15 $4,971,500.66 '4551 CAL CO INDIGENT 55.850.67 HEALTHCARE '4454 MEMORIAL MEDICAL I $103.676.23 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL CENTER . CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER /SOLERA AT WEST HOUSTON -2998 MMC-MONEY MARKET FUND '5506 MMC -NH BETHANY SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA - MEDICAREIMEDICAID '5433 MMC •NH GULF POINTE PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE htips:/lprosperity olbankin9.comlonlineMessenger 5536.68 53.512.156.46 $432.05 529.664.41 S93.754.27 $73.057.98 515.757.04 S122.435.76 5295.844.90 5335.166.66 $08.003.35 $10,240.67 $274.923.53 Treasury Center Select Group Groups Add Group Available Balance $5,511,310.58 55ASO.57 5103,676.23 5536.68 53,616,049.09 $432.05 549.542.08 5146,612.27 5125,092.88 $57.481.96 5375,104.94 5295,844 90 5335.166.66 598.033.01 $12,633.01 S289,254.15 Data Collected Balance $4,971,600.66 SSA50.67 5103.676.23 S536.68 53,512,156.46 5432.05 $29,664.41 $93,754.27 $73,057.98 515,757.04 5122,435.76 5295,844.90 S335,166.66 $98,003.35 $10,240.67 5274.923.53 Rs of Oct 24. 202: Prior Day Belanc 54,550,384.7 55.850.E 564,582.4 5536.E 53,605,627.E S432.0 528,880.E 522,076 $60.148.1 $10.885 5 5108,890.; 5295,8445 S239.258.2 $56.782.4 59,947.0 541.641 C r 1!1 Memorial Medkal Center Nursing Home UPI. Weekly Nexion Transfer ProsperityAccounts 10/24/2022 Bromoaa 4ovivnl G.&.Ma P.Mi" Tatlry'a Bedrt.t, amaunt to Be Tran"erred 0 NUM.{ NuMn Neme Nvrvb" Balama hranrferAut iTnnahr4n oe oslts Balama Nome 13,45B.91 ]3,358.91 309,ST6.23 103,676,23 103,5Tb.23 Bank Balama 101. 6.23 Mena... Note:. Ea'ha etn thmo base hewdlBe hvnV rndrorhe nvnN9dvme. Note 1: Each amount M1aa P base bvfonn o)S1C0 Me t MMC deDosiled la aam vttvun e OCT 24 2022 9Y COUNTY AUUtTOA CALHOUN COUNTY, T€, § 11nx wraxiy ttma<n\xx uPtTrmn" wmmaryUa21\onober\xx uek nan+kr 5nmm.n 1o.au2an L... in Balama 2W.co My lnteta" "Butt Inter!" "Ptambarint.nut 041D9Baleme/rrantler tent 303376:f3 / wwwuT lVo 30/24/2022 mom SP� M/17/11@ ]S9SRRaHSBIT BCD SRMT 56369455S0369179 10/171M 1 TSYS/3MXS61RST BCD S7N6TS436845559769179 lOp]/3M2 HNB-ECHO XCCLLIMPMT]46003411 4O000236MI l0/14120 2 TSYS/3RPNSFIMSKMULMT54IW55SP69 V 9 10/19/2022 TSYSAMWRRSTBXCOSTI 54NMM5B769U9 T 9 5OWEN IW2012022 OMOUTNUINHMURMt 10/20/2022 WMFOUi MFX10N HFALTXQOOIOFH [flFFX CREEK 10/20/20n TSYNRPNSRRSL BXCB STIMEN36&SSSBI691]9 10]21/2022 HDKmmt ]0/31/303E NFAIiH NYMNI3VCMC[IRIMPM]1I1600341I30113 LAM MMCPdIRON NMICK W6 Tnn�I nQ9j TMln] plMfGmpl QIM/CnmPl QI9P/Cpmp3 W9H 41M11 HNPOPSION 53.7 53.)11.15 - N.114.1J l,000.ao 4RO6.pp 1.1]I.W - I,ISIpp 3,119.9, - 1,119.35 - 119.- 119.0 - I359W.61 - I,55963 300.00 - 300.W ]J,35891 2.497.33 4I6.47 - 426q U'Jf9.91 . 10;5]6.33 103.SIsm 10/24/2022 Treasury Center Quick View Select Quick Vlew Accounts Select Group Account Number I Name Groups Add Group Account Type Searrh l All D 1=3 A Data reported as of Ocl 24, 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balane Number of Accounts: 15 $4,971,500.66 55,511,310.58 $4,971,500.66 $4,550,384.7 '4551 CAL CO INDIGENT 55.850.67 $5.850.67 $5,850.67 55.850.E HEALTHCARE '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK $103,676.23 5103.676.23 5103,676.23 $64,582.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.68 5536.68 5536.68 5536.E 2014 '4357 MEMORIAL MEDICAL 53,512,156.45 $3,616,049.09 $3,512,166.46 53,605,627.E CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER - PRIVATE $432.05 5432.05 5432.05 5432.0 WAIVER CLEARING '4381 MEMORIAL MEDICAL 529,664.41 549.542.08 $29,664.41 528,880.E CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $93,754.27 5746,612.27 $93.754.27 522,076.2 BROADMOOR '4411 MEMORIAL MEDICAL $73.057.98 5125.092.88 $73,05Z98 $60.148.1 CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $15.757.04 $57,481.96 $15.757.04 S10.885.E CENTER/NH FORT BEND -4438 MEMORIAL MEDICAL CENTER SOLERA AT $122,435.76 5375,104.94 5122,435.76 5108,890.; WEST HOUSTON '2998 MMC -MONEY MARKET $296.844,90 S295,844 90 $295,844.90 5295.844.E FUND 'S506 MMC -NH BETHANY $335.166,66 5335,166.66 5335,166.66 5239,258.: SENIOR LIVING '5441 MMC -NH GULF POINTE $98.003.35 $96,033.01 598,003.35 555,782.4 PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $10,240.67 $12,633,01 510.240.67 $9,947.0 PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY $274.923.53 5289.254.15 5274,923.53 $41,641,C VILLAGE ' https://prosperity.olbanking.comionlineMessonger V1 Memorial Medical Center Nursing Home UPL weekly HMG Transfer Prosperity Accounts 10/24/2022 NMou+ A.-..9e 4nount Be4nNW vmdins inml+mau Munln Nmm� xumMr Bdanu innd,r-0ut .- inn+Lnln /[4a CHand 0> >1Y TeM +Be n BWn[e Nun Nanr n110.N0.6] B.03033 � ].9)03] 1/ 19.1+4.b - / 3a3war v Wanrv4B+hnae lee n&I>nn ]WM vre.iev, xIXR Myne(nme> vlever SS.O W w�tlae VMs/mN)A)nrnunlnB Amne. xme3: enrnerronnlno. mo-nnemrnreol5)aamnawrce,ywrxeulervm arrounr. :at f OCT 2 4 Znp BY COUNTY AUDITUq CALHOUN COUNTY, TEXAS 1 Wu wn>hn,.Irm. ull rnminwmm,rvUWilonopn\xx urtnm,lsumm,n tn)a.)]a0, luh mmnn AWu+tlT,rtll SrvmmOrrlmmu Aaiun B,I,nrt/rnmdran) w.Iw.Br Amnunllu Be 9,naa( Tnn+l,neato Mink&l+nr< v,mnu Lore In B,hnn wlTnnnn, AWurtrnrmn Brenmberla.—t Adlurt sa.,.tnnrnrann 9],.,.s V"A1rMx3)[AS 1110 AM wrwAraltmr, vA ]a/icl)v3x mill 1D/17/2022 NNE -ECHO HCCUIMPMT746009411440000136423 10/27/2022 HUMANA INS CO HCCUIMPMT 61490283CM523730 101181202E HNE - ECHO HCCIAIMPMT 746Q0341144D0002644SB 10/19/2022 HND-ECHO MCCUIMPMT74600MIlM0000222426 20/20/2022 WIRE OUT HMG SERVICES. LLC 10/20/2022 HMO -ECHO HCCUIMPMT7460034ll440000255396 10/20/1022 HMO- ECHO HCCUIMPMT 745MUll 44600DESS4DO 1D/10/1023 HNB - ECHO HCCUIMPMT 746003411440000255403 1D/21/2022 HNE- ECHO HCCUIMPMT 746003411440000189169 10/21/2022 HNB. ECHO HCOAIMPMT 74MOM 1144MO289169 MMCPORTION QIpP/Camp QIPP/COmp4 TmnSlar•9ut Tnns/er.ln QIPP/ComPl 2 QIPp/CemP3 6bp3a QIPP 11 NN PORTION 112.72 - 112.7E 7,4=00 - 7,40000 72.01 72.M 156.02 - 156.82 7,930.32 - 1.634.81 - L634.81 447.01 - .7.03 23.62 - 29.62 E05.35 _ 10"$ 08,28 - 88.28 7.93D.32 1D,140.67 ✓ 1014047 MMCPORTION QIPp/ComP QIPP/CPM,,4 - Tnn114r-Out T_ranvl9r-In QIPP/Camel 1 QIPP/CemP3 aum QIPPTI NNPOBTION 10/17/2022 D4Pa41t - 17,6SS.W 7,635.09 MERCHANT - 1A95.70 - 3,195.78 10/17/2022 MCWIOEPOSIT496412440802364201 10/17/2022 HNB -ECHU M PM 34114MU113013 - 6A43.33 - 6.4C8A3 NSVC HC<UIM 10/19/2022 L.AIMP 0034113013E - 1,118.99 - 1.118R9 MERCTH HANT OANSVL 10/19/2022 MERCHANTMAN 96475S6 OEPOSR4964T174MV213013 - - 10/20/2022 ITUMAN SV NTf 114600M113013E 4,114.99 - 24,900.99 - 4.000.99 34,400.99 OSERVNES, AC IO/EO/E02E WIRE OUT HMG SERVICES, LLL WIRE O 18.359.53 10/20/2022 HORIOMN 33A HCCUIMPMT 6758924200001164463 - 943A3 949.43 10/21/2022 DCPWIt 23,262.94 - 23.262.94 10/21/2022 HUITM HUMAN SVC HCCUIMPMT 174600341130132 18,957.98 - 18.957.98 36199.85 108AM.02 10814402 10/24/2022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Atld Group Account Type (DDA Data reported as of Oct 24, 2021 Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $4,971,500.66 $5,511,310.58 $4.971,500.66 $4,550,384.7 '4551 CAL CO INDIGENT $5.850.67 $5,850.67 $5,850.67 55,850.E HEALTHCARE '4454 MEMORIAL MEDICAL! NH GOLDEN CREEK $103.676.23 5103,676.23 $103,676.23 564,582.4 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 5536.68 5536.68 5536.68 5536.E 2014 '4357 MEMORIAL MEDICAL 53,512,156.46 53,616,049.09 53,512,156.46 53,605,627.0 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE 5432.05 5432.05 5432.05 $432.0 WAIVER CLEARING '43B1 MEMORIAL MEDICAL $29,664.41 549,542.08 $29,664.41 528,880,E CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $93,754.27 S146,612.27 S93.754.27 $22,07"a.i BROADMOOR '4411 MEMORIAL MEDICAL $73.057.98 5125,092.88 $73.057.98 $60.148.1 CENTER! NH CRESCENT '4446 MEMORIAL MEDICAL $15,757.01 $57.481.96 $15,757.04 $10,885.5 CENTER/NH FORT BEND •44M MEMORIAL MEDICAL CENTER ! SOLERA AT $122,435.76 5375,104.94 5122,435.76 5108,890.3 WEST HOUSTON '2998 MMC -MONEY MARKET $295,844.90 5295,844.90 5295,844.90 5295,844E FUND 15506 MMC-NH BETHANY $335.156.66 S335,166.66 5335,166.66 9239,258.2 SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA- S98,003.35 t/ 598.033.01 598.003.35 555,782.4 MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $10,240.67 ✓ 512,633.01 $10,240.67 Sy 947 C PLAZA - PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE 5274,923.53 5289,254.15 5274,923.53 541,641.0 hitps:!/prosperity,olbanking.com/onlineMessenger 1l1 Memorial Medical [enter Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts ao/za/aou IUHwn •[mum Be(Innlnt Nul[Iq NeTr NumYr Balpn[e TipnllernN %Tnm9lr51 Yl�iij`4�N.�{•g;_I 69,5]Ala f 89.f]9A0 � 1]a,A5 NWe:O,rybokn[esyovn$3,OW wlp6rhomjeneem[FenwpmOFeme. NIXfl: Fn[F Mmvnl Fa[ vY[<bMa't<0/$I(O [hctMM(dyvNeety opmo[(eum. OCT 24 2022 BY COUNTYAUDITOR CALHOUN COUNTY, TEXAS B[ kBnpnm iN.933M van[nc! 4a3vdn BnLna 3W.m 6eiw[4bn[ap[m[Innmt %iflNl.i3 WIWAMIIrRE.ffO Gmnunl lace mmr.n.ew 10/17/2022 Deposit 10/19/2022 HN8-ECHO HCCIAIMPMT 746003411440DO0222741 10/20/2022 WIRE OUT LINEAR ENTERPRISES, LLC 10/21/2022 Deposit 10/21/2022 HNB- ECHO HCCIAIMPMT 7460034114,10000289169 10/22/2022 NOVITAS SOLUTION HCCIAIMPMT 676201420000123 MM[vO'MON QIPP/COmp QIPP/Camp glPp/Camp Transfer-0ut Transfer -In I 1 QIPP/CampZ 3 4&Iapse QIPPTI NHPORTION 36510.18 - 36,S10.I8 5.030.87 - S,D30.87 89,479.18 - - 31,585.62 1,721.06 199,975.80 31,565.62 1,721.06 299,975.80 89,479.19 v7 274,823.53 yl 274,023.53 10124/2022 Quick View Select Quick View Accounts Account Number / Name Accounl Type Search All IDOA Account Number Current Balance Number of Accounts: 15 $4.971,500.66 '4551 CAL CO INDIGENT 55.850.67 HEALTHCARE '4454 MEMORIAL MEDICAL / 5103.676.23 NH GOLDEN CREEK HEALTHCARE '4365 MEMORIAL MEDICAL 5536.68 CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL 53,512,156.46 CENTER - OPERATING '4373 MEMORIAL MEDICAL 5432.05 CENTER - PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL $29,664.41 CENTER / NH ASHFORD •4403 MEMORIAL MEDICAL 593.754.27 CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL 573.057.98 CENTER / NH CRESCENT '4446 MEMORIAL MEDICAL 515.757.04 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL $122,435.76 CENTER / SOLERA AT WEST HOUSTON '29 8 MMC-MONEY MARKET $295,844,90 FUND '5506 MMC -NH BETHANY $335,166.66 SENIOR LIVING '5441 MMC -NH GULF POINTE $98,003.35 PLAZA - MEDICARElMEDICAIU '5433 MMC NH GULF POINTE $10,240.67 PLAZA - PRIVATE PAY •3407 MMC -NH TUSCANY $274.923.53 VILLAGE https:llprosperity.olbanking.comlonli neMessenger Treasury Center Select Group Groups Add Grcup Data reported as or Oct 24, 202: Available Balance Collected Balance Prior Day Balanc $5,511,310.58 $4,971,500.66 $4,550,384.7 $5.850.67 55,850.67 $5.850,E 5103,676.23 5103,676.23 564,582A 8536,68 $536.68 5536.E $3.616.049.09 53,512,156.46 53,605,627.E 5432.05 5432.05 5432.0 $49.542.08 $29,664.41 $28.880.f 5146.61227 $93,754.27 522,0761 5125,092.88 $73,057.98 $60,148.1 $57,481.96 515.757.04 $10, 885.� 5375,104.94 $122,435.76 5108,890.2 5295.844.90 5295.844.90 5295,844E 5335,166.66 $335,166.66 5239,258.e $98,033.01 $98.003.35 555.782.4 $12,633,01 $10.240.67 59,947 C 5289254.15 S274,923.53 $41,641( 111 Memorial Medical Center Nursing Home ❑PL Weekly HSLTransfer Prosperity Accaunts 10/24/2022 Ptnww. Penain) Anwnemee q•nw,A e•pnn+nb Meelure n,xNrr.an NN Numbian4r-1 Hand TW• aul — nuNn H[me "h,7_m',' f B].335 A0 e},}IS Ao DSOA64fi M'161`66 d35.e66.fifi AmkAaNnn 335.16,66✓ Varian leave in[aalann SW.W wWmtuvw qupxmaeuae sff mMr gdjwt BNannNnnrlerAm1 �.i.: ))6B SA,66 f xurY.Powd..q.ni's.0.b wne[rnngmea rn aMnunmAndn[. ncuroud: Ncr[Y. Eodraacum M1at nbondolunofS]WaM1e(MM[lpnnlMroepMa[Munl. WIWAM UmK, 6Po l0/36/i6}3 APPROVED ®PJ OCT 2 4 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS I;*.w M+•n•rmWM VPur•nar.•3ummary33alltbnc6etlp IJ IL..xsumm•n Io.N.n tlu PS 10/17/30OWont 10/1]/lO22lf Oepmh 01/0ix 2Depean 0119/201f DPpoGt 10/391201f DRpovi� 10/19/EDEE HN9-9CWMPMx]0600311t i10000IIN1] ]0/10/3052 wMf OVi TMftT pORx UVpp NN, ll< 1D/xo/EmE Depoat 19/xa/x0:E D Pmt 10R1/:0:1 10/312NOWA0EE NDVYfA5501V110N NCCUIMPMI676i01 410000123 MMCpO0.fi0N jll,,ft L1 jpylLtlO NPP/QMPl OPP/6mPE QIPP/CpIPp3 a"lu""U. Q-TI I --PORTION 3A,S5159 1<1E5159 4.03616 e5,036.86 35,ESe10 35,E5. 10 1E,633M 11,53300 61061 - w61 10,62883 IO,6E8.03 0E.335.80 09,1ae ]e - 59,Sa9.16 53201,W s1,460.4E 3,505.06 3.E0106 92,]0)36 9LI87.39 92]SS.eo 335.06666 MOW" 10/24/2022 Quick View Select Quick View Accounts Account Number I Name Account Type IF Account Number Current Balance Number of Accounts: 15 $4,971,500.66 •4551 CAL CO INDIGENT $5.850.67 HEALTHCARE '4454 MEMORIAL MEDICAL 1 C K 5103.676.23 NH GOLDEN REE HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 '4357 MEMORIAL MEDICAL CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING '4381 MEMORIAL MEDICAL CENTER/NH ASHFORD •4403 MEMORIAL MEDICAL CENTER/NH BROADMOOR '4411 MEMORIAL MEDICAL CENTER/NH CRESCENT '444 MEMORIAL MEDICAL CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT WEST HOUSTON '2998 MMC-MONEY MARKET FUND 'S506 MMC -NH BETHANY SENIOR LIVING •5441 MMC -NH GULF POINTE PLAZA - MEDICARE/MEDICAID •5433 MMC -NH GULF POINTE PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE https:/Iprospedly.olbanking.comlonlineMessenger $536.68 53,512,156.46 $432.05 $29,664.41 $93,754.27 $73.057.98 $15.757.04 $122.435.76 5295,844.90 $335.166.66 $98,003.35 $10,240.67 5274.923.53 Treasury Center Select Group Groups Atld Group Available Balance 55,511,310.58 $5,850.67 5103,676.23 5536.68 33,616,049.09 $432.05 549,542.08 S 146,612.27 $125,092.88 $57.481.96 5375.104.94 5295,844.90 5335,166.66 $98,033.01 512,633.01 $289.254.15 Data Collected Balance $4,971,500.66 55,850.67 5103,676.23 5536.68 $3.512,156.46 5432.05 $29,664.41 $93.754.27 $73.057.98 $15,757.04 S122.435.76 5295,844.90 $335,166.66 S98,003.35 $10,240.67 $274,923.53 Prior Day Balanc $4,550,384.7 $5,850.E $64.582.4 5536.E 53,605,627.E 5432.0 $28,880.E 522,076., $60.148.1 510.885.E 5108.890.: S295,844 c 5239,258.2 $55.782.4 $9,947.0 $41.641.0 1!1 n w w w w w w w w w w w w r O O O O O O O O O O O O O O O O O p a A n xn xn sn n FFn n zn xn xn xa xn xn rb ryy m n C y C yy G y C C D C C y C y C C D C y C yy C r 0 O r Ar Ar �r r Ar Ar �r �r Ar Ar Ar nQ �Q tm' yA p '^ p p m m y m n o �n �n Zn �n �n �n �n En fn gn �n �n fn A A H mw o oo o yo �o y�000 o �o yyA y y D A .Dy.7 m z m r r r r r r r r r r r r r p o y n m m � P P P P P P q P W P P P P P P N t t V A B !J p C — vnz V O H AH H m(H H mmH C �e �o y .c v �o �o .c .o e D .o �o .c e e c iJ p tJ O tJ .p l� iJ O H ,3 e n w P A A N A P O P Q P r N O U W 3 "J n\ n N J N N p 3 oa Am n 3 mcm- 3 3 3 y A D ya 3 3 on v O r z j z ry�v tyA� H yya� �yv j z A a vyyo O rD-OA u H H m I7 N Q J A O N oe �p O v P ce Oe Oe J �D U P O 2 9 3 W n jo SS Rygl .'yr Z � R m o O v � 0 n yzyz yy'i CC�i yzy A H m c m m D` P T O` Q P O\ O1 T D• W W W ti o T 0 N 0 N 0 N 0 0 0 0 0 0 A A N N N N O O O O O p 6 R fi ri (i f_i n n n n N n m a n < A 'F O m m A A A A A A P O O E mH ur n 2 ^Z, E hl min n n n n fD] A A w w Oa Ce Oe ... 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