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2022-08-10 Final Packet]] Agenda Items Properly Numbered Contracts Completed and Signed II 1295's-Flagged for Acceptance (number of 1295's ) All Documents for Clerk Signature. Flagged 1, On this Ifloay of for of Day M 1-5'C��II�I ' 2022 a complete and accurate packet 2022 Commissioners Court Regular Session v was delivered from the Calhoun County Judge's office to the Calhoun County Clerk's Office. Calhoun County Judge/Assistant CO M MI SS I ONERS C OURTC H E CKLI S T/FORMS AGENDA l'I -) ;1[ : 1E, I jl Richard IH . Meyer County Judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Cary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, August 10, 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: AT4 � � Z FILED O'CLOCK—" '1. Call meeting to order. AUG Q 4 2022 Invocation. r Y � 'Pledges of Allegiance. <4./ u nu General Discussion of Public Matters and Public Participation. Consider and take necessary action to approve Halley Hayes as the Agricultural and Natural Resources Agent for the Texas A & M AgriLife Extension Service at the current budgeted salary. (RHM) / '6. Consider and take necessary action to lift o retain he county burn ban. (RHM) Consider and take necessary action on the Imposition of Optional Fees for CY 2023. (RHM) `Consider and take necessary action to approve the use of American Rescue Plan funds to be used for a combined dispatch Emergency Communications Facility up to the allocated amount of $2,067,666.50. (DEH) 4/'Considerand take necessary action to approve the Coastal Surface Lease No. SL20210034 agreement between the Texas General Land OfFce and Calhoun County that proposes to plant 2.4 acres of sea grass and oysters to mitigate for wetland impacts t at occurM during road restoration and i provement. (JMB) d/hZ 10. Conside a tak ecessary ion to authorize Commissioner Behrens to sign a rental agreeme t (#209095091) with United Rentals for a double drum smooth roller. (JMB) Page 1 of 2 m Consider and take necessary action to execute the contract with JRB Services, LLC for Rebid — Lane road Drainage Improvements for Calhoun County, TX under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract G to�S, Work Order No. B-2 and authorize the County Judge to sign. (GDR) QY2. Public Hearing regarding amending the 2022 Calhoun County budget. Glos-e Consider and take necessary action to amend the 2022 Calhoun County budget. (RHM) 14. Consider and take necessary action to authorize the County Judge to sign all necessary documentation pertaining to updating Calhoun County's Hazard Mitigation Plan ��n'-' Development and Grant Management Services in support of Calhoun County State and ✓ Federal Grants. (RHM) 15. Consider and take necessary action on the Independent Audit Report for the year ended December 31, 2021 by Armstrong, Vaughan and Associates, P.C., Certified Public Accountants. (RHM) c/ 16. Consider and take necessary action to accept an anonymous donation of $20.00 to the Sheriff's Office. (RHM) `1�Consider and take necessary action to approve an Education Affiliation Agreement between Calhoun County EMS and Victoria College and authorize the Calhoun County EMS Director to sign all documentation. (RHM) Y8G. Consider and take necessary action to declare the attached list of items from Memorial Medical Center as Waste. (RHM) 19. Accept Monthly Reports from the following County Offices: `i -District Clerk — July 2022 < Floodplain Administration —July 2022 qr Justice of the Peace, Precinct 1— July 2022 Justice of the Peace, Precinct 2 — July 2022 v! Justice of the Peace, Precinct 4 — July 2022 vl', Justice of the Peace, Precinct 5 — July 2022 Sheriffs Office — July 2022 t6. Consider and take necessary action on any necessary budget adjustments. (RHM) 21. Approval of bills and payroll. (RHM) i Richard H. Meyer, County dge Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx.ore under "Commissioners' Court Agenda" for any official court postings. Page 2 of 3 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern ]Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 (Abscnt)Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney 1Kaddie Smith, Deputy Clerk CALHOUN COUNTY C®MMISSI ONERS' C®u.JRT REGULAR TERM 2022 § AUGUST 120 2022 BE IT REMEMBERED THAT ON AUGUST 10, 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 called to order at 10 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US FLAG -Commissioner Joel Behrens Texas Flag -Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Consider and take necessary action to approve Halley Hayes as the Agricultural and Natural Resources Agent for the Texas A & M Agril-ife Extension Service at the current budgeted salary. (RHM) RESULT• APPROVED [UNANIMQUS] MOyER6 Vern Lyssy; Commissioner Pct 2 SECONDER: '. ;Joel Behrens; Commissioner. Pct 3 . , AYES Judge Meyer, Commissioner HaII, Lyssy, Behrens 6. Consider and take necessary action to lift or retain the county burn ban. (RHM) Burn ban retained per Judge Richard: Meyer '.: 7. Consider and take necessary action on the Imposition of Optional Fees for CY 2023. (RHM) 8. Consider and take necessary action to approve the use of American Rescue Plan funds to be used for a combined dispatch Emergency Communications Facility up to the allocated amount of $2,067,666.50. (bEH) RESULT `' `APPROVED [UNANIMOUS]''. .MOVER:David Hall, Commissioner Pct 1. SECONDER: Vern Lyssy, Commissioner Pct Z AXES Judge Meyer, Commissioner Hall, LySSy,' Behrens 9. Consider and take necessary action to approve the Coastal Surface Lease No. SL20210034 agreement between the Texas General Land Office and Calhoun County that proposes to plant 2.4 acres of sea grass and oysters to mitigate for wetland impacts that occurred during road restoration and improvement. (]MB) RESULT: 'APPROVED [UNANIMOUS] MOVER: Joel Behrehs,..DommissionerPct 3 SECONDER"; ' David Hall,,Conimissloner P& I AYES: Judge Meyer,'Commissloner Hall, Lyssy, Behrens 10. Consider and take necessary action to authorize Commissioner Behrens to sign a rental agreement (#209095091) with United Rentals for a double drum smooth roller. (]MB) RESULT APPROVED [UNANIMOUS] MOVER . Vernyssy, Commissioner Pct"2' SECONDER:, David Hall, Commissioner Pct L AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens: 11. Consider and take necessary action to execute the contract With JRB Services, LLC for Rebid — Lane road Drainage Improvements for Calhoun County, TX under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-2 and authorize the County Judge to sign. (GDR) ,RESULT: : APPROVED [UNANIMOUS]. ;MOVER Vern: Ss Commissioner Pct 2 Y y, SECONDER: David Hall, Commissioner Pct,:I, AYES. Judge Meyer, ComMIS sioner,Hall, Lyssy; Behrens' 12. Public Hearing regarding amending the 2022 Calhoun County budget. 7777 Closed 10:b9 am Candice gaV the report. Opened 10:11 a.m, 13. Consider and take necessary action to amend the 2022 Calhoun County budget. (RHM) it SULT: ` APPROVED [UNANIMOUS] MOVER DavidHall; Commis' sioner.Pct 1. ' SECONDER:. Joel Behrens, Commissioner Pct 3 AYES Judge Meyer, Commissioner Hall, Lyssy Behrens:.; 14. Consider and take necessary action to authorize the County Judge to sign all necessary documentation pertaining to updating Calhoun County's Hazard Mitigation Plan Development and Grant Management Services in support of Calhoun County State and Federal Grant. (RHM) RESULT APPROVED [UNANIMOUS] MOVER Vern Lyssy; Commissioner Pct 2 SECONDER: David Halle Commissioner N 1. AYES: :.Judge Meyer, Commissioner Hall, Lyssy, Behrens. 15. Consider and take necessary action on the Independent Audit Report for the year ended December 31, 2021 by Armstrong, Vaughan and Associates, P.C., Certified Public Accountants. (RHM) 16. Consider and take necessary action to accept an anonymous donation of $20.00 to the Sheriff's Office, (RHM) RESULT APPROVED [UNANIMOUS3 MOVER Vern Lyssy, Commissioner Pct 2 SECONDED David Hall, Commissioner Pct 1 AYES Judge Meyer, Commissloner Hall, Lyssy; Behrens 17, Consider and take necessary action to approve an Education Affiliation Agreement between Calhoun County EMS and Victoria College and authorize the Calhoun County EMS Director to sign all documentation, (RHM) Dustin 7enkins explained the..agreements RESULT:::' APPROVED [UNANIMOUS]. MOVER: ' `. Vern Lyssy Commissioner"Pd 2 SECONDER: ,David Hail,' Commissioner Oct AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens (: 18. Consider and take necessary action to declare the attached list of items from Memorial Medical Center as Waste. (RHM) RESULT APPROVE"UNANIMOUS3:- MOVEIM Joel Behrens; COmmissioner Pct 3 . SECONDER:: David Hall; Comissioner Pct 1 m AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens 14. Accept Monthly Reports from the following County Offices: I. District Clerk — July 2022 II. Floodplain Administration — July 2022 iii. Justice of the Peace, Precinct 1— July 2022 Iv. Justice of the Peace, Precinct 2 — July 2022 v, Justice of the Peace, Precinct 4 — July 2022 A. Justice of the Peace, Precinct 5 — July 2022 vil. Sheriffs Office — July 2022 RESULT APPROVED [UNANIMOUS3 ; MOVER: Vern: Lyssy, Commissioner. Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES. ,... Judge. Meyer, Commissioner Hall, Lyssy, Behrens:. 20. Consider and take necessary action on any necessary budget adjustments. (RHM) RESUM T . APPROVED [UNANIMOUS] MOVERd Joel..Beh:rens, Commissioner Pct 3 SECONDER: ` ` Vera Lyssy. Commissioner Pct 2 AYES: Judge Meyer Commissioner Hall, Lyssy, Behrens. 21. Approval of bills and payroll. (RHM) MMC RESULT APPROVED [UNANIMOUS] MOVER: David Hail;Commissloner. Pct:']: SECONDER:: Vern Lyssy:Commissioner Pc-2 AYES: Judge Meyer, Commissioner Ffall, Lyssy, Behrens .: County Bills,' RESPILTr APPROVED [UNANIMOUS] MOVER .Qavid Hall, tonmmissioner Pct 1 SECONDER: -. YOn Lys. , Commissioner Pet 2 AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens Adjourned:10:30 a.m. x co D o y O N O N N N O � A C� ll O W N O O O O O O O O 0 goo O O 00 O O P 00 O O o0 O O [nCA 0 0 En m W x A O O m 3 N _ m N DO N C O y Z fNll cil N � � O � 3 m F g o m F = 3 a n N CD cr # 05 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 (Absent)Gary Reese, Commissioner, Precinct 4 Sara Rodriguez, County Attorney Kaddie Smith, Deputy Clerk REGULAR TERM 2022 § AUGUST 10, 2022 BE IT REMEMBERED THAT ON AUGUST 10, 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 called to order at 10 a.m. 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US FLAG -Commissioner Joel Behrens Texas Flag -Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. N/A 5. Consider and take necessary action to approve Hailey Hayes as the Agricultural and Natural Resources Agent for the Texas A & M AgriLife Extension Service at the current budgeted salary. (RHM) RESULT:',APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: i Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Mae Belle Cassel From: kdsutherland@ag.tamu.edu (Katherine Sutherland) <kdsutherland@ag.tamu.edu> Sent: Wednesday, August 3, 2022 3:08 PM To: Mae Belle Cassel Subject: new employee consideration CAUTION: This email' originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Good afternoon Mae Belle, I need to get the extension office on the court docket August 101h with following verbiage to be entered into the agenda: "Texas A&M Agril-ife Extension requesting the consideration and approval of hiring Halley Hayes as the Agricultural and Natural Resources Agent at the current budgeted salary" Please advise. Z4ffwt6 e Saffwze"d awe X"49M =Saaet aad@ y, Mma. edu caFw" eou00 gist raio(m 311Wwvw Van66 V" Suite 1 Pont Z4aaea, ?euu 77979 361, 552, 9747 1 # 06 6. Consider and take necessary action to lift or retain the county burn ban. (RHM) # 07 7. Consider and take necessary action on the Imposition of Optional Fees for CY 2023. (RHM) Option A- No Change RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer; Commissioner Hall, Lyssy, Behrens' `texas Department of Motor Vehicles Imposition of Optional Fees Calendar Year (CY) 2023 INSTRUCTIONS: All counties must complete and return this form, even if there are no changes to fees for the upcoming calendar year. Please submit this form (including a court order, if required) via email to DMV OptionalCountyFeeUpdates@TxDMV.gov. Please submit at your earliest convenience, but no later than Thursday, September 1, 2022. COUNTY NAME: SELECT ONLY ONE OPTION BELOW: OR We appreciate your response. Thank you. Texas Department of Motor Vehicles HELPING TEXANS GO, HELPING TEXAS SHOW. July 21, 2022 Re: Imposition of Optional Fees for Calendar Year (CY) 2023 To the Honorable County Judge: County commissioners courts are statutorily required to notify the Texas Department of Motor Vehicles (TxDMV) each year regarding the imposition or removal of optional fees. Notice must be made to TxDMV each year by September 1, with new fees taking effect on January 1 of the following year. This letter and attachments will provide information on how to submit the Calendar Year (CY) 2023 notification to TxDMV. The following is a brief description of the related optional county fees from Chapter 502 of the Transportation Code: County Road and Bridge Fee (Section 502.401): • May not exceed $10; and • Revenue must be credited to the county road and bridge fund. Child Safety Fee (Section 502.403): • May not exceed $1.50; and • Revenue must be used for school crossing guard services; remaining funds must be used for programs to enhance child safety, health, or nutrition, including child abuse intervention and prevention, and drug and alcohol abuse prevention, among other purposes. Transportation Project Fee (Section 502.402): • Applies ONLY to Bexar, Brazos, Cameron, El Paso, Hidalgo and Webb counties; • May not exceed $10 for Bexar, El Paso and Hidalgo counties; • May not exceed $20 for Brazos, Cameron, and Webb counties; and • Revenue must be used for long-term transportation projects. Please complete and return the attached Imposition of Optional Fees form. If your county will keep the same optional fees for CY 2023, please select OPTION A. If your county will change imposed fees, please select OPTION B and include a copy of a commissioners court order reflecting the specific changes. DEADLINE: Please return the form and commissioners court order, if applicable, by Thursday, September 1, 2022, via email to DMV OptionalCountvFeeUpdates@TxDMV.gov (note the underscore between DMV and Optional). If you have any questions, please contact Maureen Vale, Registration Services, at 512-465-5601. Thank you for your timely response. Sincerely, Roland D. Luna, Sr., Deputy Executive Director Texas Department of Motor Vehicles RL•CT:MV Attachments cc: County tax assessor -collectors 4000 JACKSON AVENUE, AUSTIN, TEXAS 78731 1 0 512.465.3000 ♦ 888.368.4689 (888-DMVGO'rX) * F 512.465.3098 1 www.TxDMV.gov • 1., 8. Consider and take necessary action to approve the use of American Rescue Plan funds to be used for a combined dispatch Emergency Communications Facility up to the allocated amount of $2,067,666.50. (DEH) RESULT: APPROVED [UNANIMOUS]' MOVER: David Hall„ Commissioner Pct"1 SECONDER:; Vern Lyssy, Commissioner Pct 2 AYES: I I Judge Meyer, Commissioner Hall, Lyssy, Behrens David E. Hall Calhoun County Commissioner, Precinct 41 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for August 10th, 2022. • Consider and take necessary action to approve the use of American Rescue Plan funds to be used for the a combined dispatch Emergency Communications facility up to the allocated amount of $2,067,666.50 SincergL Da E. Hall DEH/apt # 09 9. Consider and take necessary action to approve the Coastal Surface Lease No. SL20210034 agreement between the Texas General Land Office and Calhoun County that proposes to plant 2.4 acres of sea grass and oysters to mitigate for wetland impacts that occurred during road restoration and improvement. (JMB) RESULT: APPROVED [UNANIMOUS); . MOVER: Joel Behrens, Commissioner pct 3 SECONDER: David Hall,Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172-Olivia, Fort. Iavaca, Texas 77979 -Office (361) 393-3346 -Fax (361) 693-5309 Email: iceLLxNrcns(Ncalhounmix.orc 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 August 10, 2022. • Please Consider and Take Necessary Action to approve the Coastal Surface Lease NO. SL20210034 agreement between the Texas General Land Office and Calhoun County for the propose to plant 2.4 acres of sea grass and oysters to mitigate for the wetland impacts that occurred during road restoration and improvement. And authorize Judge Meyer to sign all necessary documents. Sincerely, Joel Behrens Commissioner Pct. 3 DoouSign Envelope ID: 3717AEE8-C7E3-4888-9Ft8-98BF00009875 e�RRAI Cgry x TEXAS GENERAL LAND OFFICE COASTAL SURFACE LEASE NO. SL20210034 STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF CALHOUN This Coastal Surface Lease SL20210034, ("Lease"), is granted by virtue of the authority granted in Section 51.121, et seq., TEX. NAT. RES. CODE ANN., 31 TEX. ADMIN. CODE, Chapter 13, Land Resources, et sea., and all other applicable statutes and rules, as the same may be amended from time to time, and is subject to all applicable regulations promulgated from time to time. ARTICLE 1. PARTIES 1.01. In consideration of the mutual covenants and agreements set forth herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the STATE OF TEXAS, acting by and through the Commissioner of the General Land Office, on behalf of the Permanent School Fund of the State of Texas (the "State"), hereby grants to Calhoun County, whose address is 202 S. Ann, Port Lavaca, TX, 77979, (361) 552-9242 ("Lessee"), the right to use the surface estate of certain Permanent School Fund land (the "Leased Premises") for the purposes identified in Article V below. ARTICLE II. PREMISES 2.01. The Leased Premises is described below and further described or depicted on Exhibits A-1, A-2, B-1, B-2, C-1, C-2, attached hereto and collectively incorporated by reference for all purposes: Adjacent to: Mitigation sites - Keller Bay (State Tract 77) and Blind Bayou, Calhoun County, Texas 2.02. LESSEE HAS INSPECTED THE PHYSICAL AND TOPOGRAPHIC CONDITION OF THE LEASED PREMISES AND ACCEPTS SAME "AS IS" IN ITS EXISTING PHYSICAL AND TOPOGRAPHIC CONDITION. LESSEE IS NOT RELYING ON ANY REPRESENTATION OR WARRANTY OF THE STATE REGARDING ANY ASPECT OF THE PREMISES, BUT IS RELYING ON LESSEE'S OWN INSPECTION OF THE PREMISES. THE STATE DISCLAIMS ANY AND ALL WARRANTIES OF HABITABILITY, MERCHANTABILITY, SUITABILITY, FITNESS FOR ANY PURPOSE, AND ANY OTHER WARRANTY WHATSOEVER NOT EXPRESSLY SET FORTH IN THIS LEASE. THE STATE AND LESSEE HEREBY AGREE AND ACKNOWLEDGE THAT THE USE OF THE TERMIS "GRANT" AND/OR "CONVEY" IN NO WAY EVIPLIES THAT THIS LEASE OR THE LEASED PREMISES ARE FREE OF LIENS, ENCUMBRANCES AND/OR PRIOR RIGHTS. LESSEE IS HEREBY PUT ON NOTICE THAT ANY PRIOR GRANT AND/OR ENCUMBRANCES MAY BE OF RECORD AND LESSEE IS ADVISED TO EXAMINE ALL RECORDS OF THE STATE AND COUNTY IN WHICH THE LEASED PREMISES ARE LOCATED. THE PROVISIONS OF THIS SECTION SHALL SURVIVE THE EXPIRATION OR EARLIER TERMINATION OF THIS LEASE. ARTICLE HI. TERM 3.01. This Coastal Surface Lease No. SL20210034 is for a term of twenty (20) years, commencing on July 1, 2022 and terminating on June 30, 2042, unless earlier terminated as provided herein. The State reserves the right to review, amend, cancel or otherwise modify this agreement at any time during its term upon 30-day written notice to Lessee as prescribed in 3.01. Renewal of this agreement is at the sole discretion of the State, and no right to renew is implied or provided for herein. SL20210034 1 Customer1D: C000000686 srodrigu SL New Comm-0 11615 DocuSign Envelope ID: 3717AEE8-G7E3.4888-9F18-98BF00009875 ARTICLE IV. CONSIDERATION 4.01. In consideration of the mutual covenants and conditions set forth herein and the public benefits to be derived therefrom, State and Lessee acknowledge that no rental fees shall be assessed for the described use of the Leased Premises provided that Lessee is not in default of the terms agreed upon herein. ARTICLE V. USE OF THE PREAUSES 5.01. The Leased Premises may be used by Lessee solely for a mitigation project consisting of 2.4 acres of Spartina alterniflora marsh creation and 2,889 square feet of oyster shell breakwaters, for a total encumbrance of 2.47 acres of coastal public land, and for no other purpose. The Leased Premises are to remain in their current topographical and hydrologic condition during the term of the Lease. Lessee is specifically prohibited from modifying the premises in any marker not authorized herein, and from using, or allowing the use by others, of the Leased Premises for any other purpose. 5.02. Lessee shall not use, or permit the use of, the Leased Premises for any illegal purpose. Lessee will comply with, and will cause its officers, employees, agents and invitee to comply with, all applicable federal, State and local laws, ordinances and rules concerning the use of the Leased Premises. 5.03. The State reserves the exclusive right to grant easements, rights -of way and/or other grants of interest authorizing use of the Leased Premises, provided such use does not unreasonably interfere with Lessee's use thereof. 5.04. Lessee shall not grant other rights in or to the Leased Premises to any other person or entity, and any attempt to do so shall be void and of no effect and shall constitute a default by Lessee hereunder. 5.05. State reserves the right to enter upon the Leased Premises at any time with or without prior notice to Lessee to inspect the condition thereof and/or take action authorized by this Lease. 5.06. The Leased Premises are subject to prospecting, production and development of oil, gas and other minerals and other materials of commercial value by the State, its lessees, permittee, licensees or other agents, assigns or representatives. Lessee shall not interfere with such use of the Leased Premises and shall allow any lessee, permit holder, licensee or other agent, assignee or representative of the State and/or the School Land Board the right of ingress and egress over, across and through, and the use of, the Leased Premises for any and all purposes authorized by State. 5.07. Lessee may not charge States authorized lessees, permit holders, licensees or other agents, assigns or representatives surface damages, or any other fee, for use of the Leased Premises: provided, however, the foregoing shall not limit the liability of any person or entity to Lessee for damages caused to property owned by Lessee. 5.08. Lessee's use of the Premises is subject to and contingent upon compliance with the following covenants, obligations and conditions (the "Special Conditions") 1. Breakwaters shall be built of sufficient height above the substrate to be visible above the water surface at mean high tide. Permanent markers/pilings shall be installed to U.S. Coast Guard specifications. 2. No work may commence until a Coastal Boundary Survey, in compliance with TEX. NAT. RES. CODE Section 33.136, for the Mitigation Sites and any other portion of the project that may involve state-owned land has been approved and notification published as required. 3. Lessee is responsible for maintaining all structures authorized under this contract in good repair and safe condition, and in compliance with all existing state and federal regulations governing such work. 4. Any buildup of sediment resulting from the activities authorized by this contract will be property of the State of Texas, as determined by the GLO. Lessee waives any right to claim ownership of any land created by the project. SL20210034 2 CustomerlD: C000000686 srodrign St -New Comm 011615 DocuSign Envelope ID: 3717AEE8-C7E3-4888-9F18-98BF00009875 ARTICLE VI. ASSIGNMENTS 6.01. Lessee shall not assign the Premises or the rights granted herein, in whole or part, to any third parry for any purpose without the prior written consent of the State, which may be granted or denied in the State's sole discretion. Any unauthorized assignment shall be void and of no effect and such assignment shall not relieve Lessee of any liability for any obligation, covenant, or condition of this Agreement. This provision, and the prohibition against assignment contained herein, shall survive expiration or earlier termination of this agreement. For purposes of this agreement, an assignment is any transfer, including by operation of law, to another of all or part of the property, interest or rights herein granted. ARTICLE VII. PROTECTION OF NATURAL AND HISTORICAL RESOURCES 7.01. Lessee shall take no action on the premises which results in the discharge of any solid or liquid material. Lessee shall use the highest degree of care and all appropriate safeguards to: (i) prevent pollution of air, ground, and water in and around the Premises, and (ii) to protect and preserve natural resources and wildlife habitat. Lessee shall comply with all applicable rules and regulations of the General Land Office and other governmental agencies responsible for the protection and preservation of public lands and waters. In the event of pollution or an incident that may result in pollution of the Premises or adjacent property which is the result of Lessee's (or Lessee's employees, contractors, invitees and agents) acts or omissions, Lessee shall immediately notify the State, use all means reasonably available to recapture any pollutants which have escaped or may escape, and mitigate for any and all natural resources damages caused thereby. 7.02. LESSEE IS EXPRESSLY PLACED ON NOTICE OF THE NATIONAL HISTORICAL PRESERVATION ACT OF 1966, (PB-89-66, 80 STATUTE 915; §470) AND THE ANTIQUITIES CODE OF TEXAS, CHAPTER 191, TEX. NAT. RES. CODE ANN. IN THE EVENT THAT ANY SITE, OBJECT, LOCATION, ARTIFACT OR OTHER FEATURE OF ARCHEOLOGICAL, SCIENTIFIC, EDUCATIONAL, CULTURAL OR HISTORIC INTEREST IS ENCOUNTERED DURING ANY ACTIVITY ON THE PREMISES, LESSEE WILL IMMEDIATELY CEASE SUCH ACTIVITIES AND WILL IMMEDIATELY NOTIFY STATE AND THE TEXAS HISTORICAL COMMISSION, P.O. BOX 12276, AUSTIN, TEXAS 78711, SO THAT ADEQUATE MEASURES MAY BE UNDERTAKEN TO PROTECT OR RECOVER SUCH DISCOVERIES OR FINDINGS, AS APPROPRIATE. ARTICLE VIII. INDEMNITY 8.01. LESSEE SHALL BE FULLY LIABLE AND RESPONSIBLE FOR ANY DAMAGE, OF ANY NATURE, ARISING OR RESULTING FROM ITS OWN ACTS OR OMISSIONS RELATED TO ITS EXERCISE OF THE RIGHTS GRANTED HEREIN. LESSEE AGREES TO AND SHALL INDEMNIFY AND HOLD THE STATE, THE STATE'S OFFICERS, AGENTS, AND EMPLOYEES, HARMLESS FROM AND AGAINST CLAIMS, SUIT, COSTS, LIABILITY OR DAMAGES OF ANY KIND, INCLUDING STRICT LIABILITY CLAIMS, WITHOUT LIMIT AND WITHOUT REGARD TO CAUSE OF THE DAMAGES OR THE NEGLIGENCE OF ANY PARTY, EXCEPT FOR THE CONSEQUENCES OF THE NEGLIGENT ACTS OR WILLFUL MISCONDUCT OF THE STATE, THE STATE'S OFFICERS, AGENTS, EMPLOYEES, OR INVITEES, ARISING DIRECTLY OR INDIRECTLY FROM LESSEE'S USE OF THE PREMISES (OR ANY ADJACENT OR CONTIGUOUS PSF LAND) OR FROM ANY BREACH BY LESSEE OF THE TERMS, COVENANTS OR CONDITIONS CONTAINED HEREIN. THE PROVISIONS OF THIS SECTION SHALL SURVIVE EXPIRATION OR EARLIER TERMINATION OF THIS AGREEMENT. ARTICLE IX. DEFAULT. TERMINATION AND EXPIRATION 9.01. If, following 30 days prior written notice from the State specifying a default or breach, Lessee fails to pay any money due hereunder or is in breach of any term or condition of this Agreement, the State shall have the right, at its option and its sole discretion, to terminate this Agreement and all rights inuring to Lessee herein by sending written notice of such termination to Lessee in accordance with ARTICLE XI of this Agreement. Upon sending of such written notice, this Agreement shall automatically terminate and all rights granted herein to Lessee shall revert to the State. Such termination shall not prejudice the rights of the State to collect any money due or to seek recovery on any claim arising hereunder. SL20210034 3 CustomerlD: C000000686 srodrigu SL New Comm 011615 Docu8ign Envelope 10: 3717AEE8-C7E3-4888-9F7a-9BBF00009875 9.02. If Lessee fails to remove its personal property from the Leased Premises within the time specified in Section 9.01 above, or if Lessee fails to remove improvements placed or constructed on the Leased Premises by or behalf of Lessee pursuant to a notice by the State to do so pursuant to Section 9.01. above, then State may, at its sole option, remove and dispose of such property (with no obligation to sell or otherwise maintain such property in accordance with the Uniform Commercial Code), at Lessee's sole cost and expense, or the State may elect to own such property by filing a notice of such election pursuant to Section 51302, et seq., TEXAS NATURAL RESOURCES CODE ANNOTATED. If the State elects to remove Lessee's property and dispose of it pursuant to this section, then in such an event Lessee shall be obligated to reimburse the State for the reasonable costs of such removal and disposal within ten (10) days of State's demand for reimbursement. THE TERMS OF THIS SECTION SHALL SURVIVE EXPIRATION OR EARLIER TERMINATION OF THIS LEASE. 9.03. In addition to the above, Lessee shall pay and discharge any and all taxes, general and special assessments, and other charges which during the term of this Agreement may be levied on or assessed against the Premises or the Improvements constructed thereon, provided such taxes result from Lessee's use of this easement. Lessee shall pay such taxes, charges, and assessments not less than five (5) days prior to the date of delinquency thereof directly to the authority or official charged with the collection thereof. Lessee shall have the right in good faith at its sole cost and expense to contest any such taxes, charges, and assessments, and shall be obligated to pay the contested amount only if and when finally determined to be owed. 9.04. LESSEE AGREES TO AND SHALL PROTECT AND HOLD THE STATE HARMLESS FROM LIABILITY FOR ANY AND ALL SUCH TAXES, CHARGES, AND ASSESSMENTS, TOGETHER WITH ANY PENALTIES AND INTEREST THEREON, AND FROM ANY SALE OR OTHER PROCEEDING TO ENFORCE PAYMENT THEREOF. ARTICLE X. HOLDOVER 10.01. If Lessee holds over and continues in possession of the Premises after expiration or earlier termination of this Agreement, Lessee will be deemed to be occupying the Premises on the basis of a month -to -month tenancy subject to all of the terms and conditions of this Agreement, except that as liquidated damages by reason of such holding over, the amounts payable by Lessee under this Agreement shall be increased such that the Consideration payable under Section 4.01 of this Agreement and any other sums payable hereunder shall be two hundred percent (200%) of the amount payable to the State by Lessee for the applicable period immediately preceding the fast day of the holdover period. Lessee acknowledges that in the event it holds over, the State's actual damages will be difficult, if not impossible, to ascertain, and the liquidated damages herein agreed to be paid are reasonable in amount and are payable in lieu of actual damages and are not a penalty. Lessee further acknowledges that acceptance of hold over Consideration does not imply State consent to hold over. 10.02. The tenancy from month -to -month described in Section 10.01 of this Agreement may be terminated by either party upon thirty (30) days written notice to the other. 10.03. The Consideration due after notice of termination has been given is to be calculated according to Section 10.01 hereinabove on a pro rata basis. If upon notice of termination by the State, Lessee pays Consideration in excess of the amount due and payable and the State accepts such payment, the acceptance of such payment will not operate as a waiver by the State of the notice of termination unless such waiver is in writing and signed by the State. Any such excess amounts paid by Lessee and accepted by the State shall be promptly refunded by the State after deducting therefrom any amounts owed to the State. ARTICLE XI. NOTICE 11.01. Any notice which may or shall be given under the terms of this Agreement shall be in writing and shall be either delivered by hand, by facsimile, or sent by United States first class mail, adequate postage prepaid, if for the State to the Deputy Director of Asset Enhancement, addressed to 1700 North Congress Avenue, Austin, Texas 78701- 1495, Fax (512) 463-5304, and if for Lessee, to Calhoun County, 202 S. Ann, Port Lavaca, TX 77979. Any parry's SL20210034 4 CuslomedD: C000000686 smdri,-u SL New Comm 0116U DocuSign Envelope ID: 3717AEE5-C7E3-4888-9F18-98BF00009875 address may be changed from time to time by such party by giving notice as provided above, except that the Premises may not be used by Lessee as the sole notice address. No change of address of either party shall be binding on the other party until notice of such change of address is given as herein provided. 11.02. For purposes of the calculation of various time periods referred to in this Agreement, notice delivered by hand shall be deemed received when delivered to the place for giving notice to a party referred to above. Notice mailed in the manner provided above shall be deemed completed upon the earlier to occur of (i) actual receipt as indicated on the signed return receipt, or (ii) three (3) days after posting as herein provided. ARTICLE XII. INFORMATIONAL REQUIREMENTS 12.01. A. Lessee shall provide written notice to the State of any change in Lessee's name, address, corporate structure, legal status or any other information relevant to this Agreement. B. Lessee shall provide to the State any other information reasonably requested by the State in writing within fifteen (15) days following such request or such other time period approved by the State (such approval not to be unreasonable withheld). ARTICLE X1II. MISCELLANEOUS PROVISIONS 13.01. With respect to terminology in this Agreement, each number (singular or plural) shall include all numbers, and each gender (male, female or neuter) shall include all genders. If any provision of this Agreement shall ever be held to be invalid or unenforceable, such invalidity or unenforceability shall not affect any other provisions of the Agreement, but such other provisions shall continue in full force and effect. 13.02. The titles of the Articles in this Agreement shall have no effect and shall neither limit nor amplify the provisions of the Agreement itself. This Agreement shall be binding upon and shall accrue to the benefit of the State, its successors and assigns, Lessee, Lessee's successors and assigns (or heirs, executors, administrators and assigns, as the case may be); however, this clause does not constitute a consent by the State to any assignment by Lessee, but instead refers only to those instances in which an assignment is hereafter made in strict compliance with Article VI above, or in the case of a deceased natural person Lessee, refers to the instances previously referred to in this sentence and also circumstances in which title to Lessee's interest under this Agreement passes, after the demise of Lessee, pursuant to Lessee's will or the laws of intestate succession. The words "hereof .. "herein," "hereunder," "hereinafter" and the like refer to this entire instrument, not just to the specific article, section or paragraph in which such words appear. 13.03. Neither acceptance of Consideration (or any portion thereof) or any other sums payable by Lessee hereunder (or any portion thereof) to the State nor failure by the State to complain of any action, non -action or default of Lessee shall constitute a waiver as to any breach of any covenant or condition of Lessee contained herein nor a waiver of any of the State's rights hereunder. Waiver by the State of any right for any default of Lessee shall not constitute a waiver of any right for either a prior or subsequent default of the same obligation or for any prior or subsequent default of any other obligation. No right or remedy of the State hereunder or covenant, duty or obligation of Lessee hereunder shall be deemed waived by the State unless such waiver be in writing, signed by a duly authorized representative of the State. 13.04. No provision of this Agreement shall be construed in such a way as to constitute the State and Lessee joint ventures or co-partners or to make Lessee the agent of the State or make the State liable for the debts of Lessee. 13.05. In all instances where Lessee is required hereunder to pay any sum or do any act at a particular indicated time or within an indicated period, it is understood that time is of the essence. 13.06. Under no circumstances whatsoever shall the State ever be liable hereunder for consequential damages or special damages. The terms of this Agreement shall only be binding on the State during the period of its ownership of the Premises, and in the event of the transfer of such ownership interest, the State shall thereupon be released and SL20210034 5 CustomerlD: C000000686 srodrigu SL New Comm_011615 DocuSign Envelope ID: 3717AEE8-C7E3-4888-9F18-986F00009875 discharged from all covenants and obligations thereafter accruing, but such covenants and obligations shall be binding during the Agreement term upon each new owner for the duration of such owner's ownership. 13.07. All monetary obligations of the State and Lessee (including, without limitation, any monetary obligation for damages for any breach of the respective covenants, duties or obligations of either party hereunder) are performable exclusively in Austin, Travis County, Texas. 13.08. The obligation of Lessee to pay all Consideration and other sums hereunder provided to be paid by Lessee and the obligation of Lessee to perform Lessee's other covenants and duties under this Agreement constitute independent, unconditional obligations to be performed at all times provided for hereunder, save and except only when an abatement thereof or reduction therein is expressly provided for in this Agreement and not otherwise. Lessee waives and relinquishes all rights which Lessee might have to claim any nature of lien against, or withhold or deduct from or offset against, any Consideration or other sums provided hereunder to be paid to the State by Lessee. Lessee waives and relinquishes any right to assert, either as a claim or as a defense, that the State is bound to perform or is liable for the nonperformance of any implied covenant or implied duty of the Lessor not expressly set forth in this Agreement. 13.09. In the event any provision of this Lease is more restrictive than any administrative rule promulgated by the General Land Office and/or the School Land Board, this Lease shall control. ARTICLE XIV. FILING 14.01. Lessee shall, at its sole cost and expense, record a memorandum of lease in the Calhoun County Real Property Records and provide a file marked copy of same to Lessor within 60 days after this Lease is executed by all parties. ARTICLE XV. ENTIRE AGREEMENT 15.01. This Lease, including any exhibits to the same, constitutes the entire agreement between the State and Lessee; no prior written or prior oral contemporaneous oral promises or representations shall be binding. The submission of this Lease for examination by Lessee or the State and/or execution thereof by the Lessee or the State does not constitute a reservation of or option for the Leased Premises and this Lease shall become effective only upon execution of all parties hereto and deliver of a fully executed counterpart thereof by the State to the Lessee. This Lease shall not be amended, changed or extended except by written instrument signed by both parties thereto. SL20210034 6 CustomerrID: C000000686 srodrigu SLNew Comm 0116l6 DocuSign Envelope ID: 3717AEE8-C7E3-4888-9F18-98BF00009875 IN TESTIMONY WHEREOF, witness my hand and the Seal of Office. LESSOR: THE STATE OF TEXAS GEORGE P. BUSH Commissioner, General Land Office Date APPROVED: ros Contents: 13 „ OS Legal: L sGA Director: Executive: SL20210034 7 CustomerID: C000000686 srodrigu SL New Comm_011615 DocuSign Envelope ID: 3717AEEB-C7E3-4888-9F78-98BF00009875 LESSEE: Calhoun County By: (Signature) H. (Printed Name) Coc�u lu�h� (Title) Date: 6I 7 Z ACKNOWLEDGMENT STATE OF § COUNTY OF § This instrument was acknowledged before me on the 10�Z day of 20 ZZ , by Calhoun County. Notary Public, State of lzz—_ i�-ai "��fL%le ,�. ,. MAE BELLE CASSEL MyNotuyIDS732012524 My commission expires: 14 Z Z -31 ?,+;< Expires May 14, 2023 SL20210034 8 CustomerlD: C000000686 srodrigu SL New Comm_011613 DocuSign Envelope 10: 3717AEE8-C7E3-4888-9F18-988F00009875 as TEXAS GENERAL LAND OFFICE w MEMORANDUM OF SURFACE LEASE NO. SL20210034 < T x STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF CALHOUN This Memorandum of Surface Lease is made on February 1, 2022 to record the agreement (the "Agreement") heretofore entered into by the State of Texas (the "Lessor"), acting by and through the Commissioner of the General Land Office (the "GLO") as Chairman of the School Land Board (the "Board) on behalf of the Permanent School Fund (the "PSF"), and Calhoun County, (the "Lessee"), which affects certain lands located in Calhoun County, Texas (the "Premises"), which property is more particularly described on Attachments to the Agreement. WITNESSETH That for, and in consideration of, the mutual promises and undertakings recited therein, the parties have executed Surface Lease No. SL20210034 (the "Agreement"), an original of which is in the records of the GLO. The Lessee has been granted the use of certain submerged lazed (the "Premises") located in Keller Bay (State Tract 77) and Blind Bayou, Calhoun County, Texas, being more particularly described in the Agreement and its Attachments. The littoral property of Lessee that is adjacent to the Premises is described in the Agreement as Mitigation sites - Keller Bay (State Tract 77) and Blind Bayou, Calhoun County, Texas, as recorded in the Real Property Records of Calhoun County, Texas. The Premises encumbered by the Agreement to Lessee contain approximately 2.47 acres. The term of the Agreement is for a period of twenty (20) years, which term begins on July 1, 2022. The Agreement sets forth Lessee's limited right to use and occupy the property described for a mitigation project consisting of 2.4 acres of Spartina alteniflora marsh creation and 2,889 square feet of oyster shell breakwaters, for a total chargeable encumbrance of 2.47 acres of coastal public land. The Agreement is not assignable without the prior written consent of the Lessor. Use of state property without the requisite consent may subject the user to the assessment of a civil penalty of $200.00 per day, as provided in Chapter 33 of the Texas Natural Resources Code, and/or a penalty of up to $1,000.00 per day as provided in Chapter 51 of the Texas Natural Resources Code. SL20210034 1 CustomerlD: C000000696 srodrigu CntMemomndumAUS DocuSign Envelope ID: 3717AEE8-C7E3-4888-9F78-986F00009875 IN TESTIMONY WHEREOF, witness my hand and the Seal of Office. LESSOR: THE STATE OF TEXAS 01 GEORGE P. BUSH Commissioner, General Land Office Chairman, School Land Board Date: APPROVED: os !!!'`777 Contents: os Legal: SGA Director: Executive: SL20210034 2 CustomerlD: C000000686 srodrigu CntMemorandumAUS DocuSign Envelope ID: 3797AEE8-C7E3-4888-9F18-98BF00009875 LESSEE: Calhoun County r; By: ! V Signature RiH. Printed Name ( l n d Title Date: g/102z T 1 ACKNOWLEDGMENT STATE OF /r/ § COUNTY OF § This i rument was acknowledged before me on the day of 202Z by W. / (Lessee representative signing this cunzent) :sevye., MAE BELLE CASSEL My Notary ID i{ 132012524 + ,by,ti*,.• ExomMay 14,2023 Notary Public, State of My commission expires: 2,2523 SL20210034 ; CustomeriD: C000000686 srodrigu CntMemormdumAUS # Zo Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 -• Fax (361) 893-5309 Email; Ioel.bchrenS[dcalhouncotx.or4 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 August 10, 2022. • Please Consider and Take Necessary Action to allow Commissioner Behrens to sign rental agreement # 209095091 with United Rentals for a double drum smooth roller Sincerely, Joel Behrens Commissioner Pct. 3 10. Consider and take necessary action to authorize Commissioner Behrens to sign a rental agreement (#209095091) with United Rentals for a double drum smooth roller. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens 0United Rentals - BRANCH P59 824 STATE SZOMY 35 HOOTS PORT LAVACA Or 77979 361-552-1BH] 36a-552-7210 PAX m PRECINCT 3 w24627 STATE HIGHWAY 172 PORT LAVACA TX 77979-6032 A h Office: 361-553-4612 Cell: 361-920-2173 CALHOUN COUNTY 211 S ANN ST PORT LAVACA TX 77979-4203 RENTAL RESERVATION Customer # : 1255062 Reserved Date 08/01/22 Scheduled Out : 08/15/22 10:00 AM Estimated In : 09/12/22 10:00 AM DR Job Loa :PRECINCT 3 OR Job # : 23 Customer Job ID: P.O. # : TED Ordered By : JOEL BEHRENS Written By : ROGERIO ATKINSON Salesperson : ROGERIO ATKINSON This is not an invoice Please do not pay from this document acEN1XL LleJ9�: 0tV EOuimnent Description Minimum Dav Week 4 Week Estimated Amt 1 1602520 ROLLER 60-69- VIE ART DOUBLE DRUM SMOOTH 395.00 1,859.00 3,750.00 3,750.00 10886256 HAMM HD+90IVV SALES/MISCELLANEOUS ITEMS Oev Item 1 TX UNIT PROPERTY TAX 1 DELIVERY CHARGE 1 PICKUP CHARGE [DRSURTX/MCI] COMMENTS/NOTES: CONTACT: RUSEN ZARATE CELL#: 361-894-1799 TO SCHEDULE EQUIPMENT FOR PICKUP, CALL 800-UR-RENTS (800-877-3687) WE ARE AVAILABLE 24/7 TO SUPPLY YOU WITH A CONFIRMATION # IN ORDER TO CLOSE THIS CONTRACT Rental Subtotal: 3,750.00 Price Unit of Measure Extended Amt. 7.841 EACH 7.84 195.000 RACE 195.00 195.000 EACH 195.00 Sales/Misc Subtotal: 397.84 Agreement Subtotal: 4,147.84 Estimated Total: 4,147.84 NOUCE: This is not a mnml aBmemem. Theronml o:equipment and any items listed above Is subject to avalia1,19ty and sub)M to the toms and aandmans efine Rental and Selves A9roemeM, which am available at httpsdlwww.unftedmMaN.eoMIe9aVromalyarvite4arma.US and which are Ineeryo al d heroin by rs:elenu. A COW OFTNE RENTALMO SERVICE AGREEMENTTERMS ARE AVAILABLE W PAPER FORM UPON REQUEST. Page: 1 UNITED RENTALS (NORTH AMERICA), INC. POWER OF ATTORNEY Know all men by these presents, that the undersigned, a Delaware corporation (the "Corporation"), hereby constitutes and appoints those individuals employed by the company with the title Branch Manager, Area General Manager or District Manager, its true and lawful attorney -in -fact to: I. execute and submit, in the name and on behalf of the Corporation, bid documents and contracts arising out of such bid documents in relation to any state and local government solicitations provided that the Corporation's legal department has reviewed and approved such bid documents and contracts; and 2. take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney -in -fact, may be of benefit to, in the best interest of, or legally required by, the Corporation in connection with such execution and submission. The Corporation hereby grants to the attorney -in -fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary and proper to be done is the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the Corporation night or could do, hereby ratifying and confirming all that such attorney -in -fact shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. Unless sooner terminated by the Corporation, this Power of Attorney shell remain in effect for a period of the earlier of (i) one (1) year from the date hereof, and (ii) the date the person appointed ceases to be employed as a Branch Manager, Area General Manager or District Manager of the Corporation. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 4th day of January, 2022. UNITED RENTALS (NORTH AMF-RICA), INC. By: Name: Craig . Schmidt Title: Vice President— National Accounts STATE OF �ew orv— ) COUNTY OF On this 4th day of January, 2022, before me personally came Craig A. Scbmidt, to me Imown, and Imown to me to be the person who executed the foregoing instrument, and who being by me duly sworn, did depose and say that he is the Vice President -National Accounts of United Rentals (North America), Inc., aDelaware corporation, and that said instrument was executed by him for and on behalf of said corporation for the uses and purposes therein mentioned. IN WITNESS WIERROF, I have hereunto set my hand and affixed my seal this 4th day of January, 2022. Notary Public DMIIEL R. LAVOIE NOTARY FUSUC, STATE OF NEW YORK RegWration No. 02LA64oi276 Cuall led In Queens County Commisson fNewn December 09. 20� ril CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, S. and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number. 2022-918499 1 Name of business entity filing form, and the city• state and country of the business entity's place of business. United Rentals (North America), Inc Port Lavaca, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. 08/04/2022 Calhoun County Date Acknowledged: a Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. TBD- Double Drum Roller Rental of Double Drum Roller to Calhoun County 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary MGGfN N*, John Port Lavaca, TX United States X United Rentals, Inc. (parent company) STAMFORD. CT United States X 5 Check only if there is NO Interested Parry. ❑ 6 UNSWORN DECLARATION 1p My name is _ _SO ' I� 11'I A �� and my date of birth is My address is _ - (51rea7) (City) (Stale) (zip Coda) (ceunlry) I declare underpenaltyof perjury that the foregoing is true and correct. C Executed in ALIMn County, State of T6AS , on the � day of W1 >L 20 manta) (Year) l Signature of authorized agent of contracting business entity (Decieran0 Farms ernvided by Tnvnc ert.l..c r........:....:__ .._.. _. _.�.__ __.. _ --^^-•—o•,,mission www.emtes.state.tx.us Version V1.1.191b5cci- #11 11. Consider and take necessary action to execute the contract with JRB Services, LLC for Rebid — Lane road Drainage Improvements for Calhoun County, TX under Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-2 and authorize the County Judge to sign. (GDR) RESULT: APPROVED [UNANIMOUS] „ MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: ` David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens: Gary D. Reese County Commissioner County of Calhoun Precinct 4 August 2, 2022 Honorable Richard Meyer Calhoun County judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for August 10, 2022. • Consider and take necessary action to execute the contract with JRB Services, LLC for Rebid - Lane Road Drainage Improvements for Calhoun County, TX under Texas General Land Office Contract No. 20-065-064-C 182 and Calhoun County 2020 CDBG-DR Contract Work Order No. B-2 and authorize the County Judge to Sign. Sincerely, q Q.R� Gary. Reese GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: earv.reese rr.calhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 DOCUMENT NO.00500 AGREEMENT BETWEEN OWNER AND CONTRACTOR THIS AGREEMENT is dated as of the 20th day of April in the year 2022, by and between CALHOUN COUNTY (hereinafter called OWNER) and JRB Services LLC. (hereinafter called CONTRACTOR). OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: .01 THE WORK: CONTRACTOR shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as follows: REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065- 064-C182 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORK ORDER NO. B-1. .02 ENGINEER: The Project has been designed by G & W Engineers, Inc., 205 West Live Oak, Port Lavaca, Texas, 77979, who is hereinafter called ENGINEER and who will assume all duties and responsibilities and will have the rights and authority assigned to ENGINEER in the Contract Documents in connection with completion of the Work in accordance with the Contract Documents. .03 CONTRACT TIMES: a. Calendar Days The Work shall be complete and ready for final payment in accordance with Paragraph 14.07 of the General Conditions within 270 Calendar Days after the date when the Contract Times commence to run. b. Rain Days CONTRACTOR may be allowed an adjustment to the CONTRACT Times for "rain days", which are defined as follows. Any day(s) in which rainfall occurs prior to 12:00 p.m. (noon), of such quantity that, in the opinion of OWNER's representative, would prevent a safe working environment for CONTRACTOR at the constriction site. 00500-1 AGREEMENT BETWEEN OWNER AND CONTRACTOR REBID - Lane Road Drainage llnprovemelnx ror (Altonn Collmy.'rx 01.0 Conlrael No. 20-065.U64-C 182 (File No. 5310.0116) 2. Any day(s) following the above described "rain day(s)" in which the condition of the construction site, in the opinion of OWNER's representative, is not conducive to providing CONTRACTOR with a safe working environment at the site. OWNER shall only consider an adjustment in Contract Times if CONTRACTOR submits a written request for "rain days" to OWNER's representative for review, by 10:00 a.m. on the Monday following the week in which the day(s) occurred. Failure to submit such a written request shall be a representation by CONTRACTOR that additional days are not warranted. OWNER's representative shall review all requests when submitted and will have final on site determination for "rain days". Disagreements between CONTRACTOR and OWNER's representative shall be submitted to OWNER. C. Liquidated Damages OWNER and CONTRACTOR recognize that time is of the essence in this Agreement and that OWNER will suffer financial loss if the Work is not substantially complete within the time specified in paragraph .03.a above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the delays, expense and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not substantially complete on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that, as liquidated damages for delay (but not as a penalty), CONTRACTOR shall pay OWNER THREE HUNDRED DOLLARS ($300.00) for each day that expires after the time specified in paragraph .03.a. CONTRACTOR hereby agrees that said stun per day is a fair estimate of the pecuniary damages which will be sustained by OWNER in the event that the Work is not complete within the agreed time, or within extensions of time properly granted in accordance with the Contract Documents. Said sum shall be considered as liquidated damages only and not a penalty, said damage being caused by loss of timely use of the Work other injury difficult to quantify. For purposes of applying this liquidated damages clause, the CONTRACTOR agrees to waive as against the OWNER any defense to enforcement of said clause based on any of the following claims: (1) that the clause is a penalty; (2) that the daily amount stated in the clause is not a reasonable estimate and approximation as of the time of contracting of OWNER's actual damages; (3) that the damages caused to OWNER by reason of delay were not difficult to estimate at the time of contracting. 00500-2 AGREEMENT BETWEEN OWNER AND CONTRACTOR REM - Lone Road Uminnou Improvemaaa for Calhoun C enmy, rX GLO C:o"mm No. 20.065-064-082 ( Hie No. 5310.01 1b) .04 CONTRACT PRICE: OWNER shall pay CONTRACTOR for performance of the Work in accordance with the Contract Documents in current funds as per CONTRACTOR's bid which forms a part of this contract. In no event shall the amounts payable pursuant to this Contract exceed $678,771.63, being the Base Bid plus Option A, Option B and Option C, phis the amount of any duly authorized change orders or contract amendments executed by OWNER. .05 PAYMENT PROCEDURE: CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions unless otherwise amended by the Contract Documents. Applications for Payment shall also include all required documentation indicated in Division 1 - General Requirements, Section 01025 of these Specifications. ENGINEER shall process Applications as provided in the General Conditions. a. Progress Payments OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Applications for Payment as recommended by ENGINEER and as provided below. All progress payments will be on the basis of the progress of the Work measured by the schedule of values provided for in Article 2 of the General Conditions. 1. Progress payments will be in an amount equal to the percentage indicated below, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold in accordance with Paragraph 14.02.B.5 of the General Conditions. A. 90% of the Work completed (with the balance being retainage) B. 90% (with the balance being retainage) of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentation satisfactory to OWNER as provided in Paragraph 14.02.A.I of the General Conditions), 2. Request for Payments All requests for payments shall be divided into materials costs and labor/equipment costs. All requests for material payment shall be accompanied by CONTRACTOR's paid invoice for the material in accordance with Article 14.02.A.I of the General Conditions. 00500-3 AGREEMENT DETWEENOWNER AND CONTRACTOn It IialD - Laoe lw. Draivaye Impmvemcals for Calhono C000ty,'rx 01.0 CmOmcl No. 20-065-064-CI82 (pile No. 53111.01 I h) b. Final Payment Upon final completion and acceptance of the Work in accordance with Paragraph 14.07 of the General Conditions, OWNER shall pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph. .06 CONTRACTOR's REPRESENTATIONS: In order to induce OWNER to enter into this Agreement, CONTRACTOR makes the following representations: a. CONTRACTOR has examined and carefillly studied the Contract Documents (including the Addenda listed in paragraph 7 herein) and the other related data identified in the Bidding Documents including "technical data." b. CONTRACTOR has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost, progress, performance or furnishing of the Work. - c. CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. d. CONTRACTOR has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR accepts the determination set forth in the Supplementary Conditions to the extent of the "technical data" contained in such reports and drawings upon which CONTRACTOR is entitled to rely as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR acknowledges that such reports and drawings are not Contract Documents and may not be complete for CONTRACTOR's purposes. CONTRACTOR acknowledges that OWNER and ENGINEER do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Contract Documents with respect to Underground Facilities at or contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes responsibility for having done so) all such additional supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface, subsurface and underground facilities) at or contiguous to the site or otherwise which may affect cost, progress, performance or furnishing of the Work or which relate to any aspect of the means, methods, techniques, sequences and procedures of construction to be employed by CONTRACTOR and safety precautions and programs incident thereto. CONTRACTOR does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the performance and furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents. 00500-4 AGREEMENT BBTWCCN OWNER AND CONTRACTOR REMID - Line Rond Dninauc Impmvemenls Mr Calhoun County, TX M.0 Conlmcl No. 20-065-064 :182 (File No. 5310.111110 e. CONTRACTOR is aware of the general nature of the Work to be performed by OWNER and others at the site that relates to the Work as indicated in the Contract Documents. CONTRACTOR has correlated the information known to CONTRACTOR, infonnation and observations obtained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. g. CONTRACTOR has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that CONTRACTOR has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing of the Work. .07 CONTRACT DOCUMENTS: The Contract Documents which comprise the entire Agreement between OWNER and CONTRACTOR are attached to this Agreement, made a part hereof and consists of the following: This Agreement. b. Exhibits to this Agreement. C. Calhoun County — GLO Contract No. 20-065-064-C]82: Required Contract Provisions; General Affirmations and Nonexclusive List of Applicable Laws; Rules and Regulations; and Section 3 Clause d. CONTRACTOR's Bid. C. Performance, Payment and other Bonds. Notice of Award. g. Notice to Proceed. h. General Conditions. Calhoun County, Texas General Conditions. Supplementary Conditions. k. Technical Specifications. 00500-5 AGREEMENT BETWEEN OWNER AND CONTRACCOR REBID. Lace Road DminnBc Improvements ror Calhoun County. TX GLO Conlmel No. 20-065-064-018211°ik No. 5310.011 b1 Drawings numbered & titled for the different areas of work as indicated below: REBID - LANE COUNTY, TEXAS 065-064-C182 AND ORDER NO. B-1. SHEET NO. G1 ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20- CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORK DATE 02/07/22 CIVIL DRAWINGS: Cl 02/07/22 C2.1 02/07/22 C2.2 02/07/22 DITCH IMPROVEMENT PLAN: BASELINE "A": DESCRIPTION COVERSHEET GENERAL NOTES STORM FLOW DIAGRAM SHEET LAYOUT C3.1 02/07/22 STA. 0+00 — 15+00 C3.2 02/07/22 STA. 15+00 — 30+00 C3.3 02/07/22 STA. 30+00 — 45+00 C3.4 02/07/22 STA. 454 00 — 60+00 C3.5 02/07/22 STA. 60+00 — 75+00 C3.6 02/07/22 STA. 75+00 — 90-100 C3.7 02/07/22 STA. 90+00 — 105+00 C3.8 02/07/22 STA. 105+00 — 120+00 C3.9 02/07/22 STA. 120+00 — 136+00 C3.10 02/07/22 STA. 136+00 — 150+00 & BASELINE `13 STA. 0+00 — 5+00 C3.1 1 02/07/22 STA. 150+00 — 165+00 C3.12 02/07/22 STA. 165+00 — 187+00 BASELINE "B": C3.13 02/07/22 STA. 5+00 — 18+50 C4.1 02/07/22 TYP. DITCI-T SECTIONS & DETAILS C5.1 — C5.4 02/07/22 ENLARGED PLAN In. Addendum numbers One (1) to Two (2) inclusive n. The following of which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto: All 'Written Amendments and other documents amending, modifying or supplementing the Contract Documents pursuant to Paragraph 3.04 of the General Conditions. There are no Contract Documents other than those listed above in this Article 7. The Contract Documents may only be altered, amended or repealed in accordance with the appropriate provisions of Article 3 of the General Conditions. 00500-6 AGREEMENT BETWEEN OWNER AND CONTRACTOR R"11) - Lane Rand Dminave Impmvements for C.Ihoun Cuanly.'I'X GLO Cmllmei No. 20-065-064-CI82 WHO No. 5310.01 Ib) .08 MISCELLANEOUS: a. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. b. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such consent(except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. C. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, agreements and obligations contained in the Contract Documents. d. Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. IN WITNESS WHEREOF, the parties hereto have signed this Agreement in triplicate. One counterpart each has been delivered to OWNER, CONTRACTOR and ENGINEER. All portions of the Contract Documents have been signed or identified by OWNER and CONTRACTOR or by ENGINEER on their behalf. OWNER: 10 n ADDRESS: 211 S. Ann, Suite 301 Port Lavaca, Texas 77979 PHONE: (3611) 553-4600 FAX: (361) 553-4444 CONTRACTOR: JRB SERVICES LLC. IN Tce Balser, President ATTEST:'%,�� ADDRESS: 4840 State Hwy 172 Ganado, Texas 77962 PHONE: (361)781-2148 END OF DOCUMENT 00500-7 AGREEMENT BETWEEN OWNER AND CONTRACTOR W31311) - Lone Road D ainnbe Improvmnenls for Colhoon Cawtly. TX (11.0 Connacl No. 30-065-064-(:I N? (File No. 5310.01 Ib) Addendum No. 2 03/28/2022 BID hereinafter called "BIDDER", (Legal Firm Natne) is submitting this Bid for Furnishing and Performing the Work specified herein as the REBID •• LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065-064••C182 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORK ORDER NO. B-1. This BID is Submitted to the COUNTY OF CALHOUN, hereinafter called "OWNER". Terms used in this BID are defined in the General Conditions or Document No. 00120 - Instructions to Bidders and shall have the meanings indicated in the General Conditions or Instructions. 2. BIDDER proposes and agrees, if this BID is accepted, to enter into an Agreement with OWNER in the form included in the Contract Documents to furnish and perform all Work as specified or indicated in the Contract Documents for the Bid Price and within the Bid Times indicated in this BID and in accordance with the other terms and conditions of the Contract Documents. 3, BIDDER accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid Security. This BID will remain subject to acceptance for Sixty (60) Calendar Days alter the Bid Opening. BIDDER shall sign and deliver the required number of counterparts of the Agreement, including all required documents indicated by the Bidding Requirements, within Fifteen (15) Worldng Days after the date of OWNER's Notice of Award. 4. In submitting this BID, BIDDER represents, as more fully set forth in the Agreement, that: a. BIDDER has examined and carefully studied the Bidding Documents and the following Addenda, receipt of all which is hereby aclmowledged: (List Addenda by Addendum Number and Date): Addendum No,: a Date Received: b. BIDDER has visited the site and is familiar and satisfied with the general, local and site conditions that may affect cost, progress, and furnishing and performing the Work. C. BIDDER is familiar and satisfied with all federal, state and local Laws and Regulations that may affect cost, progress, and furnishing and performing the Work. 00300-1 Addendum No. 2 03/28/2022 d. BIDDER is aware of the general nature of work, if any, to be performed by OWNER (or others) at the site in relation to the Work for which this BID is submitted. e. BIDDER has correlated the information known to BIDDER, information and observations obtained From visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. f. BIDDER has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents, and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing the Work for which this BID is submitted. g. This BID is GENUINE and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, association, organization or corporation. BIDDER has not directly or indirectly induced or solicited any other BIDDER to submit a false or sham BID. BIDDER has not solicited or induced any person, firm or corporation to refrain from bidding. BIDDER has not sought by collusion to obtain for itself any advantage over any other BIDDER or over OWNER, 5. BIDDER agrees to complete the Work in accordance with the Contract Documents. a. BIDDER acknowledges that the amounts are to be shown in both words and figures, and in case of discrepancy, the amount in words shall govern. b. BIDDER acknowledges that the quantities are not guaranteed and final payment will be based on the actual quantities determined as provided in the Contract Documents. C. BIDDER aclaiowledges that, at OWNER's option and/or at OWNL^R's request, any of the quantities may be deleted, reduced, or increased based upon the respective Unit Prices. d. BIDDER acknowledges that Unit and Lump Sum Prices have been computed in accordance with paragraph 11.03.13 of the General Conditions. e. BIDDER agrees to furnish all necessary labor, superintendence, plant, machinery, equipment, tools, materials, insurance, services and all other requirements deemed necessary to complete the items of Work indicated on the following pages for the specific dollar amounts stated. 00300-2 Addendum No. 2 J/LV/LVLL BASE BID _ (Baseliue A: Station 0+00 to 145+50 Item # Iteln Description Quantity Unit Price Total Bid Price I Furnishing Mobilization and tlsurance for the BASE BID project scope as per and I LS i Co( QJQ, lU plans IC 15 (� specifications 2 Furnishing, implementing and maintaining a I LS Storm Water Pollution Prevention Plan (SWPPP) for BASE BID project limits for the duration of the entire roject per plans andspecifications 3 Traffic control and barricading for the BASE BID 1 LS project limits for the duration of the entire project ��/(('(� �n ! l ��/(j(� Oo as per plans and specifications. ,I Removal and disposal of all existing driveway and I LS roadway culverts within the BASE BID project Iimits of the Base Bid Ci�Le U1 and as called upon in the �+- / /(-�t�• drawitis as per plans and specifications 5 Regrading and digging of existing channel to a 3,300 LF bottom width of 20 feet and sloping embankment E6 at it 4:1 slope and stockpiling spoil materials into �'� �l•' l r ��.lC habitat mounds including labor, equipment and materials for a complete installation as per plans and specifications Regrading and digging of existing channel to a 11,080 LF bottom width of 15 feet and sloping embankment at a 3:1 slope and trucking of material to designated site including labor, equipment and I� ��I^ I )r�/ ��/.U• materials for a complete installation as per plans ands ecifications 7 Installation of 18" diameter HDPE corrugated 44 LF storm sewer pipe, open cut, including labor, equipment 2 11 o L Jvl l�j'1(/ rip and materials for a complete CU4 Illstallatloll as )cr plaits and specifications. 8 Installation of36" diameter HDPE corrugated 334 LF storm sewer pipe, open cut, including labor, _ C� equipment and materials for a complete / J installation as Pei, Plans all(] specifications. 9 Installation of48" diameter HDPE corrugated 168 LF storm sewer pipe, open cut, including labor, equipment and materials for a complete Illstallatloll a5 per plans andspecifications. 10 Installation of60" diameter HDPE corrugated 2,10 LF storm sewer pipe, open cut, including labor, q•2 equipment and materials fop' a corlplcte.�'I , installation as Per Iflans and s peclficatiolls. 1 I Installation of 8" Diameter Rock Rip -Rap, 300 CY including labor, equipment and materials fora/ �(� up complete installation as per plans and s peel tleatlolls. 00300-3 Addendum No. 2 BASE BID CONTINUED Item # Item Description Quantity Unit Price Total Bid Price 12 Installation of36" Diameter HDPE 22.5 Deg. 2 EA Fitting including labor, equipment and materials f\ for a complete installation as per plans and 1 specifications. 13 Installation of36" Diameter HDPE 45 Deg. 2 EA Fitting including labor, equipment and materials (N) for a complete installation as per plans and specifications. 14 Installation of36" Diameter IiDPE 90 Deg. I EA Fitting including labor, equipment and materials for I �l�V Ilit•�� 1. a complete installation as per plans and ) specifications, 15 Installation of 36" Diameter HDPE Tee Fitting I EA including labor, equipment and materials fora 60 I Jw' complete installation as per plans and 15(o. I specifications. 16 installation of36" Diameter FIDPE Reducer I EA Fitting to 18" Diameter including labor, equipment and materials for a complete I 1 !J installation as per plans andspecifications. 17 Reconstruotion of existing gravel/limestone 135 SY roadway including labor, equipment and materials f ,,���� c ��t t,) for a complete installation as per plans and `U.Ji _ .Specifications. 18 Hydromulcb seeding ofexcavated and disturbed areas including labor, equipment and materials for 12 AC rY3 I jOi�, �'�� �� a complete installation as er lans ands ecs. I TOTAL BASE BID $ %/(/ I I •� �f TOTAL 13ASE 13ID CALENDAR DAYS BASE BID DEDUCTION Ttcm N Item Description Quantity Unit Price Total Bid Dl Deduction (difference) from Base Did Item 6 for 1 LF _ Price disposing ofspoilsonsiteinlieu oftrucking material to off disposal _i 1 L� lr �, Iraq) -site area. Priced as a • deduction per linear feet ofditeh. TOTAL DEDUCTION BASE BID S r r /L1� I6? Ir� L7 00300-4 Addendum No. 2 03/28/2022 OPTION A Baseline A: Station 145•1.50 to 160•1•00 Win # Item Description Quantity Unit Price Total Bid Price A I Furnishing Mobilization and Insal'anee for the OPTION A project scope as per plans and I LS L0 S U specifications A2 Furnishing, implementing and maintahpiag a i LS Storm Water POI1atIOn Prevention Plan (S WPPP) c a Ott for OPTION A project limits for the duration of 1 the entire Project per plans andspecifications A3 Traffic control and barricading for the OPTION A project limits for the duration of the entire I LS i'� )011L) ) project 1000. as per plans'and specifications, / A4 Removal and disposal of all existing driveway and roadway culverts within the OPTION A project I LS limits of the Base Bid and as called upon in the rJ drawings as per plans andspecifications Removal including truck hauling of all excess I LS spoil materials generated from the OPTION A project limits in which the property owner wishes �o,00u• LS I O/I)LO' to have the material removed completely from the _l2roperty as per the plans and specifications A6 Regrading and digging of existing roadside 2,710 LF ditches "V" bottom and sloping embankment at a 3:1 slope including labor, equipment and pp 1 I C materials for a complete installation as per plans andspecifications A7 Installation of 18" diameter FIDPE corrugated 20 LF storm sewer pipe, open cut, including labor, I 3�!� I n'l equipment and materials for a complete • l� ll)`IU installation as per plans and specifications. A8 Installation of 24" diameter 1-IDPI:i corrugated storm sewer pipe, open cut, including labor, 185 LF ,?/S LI_ lu t�( L•� ��J equipment and materials for a complete installation as per Plans andspecifications, A9 Installation of 36" diameter I-IDPE corrugated 150 LF storm sewer pipe, open cut, including labor, It equipment and materials for a complete installation as per plans andspecifications. All) Installation of 8" Diameter Roek Rip -Rap, 50 CY % including labor, equipment and materials fora J complete installation as per plans and / specifications. A I I Installation of 36" Diameter 1IDPE 22.5 Deg, Fitting including 2 EA labor, equipment and materials I • )/lQ {�. For a complete installation as per plans and i�G{) specifications. 00300-5 Addendum No. 2 — '- UJ/Lt5/GULL OPTION A CONTINUED Item Description Quantity Unit Total Bid Price Price A 12 Installation of36" Diameter FIDPE Tee I.ittiag 2 EA including labor, equipment and materials for a lU I/hUU tO wo complete installation as per plans and specifications. A 13 Installation of 36" Diameter HDPE Reducer IRA Fitting to 24" Diameter including labor, equipment and materials for a complete I 1 tallation as per plans and ecifications. tallation of 24" Diameter HDPE Tee Pitting 4 EA 4511'stallation luding labor, equipment and materials fora mplete installation as per plans and ' r�LU �g / /� V �� CU —I't U �. cifications. of 24" Diameter 1IDPE Reducer 2 EA ing to 18" Diameter including labor, equipment II }��� e0 )�UO cU and materials for a complete (JI r installation as ter Hans and s tecifications. A 16 Reconstruction of existing asphalt roadway 615 SY including labor, equipment and materials fora .,t1 S bb i l � %), complete installation as per plans and 1Il`o s tecifications. A 17 1-1 dromulch seeding of excavated and distUrbed at including labor, equipment and materials for 1.5 AC r 1i5�O W �G 1 e�1a5(� a corn lete installation as er lans and s ces. •C`, TOTAL OPTION A TOTAL OPTION A CALANDAR DAYS 00300-6 Addendum No. 2 03/28/2022 OPTION B Baseline B: Station 1+00 to 18+00 Item # Item Description Quantity Unit Price Total Bid Price B1 Furnishing Mobilization and Insurance for the OPTION B project scope as per plans and I I,S` D ( O �j��) L) �� UJ coo. _ s)ecifications J / 132 Furnishing, implementing and maintaining a i LS Storm Water Pollution Prevention Plan (SWPPP) (— Uv( (DO C (� U do for OPTION B project limits for the duration of i the entire project per plans and specifications B3 Traffic control find barricading for the OPTION B project limits for the duration of the entire I LS \ b� ���.(%, LS , CC (,(,U. project as per Mans and specifications. B4 Removal and disposal of till existing driveway and i LS roadway culverts within the OPTION B project +� l �� limits of the Base Bid and as called upon in the / drawings as per plans and specifications BS Removal including truck hauling of all excess 1 LS spoil materials generated from the OPTION B project limits in which the property owner wishes 5 e)UU tY>J to Have the material removed completely fi•om the property as er the Mans andspecifications BC Regrading and digging of existing roadside 3,123 I,F ditches "V" bottom and sloping embankment at a 3:1 slope including labor, p0 JJ jU. 1.l2�� j equipment and LF materials for a complete installation as per plans andspecifications 67 Installation of 18" diameter I IDPE corrugated 223 LF storm sewer pipe, open cat, including labor, 00 — o C� equipment and materials for a complete` installation as per Mans and specifications. B8 Flych•omulch seeding of excavated and disturbed areas including labor, equipment and materials for 2 AC l UO I UO ��(( O a complete installation as per Ions and specs, l5(�,C . TOTAL OPTION 13 $ TOTAL OPTION B CALANDAR DAYS GI J 00300-7 Addendum No. 2 03/28/2022 OPTION C Baseline A. Station 160+00 to 187+00 Item # Item Description Quantity Unit Price Total Bid Price CI Furnishing Mobilization and Insurance for the I LS rr11,,,,U ''11col( LOl.) t( /, OPTION C project scope as per plans and ��W oov .10 specifications C2 Furnishing, implementing and maintaining a I LS Storm Water Pollution Prevention Plan (SWPPP) ( for OPTION C project limits for the duration of / the entire project per.plans andspecifications C3 Traffic control and barricading for lbe OPTION C project limits for the duration the I LS 1 ( �I-I1� L) „ U 4 of entire project _ as Per Plans and specifications, t(J�,R C4 Removal and disposal of all existing driveway and 1 LS roadway culverts within the OPTION C project limits h � W1 I �)(\O LU of the Base Bid and as called upon in the 1 / drawings as per plans andspecifications C5 Removal including truck battling of all excess _ILS spoil materials generated from the OPTION C project limits in which the property owner wish )��� L! 0pes ��L�V• to have the material removed completely from the pjxTerty as per the Plans andspecifications C6 Regrading and digging of existing roadside 4,740 LF ditches "V" bottom and sloping embankment at a 3:1 slope including labor, equipment and l Lo materials for a complete installation as per plans and specifications C7 Installation of 18" diameter HDPE corrugated 418 LF storm sewer pipe, open cut, including labor, equipment Uc L�' % (� L� I )t3��' and materials for a complete installation as ier plans and specifications. CS Hydrotnulch seeding of excavated and disturbed areas including labor, equipment for 2 AC cc and materials a complete installation as per plans and specs. TOTAL OPTION C S LlU,1 �lp f P TOTAL OPTION C CALANDAR DAYS +++++i++++++++i-++++++++++-H-++ ++++A_A-++++++-I--I--H-++++++++A-+-I—H-++-I-++++++-F++++++-I- The 5% Bid Bond is based on the GREATEST AMOUNT BID which is the sum of the Base BItI + Total Options "A", "B" and "C" GREATEST AMOUNT BID (Base Bid +Total Options "A", "B" and "C"): $ 9 1 1 I— (Q,) TOTAL CALENDAR DAYS (Base Bid +Total Options "A", "B" and "C"): 00300-8 Addendum No. 2 03/28/2022 +++-I +++++4-+++I+++++++i-+++++++-F+i+F-I--I-F1--I--F-I--F++++-I-I--F+-t-+++-I--I-++++++++-F I -+A-++++++++ The award will be based on the Base Bid with consideration of the Option A, Option 13 & Option C. +++++++-F+++i-F+++-F-1-I-i--I-+-I--F+++++++++-t-+-F-F-I--I--I--h 6. BIDDER agrees that the Work shall be completed and ready for final payment in accordance with Paragraph 14.07 of the General Conditions when the Contract 'Times commences to run. BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work within the times specified in the Agreement. The following documents are included and made a condition ofthis /BID: a. Required Bid Security in the form of b. Affidavit C. Certificate of Interested Parties, Form 1295 di System for Award Management — (sam.gov) e. Certification Regarding Debarment & Suspension and Other Responsibility Matters f. Certification Regarding Lobbying g. Disclosure of Lobbying Activities h. Conflict of Ilnterest Questionnaire, Form CIQ i. House Bill 89 Verification j. Residence Certification k. GLO — Contractor Certification of Efforts to Fully Comply with Employment and Training Provisions of Section 3 I. Document No. 00416 - Noncollusion Affidavit. in. Document No. 00420 — Bidder Qualification Statement n. Document No. 00450 - Certification of Bidder Regarding Civil Rights taws and Regulations Submit one original and three copies of this bid and forms listed above. Please do not fold, bind or staple sets. Bids must be returned in a Sealed 9 x 12 or larger envelope clearly marked: SEALED BID: REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065-064- C182 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORIC ORDER NO. B-1 Submit Sealed Bid Before 2:00:00 PM,'Thursday, March 31, 2022 to: Honorable Richard H. Meyer, County Ridge Calhoun County Courthouse 211 South Ann Street, 3111 Floor, Suite 301 Pot Lavaca, TX 77979 00300-9 Addendum No. 2 03/28/2022 8. Communications about this BID shall be directed to BIDDER's address indicated below. SUBMITTED this /l� day of1lyC.1/1 2022. Attesting Signature Name: Title: Legal Firm Name: Business Address: Phone Number: Facsimile Number B Mail Address (optional): State of Incorporation, if applicable: State Contractor License No.: CND OF DOCUMENT 00300-10 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that; or PO Box 386, Ganado, TX 77962 Bond: 107641038 a Corporation hereinafter called Principal, and Travelers Casualty and Of of One Tower Square, Hartford, CT 06183 (Address) hereinafter called Surety, are held and firmly bound unto Recipient) (Grant Recipient's Address) Six Hundred Seventy Eight Thousand hereinafter called OWNER, in the penal sum of $ Seven Hundred Seventy One and 63/100 Dollars ($ 678,771.63 ) in lawful money of the United States, for the payment of which sum well and truly to be made we bind ourselves, successors, and assigns, jointly and severally, firmly in these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER dated the 20th day of April, 2022 ,a copy of which is hereto attached and made a part hereof for the construction of: REBID - LANE ROAD DRAINAGE, IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20.065-064-C182 AND CALHOUN COUNTY 2020 CDBG- DR CONTRACT WORK ORDER NO. B-1. 00610-1 NOW THEREFORE, if the Principal shall well, truly and faithfully perform its duties in all the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the OWNER, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the OWNER from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may incur in making good any default, then this obligation shall be void, otherwise to remain in full force and effect. PROVIDED FURTHER, that the said Surely, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the Principal shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in One counterparts, each one of which shall be deemed an original, this the 1 gth clay of July, 2022. ATTEST: JRB Services, LLC X� pp n (y rincipal) � (s) Q B (Principal Secretary) (SEAL (Witness as to Prindipal) �% CAS, -N T19 6 2 (Address) PO Box 386 (Address) Ganado, TX 77962 ATTEST: Travelers Casualty and Surety Company of America (Surat ) B f Y y (Witness to Si rely) aryl C. May (Attorney in act) Todd A. Stein 5309 Tran portation Iv..leveland, OH 44125 One Tower Square, Hartford CT 06183 (Address) (Address) NOTE: Date of BOND must not be prior to date of Contract. If PRINCIPAUCONTRACTOR Is Partnership, all partners should execute BOND. "Power -of attorney for person signing for Surety Company must be attached to bond 00610-2 Bond:107641038 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that: JRB Services, LLC m of Contractor or hereinafter called Principal, and Travelers One Tower CT 06183 Surety hereinafter called Surety, are held and firmly'bound unto neremarrer caned UWNER, in the penal sum of $ Seven Hundred Seventy One and 63/100 Dollars, $ 678,771.63 in lawful money of the United States, for this Payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. THE CONFIDENTIALITY OF THIS OBLIGATION is such that whereas, the Principal entered Into a certain contract with the OWNER, dated the 20th day of April,2022 a copy of which is hereto attached and made a part hereof for the construction of: REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065.064-082 AND CALHOUN COUNTY 2020 CDBG- DR CONTRACT WORK ORDER NO. B-1. (Project Name) NOW, THEREFORE, If the Principal shall promptly make payment to all persons, firms, SUB- CONTRACTORS, and corporations furnishing materials for or performing labor in the prosecution of the WORK provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and coke, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such WORK, and all insurance premiums on said WORK, and for all labor, performed in such WORK whether by SUB -CONTRACTOR or otherwise, then this obligation shall be void; otherwise to remain In full force and effect. 00620-1 PROVIDED, FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in One (1) counter -parts, each on of (Number) which shall be deemed an original, this the 19th day of July, 2022 ATTEST: JRB Services, LLC (Principal) (PYrinIV/ciipal Secretary) Fr n^1 By (s) (SEAL) /98 (.L 'W PO Box 386 (Witness as to P incipal) (Address' Ganado, TX 77962 ATTEST: Travelers Casualty and Surety Company of America () I By (Witness Osur6ptyWl C. May (Attorney in Fact) Todd A. Stein, Attorney -In -Fact 5309 Transpo tion Blvd., CI eland, OH 44125 One Tower Square Hartford CT 06183 (Address) (Address) NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. 'Power -of attorney for person signing for Surely Company must be attached to bond 00620-2 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casually and Surely Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies'), and that the Companies do hereby make, constitute and appoint Todd A. Stein of CLEVELAND . Ohio their true and lawful Altorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies In their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April, 2021. ��yn Amity ,�u,v axon I,virrr�[N ,Y c f' tuvrrrron0. 5 e ,wrcrono. a, ��GLYk�4 W s G C`JM4�'" l Cantl s e, �s� M nM +s State of Connecticut City of Hartford as. By: Gam' Robert L. ReneyrSenior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. r°' /J �/ `+vZ umnnv t My Commission expires the 30th day of June, 2026 + .H« " Anna P. Nowik, Notary Public �.vyFct , This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and an behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizences, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed wilh the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Allorneys•in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and cenlfied by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which It is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a tore and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 19th day of July , 2022 rvniu,n ,� 'v +e yt74t 1{l�nfR 4 2 IIUCrc�rNm, � CdM.9+l +f + 4� fZ--- Kevin E. Hughes, Assiflitant Secretary ro verily the authenticity of this Power ofAttorney, please call its at 1-800-421-3880, Please refer to the above -named Attorrrey(s)-in-Fact and the details of the bond to which this Power ofAWomey is attached. Texas Department of Insurance Certificate No. 11562 Certificate of Authority 1141S ISTO O CERTIFY THAT Company No. 08-00521.7 TRAVELERS CASUALTY AND SURETY COMPANY Of AMERICA HARTFORD, CONNECTICUT has complied with the laws of the State of Texas applicable thereto and Is hereby authorized to transact the business of Fire; Allied Coverages; Hail -growing crops only; Rain; Inland Marine; Ocean Marine:; Aircraft --Liability & Physical Damage; Workers' Compensation & Employers' Liability; Employers' Liability; Automobile --Liability & Physical Damage; Liability other than Automobile; fidelity & Surety; Glass; Burglary & Theft; Forgery; Boiler & Machinery; Credit; Livestock and Reinsurance on all lines authorized to be written on a direct basis insurance within the state of Texas. This Certificate of Authority shall be in full force and effect until it is revoked, canceled or suspended according to law. IN TESTIMONY WHEREOF, wimess my hand and seal of office at Austin, Texas, this 1st day of July - --A.D. 19?7 ELTON BOMER COMMISSIONER OF INSURANCE BY m A. Wilcox / Director Insurer Scrvie4 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA HARTFORD. CONNECTICUT 05103 FINANCIAL STATEMENT AS OF DECEMDER 31, 202..1 CAPITAL STOCK $ 0.400,000 BONDS STOCKS 8 4,127,000.073 LOSSES S I,224,250,147 CASH D INVESTED CASSI T 00,602.083 LOSS ADJUSTMENT EXPENSES 167.260.612 OTHER INVESTED LE DING 3.970.380 4,009.133 COMMISSIONS OTHER EXPENSES 49.977.044 SECURITIES RF SECURITIES LENDING REINVESTED COLLATERAL ASSETS 7.433.086 TAXES. LICENSES AND FEES 46,607.690 INVESTMENT INCOME DUE AND ACCRUED 37,077,324 CURRENT FEDERAL AND FOREIGN INCOME TAXES IO,65G,025 1,072,277 REINSPRrMIURANCE RCCO REINSURANCE RECOVERABLE 293,081,729 '70.077,046 UNEARNED PREMIUMS 1.212.347.629 NET DEFERRED TAX ASSET 60,160.900 ADVANCE PREMIUM POLICYHOLDER DIVIDENDS 1,n2A,313 OTHERASSETS 3,280.703 CEDED REINSURANCE NET PREMIUMS PAYABLE 14,286.052 47.473,619 AMOUNTS WITlIHELD 7 RETAINED BY COMPANY FOR OTHERS 42,097,038 REMITTANCES AND ITEMS NOT ALLOCATED 10,579,940 PROVISION FOR REINSURANCE 0,873.132 PAYABLE TO PARENT, SUBSIDIARIES AND AFFILIATES 40,373,235 PAYABLE FOR SECURITIES LENDING 7,433,000 ESCHEAT LIABILITY 637132 RETROACTIVE REINSURANCE RESERVE ASSUMED 010,092 OTHER ACCRUED EXPENSES AND LIABILITIES 250,005 TOTAL LIABILITIES S 2,081,690.277 CAPITAL STOCK $ 0.460.000 PAID IN SURPLUS 433,803.700 OTHER SURPLUS 1.6711,177.8711 TOTAL. SURPLUS TO POLICY! IOLDERS S 2,110,A6fA30 TOTAL ASSETS 5 6,000,050,015 TOTAL LIABILITIES & SURPLUS $ 01000,059,015 STATE OF CONNEC71CUT ) COUNTY OF I IARTPORD ) SS. CITY OF IIARTFORO 1 MICNAEL J. DOODY. BEING DULY SWORN, SAYS THAT HE IS VICE PRESIDENT - FINANCE, OF TRAVELERS CASUALTYAND SURETY COMPANY OF AMERICA. AND TI IAT TO 11 Ir BEST OF Ii18 KNOWLEDGE AND BELIEF, TIIC FOREGOING IS A TRUE AND CORRECT STATEMENT OF THE FINANCIAL CONDITION OF SAID COMPANY AS OF TI If, 318T DAY OF DECEMDER, 2021. SUBSCRIBED AND SWORN TO BEFORE ME THIS 17TH DAY OF MARCH, 2022 VICSPRCSIOBNT-p1NnNLE ,.. NOTARV PUOL C - SIJSAN M. WL•'ISSIA!UIiR Nn7nrp fhl0ffc dly Caundvdnn lvp0ry Norrtnnc�r 30, 2022 DA fc-1 N IJ I 11 1U5 (ER 1`111GA IT IS ISSUH) AS A MM TFII of IlooRpAill, I j()fq !� 1110 IMMI III wo N.Ioncy If ic ONLY AND (ONFEW� NO Muirs UPON l (.FHRIIFICA'IF' Ilk) ;_Folll 1:)w crIflif4i DOETl'i [.- 5 NoA)"If 1-111 tw AITFR '114, G'"VE-PAIGI AFF-OROM-BY.-HIF P101](Al fit I w,j GOVIINAGE NAI( ir' MIkor I A iA Solvit:w! 1 1'(." PO Boy, $86 IX 7/96) lil It'lrs ' i IIIi'm"N' L I InTIP., [IF 0 AlkY [Lf�,Vl , III (:IMI'l Ill-)[1 1 fdl 1`b11 I I 1, 111 ' 'Mr I /W, )III l I., j, I 1 1, 1, 1, . M�r, '[WIM "f�r , , I'llkll P I 111,1011"AT, I,IAYPL"1.\IF4, jjlj� vIIUI:IRt) .'I� 1, Ili 1, 11[: OF I. it IF "H101 AGOVI l I I.IMI I SS,,OtAIIq lj,\� ,�/F I I') ALI M it jl�jAt, i Vqf) rr;q jl�j "All AUD t, _vvrII: 'k,F y HUMHU. P( , lilt LIA I I U1.1 I 11AI I :I i/ C-Flif FIAI I JAM ITY It hP .111 I It L1 T I All U'llUl"Olk, I'l ,till 0111W 140WOM I 'W' I;AlUl 111' III ;It l If ')fit 1; 'QKF*1t!l Wit Fj"iA II(Al AMU 111-1 O"URS I Will I FV III 'd.H1 -11114 "1 1 ItA IWIS I I ul;All(ll IVI HICI I i uli Amil n V( 'WHOWd I,) I I ISIFCAI IIRIIIIJFJCIlk. M I? I IFIGA 11. 141 CANCH I A 1101,1 "Ni TICAUN-CTR IN I I S ANIN ST 1,110111 1) All ( 01 1111 ABOVE PI 11 if II'I III GAIMI'l 11:1) 10 1 kRF IP I LAVACA, f X 171),f) (" 11 1111 IF[ "I I II( I'll:IIIII6 111FOW." FVII I I "OLAVOR 10 MAII IAI­ 01,1, '.i foll I " 1, I1I1.11i 11 (IAI.;, 11 1, lilt: U I I ilm I "it '[;If 1111110111 "1 111. 101111 IJI.,U 1141 lij,11M., of"' . A t I I �1 1,' 1, 11 1 III I tilt I it if" I tit ACORPTT,, CERTIFICATE OF LIABILITY INSURANCE DOUCER THIS CERTIFICATE 15 ISSU DATE (MMMDIY'YYY) 05/04/2022 Texana Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 1205 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ganado, TX 77962 - IINSURERS AFFORDING COVERAGE NAIC It INSURER A! Century Surety Company Jake Baler DBA JRB Services LLC INSURER B: PO Box 386 INSURFRC: -- -- --- anado, TX 77962 INSURER IT: INSURER E. COVERAGES ----...__.-_— THE POLICIES OF INSURANCE LISTED BELOW I1AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING' ANY REOUIREMEN"r, TERM OR CONDITION OF ANY CONTRACT OR OPIER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 'I ERMS, EXCLUSIONS AND CONDITIONS OF SUCI I POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTIT I TYPE 1. t1 N POLICY NUMBER POLICYEFFFCTIVE POLICYEXPIIiAT10N, OA E E MM/DU LIMITS $/ OCNERALLIABILITY j CACHOCCURRENCE $_. 1,000,000 ! ✓ICOMMERCIAL GCNCRA_LIAUILITV RENTED - ---- r PREMISES(Ea acyurenceJ I , CLMLISMADE OCCUR � MEDEXP(Anyona(creoa) CCP936521 1 12/08/2021 1 12/08/2022 1 PER90NAL&ADVINJURY $ I,Ouu,uuir ---- ---I ! GF.NERALAGGREGATE $ 2.000,000 GENT. AGGREGATE LIMIT APPLIES PCR IpROpI1CTS-COFAPIOPAGG 2,000,000 PRO- I J—�— __.. I$ AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $ ANl'ALITO IEna mianU I -- ALLOWNEDAUTOS _ -_"-- I BODILY INJURY $ C SHEDULEDAUTOS i (Par0 amonl HIREDAUTOS " BODILYI14JIJRY NON-OWNEDAUTOS (Poraccidenl) —'"-- --- PROPERTY DAMAG" $ �« IPararri,.nl) FGAIRAGELIABILITY ANY AUTO AUTO ONLY_ CA ACCIDENT $ OTHER THAN EA ACC I $ _- AIITOOHLY: AGO $ RFLLA LI BILITY _—.. EACH OCCURRENCE $ OCCUR Ir CLAIIuIE MADE ( _ . AGGREGATE-__—___ I TQ I I _ $ -- OLOUC71ULF !$ � RF. 1[iN110N 4 ! I • WORKERS, COMPENSATION AND lNC 6TA TIJ OTH-I JTGRYIIMITS EMPLOYERS' LIABILITY I _) F.R I _. ANY PROPRIETOIUPAIiI'HEREXECUTIVE E.LEACH ACCIDENT j $ OrrICCRIA,EMBER EXCLUDED' Ilyya:, noacnM1a unVar=.--. _.. __. _ E.I DISEg6E-FA ENIPLOYEEI $ _ SPCCIAL PROVISIONS b.lo._j E.L. DISEASE -POLICY LIMIT I$ OTHER -- --- i "---_--- DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENTI SPCCIAL PROVISIONS W LIVE OAK IT LAVACA, TX 77979 SIIOULDANYOr THEAOOVC DESCRIBED POLICIES BE CANCELLED DEFORETIIF EXPIIIATIOII , NATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITOIVI NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE 70 00 SO SIIAIA IMPOSE NO OBLIGATION Oil LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS ON REPIIESENTATIVES. IUTfIORIZEO REPRESENTATIVE — - NA I.)HE A� ,® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDM'YY) 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER NAUMTAGT Lauren Hajovsky Lauren Hajovsky PxoxE E , 361-782-3005 AIL0. No): 361-782.7169 nuoli. IhajovskyCbrib-ins.com Texas Farm Bureau PO Box 550 INSURERS AFFORDINOCOVERAGE NAICe Edna TX 77957 _ INSURERA: Texas Farm Bureau INSURED _ INSURER B: Texas Mutual Insurance Co. - 22945 JRB SERVICES LLC INSURER c: PO Box 386 INBURERO: Ganado TX 77962 INSURERS: _ NBURERF: MI IMRFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 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. MLIR EN rypC OPIN3UMNCESulff POLICYNUMBER O C EFF MMIDO POLICY Mf LIMITS GENEMLLIAGILITY EACH OCCURRENCE S COMMERCIAL GENERALLLASILITY CLAIMS -MADE ❑ OCCUR OA M E Ea 3 MED EXP Anyone pennon _ S PERSONAL S ADV INJURY a GENEMLAGGREGATE S GEN•L AGGREGATE POLICY LIMITAPPLIES PER: JECTIT PRO- LOG PRODUCTS -COMPICP AGO 3 $ AMOMOBILEUABILRY COMBINED SINGLE LIMIT e den 1000000 ,, BODILY INJURY (Per Pen") S ANYAUTO A AAL8NE0 x ACUNroE5ULE0 HIRED AUTOS AUT gWNEO N 21963019 06/2012022 09/07/2022 BODILY INJURY (Per accident) 3 p0P E OAMA E a S UMBRELLALIAB El OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS -MADE AGGREGATE $ DEO I I RETENTIONS S IWORKERIBCOMPENGATION B AND EMPLOYERS' LIABILITYM. ANY PROPRISTORIPARTNEIVUEOMME YIN OFFICERIMEMBEREXCLUOEOT ❑N (Ntandeleryln NN) IlyyaSCRIPTbe under NIA Y 0001318069 01/3012022 01/30/2023 X WOSTATV- OTH• 1,000,000 S 1,000,000 E.L. EACHACOIOENT EL DISEASE -EA EMPLOYEO S 1,000.000 E.LOISEASE-POUCYUMIT S 1,000,000 IONunder DESCRIPTION OPERATIONS below DESCRIPTION OF OPEM1I01481 LOCATIONS I VEHICLES (AMeh ACORD fe1, Additland RameM Seheduto, Irmen APnw Ie MReintll REBID- LANE ROAD DRAINAGE IMPROVMENTS FOR CALHOUN COUNTY TEXAS -TEXAS GENERAL LAND OFFICE CONTRACT NO.20-066-064-C182 AND CALHOUN COUNTY 2020 CCDSG-OR CONTRACT WORK ORDER NO. B-i. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Calhoun County, Texas THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 211 S. Ann St, Ste 301 ACCORDANCE WITH THE POLICY PROVISIONS. Part lavaco, TX 77979 I _ 0 1 0 ,f ACORD 25 (2010105) 0 19-2010 - RD CORPOl7AT1614. All rights reserved. The ACORD name and logo ar • e9lster marks of ACORD CERTIFICATE OF LIABILITY INSURANCE „��« 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. rvn, nlra: IT IRS ceruncale noluer is an AI lile terms and conditions of the policy, certain Lauren Hajovsky Texas Farm Bureau Po BOX 650 JRB SERVICES LLC Po Box 380 Ganado TX 77962 may require an endorsement. A statement on this certificate doas not confer rights to the ueMc Lauren Heiovskv Texas 22945 ' REVISION NUMBER: _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 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. SR TYPE OF INSURANCE POLICY U 6ER MMIDD F MIDJ100 GENERALLIABILITY' LIMITS COMMERCIAL GENERAL LUBILITY EACHOCCURRENCE S CLAIMe•MAOE OCCUR 6 F rton y_ d MED SKIP AW.nea on.. S PERSONAL& ADV INJURY d OEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE S p POLICY LOC PRODUCTS.GOMPIOPAGG S AUTOMOBILE LIABILITY E OM NEDSIN T 1,000,000 ANYAUTO (� AUUT06 NEO X LEO BODILY INJURY (Per parson) S AUTOS N 21963019 06/20/2022 09/07/2022 N NO OWNED sO01LYINJURY(PararoMenO 5 HIREDAUTOS AUTOS PPPAIAGE e pRaOPER 1 § UMBRELLA LUB OCCUR S EXCESS LMB CLAIMS•MADE EACH OCCURRENCE § LIED flET3 AGGREGATE § WORKERS COMPENSATIONT(CN S ANDEMPLOYERS•LIABILnY YE W STATEN 0FIr X R 1,0o0,000 B OFFICEMAEMB,,EXXCLUODEED�CUTIVE N/A Y0001318069 01/30/2021/0/2023E.LECHACCIDEW In Nx d 1.000.000imawalery If ...d.auleaunda, DEESSCRIPTION OF OPERATIONS ealow E.L. DISEASE -EA EMPLOYE S 1,000,000 E.L DISEASE -POLICY LIMIT I S 1,000,000 DESCRIPTION OFOPeRADONSILOCATRINS/VEMICLEB (gthch gDDRa t.LAtltlIIIPnal RomaMa SCM.tlula, Ilmere apace le re4ulretl) RESID- LANE ROAD DRAINAGE IMPROVMENTS FOR CALHOUN COUNTY TEXAS -TEXAS GENERAL LAND AND CALHOUN COUNTY 2020 CCDBG-DR CONTRACT WORK ORDER NO. OFFICE CONTRACT NO. 20-065-064-Cl62 13-1. CERTIFICATE HOLDER _...__..._._.. G&W Engineers, Inc, 205 W. Live Oak Port lavace, TX 77970 ACORD The ACORD name and logo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested partles. Complete Nos,1. 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2022.909133 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. JRB Services LLC. Ganado, TX United States Date Piled: 07/12/2022 2 Name o governmentalentity or state agency that s a party to the contract for which the form is being filed. Calhoun County, Texas Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or Identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 20-065-064-C182 Rebid -Lane Road Drainage Improvements 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only If there is NO Interested Party. ❑ 6 UNSWORN DECLARA ION ram.... + My name is _, �j�tx''/JrC'-� II�LI Ili!. ' I and my date of birth is`,aK. '?�`(,,,)`ta My address is — M-U :�1:k. N �j_ I�Rudo, V, �jqto, (street) �— (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. p ( - /T Executed in T(l�l. � Jv I County, State of 'l. G J , on the Id day of ./�, 20 2d (month) (year) Slgnaturb of authorized agent of contracting business entity (Declarant) %.yloW�uMnit`�sjelgrjlgtjl '!' ASSURANCES - CONSTRUCTION PROGRAMS OMB Number: 4040.0009 0212012022 Public, reporting burden for this collection of Information is estimated to average 16 minutes per response, Including Iitne for reviewing Instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of Information, Send comments regarding the burden estimate or any other aspect of this collection of Information, Including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0042), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY, NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact file Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional assurances. If such Is line case, you will be notified. As the duly authorized representative of (he applicaN:, I certify that the applicant: 1. Has (he legal authority to apply for Federal assistance, and the Institutional, managerial and financial capability 8. Will comply with the Intergovernmental Personnel Act (Including funds sufficient to pay the non -Federal share of 1970 (42 U.S.C, §§4728.4763) relating to prescribed standards of merit systems for programs funded Of project costs) to ensure proper planning, management and completion of project described in under one of the 19 statutes or regulations specified In Appendix A of OPM's Standards for a Merit System of this application, Personnel Administration (5 C.F.R. 900, Subpart F). 2. WIII give the awarding agency, file Comptroller General 9. Will comply with the Lead -Based Paint Poisoning of the United Stales and, If appropriate, the State, the right to examine all records, books, papers, or Prevention Act (42 U.S.C. §§4801 at seq.) which prohibits the use of lead -based paint In construction or documents related to the assistance; and will establish rehabilitation of residence structures, a proper accounting system In accordance wills generally accepted accounting standards or agency 10. WIII comply Willi all Federal statutes relating to non - directives. discrimination. These include but are not limited to: (a) 3. Will not dispose of, modify the use of, or change tt o Ilte Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, terms of the real property (tile or other Interest In the site and facilities without permission and Instructions color or national origin; (b) Title IX of the Education front the awarding agency. WIII record line Federal Amendments or 1972, as amended (20 U.S.C. §§1681 1683, and 1685.1686), which prohibits discrimination awarding agency directives and will Include a covenant In the (Ilia of real property acquired In whole or In part on Ilse basis of sex; (c) Section 604 of the with Federal usslatance funds to assure non- Rehabilitation Act of 1973, as amended (29) U.S.C. §794), which prohibits discrimination on the basis of discrimination during tine useful life of the project, handicaps; (d) the Age Discrimination Act of 1975, as 4. WIII comply with the requirements of the assistance amended (42 U.S.C. §§6101-6107), which.prohibils awarding agency Willi regard to Ilse drafting, review and discrimination on (Ise basis of age; (a) Ilse Drug Abuse approval of construction plans and specifications. Office and Treatment Act of 1972 (P.L. 92.255), as 6. WIII provide and maintain competent and adequate amended relating to nondiscrimination on the basis of drug abuse; If) the Comprehensive Alcohol Abuse and engineering supervision at the construction site to Alcoholism Prevention, Treatment and Rehabilitation ensure that tine complete work conforms with the Act of 1970 (P.L. 91-616). as amended, relating to approved plans and 8pecl9calfons and will furnish nondiscrimination on the basis of alcohol abuse or progressive reports and such other Information as may be alcoholism; (g) §§523 and 627 of the Public Health required by Ilia assistance awarding agency or Slate. Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 6. WIII Initiate and complete the work within the applicable 3), as amended, relating to confidentiality of alcohol thne frame after recelpt of approval of the awarding agency. and drug abuse patient records; Civil Rights Act or 1968 (42 U.S.C. VIII of the §§36§3601 at seq.), as 7. WIII establish safeguards to prohibit employees from amended, relating to nondiscrimination In Ilse sale, using their positions for a purpose that constitutes or rental or financing of housing; (1) any other presents the appearance of personal or organizational nondiscrimination provisions In the specific statue(s) conflict of Interest, or personal gain. under which application for Federal assistance is being made; and p) the requirements of any other nondiscrimination statues) which may apply to the application. Previous Edition Usable Authorized for Local Reproduction Slandard Form 424D (Rev. 7-97) Prescribed by OMB Circular A-102 11. Will comply, or lies already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91.646) which provide for fair and equitable trenlinent of persons displaced or whose properly Is acquired as a result of Federal and federally -assisted programs. These requirements apply to all Interests in real property acquired for project purposes regardless of Federal participation In purchases. 12. WIII comply with Ilia provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or In par[ with Federal funds. 13. Will comply, as applicable, with the provisions of the Davis - Bacon Act (40 U.S.C, §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safely Standards Act (40 U.S.C, §§327- 333) regarding labor standards for federally-asslated construction subegreemenls. 14. Will comply with flood Insurance purchase requirements of Section 102(a) of Ilia Flood Disaster Protection Act of 1973 (P.L. 93.234) which requires recipients In a special flood hazard area to participate In the program and to purchase flood Insurance If the total cost of Insurable construction slid acquisition Is $10,000 or more. 15. WIII comply with environmental standards which may be prescribed pursuant to the following; (a) Institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11614; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards In floodplains In accordance with EO 11980; (a) assurance of project consistency with the approved Slate management program developed tinder the Coastal Zone Management Act of 1072 (16 U.S.C. §§1451 at seq.); (f) conformity of Federal actions to Stale (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1965. as amended (42 U.S.C. §§7401 at seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 at seq.) related to protecting components or potential components of the national wild and scenic rivers system. 17. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (Identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (1a U.S.C. §§469s-1 0l seq). 18. Will cause to be performed the required financial and compliance audits In accordance with the Single Audit Act Amendments of 1998 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non -Profit Organizations." 19. WIII comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. 20. WIII comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award recipients or a sub-reclpienl from (1) Engaging In severe forms of trafficking In persons during the period of time that the award Is In effect (2) Procuring a commercial sex act during the period of time that the award Is In effect or (3) Using forced labor In the performance of the award or subawards under the award. SIGNAT(1 E OF AUTHORIZED CERTIFYING OFFICIAL TITL APPLICANT OR •ANIZATION � � (XV I )L DAT S B 3 ITTED area SF-424D (Rev. 7-97) Back DOCUMENT NO.00415 CONTRACTOR'S CORPORATE RESOLUTION I hereby certify that it was RESOLVED by a quorum of the directors of . Tp� �uVI C PS CbC . (Name offCorporaatioo) meeting on tile¶p L day of cll�J � , 20�z that �L'� IlJ_ K �, {r �I C.1Idy be, (Name of Principal) (Title) and hereby is, authorized to execute all documents necessary for the transaction of business in the j State of Texas on behalf ofthe said /r RyyVia ) • and (Name of Corporation) That the above resolution was unanimously ratified by the Board of Directors at said meeting and that the resolution has not been rescinded or amended and is now in fill force and effect; and in authentication of the adoption of 1this resolution, I subscribe my name this day of �l/�r 20 d0 , -� 0 Secretary -++++++-1-+++++++++++++-I-+-1-+++++i- I--I--I-++++-1-i-+ti--I--F+++++-I-++++++-1-+-I- lf you are not a corporation, please check the box and sign below ❑ Company Signed By: Print Name/Title: END OF DOCUMENT 00415-1 DOCUMENT NO.00417 TRENCH SAFETY SYSTEMS INDEMNITY AGREEMENT OWNER: Calhoun �County ( n CONTRACTOR: 1—�l km' lic . (company name) ENGINEER: G & W Engineers, Inc., Port Lavaca, Calhoun County, Texas PROJECT: REBID - LANE ROAD DRAINAGE IMPROVEMENTS FOR CALHOUN COUNTY, TEXAS - TEXAS GENERAL LAND OFFICE CONTRACT NO. 20-065-064-C182 AND CALHOUN COUNTY 2020 CDBG-DR CONTRACT WORD ORDER NO. B-1. CONTRACTOR has entered into a contract with OWNER for the construction of the Project. ENGINEER has designed the Project on behalf of OWNER, but has not designed any trench safety systems for the Project that may be required by applicable federal, state and/or local laws. CONTRACTOR, in its contract with OWNER, has agreed to prepare, and to conform all trenching work to plans for trench safety systems meeting tine standards of applicable laws. CONTRACTOR, as part of its consideration to OWNER for the contract for the construction of the Project, agrees that it will be solely responsible for compliance with its trench safety plans and with all applicable standards of federal, state and/or local laws relating to trench safety. CONTRACTOR further agrees to hold harmless, indemnify, and defend OWNER and ENGINEER, and all officers, agents and employees of either OWNER or ENGINEER, from and against any and all claims, demands or causes of action of any nature, character or description in connection with the presence, or in any way arising out of, the use or construction of trenches or trench safety systems as part of the Project. EXECUTED, this day of _ �)L u , 20 O. CONTRACTOR By; 0 ' uVIC .SLIU, . Officer's Name: l( Title of Officer: OWNER By: Officer's Name: Richard H. Meyer Title of Officer: Calhoun County Judge ENGINEER (Contractor's Seal) Eng' er's Name: Scott P. Mason. E. Title of Engineer: Sr. Project Engineer END OF DOCUMENT 00417-1 DOCUMENT NO. 00430 CONTRACTOR'S LOCAL OPPORTUNITY PLAN fV .agrees to implement the following specific affirmative action steps directed at increasing the utilization of lower income residents and businesses within CALIIOUN COUNTY, hereinafter called OWNER. A. To ascertain from OWNER's CDBG-DR program official the exact boundaries of the project area and where advantageous, seek the assistance of local officials in preparing and implementing the affirmative action plan. B. To attempt to recruit from OWNER the necessary number of lower income residents through local advertising media, signs placed at the proposed site for the project, and community organizations and public or private institutions operating within and servicing the project area such as Service Employment and Redevelopment (SER), Opportunities Industrialization Center (OIC), Urban League, Concentrated Employment Program, Hometown Plan, or the U.S. Employment Service. C. To maintain a list of all lower income residents who have applied either on their own or on referral from any source, and to employ such persons, if otherwise eligible and if a vacancy exists. D. To require all subcontracts to have an affirmative action plan including utilization goals and the specific steps planned to accomplish these goals. E. To insure that subcontracts (greater than $10,000) which are typically let on a negotiated rather than a bid basis in areas other than the covered project area are also let on a negotiated basis, whenever feasible, in a covered project area. To formally contact unions, subcontractors, and trade associations to secure their cooperation in this effort. G. To insure that all appropriate project area business concerns are notified of pending sub - contractual opportunities, I -I. To maintain records, including copies of correspondence, memoranda, etc., which document that all of the above affirmative action steps have been taken. To appoint or recruit an executive official of the company or agency as Equal Opportunity Officcr to coordinate the innplementalion of this plan. To maintain records concerning the amount and number of contracts, subcontracts, and purchases which conh•ibute to objectives. 00430-1 K. To maintain records of all projected work force needs for all phases of the project by occupation, trade, skill level, and number of positions and to update these projections based on the extent to which hiring meets these Local Opportunity objectives. As officers and representatives of :YE) g V icy . I I, l_ we, the undersigned, have read and fully agree to this Plan, and become a party to the fill implementation of the program and its provisions. /V Signa ire •l)04 fir Printed Name v Q wml- Date / dW Title END OF DOCUMENT 00430-2 list ructions 1101• Proposed Contracts Breakdown nud Eslimnled Project Wo•kt'm•ce BreAdown Proposed Contracts Breakdown for Section P 'type of Contracts — list all construction, materials, or other types of subcontracts (for example: electrical, plumbing, concrete, boring, etc.) No. of Contracts — Amount of contracts under this calegoly Approximate Total Dollar Amount —Total amount of each contract Estimated Pe•centaee of Contract to Local Business — What pereciatage of each type of contract will be awarded to a Section 3 Business Conc rn (see below for definition)? For example: will you hire any local employees or subcontractors? `/10 Pl, A - I, Listi_ tdI ateAmounht9tGo[Local Business- -Flow many dollars will be spent locally for each type of contract? For example: will you hire any local employees o• subcontractors? Estimated Projcct Workforce Breakdown Work Classifications — Classification of project employees as defined on Wage Rate 'rota) Estimated Positions -- List lire number employees for each work classification will you need on this project Number of Positions Currently Filled — List the number of estimated positions you currently have filled Number of Positions Not Filled — List the number of estimated positions you currently, do not have filled r Number of Positions to Fill with Low to Moderate income Residents — List (lie number f ocul resi lents coning low to moderate incomes that you plan to employ to fill the estimated positions not filled I �r 9rm) "Definition of Section 3 Business Couccrus; a) Businesses (lint are 51 percent or more owned by Section 3 residents; b) Businesses whose permanent, fill -time employees include persons, at least 30 percent of whom are currently Section 3 residents, or within three yeas of the dale of first employment with the firm were Section 3 residents; c) Businesses that provide evidence of a commitment to subcontract in excess of25 percent of the dollar amount of all subcontracts to he awarded to businesses (lint meet the qualifications described above; or d) Businesses located within the Grant Recipient's jurisdiction that identifies themselves as Section 3 Business Concerns because they provide economic opportunities for low- and very low income persons. DOCUMENT NO. 00440 CONTRACTOR'S SUBCONTRACT/WORKFORCE BREAKDOWN .0I PROPOSED CONTRACTS BREAKDOWN TyieofContrnets Number of Contracts EstimnteulTOtniDoliu'Atnounnl Csfinmted % to Locnl Business I Estimated $ Amount to Local Business Hbpe,000 vlplP 4s oou ce M0 uoc3 kao Dw) Totals; .02 ESTIMATED PROJECT WORKFORCE BREAKDOWN Work Clnssificaltons Tolnl Estbmated POSiBea3 No. Positions Currently Filled No. Positions Not Tilled No. Positions to Fill with LA I R sit cots o el1 $ i XmlAs Totals: END OF DOCUMENT 00440-1 SECTION 504 CERTIFICATION POLICY OF NONDISCRIMINATION ON THE BASIS OF DISABILITY nn The t ���� 91 I')U_ 1/, J�VVIUf [SC not discriminate on the basis of disability status in the admission or access to, or treatment or employment in, its federally assisted programs or activities. (Name) A b bC(. b (Address) 4fl-I I'f C 47d ��i _V 311101 City State Zip Telephone Number (3U) ) 4i Voice ( ) TDD 1Y 15 'iry �C(S l �l ` . has been designated to coordinate compliance with the nondiscrimination requirements contained in the Department of Housing and Urban Development's (HUD) regulations implementing Section 504 (24 CFR Part 8. dated June 2, 1988). U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM CONTRACTOR'S CERTIFICATION CONCERNING LABOR. STANDARDS AND PREVAILING WAGE REQUIREMENTS TO (appropriate reciipp'iern�t)' 1 �j'' _. �� WK) I 4)i 11 y ���NNNVVV""" DATE PROJ NU1M E�(IF ,4 — C/0 O p ypn r`VILI The undersigned, having executed a contract with for the construction of the above identified project, acknowledges that: (a) The labor Standards provisions are Included in the aforesaid contract, (b) Correction of any infractions of the aforeseld conditions, Including Infractions by any subcontractors and any lower tier subcontractors, is. Contractor's responsibility. 2. Certifies that: (a) Neither Contractor nor any firm, partnership or association In which It has substantial Interest is designated as an Ineligible contractor by the Comptroller General of the United Stales pursuant to Section 5.6(b)of the Regulations of the Secretary of Labor, Part (29 CFR, Part 5) or pursuant to Section3(a) of the Davis -Bacon Act, as amended. (b) No part of the aforementioned contract has been or will besubcontracted to any subcontractor It such subcontractor or any firm, corporation, partnership or association In which such subcontractor has a substantial interest is designated as an Ineligible contractor pursuant to any of the aforementioned regulatory or statutory provisions.. 3. Contractor agrees to obtain and forward tothe aforementioned recipient within ten days after the execution of any subcontract, Ineludfng those executed by subconlractoreand any lower tier subcontractors, a Subcontractor's Certification Concerning Labor StandardsandPrevailing Wage Requirements executed by the subcontractors. 4. Certifies [list: (a) The legal name.and the business address of tho undersigned are: c I tic u.m. till. anu auur.s. or tiro uwu.r, partners or onicars or me unaeral nea are: AE ADDRE a yn '/^TIITTIjL'E �4 & 1 I O ' I � i �llIYIG.S VIA- VeSI 8t W oft The names and addresses of all other persons having a substantial interest in the undersigned, and the nature of the names, e�4VIC2.S 1,LC. Dale (Contractor) By Z #12 12. Public Hearing regarding amending the 2022 Calhoun County budget. t N07lCl= OF PUBLIC HEARING — 8/10/2022 NOTICE OF PUBLIC HEARING TO AMEND 7C]E][)E 2022 BUDGET The Calhoun County Commissioners' Court will hold a Public Hearing to amend the 2 0 2 2 Budget in the Calhoun County Commissioners' Courtroom, Suite 104 of the Calhoun County Courthouse, on August 10, 2022 at 10:00 a.m. This notice is in accordance with S ection 11.007 and Section 111.0075 of the Texas Local Government code. Richard H. Meyer, County J ge Calhoun County, Texas Anna Goodman, County Clerk By: ". V Deputy Clerk 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 ww w, calhouncotx org under "Commissioners' Court Agenda" for any official court postings. AT I®JV FILED �1 O'GLOGN I M JUL 14 2022 COUNTY CLUN CO BY: UMfY, TEXAS �DE'P Page 1 of 1 Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Friday, July 29, 2022 6:01 PM To: Mae Belle Cassel Cc: Richard Meyer; Candice Villarreal; peggy hall; Erica Perez Subject: Budget Amendment Hearing Agenda Items Please include the following items on the agenda for 8/10/22: • Public Hearing regarding amending the 2022 Calhoun County budget. • Consider and take necessary action to amend the 2022 Calhoun County budget. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindy.mueller@caIhouncotx.org Calhoun County Texas 1 11, lip 2< i I s I 91 q, i rn a 0 C6 N O N T A �a zz zz 9 9 O o z z e OM rn rn 0 0 a N N O N a a W Q m co 2 J Qi LLI 0. Zz W 2 Q = F r3 O' m N O F� N La y G 3 =a W p 'a fA CODv m 3 W O a' La c C9 Z i W N 0I-ram $l Rl u F- z2 a z 2 Ql m a O N u N N O N a a WW` r (#1 W � p W O a v ME I Z W W C6 F Z` Z W � W x N 'N N CF G3 W GOD Z � c W oa v ,cw A Z a W al' V d N N a W Q� Q m z O C6 J 6 0 9 L2 S 5 #13 13. Consider and take necessary action to amend the 2022 Calhoun County budget. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner P,ct 1 SECONDER- Joel Behrens, Commissioner Pct 3 AYES: JudgeiMeyer, Commissioner Hall, Lyssy, Behrens Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Friday, July 29, 2022 6:01 PM To: Mae Belle Cassel Cc: Richard Meyer; Candice Villarreal; peggy hall; Erica Perez Subject: Budget Amendment Hearing Agenda Items Please include the following items on the agenda for 8/10/22: Public Hearing regarding amending the 2022 Calhoun County budget. Consider and take necessary action to amend the 2022 Calhoun County budget. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.553.4610 F: 361.553.4614 Cindy.mueller@calhouncotx.org Calhoun County Texas #14 14. Consider and take necessary action to authorize the County Judge to sign all necessary documentation pertaining to updating Calhoun County's Hazard Mitigation Plan Development and Grant Management Services in support of Calhoun County State and Federal Grant. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct l AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Calhoun County Emergency Management 211 South Ann Street, Suite 301 Port Lavaca, TX 77979-4249 Phone: 361-553-4400/Fax: 361-553-4444 e-mail: ladonna.thigpen@calhouncotx.org July 29, 2099 Commissioner's Court RE: Agenda Item Please place the following request on the Commissioners' Court agenda for August 10, 2022 Consider and take necessary action to authorize the County Judge to sign all necessary documentation pertaining to updating Calhoun County's Hazard Mitigation Plan Development and Grant Management Services in support of Calhoun County State and Federal Grants. Thank you, 40 LaDonna Thigpen #15 15. Consider and take necessary action on the Independent Audit Report for the year ended December 31, 2021 by Armstrong, Vaughan and Associates, P.C., Certified Public Accountants. (RHM) Debbie Fraser gave the report. RESULT: APPROVED [UNANIMOU,S] MOVER: David Hall, Commissioner Pct SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens Mae Belle Cassel From: cindy.mueller@calhouncotx.org (cindy mueller) <cindy.mueller@calhouncotx.org> Sent: Friday, July 29, 2022 6:01 PM To: Mae Belle Cassel Cc: Richard Meyer, fraser@avacpa.com Subject: Agenda Item Request Please place the following item on the agenda for 8/10/22: • Consider and take necessary action on Independent Audit Report for the year ended December 31, 2021 by Armstrong, Vaughan and Associates, P.C., Certified Public Accountants. Note: Reports will be provided at the meeting. Cindy Mueller County Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 V: 361.S53.4610 F: 361.553.4614 Cindv.muellerPcalhouncotx ore Calhoun County Texas 1 #16 16. Consider and take necessary action to accept an anonymous donation of $20.00 to the Sheriff's Office. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: s, David Hall, Commissioner Pct'1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553-4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: ACCEPT DONATION TO SHERIFF'S OFFICE DATE: AUGUST 1, 2022 Please place the following item(s) on the Commissioner's Court agenda for the date(s) indicated: AGENDA FOR AUGUST 10, 2022 * Consider and take necessary action to accept donation to the Sheriff s Office in the amount of $20.00. Sincerely, IdIA�� Bobbie Vickery Calhoun County Sheriff #17 17. Consider and take necessary action to approve an Education Affiliation Agreement between Calhoun County EMS and Victoria College and authorize the Calhoun County EMS Director to sign all documentation. (RHM) Dustin Jenkins explained the agreements. RESULT: APPROVED [UNANIMOUS]' MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER:David Hall, Commissioner Pct I AYES: Judge Meyer, Commissioner Hall; Lyssy, Behrens EDUCATION AFFILIATION AGREEMENT This Agreement is executed as of 07/01/2022 between THE VICTORIA COLLEGE hereinafter sometime referred to as "COLLEGE", in this Agreement, and Calhoun County Emergency Medical Services hereinafter sometimes referred to as "AGENCY" in this Agreement, WITNESSETH: WHEREAS, it is agreed by the parties hereto that it is to the mutual interest and advantage that the students and faculty of the COLLEGE be given the opportunity to utilize the AGENCY as a clinical teaching environment for medical technical purposes in one or more of the following areas of health care education: '" Emergency Medical Services NOW, THEREFORE, for and in consideration of the foregoing, and in further consideration of mutual benefits, the parties to this Agreement agree as follows: I. TERM AND TERMINATION OF AGREEMENT The term of Agreement shall be from 07/01/2022 to 07/01/2027 and at the end of such five (5) year period shall be renewed every five (5) years under like terms thereafter; provided, however, this Agreement may be terminated at any time for cause and/or violations of the terms hereof. Furthermore, either party may terminate this Agreement upon ninety (90) days' written notice given in accordance with Section VIII hereof. II. ARRANGEMENTS FOR FACILITIES AND COURSES: A. The AGENCY will permit students of COLLEGE to undertake practice education in one or more of the above areas of health care education under the supervision and responsibility of qualified and sufficient FACULTY of the COLLEGE. The individual FACULTY members will plan with the liaison person designated by the AGENCY for the activities of students. B. The number and distribution of students will be mutually agreed upon between the COLLEGE and the AGENCY at the beginning of each semester. C. The period of assignment shall be during regular COLLEGE sessions, except in the instance of special arrangements, such as for workshop participants. D. The COLLEGE will provide the AGENCY with the names of the students who are entitled to use the resources of the AGENCY under the terms of this Agreement. That is, prior to actual assignments; the roster of students, clinical practice assignments; scheduled rotations, and resume of course objectives will be sent to the AGENCY liaison person. E. Representatives of the COLLEGE and the AGENCY shall meet as often as necessary at the AGENCY to study the educational program and terms of this Agreement and make such changes and suggestions as are needed. F. COLLEGE personnel, faculty, and students will be subject to the rules and regulations established by the AGENCY for the division of the AGENCY to which they are assigned. III. ELIGIBLE STUDENTS: The AGENCY will accept from the COLLEGE only students who are qualified academically. A student shall be eligible for assignment in the AGENCY if, but only if, he or she shall meet and continue to meet each of the following qualifications in addition to academic qualifications: A. Medical Qualifications: The AGENCY shall have access to the health records of each student. The student's health record must include: 1. A signed statement that each student's current (within the year) health record contains the results of a tuberculin test and/or an X-Ray of his or her chest (if tuberculin test is positive) and that required immunizations are up to date. 2. Satisfactory evidence that the student has no contagious infection. 3. Evidence that a student with a known medical condition is receiving appropriate medical care and has been cleared by a physician to study in the AGENCY. B. The AGENCY will charge the COLLEGE no fees for practice opportunity afforded students. C. Students will be responsible for the payment and/or purchase of their own meals, medical care, laundry, and parking, as well as transportation to and from the AGENCY. Emergency medical care and any other health care required by the student, will be available to each student at the student's expense, the student assuming full responsibility for all billed charges. D. The AGENCY will not be charged for services, if any, performed by the COLLEGE personnel or students. E. Students will adhere to dress code prescribed by COLLEGE. F. Performance Qualifications: The AGENCY may request COLLEGE to withdraw any student whose conduct, work, or medical condition may have a detrimental effect on its staff or its patients, whereupon the COLLEGE will take appropriate action. Furthermore, the COLLEGE may withdraw any student whose progress, achievement, or adjustment does not justify his continuance with the COLLEGE. G. Liability Insurance: As a condition to permitting any staff, FACULTY, or student of the COLLEGE on its premises, the AGENCY requires that the COLLEGE furnish the AGENCY with evidence that students and FACULTY have current liability insurance of not less than $3,000,000 per incident and $1,000,000 per person to be kept current while such person is assigned to the AGENCY. IV. INSTRUCTION: The COLLEGE shall provide qualified licensed faculty of sufficient number to provide supervision of students assigned to clinical experiences and program planning and presentation. The COLLEGE shall be responsible for planning and implementing all student learning experiences. The salaries and expenses of any instructors, supervisors, or other employees of the COLLEGE will be paid by the COLLEGE and expenses of all employees of the AGENCY will be paid by the AGENCY. The COLLEGE agrees that members of its FACULTY may serve as consultants and on committees of the AGENCY when requested by the AGENCY. The AGENCY further agrees as follows: 1. To maintain the criteria for accreditation as established by appropriate accrediting agency. 2. To provide to the COLLEGE the necessary space or facilities for conference and classroom areas as available. 3. The COLLEGE shall provide an Education Coordinator who shall be responsible for the overall supervision of the clinical experience for the PROGRAM in the AGENCY. The Education Coordinator's responsibilities shall include curriculum development, student rotation assignments, student evaluation and shall act as liaison with the AGENCY. The AGENCY shall provide a Clinical Coordinator who shall work with the Education Coordinator in the areas of curriculum development, student rotation assignments, student evaluations and shall act as liaison with the COLLEGE. 4. The AGENCY shall permit PROGRAM students of the COLLEGE to observe and practice approved clinical skills under the supervision of COLLEGE faculty or an AGENCY preceptor. The COLLEGE will also have a qualified faculty member available for consultation and mediation. The faculty will plan with the liaison person designated by the AGENCY for the activities of students. 5. Instructors will abide by student tuberculin test and required immunization standards as described in III (A. 1) of this agreement. V. PATIENT CARE: The AGENCY shall remain in charge of all patient care. Students shall not be used for AGENCY staffing, but shall be responsible as students to the COLLEGE which shall remain responsible to the AGENCY for the patient care provided by the students. VI ORIENTATION: The AGENCY and the COLLEGE will provide a faculty orientation program prior to student assignment. The COLLEGE will require its faculty to orient new students at the beginning of each semester. Orientation shall include familiarization with relevant hospital policies, procedures, and facilities. VII. INDEPENDENT CONTRACTOR RELATIONSHIPS: It is recognized and agreed between the parties hereto that the facilities provided by the AGENCY or used by the students and FACULTY of the COLLEGE hereunder, are provided for use by the students for clinical experience and training experience which is a prescribed part of the curriculum of instruction of the COLLEGE for qualification of students within the program they are pursuing. Any services provided by students and FACULTY hereunder, as part of the clinical experience or training at the AGENCY, will be provided to the AGENCY by and on behalf of the COLLEGE as independent contractors and not as an agent or employee of Calhoun County Emereenev Medical Services Neither the COLLEGE staff, FACULTY, nor students shall be eligible for employee benefits of the a AGENCY as such are not AGENCY employees but are staff, FACULTY, or students of the COLLEGE and as such do not perform substantial services for the AGENCY. VIII. NOTICES: Notices or communications required or permitted to be given under this Agreement shall be given to the respective parties by certified mail at the following addresses unless otherwise designated in writing: PRESIDENT Victoria College 2200 E. Red River Victoria, Texas 77901 IX. MISCELLANEOUS: ADMINISTRATOR Calhoun County Emergency Medical Services 705 Henry Barber Way Port Lavaca, Texas 77979 9.1 Binding Effect. This Agreement shall be binding upon AGENCY and COLLEGE as of the date of its execution in accordance with its terms. 9.2 Article and Other Headings. The article and other headings contained in this Agreement are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement. 9.3 Governing Law. This Agreement has been executed and delivered in, and shall be construed and enforced in accordance with the laws of the State of Texas. 9.4 Assignment. No assignment of this Agreement or the rights and obligations thereunder shall be made without prior written consent of the other party hereto, provided that this Agreement shall automatically be assigned to and inure to the benefit of any successor corporation or other organization operating the AGENCY. 9.5 Amendment. This Agreement may be amended only by an instrument in writing signed by both parties in the manner provided in Section 9.6. 9.6 Execution. This Agreement and amendments thereto shall be executed in two (2) counterparts: (a) on behalf of the COLLEGE by its Regents and (b) on behalf of the AGENCY by its Administrator and appropriate Associate and Assistant Administrators and approved as to form by the AGENCY Counsel. Each counterpart shall be deemed an original but all counterparts together shall constitute one and the same instrument. 9.7 Non -Discrimination Statements. a. Victoria College does not discriminate on the basis of race, color, religion, national origin, gender, pregnancy, age, disability, genetic information, marital status, amnesty, veteran's status, or limited English proficiency. It is our policy to comply, fully, with the nondiscrimination provision of all state and federal rules and regulations. b. The AGENCY does not discriminate against its members, application for membership or COLLEGE personnel, faculty or students on the basis of race, color, national origin, sex, handicap or disability. COLLEGE: AGENCY: 4P SIDEN` DATA n NISTRATOR D V D` JENNIFER KENT 4USTIN JENKINS THE VICTORIA COLLEGE CALHOUN COUNTY EMERGENCY MEDICAL SERVICES 6 O .— 01-339 (8.G ) (Rev.4-13/e) Texas Sales and Use Tax Exemption Certification This certificate does not require a number to be valid. Name of purchaser, firm or agency Victoria College Address (Street & number, P.O. Box or Route number) Phone (Area code and number) 2200 E. Red River (361) 573-3291 City, State, ZIP code Victoria, Tx 77901 I, the purchaser named above, claim an exemption from payment of sales and use taxes (for the purchase of taxable items described below or on the attached order or invoice) from: Seller: Street address: City, State, ZIP code: Description of items to be purchased or on the attached order or invoice: Purchaser claims this exemption for the following reason: Services and tangible personal property are purchased for the exclusive use of Victoria College. Victoria College is exempt from Texas Sales and Use Tax in accordance with Tex. Tax Code Ann. Sec. 151.309(4), (5) et.al. Victoria College's Federal Tax Identification Number is 74.6002452. I understand that I will be liable for payment of all state and local sales or use taxes which may become due for failure to comply with the provisions of the Tax Code and/or all applicable law. 1 understand thatitis a criminal offense to give an exemption certificate to the sellerfortaxable items that I know, atthe time ofpurchase, will be used in a mannerotherthan that expressed in this certificate, and depending on the amount of tax evaded, the offense may range from a Class C misdemeanor to a felony of the second degree. here /l2�¢ ¢it z I Director of Purchasing I 06/22/2022 NOTE: This certificate cannot be issued for the purchase, lease, or rental of a motor vehicle. THIS CERTIFICATE DOES NOT REQUIRE A NUMBER TO BE VALID. Sales and Use Tax "Exemption Numbers" or "Tax Exempt' Numbers do not exist. This certificate should be furnished to the supplier. Do n_91 send the completed certificate to the Comptroller of Public Accounts. Form-9 Request for Taxpayer Give form to the (Rev. October 2007) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Servlce Name (as shown on your Income tax return) m Victoria County Junior College District A Business name, If different from above 0 o Victoria College a c Check appropriate box: ❑ Individual/Sole proprietor ❑ Corporation ❑ Partnership ❑ Exempt ❑ :0 Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ► ....... payee 0 2 ❑✓ Other (see Instructions) ► Institution of Higher Education cAddress (number, street, and apt. or suite no.) Requester's name and address (optional) a u 2200 E. Red River 1 City, stale, and ZIP code Victoria, TX 77904-4442 d List account numbers) here (optional) Identification Number Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number number to enter. 74 I 6002452 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U.S. person (defined below). Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4. Sign Signature of '' Here U.S. person ► K ��� Director of Purchasing Date ► 1uve28.2022 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (FIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: • The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W-9 (Rev. 10-2007) # Zs 18. Consider and take necessary action to declare the attached list of items from Memorial Medical Center as Waste. (RHM) RESULT: APPROVED [UNANIMOUS]' MOVER: Joel Behrens, Commissioner Pct 3 SECONDER:David Hall, Commissioner Pat 1 AYES: Judge Meyer, Commissioner Nall; Lyssy, Behrens' Calhoun County, Texas Waste Declaration Request Form Department Name: Memorial Medical Center Storage (�Units —JULY IF page 1 Requested By: Roshanda Thomas, Interirh EE INV# DESCRIPTION 1— Partial wood side table SERIAL # REASON O. WASTE No Longer Used/Broken 1— Old battery Pack No Longer Used/Over 10 yrs old 1— Table top No Longer Used 1—Warming blanket Not working/broken I— Desk Broken 2 — Draw chair Broken 12— Bedside tables Won't adjust to bedside 1— black Office fabric chair Hazard from Lab 1— Rocker Hazard from Lab 1—Tall office chair Hazard from Lab 1— Backup Hazard from Lab 1— Lab Testing equipment Hazard from Lab 1— Temperature Monitor Hazard from Lab 1— Computer equipment Hazard from Lab #19 19. Accept Monthly Reports from the following County Offices: District Clerk — July 2022 ii. Floodplain Administration — July 2022 iii. Justice of the Peace, Precinct 1— July 2022 iv. Justice of the Peace, Precinct 2 —July 2022 v. Justice of the Peace, Precinct 4 — July 2022 vi. Justice of the Peace, Precinct 5 — July 2022 vii. Sheriff's Office — July 2022 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy; Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct; I AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens *Treasurer Receipt Numbers: F2022JULY001, 014,032 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/2/2022 COURT NAME: DISTRICT CLERK MONTH OF REPORT: JULY Y{AR OF REPORT: 2022 ACCOUNT NUMBER ACCOUNT NAME DEBIT CREDIT 1000-001-44190 SHERIFF'S SERVICE FEES $2,671.51 1000-00144140 JURY FEES $206.00 1000-00144045 RESTITUTION FEE $0.00 1000-00144020 DISTRICT ATTORNEY FEES $0.00 1000-00149010 REBATES -PREVIOUS EXPENSE $0.00 1000-00149030 REBATES-ATTORNEY'S FEES $47.44 1000-00144058 DISTRICT CLERK ELECTRONIC FILING FEES $0.00 1000-00144322 - TIME PAYMENT REIMBURSEMENT FEES $3.47 1000-00143049 STATE REIMB- TITLE IV-D COURT COSTS $0.00 DISTRICT CLERK FEES CERTIFIED COPIES $582.00 CRIMINAL COURT $6.39 CIVIL COURT $2,340.58 STENOGRAPHER $515.00 CIV FEES DIFF $0.00 1000-00144050 DISTRICT CLERK FEES $3,443.97 1000-999-20771 FAMILY VIOLENCE FINE $0.00 1000-999-10010 CASH - AVAILABLE $6,372.39 2706-00144055 FAMILY PROTECTION FEE $0.00 2706-999-10010 CASH - AVAILABLE $0.00 2740-00145055 FINES - DISTRICT COURT $19.71 2740-999-10010 CASH -AVAILABLE $19.71 2620-00144055 APPELLATE JUDICIAL SYSTEM $103.00 2620-999-10010 CASH - AVAILABLE $103.00 2648-00144055 COURT FACILITY FEE FUND $412.00 2648-999-10010 CASH - AVAILABLE $412.00 2670-00144055 COURTHOUSE SECURITY $422.80 2670-999-10010 CASH - AVAILABLE $422.80 2673-00144055 CRT RECS PRESERVATION FUND- CO $10.00 2673-999-10010 CASH - AVAILABLE $10.00 2725-00144055 LANGUAGE ACCESS FUND $61.80 2725-999-10010 CASH - AVAILABLE $61.80 2739-00144055 RECORD MGMT/PRSV FUND - COUNTY $666.58 2739-999-10010 CASH - AVAILABLE $666.58 2737-00144055 RECORD MGMT/PRSV FUND -DIST CLRK $25.40 2737-999-10010 CASH - AVAILABLE $25.40 2731-00144055 LAW LIBRARY $721.00 2731-999-10010 CASH - AVAILABLE $721.00 2663-00144050 CO & DIST CRT TECHNOLOGY FUND $0.64 2663-999-10010 CASH - AVAILABL $0.64 7040-999-20740 BREATH ALCOHOL TESTING - STATE $0.00 7040-999-10010 CASH - AVAILABLE $0.00 2667-00144055 - CO CHILD ABUSE PREVENTION FUND $0.34 2667-999-10010 CASH - AVAILABLE $0.34 7502-999-20740 JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE $5.00 7502-999-10010 CASH-AVAILABE $5.00 7383-999-20610 DNA TESTING FEE - County $0.08 7383-999-20740 DNA TESTING FEE - STATE $0.77 7383-999-10010 CASH - AVAILABLE $0.85 7405-999-20610 EMS TRAUMA FUND - COUNTY $0.00 7405-999-20740 EMS TRAUMA FUND - STATE $0.00 7405-999-10010 CASH - AVAILABLE $0.00 7070-999-20610 CONSOL. COURT COSTS -COUNTY $0.81 7070-999-20740 CONSOL. COURT COSTS - STATE $7.32 7070-999-10010 CASH - AVAILABLE $8.13 7072-999-20610 STATE CONSOL. COURT COSTS- COUNTY $5.52 7072-999-20740 STATE CONSOL, COURT COSTS- STATE $49.64 7072-999-10010 CASH- AVAILABLE $55.16 2698-00144030-010 DRUG CRT PROG FEE - COUNTY (PROGRAM) $0.00 2698-999-10010-010 CASH - AVAILABLE $0.00 7390-999-20610-999 DRUG COURT PROG FEE - COUNTY (SVC FEE) $0.00 7390-999-20740-999 DRUG COURT PROG FEE - STATE $0.00 7390-999-10010-999 CASH -AVAILABLE $0.00 7865-999-20610-999 CRIM - SUPP OF IND LEGAL SVCS - COUNTY $0.01 7865-999-20740-999 CRIM - SUPP OF IND LEGAL SVCS - STATE $0.10 7865-999-10010-999 CASH - AVAILABLE $0.11 7950-999-20610 TIME PAYMENT - COUNTY $1.15 7950-999-20740 TIME PAYMENT - STATE $1.15 7950-999-10010 CASH - AVAILABLE $2.30 7505-999-20610 JUDICIAL SUPPORT -GRIM - COUNTY $0.05 7505-999-20740 JUDICIAL SUPPORT -GRIM - STATE $0.27 7505-999-10010 CASH - AVAILABLE $0.32 7505-999-20740-010 JUDICIAL SALARIES -CIVIL - STATE(42) $42.00 7505-999-10010-010 CASH AVAILABLE $42.00 2740-001-45050 BOND FORFEITURES $0.00 2740-999-10010 CASH - AVAILABLE $0.00 2729-001-44034 PRE-TRIAL DIVERSION FUND $0.00 2729-999-10010 CASH - AVAILABLE $0.00 7857-999-20610 JURY REIMBURSEMENT FUND- COUNTY $0.18 7857-999-20740 JURY REIMBURSEMENT FUND- STATE $1.61 7857-999-10010 CASH - AVAILABLE $1.79 7860-999-20610 STATE TRAFFIC FINE- COUNTY $0.00 7860-999-20740 STATE TRAFFIC FINE- STATE $0.00 7860-999-10010 CASH - AVAILABLE $0.00 7403-999-22888 DIST CRT- ELECTRONIC FILING FEE - CIVIL $30.00 7403-999-22991 DIST CRT - ELECTRONIC FILING FEE - CRIMINAL $0.79 CASH - AVAILABLE $30.79 1000-001-44050 DISTRICT CLERK FEES $11.91 1000-999-10010 CASH - AVAILABLE $11.91 2739-001-44055 RECORD MGMT/PRSV FUND - COUNTY $7.45 2739-999-10010 CASH - AVAILABLE $7.45 2669-00144050 COUNTY JURY FUND $0.30 2669-999-10010 CASH - AVAILABLE $0.30 2670-00144055 COURTHOUSE SECURITY $2.98 2670-999-10010 CASH - AVAILABLE $2.98 2663-00144050 CO & DIST CRT TECHNOLOGY FUND $1.19 2663-999-10010 CASH - AVAILABLE $1.19 2676-00144050 COUNTY SPECIALTY COURT FUND $7.45 2676-999-10010 CASH - AVAILABLE $7.45 TOTAL: $31.27 7855-999-20784-010 DIST CRT - DIVORCE & FAMILY LAW - STATE $0.00 7855-999-20657-010 DIST CRT - DIVORCE & FAMILY LAW - COUNTY $0.00 7855-999-20792-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - STATE $0.00 7855-999-20658-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY $0.00 7855-999-20740-010 DIST CRT - OTHER CIVIL PROCEEDINGS - STATE $14.25 7855-999-20610-010 DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY $0.75 7855-999-20790-010 DUE TO STATE - NONDISCLOSURE FEE $0.00 7855-999-10010-010 CASH - AVAILABLE $15.00 2677-999-20740-999 COUNTY DISPUTE RESOLUTION FUND $309.00 2677-999-10010-999 CASH - AVAILABLE $309.00 7858-999-20740-999 DIST CLK- DUE TO STATE CONSOLIDATED FEE 2022 $1,268.20 7858-999-10010-999 CASH AVAILABLE $1,268.20 TOTAL (Distrib Req to Oper Acct) $10,616.86 $10,585.58 DUE TO OTHERS (Distrib Req(s) attached) ATTORNEY GENERAL (RESTITUTION) 0.00 OUT -OF -COUNTY SERVICE FEES 0.00 REFUND OF OVERPAYMENTS 508.06 DUE TO OTHERS 0.00 TOTAL DUE TO OTHERS $508.06 REPORT TOTAL - ALL FUNDS 11,093.64 PLUS AMT OF RETURNED CKS 0.00 LESS: TOTAL TREASURER'S RECEIPTS (11,093.64) Revised 01/31/20 OVER / (SHORT) $0.00 DISTRICT COURT STATE COURT COSTS REPORT SECTION I: REPORT FOR -OFFENSES COMMITTED 01 /1 /20 - Present 01/01/04 - 12/31/19 09/01/01 - 12/31/03 09/01/99 - 08/31/01 09/01/97 - 08/31/99 09/01/95 - 08/31/97 DNA TESTING FEES EMS TRAUMA FUND JUV. PROB. DIVERSION FEES JURY REIMBURSEMENT FEE INDIGENT DEFENSE FUND STATE TRAFFIC FEES DRUG CRT FROG FEE SECTION II: AS APPLICABLE STATE POLICE OFFICER FEES FAILURE TO APPEAR/PAY FEES JUD. FUND-CONST. CO. CRT. JUD. FUND -STATUTORY CO. CRT. MOTOR CARRIER WEIGHT VIOLATIONS TIME PAYMENT FEE DRIVING RECORD FEE JUDICIAL SUPPORT FEES ELECTRONIC FILING FE. - CR TOTAL STATE COURT COSTS CIVIL FEES REPORT BIRTH CERTIFICATE FEES MARRIAGE LICENSE FEES DECL. OF INFORMAL MARRIAGE ELECTRONIC FILING FEE - CV NONDISCLOSURE FEES 0' JUROR DONATIONS JUSTICE CRT, INDIG FILLING FEES STAT PROS CRT INDIG FILING FEES STAT PROB CRT JUDIC FILING FEES STAT CNTY CRT INDIG FILING FEES STAT CNTY CRT JUDIC FILING FEES STAT CNTY CRTJUDICIAL SUPPORT CONST CNTY CRT INDIG FILING FEES CNST CNTY CRT JUDIC FILING FEES . .............................. DIST CRT DIV & FAMILY LAW .0 DIST CRT OTHER THAN DIV/FAM LAW . , 0 DIST CRT OTHER CIVIL FILINGS 4 FAMILY PROTECTION FEE _..... JUDICIAL SUPPORT FEE 1 JUDICIAL & COURT PERSONNEL TRANING FEE 2 2022 STATE CONSOLIDATED FEE 10 COUNTY DISPUTE RESOLUTION FUND TOTAL CIVIL FEES REPORT $2.30 1.15 1.15 $0.32 0.05 0.27 $0.79 $0.79 `$69.45 $ 7.81 $ 61.64 JULY COLLECTED COUNTY STATE $30.00 $30.00 $0.00 $0.00 $0.00 $0.00 - - $15.00 0.75 14.25 $42.00 $42.00 $5.00 - $5.00 $1,268.20 $1,268.20 309.00 309.00 $ 1,669.20 $ 0.75 $ 1,668.45 TOTAL BOTH REPORTS $ 1,738.65 $ 8.56 $ 1,730.09 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 420 A 44775 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Anna Kabela Address: Title: District clerk City: State: Zip: Phone: ACCOUNT NUMBER DESCRIPTION AMOUNT 7340-999.20759.999 District Clerk Monthly Collections - Distribution $10,585.58 JULY 2022 V# 967 Signature of Official 11 TOTALI 10,585.58 Date Calhoun County Floodplain Administration 211 South Ann Street, Suite 301 Port Lavaca, TX 77979-4249 Phone: 361-553-4455/Fax: 361-553-4444 e-mail: karen.rinasz@calhouncotx.org July 2022 Development Permits New Homes — 6 Renovations/Additions —1 Mobile Homes —1 Boat Barns/Storage Buildings/Garages -1 Commercial Buildings/RV Site -1 Tower Addition — 0 Fence -1 Total Fees Collected: $660 Ie ICE NO.1 5 1,51 9 1 13 27 1..06 8 82 1E 2E 17 TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT TOTAL PAGE OF HILL COUNTRY SOFWARE MO. REPORT USE OR. REQUESTINGOIBBURSEMENi UDE DR REQUESTING DISBURSEMENT DOE Eft. REQUESTING DISBURSEMENT NICE D.R. REQUESTING DISBURSEMENT UDE D.R. REQUESTING DISBURSEMENT EF REQUIRED) 3S REGEIPTS FOR MONTH.' ' ., •AMOUNT .. CKS, M Os& CREDIT CARDS • $1620,53 Calculate from ACTUAL Treasurers Receipts :_TOTAL TREAS. RECb0tS*- $M201153h„ "47LP' MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/1/2022 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: JULY YEAR OF REPORT: 0 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 5,058.22 CR 1000-001-44190 SHERIFF'S FEES 550.12 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 60.00 CHILD SAFETY 0.00 TRAFFIC 91.19 ADMINISTRATIVE FEES 1,008.29 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 1,159.48 CR 1000-001-44010 CONSTABLE FEES -SERVICE 170.00 CR 1000-001-44061 JP FILING FEES 0.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 5.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 134.38 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,068.20 TOTAL FINES, ADMIN. FEES & DUE TO STATE $8,145.40 CR 2670-001-44061 COURTHOUSE SECURITY FUND $310.12 CR 2720-001-44061 JUSTICE COURT SECURITY FUND $1.71 CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $255.80 CR 2699-001-44061 JUVENILE CASE MANAGER FUND $8.34 CR 2730-001-44061 LOCAL TRUANCY PREVENTION & DIVERSION FUND $311.23 CR 2669-001-44061 COUNTYJURYFUND $6.22 CR 2728-001-44061 JUSTICE COURT SUPPORT FUND $225.00 CR 2677-001-44061 COUNTY DISPUTERESOLUTION FUND $45.00 CR 2725-001-44061 LANGUAGE ACCESS FUND $27.00 STATE ARREST FEES DPS FEES 43.56 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 43.56 CR 7070-999-20610 CCC-GENERAL FUND 6,81 CR 7070-999-20740 CCC-STATE 61.33 DR 7070-999-10010 68.14 CR 7072-999-20610 STATE CCC- GENERAL FUND 385.92 CR 7072-999-20740 STATE CCC- STATE 3,473.32 DR 7072-999-10010 3,859.24 CR 7860-999-20610 STF/SUBC-GENERAL FUND 0.00 CR 7860-999-20740 STF/SUBC-STATE 0.00 DR 7860-999-10010 0.00 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 60.79 CR 7860-999-20740 STF- EST 9/1/2019- STATE 1,459.04 DR 7860-999-10010 1,519.83 Page 1 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/1/2022 COURT NAME: JUSTICE OF PEACE NO. 1 CR 7950-999-20610 CR 7950-999-20740 MONTH OF REPORT: JULY YEAR OF REPORT: 0 DR 7950-999-10010 TP-GENERAL FUND TP-STATE 7.44 7.43 Page 2 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/1/2022 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: JULY YEAR OF REPORT: 0 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 0.34 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 3.06 DR 7865-999-10010 3A0 CR 7970-999-20610 TL/FTA-GENERAL FUND 3.51 CR 7970-999-20740 TL/FTA-STATE 7.01 DR 7970-999-10010 10.52 CR 7505-999-20610 JPAY - GENERAL FUND 0.88 CR 7505-999-20740 JPAY - STATE 7.92 DR 7505-999-10010 8.80 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 0.68 CR 7857-999-20740 JURY REIMB. FUND- STATE 6.14 DR 7857-999-10010 5.82 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.00 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.04 DR 7856-999-10010 0.04 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 1.47 7998-999-20701 JUVENILE CASE MANAGER FUND 1.47 DR 7998-999-10010 2.93 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 189.00 189.00 REVISED 02/02/2022 TOTAL (Distrib Req to OperAcct) $15,062.96 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT: 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 662.57 WATER SAFETY FINES 476.00 $1,138.57 TOTAL DUE TO OTHERS TOTAL COLLECTED -ALL FUNDS $16,201.53 LESS: TOTAL TREASUER'S RECEIPTS $16,201.53 OVER/(SHORT) $0.00 Page 3 of 3 PAYEE Name: Address: City: State: Zip: Phone: CALHOUN COUNTY 201 West Austin Calhoun County Oper. Acct. DISTRIBUTION REQUEST DR# 450 A 44775 P"OR Official: Hope Kurtz Title: Justice of the Peace, Pct. 1 ACCOUNT NUMBER I DESCRIPTION I AMOUNT _ J 7541-999-20759-999 1JP1 Monthly Collections - Distribution $15,062.96 JULY c Signature of Official Date 15,062.96 ENTER COURT NAME. JUSTICE OF. PEACE NO.2 ENTER MONTH OF REPORT "N ENTER YEAR: OF REPORT ' 2022 CODE AMOUNT` CASHBONDS 0.00' '. REVISED 02O212022 :ADMINISTRATION FEE -ADMF - 0.00. BREATH ALCOHOL TESTING BAT. 0.00' CONSOLIDATED COURT COSTS-CCC 143.75:' ' STATE CONSOLIDATED COURT COST-2020 789.81:- '.. LOCAL CONSOLIDATED COURT COST-2020 161.18. COURTHOUSE SECURITY -CHS 14.38'. GJP 0.00' '. `CIVIL JUSTICE DATA REPOSITORY .FEE -CJDR 025 CORRECTIONAL: MANAGEMENTINSTITUTE-:CMI 0.00 CR 0.00, CHILD SAFETY -CS 0.00: -' CHILD SEATSELT FEE -CSBF - 0.00. CRIME VICTIMS COMPENSATION =CVC 0.00 DPSG/FAILURE TO APPEAR -OMNI'-.DPSC 64.05. ADMINISTRATION FEE FTAIFTP{ake OMNI)-2020 26.41= :`.ELECTRONIC FILING FEE-. EEF 0.00 FUGITIVE APPREHENSION -FA 0.00:' GENERAL REVENUE -:GR 0.00 CRIM IND LEGAL SVCS SUPPORT -IDF' 7.19 JUVENILE .CRIME & DELINQUENCY :-JCD 0.00 I' JUVENILE CASE MANAGER FUND -JCMF : 7.49' JUSTICE COURT PERSONNEL TRAINING-JCPT 0.00' : - ' JUROR: SERVICE FEE -JSF 14.3B1: - :.. LOCAL ARREST FEES -LAF 54.37'I LEW 0.00 LEDA 0.00 LEOC 0.00. OCL 000. PARKS & WILDLIFE ARREST FEES -PWAF 0.00: -.STATE ARREST FEES - SAP: 1550, SCHOOL CROSSINGICHILD SAFETY FEE -SCF 0.00:: `. SUBTITLE C-SUBC 31.63 STATE TRAFFIC FINES -EST 9.1.19-STF 282.55: TABC ARREST FEES -TAP 000:"'. TECHNOLOGY FUND=TF 14.38': TRAFFIC:-TFC' 3.13': LOCAL TRAFFIC PINE-2020: 15.78'.: TIME .PAYMENT -TIME 26.36•' TIME PAYMENT REIMBURSEMENT FEE- 2020 103201: TRUANCY PREVENTION/DIVERSION FUND TPDF 5.19 f LOCAL & STATE WARRANT FEES WRNT 565.54: - COLLECTION SERVICE FEE+MVBA CSRV 680.19. DEFENSIVE DRIVING: COURSE-ODC 10.00-` DEFERRED FEE OFF 165.24' :DRIVING EXAM FEE PROVOL 0.00' ' :FILING FEE -FFEE 0.00' STATE CONSOLIDATED CIVIL FEE -2022 147.00: LOCAL CONSOLIDATED: CIVIL FEE -2022' 231.00'.. FILING FEE SMALL CLAIMS FFSC : 0.00'' zJURY FEE=JF 22.00' COPIES/CERTIFED COPIES - CC 0.00 INDIGENT FEE: CIFF or INDF 0.00 JUDGE PAY RAISE FEE JPAY 21.57 - SERVICE FEE-: SFEE. 450.00:` OUT -OF -COUNTY SERVICE FEE 0.00: ELECTRONIC FILING FEE EEF CV 0.00 - EXPUNGEMENT FEE-: EXPG 0.00'.' EXPIRED' RENEWAL EXPR 0.00:: , ABSTRACT OF JUDGEMENT AOJ 0.00: ALL WRITS -WOP/WOE 0.00 `. CPS FTA FINE DPSF . 210.32. `. LOCALFINES-FINE 2A65.63. , LICENSE & WEIGHT FEES -LWF 0.00: PARKS & WILDLIFE FINES -PWF 50.00. `. SEATBELTAINRESTRAINED CHILD FINE - SEAT 0.00.' �- JUDICIAL& COURT: PERSONNEL:TRAININGJCPT 0.00 = • OVERPAYMENT (OVER $10)-OVER 0.00. • OVERPAYMENT($10 AND. LESS) =:OVER - 1.00 RESTITUTION -REST 000'. PARKS& WILDLIFE -WATER SAFETY FINES-WSF 0.00: MARINE SAFETY PARKS & WILDLIFE -MSO' 0.00: TOTAL ACTUAL. MONEY RECEIVED, TYPE, AMOUNT-:: TOTAL WARRANT FEES 565.54 ENTER LOCAL WARRANT FEES 280.77: REWRDONTOTAL PAGE OF HILL COUNTRYSOfiWARE Ma REPORT STATE: WARRANT FEES : $284.77 MOORE ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT DUETOOTHERS AMOUNT< DUE TO CCISD-:50%of Fine On JV=as 0.00: PLEASEINCLUDE DR.PEQUESTINGGISBURSEMENT DUE TO DA RESTITUTION FUND 0.00: PLEASE INCWDE U.R. MOLESTING DISBURSEMENT REFUND OF OVERPAYMENTS 0.00 PIEASEINCLUDE DRREGUESTINGDISBURSEMENT. OUT-OF-COUNTY'SERVICE FEE 0.00 PIEASEmcwDE OR.REDUESneGDIS&IRSEMENI - CASH BONDS 0.00' PIEASEINCLUDE DR.F¢GUESTINGDISBURSEMENT(IFREGUIRED) TOTAL DUE TO OTHERS $0.00_ TREASURERS RECEIPTS FOR MONTH: AMOUNT- GASH;CHECKS, M:O:s&CREDIT:CARDS $8;780:46.Calculate from ACTUAL Treasurers Receipts TOTAL TREAS. RECEIPTS' 760.46.,.:' MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/1/2022 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: 0 YEAR OF REPORT: 2022 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45012 FINES 2,683.45 CR 1000-001-44190 SHERIFF'S FEES 575.36 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 10.00 CHILD SAFETY 0.00 TRAFFIC 18.89 ADMINISTRATIVE FEES 191.65 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 220.54 CR 1000-001-44010 CONSTABLE FEES -SERVICE 450.00 CR 1000-001-44062 JP FILING FEES 22.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 1.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 103.20 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 660.19 TOTAL FINES, ADMIN. FEES & DUE TO STATE $4,715.74 CR 2670-001-44062 COURTHOUSE SECURITY FUND $67.20 CR 2720-001-44062 JUSTICE COURT SECURITY FUND $3.60 CR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $60.43 CR 2699-001-44062 JUVENILE CASE MANAGER FUND $7.49 CR 2730-001-44062 LOCAL TRUANCY PREVENTION & DIVERSION FUND $57.56 CR 2669-001-44062 JURY FUND $1.15 CR 2728-001-44062 JUSTICE COURT SUPPORT FUND $$35.00 CR -4 _COUNTY COUNTY DISPUTE FUND i CR 2725-001175.00 062 NDRESOLUTION LANGUAGE CC SS FU062 21.00 STATE ARREST FEES DPS FEES 60.05 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 60.05 CR 7070-999-20610 CCC-GENERAL FUND 14.37 CR 7070-999-20740 CCC-STATE 129.38 DR 7070-999-10010 143.75 CR 7072-999-20610 STATE CCC- GENERAL FUND 78.98 CR 7072-999-20740 STATE CCC- STATE 710.83 DR 7072-999-10010 789.81 CR 7860-999-20610 STF/SUBC-GENERAL FUND 1.58 CR 7860-999-20740 STF/SUBC-STATE 30.05 DR 7860-999-10010 31.63 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 10.50 CR 7860-999-20740 STF- EST 9/1/2019- STATE 252.05 DR 7860-999-10010 262.55 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/1/2022 COURT NAME: JUSTICE OF PEACE NO.,2 MONTH OF REPORT: 0 YEAR OF REPORT: 2022 CR 7950-999-20610 TP-GENERAL FUND 13.18 CR 7950-999-20740 TP-STATE 13.18 DR 7950-999-10010 26.36 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 0.72 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 6.47 DR 7865-999-10010 7.19 CR 7970-999-20610 TL/FTA-GENERAL FUND 21.36 CR 7970-999-20740 TL/FTA-STATE 42.72 DR 7970-999-10010 64.08 CR 7505-999-20610 JPAY - GENERAL FUND 2.16 CR 7505-999-20740 JPAY - STATE 19.41 DR 7505-999-10010 21.57 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 1.44 CR 7857-999-20740 JURY REIMB. FUND- STATE 12.94 DR 7857-999-10010 14.38 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.02 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.23 DR 7856-999-10010 0.25 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 2.60 7998-999-20701 JUVENILE CASE MANAGER FUND 2.60 DR 7998-999-10010 5.19 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 147.00 147.00 TOTAL (Distrib Req to OperAcct) $6,717.98 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 42.50 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $42.50 TOTAL COLLECTED -ALL FUNDS $6,760.48 LESS: TOTAL TREASUER'S RECEIPTS $6,760.48 REVISED 02/02/2022 OVER/(SHORT) $0.00 Page 2 of 2 CALFI®l1N DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 44774 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Hope Kurtz Address: Title: Justice of the Peace, Pct. 2 City: State: Zip: Phone: ACCOUNT NUMBER - DESCRIPTION - AMOUNT - 7542-999-20759-999 JP2 Monthly Collections - Distribution $6,717.98 0 2022 V# 967 TOTAL 6,717.98 1 Signature of Official Date 08-03-22;15;11 ;From:Calhoun County JP4 To:3615534444 FAX COVER SHEET August 3, 2022 FROM: JUSTICE COURT PCT, 4, CALHOUN COUNTY 103 W. Dallas Street, P.O. Box 520 Seadrift, Texas 77983 PHONE: 361-785-7082 FAX: 361-785-2179 TO: County Judge Office FAX: 361-553-4444 Ref: JULY Money Distribution Report (Revision) Please give me a call if you have any questions, Fax Cover: Pages to Follow: _5 _ Thank you, Patsy Spence, CLERK IudBe Wesfey J. Hunt ;3617852179 # 1/ 6 08-03-22;15:11 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 2/ 6 08-03-22;15:11 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 3/ 6 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/3/2022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: JULY YEAR OF REPORT: 2022 ACCOUNT NUMBER ACCOUNT NAME AMOUNT OR 1000-001-45014 FINES 951.02 OR 1000-001-44190 SHERIFF'S FEES 48.00 ADM/NIS7RA7NE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 18.00 ADMINISTRATIVE FEES 126.90 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 100D-001-44364 TOTAL ADMINISTRATIVE FEES 144.90 CR 1000.001.44010 CONSTABLE FEES -SERVICE 0.00 OR 1000-001-44054 JP FILING FEES 0.00 CR 1000 001-44090 COPIES / CERTIFIED COPIES 0.00 OR IODD•001.49110 OVERPAYMENTS (LESS THAN $10) 0.00 OR 10OD-001.44322 TIME PAYMENT REIMBURSEMENT FEE 0.00 OR 1000-001.44145 SCHOOL CROSSINGICHILD SAFETY FEE 0.00 OR 1000-999.20741 DUE TO STATE -DRIVING EXAM FEE 0.00 OR 10OM99.20744 DUE TO STATE-SEATBELT FINES 0.00 OR 1000.999.20745 DUE TO STATE -CHILD SEATBELT FEE 0100 OR 1000999-20746 DUE TO STATE•OVERWEIGHTFINES 0.00 OR 100"99.20770 DUE TO JP COLLECTIONS ATTORNEY 84,60 TOTAL FINES, ADMIN. FEES & DUE TO STATE $1,228.52 CR 267MOl-44064 COURTHOUSE SECURITY FUND $47.10 OR 2720-001-44064 JUSTICE COURT SECURITY FUND $1.00 CR 2719-001-44064 JUSTICE COURT TECHNOLOGY FUND $40.00 CR 2699-001.44064 JUVENILE CASE MANAGER FUND $0.00 CR 2730-001-44064 LOCAL TRUANCY PREVENTION & DIVERSION FUND $45.00 OR 2669-001-44064 COUNTYJURYFUND $0.90 OR 2725e001-44064 JUSTICE COURT SUPPORT FUND $125.00 CR'';267700,1 4084 COUNTY'DISPUTE RESOLUTION FUND' $26.00 CR 2725.001-44064 LANGUAGE ACCESS FUND $15.00 STATEARRESTFEES DPS FEES 2.00 P&W FEES 0.00 7ABC FEES 0.00 OR 7020 999 20740 TOTAL STATE ARREST FEES 2.00 OR 7070-999-20610 CCC-GENERAL FUND 4.00 CR 7070-999.20740 CCC-STATE 36 00 DR 7070.998.10010 40.00 OR 7D72-999-20610 STATE CCC- GENERAL FUND 55.60 OR 7072-999-20740 STATE CCC- STATE 502.20 DR 7072-999-10010 558.00 CR 7860-699.20610 STF/SUBC•GENERAL FUND 1.50 OR 786NO89.20740 STF/SUBC•STATE 2850 DR 7860.999'-10010 30.00 OR 7860-999-20610 STF- EST 9/1/2019-GENERAL FUND iD,00 OR 7860-999-20740 STF- EST 9/1/2019-STATE 240.00 DR 7860-999-10010 250.00 P8991 of 3 08-03-22;15:11 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 4/ 6 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/3/2022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: JULY YEAR OF REPORT: 2022 OR 7950-99940610 TP-GENERAL FUND 12.50 OR 7950-999-20740 TP-STATE 12.50 DR 7950-998.10010 Y5.00 Page 2 of 3 08-03-22;15:11 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 5/ 6 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 8/3/2022 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: JULY YEAR OF REPORT: 2022 OR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 OR 7480.999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 OR 7865-999.20610 OR 7865-999-20740 OR 7970.999-20610 OR 7970.999-20740 OR 7505.999-20610 CR 7505.999.20740 CR 7857.999-20810 CR 7857-999-20740 OR 7856-999-20610 CR 7856.999-20740 OR 7502-999-20740 7998-999-20740 7998-999.20701 7403-999.22889 7858-999.20740 REVISED 02/0212021 0.00 O.OD 0.00 D.OD 0.00 O.OD CRIM-SUPP OF IND LEG SVCS•GEN FUND 0.20 CRIMSUPP OF IND LEG SVCS-STATE 1.80 DR 7B65.999.10010 zoo TL/FTA-GENERAL FUND 10.00 TL/FTA-STATE 20.00 DR 7970-999-10010 30.00 PAY - GENERAL FUND 0.60 JPAY-STATE 5.40 DR 7505.999-10010 6.00 JURY REIMB. FUND-GEN. FUND 0.40 JURY REIMB. FUND -STATE 3.60 DR 7857-999-10010 4.00 CIVIL JUSTICE DATA REPOS - GEN FUND 0.01 CIVIL JUSTICE DATA REPOS- STATE 0.09 DR 7856-999.10010 0.10 JUD/CRT PERSONNEL TRAINING FUND. STATE 0.00 DR 7502-999.10010 0.00 TRUANCY PREVENT/DIV FUND - STATE 1,00 JUVENILE CASE MANAGER FUND 100 DR 7996-999-10010 2.00 ELECTRONIC FILING FEE- CV STATE 0,00 DR 7403-999-22889 0.00 STATE CONSOLIDATED CIVIL FEE 105.00 105.00 TOTAL (Distrib Req to Oper Aeat) $2.S81.62 DUE TO OTHERS (DlsiftRegAttchco CALHOUN COUNTY ISD DA - RESTITUTION REFUND OF OVERPAYMENTS OUT -OF -COUNTY SERVICE FI CASH BONDS PARKS & WILDLIFE FINES WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $0.00 TOTAL COLLECTED -ALL FUNDS $2,581.62 LESS: TOTALTREASUER'S RECEIPTS $2,681,62 Page 3 of 3 OVER/(SHORT) $0.00 08-03-22;15:11 ;From:Calhoun County JP4 To:3615534444 ;3617852179 # 6/ 6 PAYEE Name: Address: City: State: Zip: Phone: CALHOUN COUNTY 201 West Austin Calhoun County Oper. Acct. DISTRIBUTION REQUEST DR# 450 A 44776 PAYOR Official: Wesley Hunt Title: Justice of the Peace, Pct. 4 Slgnatura of OMidal I "P`.�� Oat ,. 08-02-22;17:18 ;From:Calhoun County Pct. 5 To:3815534444 ;3619832481 # 1/ 8 ANDJUM6FFORAU--. FAX COVER SHEET JUDGE NANCY POMYKAL P 0 BOX 454 PORT O' CONNOR, TX.77982 (361)983-2351 -TELEPHONE (361)983-2461 - FAX COUNTY OF CALHOUN JUSTICE COURT PCT. 5 DATE: AUGUST 2. 2022 PAGES: 8 Including this cover TO: JUDGE RICHARD MEYER & COUNTY COMMISSIONERS ATT: MaeBelle FAX NUMBER(S) 361-553-4444 SUBJECT: JULY 2022 — MONEY DISTRIBUTION REPORT NOTE, MaeBelle I am faxing the above report for JULY 2022 Please give me a call if you have anyquestions. Thank you, THE CONTENTS OF THIS FAX MESSAGE ARE INTENDED SOLELY FOR THE ADDRESSEE(S) named in this message. This communication is intended to be and to remain confidential and may be subject to applicable attorney/client and/or work product privileges. If you are not the intended recipient of this message, or if this message has been addressed to you in error, please immediately alert the sender by fax and then destroy this message and its attachments. Do not deliver, distribute or copy this message and/or any attachments and If you are not the intended recipient, do not disclose the contents or take any action in reliance upon the information contained in this communioatlon or any attachments. 08-02-22;17:18 ;From;Calhoun County Pct. 5 Tc:3615534444 ;3619832461 # 2/ 8 Money Distribution Report CALHOUN OF 5 JULY 2022 REPORT RCCe1DC Canpe/DOCODdflrtC COflep�AIDDUAEO 377680 2022.0202 07.06-2022 CCC 42.00 LAP• 5.00 LCCC 14,00 OMNR 10.00 TO Cal MCCULLOCH, AMANDA KLETBER LrFC 3.00 6TF1 50.00 CSRV 69.00 FINE 96.00 299,00 Credit Card 37j6Q1 2622 0256 .07.07-2022 CCC ,GA' 00 LAF;' S 00.,; LCCC 1'4' 00 'PINE: '219'00 :' CERVANTES:+:VEGA JVAN CA62 � ; '.' ,. 0 :.'.;. CFodit'.Cdrd '.. .: ".; .... .. „'' . 377502 18007.11-2022 J6F 4.00 CCC 40.00 CHS 3 OD LAF 5 RIPPLE, AMANDA ANDA KEY TF 4.00 dCSP 00 WRNc 50.00 474 50 Credit Card TPDP 2.00 1.00 JPAY 6.90 IDF 2.00 MVF 0.10 077683 -10 07 0960 07 11' 2D22 :JSF ::a 00 FINE 'CCC; '4Q 212.90 CSRV 109.50 JDMF 5.00 " R FFZE' AMANDA RAY i Tt 00 CHS "JPAY 3i. 00 LAP';, S 00 ;r'WRET 56:'00 "'�, 494.00 Card :', :.A 06 OCS,P: ',.CSRV: 1 00 '.61:00 '.'IDF 2 DO TPDF 2'.,00 ,Credit ,FINE 26.3. 00 119 377684 2022.0259 07-11.2022 CCC 92.00 LAP .0.0;.:,' 5.00 LCCC 14.00 FINE 104.00 RODRIGUEZ- FLOREE, JOSE ALONSO 105.00 Credit Card 377685 ',2022'0258 07 11 2922 CCC ':62 OQ LAF:: 500' 'LCCC 14:00 ..FIND,:•, 176 00 '260', ROORYGUE2•.IFLORE3, J05E ALONSO:. STF1 ... ,'LTPC' rI;,00 00 .,, .. .,. 377686 2022.0240 07-11-2022 CCC 62.00 LAP 5.00 LCCC 1q.00 FINE 304p0 SCHNEIDER, ZACHARY DEN 305.00 ;. Cash 3776'B7 70,.2Z+0262 .; 07 12 2022 CCC62 00 'LAF','; >•00 .!LCCC ':'14; DO W9PI 6y 00 ,1$0.00 Personal Check 37740E 2022-0261 07.12.2022 CCC 62.00 LAP 5.00 LCCC 14.00 LTPC 3.0E STPl HORELKA, GEORGIA RYAN DDC ID.DO 50.0E144.00 Personal Cheek „ 11 19521 .... 17;7G09 21029026E j. 07 12 2022 CCC :: HORELi(A GGOhGIA �,'6;2 DD J,AF.) 5 00 iLCCC ltl COO ,FIND;: A6 GO LTPC 3i00 " 160.0E RYAN: STF1 S..OA Fersonal... Check 377690 2022-0264 07-1E•2022 CCC 62.0E LAP 5 00LCCC 19.0E FWF 304.0E BEM50N, CLIFFDRD ALLIE 205.00 Credit Card 377G91, 2D21�0,339I 07 18 20,22, CCC Ga: 00 LAf00, ..WRNT �50`00 LCCO' 14 00'OMNR S2G,50 ROMERO) ANGEL DANIEL i PINE 2Gq' 00 CSRV.: 171 SD. 10,:OD :. .:. 377692 167 0749-2022 CCC 27 25 LAP 2 20 LCCC 9.15 OMNR PVSCHMAN, MASON HUNTER 9 4D 40.00 Credit Card„ 37T6.LU ^2022-- '' :.D7 . .... OCC LVCA9 MICHADL 'G2''00 LAi! 5 00 :LCCC �, 14 ';�00 LTPC','' Y.00 3TFL 50:.00 "11u4.00 ,,YAMES '. ;:': DDC Personal Cflack i :I0:. 00 3776942022.0209 07-20-2612 CDC 62,OD LAP 5 00 LCCC 140E FINE 25.00 HUNT, GREGORY DSor.00 Cash 3776.95 Z022.0166 .07 20 2022:9CC GZ, 00 'OESSICA LAt !' 5 ODWRNT 8`p .'p0 LCCC Ld OQ OMNR ', :STORY ,RGNE ,yfiTNO 'E6,:00 LTPC: 3 00 5tl,;00 CSRV',>' 10: 00 3GA:00 :... .. ... :... 12TF1 84 0Q 377696 2022.0272 07. 1- 2 2022 CCC 62.0E LAP 5.00 LCCC 14.00 FINE 104.00 CABRERA•SANC¢¢Z, 6AVL ANTONIO 185.0E Cash 3%7G9.7 2022,=0271 :07 21 2D22':-CCC G2J.,00 'LAF 5 A0 :.LCCC Y4, "00 F134E, : 10G 00 'LfFC' 3OA , C.ABRCW, BANCSG2: SAUL ANTONIO $TFY 50:.:p0 :. !'Q80.0.0 .: .. ., 377696 202.i• .. 0263 07-2a-x022 CCC 62.00 ... LAP .. .,..:, 5.00 LCCC '.,:, 14,00 FIND 264 00 :. '.;. RABBIS, STEVflN PAUL 345.00 Pcraonal Chcck II 2574 377699 ;20204208'' ,'07 2S 2022:CJNE ';itirvAryAob;. :'27;:71 ,LTPC': 1 26 STFi 'X'1li 0'1 '' SALVADOff NpNO2 ..: '. .: 50.: 09 ' 37770E 1712-0692 07.25.2022 JSF 4.00 CCC 40.00 CH3 3 DO PWA]' $ pp WENT CANO-GAR2A, NOE TF 4.00 JCSF 1.00 JPAY 6.00 IDF 2.00 50.0E 494,00 COMpany Check OMNC 4.00 OMN13 20,0E OMNO 6.00 PWF 228.Oo TPOP CSRV 2.00 . 11 105GGD JCMP 5.0E 114.00 .. 17770,1 r 'L022-0107� ..p7 27 2022 CCC 62,00 LAP ' "S 00 WRNT 50'% ...C, ;'. 14'OA OMNR '1p;0Q. .RAMI1tE2 EDWARD ... ii FINE "2E400, CSRV 56.SD ""•' .401.5E 00-02.2OZ2 Page I 08-02-22;17:18 ;From:Calhoun County Pot. 5 To:3615534444 ;3619832461 # 3/ 8 Money Diatl!ibUtiOn RepoXt CALHOUN JP 5 JULY 2022 REPORT Receipt Cause/Defendant Codes\Amounte Total ... .. .. ...... 377702 2021-0245 07.27-2022 CCC 62.00 PWAF 5.00 LCCC 14.00 PWF 104.06 185.00 WHITEN,=, SEAN HARRISON WHTTrH=; SEAN OXAR'JEON, ... .. .. .. ... 377704 2922-0106 07.27-2022 CCC 62.00 LAP 6.00 LCCC 19.100 6NNR 10,00 FINE 64.00 271.66 MIZE. LANCE DARREN LTPC 3.00 STF1 50.00 CS;RV 63.00 Credit Card 377705 20110244! -0747-2.022: CCC. 62'00 gwAF. S 00:; ].CCC I4; 00 !1wr 104 00 .. '' ... 377706 2021-0246 07-27-2022 CCC 62.00 PWAF 5.00 LCCC 14.00 PWF 104.00 285.00 WHITEHEAD, SEAN HARRISON Company.. Check.. 377707...:.:. .2021-d24 .-::.0.7. 27 2022 :CCC .62.do PWAF.3 LCCC ;4:!C%�PW:: 104;00 185.00 : SEANHARRISON . ......... .::0JZTEHEADi1 377708 2022-0243 07-27-2022 CCC 62.00 LAP 5.00 LCCC 14.00 FINE 86.66 LTFC 3.00 220.00 WYORYS, AMANDA NICOLE STFI 50.00 Comm service 67-218-26i2:: CCC :;:�!;�.:G2 00 LAr 5 00 Lcct NAVARRO X= VAX: C! 377710 2022-0297 07-28-2022 CCC 62.00 LAP 5.00 LCCC 14.00 LTPC 3.00 S T F1 50, " 00 , 144.00 HOSCH, SAVANNAH KRISTIKA DDC 10.00 Cashier's Check 11 054357 00-02-2022 Page 08-02-22;17:18 ;From:Calhoun County Pot. 5 To:3615534444 ;3619832461 # 4/ 8 Money Dlatribntion Report CALHOUN JP 5 JULY 2022 REPORT Type Code Description Co t Retained Di b d mon y Totals The following totals represent . Cash and C6Cke Collected COST CCC CONSOLIDATED COURT COSTS 16 95.20 COST CCC CONSOLIDATED COURT COSTS 1 892.60 092.00 COST CHS COURTHOUSE SECURITY 4.00 36.00 40.00 COST IDF INOTGENT DEFENSE PUNO 1 1 3.00 0.00 3.00 COST JCSF JUSTICE COURT SECURITY FUND 1 0.20 1.00 2.00 COST JPAY JUDGE PAY RAISE FEE 1 1.00 0.00 1.00 COST JSF JUROR SERVICE FUND 0.60 5.40 6.00 COST LAP SHERIFF'S PEE 1 0,40 3.60 4.00 COST LCCC LOCAL CONSOLIDATED COURT COST 1-1-20 11 1d 05,90 9.00 55.00 COST 14VF MOVING VIOLATION FEE 0 224.00 0.00 224.00 COST OMNC DPS OMNI FEE COUNTY 0.00 0.00 0.00 COST OMND DPS OMNI FEE - DPS 1 4.00 0.00 4.00 COST OMNO DPS OMNI FEE - OMNIDASE 1 0.00 20.00 20.00 COST OMNR OMNI REIMBURSEMENT PEE (EF•F. 1. 1.20) 1 1 0.00 6.00 4.00 COST PWAF TEXAS PARKS & WILDLIFE G 30.00 0.00 10.OD COST IF TECHNOLOGY FUND 24,g0 6.09 ]000 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 1 1 4.00 D.00 4.00 COST WRNT WARRANT PEE 0.00 2.00 2.00 FEES C$RV COLLECTION SERVICES FEE 2 200.00 0.00 10D.00 FEES DOC DRIVER SAFETY COURSE - 2020 2 190.00 0.00 19S.o0 FEES JCMF JUVENILE CASE. MANAGER FEE 3 1 30.00 0.00 30.00 FINE FINE FINE 5.00 0.00 5.00 FINE LTtd LOCAL TRAFFIC FINE (EFF. 9.1.29) S 7 792.73 0.00 782.73 FINE PWF PARKS & WILDLIFE FINE 19.29 0.00 19,2G FINE 5771 STATE TRAFFIC FINE (EPP. 9.1.19) 6 109.20 618.80 728.00 FINE WSP WATER SAFETY FINE 7 12.94 308.17 321.01 1 10,35 S8.65 G9.00 Money Totals 18 1,696.78 1,959.22 31656.00 The following totals represent - Transfers Collected COST CCC CONSOLIDATED COURT COSTS 0 0.00 COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 COST CHS COURTHOUSE SECURITY 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 0 D.DO 0.00 0.00 COST CCSF JUSTICE COURT SECURITY FUND 0.06 0.00 D.00 COST JPAY JUDGE PAY ARISE FEE o 0.00 0.00 0.00 COST JSF JUROR SERVICE FUND 0 0.00 O.DO 0.00 COST LAP SHERIFF'S PEG 0 0.00 0.00 0.00 COST LCCC LOCAL CONSOLIDATED COURT COST 1-1.20 0 D 0.00 0.00 0.00 COST MVF MOVING VIOLATION FEE 0100 0.00 D.00 COST OMNC ITS OMNI FEE - COUNTY 0 0.00 0.00 0.00 COST OMND DPS OMNI FEE - DES 0 O.OD O.DO 0.00 COST OMNO DPB OMNI FEE OMNIBASE D 0.90 0.00 0.00 COST OMNR OMNI REIMBURSEMENT FEE (EPP. 1.1.20) 0 0 0.00 0.00 0.00 COST PWAP TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST IF TSCHNOLOGY FUND 0.00 0.00 D.00 COST TPDF TRUANCY PREVENTION A DIVERSION FUND 0 0 0.00 0.00 0.00 COST WRNT WARRANT FEE 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0 0.00 O.OD 0.00 FEES DOC DRIVER SAFETY COURSE - 2020 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 FINE FINE FINE 0.00 0.00 0.00 FINE LTFC LOCAL TRAFFIC FINE (EPP. 9.1.19) 0 0.00 0.00 0.00 FINE PWF PARKS & WILDLIFE FINE 0 0 0.00 0.00 0.00 FINE STF1 STATE TRAFFIC FINE (EPP. 9.1.191 0 0.00 0.00 0.00 FINE WSP WATER SAFETY FINE 0.00 0.00 0.00 0 0.00 0.00 0.00 Transfer Totals 0 0.00 0.00 0.00 The fallowing totals represont - Jaii Credit and commo.4ity 8axviee COST CCC CONSOLIDATED COURT COSTS 1 COST CCC CONSOLIDATED COURT COSTS 0 6.20 55.80 62.00 COST ONE COURTHOUSE SECURITY 0 0.00 0.00 C.00 COST IDF INDIGENT DEFENSE FUND 0.00 0.09 0.00 COST JCSF JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00 COST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 0 0.00 9.00 9.00 09-02-2022 Page 08-02-22;17:18 ;From:Calhoun County Pot. 5 To:3615534444 ;3619832461 # 5/ 8 Money DiLtribYtion Report CALEOON JP 5 JULY 2022 REPORT Type Code Deacription Count Retained Dlabureed MoaeyT0ta1a COST JSF JUROR SERVICE FUND COST LAF SHERirr-S FEE D O.DO o.00 D .Do.00 0 COST LCCC LOCAL CONSOLIDATED COURT COST 1.1.20 0 1 S.00 0.00 COST MVP MOVING VIOLATION FEE 14.40 0.00 35.00 COST OMNC OPS OMNI FEE - COUNTY 0 0.00 0.00 0.00 COST OMND OPS OMNI FEE - DPS 0 0.00 0.00 0.00 COST ONNO DPS OMNI FEE OMNI,ASS 0 0.00 0.00 0.00 COST OMNR OMNI REIMBURSEMENT FEE (EPP. 1.1.20) 0 6 0.00 0.00 0.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 0.o0 0.00 O.DO COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 0 0.00 0.00 0.00 COST NRNT WARRANT FEE 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES PEE 0 0.00 0.00 O.OD FEES DOC DRIVER SAFETY COURSE - 2020 0 0.00 O.DO 0.00 FEES JCMF JUVEN.LE CASE MANAGER FEE 0 0.00 0.00 0.00 FINE FINE FINE 0 0.00 0.00 0.00 FINE LTFC LOCAL TRAFFIC FINE (EFF. 9.1.19) 1 86.00 0.00 86.00 FINE PWF PARKS & WILDLIFE FIN, 1 3.00 0.00 3.00 FINE STPI STATE TRAFFIC FINE (EFF. 9.1.19) 0 0.00 0.00 0.00 FINE WSF WATER SAFETY PINE 1 2.00 48.00 50.00 0 0.00 0.00 0.00 Cret!lt Totals 1 114.20 103.80 220.00 The following totals repreoant - Credit Card Peymeat, COST CCC CONSOLIDATED COURT COSTS COST CCC CONSOLIDATED COURT COSTS ID 58.52 526.73 585.25 COST CHS COURTHOUSE SECURITY 2 0.00 72,00 80.00 COST TDF INDIGENT DEFENSE FUND 2 0 COST JCSF JUSTICE COURT SECURITY FUND 2 0,4 0.40 3 .60 4 ,pp COST JPAY JUDGE PAY RAISE FEE 2 2.00 0.00 2.00 COST JSF JUROR SERVICE FUND 2 1.20 10,00 12.00 COST LAF SHERIFF'S FEE 2 0160 7.20 A.00 COST LCCC LOCAL CONSOLIDATED COURT COST 1-1-20 12 57.20 0.00 57.20 COST MVP MOVING VIOLATION FEE 10 132.15 0.00 132.15 M4 COST OMNC DPS OI FEE - COUNTY 1 0.01 0.00 0 0.0.30 COST OMNU DPS OMNI FEE - DPS 0 0.00 0.00 COST OMNO DPS OMNI FEE - OMNIBASE 0 0.00 0.00 0.00 COST OMNR OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 0 0.00 0.00 0.00 COST DWAF TERAB PARKS & WILDLIFE 5 44.40 9.90 44.40 COST TF TECHNOLOGY FUND 0 0.00 0.00 O.DO COST TPDF TRUANCY PREVENTION & DIVERSION FUND 2 2 8.00 0.00 9.00 COST WRNT WARRANT FEE 0.00 4.00 4.00 FEES CSRV COLLECTION SERVICES FEE 4 200.00 0.00 200.00 FEES nOC DRIVER SAFETY COURSE - 2020 6 533.5D 0.00 533.50 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0,00 FINE FINE FINE 1 S.00 O.DD 5.00 FINE LTPC LOCAL TRAFFIC FINE (6FF. 9. 1.19) 10 1,644.15 0.00 1.644,95 FIND PWF PARRS & WTL➢LIFE FINE 4 5. 0.00 . FINE STF1 STATE TRAFFIC FINE (EFF. 9.1,1F) 1 15.60 60 88.4D 104.0000 FINE wSF WATER SAFETY FINE 4 6.27 160.91 15d.E4 0 0.00 0.00 0.00 Credit Card Total, 12 2,733.11 963,39 3,596,50 The lollowiog total, reprcaent - Combined Mpaey COST CCC CONSOLIDATED COURT COSTS 26 COST CCC CONSOLIDATED COURT COSTS 157.72 1,419.53 1.577,25 COST CHS COURTHOUSE SECURITY 3 12.DO IOB.DO 120.00 COST IDF INDIGENT DEFENSE FUND 1 P.DO 0.00 9, pp3 COST JCSF JUSTICE COURT SECURITY rUKD 0.60 5.40 5.40 6.00 6.00 COST JPAY JUDGE PAY RAISE FEE 3 3.60 COST JSF JUROR SERVICE rmo 3 1.80 iG.20 13.00 COST LAF SHERIFF'S FEE 3 1.90 15.20 18.00 COST LCCC LOCAL CONSOLIDATED COURT COST 1.1-20 23 26 111.20 0,80 112.00 COST MVP MOVING VIOLATION FEE 356.15 0.00 35G,15 COST OMNC CPS OMNI FEE - COUNTY 1 0.01 0.09 0.10 COST OMND DPS OMNI FEE - DPS 1 4.00 0.00 4.00 COST OMNO OPS OMFS FEE - OMNIBASE 1 0.00 20.00 20.00 COST OMER OMNI REIMBURSEMENT FEE (EFF. 1.1.20) 1 0.00 6.00 6.00 COST PWAP TEXAS PARKS & WILDLIFE 5 54.40 0.00 54,40 6 21.00 G.DO 30.00 08-02.2022 Page 4 08-02-22;17:18 ;From:Calhoun County Pet. 5 To:3615534444 ;3619832481 # 6/ 8 Money Diotributiaa Report CALHOUN JP 5 JULY 2022 REPORT Type Cade Deaaription Count Retained nlgburaed MeneyTobela COST TF TECHNOLOGY FUND COST TPDF TRUANCY PREVENTION A DIVERSION FUND 3 3 12.00 0.00 22,00 COST WANT WARRANT FEE 0.00 6.00 6.00 FEES CSRV COLLECTION SERVICES FEB 6 300.00 0.00 300.0D FEES UDC DRIVER SAFETY CDURSE - 2020 8 731,50 0.00 731.50 FEES JCMF JUVENILE CASE MANAGER FEE 3 30.00 0.00 30.00 FINE FINE FINE 2 10.00 0.00 10.00 FINE LTFC LOCAL TRAFFIC [FINE (EFF. 9.1. 10) le 2,427.38 0.00 2,427.3E FINE PWF PARKS a WILDLIFE FINE 11 28.67 0.90 2828.67 .fi7 FINE STFS STATE TRAFFIC FINE (SFF. 9.1.19) 7 124.80 707.20 032.00 FINE WSF WATER SAFETY FINE 11 19.21 458.74 477.85 l 10,35 58.65 69.00 Money Totals The 90139wing totAlo rapreaent • Combined Money and Credits COST CCC CONSOLIDATED COURT COSTS COST CCC CONSOLIDATED COURT COSTS COST CHS COURTHOUSE SECURITY COST IDF INDIGENT DEFENSE FUND COST JCSF JUSTICE COURT SECURITY FUND COST JPAY JVDGE PAY RAISE FEB COST JSF JUROR SERVICE FUND COST LAF SHERIFF'S PEE COST LCCC LOCAL CONSOLIDATED COURT COST 1-1-20 COST MVP MOVING VIOLATION FEE COST OMNC UPS OMNI FEE • COUNTY COST OMND UPS OMNI FEE - DPS COST OMNO CPS QMNj FEE - QMW18ASC COST OMNR OMNI REIMSURSEMENT FEE (EFF. 1.1.20) COST PWAr TEXAS PARKS i WILDLIFE COST IF TECHNOLOGY FUND COST TPDr TRUANCY PREVENTION 6 DIVERSION FUND COST WRNT WARRANT FEE FEES CBRV COLLECTION SERVICES FEB FEES DDC DRIVER SAFETY COURSE - 2020 FEES JCMF JUVENILE CASE MANAGER FEE FINE FINE FINE FINE LTFC LOCAL TRAFFIC FINE (EFr. 2.1.191 PINE PWP PARK9 6 WILDLIFE FINE FINE STF1 STATE TRAFFIC FINE (ErF. 9.1.19) FINE WSF WATER SAFETY FINE Report Totals 30 4,429.09 2,822.61 7,2S2.5o 27 163.92 1,475.33 1,639.25 3 12.00 108.00 120.00 3 5.00 0.00 9.00 3 0.60 5.40 6.00 3 3.00 0.00 3.00 3 1.80 16.20 18.00 3 2.20 10.8D 12, 00 24 117.20 0.00 117.20 27 370.15 0.00 370.15 1 0.01 0.00 0.10 1 4.00 0.00 4.00 1 0.00 20,00 20.Oo 1 0.00 6.OD 6.00 6 94.40 0.00 54.40 6 24.00 C.00 30.00 3 24.00 0100 12.00 3 0.00 6.00 6.00 6 300.00 0.00 300.00 a 731.50 0.00 731.60 3 30.00 0.00 30.00 2 10.00 0100 10.00 19 2,513.32 0.00 2,513,38 12 31.97 0.00 31.57 7 124.80 707.20 832.00 12 21.12 506.74 527.85 1 10.35 58.65 69.00 31 4,546.09 2,926.41 71472.50 08-02-2022 Pa9a 5 08-02-22;17:18 ;From:Calhoun County Pot. 5 To:3615534444 ;3619832461 # 7/ 8 money Distribution Report Date 00-00-9000 Pevmene Type Cash & Checks Collected Jail Credits & Comm Service Credit Cards & Transfers Total of all Collections rinse 0.00 0.00 0.00 0.00 Court cameo 0.66 0.00 O.OD 9.90 CALNOON JP Pees 0.00 also 0.06 0.00 5 JOLY 7022 RNPORT Sonde Restitution 0.00 0.00 O.Oo O.DO else 0.00 0.00 0.00 Other 0.00 0.00 0.00 0.06 Total O.OD 0.00 0.00 0.00 09-D1.1991 Cash & Cheeks Collected Jail Credits & Comm Service Credit Cards & TrAnafere Total of all Collections 0.00 else else 0.00 0.00 also 0.60 0,0o 0.00 0.00 plop 0.00 0.00 0.00 also also 0.00 0.00 0.00 0.00 0.00 0.00 0.as 0.00 0.00 0.00 0.00 0.00 01-01-2004 Cash & Checks Collected Sail Credits & Comm Service Credit cards & Transfers Total of all Collections 225.00 0.00 505.so 733.90 147,00 . 234,10 10 361.10 113.00 0.0 228.50 347.50 0.00 a,aD else 0.0e 0.00 0.00 else else 0.00 0.00 else else 990.00 0.00 966,50 1,962.$0 02-01-2020 Cash & Cheeks Collected Jail Credits & Comm Service Credit Cards 6 Transfers Total of all Collections 11692.00 139.00 1,409.00 3,240.00 1,356.00 91.00 90p,00 2,346.Oa 114.00 0.00 330100 424.00 0.00 0.00 0.00 else 0.0p 0.00 0.00 else else 0.00 0.00 else 3�162.00 220.00 2,62S. 6, 010.00 0 TOTALS Cash & Checks Collected Jail CraditS & COMM Service Credit Cards & Transfers Total Of all Collections 1,920.00 139.00 1,973.90 3,973.90 1,503.00 01.00 1,143.10 2, 727.10 233.00 6,00 771.5a 771.50 0.00 0.00 else 0.00 also O.OD else a.00 0.00 0.00 else also 3, 220.00 220.00 3,596.50 7,472.s0 00.02.2022 Pnge 08-02-22;17:18 ;From:Calhoun County Pot. 5 To:3615534444 money Distribution Report 3619832461 # 8/ 8 State of Texas Ouarterly Reporting Totals State Comptroller Cost and Fees Report Section 7: Report for Offenses Committed 01-01-20 Forward 01.01-04 - 12-31-19 0p-01-91 - 12.31-03 Bail Bond Pee DNA Testing Fee - Juvenile EMS Trauma Fund (EMS) Juvenile Probation Diversion Fees State Traffic Fine (off. op-01.19) State Traffic Fine (prior 09-01.19) Intoxicated Driver Fine Prior Mandatory Costs (JRF,IDF,JS) Moving Violation Fees DNA Testing Fee - Conviction. DNA Testing Foe - Comm Supvn Truancy Prevention and Diversion Fund Failure t0 Appear/Pay Feea Time Payment Fees Judicial Fund - Ccnst County Court Judicial Fund - statutory County Court Section II; As Applicable Peace Officer Fees Motor Carrie; w0ight Violations Driving Record Fee Report Sub Total State Comptroller Civil Fee. Report Cr: girth Certificate Fees CF; Marriage License Fees CF: Declaration 94 Informal Marriage CF; Nondisclosure Fees CF, Juror Donations CF: Justice Court Indig Filing Fees Cr: SUL Prot Court Indig Filing Fees CF: Stac Prob Court Judie Filing Fees CF: Stat Cnty Court Indig Filing Face Cr•, Seat Cnty Court Judic Filing Feeo CF: Cost Cnty Court Indig Filing Free CF: Cnst Cnty Court Judic Filing Fees CF, Disc Court Divorce a Family Law CF: Dist Court Other Divorce/Family Law CF: Dist Court Indig Legal Services CF: Judicial Support Fee CPI Judicial a Court Pets. Training Fee Report Sub Total Total Due For This period Wo"eccea Retained Disbursed 26 1,677.25 267.72 1,41p,53 3 120.00 12.00 100,00 0 0.00 0.00 O.DO 0 0.00 0.00 0.00 0 0.00 0.00 0100 0 0.00 0.00 0.00 0 0.00 0.00 0100 11 477,85 19.11 436.74 0 0.00 0.00 0.00 0 0.00 0.00 0.0 p 36.00 3.60 32,40 1 0.10 0101 0.09 0 0.00 0.00 0.00 0 0.00 0.00 O,Og 0 0.00 0100 0.00 1 20.00 0.00 20.00 0 0.00 0100 0.00 0 0.00 0.00 0.00 0 0.00 0.00 0.00 G 30.00 24.00 1.00 0 0.00 0.00 0.00 0 0.00 0.00 0,00 57 2,2G1.20 216.44 2,044,76 0 0.00 0.00 0.00 0 0,00 0.00 0100 6 0.00 0.00 0.00 0 0.00 0.00 0.00 0 0,00 0.00 0.00 0 0.00 0.00 0.66 0 0.00 0,00 0.00 0 0.00 0.00 0.00 0 0.00 0.00 00 . 0.00 0.00 0.0000 0 0 0.00 0.00 0.00 0 0.00 0.00 0.00 0 0,00 0,00 0,00 0 0.00 0.00 0.00 0 0.00 0100 0.00 0 0.00 0.00 0.00 0 0.00 0.00 0.00 0 0100 0.00 0.00 57 2,263.20 210.44 2,044,76 THE STATE OF TEXAS Before me, the undersigned authority, this day County of Calhoun County personally appeared Nancy pomykalI JUBtiCe of the Peace, Precinct No 5, Calhoun County, Texas, who be;'ng duly sworn, deposes and says that the above fOregoi7 report is true and correct. /' Witness my hand Calhoun Cyr*y, Texas 2.1 0�O-Z��Z SHERIFF'S OFFICE MONTHLY REPORT Jul-22 BAIL BOND FEE $ 645.00 CIVIL FEE $ 294.75 CASH BOND JP#1 $ 342.00 J P#2 $ 453.00 JP#3 $ J P#4 $ 320.00 JP#5 $ 184.00 SEADRIFT MUN. $ 310.00 PC MUN OTHER TOTAL: $ 2,548.75 v # zo 20. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER:! Vern Lyssy, Commissioner Pct=2 AYES:. IJudge Meyer, Commissioner Hall, Lyssy, Behrens` - _§��_ B■§ ££ _ §� �- ■ - ��"-- ■ ■ � e �(\ � k § , ;g ) §2& � z ■ # LU ■ § § �)] ■ @ � §z @ L §§ \�§ % § ■ w ■ §§� , mG § 0 z Ic �&: § � \| & _22 §L6§®§ , � ) ■ ! � § k .j � § §} � § .z §: $ /§ % w ;§ ■ LLI uj �k( @ 12 k � � � § � § § ■ ■ � ■ 2 ■ 2 § k B § . ■ / ■ § ■ \ K § � :C) :0 :z :z :§ :L :§ I $ I a �B0 k, § � ■ ®(S �( \\ | � |§§ — |■ §EI �§2 (§ k § ( 1w&k § . § /§ )2 � c§k _ �§ w §§\ k � �L6 ■■ �© � ■ §W o ■ § \§ o § �� %z • ! � ■ �� @ UA § § k 2 LL 2 LL � q § q 7 2 / ;k 'o :z ;z �§ .L �§ §we)(7 § �&Sz& !»»» 0000 22;2 ■,�„ §°mmm ■° 0 U. § #21 21. Approval of bills and pavroll. (RHM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: " David Hall, Commissioner Pct SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy; Behrens County Bills' . RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct'1 SECONDER: ! Vern Lyssy, Commissioner Pct 2 AYES:,,,,,Judge Meyer, Commissioner Hall, Lyssy, Behrens Adj ourned: 10: 3 0 a.m. M N lO m O I(1 lf1 I(1 q � H M H M Nm O N \D m O OlN M l0 P C N l0 N w �p �p N O� 01 C C N tIl d� H M m � N CL 9m9axa a awaawr� N N N N N N N N N N O O O O O N N N N N mn� in in 0 0 0 0 0 mmmmm w 000 0o ro C7 aaaaaooi a a a a a N p 00000 a x aN a a a a a a h a z 0 a a x £ � w H A uH aN H V1 x U E z �w m E zaw o9x H H H W E x z w awa ou Ea VEE P+ U H W H zzx W £ 0 OmVA W E H E A H E 18 W W axa- E E- H 00 W O W $ U CC 7W DI 0 u of 0 Wwzo00 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---August 10, 2022 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 473,177 24 `-� TOTAL TRANSFERS BETWEEN FUNDS $ 242,782.74 TOTAL NURSING HOME UPL EXPENSES $ 626,640.92 `/ TOTAL INTER -GOVERNMENT TRANSFERS $ GRAND TOTAL DISBURSEMENTS APPROVED Au ust 10, 2022 $ 1,342,600100'; ✓ MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---August 10, 2022 PAYABLES AND PAYROLL 8/5/2022 Weekly Payables 274,848,41 81SM022 Patient Refunds 1,172.68 8/8/2022 McKesson340B Prescription Expense 3,406.27 8/8/2022 Amedsouroe Bergen-340B Prescription Expense 1.235.19 Prosperity Electronic Bank Payments 8/2-8/3/22 Credit Card & Lease Fees 651.92 8/1512022 TCDRS July Retirement 189,245.84 811-815122 Pay Plus -Patient Claims Processing Fee 303.32 8/5/2022 ExpertPay- child support 2,290.01 8/2/2022 Authnet Gateway Billing-3rd Party Payor Fee 2370 TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 473,17724_ TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 815/2022 MMC Operating to Fort bend -correction of NH insurance payment deposited 2,464.00 into MMC Operating 81512022 MMC Operating to Broadmoor-correction of NH insurance payment deposited 17.91 into MMC Operating 8/5/2022 MMC Operating to Crescent -correction of NH Insurance payment deposited 20,769.00 . into MMC Operating in error 815/2022 MMC Operating to Golden Creek -correction of NH insurance payment 57,617.99 deposited into MMC Operating in error 8/5/2022 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 63,994.91 deposited into MMC Operating 8/5/2022 MMC Operating to Tuscany Village -correction of NH insurance payment 23,779.66 deposited into MMC Operating 8/5/2022 MMC Operating to Bethany -correction of NH insurance payment deposited 71,781.97 into MMC Operating In error MEDICARE ADVANCE PAYMENT RECOUP 8/8/2022 Golden Creek to Tuscany Village -correction of Golden Creek medicare 2,35T30 recoup taken from Tuscany Village TO,T, TRANSFERS•BETINEEN FUNKS $ 242;782 74 NURSING HOME UPI. EXPENSES 8/812022 Nursing Home UPL-Cantex Transfer 294,219.67 81812022 Nursing Home UPL-Nexion Transfer 22,035.15 8/8/2022 Nursing Home UPL•HMGTransfer 23,133.41 818/2022 Nursing Home UPL-Tuscany Transfer 53,374.90 8/8/2022 Nursing Home UPL-HSL Transfer 124,615,17 QIPP CHECKS TO MMC 8/8/2022 Ashford 818/2022 Broadmoor 8/8/2022 Crescent 818I2022 Fort Bend 8/8/2022 Solera 8/8/2022 Tuscany TOTAL NURSING kOME.UPL EXPENSES TOTAL INTER -GOVERNMENT TRANSFERS 32,964.61 14,800.26 11,548.19 14,217.68 13,830.78 21,800.20 $ 626A4602, GRAND TOTALbISBURS€MENTS APPROVED Au Ust 10;'2022 $ 1,242,600 00 Page 1 of 13 RECEIVED BY THE COUNTY AUDITOR ON r"l&492(129p9 ? MEMORIAL MEDICAL CENTER AP Open Invoice List 0 14:46 ap_open_invoice.templale CALHOUN COUNTY, TEXAS Due Dates Through: 08/25/2022 Vendor# Vendor Name Class Pay Code / 11237 3WON, LLC ✓ Invoice# Comment Tran Ot Inv Ot Due Dt Check 0 Pay Gross Discount No -Pay Net 2975 ✓ 07/29/20 07/05/20 08/05/20 398.00 0.00 0.00 398.00 CREDENTIALING Vendor Totals Number Name Gross Discount No -Pay Net 11237 3WON, LLC 398.00 0.00 0100 398,00 Vendor# Vendor Name Class Pay Code R1200 ADTCOMMERCIAL r/ Invoice# Comment Tran or Inv or Due Dt Check D' Pay Gross Discount No -Pay Net 146269632 ✓ 07129/20 07/06/20 07/31/20 53.61 0.00 0.00 53.61 f FIRE MONITORING Vendor Totals Number Name Grass Discount No -Pay Net R1200 ADT COMMERCIAL 53.61 0.00 0.00 53.61 Vendor# Vendor Name Class Pay Code A1680 AIRGAS USA, LLC-CENTRAL DIV,% M Invoice# Comment Tran or Inv DI Due Dt Check D- Pay Gross Discount No -Pay Net D127888550 f 07/29/20 07/13120 08/07/20 110.20 0.00 0.00 110.20 OYXGEN Vendor Totals Number Name Gross Discount No -Pay Net A1680 AIRGAS USA, LLC -CENTRAL DIV 110.20 0.00 0.00 110.20 Vendor# Vendor Name Class Pay Code A0400 AUREUS RADIOLOGY LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2673534✓ 07129/20 07/11/20 08/10/20 3,400.OD 0.00 0.00 3.400.00 ✓ LABSTAFFING `4121.8l�y1��,2}I'll 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 Cade 14088 AZALEA HEALTH f Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net / 76766 ✓ 07/29/20 07/01/20 07/01/20 650.00 0.00 0.00 550.00 JUL 22 MONTHLY PROCESSIk 77106 ,/ 07/29/20 08/01/20 08/01/20 550.00 0.00 0.00 550.00 AUG 22 MONTHLY PROCESSIt Vendor Totals Number Name Gross Discount No -Pay Net 14088 AZALEA HEALTH 1,100.00 0.00 OAO 1,100.00 Vendor# Vendor Name Class Pay Code 81150 BAXTER HEALTHCARE f W Invoice# Comment Tran Dt Inv Dt Due Dl Check D Pay Gross Discount No -Pay Net 75777902v/07/29/20 07/11/20 08/05/20 134.55 0.00 0.00 134.55 la^UPPLIES ✓ 75824383 07/29/20 07/14/20 08/08/20 110.91 0100 0.00 110.91 SUPPLIES 75848246 ✓ 07/29/20 07/18/20 08/12/20 690.07 0.00 0.00 690.07 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 935.53 0.00 0.00 935,53 file:///C:/IJsers/ltrevinn/cnsi/memmed.ensinet.com/u88125/data 5/tmn ew5renort4726978... 8/4/2022 Page 2 of 13 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC „i M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110019525✓ 07/29/20 07/15/20 08/09/20 1,288.46 0.00 0.OD 1.288.45 r� SUPPLIES 110019282 07/29/20 07/15/20 08/09/20 219.72 0.00 0.O0 219.72 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMANCOULTERINC 1,508.17 0.00 0.00 1,508.17 Vendor#- Vendor Name Class Pay Code 11224 CABLES AND SENSORS 1/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6191 f 01/12/20 01/07/20 08/01/20 -115.00 0.00 0.00 -115.00 CREDIT / 134426 ✓ 07/29/20 07/19/20 08/01/20 150.00 0.00 0.00 1 s0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11224 CABLES AND SENSORS 35.00 0.00 0.00 35.00 Vendor# Vendor Name Class Pay Code f 14064 CAPITAL ONE ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1643130262 07/2912007119/2008/Ol/20 462.36 0.00 0100 462.36 ✓� .SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 14064 CAPITALONE 462.38 0.00 0.00 462.36 Vendor# Vendor Name Class Pay Code A1825 CARDINAL HEALTH 414,LLC M Invoice# Comment Tran Dt Inv DI Due Dt Check D-Pay Gross Discount No -Pay Net 8002901514 07/29/20 07/09/20 08/08 20. 855.04 0.00 0.00 855.04 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net A1825 CARDINAL HEALTH 414,LLC 865.04 0.00 0.00 865.04 Vendor# Vendor Name Class Pay Cade 13028 CAVALLO ENERGY TEXAS LLC ✓/ Invoice# Comment Tran Dt Inv Di Due Ot Check DPay Gross Discount No -Pay Net 17826683 ✓ 07129/20. 07/19/200812PJ20 79351 0.O0 0.00 793.51 ✓ ELECTRICITY 1782/6682 070/20 07/19/20 08/22/20 2,052.66 0.00 0.00 2,052.66 kLECTRICITY 17826684 ✓ 07/29/20 07/19/20 08/22/20 16.93 0.00 0.00 16.93 /ELECTRICTY 17944698 ✓ 07YL9/20 07/21/20 08/22/20 10.17 0.00 0.00 10.17 f ELECTRICTY Vendor Totals Number Name Gross Discount No -Pay Net 1$028 CAVALLO ENERGY TEXAS LLC 21873.27 0.00 0.00 2.873.27 Vendor# Vendor Name Class Pay Code / C1992 COW GOVERNMENT, INC. ✓ M Invoice# / Comment Tran Dt Inv Ot Due Ot Check D Pay Gross Discount No -Pay Not 81-0188 ✓ 07/29/20 07/15/20 06114120 615,64 0.00 0.00 515.64 .i SUPPLIES / BN22341 ✓ 07/29/20 07/19/20 08/18/20 172,15 0.00 t1.00 172.15 file:///C:/Users/ltrevino/eDsi/nietnined.cnsinet.com/u88125/data 5/tmD cw5reuort4726978... 8/4/2022 Page 3 of 13 SUPPLIES / BN22774 ✓ 07/29/20 07/19/20 08/18/20 57.39 0.00 0.00 57.39 SUPPLIES Vendor Total: Number Name Grass Discount No -Pay Net C1992 COW GOVERNMENT, INC. 745.18 0.00 0.00 745.18 Vendor# Vendor Name Class Pay Code 12768 CHEMAQUA Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net / 7856813 ✓ 07/29/20 07/10/20 07120/20 518.75 0.00 0.00 518.75 ✓ '- WATER TREATMENT Vendor Totals Number Name Gross Discount No -Pay Not 12768 CHEMAQUA 518.75 0.00 0.00 518.75 Vendor# Vendor Name Class Pay Code , C1730 CITY OF PORT LAVACA ,/' W Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 071522A 07/29/20 07/15/20 08/05/20 5,138.79 0.00 0.00 5,138.79 WATER 071522 07/29/20 07/15/20 08/05/20 27.04 0.00 0.00 27.04 WATER 071522C 07/29/20 07/15/20 08/05120 55.14 0.00 0.00 55.14 WATER 071522B 07/29/20 07/15/20 08/05/20 93.34 0.00 0.00 93.34 r/ WATER Vendor Totals Number Name Gross Discount No -Pay Net C1730 CITY OF PORT LAVACA 5,314.31 0.00 0.00 5.314.31 Vendor# Vendor Name Class Pay Code C1166 COASTAL OFFICE SOLUTONS W Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net OEQT202001 f 07/29/20 04/27/20 05107120. 165.88 0.00 0.00 165.88, SUPPLIES OEOT203171 07129120 07/15/20 07/25/20 699.84 0.00 0.00 699.84 .� SUPPLIES OEOT208751 r// 07/29/20 07/28/20 08/07/20 24.12 0.00 0.00 24.12 f" SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1166 COASTAL OFFICE 50LUTONS 889.84 0.00 0.00 589.84 Vendor# Vendor Name Class Pay Code 11029 COASTAL REFRIGERATION , - Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 5114565107/29120 07120/20 08101/20 1,104.50 0.00 0.00 1,104.50 LABOR/MATERIALS t1U4F-F1p AIL 1UULAjj✓ Vendor Totals Number Name Gross Discount No -Pay Net 11029 COASTAL REFRIGERATION 1,104.50 0.00 0.00 1,104.50 Ventlor# Vendor Name Class Pay Code / 10646 COVIDIEN ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5866568868 1// 07/29/20 07/15/20 07/25/20 298.44 0.00 0.00 298.44 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10646 COVIDIEN 298.44 0.00 0.00 298,44 Vendor# Vendor Name Class Pay Code file.-///C.-/Tlgerc/ltrevinn/rnci/memnled-pnsinet.com/nRR125/data 5/tmn ew5renort4726978... 8/4/2022 Page 4 of 13 10789 DISCOVERY MEDICAL NETWORK INC Invoice# Comment Tran or Inv Dt Due DI Check D Pay Gross Discount No -Pay Net MMC073122 / 07/29/20 07/31/20 08/01/20 133,561,23 0.00 0.00 133,561.23 ✓ PHYSICIAN SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 10789 DISCOVERY MEDICAL NETWORK INC 133,561.23 0.00 0.00 133,561.23. Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 10655 .% 07/29120. 07111/2008105120 160.00 0.00 0,00 160.00 f PEST CONTROL 11034 ✓� 07/29/20 07/26/20 08/15/20 105.00 0.00 0.00 105.00 PEST CONTROL Vendor TotalENumber Name Gross Discount No -Pay Net 11291 DOWELL PEST CONTROL 265.00 0.00 0.00 265.00 Vendor# Vendor Name Class Pay Code 10042 ERBE USA INC SURGICAL SYSTEMS Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 766541 J 07/29/20 07/20/20 08/03/20 139.50 0.00 0,00 139.50 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10042 ERBE USA INC SURGICAL SYSTEMS 139.50 0.00 0.00 139.50 Vendor# Vendor Name Class Pay Code C2510 EVIDENT ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net T2207201378 ✓ 07/29/20 07/20/20 07/20/20 8,846.44 0.00 0.00 8,846.44 ✓'' CONSULTING SERV Vendor Totals Number Name Grose Discount No -Pay Net C2510 EVIDENT 8,846,44 0.00 0.00 8.646.44 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE ,/ M Invoice# . Comment Tran DI Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 4696979 ✓ 07/29/20 07/18/20 08/12/20 199.87 0.00 0.00 199.87 y SUPPLIES 4739451 ✓ 07/29/20 07/19/20 08/13/20 199.41 0.00 0.00 199.41 SUPPLIES f 4739450 ✓ 07/29/20 07/19/20 08113/20 143,87 0.00 0.00 143,87 % SUPPLIES Vender Totals Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 543.15 0.00 0.00 543.15 Vendor# Vendor Name Class Pay Code 13960 G & S MANAGEMENT GROUP LLC r% Invoice# Comment Tran or Inv or Due Dt Check D Pay Gross Discount No -Pay Net $40385661 �/ 07/29/20 06/30/20 07/10/20 260.55 0.00 0.00 ,r 260.5.9 y JUNE 22 SERVICE Vendor Totals Number Name Grass Discount No -Pay Net 13960 G & S MANAGEMENT GROUP LLC 260.55 0.00 0.00 260.55 Vendor# Vendor Name Class Pay Code 13148 GRACE FLOORING AND GLASS ✓ Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Not 001375 07/29/20 07/27/20 08/10/20 2,874.75 0.00 0.00 2,874.75 .1 file:///C:/Users/Itrevino/cnsi/memmed.cDsinet.com/u88125/data 5/tmo cw5reoort4726978... 8/4/2022 Page 5 of 13 3RD FLOOR INSTALL Vendor Totals Number Name Gross Discount No -Pay Net 13148 GRACE FLOORING AND GLASS 2,874.75 0.00 0.00 2,874.75 Vendor# Vendor Name Class Pay Code G0401 GULF COAST DELIVERY v` Invoice# , Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net 959627 ti/ 07/29/20 07/08/20 08/07/20 25.00 0.00 0.00 25.00,,,/ SLIDES Vendor Totals Number Name Gross Discount No -Pay Net G0401 GULF COAST DELIVERY 25.00 0.00 0100 25.00 Vendor# Vendor Name Class Pay Code 12380 HEALTH SOLUTIONS DIETETICS ✓ Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 072922 07/29/2007/29/2008/01/20 3,750.00 0.00 0.00 3,750.00✓" DIETICIAN SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 12380 HEALTH SOLUTIONS DIETETICS 3,7%00 0.00 0.00 3,750.00 Vendor# Vendor Name Class Pay Code H0416 HOLOGIC INC Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /Comment 10207194 ✓ 07/29/20 07/21/20 08/03/20 3,285.00 0.00 0.00 3285.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net H0416 HOLOGIC INC 3,285.00 0.00 0.00 3,285.00 Vendor# Vendor Name Class Pay Code 11260 INTOXIMETERS INC M Invoice# Comment Tran Dt Inv Dt Due D1 Check D Pay Gross Discount No -Pay Net 712739 f 07/29/20 07/27/20 00/21/20 80.00 0.00 0.00 80.00 f SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 11260 INTOXIMETERS INC 80.00 0.00 0.00 80.00 Vendor# Vendor Name Class Pay Code J0150 J& J HEALTH CARE SYSTEMS, INC Invoice# Co ment Tran Dt Inv or Due Dt Check D, Pay Gross Discount No -Pay Net 930284865 ✓ 07129120 07121120 08/20/20 1,222.76 0.00 0.00 1.222.76 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net J0150 J & J HEALTH CARESYSTEMS, INC 1,222.76 0.00 0.00 1,222.76 Vendor# Vendor Name Class Pay Code 10972 M G TRUST ,/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 072822 07/29120 07/28/20 08/01/20 640.86 0100 0.00 640.86 .J PAYROLLOEDUCT Vendor Totals Number Name Gross Discount No -Pay Net 10972 M G TRUST 640.86 0.00 0.00 640.86 Vendo(# Vendor Name Class Pay Code ! M2178 MCKESSON MEDICAL SURGICAL INC, , Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 19628210 07/29/20 07/26/20 08/10/20 229.79 0.00 0.00 229.79 Ni /SUPPLIES 19629296 �{ 07/29/20 07/27/20 08/11/20 543.03 0.00 0.00 543.03 file:///C:/Users/ltrevino/eDsi/memmed.ct)sinet.coni/u88125/data 5/tmD cw5report4726978.,. 8/4/2022 Page 6 of 13 SUPPLIES 19637277 J/ 07/29/20 07/28/20 08/12/20 173.27 SUPPLIES Vendor Totals Number Name Gross M2178 MCKESSON MEDICAL SURGICAL INC 946.09 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. ,/ A/P Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 30513491 07/29/20 07/25/20 08/15/20 43.35 INDIGENT Vendor Totals Number Name Gross 10613 MEDIMPACT HEALTHCARE SYS, INC. 43.35 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC M/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 2218255464 ,{ 07/29/20 07/06/20 07/31,20 247.08 SUPPLIES 2218BI4596 07/29/2007/08/2008/02/20 216.01 SUPPLIES 221886SSSO ✓ 07/29/20 07/09/20 08/03120 277.00 SUPPLIES 2218863828 07/29/20 07/09/20 08/03/20 77.72 SUPPLIES 2218863829 07/29/20 07/09/20 08/03/20 ✓ 186.60 SUPPLIES 2219020735 V/ 07/29/20 07111/20 08/05120 31,54 SUPPLIES 0.00 9:00 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 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2219244329 „% 07/29/20 07/12/20 08/06/20 569.01 0.00 SUPPLIES 22119244326�/ 07/29/2007/12/2008/06/20 1,040.85 0.00 SUPPLIES. 2219244322 1 07/29/20 07/12/20 08/06/20 331.64 0.00 SUPPLIES 2219244328 ✓ 07/29/20 07/12/20 08/06/20 4,464.32 0.00 SUPPLIES 2219189709 07/29/20 07/12120 08/06120 232.00 0,00 SUPPLIES 2219244327 „% 07/29/20 07112/20 08/06/20 527.51 0.00 SUPPLIES / 2219189710 1/ 07/29/20 07/12/20 08/06/20 2,268.10 0.00 SUPPLIES 2219244321 V/ 07/29/20 07/12/20 08/06/20 22.29 0.00 SUPPLIES 2219189708 ,/ 07/29/20 07/12/20 08/06/20 2530 0.00 SUPPLIES 2219244323 / 07/29/20 07/12/20 08/06/20 192.03 0.00 SUPPLIES 2219244324 v1 07/29/20 07/12/20 08/06/20. 576.09 0.00 SU�'PLIES 7 2219468448 07/29/20 07/13/20 08/07/20 8.51 0100 SUPPLIES 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 173.27 4% Net 946.09 Net 43.35 v Net 43,35 Net 247.08 i 216.01 �,/ 277.00 ,/ 77.72 / 186.60 31.54 ✓ 569.01 ,% 1,040.85 ✓' 331.64 ✓ 4,464.32 f 232.00 ✓ 527.51 % 2.268.10 /✓� 22.29 ✓ 25.70 / 192.03 ✓ 576.09 8.51 " / file:///C:/Users/ltrevino/eDsi/memmed.ct)sinet.com/u88l25/data 5/tmu ew5reDort4726978... 8/4/2022 Page 7 of 13 2219550236 �/ 07129/20 07118120 08/07/20 359.41 0.00 0100 359.41 SUPPLIES 2219468449 ✓f 07/29/20 07/13/20 08/07/20 29,10 0.00 0.00 29.10 ✓' S PPLIES 2219552611 ✓ 07/29/20 07/13/20 08/07/20 2,485.01 0.00 400 2,485.01 ,✓ SUPPLIES 2219468450 J 07/29/20 07/13/20 08/07/20 89.71 0.00 0.00 69.71 SUPPLIES 2219344067 ✓' 07/29/20 07/13/20 08/07/20 4,201,79 0100 0.00 4,201.79 ✓ SUPPLIES .. 2219766213v/ 07129/20. 07/1412008108120 359.41 0.00 0.00 359.41 SUPPLIES 1 2219694941 ✓ 07/29/20 07/14/20 08/08/20 16.89 0.00 0.00 18.89 ✓� SUPPLIES 2219981636 ✓ 07/29/20 07/16/20 08/10/20 55.38 0.00 0.00 55,38 SUPPLIES 2219981533 ✓ 07/29/20 07/16/20 08/10/20 44.38 0,00 0.00 44.38 SUPPLIES 2220290867 ,✓ 07/29/20 07/18/20 08/12/20 259.89 0,00 0.00 259.89 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No Pay Net M2470 MEDLINE INDUSTRIES INC 19,196.97 0.00 0.00 19,196,97 Vendor# Vendor Name Class Pay Code 11788 MEMORIAL-ME616AL-CENTER 1/ ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 1 Net 070522 07/29/21)07/05120 08/05/20 82.7d 0.00 0.00 ` 82J79 .✓ INDIGENT - VendorTotalsNumber Name Gross Discount No -Pay Net 11788 MEMORIAL MEDICAL CENTER 69'79 0.00 0.00 �X9 Vendor# Vendor Name Class Pay Code 12308 ME149RIAL-MEDICAL-CENW ICP Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 070522 07/29/20 07/05/20 08/05/20 �- 5,258.7fl' 0.00 0.00 ! 5,2q,70 INDIGENT �' Vendor Totals Number Name Gross Discount No -Pay Net 12308 MEMORIAL MEDICAL CENTER 5,25,0/70 0.00 0.00 5,2, .// 70 Vendor# Vendor Name Class Pay Code lo090 MENIORIAL'MEENEAL-GEWZR ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 371 07/29120 07/05120 08/05/20 4.16 7 0.00 0.00 4,WK67 INDIGENT JUNE 22 Vendor Totals Number Name Gross // Discount No -Pay Net 10090 MEMORIAL MEDICAL CENTER 4,16;.67 0.00 0-00 4,166/ Vendor# Vendor Name Class Pay Code 10825 .WEMORIAl.-MEDICAL-GWN1C_ ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross � Discount No -Pay Net Ne/tt 070522 07/29/20 07/05/20 08/05/20 070522 615,81 0.00 0.00 INDIGENT Vendor Totals Number Name as Discount No -Pay Ne�tt� 10825 MEMORIAL MEDICAL CLINIC 67s. 81 0.00 0.00 61}r.81 Vendor# Vendor Name Class Pay Code ftle:///C:/Users/Itrevino/cosi/memmed.cpsinet.com/u88125/data 5/tmp ow5report4726978.., 8/4/2022 Page 8 of 13 10963 MEMORIAL MEDICAL CLINIC y/ Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross 072822 07/29/2007/28/2008/01/20 111.00 PAYROLLDEDUCT Vendor Totals Number Name Gross 10963 MEMORIAL MEDICAL CLINIC 111.00 Vendor# Vendor Name Class Pay Code M2621 MMC AUXILIARY GIFT SHOP ,/ w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 072822 07/29/20 07/28/20 08/10/20 119.26 Vendor Totals Number Name Gross M2621 MMC AUXILIARY GIFT SHOP 119,26 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC ,✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross 84538B3 r/'� 07/29/20 07/21/20 07/31/20 57.32 INVENTORY 8464995 ✓ 07/29120 07/21/20 07131/20 609.91 INVENTORY 8453886,/ 07/29/20. 07/21/2007/31/20 428.06 INVENTORY 8456203 07129/20 07/21/20 07/31/20 136.43 INVENTORY 8456202 ✓ 07/29/20 07/21/20 07/31/20 147.26 INVENTORY 8453884 07/29/20 07/21/20 07131/20 660.09 INVENTORY / 8617 ,/ 07/29/20 07/21/20 07/31/20 -11.73 CREDIT Discount No -Pay Net 0.00 O.OD 111.00 f' Discount No -Pay Net 0,00 0.00 111.00 Discount No -Pay Net 0.00 0.00 119.26 f Discount No -Pay Net 0.00 0,00 119.20 Discount No -Pay Net 0.00 0.00 57.32 ✓ 0.00 0.00 609.91 ✓ 0.00 0.00 428.06 ✓ 0.00 0.00 136.43 D.00 0.00 147.26,% 0.00 0.00 ux*=%11r: 845388507/29/2007/21/2007131/20 2,387.55 0.00 INVENTORY 8467570 ✓� 07129/20 07/21 /20 07/31/20 146.78 0.00 ,INVENTORY 8458014 07/29/20 070120 07/31/20 229.52 0.00 / INVENTORY 8424,! 07/29/2007/21/2007/31/20 -470.8f CREDIT 8466666 ✓ 07/29/20 07/21/20 07/31/20 273.29 INVENTORY / 8463496 ✓ 07/29/20 07/24/20 08/03/20 17.83 INVENTORY 8463494 r,/ 07/29/20 07/24/2D 08/03/20 11.65 /INVENTORY 8463495 ✓ 07/29/20 07/24/20 08/03/20 351.12 INVENTORY / 8461439 ✓ 07/29/20 07/24/20 08/03/20 245.11 INVENTORY 8461440 07/29/20 07/24/20 08/03/20 399.77 INVENTORY 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 660.09 ,/ -11,73 ✓ 2,387.55 146.78 ✓ 229.52 ✓ -470.89 273.29 v% 17.83 / 0.00 0.00 11.65 0.00 0.00 351.121/ 0.00 0.00 246.11 ✓, 0.00 0.00 399.77 ✓ 8461441 07/29/20 07/24/20 08/03/20 1,135.86 0.00 0.00 1.136.88 ,✓ file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp cw5report4726978... 8/4/2022 Page 9 of 13 INVENTORY / 8461442 1/ 07/29/20 07/24/20 08/03/20 1.719.36 0.00 0.00 1,719.36 L/ /INVENTORY 8467572 ,/ 07/29/20 07/25/20 08M4/20. 21.62 0.00 0100 21.62 INVENTORY , 8464997 07/29/20 07/25/20 08/04/20 2.32 0.00 O.OD 2,32 INVENTORY 8467571 ✓ (17129/20 07/25/20 08/04120 424.03 0.00 O.OD 424.03 ✓ INVENTORY 8466499 ,�� 07/2912D 07/25/20 08/04/20 10.86 0.00 0.00 io.86 ✓ INVENTORY B467569 f 07/29/20 07/25/20 08/04/20 28.64 0.00 0.00 28.64 ✓ INVENTORY 8470032 07/29/20 07/26/20 08/05/20 6.95 0.00 0.00 6.95 ✓ INVENTORY 8470035 ,j� 07129120 07/26/20 08/05/20 1,077.41 0.00 0.00 1,077.41"'/ /INVENTORY 8470033 ✓ 07/29/20 07/26/20 08/05/20 5,025.68 0.00 0.00 5,025.68 ✓ INVENTORY 8470034 07/29/20 07/26/20 08/05/20 133.56 0.00 0.00 133.56 ✓ INVENTORY 8471317 1% 07/29/20 07/26/20 08/05/20 5.46 0.00 0.00 5.46 INVENTORY 8473029 ,,/ 07/29/20 07/26/20 08/05/20 84.82 0.00 0.00 84.82 INVENTORY 8470031 �,% 07/29/20 07/26/20 08/05/20 16.31 0.00 0.00 16.31 INVENTORY 8470036 07/29120.07/26/2008/05/20, 1,191.37 0.00 0.00 INVENTORY 8471318 07/29/20 07/28/20 08/05/20 8.69 0.00 0.00 8.69 INVENTORY 8473030 / 07/29/20 07/26/20 08/05/20 279.94 0.00 0.00 279.94 INVENTORY Vendor Total: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 16,791.95 0.00 0.00 i6,791.95 Vendor# Vendor Name Class Pay Code ! 00920 OFFICE DEPOT ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 253723303002 w/ 07/29/20 O6/30/20 07/30/20 325.98 0.00 0.00 325.96-' SUPPLIES 253723303001 ✓ 07/29/20 06/30/20 07/30/20 40.07 0.00 0.00 40.07„/ SUPPLIES 253711462001 �/ 07129/20 06/30120 08/03/20 146.28 0.00 0,00 146.26 w/ SUPPLIES Vendor TotaleNumber Name Gross Discount No -Pay Net 00920 OFFICE DEPOT 512.33 0.00 0.00 512.33 Vendor# Vendor Name Class Pay Code 10152 PARTSSOURCE, LLC / Invoice# Com/ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net CM00015417 ✓ 01/31/20 01/12/20 02/12/20 -438.05 0.00 0.c0 -438.05✓ / CREDIT filc:///C:/Users/Itrevino/cpsi/memmed,cpsinct.com/u88l25/data 5/tmp_cw5report4726978... 8/4/2022 Page 10 of 13 04425723 107/29/20 07/07/20 08106/20 83.45 0.00 0.00 83.45 ✓ SUPPLIES 04429299 07/29/20 07111 /20 08/10/20 148.90 0.00 0.00 145.90 ,/ SUPPLIES 04438263 f 07/29/20 07/18/20 08/17/20 238.61 0.00 0.00 238.61 SUPPLIES Vendor Totale Number Name Gross Discount No -Pay Net 10152 PARTSSOURCE, LLC $2.91 0.00 0.00 32.91 Vendor# Vendor Name Class Pay Code 12544 PATRIGK OCHOA �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net JULY2022 07/29/200713112008/01/20 520.00 0.00 0.00 / 520.00 LAWN MAINT JULY22B 07/29/2007131/2008/01/20 200.00 0.00 0.00 200.00 LAWN MAINT JULY2022A 07129120. 0713112008/01120 380.00 0.00 0.00 380.00 LAWN MAINT , Vendor Totals Number Name Gross Discount No -Pay Net 12544 PATRIGK OCHOA 1,100.00 0.00 0.00 1.100.00 Vendor# Vendor Name Class Pay Code 10896 QIAGEN INC ✓/ Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 998393592V / 07/29/20 07/12/20 08/11/20 359.28 0.00 0.00 359.28 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10896 OIAGEN INC 359.28 0.00 0.00 359.28 Vendor# Vendor Name Class Pay Code 11080 RADSOURCE �! Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net SG32090822, / 07/29/20 07/12120 08/06/20 1,791.67 0.00 0.00 1,791.67-i SERVAGREEMENT , Vendor Total;Number Name Gross Discount No -Pay Net 11080 RADSOURCE 1,791,67 0.00 0.00 1,791.67 Vendor# Vendor Name Class Pay Code 13460 RELIANT, DEPT 0954 ,,./ Invoice# hI� Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 304001341a204 07/29/2007121/2008122/20 35,543.99 0.00 0.00 l 35,543.99 r' ELECRICITY , Vendor Totals Number Name Gross Discount No -Pay Net 13460 RELIANT, DEPT 0954 35,543.99 0.00 0.00 35,543.99 Vendor# Vendor Name Class Pay Code 14048 REYNALDO D. TUAZON ✓ ' Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discaunt No -Pay Net 073022 07/29/20 07/20/20 08/01/20 56074 0.00 0.00 560.74 TRAVEL THT CONFERENCE (1)14-713o)aa) Vendor Totals Number Name Gross Discount No -Pay Net 14046 REYNALDO D. TUAZON 560.74 0.00 0.00 560.74 Vendor# Vendor Name / Class Pay Code 11252 RX WASTE SYSTEMS LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 3744 / 07/29/20 07/01 /20 07/26/20 85.00 0.00 0.00 85.00 file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/t88125/data 5/tmp cw5report4726978... 8/4/2022 Page 11 of 13 MAIL BACK BOXES Vendor ToialeNumber Name Gross Discount No -Pay Net 11252 RX WASTE SYSTEMS LLC 85.00 0.00 0.00 85.00 Vendor# Vendor Name Class Pay Code / S2001 SIEMENS MEDICAL SOLUTIONS INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 116239980 �i 07/29/20 07/16/20 08/10/20 2,193,83 0.00 0100 2,193.83 CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net S2001 SIEMENS MEDICAL SOLUTIONS INC 2,193.83 0.00 0.00 21193.83 Vendor# Vendor Name Class Pay Code 12472 SOMETHING MORE MEDIA, INC. ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1813 ✓ 07/29/20 07/31/20 08/15/20 2.225.00 0100 0100 2,225.00 ADVERTISE , Vendor Totals Number Name Gross Discount No -Pay Nei 12472 SOMETHING MORE MEDIA, INC. 2,225,00 0.00 0.00 2,225.00 Vendor# Vendor Name Class Pay Cade 10094 ST DAVIDS HEALTHCARE ,✓' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMCPL20226 07/29/2007/22/2008/15/20 570,00 0.00 0.00 570.00 C61J NECTIVITY FEE MAY 22 , Vendor Totals Number Name Gross Discount No -Pay Net 10094 ST DAVIDS HEALTHCARE 570.00 0.00 0.00 570.00 Vendor#Vendor Name Class Pay Code T1880 TEXAS DEPARTMENT OF LICENSING-' A/P Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Nat 072822 07/29/20 07/28/20 08/01/20 60.00 0.00 0.00 60.00 ELEVATOR INSPEC Vendor Totals Number Name Gross Discount No -Pay Net T1B60 TEXAS DEPARTMENT OF LICENSING 60.00 0.00 0.00 60.00 Ventlor# Vendor Name Class Pay Code 10985 THE COMPLIANCE TEAM, INC % Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 00033430,07129120. 07115/2007/16120 2,850.00 0.00 0.00 2,850.00 ✓ ACCREDIT CONTRACT 1 ST IN Vendor TotalENumber Name Gross Discount No -Pay Net 10985 THE COMPLIANCE TEAM, INC 2,850,00 0.00 0.00 2,850.00 Vendor# Vendor Name Class Pay Code 11067 TRIZETTO PROVIDER SOLUTIONS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 35FK072200✓/ 07/2912007107/2008/01/20 1,175.80 0.00 0.00 1,175.80 �- STATEMENTS Vendor Totals Number Name Gross Discount No -Pay Net 11067 TRIZETTO PROVIDER SOLUTIONS 1,175.80 0.00 0.00 1,175.80 Vendor#Ventlor Name Class Pay Code 11001 ULINE Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 151491947 07/29/20 07/18120 08/17/20 220,24 0.00 0.00 220.24„- SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net filet//CJ[Icelts/Itrevino/rnsi/memmed-cnsinet.cnm/uRR125/data 5/tmn ew5rennrt4726978... 8/4/2022 Page 12 of B 11001 ULINE 220.24 0.00 0,00 220.24 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8400399869 V'' 07/29/20 07/21/20 08/16/20 206,64 0.00 0.00 206.64 LAUNDRY 8400399858 1% 07/29/20 07/21/20 08/15/20 194.80 0.00 0.00 194.80 LAUNDRY 8400399857 �/ 07/29/20 07/21/20 08/15/20 201.59 0.00 0.00 201.59 LAUNDRY 8400399875 ✓f 07/29/20 07/21/20 08/15/20 98.81 0.00 0.00 98.81 LAUNDRY 8400399897 ✓ 07/29/20 07/21/20 06/15/20 105.04 0.00 0.00 105.04 4„s LAUNDRY 8400399856 ✓/ 07/29/20 07/21/20 08/15/20 26.78 0.00 0.00 26.76 LAUNDRY 8400399860 ✓` 07/29/20 07/21/20 08/15/20 208.13 0100 0.00 208.13 LAUNDRY ,/ 8400399883 07129/2007/2112008/15/20 1,588.09 0.00 0.00 1,588.09 LAUNDRY Vendor Totals Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 2,629.86 0.00 0.00 2,629.86 Vendor# Vendor Name Class Pay Code 12400 UPDOX LLC ✓' Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV003548661/ 07/28/2007/31/2008/01/20 1,292.09 0.00 0.00 1,292.09 �. FAX Vendor Total.- Number Name Gross Discount No -Pay Net 12400 UPDOX LLC 1,292.09 0.00 0.00 1,292.09 Vendor# Vendor Name Class Pay Code U200p US POSTAL SERVICE Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 080222 07/29/20 08/02/20 08/02/20 2,200.00 0.00 0.00 2.200.00 POSTAGE Vendor Total: Number Name Gross Discount No -Pay Net U2000 US POSTAL SERVICE 2,200.00 0.00 0.00 21200.00 Vendor# Vendor Name Class Pay Code 10082 VICTORIA EY�NTER ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount Discount No -Pay Net 070522 07/29/20 07/05/20 08/05/20 99,�X 0.00 0.00 INDIGENT Vendor Total: Number Name Gross Discount No -Pay Ne�tt ;.17 10082 VICTORIA EYE CENTER 99W 0.00 0,00 Vendor# Vendor Name Class Pay Code 10768 VICTORIA MEDICAL FOUNDATION Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 129 07/29/20 05/10/20 06/10/20 422.94 0.00 0.00 422.94 OORATED MEMBERSHIP Vendor Totals Number Name Grass Discount No -Pay Net 10768 VICTORIA MEDICAL FOUNDATION 422,94 0.00 0.00 422.94 Vendor# Vendor Name Class Pay Cade file:///C:/Users/Itrevino/cDsi/Mcinmed.eDsinet.com/n88l25/data 5/tmD cw5reDort4726978... 8/4/2022 Page 13 of 13 12208 WAGEWORKS Invoice# Com ant Tran Dt Inv Dt Due Dt Check D, Pay Gross INV3987554 o7/29/2007/15/2008/15/20 496.25 JUNE 2222 ADMIN/COMPLIAN( INV4033823 07/29/20 07/25/20 08101/20 396.50 MONTLY COMPLIANCE JULY f Vendor Totals Number Name Gross 12208 WAGEWORKS 892.75 Vendor# Vendor Name Class Pay Code 10793 WAGEWORKS, INC. Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 072622 07/29120. 0712812008/01/20 3,253.25 PAYROLLDEDUCT Vendor TotalsNumber Name Gross 10793 WAGEWORKS, INC. 3,253.25 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC Invoice# Cam ent Tran Dt Inv Dt Due Dt Check D Pay Gross 91111867757 07129/20 07115/20 08109/20 1,671.67 CONTRACT Vendor Tctalt Number Name Gross 11110 WERFEN USA LLC 1,571.67 Report Summary Grand Totals: Gross Discount 285,071.55 0.00 AWROVM ON AUG 0 6 2022 BY COUNTY AUDROR CALHOUN COUNTY, TEXAS Discount No -Pay Net 0.00 0.00 495.25 0.00 0.00 396.50 Discount No -Pay Net 0.00 0.00 892.75 Discount No -Pay Net 0.00 0.00 3,253.25 Discount No -Pay Net 0.00 0.00 3,253.25 Discount No -Pay Net 0.00 0.00 1,571.67 Discount No -Pay Net 0.00 0.00 1,571.67 No -Pay Net 0.00 285,071,55 z S -IT> < 5, a 50--W> L u15.91} IT> � a't�t 8N8.4 l file:///C:/Users/Itrevino/ct)si/inemmed.cpsinet.com/u88125/data 5/tmp cw5report4726478... 8/4/2022 Report Summary Grand Totals: Gross Discount 285,071.55 0.00 AWROVM ON AUG 0 6 2022 BY COUNTY AUDROR CALHOUN COUNTY, TEXAS Discount No -Pay Net 0.00 0.00 495.25 0.00 0.00 396.50 Discount No -Pay Net 0.00 0.00 892.75 Discount No -Pay Net 0.00 0.00 3,253.25 Discount No -Pay Net 0.00 0.00 3,253.25 Discount No -Pay Net 0.00 0.00 1,571.67 Discount No -Pay Net 0.00 0.00 1,571.67 No -Pay Net 0.00 285,071,55 z S -IT> < 5, a 50--W> L u15.91} IT> � a't�t 8N8.4 l file:///C:/Users/Itrevino/ct)si/inemmed.cpsinet.com/u88125/data 5/tmp cw5report4726478... 8/4/2022 RECEIVED BY THE RUNVIAfM8yUA22C3R ON MEMORIAL MEDICAL CENTER TAM EDIT LIST FOR PATIENP REFUNDS ARID=OOD1 U:47 2022 PATIENT PAY PAT C04BERJN CCPA1W, DATE AMOUNT CODE TYPE DESCRIPTION --------------------------- ---------------------------------------------_-------------------' 080322 319.53 ✓ 2 REFONI 080322 150.00✓ 3 REFUND 080322 422,48,/ 2 ✓2 REFUNI ------------ '---------------------- ----------------------------------------------------------- 080322 280.57 REFUND F. ARID=0001 TOTAL ..................."------. TOTAL APPROVED OPT AUG 0 5 202 BY COUNTY AUDITOR CALHOUN COUNTY,TXXAB 1172.58 ............................... 1172.58 PAGE 1 APC➢EDIT GL NU4 -------------------------------------- MSKESSON STATEMENT As ot: 00/05/2022 Page: 002 To orreum Proper credit to your eeeowd, doesch and M. this umna,n e000 all with Your remittance DC: 8116 As of. 08/05/2022 Page: 002 MEMORIAL MEDICAL CBJTQi AMT DUE REMITTED VIA ACH DEBT Territory -.Mall to: Comp: TOM Slalummt for Information only ANT DUE REMITTED VIA ACH OMIT N IA STREET 536 CUte: 63222 Statement for information only PO AVAC POW LAVACA TX ]7919 081 Date: OB/OB/2022 Cast: 632536 PLEASE CHECK ANY Date: 08/06/2022 ITEMS NOT PAID (v) gllln9 Due assent,a4uu atlonal Account y05 Cash Amount P Amoum P Re4 ole ,at:Dale Number Rate.Description DI¢ount (Ilmsa) F (n4i) F Number h: column legend: P = Poet Duo Item, F = Futtem Due Item, Mank = Current Due Item 'OTAL National Amt 632536 MEMORIAL MEDICAL CENTER Subtotals: 3,475.78 USE) 'Kure Due: 0.00 OW If Paid On Time: It Peld By 0810912022, USD 3,406.27 rest Due: 0.00 Pay This Amount: 3.406.27 USD Dim last 8 paid Mle: 69.51 art Payment 2,451.97 If Paid After 0810912022, Due It Paid Late: 18/07/2017 Pay this Amount: 3,475.78 USD U50 3,475.78 APPROVEDO14 AUG 0 8 2022 By COUNTY AUDROR CALHDUN COUNrv,To" For AR Inquiries please contact 800-867-0333 m=RCDDVIY STATEMENT As of:08/0512022 Page:001 To makes, proper credit to yess acommi, detach and return this com2�y: s000 stub with your randuenloe OC: 8115 As of: OB/O5/2022 Page: 001 WALMART 1098/MBd MFD PILE AMT DUE REMITTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER Stalemenl for information only VICKV KALISEK B15 N VIRGINIA ST PORT LAVACA TX 77979 Territory: 400 Customer: 256342 Date: OB106/2022 Mall to: C-P: BODO AMT DUE RMTTED VIA ACH DEBIT Stalement far information only Cual: 256342 PLEASE CHECK ANV Date: 08/06/2022 If@AS NOT PAID (1) Allln9 Due )are Date Secelvatu ationel Account bW6 Number Reference Cash Dexdptlon Discount Amaunl P (9-) F Amount P Sacelvabla (est) F Number - .utlomn Number 256342 WAL81ART 1098INI M Mm PHS 18/01/2D22 08/09/2022 7367137690 41531168 1151nvoice 0.16 0.16✓ 7357137890 16/01/2D22 08/09/2022 7357137892 41600028 1151nvoice 0.09 0.09✓ 7357137892 18/01/21322 00/09/2022 7357313475 0729221044 1151moics 0.01 0.32 0.31✓ 7357313475 IS/01/2D22 00/09/2022 7357313476 0729220747 19simmice 0.01 0.32 0.31✓ 7357313476 18(0212022 08/09/2022 7357448637 41761051 115invoice 16.86 842.S8 826.02✓ 7357448637 18/02/2022 OB/09/2022 7357446638 41760031 1151nvoice 7.02 350.99 343.97✓ 7357448638 18/02/2022 08/09/2022 7357613989 0801220821 1151nv01ce 3.47 173.50 170-03 ✓ 7357613989 )8/03/2022 O41/09/2022 7357720266 41913954 1151nvoice 8.21 410.60 4D2.39✓ 7357720266 I8/03/2022 08/09/2022 7357720267 41913954 1151nvoice 2.32 116.08 113.76 1/ 7357720267 W/04/2022 08/09/2022 18/04/2022 08/09/2022 7367074400 7367974481 41978746 42044687 1151nvoice 0.01 1151nvoice 0.63 0.09 U.62 ✓ 7357974480 0.09 ✓ 7357974481 18/05/2022 08/09/2022 7358233185 42092950 1151mmice 5.32 266.10 26a78 ✓ 7358233105 18/05/2022 08/09/2022 7368233186 42159636 115lnvoice 570 285.16 279.48 ✓ 7358233106 18/05/2022 08/09/2022 -8/0512022 08/09/2022 7358233187 7358383411 42159636 0804220730 1151molce 1.27 1951nvoice 172 63.70 85.96 62.43 ✓ 7358233187 84.24 ✓ 73583B3411 18/05/2022 011/09/2022 7358383412 0804221031 1151nvoice 0.02 0.95 0.93 ✓ 7350303412 W column legend: P e Pan Due Rem, F = Future Due Hem, blank a Current Due Ilem 'OTgL Cusomer Number 268342 WAIMARr 1098IMQA M® PlIS Subtotals 2,597.55 USO 7 trtum Due: 0.00 Due It Paid On Time: It Paid By UB/09/2022, USD 2,545.61 ran Due: 0.00 Pay This Amount: 2.545.61 LSD DHc lost it paid late: 51.94 ast Payment 6.069.67 It Pald Alter 0810912022, Due It Paid We: 19r01/2022 Pay this Amount: 2.597.55 USD USD 2,597.55 11PPROVED ON 260J�2 AUG 08 2022 For AR fn ui 4 ies r P lease contact 800-867-0333 CAr. . J:, i, .. Ir,1AH MSKESSOIN STATEMENT A. of: 08/05/2022 Page: 001 To elml9e Proper credit to your accmmt, detach saw teNm tide Gomoa,v: Boca stub with your mmMm ve DC: 8115 As of; OB/06/2022 Page: 001 TIED PHY PC 4901MW MC PHS AMT DUE REMITTED VIA ACH DEBIT Territory: 400 Mail to: camp: 8000 MEMORIAL MEDICAL CENTER Statement for information only AMT DUE REMITTED VIA ACH DEBT VICKY KALISE( Commoner.445 Cu510men 464450 Statement for Information only 815 N VIRGINIA ST Comm 022 PORT LAVACA TX 77979 Cunt: 464450 PLEASE CNECK ANY Bata: 08/06/2022 ITEMS NOT PAID (V) filing Due foeehreblvaltonal Account bwps Cash Amount P Amount P Rxaivabb late Data Number Reference Ceecdptlan Discount (gross) IF(net) IsNumber :ustemw Number 464450 H® PHY FC 490IMEd MC PHS 18/01/2022 08/09/2022 7357126200 55x638931 if 5lnvolce 1.52 76.09 74.57✓ 7357126200 I8/03/2022 08/09/2022 7357692848 55x645106 1151nvdce 0.21 10.6D 10.39✓ 1357692848 1810=022 OB/09/2022 7357692849 55x645263 I151nvalco 1.29 64.27 62.98✓ 7357892849 18/04/2022 08/09/2022 7357968370 55x647157 1151nvdce 0.16 0.16 ✓ 73579fi8370 18/04/2022 00/09/2022 7357968371 55447558 1151nvoioe 0.08 3.95 3.87✓ 7357968371 18/05/2022 08/09/2022 7358229713 55x649469 1151nvoice 0.53 26.30 25.77 �/ 7358229713 18/05/2022 08/09/2022 7368229714 S5x649430 1151.0tcc 12.78 639.00 626.22 • 7358229714 18/05/2022 08109MO22 7356229715 65K649943 1151mr,ace 0.02 0.80 0.78 7368229715 W column legend: P = Past Due Item, F = Future Due Item, blank = Comm Due Item 'OTAL Customer Number 464450 HEB PHY PC 490/MEd MC PHS Sumotde: 021.17 USD 'of" Due: 0.00 Due If Paid On Tim: It POW By 0810912022, USD 80074 %st Owe: 0.00 Pay This Amount: 804.74 USD 01. lost it paid late: 16.43 am Payment 6,069.67 D Paid After 0810912022, Due If Paid late: mfOl/2022 Pay this Amount: 821.17 USD USD 821.17 APPROVEDON AUG 08 2022 BY COUNTY AUDITOR CALHOUN COUNTY. TD(AB For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As of: 08/05/2022 Page: 00i To resumeproper credit to your answered, detach and return this wmwnn sane aWb with Your reniftamc , DC: 8115 A. of: OW5/2022 Page: 001 CVS PHCY 89231MEM MC PHS ANT DUE TED VIA ACH DEBIT Territory: 400 Mel, to: Comp: 8000 MEDICAL CMTEa MEMORIALfor Inl Statement for nlarmelian only AMT DUE REMITTED VIA ACH DEBIT KY VICKALIB®( Customer: 835434 formlo Statement for inlormalian only 815 N VIRGINIA ST Dale: 08/06/2D22 PORT LAVACA TX 77979 Cull: 835434 PLEASE CHECK ANY Oats: 08/06/2022 ITEMS NOT PAID (�) filling Due ReceNabla'dlonal Account YUPS Cash Amount P Amount P Receivable )ale Date Number Reference Description Discount (grass) F (nett F Number ;wWwaer Number 835434 CVS PHCY 8923IM13A MC PHS )8/03/2022 08/09/2022 7357702192 1809469 1151nvoice 1,10 55.12 64.02,/ 7357702192 O column legend: P = Pest Due Item, F = Future Due Item, blank = Current Due Item —PHIS :OTAL• CUMomar NMnbsr 838434 CVS PHCY 8923IMEA MC Subtatca: 55.12 USO id wa Due: 0.00 Due If Paid On Time: If Paid By 08109/2022, USD 54.02,/ 'ant Due: 0.00 Pay This Amount: 54.02 USD Disc lost If paid late: 1.10 set Payment 6,017.08 If Paid After 08/09/2022, Due If Paid late: 17/25/2022 Pay this Amount: 55.12 USD USD 55.12 APPROVEDON AUG 0 8 2022 CARLHOUN COUNTY,)TTEBM For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As of: 08/05/2022 Page: 001 To ensure proper crer8t to Vast account, detach and rotum this companr: saeo stub with your n mhtacce DC: 8115 As or: 08/95/2022 Page: 001 CVS PHOY 74751MEM MC PHS qMT DUE REM I1-fED VIA ACH OMIT Territory: 400 Mail to. Comp: B000 MEMORIAL MEDICAL CENTERory• Statement for information only T DUE REMfor ITTEDAConlY DEBIT VICKY KALISEK Customer. 835438 St enDon 815 N VIRGINIA ST Data: 08/06/2022 PORT IAVACA TX 77979 Coat: 835438 PLEASE CHECK ANY Dale: 08/06/2022 ITEMS NOT PAID (+I Ronal Accrunt 6 camOiling Due RacavaNumber i3 Disc )ale Date Number—Reimnna Desetplion Discount Amount P (gross) F Amount P Number le (trot) F Number )ustomer Number B36438 CVS PHCY 747S/MBA MC PHS — 18/0312022 08/09/2022 7357675316 1809180 1151nvoico 0.04 1.94 1.90 ,/ 7357875316 -F In legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item 'OTAU Cu&aner Number 835438 CVS PHCY 7475/MB.1 MC PHS Subtotals 1.94 USO Auna Due: 0.00 If Palo By 0810912022, Due If Pad On Time: LED 1.80 'art Oua: 0.00 Pay This Amount: 1.90 USD DI. lost if paid late: 0.04 am Payment 6.069.67 It PeM After 08/09/2022, Due if Paid late: 18/01/2D22 Pay this Amount: 1.94 USO USO 1.94 APPROVEDON AUG 08 2022 BY COUNTY AUDITOR CALHOUN COUNTY. TE)(AE For AR Inquiries please contact 800-867-0333 I or STATEMENT Statement Number: 63507522 AmerisourceBergen- Date: 08.05-2022 AMERISOURCEBERGEN DRUG CORP WALGREENS 012494 3408 1001352841037028186 12727 W. AIRPORT BLVD. MEMORIAL MEDICAL CENTER ' SUGAR LAND TX 77478E101 1302 N VIRGINIA ST PORT LAVACA TX 77979-2509 Sal -Frt Due in 7 daye DE A: RA0289276 866-451.9655 AMERISOURCEBERGEN Not Yet Due: 0.00 P.O. Box 905223 CHARLOTTE NC 28290-5223 Current: 1,235.19 Past Due: 0.00 Total Due: 1235.19 Account Balance: 1.235.19 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 08.01-2022 08-12-2022 3101147978 166917 Invoice 402.28 0.00 102.28 08-01.2022 08-12-2022 3101147979 166918 Invoice 0.29 0.00 0.29 08.01-2022 08-12-2022 3101148580 16019 Invoice 173.14 0.00 173.14 08-01.2022 08-12-2022 3101148581 166920 Invoice 11.81 0.00 11.81 08-01.2022 08.12-2022 3101188515 166987 Invoice 13.45 0.00 13A5 08.02-2022 08-12-2022 310132SOBB 166974 Invoice 15.98 0.00 15.98 08-03.2022 08.12-2022 3101479451 166983 Invoice 7726 0.00 77.26 OB-05-2022 0842-2022 31017118229 167004 Involve 839.97 0.00 839.97 Current 1-15 Days 16.30 Days 31.60 Days 61.90 Days 91420 Days Over 120 Days 1,235.19 0.09 0,00 0.00 0.00 0.00 10.00 Thank You for Your Payment Date Amount 08-054022 (624.71) APPROVEDON9 1/ � 2 W &P 3 AUG 0 8 2022 CjI" CAWOLIN COUNTY,BYCOU7TECAS Reminders Due Dale Amount / 08-12.2022 1,235.19 ✓ Total Due: 1,235.19 i MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT--- August 1, 2022 - August 7, 2022 Data Bank Descdption 8/1/2022 PAY PLUS ACHTRAN5452579291101000696583468 MMCNOtes 8/2/2022 PAY PLUS ACHTRANS 452579291101000697757781 - 3rd Party Payer Fee -3rd Party Payor Fee 812/2022 MCKESSON DRUG AUTO ACH ACH05120812910000182 -340D Orug Program Expense 8/2/2022 TSYS/TRANSFIRST BKCO STLMT 39300982541616 61 - Credit Card Processing Fee 812/2022 AUTHNET GATEWAY BILLING 123644042 1040DO173 - 3rd Parry Payer Fee 8/3/2022 PAY PLUS ACHTRANS 4525792911010001599288909 - 3rd Party Payer Fee 8/3/2022 MERCHANT BANKCD FEE 97116091388791000035110 S/3j20Z2 MERCHANT BANKCD FEE 97116091088391000DI5110 - Credit Card Processing Fee 8/3/2022 MERCHANT BANKCD INTERCHNG 97116091388791000 - Credit Card Processing Fee - Credit Card Processing Fee 8/3/2022 MERCHANT BANKCD DISCOUNT 973160913M7910000 - Credit Card Processing Fee 9/3/2922 MERCHANT BANKCD DISCOUNT 9711609108839100DO 8/4/2022 - Credit Card Processing Fee PAY PLUS ACHTRAN5452579291101000690225507 - 3rd Party Payer Fee 8/5/20225TATE COMPTRLR TEKNET 067936041208042100002 -DSH IGT 8/5/2022 PAY PLUSACHTRANS 452579291101000691248744 -3rd Party Payer Fee 8/5/2022EKPERTPAY EXPERTPAY 74600341191600014551054 -Child Support Payment 9/5/2022 AMERISOURCE BERG PAYMENTS 0100007768 2100002 .340D Drug Program Expense 8/5/2022 MEMORIAL MED%I/CALLLPPAYROLL 7460034111131226SO -Payroll William Little, CFO August 8, 2022l Memorial Medical Center pgrm. l 01.03.2t. Ct- PROSPERITY BANK if �(rs N'�a1VuA 03"7'7 •'L2 cr. ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT— ESTIMATED ACHS Date Description MMC Notes 8/15/2022 TCORS -RETIREMENT William Little, CFO Memorial Medical Center 2022 VAxt Pas u•ItF Ieu,L„. A'/•ZJ Amount I GL wo-s Ale4 6069.67# 9S-6tl 0.01 9 • 9 ` 23.70 52 • ti 19;j•8'S' O7"ri a / > S ; 9.95 152.86 6 i 27355 29.95 2 527.39 6T:1 EVurv�i 3]3,533.954 633.45 2�29n,ul - 386,024.17":i.a""'ii'v`P>I ti=: G3.7U ` 2��9LI 17I ` Amount 3 • •<' 6. 1; • Y •. .. 189,245.94 189,]AS.B4 C, .1 0 0 .- Date/Time 08-02-2022 / 10:15 AM Submitted By Pay Date 07-31-2022 Employee Deposits $74,800.82 Employer Contributions $114.445.02 Group Term Life Premiums $0.00 Total $189,245.84 Comments Payroll File July 2022 Retirement Upload.xlsz Page 1 of 1 RECEIVED BY THL COUNTVAUDITOR ON AUG 0 5 2022 CALHOLNIO-G V, Y&M§ MEMORIAL MEDICAL CENTER AP Open Invoice List 0 09:42 ap_openinvolce.template Dates Through: Vendor# Vendor Name Class Pay Cade 11820 FORTSEND HEALTHCARE CENTER Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 072122 07/29120. 07/21/2008/29/20 1,316.00 0A0 0.00 1,316.00 1 TRANSFER W6 IP1UAXUL �J (,(1Nr�jrTc�, 'lqb WkVKL OVLK&AT 072122A 07/29/2007121/2008/29120, 1,148.00 0.00 0. 1,148.00 TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 11820 FORTBEND HEALTHCARE CENTER 2,464.00 0.00 0.00 2.464.00 Report Summery Grand Totals: Gross Discount No -Pay Net 2.464.00 0.00 0.00 2,464.00 AMOV00" AUG 0 5 2022 By CAALHOUNICCOOUNNfY,, TEXAS file:///C:/Users/itrevino/cpsi/inemmed.cpsinet.com/u88125/data_5/tmp_cw5report9185567... 8/5/2022 Page I of 1 RECEIVED RY THE COUNTY AUDITOR ON MEMORIAL MEDICAL CENTER OB/O�M7�2�022 AL;�,1 AP Open Invoice List Dates Through: 0 ap_open_invoice.tem plate t,ALH00ygp"r N006ENWa Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 072822 07/29/20 07/28/20 08/29/20 17.91 0.00 TRANSFER N M(WkYtU- x,- acp Pb ON1i1� t iV�M , UP Vendor Total: Number Name Gross Discount 11832 BROADMOOR AT CREEKSIDE PARK 17.91 0.00 Report Summary Grand Totals: Gross Discount No -Pay 17.91 0.00 0.00 AUG 05 2022 13Y COUNTY AUDITOR CALHOUN COUNTY, TEXAS No -Pay Net 0.00 17.91� No -Pay Net 0.00 17.91 Net 17.91 file:///C:/Users/Itrevino/cpsi/memmed.cpsinet.com/u88l25/data 5/tmp ew5report2312632... 8/4/2022 Page 1 of 1 RECEIVED By THE COUNTYAUDITOR ON AUG 0 5 2022 08/04/2022 CALiAJOd COUNTY, TEXAS Vendor# Vendor Name / 11824 THE CRESCENT ✓ MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code 0 ap_open involce.template Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 072622 07/29/20 07/26/20 08/29/20 5,835.00 0.00 0,.�00 TRANSFER Nt 'IyIWVLn.u. 06k i j1.(i61nt'a ik'� AW.L. 00AA 072822 07/29/20 07f28/20 08l29/20 12,600.00 0.00 0.0 TRANSFER u n 072922 07/29/20 07/29/20 08/29/20 2,334.00 0.00 0.00 TRANSFER " h Vendor Totals Number Name Gross Discount No -Pay 11824 THE CRESCENT 20,769.00 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 20,769.00 0.00 0.00 AUG 0 5 2022 By COUNTY AUDITOR CALHOUN COUNTY, To" Net 5.835.00 12,600.00 ✓ 2,334.00 ✓ Net 20,769.00 Net 20,769.00 file:///C:/Users/Itrevino/cDsi/memmed.ci)sinct.com/u88125/data 5/tmv cw5reoort5450259... 8/4/2022 Page 1 of 1 EGI=P/€Q BY THE � NOTY AUDITOR ON AUG 0 5 202Z MEMORIAL MEDICAL CENTER 08/04/2022 0 AP Open Invoice List CnI,H��?J?4p,�1NTY.TE7iAS ap_opan_invcice.template �- - Dates Through: Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 071322A 07/29/20 07/13/20 08/29120 199.23 0.00 TRANSFER ftyk" P9tk+ jg0019 cA IA.-b �T1 T %ki, 0R,&iAV 071322 07/29/20 07/13120 08/29/20 673.63 0.00! TRANSFER It 11 072222 07/29/20 07/22/20 08/29/20 949.26 0.00 TRANSFER tI 11 072222A 07/29/20 07/22/20 08/29/20 13,744.06 0.00 TRANSFER ' t 11 072522 07/29/20 07/25/20 08/29/20 41,556.19 0.00 TRANSFER It it 072922 07/29/20 07/29/20 08/29/20 495.62 0.00 TRANSFER 11 it Vendor Totals Number Name Gross Discount 11836 GOLDENCREEK HEALTHCARE 57,617.99 0,00 Report Summary Grand Totals: Gross Discount No -Pay 57,617.99 0.00 0.00 AUG 0 5 2022 SY COUNTY AWTION CALHOUN COUMY, TEM No -Pay Net 0.00 199.23✓ 0.00 673.63 ✓ 0.00 949.26 / 0.00 13,744.06 0.00 41,556.19 ✓ 0.00 495.62 No -Pay Net 0.00 57,617.99 Net 57.617.99 file:///C:/Users/ltrevino/cDsi/Memmed.cosinct.com/u88125/data 5/tmp cw5report2130847... 8/4/2022 1 Page 1 of 1 RECEIVED BY THE COUNTYON tNtTYpAUDITOR F-K&022 MEMORIAL MEDICAL CENTER 16:18 AP Open Invoice List 0 ap_open invoice.template CALHOUN COUNTY, TEXAS Dates Through: Vendor#Vendor Name Class Pay Code 12696 GULF POINTE PLAZA Invoice# Comment Tran Dt Inv Dt Due Ot Check DPay Gross Discount No -Pay Net 071322 07/13/20 08/29//20 25,323.98 0.00 0.00 25.323.98 ✓ ��0//7129120 1- TRANSFER I� 1Y1511YNyiu, P�NL7 Ohl'Itr� IV\'6 WkKL LVtVlIW r 072222 07129/2007/22/200 /29/20 1,541.19 0.00 U 0.00 1,541,19✓ TRANSFER It 'I 072222A 07/29/20 07/22/20 08/29/20 165.42 0.00 0.00 165.42 w-' TRANSFER 072522 07/29/20 07/25/20 08/29/20 5,360.55 0.00 0.00 5,360.55 11 TRANSFER 11 1t 072622 07/29/20 07/26/20 08/29/20 22,748.39 0.00 0.00 22,748.39'-� TRANSFER a 1' 072722A 07/29/20 07/27/20 08/29/20 7,344.00 0.00 0.00 7,344.00 TRANSFER It 'I 072722 07/29/20 07/27/20 08/29/20 1,511.38 0.00 0.00 1.511.38 f TRANSFER a It , Vendor Totals Number Name Gross Discount No -Pay Net 12696 GULF POINTE PLAZA 63,994.91 0.00 0.00 63,994.91 Report Summary Grand Totals: Gross Discount No -Pay Net 63,994.91 0.00 0.00 63,994.91 , AUG D 5 2022 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:///C:/Users/ltrevino/cnsi/memmed.ensinet.com/u88125/data 5/tmn cw5renort4544000... 8/4/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON AUG 0 5 2022 08/04/2022 MEMORIAL MEDICAL CENTER 0 ti.ALHiq' #.WoUNTY,T&M AP Open Invoice List ap_open_invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 13004 TUSCANY VILLAGE J Invoice# Comment Tran Di Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 071322 07/29/20 07/18/20 08/29/20 8,833.34 0.00 0.00 8,833.34 TRANSFER WlVWVMLL Wt dtjxidttct rm-lh µw4-0I1Lix1 . 072622A 07/29/20 07/26/20 08/29/20 2,644.46 0.0 0.00 2,644.46 TRANSFER t` of 072622 07/29/20 07/26/20 08/29/20 1,086.47 0.00 0.00 1,086.47 ✓ TRANSFER u n 072722 07/29/20 07/27/20 08/29/20 8,881.39 0.00 0.00 8,881.39 TRANSFER a It . 072922 07/29/20 07/29/20 08/29/20 2,334.00 0.00 0.00 2,334.00 TRANSFER Vendor Totals Number Name Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 23,779.66 0.00 0.00 23,779.66 Report Summary Grand Totals: Gross Discount No -Pay Net 23,779.66 0.00 0.00 23,779.66 APPR®VEDON AUG 0 5 2022 OR CAAiLHOUN COUMYO,'TTEXAS file:///C:/Users/]trevino/ct)si/memmed.ciisinet.com/u88125/data 5/tmD ew5renort2347260... 8/4/2022 Page 1 of 1 RECEIVED BY THE COUNTY AUDITOR ON AMd I&N22 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 16:19 ap_open_Invoice.template CALHOVN �OVNTY, TEXAS Vendor Name Dates Through: ' en or J Class Pay Code 12792 BETHANY SENIOR LIVING . Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 071322 07129/20 07113120 08/29120 19C50 0.00 0.00 194.50 V TRANSFER NN'j"tQAwt_ p�Kj auger i+ca Jk6 hkML. dpt.M 071322A 07/29/20 07/13/20 08/29/20 365.67 0.00 TRANSFER It II 072222 07129/20 07/22/20 08/29/20 384.90 0.00 0.00 384.90� TRANSFER It it 072622A 07/29/2007126/2008/29/20 17,545.67 0.00 0.00 17,545.67 TRANSFER It u 072622 07/29/20 07/26/20 08/29/20 193.48 0.00 0.00 193.481/ 1 TRANSFER 1t 11 072722 07/29/20 07/27/20 08/29/20 53,097.75 0.00 0.00 / 53,097.75 ✓' TRANSFER N It Vendor Totals Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 71,781.97 0.00 0.00 71,781.97� Report Summary Grand Totals: Gross Discount No -Pay Net 71,781.97 0.00 0.00 71,781.97 APPAWwON AUG 0 5 2022 BY COUNTY AUDROR CALHOUN COUNTY, TEXAS file:///C:/Users/Itrevino/cDsi/memmed,cDsinet.coni/u88125/data 5/tmn cw5reoort4117018... 8/4/2022 Request for Transfer of Funds Tnmin P: wmRe —10 MpuesleJ LY MCNEIRPEHNAi RCpunlof3 [mall RwuniW'Spllonc number 713]]0330 OIi1rIROr C-n, Rgr1ZGPW .mw ID3MNYwmt m[Xeme NLF(NLIPFI/f ka150rWn Trwolpevm 1 m Rmwmelpmvma alymmReMmnm Rya4��InaPut XIS R IpFQ WREp1 pakal Ra qeh/ M_ RpNmIPFOYMFPI get[ Numbn eE Inedi NnYs 536.33 FR 5 x.15>.3o e(16354Ni R2133MbxRXR. ts 235].30 WE T.I..l FROM GGLYEN CREEK tOtPL E.31].30 x357.M 1pbennwNut moNam.elacnnu.: mu veN: •pplpee4 bY: MRYM Mn iIN[E Gau M3ranNel: 8/IW x i(mmEatlllly: GIXGEN CREFN in E,avry: ns[ xr unW rknNn Ym,k Oa1e W4ani101: Emm Eatlllry: T.Nallry: PmwNC AUG 08 2022 CBwaua OW REquWsforO8.08.22AO Medicare Reowme.t RD Name FmmCP5IO2nkACd# UK P.,, Gl.# Ma TUSCRNY GOLDEN CREEK 2.357.30 8/201202 xn- olal N.W Approved: WILLIAM LITRE, CFO 9/8/2022 Memorial Medical Center Nursing Home UPL Weekly Cant" Transfer Prosperity Accounts 8/8/2022 yr r Amwm eefnnly / AM trnemb xunb IMme x"mex e+umt r F,IMOut n.nnrnm a. r 19e.91s.16 9a99fi[ e3,107e6 394.9319E 39i.)9056 ✓61.891.11 MARIONNEW 14a,66).96/141.54069✓102,300.04 SHIRMINEW 110,42961tr 110,32186/56,644.51 f � 351,193,32✓311,0>5.6[2/ 15,)5>.66 57=2�°2tit:, 9��,�.,. rrw eree/A,e.M.tM Gt G 6'2 294f<is NPIt On11bNMrn v/tv[r45.OfpnHl6enM,pnte la lAenuninO6fm! 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B+Nnt!/Inn+ler Aml 10,13L61 6950.1E l :6.950.27 42,626.34 Bmk Sul+nat ✓ Varimte lNwIn 941mw 10.00 MOUNAQIPP 14,217.69 t/ luhlnmren 5.75 ✓ Avryfllntlrin Septemblr Mleren A4Emt Bal+mtt/EnmferAml 4206.N ✓ Esen.. ✓ 64926be e>nABaOnIt 75,875.20 .nu. 5levemb+Nne! low �IPAROYEOOR9 MOUNAQIPP 13,810.78 ✓ AUG 0 8 2022 1P4IM4mft 6, / ByCOUNPYAUDITOR CAWOUNCOUNTY Se9tlmb<rmmmn / ET'®fA8 Adjun ealenmlrr+ndn Aml 64R6Bs V rorumutubu 1f4 ;6r Ap d WIWAM LITTLE, CFO - e/8/2Q32 lluxw,<3me,<n.rgemLownm,ewonm<N,1]attlAUluntxx Nnl anwM<,<ma622N,uma1 W22.N, REeI MMCMANW 'jllnlla<.pue ]nn[Iw•In OIIP/Cnmp1 OIPPGm 2 OIPP/Camp3 OIPI/Cnmp6Lbpi[ 41PP➢ NXPmnO 1/2/7021 HUMANA ONOOSOKCMIMPWIMM4] IJ1) A3MW - 3,3H)m "all O<Pril IL491A5 23AIUAS e/3/3N2 MWNAM[MM[MM04NAMN011II16s A20i012 - "LEE l,S!'/AL -U."u0 1EAN,SS IyrSeS,Va WAN) 1;65226, 15 umm 2,WA6. Iki41,b1 1,3/I�}3` UMWS U<nMIIeNIM1e,rt 13[MIMPMSI<6COHII Ii11M 6JSOSa "SAM NARO]E WIPE OUT ASHHHD REASON CARE CENTER tTN 198.]9549 - E94Ab.49✓ R.T6).W Y 15,1W.W 3A4Li6 )ABIAl SI.YLH l;fHbl WW,I6 MM[POPNOM Tn QU VCampl CH"ISAnp3 OMP/COmpl CIPP/GmP[i)Apn CllpIN NNMPNON e/1/30R MM9-F[NON[[UIM<MI NiWY1IMWMINN< - e/]/i@SM[NaOGNOnR1]Ie MNS pMMm1M.bN1393C1 � i,<16W 1AM. 4,950.10 41800 ep/301]VnIMMullmne NCCNWPMt)NMHIl L6lN - ],310W ),110.W e/11103] ONCWMMUNIM1 PLNCCIAWIMI)im1H1191WW ID )0],13 NNfU0IM1pMNnNCFHPAIiNGRMM1HHI !SS. 345.W AUJV32 NIALTHNYMAINSOCH[OMMPMTlii6OU411ENT I 6E90 DUOINMMIMW)91 1/1/l52122 Nb IIWAOli! - UA"', 46L1M 10,/95iS i.3N31 bkSV1 U3I1011 MWNAXFMTNCMMOUN.W,IIWIIl�N12Y0pPlx - 4E�I]a.. ylLf.6O 9261. 4.E95.91 "41: OIMO12 IIUMANAINSCO NCWIMPMT550661e3W W5]1 W MONS &I1019 [0=1Z WIP L.VT IAMEYn4LM GCE GXI(MlA 191.7.318 - RNE IA/3 VniIMNnllm,n NCCGIMPMT]<PfaHlN l AET I,SNW 1,53000 6EU30]3 NFAITN NYMANSV CHIO.NM<MEI]igH115m1] S.19i59 - 5.715,59 RIU2LRE NM dCNVxCCWIMPM2)UWHIlNWW]2mL - 901-26 - 181,16 85nCQZ NNL [ENO N[CYIMPMI )Mptl<]peWLIEbE[ <.3H[3 9,IIIU 294.791.511 ./ S&IN1 ,/ 6,169.60 ELSE 6.61Lb 1DMS.]! LIW.26 19,03p.[6 MMCPORNON „,; i16p2({+QI Icy QIpP/[ompl OIPI/COPg3 OIIP/CPmW OIPP/COmp9611p1e NIPPTI COMPETITION 8111I022 MPNA6FANDNC1IIl0 MN9PMNIOOWWWM01160b 0.568W - B,S6mW 8/1/]012 HOVANAI0$COHoCCCGIMPM96)6313CONNO1Rl LAMAS - 1,18E45 INment&HUIMPMT39016183WW5A3U IMLY) - 1,59,50 0/1/}DIE MRPPNA MPPSuppkm<nu NCCUIMPMi)1211.3 1 SN.50 - 51330 ME/;a2z 00 NUim]pFVOtfOx[ALTHONCCWIMPMi I]11bI96098506 - >,IOO.W - 7,10,0 JI/3/3023 MWNNANFAIiNGQ,MDHNMSN Dt341EW�3RPWti - U.2)192 ilxul A150AE 6.136A6 51135156' 0114E)P6,i100W1S - 9;WE,06 9,OlI.m ES9.i0 3,ti111 754,21 4131202j2,ptINANGtiNCQPMouNMSH 8/3/1021 1bI1N MCg111 N<CIAIMPMfPn1669N00ESA2W sse.n - SSLP 4/4/1022 V NCCW MPM9]EEW36l11163N 110.Po pp,Op Ii4dHNNRun 1/e/1W1 WOEOVTGNRx NUITNGR[CFNIC85111 1913C069 8111101E CObW%M93161i1 J.192.50 - OJ9]50 NNE- ECHO HCCLIARMNSpMNi 1H/2012 HN0-CCXO 3,3WM 3.190.1E ,.NAMPMTH6WIAlIMOWW81M EMjUQU UHCCOCANI.XCCWIMPMFMI Y4M 9,WOW - 9NOW MUN 911E CWIMPA)T)A1403NISJOIZ E/A2,12 UXOTED - 3,030.5E - 3.1015E HEALTH EUCl. 0/412.22 DEVOTED HEALTH PHLCUIMPM) 121N035N OMN) 1161202E DEVOTED HEALTH 11I110IW36I110 ACOLW I,OW W - I'm ED TNIMNMPM) 8/5/]OE23MNA6EWpNI"PLMM1IMPTIAWMIASI6 1 1,190.W - COHEN e/5/IDEE UNCCOR)MUMIIY pt XCCWIMPAR A6WN11910N0 3,H0.1] - 3.740.17 3.10.3E 1151203E AS VUN AOMINIfT C W MPMry199E 111bW)13 I.1W.W 015130IE DEVOTED HEALTH p TI 1211403920N799 10,6N;W IO,NIW owED HOWIMPMT 1/5/20220WOTED HEALTH PNCCUIMPME 1AW.b - U11493OW29HI 8151101E DfVOI:DHGIiN pHCCUIMOMf 111100391030W1 � p,tOflW - A,IOB D0 AUNM 8151102E CI0NAMCCUIMPMT 166W106t591W001t199}36 :EK' NEjb.69 lOL3W,0i 7 S,OII.W 18936 3.91L91 II]SO.M SLly,l9 A,`A`3J.6 Imnn<nom S/UMI2VX0[ONfALINfM[MCCWIMPMf]f6WNI1128]N Nu2n, MAUTHRO ARAVC [CINMIM)615663[]dU]HI NU]OI] NUl[X NVMAN1VCNIfWMIMI IIi[mH1130%] e) V10]] AMP WOPkmeMl NICUIMPM[ 1[6W1NL 12f1M N3I2021 MRPSUPpkmenk HCfwm,w)Eb]H1IIHNP Cle/NISI WIRT OUT WMfX HEALTH CARE CENTERS IN MVID2I WIIMN0Hh,n NCC1AIMMT]IEWHIll3ifN N51A31 AYNAO[AMONfTI)H MM PMMh.U]111ll'Y1191 t/UW}} LINO-[<XO M[[UIMIM[H6WH11U0.W141W [/Ulll}] NOVNM SOIMNNMf<WMIMfNNIp<}�1R1 NVIUM} INAOR, SOWIIONM«WMIMt6Ji1101EgXVlN "Ang 0 N 6/3%20}E:I.IDLINA x[AlntuP,M,o(]NUM bus[Jm62ooWJ} SflnW LPl1N6xfuE110[RMOlIN4O(011Ht1)[JC0EYIE NHJb2 WiIMRASOLUTI NC[GIMPMJJf[ UH1I =1 WYNNE NWN AINSCO CN MPhPMJN6J10[ A7[1 NUI022 WIRE O.IN[[ONCCWMPRN3mNEATEN )b[ UNIW} WIRE OUGMU M WOX[Mf [fM[MIII R1[E11]} fMNPNANONFiI)IeMMIMNI1ie]Il )OIALS MMCEORNGN Tnn,lenln OVP/Gmpl DIPPICpmpl pNP/Wm13 OSM Gmp4GpN QIPPN "PORTION LITHO 3,81044, 5,32, 68 5A27.48 1,93A m 3.94 35 W9b - 1.145,10 9430.63 9,13063 TRUE" OILSEDS SEEM 6,391.73 8E9.33 19,]n).E9 I,547* t4ANWDE 7.6"95 ip23:9S ANGLES - 2,901d5 LEl9W 2.119.SP 11D,3JLB6 am Ca.31t 9D6.50 1I0,3>L16 V 99,9N91 V b.IN.W 9M.96 1,241A1 30.IPoD1 ifEU.61 ./ A46'l6A5 MMCPORNON TAHf.,LQAI ISn rin I OIPP/CPmPI NmP/C1mp2 WPP/Gmp3 NPP/[nRAP AMOK, NPPN NHMRN CAUTO 010P110 IDYSIN - IOj0168 I2AWL 6.103E 6,IN.30 ISe191, 178DDl !WN 7.314,74 710,171. S,9EE" SAM?. 6Alaw_ YIIS1" A]bno 3.2000 - 13,IN.IB 33,I86.86 2.436 W 35LN5.68 - 1.3H.'A - 3)1650 391.07S.N / 16,15).66 ✓� 9.916.110 L]lLM 1,149.63 9JTA 11,6W.1761926.6E LW7515.30 381.51119 ]36Wi0 5.536,25 S6,IN.LT 14ID 40 6).E61d9 )94.)69.70 8/8/2022 Quick View Select Quick View Accounts Account Number I Name Account Type Searrh All DDA Account Number Current Balance Number of Accounts: 15 $4,720,767.25 '4551 CAL CO INDIGENT 59,954.68 HEALTHCARE '4454 MEMORIAL MEDICAL / $24.605.48 NH GOLDEN CREEK HEALTHCARE 44365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.54 2014 '4357 MEMORIAL MEDICAL 54,075,157.69 CENTER -OPERATING -4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.93 WAIVER CLEARING '43$1 MEMORIAL MEDICAL $83,906.55 CENTER / NH ASHFORD '4403 MEMORIAL MEDICAL CENTERINH 563,005.46 BROADMOOR '4411 MEMORIAL MEDICAL $104,627.31 CENTER INH CRESCENT '4446 MEMEMORIAL MEDICAL $56,950.27 CENTER/NH FORT BEND '4438 MEMORIAL MEDICAL CENTER I SOLERA AT $75.875.20 WEST HOUSTON '2998 MMC-MONEY MARKET $703,78 FUND 'S506 MMC -NH BETHANY $124.745.60 SENIOR LIVING •5441 MMC -NH GULF POINTE $23,243.26 PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE 51,848.40 PLAZA - PRIVATE PAY '3407 MMC •NH TUSCANY $75275.10 VILLAGE https://prosperity.olbanking.com/onlinaMessenger Treasury Center Select Group Groups Add Group Data reported as of Aug 8, 2021 Available Balance Collected Balance Prior Day Balanc $4,802,676.32 $4,720,767.25 34,796,028.! $9,954.68 $9,954.68 $9,954.E $42.896.90 $24,505.48 $8.162.7 $536.54 5536.54 $536.5 $4.102,461,07 $4.075.157.69 S4,210,895,2 5431.93 8431.93 5431E $98,698A7 $83,906.55 $83,906.° 581,952.35 $63,005,46 $58,409.7 5142,253,46 5104,627.31 $72,034 E $65,388.79 $58,95027 $56,045.7 591,691.56 $75.875.20 $75,876.2 5703.78 5703.78 5703.7 $130,401.09 5124,745.60 $124,745.E $51.170.85 $23.243.26 $21.162.E 52,085.10 51,848A0 51,848.4 $82,039.75 $75.275.10 $71,315.1 1J1 Memorial Medical Center Nursing Home UPL Weekly Neltion Transfer Prosperity Accounts 8/8/2022 PrtNoua ALTOynt Bginning Pending i4daY'4 Beginning AmpuntiP BeTnmfvretl tP Nunlq ON I Npme Number Bahnee yranNenOut Trandealn De wits Balanw NOm4 om-86.546.94 88533.91 2 ,391.45 / - 24,505.49 22,035.15 ✓ Bank Balm.. 24.505.48 / vananw ✓ have In Balan.. 100.00 MEDICARENEPAYMEWTOTUSCANY MUM a� IUlylntmen 13A3 Augwtlnte.. Septemherintere.t laB3• Atllwt Balance/TnnSlerAml 22A35.1g Note: on<w ofever SS,BBa wNl belmm/naN ep Mrnuninp home. Npfe 2: foeh £OM ue[Ount 4pa a base Beknce of$ICb Mo1MMCtleppeitetllp ep<n PCWuni. APprevad� / // WILIIAM 11TiLE, [PO B/8/g0E1 AUG 0 8 2022 CBLHOUN�NTV, TM8 JANN Weekly TmndenlNN UPLT angler SummaryVBl]\du,mlViN UPS T—fer SumMJNO9QB 22 ASA WU2022 T5YSrMNSfIa5T 9XCD STIMf f 15645556]6979 4' V/U O)) TSYSrtMNSfIRST 9XCD 5TLW S<)6w555a69v 9 &1/]W} TSY RANSNRSTBFCDSTLM55W6RC5556]69119 NLI0}) NOVIAMR(OSNEXIO HMtTH MC OLDE09]O]OOWSJO 6/Jp0]} 6NRf WTN6AONH6AlTHAT60l0CNCREEK 8/512022 TSYS/]MNSfIR5T9XW STLMSU6w5558}691)9 US/}0)) OOVITASS LUPONYM LAIMP }1w56910p001M BISfIO)) NWITASSOIUTON HCCIAIM9Mf 6]6W]C}pppplw MMCM71'N avv/[o, Ins k3 »n aPP/[nmpa GIPplUmpa nIPrICW6 a 6paI.le appn xx pORnpx . IM laoD U Iw.)1 lwll - 1.009.a6 Ip ERR 39.8E 39.6E - 6,69}66 602.66 Msli.91 , i.W oa 1.5))09 3.2OO.M - 11.565.61 11,56961 a6,5a1.91 Rugu5 24.393,45 8/8/2022 Treasury Center Quick View Select Quick View Accounts Select Group Account Number/Name Groups Accounl Type Atltl Group LID OA Data reporten a5 of Aug 8 202' Account Number Current Balance Available Balance Collected Balance Prior Day Balanc Number of Accounts: 15 $4,720,767.25 $4,902,676.32 $4,720,767.25 $4,796,028.5 '4551 CAL CO INDIGENT S9.954.58 $9,954.68 $9,954.68 $9,954.E HEALTHCARE '4454 MEMEDICAL ! NH GOLDEN OLDEN CREEK S24.505.48 $42,896.90 S24,505.48 $8,162.7 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES $536.54 5536.54 5536.54 5536.E 2014 '4357 MEMORIALMEDICAL S4,075,157.69 S002,461.07 54,075,157.69 $4,210,895.2 CENTER -OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.93 S431.93 $431.93 5431.E WAIVER CLEARING '4381 MEMORIAL MEDICAL $83,906.55 $98,698.47 $83,906.55 S63,906.E CENTER/NH ASHFORD '4403 MEMORIAL MEDICAL CENTER/NH $63.005.46 S81,962.35 $63,005.46 S58,409.7 BROADMOOR '4411 MEMORIAL MEDICAL S104.627.31 S142,253.46 S104,627.31 S72,034.E CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL S56.950.27 S65.388.79 S56,950.27 S56,045.7 CENTER I NH FORT BEND '4438 MEMORIAL MEDICAL CENTER! SOLERA AT $75,875.20 $91,691.56 $75,875.20 $75,875.2 WEST HOUSTON '2998 MMC -MONEY MARKET S703.78 $703.78 S703.78 $703.7 FUND '5506 MMC-NH BETHANY $124,745,50 $130,401.09 $124.745.60 8124,745.E SENIOR LIVING '5441 MMC -NH GULF POINTE PLAZA - $23.243.26 $51.170.85 S23,243.26 $21,162.E MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE S1,848.40 $2,085.10 $1.848.40 S1,848.4 PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY $75.275.10 S82.039.75 $75.275.10 $71,315.1 VILLAGE htlps:llprosperity.olbanking.com/onlineMessenger - iry Memorial Medical Center Nursing Home UPI. Weekly HMG Transfer Prosperity Accounts 8/8/2022 vrwiw, 6awM BelNnlni Xmvin Nem< NumOn dapn[e I3,93}.03: Aneunt Nunl Name NYmbn Amain, Mn e,f¢r6VH t, H,,, pnwni Wkp .", 4aNanR leaveln Nlvnre low Amoum rase n.n,r.mam lulylntenrt !.1! Ruµrtlnt<nn R<p\emberintertrt / Adina eaan[.pRnnnnmt ulsdl y p[eulaYr <mwntte B< Ieliimlry Pondini Trwrettrtl to m,n ttimr<.6m /n.mr. m l i d dm xn w ),d0.99 93.]p38< 33,13).{1 Y 33. �3.11).01 BIM Bahn[e }3.vin;N1.16 ✓ VarunR l<areln 0alantt 1%.M XWr: MrybMwrn pF.Ir d4Rp9,rMbe XnM/nredtp Nenurcinpdomr. Nure}: Fort ue. 1 h., nhmebulcnreaf 31W@nr M,,CdIp .d Ropmocmunl. AUG 0 8 202? By COUNTY AUDITOR OAIHOUN MUNTY, TEXAS M, MtenN vJs .......... ✓ blplembalntercn / Adlurt Belanre/rtwlel Ln\ 33:11)AI y( TO]RLIRFRYi0R9 ;4g9A9 WIW0.Mnrne. RO d/d/;eiE r:\mlvb.Ihn.Mmtxx urunn✓o mmm.MlovU.i•nWn unnannm s.mm..r R31un..b. B/l/2022 NNE -ECHO NCCSMMPMT 74SN3411440W0263444 8/1/2022 NNE- ECHO HCCLAIMPMT 34600341144W00263444 B/1/Z022 NNE- ECHO HCCLAIMPM1246 MIl 440000243445 8/312022 NNE - ECHO NCCIAIMPMT 74WI411440W0251156 8/4/2022 WIRE OUT HMG SERVICES, LLC 0/4/2012 NNE - ECHO HCCLMMPMT 746003412440GOVISMI. 8/3/2022 MERMANTBAN8C00EPOS049M385188899ID]001 8/3/2022 NORIOMN33AKKCIAIMPMT625892420=1489165 6/312022 HEALMHUMANSVCHCCIAIMPMT3246 M[130132 $1412022 WIRE OUT HMG SERVICES, LLC 8/4/2022 MERCHANTBANRCDOPP0SIT496438518889 91WCOL 8/5/2022 MCACHRNTBANRCDDEO SIT49M2B5186a99100W1 8/511M HEALTH HUMAN SVC HCCLAIMPMT 1.60CM1130132 I i MMC POPTION QIPP/Comp QIPP/COMP0 Tmmlep0ul TmnshMn QIPP/Compl 3 QIPP/Cam 3 6b sv QIPP TI NH PORTION 592.24 - $92.24 13.96 - ISM 23.52 - 23.52 320.22 - 310.22 12,669.70 - , 906.14 806.14 MMCPORTION QIPP/Comp QIPP(CPmP4 7nm94M3u1 TeanshMn LICEmp; 2 QIPP/Cvmp3 Ll4psv QIPPTI NRPORTION 4,5D2.92 - 41502.92 376.31 376.31 12,91134 - 12,971.54 92J0324 - - 3,202A0 - 3,202.90 42850 478.90 /I,E0474 2,691.74 9I.N13.24 13.133.41 23.133 41 105,622.94 24,079.49 Z4,839.49 8/8/2022 Treasury Center Quick View Select Oulck View Accounts Select Group Account Number/Name Grou s Account Type Add Group LDDA Data reported as of Aug 8 202: Account Number Current Balance Available Balance Collected Balance Prior Day Balarlc Number of Accounts: 15 $4.720,767.25 $4,902,676.32 $4,720,757.25 $4,796,028 E '4551 CAL CO INDIGENT $9,954.68 $9,954.68 $9.954.68 $9,954.E HEALTHCARE •4454 MEMORIAL MEDICAL / NH GOLDEN CREEK 524,505.48 542,896.90 $24.505.48 $8.162.7 HEALTHCARE '4365 -MEMORIAL MEDICAL CENTER -CLINIC SERIES $536.54 5536.54 $536.54 5536,E 2014 '4357 MEMORIAL MEDICAL 54,075,157.69 $4.102,461.07 54,075,157.69 54,210;895,2 CENTER - OPERATING '4373 MEMORIAL MEDICAL CENTER -PRIVATE $431.93 5431.93 $431.93 5431 c WAIVER CLEARING '4381 MEMORIAL MEDICAL $83,906.85 598,698.47 $83,906.55 $63,906 CENTER INH ASHFORD *4403 MEMORIAL MEDICAL CENTER/NH $63,005.46 $81.962.35 $63.005.46 558,409.7 BROADMOOR '4411 MEMORIAL MEDICAL $104,627.31 5142,253.46 5104,627.31 $72,034.E CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL $56.950.27 $65,388.79 $56,950.27 $56,045.7 CENTER/NH FORT BEND '4436 MEMORIAL MEDICAL CENTER I SOLERA AT $75,875.20 591,691.56 575,875.20 575,876.2 WEST HOUSTON '2998 MMC -MONEY MARKET 5703.78 $703.78 $703.78 5703.7 FUND 'S506 MMC-NH BETHANY SENIOR LIVING 5124.745.60 S130,401.09 5124,745.60 5124,746.E 'S441 MMC -NH GULF POINTE PLAZA- $23,243.26 $51.170.85 $23.243.26 $21.162.E MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE $1.848.40 $2,085,10 $1.848.40 $1.848.4 PLAZA - PRIVATE PAY '3407 MMC-NH TUSCANY VILLAGE 575.275.10 582.03975 $76.275,10 $71,315.1 https://prosperity.olbanking.comionlineMessenger 1!1 Memorial Medical Center Nursing Home UPL Weekly Tuscany Transfer Prosperity Accounts 8/8/2022 Naa Aonum Bginni, xunl xnme NumWr Wma ]]I,WIYl� Nme:Oybdonmoj—SS,O]O WO be usnn d la hp,, W101'each casu rhaan Burcbolvnne(SIW (hot Mmcdg ,nlm npn Rton]. AUG 0S nw) evcoUNWAUMTOR CALHOUN COUNTY, TDWS 4m g: inndlm.Win010 Bank Babnn 75.215.50 V.,4— Lnarn In M.... SW.. MOVNAMPP 11.BW.10 4dµn Bdmn/]nmleeGmt Sf I11.90 N/ P � HIB 101] WIIIIaFSxIRF, RO e/l/2022 MOIIne HC Of TXHCCIAIMPMT P1,1117S7178944280 8/1/2022 HNB- ECHO HCCIAIMPMT 746W3411440W0263444 6/2/2022 NOVITAS SOLUTION HCCLMMPMT67S2014Z=X)148 8/3/2022 MOLINAHEALTHW MOUNMO1011136514200W12 8/4/2022 WIRE OUT LINEAR ENTERPRISES. LLC 8/4/2022 NOVITAS SOLUTION HCCI.MMPMT 676W14200W174 8/5/2022 KS PLAN AOMINIST HCCIAIMPMT 179 11 10=22316 MMCPORTION QIPP/Comp QIPP/Comp QIPP/Comp I TransferH ut Transfer -In 1 QIPP/Comp2 3 4&Lapse QIPPTI NHPORTION - 1514.84 - 1,514.84 - 1.646.57 - 1,646.57 - 10,752.37 - 10.752.37 34;741.19 8,859.20 1,524.71 9,309.36 15,047.92 21,800.20 12,941,00 172,901.02 - - - - 22,560.21 - 22.560.13 - 3,960.0 - 3,960.00 172,901A2 75,175.10 8,859.20 1.524.71 9,309.36 15.047.9E 21.800.20 . S3,379 91 818/2022 Treasury Center Quick View Select Quick Vlew Accounts Select Group Account Number / Name Groups Add Group Account Type Snnrch All DDA Data reported as of Aug 8 202; Account Number Current Balance Available Balance Collected Balance Prior Day Belem: Number of Accounts: 15 $4,720.767.25 54,902,676.32 $4,720,767.25 $4,796,028.5 '4551 CAL CO INDIGENT 59.954.68 $9,954.68 $9,954.68 59,954.E HEALTHCARE '4454 MEMORIAL MEDICAL/ NH GOLDEN CREEK $24.505.48 $42,896.90 $24.505.48 $8,162.7 HEALTHCARE '4365 MEMORIAL MEDICAL CENTER - CLINIC SERIES 5536.54 $536.54 5536.54 5536,E 2014 '4357 MEMORIAL MEDICAL $4,075,157.69 $4,102,461-07 54.075,15T69 54,210,895.2 CENTER -OPERATING .4373 MEMORIAL MEDICAL CENTER - PRIVATE $431.93 $431.93 $431.93 5431 WAIVER CLEARING '4381 MEMORIAL MEDICAL $83.906.55 598,698.47 $83.906.55 $83,906.E CENTER I NH A5HFORD '4403 MEMORIAL MEDICAL CENTER/NH $63,00SA6 581,962.35 $63,005.46 $68,409.7 BROADMOOR '4411 MEMORIAL MEDICAL $104,627.31 $142,253,46 5104,627.31 $72,034.E CENTER/NH CRESCENT '4446 MEMORIAL MEDICAL 556.950.27 865,388.79 $55,950.27 $56.045.7 CENTER/NH FORT BEND MEMORIAL MEDICAL CENTER /SOLERA AT $75,875.20 $91,691,56 $75,875.20 $75,875.< WEST HOUSTON '2998 MMC -MONEY MARKET 5703.76 $703.78 $703.78 $703.7 FUND 'S506 MMC -NH BETHANY $124,745.60 $130,401.09 $124,745.60 5124,745.E SENIOR LIVING 441 MMC -NH GULF POINTE PLAZA- $23,243.26 $51.170.85 523.243.26 $21.162.E MEDICAREIMEDICAID '5433 MMC -NH GULF POINTE 51,848.40 $2.085.10 $1,848.40 51,848.4 PLAZA -PRIVATE PAY '3407 MMC-NH TUSCANY $75,275.10/ $82,039.75 575.275.10 $71.315.1 VILLAGE https://prosperity.oibanking.com/cnlineMessonger 111 Memorial Medical Center Nursing Home UPL Weekly HSLTransfer Prosperity Accounts 8/8/2022 rmbus MmvM BeirnnNi NUM_n Nomf �YyYY Numb,KALM eat•",_ xme: onhbvlOnn,O/ouavfs.o]O wuerlrvn,/mMmenrnonm9nem0. NONl: (O[Ii 0[[Ounthm vbvlrevkn[f 0/SlW IhvIMMCdePo,lledty open v[[oune. AUG 08 2022 BY COUNTY AUDITOR CALHOUN COUNTY, 78M 9rnNnB Iftnore Amwntte Be Trunf—tliv BwrY B+l+n[e VArun[e «+win Lhnm /mpneeln+ 9B.a s/ .......... sf9r.mb+r mlam Aalmu+4.<fpr.nr s9a,us.n wlwnM ufllf, tlo a/U1Wl rUlx weHN rr+mla+V! n un inm Iv summ+rvLLatlwywnxx urL rnmlx summ+n m tl n.+N 8/V303I HUB- ECHO HCCMIMPMT 74600NII d4MMZ63445 B/VI03E H05PICE OF SOUTH Prymenl4 HP 1131}}6900W 395 WVI02E HIALTH HUMAN RC HOCLAINVAi 1146W9011I0142 UYEOR U." 43120E Depxll 9/4/!0E} WI9f OUT PORT IAVRCA HIE, IIC fl4/30EE Oepe3il 4]400 pom Blom OeOepepl - 49i243 / / bJs0,65 _ _II_i,6I5.O / ]L61S 3 MMCPOPIIOH Iltm1➢fcOSt Imalfepip ayP/CPmP1 Oi9PrcemP2 a9P/CemP3 OVP/UmpUlMM9 OIPPTJ NH POft OH - I9,99155 ]9,9iI15 1.919. I.SISAi ' I,BIB.96 66 3.59L W SAW W 3.501 61,53L9] FA,531.9}20,751,22 69.15069 . 414.W 1,9iLa3 1)AIO 802022 Quick View Select Quick View Accounts Account Number / Name Account Type Account Number Number of Accounts: 15 •4551 CAL CO INDIGENT HEALTHCARE -4454 MEMORIAL MEDICAL I 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 I 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 I SOLERA AT WEST HOUSTON '2"ll MMC -MONEY MARKET FUND *55 6 MMC -NH BETHANY SENIOR LIVING 'S441 MMC -NH GULF POINTE PLAZA- MEDICARE/MEDICAID '5433 MMC -NH GULF POINTE PLAZA -PRIVATE PAY '3407 MMC -NH TUSCANY VILLAGE https://prosperity.olbanking,comfonlineMessongai Current Balance $4,720,767.25 59,954.68 $24.505.48 $536.54 54,075,157.69 $431.93 $83,906.55 $63.005,46 $104,627.31 $56,950.27 $75,875.20 $703,78 $124.745,60 $23,243.26 51,848.40 $75.275.10 Treasury Center Select Group Groups Atle croup Available Balance Collected Balance $4,902,676.32 $4.720,767.25 $9.954.68 59,954.68 $42,896.90 $24,505.48 as of Aug 8, 202: Prior Day Balanc $4,796,028.5 59,954.E $8,162.7 5536.54 $536.54 $536.° $4.102,461.07 54,075,157.69 54,210,895.2 $431.93 $431.93 $431 c $98,698.47 $83,906.55 583,906.E $81,962.35 $63.005.46 $58.409.7 5142.25346 5104.627.31 $72,034.' $65,388,79 $56,950.27 $56,045.7 591,691.56 $75,875.20 575,875.E 5703.78 5703.78 5703.7 5130.401,09 $124.745.60 $124,745.E 551,170.85 $23,243.26 $21,162.E $2,085,10 $1,849.40 $1,848A $82.039.75 575,275.10 $71.315.1 1/1 l"i[dVIORIAL MEDE"AL e-EN!"T EQ� l., MEMORIAL MEDICAL CENTER 8/8/22 I FORACCT. USE ONLY APPROVED ON F AUG 0 8 2022 1 ❑Alp E By COUNTY AUDITOR .-------PALHOUN COUNTY. TEXAS I Li AdVIOWN'T ._$ 2,964.61 c/f NUMBER. 10255040 I'X r LA /111'.1 Q N: MOLINA JUNE & Q3 QIPP PAYMENTS w. --- -- ------ Mayra Martinez iil;J MZFfm W': I K41F(VIC)CIAL 1"NAL iICAL Ct:_N F Eft f't1s-1- i — P;voud�aur E� MEMORIAL MEDICAL CENTER Date Rc�rluesi-e,d; 8/8/22 A Y E 6 AFODUNT r-OR ACCT. USE ONLY aAPPROVED®N ulrnprestCasi,, FIA'P Cher; AUG D 8 2022 pmaii Check to Vendor CReturn Check io Depr BYCOUNifAUDITOR �__..—._—_.._..-_ _.-. CALHOUN COUNTY, TEXAS 5/i. I`IIJNIBER: 10255040 rXPLANIATlON': MOLINAJUNE & Q3 QIPP PAYMENTS G Mayra Martinez 1<< z MEIVICIMAL MEDICAL CENTER MEQUEST— elvc%t4 MEMORIAL MEDICAL CENTER Date Requested: 8/8/22 in APPROVEDON y AUG 0 8 2022 BYCOLINTYAUDITOR E CALHOUN COUNTY, TOM FUN AC1a. USE ONLY 1-11mi), est cash nA/P Check Mail "heckto Vendor LjIleEurn Checlz Lo Depl. AMOUNT $11 548.19 c:/L f.Iufvjp'f�*r': 10255040 FXPLANAI'l0ft MOLINAJUNE & Q3 QIPP PAYMENTS ........ .. ... . Mayra Martinez '.j BY - ------- -- --------- -- A IVIE=,►Eil0R1AL V!E ;;CAI OF Nf I * EIR r,,,.CV a�.�.. , MEMORIAL MEDICAL CENTER Date Requested: 8/8/22 APPROVED ON _ ----- — AUG 08 2022 BY COUNTY AUDfTOR f....V_._„__..�..,.______.C,ALHOUN COUNTY, TEXAS FOR ACCT. UiE ONLY L_llrnprest Cash �A%P Check u iJ!sll Chink to Vendor j Roan r: Check to Dept AMOUNT $14,217.68____^_ ,_____._______ C/I. NUMBER: 10255040 MEMOMAL MEMCAL CENIVER CH ECY REQU EST - Mtvl�, P MEMORIAL MEDICAL CENTER A Datp Requested: 8/8/22 APPROVED ON AUG 0 8 2022 E EIY COUNTY AUDITOR ---CALHOUN COUNTY, TEXAS rOR ACCT. US F ONLY u '7 Irnprest Cash �A/p rheck 1] Mail "'heck to Venidur [.]Retuyr, io F)ppi AMOUNT 10255040 [iXPL41,.'Aflor%l: MOLINA JUNE& Q3 QlPP PAYMENTS Mayra Martinez AOYHORIZED BY ...... --- ------- p A ),,AlE[)!(-'Al- CENTER CHECK REQUE.ST --rmuvt� MEMORIAL MEDICAL CENTER 8/8/22 AUG 0 9 2022 By COUNTY AUDITOR GOLJI`M, 1V-"9 FOR ACCT. USE ONLY Flmpre.it Cash �A/P Check 11 Mall Check to Vendor r Return Check Lo Depi: AMOUNT GA MUMSER: 10255040 FXPLANAT!ONI: MOLINA JUNE & Q3 QIPP PAYMENTS ......... .... . ----- -- Mayra Martinez i id 'QUE:; Fri, NV: Ak.171 .F; ay.vwnommoowP:xn�. QIPP MMC iommo INLUgMLLIAed:�,i M IIiRF. 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