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2023-07-19 Final PacketNOTICE OF MEETING—7/19/2023 July 19, 2023 MEETING MINUTES OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING 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. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Joel Behrens Gary Reese (ABSENT) Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call meeting to order. CountyJudge Commissioner Pct i Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at 10:00 am by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. n/a 5. Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. (RHM) Pass Page 1 of 4 NOTICE OF MEETING — 7/19/2023 6. Consider and take necessary action to authorize the use of $154,080 of GOMESA funds to replace the public restrooms at Magnolia Beach near the Camel Monument with a new Off Commercial Restroom and outdoor shower and authorize all appropriate signatures. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Consider and take necessary action to extend the feasibility contract with Texas A & M Agril-ife to October 31, 2023. There is no additional cost associated with this extension. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the Infrastructure Development Plan for the Marquis Laydown Yard. (VLL) Pass Consider and take necessary action to approve the Rental Agreement with Anderson Machine Company for a Bomag BW 151AD-5 double drum roller and authorize Commissioner Reese to sign all documentation. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to accept the Letter of Transfer for Held -In -Trust Collections from the Texas Historical Commission for the Green Lake Enhancements Project, Permit # 30942 and authorize Judge Meyer to sign all documentation. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 4 NOTICE OF MEETING — 7/19/2023 11. Consider and take necessary action to remove from Precinct 4 R & B inventory asset number 24-0495; a 2018 Dodge Ram 1500; VIN 1C6RR6FT7JS139704 and transfer to Texas Agri Life Extension Service. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Approve the minutes of the July 5, 2023 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 13. Accept Monthly Report from the following County Office: I. District Clerk — June 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 4 NOTICE OF MEETING — 7/19/2023 15. Approval of bills and payroll. (RHM) MMC Bills: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Indigent Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:10am Page 4 of 4 w I:I��' ( AI 1501�1� a� All Agenda Items Properly Numbered V Contracts Completed and Signed All 1295's Flagged for Acceptance (number of 1295's I) All Documents for Clerk Signature Flagged (All documents needing to be attested to need to be signed day of Commissioner's Court.) On this .1. `ifv day of� 2023, the packet for the a of 2023 Commissioners Court Regular Session was s mitt from the Calhoun County Judge's office to the Calhoun County Clerk's O ice. ie2� Calhoun County Judge/Assistant C:\Users\Maebelle.Cassel\Desktop\Agenda Templates\PACKET COMPLETION SHEET.Docx AGENDA NOTICE OF MEETING — I/:19/2023 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern lLyssy, 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, July 19, 2023 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 21I S. Ann Street;, Suite 104, Port ]Lavaca, Calhoun. County, Texas. AGENDA AT_LJ FILED � ql The subject matter of such meeting is as follows: O'CLOCK 7. Call meeting to order. JUL k 2023 �/ cot i s s s 2�Invocation. BY: 's�Pledges. of Allegiance. kF. Generaf Discussion of Public Matters and Public Participation. Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. /(RHM) `6. Consider and take necessary action to authorize the use; of $154,080: of GOMESA funds to replace the public restrooms at Magnolia Beach near the. Camel Monument with a new CXT Commercial Restroom and outdoor shower and authorize all appropriate /signatures. (DEH) Consider and take necessary action to extend the feasibility contract with Texas A & M. AgriLife to October 31, 2023. There Is no additional cost associated with this extension. s(RHM) `8. Consider and take necessary action to approve the Infrastructure Development Plan for the Marquis Laydown Yard. (VLL) 9 Consider and take necessary action to approve the Rental Agreement with Anderson Machine Company for a Bomag BW 151AD-5 double drum roller and authorize Commissioner Reese to sign all documentation. (GDR) Page 1 of I NOTICE OF MEETING— I/19/2023 consider and take necessary action to accept the Letter of Transfer for Held -In -Trust Collections from the Texas Historical Commission for the Green Lake Enhancements Project, Permit # 30942 and authorize Judge Meyer to sign all documentation. (GDR) K Consider and take necessary action to remove from Precinct 4 R & B inventory asset number 24-0495;. a 2018 Dodge Ram 1500; VIN 1C6RR6FT7JS139704 and transfer to Texas Agrilrfe Extension Service. (GDR) I2�Approve the minutes of the July 5, 2023 meeting, 13. Accept Monthly Report from the following County Office:. fr�bistrictClerk —June 2023 f4f Consider and take necessary action on any necessary budget adjustments. (RHM) Approval of bills and. payroll. (RHM) Ric and H. Meyer, County Judg JJ Calhoun County, Texas A copy of this Notice has been placed onthe outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port. Lavaca, Texas, wh rch is readily accessible to thegenera[ public: at al I times. This Notice shall remain posted continuousfyfor at least 72hours precedr ng the scheduled meeting time. For your convenience, you mayvisit the county's website at www.caIhouncotx ore under "Commissioners' Court Agenda" far any official court postr ngs. Page Z of 2 # 05 I NOTICE OF MEETING — 7/19/2023 July 19, 2023 MEETING MINUTES OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING 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. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Joel Behrens Gary Reese (ABSENT) Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call meeting to order. County Judge Commissioner Pct 1 Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at 10:00 am by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. n/a 5. Consider and take necessary action to approve an Order Prohibiting Outdoor Burning. (RHM) Pass Page 1 of 11 I BURN BAIU ORDER — 7/19/2023 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 WHEREAS, on the 19th day of July, 2023, the Commissioners' Court finds that circumstances present in all unincorporated areas of the County create a public safety hazard that would be exacerbated by outdoor burning. IT IS HEREBY ORDERED by the Commissioners' Court of Calhoun County that all outdoor burning is prohibited in the unincorporated area of the County for 90 days from the date of adoption of this Order. The County Judge may rescind this Order upon a determination that the circumstances that required the Order no longer exist Household Trash may be burned in a closed or screened container. This Order is adopted pursuant to Local Government Code §352.081, and other applicable statutes. This Order does not prohibit outdoor burning activities related to public health and safety that are authorized by the Texas Commission on Environmental Quality for: (1) firefighter training: (2) public utility, natural gas pipeline or mining operations; (3) planting or harvesting of agricultural crops; or, (4) burns that are conducted by a prescribed burn manager certified under Section 153.048, Natural Resources Code, and meet the standards of Section 153.047, Natural Resources Code. In accordance with Local Government Code §352.081(h), a violation of this Order is a Class C misdemeanor, punishable by a fine not to exceed $500.00. ADOPTED this 19th day of July, 2023 by a vote of ayes and nays. Richard H. Meyer Calhoun County Judge ATTEST: Anna Goodman, County Clerk By: Deputy Page 1 of 1 # 06 NOTICE OF MEETING — 7/1.9/2023 6. Consider and take necessary action to authorize the use of $154,080 of GOMESA funds to replace the public restrooms at Magnolia Beach near the Camel Monument with a new 07 Commercial Restroom and outdoor shower and authorize all appropriate signatures. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 11 David E. Hall Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax (361)553-8734 Please place the following item on the Commissioners' Court Agenda for July 26th, 2023. • Consider and take necessary action to utilize GOMESA funds to replace the public restrooms at Magnolia Beach near the Camel Monument with a new CXT Commercial Restroom and outdoor shower in the amount of $154,080 and authorize all appropriate signatures Sincer L David . Hall DEH/apt iu'wmeme�,exoni.mwui�m�,xuemi w.xwa.. _. _.._.,.,.�'.4 qn 17 �ƒ - \ � � � Q� . � � :� yy� /� ��=��«a\?d22 .. a. . . � ws .� �?w��\��d:«\w � � � � � � � � � " � � \�� \ : . y Y..�y� � /� � �. � � � � � � �� J� . � � � ' §\� .. .. � . y� � � � t` � � \<\� � y.. . . : »22 \�\w��a��«, : a�\�� : � :�° © w � � \�� & w . r��\v ' � � � �� ` . I \ � � � y. � «� - 12��\�� ` � j� 7��. \ , a.. �»: \\ o 1 t y' � M ;a J s R q� 1i�itvJew su _ _ � 4 a+<'+ y �;� x � F r @ � � u j �.. �. �.-. � s�- r ..go-, "41`.€;s `�� « � d, t' .`�`; �' �„ ao� ^� "�; .,� i 'v j„lk , i J CXT° Precast Concrete Products manufactures restroom, shower and concession buildings in multiple designs, textures and colors.The roof and walls are fabricated with high strength precast concrete to meet all local building codes and textured to match local architectural details. All CXT buildings are designed to meet A.D.A. and to withstand heavy snow, high wind and category E seismic loads. All concrete construction also makes the buildings easy to maintain and withstand the rigors of vandalism. The buildings are prefabricated and delivered complete and ready -to- use, including plumbing and electrical where applicable. With thousands of satisfied customers nationwide, CXT is the leader in prefabricated concrete restrooms. 1. ORDERING ADDRESS(ES): CXT Precast Concrete Products, 606 N. Pines Road, Suite 202, Spokane Valley, WA99206 2. ORDERING PROCEDURES: Fax 509-928-8270 3. PAYMENT ADDRESS(ES): Remitting by check: CXT, Inc., PO Box 676208, Dallas, TX 75267-6208 Remitting by ACH or wire transfer: Beneficiary: CXT, Inc. Beneficiary Bank: PNC Bank, Pittsburgh, PA Account: 1077766885 ABA/Routing: 043000096 Email remittance details to AR@Ibfoster.com 4. WARRANTY PROVISIONS: CXT provides a one (1) year warranty. The warranty is valid only when concrete is used within the specified loadings. Furthermore, said warranty includes only the related material necessary for the construction and fabrication of said concrete components. All other non -concrete components will carry a one (1) year warranty. CXT warrants that all goods sold pursuant hereto will, when delivered, conform to specifications set forth above. Goods shall be deemed accepted and meeting specifications unless notice identifying the nature of any non- conformity is provided to CXT in writing within the specified warranty. CXT, at its option, will repair or replace the goods or issue credit for the customer provided CXT is first given the opportunity to inspect such goods. It is specifically understood that CXT's obligation hereunder is for credit, repair or replacement only, F.O.B. CXT's manufacturing plants, and does not include shipping, handling, installation or other incidental or consequential costs unless otherwise agreed to in writing by CXT. This warranty shall not apply to: 1. Any goods which have been repaired or altered without CXT's express written consent, in such a way as in the reasonable judgment of CXT, to adversely affect the stability or reliability thereof; 2. To any goods which have been subject to misuse, negligence, acts of God or accidents; or 3. To any goods which have not been installed to manufacturer's specifications and guidelines, improperly maintained, or used outside of the specifications for which such goods were designed. 5. TERMS AND CONDITIONS OF INSTALLATION (IF APPLICABLE): All prices subject to the "Conditions of Sale" listed on the CXT quotation form. Customers are responsible for marking exact location building is to be set; providing clear and level site, free of overhead and/or underground obstructions; and providing site accessible to normal highway trucks and sufficient area for the crane to install and other equipment to perform the contract requirements. Customer shall provide notice in writing of low bridges, roadway width or grade, unimproved roads or any other possible obstacles to access. CXT reserves the right to charge the customer for additional costs incurred for special equipment required to perform delivery and installation. Customers will negotiate installation on a project - by -project basis, which shall be priced as separate line items. For more information regarding installation and truck turning radius guidelines please see our website at,,htt=//wwmcxtmc.com In the event delivery of the building/s ordered is/are not completed within 30 days of the agreed to schedule through no fault of CXT, an invoice for the full contract value (excluding shipping and installation costs) will be submitted for payment. Delivery and installation charges will be invoiced at the time of delivery and installation. Should the delivery and installation costs increase due to changes in the delivery period, this increase will be added to the price originally quoted, and will be subject to the contract payment terms. In the event that the delivery is delayed more than 90 days after the agreed to schedule and through no fault of CXT, then in addition to the remedies above, a storage fee of 1-1/2% of contract price per month or any part of any month will be charged. "Customer is responsible for all local permits and fees. 6. DELIVERY CHARGE: All prices F.O.B. origin prepaid and added to invoice. CXT operates three (3) manufacturing plants in the United States and will deliver from the closest location on our carriers. 7. PAYMENT TERMS: All orders are cash in advance. At CXT's discretion, credit may be given after approval of credit application. Payment to CXT by the purchaser of any approved credit amount is net 30 days after submission of invoice to purchaser. Interest at a rate equal to the lower of (1) the highest rate permitted by law; or (ii) 1.5% per month will be charged monthly on all unpaid invoices beginning with the 35th day (includes five (5) day grace period) from the date of the invoice. Under no circumstance can retention be taken. If CXT initiates legal proceeding to collect any unpaid amount, purchaser shall be liable for all of CXT's costs, expenses and attorneys'fees and costs of any appeal. 8. LIMITATION OF REMEDIES: In the event of any breach of any obligations hereunder; breach of any warranty regarding the goods, or any negligent act or omission of any party, the parties agree to submit all claims to binding arbitration. Any settlement reached shall include all reasonable costs including attorney fees. In no event shall CXT be subject to or liable for any incidental or consequential damages. Without limitation on the foregoing, in no event shall CXT be liable for damages in excess of the purchase price of the goods herein offered. 9. DELIVERY INFORMATION: All prices F.O.B. origin prepaid and added to invoice. CXT operates three (3) manufacturing plants in the United States and will deliver from the closest location on our carriers. Use the information below to determine the origin: • F.O.B. 6701 E. Flamingo Avenue, Building 300, Nampa, ID 83687 applies to: AK, CA, HI, ID, MT, NO, NV, OR, SD, UT, WA, WY. • F.O.B. 901 North Highway 77, Hillsboro, TX 76645 applies to AR, AZ, CO, IA, KS, LA, MN, MO, MS, NE, NM, OK, TX. • F.O.B. 362 Waverly Road, Williamstown, WV 26183 applies to AL, CT DE, FL, GA, IL, IN, KY, MA, MD, ME, MI, NC, NH, NJ, NY, OH, PA, PR, RI, SC, TN, VA, VT, WI, WV. • Prices exclude all federal/state/local taxes. Tax will be charged where applicable if customer is unable to provide proof of exemption. Rev. 0511112022 CORTEZ -10' 3" X 17' Cortez with chase has two single user fully accessible flush restrooms. Standard features include simulated bornwood textured walls, simulated cedar shake textured roof, vitreous china fixtures, interior and exterior lights, off loaded, and set up at site. Restroom*$62,587.80 Qty: = $0.00 Family Assist Shower/Restroom Combo*$73,027.80 Qty: _ $0.00 Concession* $72,558.00 Qty: _ $0.00 "Includes 4-gallon water heater. \r t 800.696.5766 l I \ gA *Base Price $ 62,587.80 Shower*$75,690.00 Qty: = $0.00 Storage $57,942.00 Qty: =$0.00 Sections $ 0.00 Final Connection to Utilities (per section) $ 5,000.00 © 5,000.00 Optional Wall Texture (per section)- choose one 0 Split Face Block ($5,500) 0 Stone ($7,000) Reset Wall Texture 0.00 Optional Roof Texture (per section) ❑ Ribbed Metal $ 5,500.00 0.00 Insulation and Heaters (per section) $ 19,500.00 ❑ 0.00 Stainless Steel Water Closet (each) Qty: $ 1,750.00 ❑ 0.00 Stainless Steel Lavatory (each) Qty: $ 1,500.00 ❑ 0.00 Electric Hand Dryer (each) Qty: $ 700.00 ❑ 0.00 Electronic Flush Valve (each) Qty: $ 1,500.00 ❑ 0.00 Electronic Lavatory Faucet (each) Qty: $ 1,500.00 ❑ 0.00 Paper Towel Dispenser (each) Qty: $ 350.00 ❑ 0.00 Toilet Seat Cover Dispenser (each) Qty: $ 350.00 ❑ 0.00 Sanitary Napkin Disposal Receptacle (each) Qty: $ 100.00 ❑ 0.00 Baby Changing Table (each) Qty:2 $ 750.00 ❑✓ 1,500.00 Skylight in Restroom (each) Qty: $ 1,600.00 ❑ 0.00 Marine Grade Skylight in Restroom (each) Qty: 2 $ 2,450.00 © 4,900.00 Marine Package (excluding fiberglass doors and frames) (per section) $ 2,350.00 © 2,350.00 Exterior Mounted ADA Drinking Fountain w/Cane Skirt (each) Qty: $ 5,600.00 ❑ 0.00 2KAnti-Graffiti Coating (per section) $ 4,000.00 ❑ 0.00 Optional Door Closure (each) Qty: $ 700.00 ❑ 0.00 Fiberglass Entry and Chase Doors and Frames (each) Qty: 3 $ 3,300.00 © 9,900.00 Timed Electric Lock System (2 doors- does not include chase door) (each) Qty: $ 1,350.00 ❑ 0.00 Exterior Frostproof Hose Bib with Box (each) Qty: $ 1,200.00 ❑ 0.00 Total for Added Cost Options: $ 23,650.00 Custom Options: Installation Surcharge (6,260), Site Work --See Scope Ex "A' details (44,842) $ 51,092.00 Engineering and State Fees: $ 4,000.00 Estimated One -Way Transportation Costs to Site (quote): $ 5,650.00 Estimated Tax: $ Total Cost per Unit Placed at Job Site: $ 146,979.80 Estimated monthly payment on 5 yearlease $2,954.29 Disclaimer. Please call to confirm selected sections are compatible. This price quote is good for 60 days from date below, and is I accept this quote. Please process this order. !_a•vx^'^'° _ accurate and complete. Company Name CXT Sales Representative Date Company Representative Date Exterior Color(s) (Forsingle color mark an X For two-tone combinations use W = Walls and R = Roof.) Amber Rose Berry Mauve Buckskin Cappuccino Cream Charcoal Grey Coca Milk Evergreen Georgia Brick Golden Beige Granite Rock R Hunter Green Java Brown Liberty Tan Malibu Taupe Mocha Caramel W Natural Honey Nuss Brown Oatmeal Buff Pueblo Gold Raven Black Rich Earth Rosewood Sage Green Salsa Red Sand Beige Sun Bronze Toasted Almond Western Wheat Special roof color # Special wall color # Special trim color # Rock Color ❑ Basalt ❑ Mountain Blend ❑ Natural Grey Romano Roof Texture ✓❑ Cedar Shake Ribbed Metal Wall Texture(s) (Forsingle color mark an X. For top and bottom textures use T = Top and B = Bottom.) X Bornwood Horizontal Lap Split Face Block Board ii Batt Napa Valley Rock River Rock Stucco/Skip Trowel Brick Flagstone (Textures not included in CXT's quote are additional cost.) Door Opener Non -locking ADA Handle ❑✓ Privacy ADA Latch Pull Handle/Push Plate Deadbolt ❑✓ Accessible Signage ❑✓ Men ❑✓ Women Unisex Toilet Paper Holder F-12-Roll Stainless Steel ❑✓ 3-Roll Stainless Steel Notes: NOTE: CHASE DOOR TO BE LOCATED ON FRONT OF BLDG. cxtinc.com 800.696.5766 aw® �G Inc. an L.B. Foster Company Quote: BH/7/13/23/ReuIler--Cortez Job Name: Calhoun Cty/Port Lavaca TX Scope: • Construct 6" gravel -based pad to CXT spec for CXT Cortez building. • Includes plumbing and electrical utilities in gravel pad to CXT spec. • Gravel based pad constructed on current building grade. • Does not include any subgrade preparation (elevation change, removal of stumps or other underground obstacles, relocation of utilities not related to existing building). • Includes utilities run out to 5' from pad. • Utilities schedule 40 PVC for sewer and copper for water to CXT spec. • Full install must be ordered. • Does not include connecting main utilities to pad utilities. • Includes 1 mobilization and demobilization. • Change orders must be approved with 24 hours if necessary. • Owner must have site ready prior to construction. • CXT not responsible for incidental damage to surrounding landscape. Site Work—Pad/Utility Stub -ups --- $44,842.00 Notes: • Price does not include the following customer responsibilities. • Elevation benchmark must be marked on site prior to construction. • Owner responsible for survey. • Owner responsible for geotechnical services. • Owner responsible for all locates for building. • Owner responsible for any and all permits. • Does not include any retaining walls. • Does not include any tree removal. • Does not include any subgrade work, curbing, or flat work • Does not include any provisions for archeological occurrence. • Main utilities to building must be marked and clearly identified. • Main utilities must meet CXT specifications for CXT Flush building. • Change orders must be approved within 24 business hours. 606 N Pines Rd. Suite 202 Spokane Valley, WA 99206 Phone: 509.921.8766 • Fax: 509.928.8270 Tall Free: 800.663.5789 Email: info@cxlinc.com • w .cxtinc.com CXT Concrete Buildings DELIVERY AND INSTALLATION QUESTIONNAIRE 1. Customer: Calhoun County 2. Your name: David Hall 3. Desired delivery date: Site location: 2506 N Ocean Dr Park Site 2 Title: Commissioner 4. Physical address: 2506 N Ocean Or Port Lavaca, TX 77979 Please provide written directions from the closest town to your job site (maps acceptable). 5. Who will be the representative on site? David Hall Phone M 361+220-1751 NOTE: This person will have the ability to sign for the acceptance of the building as well as authorize any changes onsite. 6. Is there cell phone coverage at the site? ❑✓ YES ❑ NO If NO, how far would we need to travel to get service? The trucks delivering your building can range from 75'to 120' long and can weigh up to 150,000 lbs. They require a 32' wide, firm surface to make a 90 degree turn. Some of the trailers only have 6 to 8 inches of ground clearance so even road camber can cause a problem. These trucks need a 14' wide by 15' tall clear path for travel and even wider clearance at corners. 7. Will your site accommodate the scenario listed above? OYES ❑NO If NO, additional equipment and crane time will be required. Please call for quote. 8. Is it possible that our transport driver will encounter any of the following on our way to the job site or during the installation (including overhead obstacles): ❑ Load limit bridges ❑ Seasonal road restrictions ❑Switchback roads ❑ Low clearance ❑ Steep grade ❑ Rough terrain El Trees or stumps ❑ Power lines ❑ Signs ❑ Fences Please provide detail if any of the above apply. 9. Will the transport equipment be able to access the site in inclement weather (rain, snow, etc.)? ❑✓ YES ❑ NO anernate route to access the site? Page 1 of 4 �u Concrete Buildings DELIVERY AND INSTALLATION QUESTIONNAIRE 10. Due to the weight, the equipment can damage underground utilities in parks. Is there any possibility of this happening? YES �✓ NO PLEASE NOTE: CUSTOMER IS RESPONSIBLE FOR MARKING THE EXACT LOCATION OF THE BUILDING AND A UTILITY LOCATE (CALL BEFORE YOU DIG) MUST BE DONE PRIOR TO OUR ARRIVAL FOR INSTALLATION. If YES, please explain: 11. Does a tractor trailer and a crane have the ability to get within 2 feet of the actual install site? �✓ YES MNO Please reference the site mock ups to determine if either of these two scenarios is acceptable. 12. Is the pad built to or the hole dug to the specifications provided by CXT? YES �✓ NO 13. Has the pad compaction and level been verified by a third party inspection? ❑ YES �✓ NO NOTE: Your building pad is required to be constructed in accordance with the FOUNDATION DETAIL in your drawing packet as well as the CXT CONCRETE BUILDINGS SUBGRADE PREPARATION CHECKLIST. If this is not verified by a certified testing agency, your warranty may be voided. 14. Are the stub ups correct per the drawing for your building? ❑ YES Q NO 15. Willa plumber and/or electrician be on site to adjust the stub ups if they are not correct? ❑ YES �✓ NO It is your responsibility to make sure that water and electricity are available and ready to be connected on the day of the installation and that the stub ups and pad are correct! There is a possibility that damage to your site may occur (sidewalks, grass, curbing, asphalt, underground utilities, etc.). While we do not accept liability for this damage, there may be steps we can take to minimize the potential for this damage (steel plates, gravel ramps, etc.) at an additional cost. • For forest service projects, per FAR 52.236-2, differing site conditions will need to be agreed upon prior to the start of the project. The installer will conduct a safety meeting the morning of the installation. Anyone who plans to be onsite during the installation is required to attend this meeting. :• Any work outside of this scope you will need to negotiate directly with the installer. it is up to their discretion whether or not to accept it! -• IMPORTANT: Additional charges can and/or will be charged to the customer for any out of scope site work including, but not limited to: any of the above listed conditions, temporary off load due to any cause (weather), short trailer transfer, blasting/rock removal, andlarger than normal crane requirements. Please check with CXT if you have any concerns or questions Please visit our website at htto://www.cxtinc.com as it contains information that can be very helpful to you. Page 2 of 4 W a Z Z O P N W D cr Z O J a N Z_ z a } 5 W J W (U W N .N c m L V V .3 L V! u i !0 N V V m Q O Yf 41 d O Ul d CL 4J d f0 •+ a a u v A G! m 0 Lm Qm d Y Q (f� Y d m �L Y 0 N 1� a w cr Q z z O F VI w Z O F g J F N Z 0 Z Q } o: w J w a O O N N N O n . t m Y O m y L] C 7 m to C - a 3 GG V 7/14/23, 8:34 AM Murdock® M-PCS2 Two StaBon Outdoor Round Pedestal Shover 4-41 We use cookies to analyze site traffic, personalize content consent to our use of cookies. m Home > Murdock® M-PCS2 Stainless Steel Two Station Outdoor Round Pedestal Shower advertisements. If you continue to use this site, you 10RE hops://protechonllne.neVmuMackr-m-pcs2-two-station-outdoor-mund-pedestalahowerlgad=l agclld=CIW KCAIw8MOIBhBTEI WAAJ8el s8byN7-Vueha9G4OLISbBcdiSATM2GZIRSEWVIMfvagne3UNMvd... 1/6 7114123, 8:34 AM SKU* SHXMM-PCS2 Murdock® M-PC82 Two SteBon Outdoor Round Pedestal Shower Murdock® M-PCS2 Stainless Steel Two Station Outdoor Round Pedestal Shower This stainless steel, vandal, corrosion -resistant pushbutton, the two -station shower is perfect for a busy pool or the beach. The timing can be adjusted from 5 to 60 seconds to reduce water waste. This unit also has a shut-off valve for easy... We use cookies to analyze site traffic, personalize content and serve targeted advertisements. If you continue to use this site, you consent to our use of cookies. READ MORE OK$7.04lpM MORE ht¢n://pmtechonline.net/murdoekr.m.pcs2-two-sta8onoutdour-round-padesW"hower7gad=lagdid=gwKCAlw5M01BhBTBIwAAJBe1 s8d-yN7-Vu5ha5040L13bBc ISATM2CUIR5e VIMkogne3UNMW... 216 7114123, 8:34 AM MurdockO WPC82 Two Station Outdoor Round Pedestal�Shmer ur ock l^1 SINCE 1853 Style Satin Other Options t-- -- -- - - t Underground Freeze -Resistant Valve for Two Push Buttons+$ ,S 67 ( In -Ground Anchor Plate (Replaces Standard Anchor Plate)+$452.0G X MY t ADD TO CART Pay with livik We use cookies to analyze site traffic, personalize content and serve targeted advertisements. If you continue to use this site, you DETAILS consent to our use of cookies. ^ OK READ MORE This stainless steel, vandal, corrosion -resistant pushbutton, the two -station shower is perfect fora busy pool or beach. The timing can be adjusted from 5 to 60 seconds to reduce water waste. This unit also has a shut-off valve for easy servicing, it is available In a stainless steel satin finish or ____ —A . F/.... n.... 4n ---- I /...s...... -tJ F..:..A.... ..... ......p..bl................... A .........,-14---- ....._ _J_ hdps9/pmtechonllne.neamuMackr-m-pcs2-twostaffonautdoor-mund-pedeste6aho r?gad=1&gclld=CIwKCAlw5M01BhBTEIwAAJ8e1 sBd-yN7-Vu5ha5G40L13bBcdISATM2GzIR5EWIMfmgne3UNMvd... 3/6 # 07 ' NOTICE OF MEETING -- 7/19/2023 7. Consider and take necessary action to extend the feasibility contract with Texas A & M Agri Life to October 31, 2023. There is no additional cost associated with this extension. (RHM) RESULT: ` 'APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 11 • 1: ' N0110E OF MEETING — 7/19/2023 8. Consider and take necessary action to approve the Infrastructure Development Plan for the Marquis Laydown Yard. (VLL) Pass Page 4of11 Vern L Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 July 6, 2023 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary action to approve the Infrastructure Development Plan for the Marquis Laydown Yard. Sincere) n Lyssy VL/Ij i iiim2W9 olP IR @m asWa $m° Ae _^ _m m MARQUIS LAYDOWN YARD MARQUIS INDUSTRIAL SERVICES CALHOUN COUNTY, TEXAS 8 �0 0 W G & W ENGINEERS, INC. • ENGINEERING • SURVEYING • PLANNING 205 W. LIVE OAK STREET, PORT IAVACA, TEXAS 77979 WIS FlRM NO.: 10022100 (561) 552-4505: PORT LAVACA (979) 321-9100: SAY cm PeWT NUNRE FZTFATERPEFPW NUMB159HERE I GPS. ROADWAY REQUE—STOA LATITUDE4LONG1717110E 14WYNAMS '2AP1Z7T4,-9&6757%Z FORTA06PSESIr ,CONTROL 1 0144 si4CTPN 1 03 MAILING AQDFE S' '*tu I m, cffY. STATE: 0 rr�ja 7(7 515 Fl- a& 97 {John ;�4 —70 Is this parcel in current Illga6ri wilkitte Shilp ofroxael 1771 YO 9 No This permit is subject -to lbe,AcresaDrivaway policy described an page tend We following; 1. The undersigned heisbyagrees to comply with the terms and conrillions set fortli h 10 permit for 4pnetiuctop and mairtenance of an access driveway on the state highway right ofway, 2, The Permittee represents thatthe design of the facilities; as shown In the offachad sketch, is In accordance with the Roadway Design Manuel, Hydraulic Design Manuel And set laft, hithe Access Management Manual 3. Construction of the driveway,%haJ be in acdoiclanoO with the ettach6d,design .sketch and Is suNect to hepeollon and approval by the State, 4. Mainterrance.offacilkies cronotrusitec.Nkreunder shall be the responsibility of the permittee, and the State rarrarv69 -ft rtht to reoulreanvolhanaes.ma , hterranceorreirallsasmaybe, I neogsaarV to provide I pro"On of life or property on oradjacentto the 5. The Permittee shall hold harmless the State and Its duly appointed verrt"nd employees against any action for personal hqury-or property damagerelated to the driveway permitted hemnder. 91 7. The State reserves;the right to requieea new access 4dVeW#y permit In'the,evetit of:(!) a metaiial change inland use, driveway traffic volume or vehicle types using Ing the drivewayj br,(II) reconstruction or:orthermoriffication of the highway facility by the State, S. The State mayrevoke this permit Upon vrolagan of any provision of this parm1k by the Peratittee. 9. This permit will become null arid ycjd If ft above -referenced drIrvaway,fAciIWss;kre, not constructed within six, (6) Mariths from the. Issuanrodgle,ofthig permit. 10. The Parmittee will contact the StAlle's representative Jon Aflame telephone, ( 361 ) 552-6131 the work authorized.by this permit. ll. The iequeAng Permittee will be proviledinstructl5fra on the appeal proolas if this permit request Is denied by the Slow. The undersigned honaby.agree0t6 comply Will lhe'term.* d6nditionsastforth in this.permitflor construction and maintenance clan access driveway on thef highway. r1olltotway. Ulstftt t n9ineetuor"I (No Walagalloh) Access Driveway Policy TxD(Y,t briVewayPorinitRegWst CoOtdct' Fora Igcalcontaotfd3 youYTXDOq` Driveway Permit"Request or. variance request, VW;.hdo'!/'wmw.bt &-govtinsid62xd6i/t(strfct.h#ml. Youcan cicknnthe saetan`of the;mep closed dTXXT°effice. You.eanaisadinn he dropdown b.Xfi below the map to find the'dstdetfor`ypur ounty, Other CondlO or s permit, the facility`shali also kre in accordance with the attached sketch andsubject to the Variance DocumBntaticn 4iolifficAtion For a Variance req uast please indicate which of the below are applicable, as raquired by TAC g i 1.62(e): ❑a srgnmcam negauve rrt,paai w-ure uwna, ar."•�-•. •- ._._�___ _,_.__.._.. including fhe loss of reasonable access to the, pmpetty or obdue hardahipon a business loeafed. on the property. an unusual condltlon.aifectng the property esdats thatwas not caused by the prapetty owmePand lustbies the request fortha. variance. For the conditions seieeted above; For MOT use below. --_----,.. —. — .,-=x.�- .a ...—em--------------------------------------- For Variance denials; please Indicate which of tha below gondition% as proutled in TAC-, Iy1 `,52(a)i wale determined: adverseiyaffedt esafety;desigrbcon*Lidon,mobiltyeMeentop otjonormatotarwnaeofthahghway;or likely Impairthe abitty ofthe stateor the depadoord,to receive fonds for bighway, construction o�malnienancefrom the federal government Attachments: sketch of installation AI I Variance Doctime0tatl0h �, MI . « In.<mi wi.na mnd SIMMAOlIdWl SVX3t b0VAVllifOd h711L300N1 SMI)I W wr. 3$1 y(.t - _ y a meaaas+uo! ®rsu nea/sd d11fti°"A .�..w.:e •a...w:i e...,m.:,:....r �3 +' 1% 4 1F3 �6gkg 91' 11a1� lay ("'J �� k ��•{g��&�. s) y� IW n45 a r iN 1 � I 1w5�kffi'. Ixl .I N r �I gS III I I I � �YY j>ig :p 1 ♦ Y' W to W. R 1 i R I h I , 77 �I k r �� Y W ' ti�fJ$ ., `',H t?y.'�t� A •"".tl, if# �.' � P F l�:%4y { �E tk "Sqr • -iv T �� 'F, �y g§ * 4 j �I @gm �i} G W J�, I i s h i (� Y w� {e W.'. a n. oo, w+, n . m ,m, aanwiNOO hMd 51N3w3AOsdw1 SVDVA1N3 VX3;L tlOYAtl'112lOd 1N3wdO1aA3a t 35VHdw. 1vtaasnc sjnmvw +^f y S� Cf �6I�x � * Q.. -' F §§ 3 7 a€ € 8. a AT 0 dR ; ; g 01111 n , i N� ' '��'• I��gF�°j ggyy ggpp ryry n 71 ttY .. .? 'AID ,\ `A Yk W r K. a r g Lul JA � � •v P NMWiaiOU, ' J '. �t.X k �,r(Cyyr�(t4 z ) e t )" 1 �L` J .r,,<•�„. �-��.1'i"` �,,. -1. un -T �'?-�tF2� ih^., i��yat�� r 4��' '�? . _ V6.� '>.Z.y,Si� �x`�.L j'�'i'� o'dk{'�Y' C,i "i"C z7��y'7y�� 3 kk �5"x 7 �A� 5'�^ X a." �Y++% M 5'. ,,,,y'�{.i"•"f1{ Es`�''''`?!t X( 'fa . C; .p f R1�3 ` 1{� `cV'p�L'i'nu a{C^,•-+Y a 5 k lj,E q"`hh[r,,�7 "-�, y j i reY 7� t.{y� u`6°% J ka'W ��"t` ':h `�•J1(,`^ $ ' t '{ ?Y t yr y fi, . F ,., " '^;'•� `` ik ys-nor , ,, ry 'mo .e Iwaemm u+a T�a➢tt�tut u,.0 wfx c�wwn y39b'NI- 'JNIISIX3 surd bavAVIclod 1NSMMAW L 3SVHd 7VIil1S(ibNI SIfIbwW: gg �,�`�yv'\k it ' c �� &� � � 8 ere. .v va mean wa mrsx vw mn. oat ara.,..ess .. n a cna+n su. e n N,u M' i �� 'III �!� I. ``• I to :. U) 61 i_�- - -- -�;_ .I w t »1 i i ZP S I 5 I �y \ \ ZS xwv wuaanrey - o n oX�i f 1 r v wry au.w,w¢ nm¢ ys mr we. laVY 3eaMvj8a rnaeam w3 o3ms F/f /m .a'axNw¢I ¢ nu �+a:+awn .ae v xm .�n v mi a35odottd :xwm ma osutuvna ¢wmmw SV%3t'l¢'JY 1VINod 1N3W4013A3a L 39VHd o ivlaisnaw wn NW. " ¢vo Nib 1 „ti, Ate: , µf _ Vkhill\ F ka e I I L I > vh y X y 1 CL II o a \ 1 ¢�ea�.v > ti °ry # 09 NOTICE OF MEETING - 7/19/2023 9. Consider and take necessary action to approve the Rental Agreement with Anderson Machine Company for a Bomag BW 151AD-5 double drum roller and authorize Commissioner Reese to sign all documentation. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 11 Gary D. Reese County Commissioner County of Calhoun Precinct 4 July 11, 2023 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 July 19, 2023. Consider and take necessary action to approve Rental Agreement for a Bomag BW 151AD-5 double drum roller and authorize Commissioner Reese to sign documentation. Sincerely, T Z' Gary D. Reese GDR/at P.O. Box 177 —Seadrift. Texas 77983 —email: eam.reese it calhouncoec.ore — (361) 785-3141 —Fax (361) 785-5602 LEASE & RENTAL AGREEMENT Lessee: Calhoun Co Pct.4 Salesman: 530 Address: P.O. Box 177 Seadrift, Tx 77983 Description Equipment # Bomag BW 151AD-5 double drum roller 3444 Serial # 101921011015 Start Date: 7-13.23 Hour Meter: '1750.0 Equipment Value $ 135,000.00 Guaranteed Term: Month Purchase Order $0 Single shift base rate per month $ 3,600.00 Gary Insurance Subtotal Customer Provided $ 3,600.00 Estimated Delivery & Pickup X Lessor Lessee Charges 5325 each v+ay HET 0.1889% TERP 1.50 $ 6.80 Jobsite Location Sales Tax 825% Malson Rd Port Lavaca, Tx Total due per month $ 3,606.80 Fuel: Unit will be furnished with a full tank of fuel on delivery Lessee agrees to returnthe unit with a full tank or reimburse the Lessor for the cost of filling the fuel. tank. Any unit that requires der fluid will be handled the same way as fuel Repair : Lessee agrees to pay repair cost except normal wear. Lessee also agrees to pay for high wear items like cutting edges, teeth, tires, hammer points and undercarriage (tires andundercarriage will prorated) Lessee agrees that the time required to complete rapairs to the above described equipment after return from rental, whether necessitated by physical damage and covered by Lessee's insurance or resulting from repairs, required as a damage beyond normal wear. will be billed at 50 % of the appropriate single shift base rate above and Lessee agrees to pay the charges therefor Non -Waiver : Time is of the essence Lessor's failure at any fine torequire strict performance by Lessee of any of the provisions laical shall not waive or diminish Lessorsright thereafter to demand strict compliance therewith or with any other provision Waiver of any default shall not waive any other default. No remedy of Lessor hereunder shall be exclusive of any other remedy herein or by law provided. but each shall be cumulative andin addition to every other remedy. Send all payments to: 5309 US Hwy 59 N -Victoria -TX - 77905 All conditka s`on) is contract and attached "Terms and Conditions" are accepted by: Anderson Machin(4Oom'pany Lessee: Calhoun Co Pct.4 Nai9 Mmne Title: Date. 7 Title: 1I`1yt(.71r1� Date: (Not valid unless sipnej byah officer of Anderson Machinery Company) CERTIFICATE OF INTERESTED PARTIES FORM 1295 1011 Complete Nos. 1-4 and ON mere are Interested parties. OFFICE USE ONLY Complete Net. 1, 2, 3, 5, and a If mere are no Interested parries. CERTIFICATION OF FILING Certificate Number; 1 Name of business entity filing form, and the city, state and country of the business entlty's place of business. 2023-1045027 Anderson Machinery Company Victoria, TX United States Date Filed: 07/12/2023 2 Name of governmental entry or state agency that isa party tothe contract for whit a arms being flied. Calhoun Cc Precinct 4 Data Acknowledged: 3 Provide the identification number used by the governments! entity or stem agency to track or Identity the conrmot, and provide a description of the services, goods, or other property to be provided under the contract. 1 Rental of double drum roller. 4 Name of interested Parry City, Stem, Country (place of business) Natumaflnterest (check applicable) Controlling Intermediary Anderson Machinery Company Victoria, TX United States X 5 Check only Mom to NO interested Parry. a UNSWORN DECLARATION v My name is vOa 1"�iv at . and my dale of birth Is��c.s, My address is (street) r (DAY) (stele) (zip coda) ("Amoy) I declare under penally of perjury mat the tamping Is two and correct. Executed In �tG^CO �'. w County, State of onme ��►► ��14q J_.dayol 20grZ. � (Y—) r_—_ Signaturoof unto zedagen[ (Der a son) anus ngbuslness entity Forms provided by Texas Ethics Commission www.ethlcs.state.ot.uA,,/ Version V3.5.1.alSea2ca TERMS AND CONDITIONS OF RENTAL CONTRACT— ANDERSON MACHINERY COMPANY LESSEE ACKNOWLEDGESTHAT A LARGE -PRINT VERSION OF THESE TERMS AND CONDITIONS HAS BEEN MADE AVAILABLE TO LESSEE Copyright ® EquipmentRentalContracts.com. (866) 582-2586. All rights reserved. Unauthorized reproduction and/or distribution expressly prohibited. For good and valuable consideration, you and Anderson Machinery Company, a Texas corporation (also referred to herein as, "AMC," "Lessor," "we," "us" and "our") agree as follows:1. As used herein, "P.1" refers to the first page or "face" of this Contract; "Contract" refers to PA together with these Terms and Conditions of Rental Contract; "Rented Item sl" or "Item(sl" means the item(s) rented to you, as identified on PA (including any "Instructions" and/or safety devices provided per the terms of Section (or "§") 3 below); "Site" means the delivery or use address set forth on P.1; and "Customer," "Lessee," "you" and "your' mean the "Customer, "Renter' or "Lessee" Identified on P.1. 2. You agree to: (a) rent from AMC the Rented Item(s) for the periad(s) specified on P.1 (the "Term"); (b) fully and timely pay us as and when due the rental rates) set forth on P.1 (the "Rent"), together with all other charges accruing hereunder, without proration, reduction or setoff; and (c) remaln liable for all loss of and/or damage to and/or caused by the Rented Item(sl for the entire Term and until all such Rented Item(s) Is/are returned to and accepted by AMC in the proper return condition per § 10. Unless otherwise agreed in writing by AMC, all Rental rates are charged for normal use of the Rented Item(s), not exceeding 8 hours per 24-hour period for which Rent is charged hereunder (each, a "Rental Day"), 40 hours per 7-Rental Day period, 160 hours per 28-Rental Day period (zero hours for all uncharged -for periods) in accordance with the terms of this Contract. Additional Rent will be charged as provided in § 10 for late returns and overuse. You will not be entitled to any cancellation right or reduction of Rent or other amounts coming due hereunder in order to account for time in transit, Act(s) of God, event(s) of force majeure or any other periods) of unavailability or nonuse of any Rented Item(s). We have estimated the Rent based on your estimate of the length of the Term (the "Estimated Rent"). Unless otherwise specified on P.1, you: (a) will pay us: (I) any and all deposit(s) as well as the Estimated Rent specified on PA in advance OR at the time of delivery, (as requested by AMC), (the "Prepayment"); and (it) all other amounts coming due hereunder on Net 30 terms; and fb) agree that: (i) we may deduct any amount you owe us from any Prepayment; (11) no Interest will accrue on any Prepayment; (iii) no Prepayment will be deemed a limit of your liability under or in connection with this Contract; and (Iv) all Prepayments are NON-REFUNDABLE except only as provided In § S. Anything remaining with, in or on any Item(s) upon return to AMC will be deemed surrendered and abandoned. 3. Upon the earlier of your receipt, or our delivery to the Site, of the Rented Items) unless you immediately reject it/them, you represent, warrant, acknowledge and agree that: (a) each Item: (1) is complete and in good order, condition and repair; (li) is appropriate for your purposes and In all ways acceptable to you; and Jill) was selected (not based on any recommendation by AMC), carefully examined and tested by you or your agent(s); and (b) you: it) have carefully reviewed and understand all applicable laws, rules, regulations, standards, training, Instructions, manuals and other Information, if any, Including all applicable EPA, OSHA, MSHA, ASME, IBC, IFC, IEEE, UL, ASSE, DOT, FMCSA, ANSI, NCCCO and other standards, Including state and local equivalents (collectively, "Instructions"); (n) will fully and timely comply therewith (including Tier 4, Silica Dust, ELD, Licensing (Including Hoisting Ucensure), Cleaning and Disinfection requirements); (III) have been made aware of the need to use all applicable personal protective equipment (Including RESPIRATORY and FALL PROTECTION devices); (iv) will use each Item only for Its Intended purpose, in a reasonable and safe manner; (v) will timely give all applicable notice(s) to, and obtain all applicable licenses, authorizations, permits and approvals from, all affected parties, including governmental authorities, utilities, cable companies and the owners) of the Site, and ensure that all underground lines, cables and candults are clearly and properly marked before using any Item(s) to dig or disturb the ground surface (call 811 and go to www.Texas811.org at least 3, but not more than 14, full business days In advance); (A) will Immediately cease using any Item that Is damaged, breaks down, or proves defective (a "Malfunction"); and (vii) will ensure that all others comply with this Contract at all times. You agree to immediately notify: (A) the local police and AMC In the event of any theft or accident Involving any Rented Itemfs); and (8) AMC if any of the other requirements of this Section shall prove incorrect. 4. Except with respect to Rented Items which we rent from one or more third parties (each, a "TPO") and then re -rent to you ("re -rented items"), AMC owns and will retain title to all Rented Items at all times. You will have exclusive control over the use of the Rented Items) during the Term, subject however, to your duty to fully and timely comply with this Contract at all times. You SHALL NOT: ja) permit the taking or existence of any lien, claim, security interest or encumbrance on any Rented Item(s); jb) have any title or ownership Interest In or with respect to any Rented Item(s); or (c) loan, transfer, sublease, re -rent, surrender, store, sell, encumber, assign or dispose of any Items) or this Contract, without our prior written consent (in our sole discretion). We may sell and/or assign all or any part of our Interests in such Item(s) and/or this Contract, In which event, you will attorn to the assignee, who will not be responsible for any pre-existing obligations or liabilities of AMC or any TPO. S. In the event of a Malfunction as defined in § 3, you will immediately notify, and return the Malfunctioning Item to, AMC, and provided such Malfunction did not result from or in connection with any wrongful or negligent act or omission of, or any breach of any provision of this Contract by, you or anyone you permit to use or deal with such Item(s), we may, at our option: is) repair such Item; (b) provide you with a comparable Item; or (c) solely with respect to the Malfunctioning Item, return the unused portion of the Rent and cancel this Contract. The foregoing remedies are EXCLUSIVE. We will have no other obligationjs) with respect to Malfunctions, all of which you waive, together with all associated direct and indirect liabilities, losses, clalms and damages. 6. WARNINGS: THE RENTED ITEM(S) CAN BE DANGEROUS, AND SHOULD BE TRANSPORTED, SERVICED, MAINTAINED, REPAIRED AND USED WITH EXTREME CARE, ONLY FOR ITS/THEIR INTENDED PURPOSE(S), AND ONLY BY COMPETENT, PROPERLY TRAINED, FAMILIARIZED, QUALIFIED, CERTIFIED, SUPERVISED, INSTRUCTED, AND IF APPLICABLE, LICENSED, ADULTS. YOU AGREE TO PROVIDE ALL APPLICABLE TRAINING, FAMILIARIZATION, INSTRUCTIONS AND WARNINGS TO ALL USERS, OPERATORS AND OCCUPANTS OF THE RENTED ITEM(5), and ensure that each Item is used reasonably, safely and only: (a) for Its Intended purpose(s); (b) within Its rated capacity; (c) unless otherwise specifically agreed by AMC on a case -by -case basis, at the Site; (d) by adults who satisfy the above requirements; and (e) otherwise in full compliance with this Contract, at all times. 7. You shall ensure the Site is reasonably clean, safe, secure and otherwise fit for delivery and use of the Rented Items) at all times without modification by AMC. If we agree to provide any services) (including without limitation, delivery, setup and/or retrieval), you agree to: (a) pay our regular charge(s) therefor, and for all waiting time; (b) be present at the Site at the agreed time(s); and jc) ensure our personnel have full access to the Site. We will not he responsible for any delayfs) caused by other parties, including providers of other equipment or services ("Other Providers") for which you agree to indemnify, defend and hold harmless AMC. If you are not present upon delivery or retrieval of any Itemf s), you agree to accept the statements of our representatives regarding the same (Including status, condition, quality, utility and quantities of the Item(s) and the Site). 8. NO WARRANTIES: AMC IS NOT THE MANUFACTURER OR DESIGNER OF ANY OF THE ITEMS, all of which are provided "AS -IS". AMC MAKES NO WARRANTY(IES), EXPRESS OR IMPLIED (INCLUDING ANY WARRANTY(IES) OF MERCHANTABILITY, SUITABILITY, FITNESS FOR A PARTICULAR PURPOSE, FUNCTION, DESIGN, QUALITY, CAPACITY, FREEDOM FROM DEFECTS AND/OR CONTAMINATION, GOOD AND WORKMANLIKE PERFORMANCE, AND ANY WARRANTY(IES) ARISING FROM ANY COURSE OF DEALING, COURSE OF PERFORMANCE AND/OR USAGE OF TRADE) regarding any Item(s) or Service(s) referenced In this Contract, nor does AMC make any warranty(ies) against INTERFERENCE OR INFRINGEMENT, all of which you waive. No depictions, models, descriptions, specifications, recommendations or advertisements made or received by AMC constitute representations or warranties by AMC or any TPO. 9. INDEMNITY: TO THE MAXIMUM EXTENT PERMITTED UNDER APPLICABLE LAW, YOU HEREBY: (A) ASSUME ALL RISK OF PERSONAL AND BODILY INJURY, ILLNESS, PRODUCTS LIABILITY, LOSS, THEFT, DAMAGE AND CONTAMINATION OF, TO, AND/OR ARISING IN CONNECTION WITH, THE ITEM(S) AND/OR SERVICE(S) REFERENCED IN THIS CONTRACT, INCLUDING WITHOUT LIMITATION, ALL LIABILITIES, CLAIMS AND DAMAGES ARISING IN CONNECTION WITH THE SELECTION, PROVISION, INSPECTION, DESIGN, MANUFACTURE, USE, LOADING, UNLOADING, TRANSPORTATION, DEMONSTRATION, STORAGE, CLEANING, CONTAMINATION, DISINFECTION, SERVICING, MAINTENANCE, REPAIR, DELIVERY AND/OR RETRIEVAL THEREOF (COLLECTIVELY, "RISKS"); (B) RELEASE AND DISCHARGE, AND AGREE TO INDEMNIFY, DEFEND AND HOLD HARMLESS, ANDERSON MACHINERY COMPANY, each TPO, their respective parents, partners, suppliers, affiliates and subsidiaries, and their respective owners, shareholders, members, managers, officers, directors, agents, employees, Insurers, representatives, subrogees, successors and assigns (each, an "Indemnitee" and collectively, the "Indemnitees"), for, from and against all such RISKS (Including without limitation, attorneys' fees) as well as any breach of this Contract by you, your agents, employees, contractors and/or invitees; and except only as provided in § S. (C) WAIVE all rights, remedies, claims, damages and defenses available under the Uniform Commercial Code, as well as all direct, indirect, Incidental, consequential, general, special, exemplary and punitive damages, against the Indemnitees (and each of them). 10. You agree to protect, properly service, maintain and care for each Rented Item at all times, keep itsafely and securely stored and locked when not In use, and return It to AMC on time at the and of the Term, complete (including all attachments), clean, free of contamination (Including without limitation, silica, beryllium, asbestos and pathogens), in good order, condition and repair, properly serviced and meIntalned, and if applicable, full of the proper fuel, fluids and lubricants. If you fall to do so, then in addition to the amounts set forth on P.1, you will pay us: (a) Rent at our highest incremental rate for each succeeding full rental period until all Item(s) have been returned or replaced as required; and (b) all costs and expenses we incur in connection with such failure. You shall not, nor shall you permit anyone else to: (1) use any Rented Item while under the influence of any intoxicants) (Including without limitation, CANNABIS AND ALCOHOL), abuse, misuse, overuse, conceal, store with any third party, repair, modify or damage any Rented Item(s); (II) violate any Instruction, Insurance policy or warranty; fill) expose any Rented Item(s) to any flammable, explosive, harmful or hazardous substance(s) or circumstance(s); (N) disable, misuse or circumvent any safety equipment or device(s) In, on or with any Rented Item(s); Ivl take possession of or exercise control over any Rented Item(s), without our prior consent (in our sole and absolute discretion); or (vi) place or store In any Rented Items) (including trailers) any contraband. IL You agree to maintain all insurance we may require, Including without limitation: (a) liability insurance with minimum limits of $1,000,000 per occurrence; (b) workers' compensation and employers liability Insurance; (c) property damage/inland marine Insurance covering all Items for the full (new) replacement cost thereof; and (d) hired auto liability and physical damage Insurance, and with respect to each, whenever possible: (i) covering submerging, overturning and overloading; (ii) naming AMC as an additional Insured and loss payee; (iii) waiving subrogation against AMC; IN) being primary and non-contributory; and (v) including such other provisions (including deductibles) as AMC may require. You irrevocably appoint Anderson Machinery Company as your agent and attorney -in -fact for purposes of submitting, negotiating and settling claims on all such policies. 12. Your Rental shall be deemed a "net" rental. Accordingly, your obligations hereunder are unconditional and are not subject to reduction, setoff, abatement or counterclaim for any reason. If you or any guarantor shall: (a) fall to fully and timely honor, pay, perform or comply with this Contract, any other agreement(s) ("Other Contract(s)") between you and any Indemnitee, and/or any of your obligations arising (t)hereunder or In connection (t)herewith; (b) provide any Incorrect or misleading information to us; (c) become insolvent or bankrupt, or (d) die or cease conducting business; If AMC reasonably deems Itself Insecure; or If any Rented Item(s) shall be lost or damaged, you will be in DEFAULT under this Contract and at the option of AMC, under such Other Contract(s), whereupon, AMC may with or without legal process or notice (and without liability to you), to the maximum extent permitted under applicable law: (1) cancel the Term and/or the subject Contractjs) (and/or your rights to use and possess the Rented Item(s)); (11) seek rellef from stay; (1111 recover, empty, lock, restrict, shut down, disassemble and/or disable any one or more of such Item(s) without being guilty of breach, trespass or wrongful Interference, or liable for any injuries or property damage (for which you agree to indemnify, defend and hold harmless each Indemnitee); (Iv) perform your obligations (tlhereunder on your behalf, without being obligated to do so; (v) purchase replacement Item(s); (vi) recover from you and/or any guarantors) our associated direct and Indirect damages, losses, costs and expenses (including without limitation, Rent for the entire scheduled Term, overtime, loss of use, interest, attorneys' fees, court costs, retrieval/repossession costs, and collection costs); and/or (vli) pursue any one or more other rights and/or remedies available (t)hemunder, at law and/or in equity, all of which are and shall remain cumulative and unimpaired. 13. This Contract shall be governed by and enforceable under the laws of Texas. Disputes arising under and/or in connection with this Contract and/or its subject matter, shall, at the sole option of AMC, be submitted to binding ARBITRATION in accordance with the Commercial Arbitration Rules of the American Arbitration Association at Its officals) located nearest to AMCs principal place of business before a single arbitrator selected by AMC. Judgment on the arbitrators award shall be final and binding on the parties hereto and may be entered in any court of competent jurisdiction. Proper venue for all other civil legal actions commenced in connection herewith shall lie exclusively In the federal, state and local courts located In or nearest to the AMC location from which you obtained) the applicable Item(s) (unless waived by AMC). You consent and submit thereto and waive all claims that such venue Iles In an inconvenient forum. EACH PARTY VOLUNTARILY WAIVES ITS RIGHTS TO: (A) PARTICIPATE IN ANY JOINT, COLLECTIVE OR CLASS ACTION AGAINST THE OTHER PARTY HERETO; AND (8) TRIAL BY JURY. 14. This Contract, and any addenda(umI we provide, each of which is Incorporated herein, represent(s) the entire agreement between you and AMC, superseding all other agreements and representations (including our webslte and advertising). The terms of this Contract are severable.. if any provision hereof shall be deemed invalid or unenforceable by any court or arbltral body of competent jurisdiction, such provision will be deleted, and the remainder of this Contract will remain valid and enforceable. This Contract cannot otherwise be amended or extended except in a writing signed by AMC. Time is of the essence. These Terms and Conditions apply to the Item(s) Identified on P.1 and to all other Items you obtain from us at any time (except only as we may otherwise agree in writing). This Contract: (a) constitutes an operating lease, and not financing; (b) is fair and reasonable, and (c) shall bind and be enforceable by you, Anderson Machinery Company, the other Indemnitees, and such parties' respective insurers, sub rogees, successors and permitted assigns (there being no other third -party beneficiaries hereto). You agree to pay all sales, use and other taxes (Including without limitation, all Texas Emissions Reduction Plan and Dealers Heavy Equipment Special Inventory taxes), as well as all tolls, fines, fees, duties, assessments and other charges related to the Rented Item(s) and/or this Contract. In the event legal action Is commenced in connection herewith, we will be entitled to recover our costs and expenses associated therewith (including without limitation, our attorneys' fees and expenses) from you if we prevail. Neither our exercise, nor our failure or delay in the exercise, of any rights or remedies available in connection herewith will constitute an election of remedies or a waiver of any of our rights or remedies. To the maximum extent permitted under applicable law, you grant to AMC: (1) a lien on all real and personal property: (A) placed In or on; and/or (8) Improved with, any Rented Item(s); and (11) the right to claim on any bond provided in connection therewith. We may, without notice or liability to you, monitor and/or inspect (in person and/or electronically, including via GPS and/ortelematics) any Rented Item(s) at any time. You consent thereto and agree that all information thereby obtained wl11 be our property. If any performance required of us is delayed or impaired as a result of any act or omission of/by you, any Other Providerls) or any "Act of God" event of force majeure (Including without limitation, war, fire, good, wind, storm, earthquake, civil insurrection, riot, act of terrorism, power surge or intermption, epidemic, pandemic and/or governmental or regulatory action or mandate), or other facts or circumstances beyond our reasonable control, we will be excused from such performance. All amounts due to AMC hereunder but not timely paid will bear interest at the lesser of: (a) 28%per annum; or (b) the highest rate permitted under applicable law until paid. You authonte us to charge all amounts due and coming due hereunder to any debit and/or credit card(s) you provide. You agree to pay us the maximum lawful charge for any check you write which is returned unpaid. Our maximum liability in connection with this Contract is limited to the amounts) actually paid by you hereunder. Digital, electronic, photocopied and facsimiled signatures appearing on this Contract and/or any Addenda(um) we provide will be deemed originals. 15. Any item(s) sold to you ("Sale Items"), as provided on PA are provided "AS -IS" and are subject to the terms of this Contract (modified to address sales), except that § 5 shall not entitle you to return any Sale Item(s). All Item(s) not specifically Identified as Sale Items on P.1 will be deemed to be "Rented Item(s)". 16. WARNING: Wrongfully obtaining or withholding property and/or services of another which are available only for compensation may be deemed THEFT, resulting In CIVIL LIABILITY and/or CRIMINAL PROSECUTION. See Tens Penal Code § 31.04, at seq. and Its/their successar(s) for details. Page 2-1 Copyright ® EquipmentRentalContracts.com, I.I.C. (866) 582-2586. All rights reserved. Unauthorized reproduction and/or distribution expressly prohibited. TERMS AND CONDITIONS OF RENTAL CONTRACT (Enlarged Version) For good and valuable consideration, you and Anderson Machinery Company, a Texas corporation (also referred to herein as, "AMC," "Lessor," "we," "us" and "our') agree as follows:1. As used herein, "P.1" refers to the first page or "face" of this Contract; "Contract" refers to P.1 together with these Terms and Conditions of Rental Contract; "Rented Item(s)" or "Item(s)" means the item(s) rented to you, as identified on PA (including any "Instructions" and/or safety devices provided per the terms of Section [or "§"j 3 below); "Site" means the delivery or use address set forth on P.1; and "Customer," "Lessee," "you" and "your' mean the "Customer," "Renter" or "Lessee" identified on P.1. 2. You agree to: (a) rent from AMC the Rented Item(s) for the periods) specified on P.1 (the "Term"); (b) fully and timely pay us as and when due the rental rate(s) set forth on P.1 (the "Rent"), together with all other charges accruing hereunder, without proration, reduction or setoff; and (c) remain liable for all loss of and/or damage to and/or caused by the Rented Item(s) for the entire Term and until all such Rented Items) is/are returned to and accepted by AMC In the proper return condition per § 10. Unless otherwise agreed in writing by AMC, all Rental rates are charged for normal use of the Rented Item(s), not exceeding 8 hours per 24-hour period for which Rent is charged hereunder [each, a "Rental Day"], 40 hours per 7-Rental Day period, 160 hours per 28-Rental Day period (zero hours for all uncharged -for periods) in accordance with the terms of this Contract. Additional Rent will be charged as provided in 110 for late returns and overuse. You will not be entitled to any cancellation right or reduction of Rent or other amounts coming due hereunder in order to account for time in transit, Act(s) of God, event(sl of force majeure or any other period(s) of unavailability or nonuse of any Rented Item(s). We have estimated the Rent based on your estimate of the length of the Term (the "Estimated Rent"). Unless otherwise specified on P.1, you: (a) will pay us: (I) any and all deposit(s) as well as the Estimated Rent specified on P.1 in advance OR at the time of delivery, (as requested by AMC), (the "Prepayment"); and (li) all other amounts coming due hereunder on Net 30 terms; and (b) agree that: (i) we may deduct any amount you owe us from any Prepayment; (it) no interest will accrue on any Prepayment; (III) no Prepayment will be deemed a limit of your liability under or in connection with this Contract; and IN) all Prepayments are NON-REFUNDABLE except only as provided In § S. Anything remaining with, in or on any Item(s) upon return to AMC will be deemed surrendered and abandoned. 3. Upon the earlier of your receipt, or our delivery to the Site, of the Rented Item(s) unless you immediately reject It/them, you represent, warrant, acknowledge and agree that: (a) each Item: (i) is complete and in good order, condition and repair; (it) is appropriate for your purposes and in all ways acceptable to you; and (III) was selected (not based on any recommendation by AMC), carefully examined and tested by you or your agent(s); and (b) you: (1) have carefully reviewed and understand all appliable laws, rules, regulations, standards, training, Instructions, manuals and other Information, If any, including all applicable EPA, OSHA, MSHA, ASME, IBC, IFC, IEEE, UL, ASSE, DOT, FMCSA, ANSI, NCCCO and other standards, Including state and local equivalents (collectively, "Instructions"); (ii) will fully and timely comply therewith (Including Tier 4, Silica Dust, ELD, Licensing (including Hoisting Licensure), Cleaning and Disinfection requirements); (III) have been made aware of the need to use all applicable personal protective equipment (including RESPIRATORY and FALL PROTECTION devices); (iv) will use each Item only for its intended purpose, in a reasonable and safe manner; (v) will timely give all applicable notice(s) to, and obtain all applicable licenses, authorizations, permits and approvals from, all affected parties, Including governmental authorities, utilities, cable companies and the owner(s) of the Site, and ensure that all underground lines, cables and conduits are clearly and properly marked before using any Items) to dig or disturb the ground surface (all 811 and go to www.Texas831.orgat least 3, but not more than 14, full business days In advance); (vl) will Immediately cease using any Item that is damaged, breaks down, or proves defective (a "Malfunction"); and (vil) will ensure that all others comply with this Contract at all times. You agree to immediately notify: (A) the local police and AMC in the event of any theft or accident involving any Rented Item(s); and (8) AMC if any of the other requirements of this Section shall prove Incorrect. 4. Except with respect to Rented Items which we rent from one or more third parties (each, a "TPO") and then re -rent to you ("re -rented items"), AMC owns and will retain title to all Rented Items at all times. You will Page 2-2 Copyright ® EqulpmentRentalContracts.com, I.I.C. (866) 582-2586. All rights reserved. Unauthorized reproduction and/or distribution expressly prohibited. have exclusive control over the use of the Rented Item(s) during the Term, subject however, to your duty to fully and timely comply with this Contract at all times. You SHALL NOT: (a) permit the taking or existence of any lien, claim, security interest or encumbrance on any Rented Item(s); (b) have any tide or ownership Interest in or with respect to any Rented Item(s); or (c) loan, transfer, sublease, re -rent, surrender, store, sell, encumber, assign or dispose of any Item(s) or this Contract, without our prior written consent (in our sole discretion). We may sell and/or assign all or any part of our interests in such Item(s) and/or this Contract, In which event, you will attom to the assignee, who will not be responsible for any pre-existing obligations or liabilities of AMC or any TPO. S. In the event of a Malfunction as defined In § 3, you will Immediately notify, and return the Malfunctioning Item to, AMC, and provided such Malfunction did not result from or In connection with any wrongful or negligent act or omisslon of, or any breach of any provision of this Contract by, you or anyone you permit to use or deal with such Item(s), we may, at our option: (a) repair such Item; (b) provide you with a comparable Item; or (c) solely with respect to the Malfunctioning Item, return the unused portion of the Rent and cancel this Contract. The foregoing remedies are EXCLUSIVE. We will have no other obligation(s) with respect to Malfunctions, all of which youwaive, together with all associated direct and Indirect liabilities, losses, claims and damages. 6. WARNINGS: THE RENTED ITEM(S) CAN BE DANGEROUS, AND SHOULD BE TRANSPORTED, SERVICED, MAINTAINED, REPAIRED AND USED WITH EXTREME CARE, ONLY FOR ITS/THEIR INTENDED PURPOSE(S), AND ONLY BY COMPETENT, PROPERLY TRAINED, FAMILIARIZED, QUALIFIED, CERTIFIED, SUPERVISED, INSTRUCTED, AND IF APPLICABLE, LICENSED, ADULTS. YOU AGREE TO PROVIDE ALL APPLICABLE TRAI NING, FAMILIARIZATION, INSTRUCTIONS AND WARNINGS TO ALL USERS, OPERATORS AND OCCUPANTS OF THE RENTED ITEM IS), and ensure that each Item Is used reasonably, safely and only: la) for its intended purpose(s); (b) within Its rated capacity; (c) unless otherwise specifically agreed by AMC on a case -by -case basis, at the Site; (d) by adults who satisfy the above requirements; and (a) otherwise 1n full compliance with this Contract, at all times. 7. You shall ensure the Site is reasonably clean, safe, secure and otherwise fit for delivery and use of the Rented Items) at all times without modification by AMC. if we agree to provide any services) (including without limitation, delivery, setup and/or retrieval), you agree to: (a) pay our regular charge(s) therefor, and for all waiting time, (b) be present at the Site at the agreed time(s); and (c) ensure our personnel have full access to the Site. We will not be responsible for any delay(s) caused by other parties, Including providers of other equipment or services ("Other Providers") for which you agree to indemnify, defend and hold harmless AMC. If you are not present upon delivery or retrieval of any Item(s), you agree to accept the statements of our representatives regarding the same (including status, condition, quality, utility and quantities of the Item(s) and the Site). 8. NO WARRANTIES: AMC 15 NOT THE MANUFACTURER OR DESIGNER OF ANY OF THE ITEMS, all of which are provided "AS -IS". AMC MAKES NO WARRANTY(IES), EXPRESS OR IMPLIED (INCLUDING ANY WARRANTY(IES) OF MERCHANTABILITY, SUITABILITY, FITNESS FOR A PARTICULAR PURPOSE, FUNCNON, DESIGN, QUALITY, CAPACITY, FREEDOM FROM DEFECTS AND/OR CONTAMINATION, GOOD AND WORKMANLIKE PERFORMANCE, AND ANY WARRANTY(IES) ARISING FROM ANY COURSE OF DEALING, COURSE OF PERFORMANCE AND/OR USAGE OF TRADE) regarding any Item(s) or Service(s) referenced in this Contract, nor does AMC make any warranty(les) against INTERFERENCE OR INFRINGEMENT, all of which you waive. No depictions, models, descriptions, specifications, recommendations or advertisements made or received by AMC constitute representations or warranties by AMC or any TPO. 9. INDEMNITY: TO THE MAXIMUM EXTENT PERMITTED UNDER APPLICABLE LAW, YOU HEREBY: (A) ASSUME ALL RISK OF PERSONAL AND BODILY INJURY, ILLNESS, PRODUCTS LIABILITY, LOSS, THEFT, DAMAGE AND CONTAMINATION OF, TO, AND/OR ARISING IN CONNECTION WITH, THE ITEM(S) AND/OR SERVICE(S) REFERENCED IN THIS CONTRACT, INCLUDING WITHOUT LIMITATION, ALL LIABILITIES, CLAIMS AND DAMAGES ARISING IN CONNECTION WITH THE SELECTION, PROVISION, INSPECTION, DESIGN, MANUFACTURE, USE, LOADING, UNLOADING, TRANSPORTATION, DEMONSTRATION, STORAGE, CLEANING, CONTAMINATION, DISINFECTION, SERVICING, MAINTENANCE, REPAIR, DELIVERY AND/OR RETRIEVAL THEREOF (COLLECTIVELY, Page 2-3 Copyright EquipmentRentalCOntracts.com, LLC. (866) 582-2586. All rights reserved. Unauthorized reproduction and/or distribution expressly prohibited. DRAFTNOT ENFORC EABLE "RISKS"); (B) RELEASE AND DISCHARGE, AND AGREE TO.INDEMNIFY, DEFEND AND HOLD HARMLESS, ANDERSON MACHINERY COMPANY, each TPO, their respective parents, partners, suppliers, affiliates and subsidiaries, and their respective owners, shareholders, members, managers, officers, directors, agents, employees, Insurers, representatives, subrogees, successors and assigns (each, an "Indemnitee" and collectively, the "Indemnitees"), for, from and against all such RISKS (including without limitation, attorneys' fees) as well as any breach of this Contract by you, your agents, employees, contractors and/or invitees; and except only as provided In § 5, (C) WAIVE all rights, remedies, claims, damages and defenses available under the Uniform Commercial Code, as well as all direct, indirect, incidental, consequential, general, special, exemplary and punitive damages, against the Indemnitees (and each of them). 10. You agree to protect, properly service, maintain and care for each Rented Item at all times, keep It safely and securely stored and locked when not in use, and return it to AMC on time at the end of the Term, complete (including all attachments), clean, free of contamination (Including without limitation, silica, beryllium, asbestos and pathogens), in good order, condition and repair, property serviced and maintained, and if applicable, full of the proper fuel, Fluids and lubricants. If you fail to do so, then in addition to the amounts set forth on P.1, you will pay us: (a) Rent at our highest Incremental rate for each succeeding full rental period until all Item(s) have been returned or replaced as required; and (b) all costs and expenses we incur in connection with such failure. You shall not, nor shall you permit anyone else to: (1) use any Rented Item while under the Influence of any Intoxi-cants) (including without limitation, CANNABIS AND ALCOHOL), abuse, misuse, overuse, conceal, store with any third party, repair, modify or damage any Rented Item(s); (11) violate any Instruction, Insurance policy or warranty; (III) expose any Rented Item(s) to any flammable, explosive, harmful or hazardous substances) or circumstance(s); IN) disable, misuse or circumvent any safety equipment or devim(s) In, on or with any Rented Item(s); (v) take possession of or exercise control over any Rented Item(s), without our prior consent (in our sole and absolute discretion); or (vi) place or store In any Rented Item(s) (Including trailers) any contraband. 11. You agree to maintain all insurance we may require, including without limitation: (a) liability Insurance with minimum limits of $1,000,000 per occurrence; (b) workers' compensation and employer's liability Insurance; (c) property damage/Inland marine insurance covering all Items for the full (new) replacement cost thereof; and (d) hired auto Ilability and physical damage Insurance, and with respect to each, whenever possible: (I) covering submerging, overturning and overloading; (11) naming AMC as an additional Insured and loss payee; (ill) waiving subrogation against AMC; (Iv) being primary and non-contributory; and (v) including such other provisions (including deductibles) as AMC mayrequire. You irrevocably appoint Anderson Machinery Company as your agent and attorney -in -fact for purposes of submitting, negotiating and settling claims on all such policies. 12. Your Rental shall be deemed a "net" rental. Accordingly, your obligations hereunder are unconditional and are not subject to reduction, setoff, abatement or counterclaim for any reason. If you or any guarantor shall: (a) fall to fully and timely honor, pay, perform or comply with this Contract, any other agreements) ("Other Contracts)") between you and any Indemnitee, and/or any of your obligations arising (t)hereunder or in connection (t)herewith; (b) provide any incorrect or misleading information to us; (c) become Insolvent or bankrupt; or (d) die or cease conducting business, if AMC reasonably deems itself insecure; or if any Rented Item(s) shall be lost or damaged, you will be in DEFAULT under this Contract and at the option of AMC, under such Other Contract(s), whereupon, AMC may with or without legal process or notice (and without liability to you), to the maximum extent permitted under applicable law: (I) cancel the Term and/or the subject Contract(s) (and/or your rights to use and possess the Rented Item(s)); (11) seek relief from stay; (iii) recover, empty, lock, restrict, shut down, disassemble and/or disable any one or more of such Items) without being guilty of breach, trespass or wrongful Interference, or liable for any injuries or property damage (for which you agree to indemnify, defend and hold harmless each Indemnitee); (Iv) perform your obligations (t)hereunder on your behalf, without being obligated to do so; (v) purchase replacement Item(s); (vi) recover from you and/or any guarantor(s) our associated direct and indirect damages, losses, costs and expenses (Including without limitation, Rent for the entire scheduled Term, overtime, loss of use, interest, attorneys' fees, court costs, retrieval/repossession costs, and collection costs); and/or(vii) pursue any one or more other rights and/or remedies avallable (t)hereunder, at law and/or in equity, all of which are and shall remain cumulative and unimpaired. Page 2-4 Copyright ® EquipmentilentslContracts.com, I.I.C. (866) 582- 2586. All rights reserved. Unauthorized reproduction and/or distribution expressly prohibited. 13. This Contract shall be governed by and enforceable under the laws of Texas. Disputes arising under and/or In connection with this Contract and/or its subject matter, shall, at the sole option of AMC, be submitted to binding ARBITRATION in accordance with the Commercial Arbitration Rules of the American Arbitration Association at its officals) located nearest to AMC's principal place of business before a single arbitrator selected by AMC Judgment on the arbitrator's award shall be final and binding on the parties hereto and may be entered in any court of competent jurisdiction. Proper venue for all other civil legal actions commenced in connection herewith shall Ile exclusively in the federal, state and local courts located In or nearest to the AMC location from which you obtain(ed) the applicable Item(s) (unless waived by AMC). You consent and submit thereto and waive all claims that such venue lies in an Inconvenient forum. EACH PARTY VOLUNTARILY WAIVES ITS RIGHTS TO: (A) PARTICIPATE IN ANY JOINT, COLLECTIVE OR CLASS ACTION AGAINST THE OTHER PARTY HERETO, AND (B) TRIAL BY JURY. 14. This Contract, and any addenda(um) we provide, each of which is incorporated herein, represent(s) the entire agreement between you and AMC, superseding all other agreements and representations (Including our website and advertising). The terms of this Contract are severable. If any provision hereof shall be deemed Invalid or unenforceable by any court or arbitral body of competent jurisdiction, such provision will be deleted, and the remainder of this Contract will remain valid and enforceable. This Contract cannot otherwise be amended or extended except Ina writing signed by AMC. Time is of the essence. These Terms and Conditions apply to the Item(s) identified on PS and to all other Items you obtain from us at anytime (except only as we may otherwise agree in writing). This Contract; (a) constitutes an operating lease, and not a financing; (b) is fair and reasonable; and (c) shall bind and be enforceable by you, Anderson Machinery Company, the other Indemnimes, and such parties' respective Insurers, subrogees, successors and permitted assigns (there being no other third• party beneficiaries hereto). You agree to pay all sales, use and other taxes (Including without limitation, all Texas Emissions Reduction Plan and Dealer's Heavy Equipment Special Inventory taxes), as well as all tolls, fines, fees, duties, assessments and other charges related to the Rented Items) and/or this Contract. In the event legal action Is commenced in connection herewith, we will be entitled to recover our costs and expenses associated therewith (including without limitation. our attomevs' fees and # Zo NOTICE OF MEETING - 7/19/2023 10. Consider and take necessary action to accept the Letter of Transfer for Held -In -Trust Collections from the Texas Historical Commission for the Green Lake Enhancements Project, Permit # 30942 and authorize Judge Meyer to sign all documentation. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6of11 Gary D. Reese County Commissioner County of Calhoun Precinct 4 July 13, 2023 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 July 19, 2023. Consider and take necessary action on Letter of Transfer for Held -In -Trust Collections from the Texas Historical Commission for the Green Lake Enhancements Project, Permit # 30942 and authorize Judge Meyer to sign all documentation. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 -- email: earv.reese(i4calhouncotx.ore — (361) 785-3141 — Fax (361) 785-5602 For CAS Use Only CAS Accn# GOVERNMENTAL AGENCY LETTER OF TRANSFER FOR HELD -IN -TRUST COLLECTIONS This letter documents the transfer of archaeological collections and records from Calhoun Cou name of governmental agency to the Center for Archaeological Studies (CAS), Texas State University (TxState) for the following: Project Green Lake Enhancements Project Project No County(ies) 22-94332.001 Calhoun Site No(s) 41 CL1. 41 CL13. 41 CL113 Permitting Agency Texas Historical Commission Permit # 30942 Description of Materials tecords, Diqital Photos, Artifacts The transfer of the above described documents and materials to CAS is made for the purpose of allowing CAS to retain in trust for Sponsor in accordance with the provisions of Tex. Nat. Res. Code §191.058(b), the regulations promulgated by the Texas Historical Commission found in 13 T.A.C. §26.1, at. seq., and all other applicable laws and regulations. As the curating facility, CAS may make copies, electronically scan images or documents, microfilm, make loans, request and authorize analyses, reorganize the collection, and otherwise preserve, conserve and use these materials as outlined in guidelines for curation repositories. Any permanent transfer of items should be to a facility with equal capacity for permanent curation. Though CAS is the acknowledged holder of these materials and may use them as stated above, actual ownership of the materials and records rests with the governmental entity indicated as Sponsoring Agency. Unless otherwise prohibited by state or federal law or regulation agrees that upon the written request of Sponsor, the materials shall be returned to Sponsor for temporary or permanent display in a certiW c®ration facility -that can properly dis d maintain the materials. n Signature - Authorized Agent o(,UUb. Gov. Agency Signature -Authorized Agent bf Sub. Arch Richard Meyer Authorized Agent of Sponsor (type or print) County Judge Title/Position Date Address: Calhoun County 211 S. Ann St. Ste 301 Port Lavaca, TX 77979 Tony Scott Authorized Agent of Sub. Arch. (type or print) Senior Principal Investigator Title/Position 07/12/2023 Date Address: Gray & Pape, Inc. 110 Avondale St. Houston, TX 7006 Government Agency Ownership 11 /18110 CenterforArchaeological Studies, Texas State University, 601 University Drive, San Marcos, Texas, 78666 (512) 245-2724 Fax(512) 245-8076 #11 NOTICE OF MEETING — 7/19/2023 11. Consider and take necessary action to remove from Precinct 4 R & B inventory asset number 24-0495; a 2018 Dodge Ram 1500; VIN 1C6RR6Ff73S139704 and transfer to Texas Agri Life Extension Service. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 11 Gary D. Reese County Commissioner County of Calhoun Precinct 4 July 13, 2023 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 July 19, 2023. • Consider and take necessary action to remove from Precinct 4 R&B inventory asset number 24-0495; 2018 RAM 1500; VIN IC6RR6FT7JS139704 and transfer to Extension Services. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Scadrifl. Texas 77983 — email: ¢arv.reese&D.calhouncoix.ore — (361) 785.3141 — Fax (361) 785-5602 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: COMMISSIONER GARY REESE, PCT 4 R&B Inventory Number 24-0495 Description 2018 RAM 1500 Serial No. 1C6RR6FT7JS139704 Transfer From/To Department Precinct 4 R&B to Extension Service #12 ' NOTICF 0I- MFFTING — 7/19/7.023 12. Approve the minutes of the July 5, 2023 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 11 Richard lH . Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, July 5, 2023, 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. Attached are the true and correct minutes of the above referenced meeting. Richard H. Meyer, my Judge Calhoun County, Texas Anna Goodman, County Clerk 7--/9- -ZO Z-_� Date � -1�1 Date Page 1 of 1 I NOTICE OF MEETING — 7/5/2023 July 5, 2023 MEETING MINUTES 9L VN OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING 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. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Joel Behrens Gary Reese (ABSENT) Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call meeting to order. County Judge Commissioner Pct 1 Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at 10:00 am by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. n/a Page 1 of 8 NOTICE OF MEETING -- 7/5/2023 5. Consider and take necessary action to authorize work on the CDBG-MIT regional application for the Magnolia Beach Fire Station Project. KSBR and G&W will begin work to prepare the project application due to the Texas General Land Office by October 20, 2023.(DEH) RESULT: - APPROVED [UNANIMOUS]• MOVER David Hall, Commissioner Rct 1 S CONDERp Vern-Lyssy, Commissioner Pct 2 AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese" ` 6. Hear report from Memorial Medical Center. Roshandd Thomas:',gave the report. 7. Consider and take necessary action for an extension agent to present V. G. Young Certificates to the Court. (RHM) Karen LyssY and Emily Deforest presented certificates to judge Richard Meyer and -:Commissioner ]oel Behrens. No action taken. 8. Consider and take necessary action to authorize a credit card for the Human Resources Director with a credit limit of $2,500. (DEH) RESULT. APPROVED [UNANIMOUS]• MOVER: Vern Lyssy, Commissioner Pct 2 SI CONbER: GaryReese, ComrTilssioner Pct 4 AYES. Judge Meyer, Commissioner' Hall, Lyssy, Behrens, Reese 9. Consider and take necessary action to approve the final payment to Kraftsman, LP in the amount of $109,086.50 for the Magnolia Beach Miller's Point Pavilion CMO Grant. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: . , David Hall, Commissioner Pct I- SErCONDEki Joel Behrens, Commissioner.Pct 3 AYES JudgeNeyer, Commissioner.Hall; Lyssy, Behrens, Reese 10. Consider and take necessary action to authorize the use of $500.00 of GOMESA funds for Kathy Smartt of Smartt Grants for the preparation of the GLO CMP Special Projects grant that was approved on May 3, 2023, agenda item #8. (DEH) RESULT: `APPROVED [UNANIMOUS] MOVER: David Hall, Cornmissioner:P.ct 1 SECONDER: Gary Reese, Commissioner Pct 4 AXES: Judge Meyer, Commissioner -Hall, Lyssy, Behrens, Reese.:` - Page 2 of 8 I NOTICE OF MEETING - 7/5/2023 11. Consider and take necessary action to authorize work on the CDBG-MIT regional application for the West Side Subdivision Drainage Project. KSBR and G&W will begin work to prepare the project application due to the Texas General Land Office by October 20,2023.(DEH) RESULT APPROVED. [UNANIMOUS] MOVER: David Hall;. Commissioner_: Pct, I.. SECONDER: Gary Reese, Commissioner Rgt,4 AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to authorize work on the CDBG-MIT regional application for the Crestview Drainage Improvements Project. KSBR and G&W will begin work to prepare the project application due to the Texas General Land Office by October 20, 2023. (DEH) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SEWN,DER: Joel Behrens, Commissioner Pct 3 AYES. Judge Meyer, Commissioner. Hall, Lyssy, Behrens, Reese , 13. Consider and take necessary action to approve the Final Plat of the Breakwater Point subdivision situated in the James Hughson Survey, Abstract no. 23, Calhoun County, Texas. (JMB) Henry DanySh explained final piat RESULT. APPROVED [UNANIMOUS:]. MOVER .:.''" Joel.Behrens, Cothrrilssioner Pct 3 SECONDER: Gary 12eese, Commissioner P.Ct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese. 14. Consider and take necessary action to close Water Street, between 13th Street and the POC Fishing Center west of 15th Street and 14th Street between Commerce Street and Water Street on Friday, July 21, 2023 between the hours of 7:00 pm - Midnight and Saturday, July 22, 2023 1:00 pm - 7:30 pm in Port O'Connor, Texas. (GDR) RESULT„ . APPROVED: [UNANIMOUS] MOVER: Gary Reese, Commissioner: Pct 4 SECONDER: David Hail, Commissioner Pct 1. AYES: Judge Meyer, Commissioner`:Hall, Lyssy, Behrens, Reese'' Page 3 of 8 NOTICE OF MEETING -- 7/5/2023 15. Consider and take necessary action to approve the Preliminary Plat of the Replat of Lot 1100 of the American Townsite Company Subdivision situated in the Basibio Maldonado Survey, Abstract No. 26, Calhoun County, Texas. (GDR) 16. Consider and take necessary action to approve the Final Plat of the Replat of Lot 1100 of the American Townsite Company Subdivision situated in the Basibio Maldonado Survey, Abstract No. 26, Calhoun County, Texas. (GDR) 17. Consider and take necessary action to accept an auction proceeds check for $18,459.00 from CM Auction Company and deposit $13,333.50 into 760-60360 — Vehicle Maintenance and $5,125.50 into the Narcotics Forfeiture Fund. (RHM) RESULT: rAPPROVED [UNANIMOUS] MOVER °Vern Lyssy; C6mnnIssIoner:Pct 2 SECONDER; `David Hall; CommissicirW`Pct i AYES Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese <. 18. Consider and take necessary action to approve the amended contracts with the following Contractors/Haulers for Road Materials, Bid Number 2023.03 and authorize the County Judge to sign all necessary documents. The amended contracts are effective June 21, 2023 through December 31, 2023. (RHM) a. Marek & Marek Truck Wash, Inc. dba Frank Marek Trucking b. K-C Lease Service, Inc. dba Matagorda Construction & Materials c. Quality Hot Mix, Inc. d. Vulcan Construction Materials, LLC e. Blades Group, LLC f. Waller County Asphalt, Inc. g. MidTex Materials, LLC RESULT: ,APPROVED (UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pet 2 SECONDER: Gary .Reese, Commissioner Pet 4 AYES Judge Meyer, Commissionef Hall, Lyssy, Behrens, Reese Page 4 of 8 NOTICE OF MEETING - 7/5/2023 19. Consider and take necessary action to approve the amended contracts with the following Contractors/Haulers for Asphalts, Oils and Emulsions, Bid Number 2023.02 and authorize the County Judge to sign all necessary documents. The amended contracts are effective June 21, 2023 through December 31, 2023. (RHM) a. Cleveland Asphalt Products, Inc. b. Martin Asphalt Company c. P Squared Emulsion Plants, LLC RESULT APPROVED [UNANIMOUS]MOVER. "; Gary Reese, Corntn ssionet @ct 4 SE ONDER: - JoelBehrensCommissioner Pct 3 AYES JMeyer;'CorrrrnlssionerHall, Lysy, Behrens, Reese udge 20. Consider and take necessary action to approve the amended contract with the following Contractor/Hauler for Fly Ash — Road Material, Bid Number 2023.06 and authorize the County Judge to sign all necessary documents. The amended contracts are effective June 21, 2023 through December 31, 2023. (RHM) a. MidTex Materials, LLC RESULT. `' APPROVED [0. IMOUSj MOVER. David: Hall, CommI55ioner. Pct 1 SEiCONDER GaryReese, Commissioner Pet 4 A1iESa Judge Meyer, Commissioner`HaII; Lyssy, Behrens, Reesa: Page 5 of 8 I NOTICE OF MEETING.- 7/5/2023 21. Consider and take necessary action to accept the following audit reports; a. Justice of the Peace, Precinct 1- Q4 - 2022 b. Justice of the Peace, Precinct 2 - Q1-Q4 - 2022 c. Justice of the Peace, Precinct 3 - Q4 2022 d. Justice of the Peace, Precinct 4 - Q4 2021- Qi-Q4 2022 e. Juvenile Probation Department - Q2-Q4 2022 f. Treasurer - Q2-Q4 2022 g. Waste Management - Q3-Q4 2022 h. DA Hot Check Fee Fund - Q4 2022 i. DA Hot Check Restitution Fund - Q4 2022 j. District Clerk - Q4 2022 k. EMS - Q4 2022 I. Floodplain Administration - Q2-Q4 2022 m. Justice of the Peace, Precinct 5 - Q3 2020 - Q4 2021 n. District Clerk - Q1 2023 o. EMS - Q1 2023 p. Sheriff VINE Grant - FY2022 - Q2 FY2023 q. Waste Management - Q1 2023 r. DA Hot Check Fee Fund - Q1 2023 s. DA Hot Check Restitution Fund - Q1 2023 t. Museum - Q2 2022 - Q1 2023 u. Fairgrounds Facility Rentals - Q1 2023 v. POC Community Center Rentals - Q2-Q4 2022 w. Fairgrounds Facility Rentals - Q4 2022 RESULT, APPROwb [UNANIMOUS] MOVER: Vern Ly sy, Commissibner Pot 2 SE,CQNDER: :bavid Hall, Cornmissi0neir, Pd. 1 AYES. Judge Meyer,;Commtsioner Hall,'Lyssy, Behrens, Reese _. Page 6 of 8 NOTICE OE MEETING — 7/5/2023 22. Consider and take necessary action to accept the following cash count reports: a. Treasurer— 3/8/23 b. Waste Management — 3/3/23 c. County Clerk — 3/22123 d. DA — 2/23/23 e. District Clerk — 2/23/23 f. Elections — 3/3/23 g. EMS — 3/9/23 h. Fairgrounds Facility Rentals — 3/9/23 I. Floodplain Administration — 2/23/23 and 6/20/23 j. Jail — 3/7/23 k. Justice of the Peace, Precinct 1 — 3/7/23 and 6/13/23 I. Justice of the Peace, Precinct 2 — 3/7/23 and 6/13/23 m. Justice of the Peace, Precinct 3 — 3/9/23 n. Juvenile Probation — 3/7/23 and 6/13/23 o. Library — 3/8/23 p. Museum — 3/3/23 q. Sheriff — Buy Money — 3/30/23 r. Sheriff — 3/30/23 s. Tax Office — 3/2/23 and 6/20/23 t. Library — Port O'Connor — 12/21/22 u. Library — Seadrift—12/21/22 v. POC Community Center — 12/21/22 w. Sheriff — 12/28/22 x. Sheriff — Narcotics Buy Money — 12/28/22 y. Treasurer — 12/15/22 z. Waste Management—12/16/22 aa. Adult Detention Center—12/20/22 bb. District Clerk—12/28/22 cc. Elections—12/20/22 dd. EMS—12/16/22 ee. Fairgrounds Facility Rentals—12/16/22 ff. Justice of the Peace, Precinct 3—12/20/22 gg. Justice of the Peace, Precinct 4—12/21/22 hh. Justice of the Peace, Precinct 5 — 12/21/22 ii. Library — Main—12/20/22 RESULT APPROVED [UNANIMOUS] MOVER: Vern Ly. *, Commissioner Pct 2 SECONDER: David Halt,.Commissioner Pct I AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 23. Approve the minutes of the June 21, 2023 meeting. ItE3ULT: APPROVED UNANIMOUS] LOVER: Vern Lyssy, Commissioner Pct 2- SECONDER. Joel Behrens, Commissioner Pct.3 AYES Judge Meyer, Commissioner HaII;.Lyssy, Behrens, Reese Page 7 of 8 NOTICE OF MEETING — 7/5/2023 24. Consider and take necessary action to declare the attached list of equipment from Memorial Medical Center as Waste. (RHM) RESULT: 'APPROVED [UNANIMOUS] MOVER; ;7oel Behrens, Commissioner PCt 3 SECONDER: Gary Reese, Comm ssioner?ct 4 AYES: Judge Meyer, Commissioner Half, t yssy, Behrens, Reese': 25. Consider and take necessary action to declare the attached list of equipment from Justice of the Peace, Precinct 1 as Waste. (RHM) RESULT".' APPROVED [UNANIMOUS] MOVER Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Comitiissioner Pct 1 AYES-—Judge.Meyer, Commissioner Hall; Lyssy, Behrens, Reese 26. Accept Monthly Report from the following County Office: i. Tax Assessor -Collector — May 2023 RESULT: APPROVED [UNANIMOUS] .OVER Vern Lyssy, Commissioner Pet 2 SECONDER:. David Hall, Commissioner Pct 1 AYES: mmis Jgdge:Meyer, Cosioner Hall, Lyssy, Behrens, Reese 27. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MQUER: Gary Reese, Commissioner Pct 4 SECONDER: Joel.BehrenS.r Commissioner. Pct 3 AYES. `Judge Meyer, Commissioner; Hall, Lyssy, Behrens, Reese ., 28. Approval of bills and payroll. (RHM) MM,C Biliv: RESULT: APPROVED [UNANIMOUS]. MOVER: David Hall, Commissioner Pcf_1 SECONDER: Vern Lyssy Commissioner Pet 2 AYES,, lodge Meyer, Commissioner Nall, Lyssy, Behrens, Reese .' County Bills RESULT: APPROVED [UNANIMOUSI MOVER: David Hall; Commissioner Pct I SECONDER, Vern Lyssy, Commission& Pct, 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Meese Page 8 of 8 #13 NC71-ICF OF MFFTING — 7/19/2023 13. Accept Monthly Report from the following County Office: i. District Clerk — June 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 11 Treasurer Receipt Nos. F20237UN005,017,029, 033,039 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS COURT NAME: DISTRICT CLERK MONTH OF REPORT: JUNE YEAR OF REPORT: 2023 ACCOUNT NUMBER ACCOUNT NAME DEBIT CREDIT 1000-00144190 SHERIFF'S SERVICE FEES $1,629.63 1000-001-44140 JURY FEES $233.20 1000-00144045 RESTITUTION FEE $0.00 1000-001-44020 DISTRICT ATTORNEY FEES $0.00 1000-00149010 REBATES -PREVIOUS EXPENSE $10.11 1000-001-49030 REBATES-ATTORNEY'S FEES $1,740.72 1000-001-44058 DISTRICT CLERK ELECTRONIC FILING FEES $0.00 1000-00144322 TIME PAYMENT REIMBURSEMENT FEES $68.79 1000-001-43049 STATE REIMB- TITLE IV-D COURT COSTS $0.00 DISTRICT CLERK FEES CERTIFIED COPIES $599.00 CRIMINAL COURT $6.68 CIVIL COURT $3,079.09 STENOGRAPHER $583.00 CIV FEES DIFF $0.00 1000-001-44050 DISTRICT CLERK FEES $4,267.77 1000-999-20771 FAMILY VIOLENCE FINE $100.00 1000-999-10010 CASH - AVAILABLE $7,950.22 2706-00144055 FAMILY PROTECTION FEE $0.00 2706-999-10010 CASH - AVAILABLE $0.00 2740-00145055 FINES - DISTRICT COURT $1,780.40 2740-999-10010 CASH -AVAILABLE $1,780.40 2620-00144055 APPELLATE JUDICIAL SYSTEM $116.60 2620-999-10010 CASH -AVAILABLE $116.60 2648-00144055 COURT FACILITY FEE FUND $466.40 2648-999-10010 CASH - AVAILABLE $466.40 2670-00144055 COURTHOUSE SECURITY $478.69 2670-999-10010 CASH - AVAILABLE $478.69 2673-00144055 CRT RECS PRESERVATION FUND- CO $22.88 2673-999-10010 CASH - AVAILABLE $22.88 2725-00144055 LANGUAGE ACCESS FUND $69.96 2725-999-10010 CASH - AVAILABLE $69.96 2739-00144055 RECORD MGMT/PRSV FUND - COUNTY $723.32 2739-999-10010 CASH - AVAILABLE $723.32 2737-00144055 RECORD MGMT/PRSV FUND -DIST CLRK $43.30 2737-999-10010 CASH - AVAILABLE $43.30 2731-00144055 LAW LIBRARY $816.20 2731-999-10010 CASH - AVAILABLE $816.20 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 2667-00144065 CO CHILD ABUSE PREVENTION FUND $1.33 2667-999-10010 CASH - AVAILABLE $1.33 7502-999-20740 JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE $5.64 7502-999-10010 CASH-AVAILABE $5.64 7383-999-20610 DNA TESTING FEE - County $0.36 7383-999-20740 DNA TESTING FEE - STATE $3.28 7383-999-10010 CASH -AVAILABLE $3.64 7405-999-20610 EMS TRAUMA FUND - COUNTY $0.35 7405-999-20740 EMS TRAUMA FUND - STATE $3.12 7405-999-10010 CASH -AVAILABLE $3.47 7070-999-20610 CONSOL. COURT COSTS - COUNTY $42.39 7070-999-20740 CONSOL. COURT COSTS - STATE $381.52 7070-999-10010 CASH - AVAILABLE $423.91 7072-999-20610 STATE CONSOL. COURT COSTS- COUNTY $81.98 7072-999-20740 STATE CONSOL. COURT COSTS- STATE $737.77 7072-999-10010 CASH- AVAILABLE $819.75 2698-001-44030-010 DRUG CRT PROG FEE - COUNTY (PROGRAM) $2.07 2698-999-10010-010 CASH -AVAILABLE $2.07 7390-999-20610-999 DRUG COURT FROG FEE - COUNTY (SVC FEE) $0.41 7390-999-20740-999 DRUG COURT FROG FEE - STATE $1.66 7390-999-10010-999 CASH -AVAILABLE $2.07 7865-999-20610-999 CRIM - SUPP OF IND LEGAL SVCS - COUNTY $0.04 7865-999-20740-999 CRIM - SUPP OF IND LEGAL SVCS - STATE $0.32 7865-999-10010-999 CASH - AVAILABLE $0.36 7760-999-20790-010 CRIM - DUE TO STATE - NONDISCLOSURE FEE $0.00 7760-999-10010-010 CRIM - DUE TO STATE - NONDISCLOSURE FEE $0.00 7950-999-20610 TIME PAYMENT - COUNTY $2.59 7950-999-20740 TIME PAYMENT - STATE $2.58 7950-999-10010 CASH - AVAILABLE $5.17 7505-999-20610 JUDICIAL SUPPORT-CRIM - COUNTY $0.19 7505-999-20740 JUDICIAL SUPPORT -GRIM - STATE $1.05 7505-999-10010 CASH - AVAILABLE $1.24 7505-999-20740-010 JUDICIAL SALARIES -CIVIL - STATE(42) $78.22 7505-999-10010-010 CASH AVAILABLE $78.22 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 $0.10 7857-999-20740 JURY REIMBURSEMENT FUND- STATE $0.92 7857-999-10010 CASH - AVAILABLE $1.02 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 $0.70 CASH - AVAILABLE $30.70 -44050 DISTRICT CLERK FEES $17720 -10010 CASH - AVAILABLE $177.20 -44055 RECORD MGMT/PRSV FUND - COUNTY $110.75 -10010 CASH - AVAILABLE $110.75 -44050 COUNTY JURY FUND $4.43 -10010 CASH - AVAILABLE $4.43 -44055 COURTHOUSE SECURITY $44.30 -10010 CASH - AVAILABLE $44.30 -44050 CO & DIST CRT TECHNOLOGY FUND - $17.72 -10010 CASH - AVAILABLE $17.72 -44050 COUNTY SPECIALTY COURT FUND $110.75 -10010 CASH - AVAILABLE $110.75 TOTAL: $465.16 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 $10.11 7855-999-20610-010 DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY $0.53 7855-999-20790-010 DUE TO STATE - NONDISCLOSURE FEE $0.00 7855-999-10010-010 CASH - AVAILABLE $10.64 2677-999-44050-999 COUNTY DISPUTE RESOLUTION FUND $349.80 2677-999-10010-999 CASH -AVAILABLE $349.80 7858-999-20740-999 DIST CLK- DUE TO STATE CONSOLIDATED FEE 2022 $1,600.84 7858-999-10010-999 CASH AVAILABLE $1,600.84 TOTAL (Distrib Req to Oper Acct) $16,738.80 $16,373.64 DUE TO OTHERS (Distrib Req(s) attached) ATTORNEY GENERAL (RESTITUTION) 0.00 OUT -OF -COUNTY SERVICE FEES 1,575.00 REFUND OF OVERPAYMENTS 8.00 DUE TO OTHERS 0.00 TOTAL DUE TO OTHERS $1,583.00 REPORT TOTAL - ALL FUNDS 17,956.64 PLUS AMT OF RETURNED CKS 0.00 LESS: TOTAL TREASURER'S RECEIPTS (17,956.64) Revised 04/03/23 OVER / (SHORT) $0.00 3 DISTRICT COURT JUNE STATE COURT COSTS REPORT 2023 JUNE SECTION I: REPORT FOR OFFENSES COMMITTED COLLECTED COUNTY STATE 01/1120-Present 81.98 737.77 01/01/04-12/31/19 $422.83I 42.28 380.55 09/01/01 - 12/31/03 "T 0.03 0.31 09/01/99 - 08/31/01 0.07 0.67 09/01 /97 - 08/31/99 - - 09/01/95-08/31/97- 09/01/91-08/31/95 DNA TESTING FEES 3.64 0.36 3.28 EMS TRAUMA FUND 3.47 0.35 3.12 JUV. PROB. DIVERSION FEES JURY REIMBURSEMENT FEE $1.02 0.10 0.92 INDIGENT DEFENSE FUND - $0.00 STATE TRAFFIC FEES $0.00 - $0.00 DRUG CRT PROG FEE $4.14 $2.48 1.66 SECTION II: AS APPLICABLE STATE POLICE OFFICER FEES FAILURE TO APPEAR/PAY FEES - - JUD. FUND-CONST. CO. CRT. a; JUD. FUND -STATUTORY CO. CRT. MOTOR CARRIER WEIGHT VIOLATIONS TIME PAYMENT FEE $5.17 2.59 2.58 DRIVING RECORD FEE JUDICIAL SUPPORT FEES $1.24 0.19 1.05 ELECTRONIC FILING FEE - CR $0.70 $0.70 NONDISCLOSURE FEES -CR $0.00 $0.00 TOTAL STATE COURT COSTS $1,263.04 $ 130.43 $ 1,132.61 CIVIL FEES REPORT JUNE COLLECTED COUNTY STATE BIRTH CERTIFICATE FEES MARRIAGE LICENSE FEES DECL. OF INFORMAL MARRIAGE ELECTRONIC FILING FEE - CV $30.00 $30.00 NONDISCLOSURE FEES - CV ''.-0 $0.00 $0.00 JUROR DONATIONS JUSTICE CRT. INDIG FILLING FEES STAT PROB CRT INDIG FILING FEES STAT PROB CRT JUDIC FILING FEES STAT CNTY CRT INDIG FILING FEES STAT CNTY CRT JUDIC FILING FEES STAT CNTY CRT -JUDICIAL SUPPORT CONST CNTY CRT INDIG FILING FEES CNST CNTY CRT JUDIC FILING FEES DIST CRT DIV & FAMILY LAW 0'.. $0.00 - - DIST CRT OTHER THAN DIV/FAM LAW_ 0- $0.00 - - DIST CRT OTHER CIVIL FILINGS 6'; $10.64 0.53 10.11 FAMILY PROTECTION FEE JUDICIAL SUPPORT FEE ! 5 ''. $78.22 $78.22 JUDICIAL & COURT PERSONNEL TRAINING FEE,.. _.,6: $5.64 - $5.64 2022 STATE CONSOLIDATED FEE - :. '13- $1,600.84 $1,600.84 COUNTY DISPUTE RESOLUTION FUND 349.80 349.80 TOTAL CIVIL FEES REPORT $ 2,075.14 $ 0.53 $ 2,074.61 TOTAL BOTH REPORTS $ 3,338.18 $ 130.96 $ 3,207.22 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 420 A 45110 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Anna Kabela Address: Title: District clerk City: State: Zip: Phone: ACCOUNT NUMBER Dlr$GRIPTION AMOUNT 7340.999-20759-999 District Clerk Monthly Collections - Distribution $16,373.64 JUNE 2023 V# 967 TOTAL 16,373.64 s Sio6ature of Official Date #14 ' NOTICE OF MEETING— 7/19/2023 14. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 11 b B �k :0 :z ;z LLI )s � IL B:§ . § � § � « B 3 ■ §f \ §) kw - � Bk�� Is § bm .R ;o - 'z ■ ;z ;■ a $ kisbw & § §ee z 0 '20 ■ 2 2 k k § k 7 2 2 k k « § e § §we\$( � \| §0 � \| §0 - §�-®--- 2 §�&aas2 e O �■§ ■§� §M § §zz \\ zz §*2 ■° \) \z 22 lz2 \§ /ui k/ §(\ § LU k § N n N O z H z a Q 9 z 9 0 0 z rn m m e�a N Q W J IL IL ui rr m H z o ra m v 0 00 O a J 0 O 0 0 z x w z 0 a 0 0 z zz 0 � u yaa� a f z 00 oc 0�06 Q fA fll 00 0� �a 00 wW F»v3 s 00 �a z z 00 zz rn rn 0 N 0 9 i m 6 2 w Q r z W a d W a 19 W U. W LU W H C W C3 H C N N W O (r0 C-� WW �fll eW W N � N 6WD�� C\F eqcli N u,� N O N pppyJ O N N (p 0 0 ZOC Q fV N �0 00 � � 000 w000 Z W 6 Z W W z J Q a G 0 a � W J a W W d, W LL 20 z cW G p z 1� 6 N Nlu �c 0 c z2 a mF Q� J c 0. S� z - g u H e za W 2 12 w u > e 0 _ LL� z z z gaQ� 000 z z z e rn rn rn W_ .J i vW 6 z Z w J a W a0 O 00- aw Z O Lu cW G zz = O V G 6 0 N ti O N 2 T 4' rn a Z LL J LU Z uj C9 g Z Z LL 4 wi r V zLU j V � m IL 14 Wj d � h � W z a a W F W W J Z H Wlu z W 12 012 W M M O O N 7 V e w w J a �i U)P C W o� in~ in UJ 06 a 00 Xw J F F z 2 W a iu 0 00 z Z a 0 0 w 00 �a zJ z Q m J Z 6LU U UJ z a�Q D�nE N w w J fain 0 (n 7 O N O O M T 0 m rn a \ \ � §�\&& §■" ■-mo- §000 § « - §s as §�§ §2a&aa §■ z k @ z �k )o !z :z Lu � :L :§ | ) ) 0 � #15 NOTICE OF MEFTING — 7/19/2023 15. Approval of bills and payroll. (RHM) MMC Bills: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Nils APPROVED[UNANIMOI David Hall, Commissioner F ER: Vern Lyssy, Commissioner Judge Meyer, CommissionE S] ct 1 'ct 2 / - Indigent Healthcare RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:10am Page 11 of 11 MEMORIAL MEDICAL CENTER COMNIiSSIONERS COURT APPROVAL LIST F..OR,•---July 19:,2023 by:DC INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES HEB Pharmacy (Medimpact) Pharmacy Reimbursement 26.25 MMCenter (In -patient so/ out -patient $519.25 / ER go) 519.25 SUBTOTAL 645.60 Memorial Medical Center (Indigent Healthcare Payroll and Expenses) 4,166.67 Subtotal 4,712.17 Co -pays adjustments for June 2023 (10:00)' Reimbursement from Medicaid 0.00 COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES QUANTITY UNIT PRICE TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $4,702.17 approved by Commiss Toners Court":on 07/19%2023 1000-001-46010 June ,3.p, 20'13 Interest ($1.93) $4,700.24 COUNTY AUDITOR APPROVAL ONLY THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD CO ION AND REQUEST THE COUNTY TREASURER TO PAY THE A80 IGATION. r BY: 7/17/2023 APPRDVWON JUL 1.7 2023 BYGOUNTYAUDITOfl IDEPATETMENT HEAD DATE ®IHs Source Totals Report Issued 07/11/23 Calhoun Indigent Health Care Batch Dates 07/01/2023 through 07/01/2023 For Vendor: All Vendors Source Description Amount Billed Amount Paid 02 Prescription Drugs 26.25 26.25 14 Mmc- HospitalOutpatient 1,093.00 519.25 Expenditures 1,119.25 545.50 Reimb/Adjustments Grand Total 1,119.25 545.50 Expenses 4,166.67 Co -Pays < 10.00 > Total 4,702.17 23 JUL 17 2023 BY COUNTY AUDITOR CAI MN COUNTY, TBM BINS Source Totals Report Issued 07/11/23 Calhoun Indigent Health Care Batch Dates 02/01/2023 through 07/01/2023 For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 517.00 23.53 01-2 Physician Services -Anesthesia 1,265.00 230.39 02 Prescription Drugs 94.69 94.69 08 Rural Health Clinics 378.00 J .255.81 14 Mmc - Hospital Outpatient 12,690.01 5,716.60 15 Mmc-ErBills V31.00 - 783:45 Expenditures 16,691.82 7,120.59 Reimb/Adjustments -16.12 -16.12 Grand Total 16,675.70 7,104.47 Expenses 25,001.02 Co -Pays < 30.00 > Total 32,075.49 MEMORIAL MEDICAL CENTER CHECK REQUEST _6")c 0 P P Calhoun County Indigent Account �/7/23 Date Requested: A y PkPRROVrf3 f1pq JUL 13 2023 E BY COUNTY AUOITOp CALHOUN COUNTY TEXAS AMOUNT 10.00 EXPLANATION: June Indigent Copays REQUESTED BY: Caitlin Clevenger FOR ACCT, USE ONLY fJ Imprest Cash []A/P Check Mail Check to Vendor Return Check to Dept G/L NUivIBER: 50240000 AUTHORIZED BY: RUN DATE: 07/07/23 MEMORIAL MEDICAL CENTER PAGE 127 TIME; 10:44 RECEIPTS FROM 06101/23 TO 06/30/23 RCMREP G/L RECEIPT PAY CASH RECEIPT DISC COLL GL CASH NUMBER -- ----------- DATE NUMBER TYPE PAYER AMOUNT AMOUNT NUMBER NAM DATE INIT CODE ACCOUNT 50200.000 ------------------------------------------------------------- 06/28/23 669235 IN CIGNA HEALTHCARE .00 --------- -------"-------------------'.................... .00 00100/00 RM 2 50200.000 06/28/23 669239 IN CIGNA HEALTHCARE 20.00- 20.00- 00/00/00 RM 2 50200.000 06/29/23 669267 IN UNITED HEALTHCARE 74.26- 74.26- 00/00/00 RM 2 50200.000 06129/23 669269 IN UNITED HEALTHCARE 179.92- 179.92- 00/00/00 RM 2 50200.000 06/29/23 669272 IN UNITED HEALTHCARE 635.86- 635.86- 00/00/00 RM 2 50200.000 06/30/23 669418 IN MEDI-SHARE 603.95- 603.95- 00/00/00 RM 2 50200.000 06/30/23 669443 IN VITORI HEALTH 501,85- 507.85- 00/00/00 RM 2 50200.000 06/30/23 669496 IN UNITED HEALTHCARE 515,65- 515.65- 00/00/00 RM 2 50200.000 06/30/23 669502 IN AETNA-DOW CHEMICAL .00 .00 00/00/00 RM 2 **TOTAL** 50200.000 CONNE RCIAL INS. -ADJ -420262.03 50240.000 06/29/23 669152 CA 10,00 10.00 00/00/00 PLO 2 **TOTAL** 50240.000 COUNTY INDIGENT COPAYS 10.00 50460,000 06/12/23 667424 CR CENTENE MANAGEMENT 6521.02 6521.02 00100/00 PLB 2 **TOTAL** 50460.000 RAPPS - OTHER REV 6521.02 50510.000 06126/23 668719 CA CAFE 404.79 404.79 00/00/00 14RP 2 50510,000 06/26/23 668720 US CAFE 34.90 34.90 00/00/00 MRP 2 50510.000 06/26/23 668721 VI CAFE 420.49 420.49 00/00/00 MRP 2 50510.000 06/26/23 668722 MC CAFE 216.80 216.80 00/00/00 MRP 2 50510.000 06/01/23 666260 VI CAFE 469.52 469.52 00/00/00 PLB 2 50510.000 06/01/23 666262 AS CAFE 20.49 20.49 00/00/00 PLB 2 50510.000 06/01/23 666263 OS CAFE 29.31 29.31 00/00/00 PLB 2 50510.000 06/01/23 666264 CA CAFE 290.28 298.28 00/00/00 PLO 2 50510,000 06/02/23 666417 VI CAFE 411.71 411.71 00/00/00 PLB 2 50510.000 06/02/23 666418 MC CAFE 183.59 183,59 00/00/00 PLB 2 50510.000 06/02/23 666419 CA CAFE 251.47 251.47 00100/00 PLB 2 50510.000 06/05/23 666591 VI CAFE 427.04 427.04 00/00/00 PLB 2 50510.000 06/05/23 666592 14C CAFE 142.27 142.27 00/00/00 PLB 2 50510.000 06/05/23 666593 AS CAFE 10.49 10.49 00/00/00 PLB 2 50510.000 06/05/23 666594 US CAFE 59.12 59.12 00/00/00 PLB 2 50510.000 06/05/23 666595 CA CAFE 457.56 457.56 00/00/00 PLB 2 50510.000 06/06/23 666737 VI CAFE 366.19 366,19 00/00/00 PLB 2 50510.000 06/06/23 666738 MC CAFE 111.81 111,81 00/00/00 PLB 2 50510.000 06/06/23 666739 US CAFE 9.41 9.41 00/00/00 PLB 2 50510.000 06/06/23 666740 CA CAFE 237.63 237.63 00/00/00 PLB 2 50510.000 06/07/23 666862 VI CAFE 353.84 353.84 00/00/00 PLB 2 50510.000 06/07/23 666863 14C CAFE 137.24 137.24 00/00/00 PLB 2 50510.000 06/07/23 666864 AS CAFE 10.49 10.49 00/00/00 PLB 2 50510.000 06/07/23 666865 US CAFE 17.73 17.73 00/00/00 PLB 2 50510.000 06/07/23 666866 CA CAFE 291.38 291.38 00/00/00 PLB 2 50510.000 06/08/23 667005 VI CAFE 514.60 514.60 00/00/00 PLB 2 50510,000 06108/23 667006 NC CAFE 179.53 179.53 00/00/00 PLB 2 50510.000 06/08/23 667007 AE CAFE 9.41 9,41 00/00/00 PLB 2 5D510.000 061OB/23 667008 CA CAFE 335.93 335.93 00/00/00 PLB 2 50510.000 06109/23 667137 MC CAFE 165.06 165.06 00/00/00 PLB 2 50510.000 05/09/23 667138 AS CAFE 3.14 3.14 00/00/00 PLB 2 50510.000 06/09/23 667139 CA CAFE 275.02 275.02 00/00/00 PLB 2 50510.000 06/09/23 667140 VI CAFE 496.42 496.42 00/00/00 PLB 2 50510,000 06/12/23 661322 VI CAFE 342.44 342.44 00/00/00 PLB 2 RUN DATE: 07/07/23 MEMORIAL MEDICAL CENTER PAGE 127 TIME: 10:44 RECEIPTS FROM 06/01/23 TO 06/30/23 RMP GA RECEIPT PAY CASH RECEIPT NUMBER DATE NUMBER TYPE PAYER AMOUNT AMOUNT NUMBER NAME 50240.000 06/29/23 669152 CA 10.00 10.00 '•TO1AL" 50240.000 COUNTY INDIGENT COPAYS 10.00 DISC COLL G1 CASH DATE INIT CODE ACCOUNT 00/00/00 PLB Calhoun County Indigent Care Patient Caseload 2023 Approved Denied Removed Active Pending January 0 0 0 1 7 February 2 0 1 2 6 March 0 5 0 2 5 April 2 1 0 4 5 May 1 6 1 4 3 June 0 2 2 3 4 July August September October November December YTD 5 14 4 16 30 Monthly Avg 1 2 1 3 5 December 2022 Active 1 Number of Charity patients 205 Number of Charity patients below 50% FPL 108 Number of Charity patients who meet State Indigent Guidelines 106 Calhoun County Pharmacy Assistance Patient Caseload 2023 January February March April May June July August September October November December Approved Refills Removed Active Value 0 2 0 5 $1,667.46 0 21 0 14 $14,786.76 1 3 0 16 $2,460.00 3 12 0 22 $11,674.00 1 3 0 24 $2,954.67 2 9 0 29 $5,673.30 YTD PATIENT SAVINGS $39,216.19 Monthly Avg 1 8 December 2022 Active 55 18 $6,536.03 Bill To: Calhoun County i 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552.6713 Date: 7/7/2023 Invoice # 382 For: Jun-23 t flQSC".l1PTIQ�t . ' 1?�l�T' Funds to cover Indigent program operating expenses. $ 4,166.67 Total $ 4,166.67 Andrew De Los Santos Controller In APPRMON JUL 17 2023 By COUNTY AUDITOR CAU40UN COUNTY, TEW 0 g PROSPERITY • •.•. 1• n Statement Date Account No THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13497 6/30/2023 `*4551 Page 1 of 2 STATEMENT SUMMARY 6 0 Public.Pund Cnn[ractual Ckg w IntAccount No:`±**4551 .fi>. r r 1 Deposits/Other Credits + $1.93 6 Checks/Other Debits - $4,380.64 06/30/2023 Ending Balance 30 Days in Statement Period $5,729.21 Total Enclosures 6 D•• Date Description Amount 06/30/2023 Accr Earning Pymt Added to Account $1.93 Check Number Date Amount Check Number Date Amount Check Number Date Amount 12594 06.05 $5.35 12598 06-26 $32.67 12600 06.29 $9.89 12597` 06-26 $4,166.67 12599 06.26 $135.81 12601 06-26 $30.25 DAILY ENDING Date Balance 06-01 $10,107.97. 06.05 $10,102.57 Interest Paid This Period Interest Paid YTD MEMBER FDIC Date Balance 06-26 $5,737.17 06-29 $5,727.28 Below is an itemization of the Earnings paid this period. $1.93 Annual Percentage Yield Earned $11.41 Days in Earnings Period Earnings Balance Date Balance 06-30 $5,729.21 0.25 % 30 $9,375.06 NYSE Symbol "PB" �ewoes MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---July 19, 2023 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS TOTAL TRAN$FERS BETWEEN FUNDS $ 130,826.48 ✓ TOTAL NURSING HOME UPL EXPENSES $ 785,210;68' TOTAL INTER40VERNMENTTRANSFERS $ GRAND TOTAL DISSORSEMENTSAPPROVED.Jul 19,2023 $ 2,=j=-.31 IZ MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR --July 19 2023 PAYABLES AND PAYROLL 7/13/2023 Weekly Payables 7113/2023 Patient Refunds 7114/2023 Citibank Credit Card -see attached 7/14/2023 Calhoun County -repayment of loan 1. of 16 7/17/2023 McKesson-340B Prescription Expense 7/17/2023 Amerisource Bergen-3406 Prescription Expense 7/17/2023 Payroll Liabilities -Payroll Taxes 711712023 Payroll Prosperity Electronic Bank Payments 7/10/2023 Credit Card & Lease Fees 7/20/2023 Sales Tax for June 2023 7/10/2023 Cleargage-Patient Financing Service 10-7tl4123 Pay Plus -Patient Claims Processino Fee 636,025.12 1,488.99 3,712.08 150.000.00 10,171.85 $31.61 132,075.31 396,162.67 5,018.96 1,773.67 118.20 197.69 S 'Is336;2Z6 6 TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 7/13/2023 MMC Operating to Fort bend -correction of NH insurance payment deposited into 3.185.00 MMC Operating 7/13/2023 MMC Operating to Golden Creek -correction of NH insurance payment deposited 52,304.02 into MMC Operating in error 7/13/2023 MMC Operating to Gulf Pointe Plaza -correction of NH insurance payment 5,824.23 deposited into MMC Operating 7/1312023 MMC Operating to Tuscany Village -correction of NH insurance payment. 30,222A7 deposited into MMC Operating 7/13/2023 MMC Operating to Bethany -correction of NH insurance payment deposited into 39.289,76 MMC Operating *FAORA *- EEWFUNDS S 13Q,82S. t8', NURSING HOME UPI. EXPENSES 7/1712023 Nursing Home UPL-Cantex Transfer 483,160.56 711712023 Nursing Home UPL-Nexion Transfer 18,423.07 7/1712023 Nursing Home UPL-HMG Transfer 97,002.14 7/17/2023 Nursing Home UPL-Tuscany Transfer 26,884.39 7117/2023 Nursing Home UPL-HSL Transfer 32,806.96 NURSING HOME BANK FEES 7/142023 Ashford -Enhanced analysis fee 84.16 Nursing Home Electronic Bank Payments 711112023 Bethany -returned check 181.00 QIPP CHECKS TO MMC 7/17/2023 Ashford 44,214.52 7/17/2023 Broadmoor 16,355.67 7/17/2023 Crescent 12,085.26 7/17/2023 Fort Bend 13.836.33 7117/2023 Solera 13,231b3 7/17/2023 Tuscany 26,829A1. TRANSFER BETWEEN FUNDS TO MMC OPERATING 7/1712023 Gulf Pointe Plaza MM to MMC-correction of MMC insurance payment deposited 116.98 into Gulf Pointe MM In error TQTAG NURSING HOME tiP& EXREN$♦ S; $ ; 785;21Q-68,' TOTRLINTER GQYERNMENTfRANSFERS GRAND`TOTALO`f$BURSEMENTSAPPROVEDJul 19,2023 S t2031231'- RECEIVED 7YTIiE COUNTYAUDffOR ON Page 1 of 17 CALHC*ft#f¢iA9y TEXAS MEMORIAL MEDICAL CENTER AP Open Invoice List 0 12.47 ap_open_invoice.template Due Dates Through: 08/0412023 Vendor# Vendor Name Class Pay Code �r A1680 AIRGAS USA, LLC-CENTRAL DIV✓ M Invoice# Comment Tran Dt Inv Dt Due Dt CheckD Pay Gross Discount No -Pay Net 9139657489./ 07/12/2007/03/2007128/20 3,346.34 0,00 0.00 3,346.34 V� BUL 9139790671 07112/2007/0712008/01120 337.01 0.00 0.00 337.01 L OXYGEN Vendor Totals Number Name Gross Discount No -Pay Net A1680 AIRGAS USA, LLC -CENTRAL DIV 3,683.35 0.00 0.00 3,683.35 Vendor# Vendor Name Class Pay Code A1746 ALPHA TEC SYSTEMS INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV-0016143 0' 07/12120 06/30/20 07/30/20 103.35 0.00 0.00 103.35 yer`'r SUPPLIES Vendor TotaliNumber Name Gross. Discount No -Pay Net A1746 ALPHA TEC SYSTEMS INC 103.25 0100 0.00 103.35 Vendor# Vendor Name Class Pay Code 12800 AUTHORITYRX y Invoice# i Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net 1858 0/' 07/12/20 07/05/20 07/06/20 740,00 0.00 0.00 740.00 3408 1841 , 07/12120 07/05/20 07/06/20 9,940.00 0.00 0.00 9,940.00 340B Vendor Totals Number Name Gross Discount No -Pay Net 12800 AUTHORITYRX 10,680.00 0.00 0.00 10,660,00 Vendor# Vendor Name Class Pay Code 14088 AZALEA HEALTH �/ Invoice# Comment Trail Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 91031 V 07/12/20 07/01/20 07/02/20 594.00 0.00 0.00 594,00 PROCESSING FEES ,. Vendor TotalsNumber Name Gross Discount No -Pay Net 14088 AZALEA HEALTH 594,00 0.00 0,00 594.00 Vendor# Vendor Name Class Pay Code 81150 BAXTER HEALTHCARE y'' w Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 79080441 ,/�f 07/13/20 05/15/20 06/09/20 43.08 0.00 0.00 43.06 v' SUPPLIES 79407467 w-' 07/13/20 06/15/20 C7/10/20 765.63 0.00 0.00 765.63 v'f (SUPPLIES ✓ 79409612 07113/20 06/15/20 07/10/20 43.84 0.00 0.00 43.84 Gs'' SUPPLIES 79446587 07118/20 06/20/20 07/15120 138.25 0.00 0.00 138.25 v "f SUPPLIES 79457394 07/13/20 06/21/20 07/16/20 629.50 0.00 0.00 629.50, SPECTRUM 12713457 sf 07/13/2006/24/2007/19/20 82.01 0.00 OW 82.01 ✓` LATE FEE 79497000 / 07/13/20 06/26/20 07/21/20 635.39 0.00 0100 635.39 file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.cons/u88125/data_5/tmp_cw5repo13223686... 7/13/2023 Page 2 of 17 /SUPPLLES 79536068 07/13/20 07/06/20 07/31/20 43.06 0.00 0.00 43.06 SUPPLIES Vendor Total:Number Name Grass Discount No -Pay Net B1150 BAXTER HEALTHCARE 2,380.74 0.00 0.00 2,380.74 Vendor# Vendor Name Class Pay Code M2485 BAYER HEALTHCARE s,'� M Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Grass Discount No -Pay Net 6010630612 �.' 07/12/2006/2812007128120 1.104.08 0.00 0.00 1,104.08 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCARE 1,104.08 0.00 0.00 1,104.08 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 110676220 s17 07/11/20 06/12/20 07/07/20 661.79 0.00 0100 661.79 a✓'f SUPPLIES 110720003 wfi 07111/2007103/2007/28/20 428.38 0.00 0100 428.38 E SUPPLIES ! 5474812 ✓ 07/12/20 W13/2007/08/20 5,016.58 0.00 0.00 5,016,58 >x"` LEASE 110686423 ✓`' 07/12/20 06/15/20 07/10120 3,843.70 0.00 0.00 3,843.70 ++' SUPPLIES 110685386 0 07/1 2120 06115/20 07/10/20 1.288.45 0.00 0.00 1,288.45 v SUPPLIES 110899442 Q7H2/20 06/23/20 07/18/20 789.17 0.00 0.00 789.17 V /SUPPLIES 5475337 w` 07/12/20 06/25/20 07/20/20 1,337.05 0.00 6.00 1,337.05 N*'� LEASE 110704413✓ 07/12120 06/26/20 07121/20 919.29 0.00 0.00 9t9.29 SUPPLIES 110721453 ✓' 07/12/20 07/03/20 07/28/20 999.89 0,00 0.00 999.89 SUPPLIES 1107192230711PJ2007/04/2007129120 3,120.89 0.00. 0.00 3,120.69 ' SUPPLIES 110725919 ,/ 07/12/200710612007/31/20 1,520.93 0.00 0.00 1.520.93 ✓+r SUPPLIES 110725924V 07/12/2007/06/2007/3l/20 16,184.07 0.00 0.00 10,184,07 ++✓j SUPPLIES 110728461 07/12/20 07/09/20 08/03/20 304.12 0.00 0.00 304.12 ,I,NNV-219012 110729491 y 07/12/200711012D 08/04/20 197.49 0.00 0.00 197.49 W SUPPLIES 110732106 , f 07/12/20 0711.0120 08/04/20 864.93 0.00 0.00 864.93 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 61220 BECKMAN COULTER INC 37,476,73 0.00 0.00 37,476.73 Vendor# Vendor Name Class Pay Code B1320 BEEKLEY CORPORATION �/' M Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net INV1630207 / 06/29120 06113/20 07/31120 398,00 0.00 0.00 398.00 file:!//C:/Users/ltrevinolcpsilmemmed.cpsinet.comlu881251data_51tmp_cw5report223686... 7/13/2023 Page 3 of 17 SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net B1320 BEEKLEY CORPORATION 398.00 0.00 0.00 398.00 Vendor# Vendor Name Class Pay Code 14753 BIOMERIEUX, INC Invoice# Comment. Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net 1213043762 , / 07/12/20 06/13/20 07/05/20 50,786.47 0.00 0.00 50.786.47 V✓` GI/BIOFIRE TESTS , 1213058193 r/! 07112120 07/06/20 08101/20 9,527.84 0.00 0.00 9,527.841� SUPPLIES Vendor Total_ Number Name Gross Discount No -Pay Net 14753 SIOMERIEUX, INC 60,314.31 0.00 0.00 60,314.31 Vendor# Vendor Name Class Pay Code 12324 BLUE CROSS BLUE SHIELD Invoice# Comment Tran Dt Inv Dt Dee Dt Check D Pay Gross Discount NaPay, Net 06162023 07111120 06116/20 07/01/20 163,18. 0.00 0.00 153.18 COBRA/DENTAL- MAYRA MAR Vendor Totals Number Name Gross Discount No -Pay Net 12324 BLUE CROSS BLUE SHIELD 153,18 0.00 0.00 163.18 Vendor# Vendor Name Class Pay Code B1655 BOSTON SCIENTIFIC CORPORATION V M Invoice# Comment Tran or Inv Dt Due or Check D Pay Gross Discount No -Pay Net 992784700 .% 07/12/20 06/26/20 07/12/20 755.00 0.00 0.00 756,00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1655 BOSTON SCIENTIFIC CORPORATION 755.00 0.00 0.00 755.00 Vendor# Vendor Name Class Pay Code 01048 CALHOUN COUNTY �f� vV Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Grass Discount No -Pay Net 52583397., 1 07/12120. 06/23/20 07/23/20 8.47 0.00 0.00 8,47 b''A ELECTRICITY 62579258 V' 07/12/20 06/23/20 07/23/20 531.08 0.00 0.00 531.08 ELECTRICITY . 52578834 r'� 07/12/200612312007/23/20 1.661.06 0.00 0.00 1,661.06 ELECTRICITY 52578819 ✓ ' 07/12/20 06/23/20 07/23/20 33,377.47 0.00 0.00 33,377.47 ELECTRICITY , 52578818 ,/ 07/12/20 06/23/20 07/23/20 16.85 0.00 0.00 18.85 j. ELECTRICTY , Vendor Totals Number Name Gross Discount No -Pay Net C1048. CALHOUN COUNTY 35,596.93 0.00 0.00 35,596.93 Vendor# Vendor Name Class Pay Code 14120 CALHOUN COUNTY EMS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2023-06 ✓ 07112/2007/03/2008103120 2,840.00 0.00 0.00 2,640.00 JUNE 23 TRANSFERS , Vendor Totals Number Name Gross Discount No -Pay Net 14120 CALHOUN COUNTY EMS 2,640.00 0.00 0.00 2,640.00 Vendor# Vendor Name Class Pay Code 11296 CALHOUN COUNTY INDIGENT ACCOUN v✓ Invoice# Comment Tran Dt Inv Dt Due Of Check D Pay Gross Discount No -Pay Net file:///C:/Users/itrevino/cpsi/memmed.cpsinet.con-i/u88125/data 5/tmp_ew5report223686... 7/13/2023 Page 4 of 17 070723 07/12/20 07/07/20 07108/20 10.00 0.00 0.00 10.00 <" JUNE 23 INDIGENT ,. Vendor Total_ Number Name Gross Discount No -Pay Net 11295 CALHOUN COUNTY INDIGENT ACCOUN 10.00 0.00 0.00 10.00 Vendor# Vendor Name Class Pay Code 14260 CAREFUSION SOLUTIONS, LLC / Invoice# Comment Tran or Inv or Due Dt Check D Pay Gross Discount No -Pay Net 1002088017-6 1 0711212006/0712G 07/07/20 1,788.00 0.00 0.00 1,788.00 Y` MAINT 1002088018.4 ✓" 07/12/20 06/07/20 07/07/20 2.00 0.00 0.00 2,110 MAINT Vendor Totals Number Name Gross Discount No -Pay Net 14260 CAREFUSION SOLUTIONS, LLC 1,790.00 0.00 0.00 1,790.00 Vendor# Vendor Name Class Pay Code 13264 CERVEY, LLC _/ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 22987�/ 07/1212006/30/2007/25/20 11699.00 0.00 0.00 1,699.00 MONTHLY LICENSE Vendor Total: Number Name Gross Discount No -Pay Net 13264 CERVEY, LLC 11699.00 0.00 0.00 1,699,00 Vendor# Vendor Name Class Pay Code / C1600 CITIZENS MEDICAL CENTER 1" W Invoice# Comment Tran Dt Inv or Due Dt Check D Pay Gross Discount No -Pay Net _ 063023 06/30120 06130/20 07/30/20 57,881.65 0.00 0,00 57,881.85 JUNE 23 CRNA COVERAGE _ Vendor TotaleNumher Name Gross Discount No -Pay Net C1600 CITIZENS MEDICAL CENTER 57,881.65 0.00 0.00 57,881.65 Vendor# Vendor Name Class Pay Code 10212 CLINICAL PATHOLOGY LABS , ICP Invoice# Comment Tram Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1765&202305 ,! 07112/20 05/31120 06130120 17,038,34 0,00 0.00 17,038.34 LAB SERV Vendor Totale Number Name Gross .Discount No -Pay Net 10212 CLINICAL PATHOLOGY LABS 17,038,34 0.90 0.00 17,038.34 Vendor# Vendor Name Class Pay Code 13336 COCA COLA. SOUTHWEST BEVERAGES I Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 36408331007 ,r" 07/1=0 07/05/20 08/04/20 779.37 0.00 0.00 779.37 36408331009 ✓`07l13120 07/05/20 08/04/20 -125.00 0.00 0.00 -125.00 `�- CREDIT Vendor Totals Number Name Gross Discount No -Pay Net 13336 COCA COLA SOUTHWEST BEVERAGES 654.37 0.00 0.00 654.37 Vendor# Vendor Name Class Pay Code 13572 COMMUNITY INFUSION SOLUTIONS v/ Invoice# C mment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 202307-16 07112/20 07/06/20 07/16/20 14,542A3 0.00 0.00 14,542.43 INFUSION SERV Vendor Total.- Number Name Gross Discount No -Pay Net 13572 COMMUNITY INFUSION SOLUTIONS 14,542.43 0.00 0.00 14,542.43 Vendor# Vendor Name Class Pay Code file:///C:/UsersAtrevino/cpsilmemmed.cpsinet.com/u8 8125/data_5/tmp_cw5report223686... 7/ 13/2023 Page 5 of 17 10060 DETAR HOSPITAL ICP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net JUNC2023 01/12120 06/30120 07/30/20 453.64 0.00 0.00 453.64 yrf� LAB SERV Vendor TotalsNumber Name Gross Discount No -Pay Net 10060 DETAR HOSPITAL 453.64 0.00 0.00 463.64 Vendor# Vendor Name Class Pay Code 10368 DEWITr POTH & SON Invoice# omment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 723279-0 07/12/20 07/05/20 07/30/20 750.74 0.00 0.00 750.74 SUPPLIES 723415.0 ✓ 07/12/20 07/06/20 07/31/20 56.96 0.00 0.00 56.96 SUPPLIES 723413-0 07/12/20 07/06120 07/31/20 59.90 0.00 0.00 59.20 SUPPLIES Vendor TotalsNumber Name Gross Discount No -Pay Net 10868 DEWITT POTH & SON 866.90 0.00 0.00 866.90 Vendor# Vendor Name Class Pay Code 10175 DSHS CENTRAL LAB MC2004 „✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net CM1838-052023 v+07/12/2006/01/9006/26120 50.48 0.00 0.00 50.48 y"- LAB SERV Vendor TotalsNumber Name Gross Discount No -Pay Net 10175 DSHS CENTRAL LAB MC2004 50.48 0.00 0.00 50.48 Vendor# Vendor Name Class Pay Code / 11284 EMERGENCY STAFFING SOLUTIONS ✓' Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net r 42361 ✓ 07112/20 06130/20 07/21/20 13,860m 0.00 D,00 13,860.00 yam` CAPEKrrHOMPSON 42354 0 07/13120 07/15120 07/25/20 40,062.50 0.00 0.00 ,. 40,06250 u,.✓ PHYSICIAN SERVICES f t-1 � Vendor Totals Number Name Gross Discount No -Pay Net 11284 EMERGENCY STAFFING SOLUTIONS 53,922.50 0,00 0.00 53,922.50 Vendor# Vendor Name Class Pay Code S0501 EVOQUA WATER TECHNOLOGIES LLG ° Invoice# Comment Tran Dt Inv Dt Due Dt Check Ur Pay Gross .Discount No -Pay Net E105959240 ✓ 07112/20 07/01/20 07/26/20 2,877.90 0.00 0.00 2,877.96 `CONTRACT OUS95241 J 07/12120 07/01/20 07126120. 2,755.39 0.00 0.00 2,755.39 CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net S0501 EVOGUA WATER TECHNOLOGIES LLG 5.633.35 0.00 0,00 5.633,35 Vendor# Vendor Name Class Pay Code 10003 FILTER TECHNOLOGY CO, INC/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net �" 118796 ✓' 07/12/20 06/28/20 07/28/20 228.12 0.00 0.00 / 228.12 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10003 FILTER TECHNOLOGY CO. INC 228.12 0.00 0.00 226.12 Vendor# Vendor Name Class Pay Code / F1400 FISHER HEALTHCARE J M file:///C:fUserslltrevinolepsilmemmed.cpsinet.comlu88125/data 51tmp_ew5report223686... 7/13/2023 Page 6 of 17 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net / 3245242✓` 07/01/20 05124/20 06/18120 341.40 0.00 0.00 341.40 SUPPLIES 4046944.,/f 07/11/20 06/23{20 07/18/20 199.66 0.00 0.00 199.66 SUPPLIES 4084194 +�' 07/11/20 06/26/20 07/21120 2,455.26 0.00 0.00 2,455.26 ✓f SUPPLIES 4084195✓ 07/1112006/26/2007121/20 246.02 0.00 0.00 245.02 ✓ SUPPLIES 4124303 ✓ 07/11/20 06/27/20 07/22120 35.65 0.00 0.00 35.65 ✓� ,SUPPLIES 4124302,/'r 07/11/20 06/27/20 07/22/20 114.26 0.00 0.00 14.26 UPPLIES 4124304 07/11/2006/27/2007122/20 78,62 0.00 0.00 78.62.!- SUPPLIES 4124305 ✓ 07111 /20 06/27/20 0712MO 890.58 0.00 0.00 890,58 ✓� ,.SUPPLIES 4204618 07/11/20 06/29/20 07/24/20 766.28 0.00 0.00 766.28 J SUPPLIES 4273150✓' 07/11/20 07/03/20 07/28/20 67.27 0.00 0.00 �.r 67.27 r/ J. SUPPLIES 4302363✓' 07111/20 07105120 07130120 -742.28 0.00 0.00 -742.28 /CREDIT 4302364.E 07/11/20 07105/20 07/30/20 411.12 0.00 0.00 411.12 SUPPLIES 4337267E 07/11/20 07/06/20 07/31/20 3,414.00 0.00 0.00 3.414.00 ✓� SUPPLIES 4337264o 07/11/20 07/06/20 07131/20 266.35 0.00 0.00 256.35 a SUPPLIES 4337268 ,✓ 07/11/20 07/06/20 07/31/20 355.34 0.00 0.00 355,34 vf'� /SUPPLIES 4337266 v- 07111120 07/06/20 07131120 341.40 0.00 0.00 341.40 SUPPLIES 4337265 yE 07/11 /20 07/06/20 07/31/20 298.81 0.00 0.00 298,81 SUPPLIES Vendor TotalENumber Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 9,429.74 0.00 0:00 9,429.74 Vendor# Vendor Name Class Pay Code 1/ 0599 FORVIS ✓ Invoice# Comment Tran Ut Inv or Due Dt Check D Pay Gross Discount No -Pay Net BKO1830761 ✓f 07/12/20 06129120 07/24120 24,150.00 0.00 0.00 24,150.00 DY 1NALRECON 13KO1630034 1 07/12/20 06/29/20 07/24/20 21,000.00 0.00 0.00 f 21,000.00 w PROF FEES/AUDIT Vendor Total -Number Name Gross Discount No -Pay Net 10599 FORVIS 45,150.00 0.00 0.00 45,150.00 Vendor# Vendor Name Class Pay Code 11183 FRONTIER f Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 070223 07/1312007/02/2007/26/20 1,200.23 0.00 0.00 1,208,23 yr'' PHONE file:///C:lUsers/ltrevinolcpsilmemmed.cpsinet.com/u88125/data 5/tmp_cw5report223686... 7/13/2023 Page 7 of 17 Vendor TotalENumber Name Gross Discount No -Pay Net 11183 FRONTIER 1,208.28 0.00 0.00 1,208.23 Vendor# Vendor Name Class Pay Code 12404 GE PRECISION HEALTHCARE, LLC ,./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6002441172 y/ 07/12/20 07/01/20 07/31/20 61.67 0.00 0.00 �. 61.67 w� IM GING CONTRACT 600244117007/12/20 07/01120 07131 /20 86,67 0.00 0.00 86.67 CONTRACT 6002441324 �e' 07/12/20 07/01/20 07/31/20 868.16 0.00 0.00 068.16 y*' CONTRACT 6002441169 ✓� 07/12/2007l01/2007/31/20 3588.58 0.00 0.00 f 3,588.58 CO TRACT 6002441189 07(12/20 07/01/20 0713IJ20 6,665.83 0.00 0.00 5,665.83_," CONTRACT 6002441171 07/12120 07101/20 07/31/20 2,422.50 0.00 0.00 2,422.50 CONTRACT Vendor TotalaNumber Name Gross Discount No -Pay Net 12404 GE PRECISION HEALTHCARE, LLC 12,893.41 0.00 0.00 12,693.41 Vendor# Vendor Name. 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Discount No -Pay Net 12946 GREAT AMERICA FINANCIAL SVCS 10,657.62. 0,00 0.00 10,657.62 Vendor# Vendor Name Class Pay Code 11984 GUERBET,LLD L",,r Invoice# Comment Tran Ot Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 18684444 V 07113/2004/28/2005128120 350.00 0.00 0.00 350.00 SUPPLIES file://JC:/Users/ltrevinolepsilmemmed.cpsinet.comlu88125/data 51tmp_cw5report223686... 7/1312023 Page 8 of 17 18684493 / 07/13/20 04/28/20 05/28/20 350.00 0.00 0.00 350.00 f SUPPLIES Vendor Totals Number Name Grass Discount No -Pay Net 11984 GUERBET, LLC 700.00 0,00 0.00 700.00 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY .�'f M Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2411748 .F 0711.1/20 06/30/20 07/30/20 343.42 0,00 0.00 343.42 SUPPLIES 2412254 gyp/ 07M 1120 07/03/20 08/02/20 567.95 0.00 0,00 567.95 SUPPLIES Vendor TotalsNumber Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 911.37 0.00 0.00 911.37 Vendor# Vendor Name Class ass Pay Code 10804 HEALTHCARE CODING & CONSULTING t, Invoice# Comment Tran Dt Inv Dt Dua Dt Check.D- Pay Grasa Discount No -Pay Net 14032 V / 07/1 PJ20 06/30/20 07/30/20 355.00 0.00 0.00. 355.00 CHARTS Vendor Totals Number Name Gross Discount No -Pay Net 10804 HEALTHCARE CODING & CONSULTING 355.00 0.00 0.00 355.00 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 100772921 .+`/ 06/30/20 06127120 08101/20 4,610.62 0.00 0.00 4,610.52 LEASE 100777856 ..,/07/12120 07/07/20 08/01/20 1.797.44 0.00 0.00 1,797.44 ` LEASE Vendor Totals Number Name Grass Discount No -Pay Net 11552. 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Vendor Total:Number Name Gross Discount No -Pay Net 14540 JINDALXLLC 9,000.00 0.00 0.00 9,000.00 Vendor# Vendor Name Class Pay Code L0700 LABCORP OF AMERICA HOLDINGS ,y ,^`� M Invoice# Comment Tran Dt Inv Ot Due Di Check D Pay Gross Discount No -Pay Net 76749130 07/12120 05/27/20 06/21/20 53.60 0.00 0.00 f 53.60 ✓` B SERV 76671335 , 07112/20 05/27/20 06/21/20 747.34 0.00 0.00 747.34 LAB SERV mow✓' Vendor TotalsNumber Name Gross Discount No -Pay Net L0700 LABCORP OF AMERICA HOLDINGS 800.94 0.00 0.00 800.94 Vendor# Vendor Name Class Pay Code L1005 LAERDAL MEDICAL CORPORATION „A Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2000030845 .F%`R 07/1 PJ20 06128/20 07/28/20 105.00 0.00 0.00 105.00 SUPPLIES. _ Vendor Totals Number Name Gross Discount No -Pay Net L1005 LAERDAL MEDICAL CORPORATION 105,00 0.00 0.00 105.00 Vendor# Vendor Name / Class Pay Code L1640 LOWE'S BUSINESS ACCT/SYNCB yP W Invoice# Comment. Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 070223 07/13/20 07/02/20 07/26/20 877.07 0.00 0.00 877.07 4.ed� Vendor Totals Number Name Gross Discount No -Pay Net L1640 LOWE'S BUSINESS ACCT/SYNCB 87T07 0.00 0.00 677.07 Vendor# Vendor Name Class Pay Code M2310 MEDELA INC M Invoice# Comment Tran Dt Inv Dt Due. Dt Check D Pay Gross Discount No -Pay Net 7001575487 10,11, 07/12/2006/22/2007122/20 73.20 0.00 0,00 73.20 SUPPLIES Vendor Totals Number Name Gross Discount NaPay Net M231D MEDELAINC 73.20 0.00 0.00 73.20 Vendor# Vendor Name Class Pay Code 11141 MEDICAL DATA SYSTEMS, INC...».'' Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount NaPay, Net 183308 1„"` 07/12/20 06/30/20 07/25/20 159,51 0.00 0.00 159.51 COLLECTION FEES 183306 i'F 07/12/20 06/30/20 07/25/20 817,37 0.00 0.00 817.37 s' , COLLECITN FEES 188307V 07/12/20 06/30/20 07/25/20 2,021.70 0.00 0.00 2,021.70 file:///C:/Userslltrevinolepsilmemmed.cpsinet.cornlu881251data_51tmp_ew5report223686... 7/ 13/2023 Page 10 of 17 COLLECTION FEES ; 182934 ,� 07/12/20 06/30/20 07/25/20 78.05 0.00 0.00 78.65 BUSINESS SERV Vendor TotalsNumher Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC. 3,077.23 0.00 0.00 3,077.23 Vendor# Vendor Name Class Pay Code 12588 MEDICAL TECHNOLOGY ASSOCIATES Invoice# Comment Tran Dt Inv Ot/ Due Dt Check D Pay Gross Discount No -Pay Net INV-214398 �^� 07/0112003r28/2004/22120 9,010.34 0,00 0,00 9,010.34 INV-219012. .,I/ 07112/2006/30/2007/25/20 630.00 0.00 0.00 630.00 CT VENTILATION TESTING Vendor TotalsNumher Name Grass Discount No -Pay Net 12588 MEDICAL TECHNOLOGY ASSOCIATES 9,640.34 0.00 0.00 9,640.34 Vendor# Vendor Name Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. A/P V„i Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net ,C/gmment ,,.+' 30911878 07/13/20 07/11/20 07/20/20 28.91 0.00 0.00 28.91 INDIGENT Vendor Total: Number Name Gross Discount No -Pay Net 10613 MEDIMPACTHEALTHCARE SYS, INC. 28.91 0.00 0.00 28.91 Vendor# Vendor Name Class Pay Code M2470 MEOLINE INDUSTRIES INCM Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net. 2268909004 ✓/07/01/20. 05/24/2006/18/20 4,145A6 0.00 0.00 4,145.46 ✓'l SUPLIES 2271656123 / 07/01120 06/14/20 07/09/20 638.10 0.00 0.00 638.10 SUPPLIES F 2273016848 J 07111 /20 06/23/20 07/18/20 123.76 0.00 0.00 123.76 y SUPPLIES 2272966293 ,f 07/11/20 06/23/20 07/15/20 12.40 0.00 0.00 12AO ems% SUPPLIES 2273370765 ,11' 07/11/20 06/27/20 07/22/20 47.28 0.00 0.00 47.28 SUPPLIES 2973370764 / 07/11/20 06/27/20 07/22/20 645.52 0.00 0.00 845.52�f'+' SUPPLIES 2273427376 a/' 07/11/20 06/27/20 071VJ20 172.97 0.00 0.00 172.97 61. ^` SUPPLIES 22733707671/ 07/11/20 06/27/20 07/22/20 9.84 0.00 0.00 9A4 SUPPLIES 2273370763 ,/ 07/11/20 06/27/20 07/22/20 2B5.32 0.00 0.00 265.32 �,✓ SUPPLIES .. 2273370766 `"* 07/11/20 06/27/20 07/22/20 239.38 0.00 0.00 239.38 SUPPLIES 2273499999 > 07111120. 06/28/20 07/23/20 122.70 0.00 0.00 122.70 ..yr SUPPLIES - 2273499992 07/11/20 06/28/20 07/23/20 62.92 0.00 0.00 62.92 SUPPLIES 2273499990 Z 07111120 06/28/20 07/23/20 556.52 0.00 0.00 556.52 SUPPLIES 2273499991 / 07111/20 06128/20 07/23/20 5.14 0.00 0.00 5.14 file:///C:/Userslltrevinolcpsifinemmed.cpsinet.com/u881251data_51tmp_cw5report223686... 7/13/2023 Page 11 of 17 SUPPLIES 2273499984 %// 07/11/20 06/28/20 07/23/20 322.90 SUPPLIES 2273499987 v/ 07/11/20 06/28/20 07/23/20 28.90 SUPPLIES 2273499989 f 07/1 V20 06/28/20 07/23/20 54.20 SUPPLIES 2273499998 .1"/ 07/11/20 06/28/20 07/23/20 130.71 SUPPLIES 0.00 0.00 322.90 0.00 0.00 28.90 �✓"� 0.00 0.00 54.20 2273939199 ✓ 07/1112008130/2007/25/20-534.52 0,00 0.00 CREDIT Vendor TotalsNumher Name Gross Discount No -Pay M2470 MEDLINEINDUSTRIES INC 7,269.50 0.00 0.00 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC �+ Invoice# Comment .+r Tran Dt Inv Dt Due Dt Check D, Pay Gross / 9762607 LI 07/12/20 07/02/20 07/12/20 62.81 ,INVENTORY 9762608 tin'' 07/12/20 07/02/20 07/12/20 584.59 INVENTORY 9766560 i,{` 07112120. 07/03/20 07/13/20 24.13 INVENTORY 9766707 07112J20 07/03/20 07/13/20 108.01 INVENTORY 130.71 -534.52 Net 7,269.50 Discount No -Pay Net 0.00 0.00 02.81 d.•"`r 0.00 0.00 584.591"' 9766708 07/12120. 07/03/20 07/13/20 3.70 0.00 INVENTORY 9772146 % 07112/20 07/05/20 07/15/20 73.36 0.00 INVENTORY 9769355 r/ 07/12/20 07/05/20 07/15/20 5,326.42 0,00 }} /INVENTORY CM3577 ✓ 07/12/20 07/05/20 07/15/20 -7.82 0.00 o.ao 0.00 0.00 0.00 0.00 0,00 CREDIT 9772147q,/ 07/12/20 07/05/20 07115120, 46.45 0.00 0.00 INVENTORY 9769356 ar'I j 07/12/20 07/05/20 07/15/20 82.89 0.00 0,00 INVENTORY 9771875 07/12/20 07/05/20 07/15/20 64.58 0.00 0.00 INVENTORY 9771878./ 07/12/20 07/05/20 07/15/20 276A2 0.00 0.00 INVENTORY 9774952 � ` 07/12/20 0710612G 07/16/20 1.680.32 0.00 OAO INVENTORY 9777879 v/ - 07/12/20 07/06/20 07N 6/20 215.47 0.00 0.00 INVENTORY 9774953 p+ 07/12/20 07/06120 0711.6/20 148.19 0.00 0.00 ,{- INVENTORY 9778272v' 07/12/20 07/06/20 07/16/20 53/1 0.00 0.00 INVENTORY 8122 /r 07/12/20 07/06/20 07/16/20 -13,12 0.00 0.00 CREDIT 9782857 ✓j 07/12120 07109120 07/19/20 51590.83 OAO 0.00 24.13 108.01 3.70 a 73.35 ✓ 5,326.42 as/ -7.82 ✓/ 46.45 u 8289 64.58 % f 276.42 4 1.680.32 215.47 V ' 148.19'�'` .r Vol -13.12 5.590.63 file:///C:[Users/Ltrevino/cpsi/memmed.opsinct.com/u88125/data_5/tmp_cw5report223686... 7/13/2023 Page 12 of 17 INVENTORY 9785067 vJ 07/12/20 07/09/20 07/19/20 63.46 0.00 0.00 INVENTORY 9783927 a / 07/12/20 07/09/20 07/19/20 21.99 0.00 0.00 INVENTORY 9782856./ 07/12/20 07/09/20 07/19/20 778.45 0.00 C.00 INVENTORY 9785058 0� 07/12120 07/09/20 07/19/20 762.06 0.00 0.00 INVENTORY 9786587 07/12/20 07/10/20 07/20/20 85.89 0.00 0.00 .INVENTORY 9788198 v°� 07/12120 07/10/20 07/20/20 419.56 0.00 0.00 INVENTORY 9788199 '� 07/12/2007/10/2007120120 1,339.52 0.00 0.00 ,,!INVENTORY 9785956.i 07/12/2007/1012007/20120 546.68 0.00 0.00 �NVENTORY CM45089,/ 07/12/20 07/11120 07121/20 -62.24 0.00 0.00 CREDIT 9791860 / 07/12/20 07/11/20 07/21/20 43.88 0.00 0.00 NVENTORY CM45086 07/12/2007/11/2007121/20 -1,99 0.00 0.00 CREDIT CM45087�Ff 07112/2007/11/2007/21120 -1,597.81 0.00 0.00 CREDIT 9791861.,/ 07/1212007111/2007/21/20 1,294.23 0100 0.00 INVENTORY CM45088 VI 07/12/20 07/11/20 07/21120. -10.53 0.00 0.00 CREDIT 9791859 ,/ 07/12/20 07/11/20 07121/20 168.71 0.00 0.00 INVENTORY CM45085 rA/07/12/20 07/11/20 07/21/20 -9,143.18 0.00 0.00 CREDIT Vendor Totals Number Name Gross Discount No -Pay 10538 MORRIS & DICKSON CO, LLC 9�8.91 0.00 0.00 Vendor# Vendor Name Class Pay Code it u M2659 MXR IMAGING, INC y„*''` M Inocice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay 8 1 042436 07/12f20 06/28/20 07/28/20 250.81 0.00 0.00 SUPPLIES Vendor Total? Number Name Gross Discount No -Pay M2659 MXR IMAGING, INC 250.81 0.00 0.00 Vendor# Vendor Name Class Pay Code 10186 NATUS MEDICAL INC V" Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay 1041468395 ,/ 07/01/20 06/13/20 07/08/20 986.96 0.00 0,00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay 10188 NATUS MEDICAL INC 986,96 0.00 0.00 Vendor# Vendor Name Class Pay Code 13624 NEXION HEALTH AT NAVASOTA INC / 63.46 F 21.99 .7 778.45 v , 762.06,/ 85.89 ✓, 419.56 1,339.52 W/ 546.68 w` -62.24} 43.88 -1.99 y,✓"' ,i -1,597.81 or 1,294.23. y% -10.53 nw/ 168,71 w/ -9,143.18 v' Net 9,0281 Net 250.81 Net 250.81 Net 986.96 Net 966.96 file:///C:/Users/Itrevino/cpsi/memmed.cpsinct.com/u88125/data_5/tmp_cw5report223686... 7/13/2023 Page 13 of 17 Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net P02306021 07/12120 07/01120 (17115/20 1,000.00 0.00 0.00 1,000.0() �',✓ TELEMEDINCE JUNE 23 Vendor Totals Number Name Gross Discount No -Pay Net 13624 NEXION HEALTH AT NAVASOTA INC i'mo O 0.00 0.00 1,000.00 Vendor# Vendor Name Class Pay Code 11472 OCCUPRO LLC Invoice# Comment Tran or Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 30690 07/12/20 05107/20 06/06/20 502.11 0.00 0.00 502.11 pf LICENSE Vendor Totals Number Name Gross Discount No -Pay Net 11472 OCCUPRO LLC 502A 1 0.00 0.00 502.11 Vendor# Vendor Name Class Pay Code f 00920 OFFICE DEPOT ✓ Involce# Comment Tran Ot Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 319244259001 V/ (17/12/20 06/20/20 07/23/20 621.98 0.00 0.00 621.98,,-" SUPPLIES 319241097001 , / 07/12/20 06/23/20 07/23/20 347.98 0.00 0.00 347.98 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 00920 OFFICE DEPOT 969.96 0.00 0.00 959.96 Vendor# Vendor Name Class Pay Code 01416 ORTHO CLINICAL. DIAGNOSTICS , /- Involce# CommentTran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1853018117r ✓ 07/12120 06/29/20 07129120 1,148.18 0.00 0.00 1,148.18 �/• SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 01416 ORTHO CLINICAL DIAGNOSTICS 1,148.18 0.00 0.00 1,148,18 Vendor# Vendor Name Class Pay Code 11165 PARAREV ✓` Invoice# Comment Tran Ot Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net / 904253 07/1312007/0112007/31/20 3,084.00 0.00 0.00 3.084.00 ps' REVENUE INTEGRITY ,. Vendor TotalsNumber Name Gross Discount No -Pay Net 11156 PARAREV 3.084,00 0.00 0.00 3,084.00 Vendor# Vendor Name Class Pay Cade 10152 PARTSSOURCE, LLC a/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 048370321-r' 07/12/20 06/20/20 07/20/26 144.42 0.00 0.00 144.42 SUPPLIES 04847301 07/12/20 06/28/20 07/28/20 724.84 0.00 0.00 724.84 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10152 PARTSSOURCE, LLC 869.26 0.00 0.00 869.26 Vendor#Vendor Name Class Pay Code 12336 PFIZER INC. y% Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1800017499v/ 07112120 07/05/20 08/04120 63,856.44 0.00 0.00 63.656.44 340E PAYMENT . Vendor Totals Number Name Gross Discount No -Pay Net 12336 PFIZER INC. 63,856,44 0.00 0.00 63,656.44 file:l/IC:/UserslltrevinolGpsilmemmed.cpsinet.comlu881251data_51tmp_cw5report223686... 7/1312023 Page 14 of 17 Vendor# Vendor Name Class Pay Cade P2200 POWER HARDWARE *,,�W Invoice# Comment Tran Ot Inv Dt Due of Check D Pay Gross Discount No -Pay Net 053023 07/13/20 06/30/20 07/10/20 98.02 0.00 0.00 98.02 SUPPLIES Vendor Totals -.Number Name Gross Discount No -Pay Net P2200 POWER HARDWARE 98.02 0.00 0100 98.02 Vendor# Vendor Name Class Pay Code 11932 PRESS GANEY ASSOCIATES, INC. Invoice# Comment Tran Ot. Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net IN000596243 07/12/2006/3012007130120 J 2,729.72 0.00 0.00 2,729.72 y„r CONTRACT FEES _ Vendor Totals Number Name Gross Discount No -Pay Net 11932 PRESS GANEY ASSOCIATES, INC. 2,729.72 0,00 0,00 2,729.72 Vendor# Vendor Name Class Pay Code 12480 PRO ENERGY PARTNERS LLC ✓� Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 2306-moo ,/ 07/13/20 07/11/20 07/26/20 1.583.67 0.00 0.00 1,583.67 ENERGY Vendor Totals Number Name Grass Discount No -Pay Net 12480 PRO ENERGY PARTNERS LLC 1,583,67 0.00 0.00 1,583.67 Vendor# Vendor Name. Class Pay Code 11252 RX WASTE SYSTEMS LLC V/ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross. Discount No -Pay Net 4104 07/12/20 06/01/20 06126/20 / 60.00 0.00 0.00 60.00 yf' WASTE Vendor Total., Number Name Gross Discount No -Pay Net 11252 FIX WASTE SYSTEMS LLC 60.00 0.00 0L10 60.00 Vendor# Vendor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES I` Invoice# Comment Tran Ot Inv Ot. Due Ot Check D- Pay Gross Discount No -Pay Net 5638230049370 r�' 07M3120 06124120 07/14/20 4,038.24 0.00 0.00 4,038.24 RENTAL A20002359 , Vendor Totals Number Name Gross Discount NaPay Net 10936 SIEMENS FINANCIAL SERVICES 4036.24 0.00 0.00 4,038.24 Vendor# Vendor Name Class Pay Code 14716 SINGLETON ASSOCIATES PA 1 Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Grosse Discount No -Pay, Net 51-24 , / 05111/20 07/03/20 08103/20 272.75 0.00 0,00 272.75 RADIOLOGY SERV Vendor Totals Number Name Gross Discount No -Pay Net 14716 SINGLETON ASSOCIATES PA 272.75 0.00 0.00 272.75 Vendor# Vendor Name Class Pay Code 14868 SINGLETON ASSOCIATES, P.A. Invoice# Comment Tran Dt Inv Or Due Dt Check D Pay Gross Discount No -Pay Net 246-063023-001 07112/20. 07/06/2007/15/20 14,266.66 0.00 0.00 14,266.66 ONSITE SERVICES w' Vendor TotalE Number Name Gross Discount No -Pay Net 14868 SINGLETON ASSOCIATES, P.A. 14,266.66 0.00 0.00 14,266.66 Vendor# Vendor Name Class Pay Code S2362 SMITH & NEPHEW, INC. V file:/l/C:fUserslltrevinole,psilmemmed.cpsinet.com/u88125/data_5/tmp_gw5report223686... 7/13/2023 Page 15 of 17 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 981958886107/1212006/28/2007/28/20 673.28 0.00 0,00 673.28 SUPPLIES ems` 981985286 ✓ 07112/2007/0412008/01/20 1,909.28 0.00 0.00 1.909.28 f SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net S2362 SMITH & NEPHEW, INC. 2,582.56 0.00 0.00 2,582.56 Vendor# Vendor Name Class Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE CEN o,/f Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Grass Discount No -Pay Net 107032587y/ 07M W20 06/30/20 07/25/20 6,436.00 0.00 0.00 5,436.00 BLOOD CM9789 y% 07/12/20 06/30/20 07/25/20 -4.224.00 0.00 0.00 -4,224.00 CREDIT Vendor Totals Number Name. Gross Discount No -Pay Net 11296 SOUTH TEXAS BLOOD & TISSUE CEN 1.212.00 0.00 0.00 1.212.00 Vendor# Vendor Name Class Pay Code S2345 SOUTHEASTTEXAS HEALTH SYS ,✓f W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 26799 f 07/13/20 07/05/20 08/04/20 5,000,00 0.00 0.00 5,000.00 2023 JULY-SEPT MEMBERSHII Vendor Totals Number Name Gross Discount No -Pay Net S2345 SOUTHEAST TEXAS HEALTH SYS 5,000.00 0.00 0.00 51000,00 Vendor# Vendor Name Class Pay Code 14776 SOUTHEASTERN BIOMEDICALASSOC ✓`` Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 671171/ 07112120 06/28/20 07113120 928.00 0.00 0.00 928.00 SERVICE WORK - Vendor Totals Number Name Gross Discount No -Pay Net 14776 SOUTHEASTERN BIOMEDICAL ASSOC 928.00 0.00 0.00 928.00 Vendor# Vendor Name ! I Class Pay Code 12288 SPBS CLINICAL EQUIPMENT SRVC b/- Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV019730723 ✓`f 07/121200710112007/02/20. 9,458.59 0.00 0.00 9,458.59 CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net 12288 SPBS CLINICAL EQUIPMENT SRVC 9,458.59 0.00 0.00 9,458.59 Vendor# Vendor Name Class Pay Cade 13528 STRYKER FLEX FINANCIAL. / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 297256 ✓1 0613012006/14/2008/01120 1,294,26 0.00 0.00 1,294.26 LEASE Vendor Totals Number Name Gross Discount No -Pay Net. 13528 STRYKER FLEX FINANCIAL 1,294.26 0.00 0.00 1,294.26 Vendor# Vendor Name Class Pay Code S2830 STRYKER. SALES CORP'` M Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 9204181752 ✓ 07/12120 06/27120 07/27120 839.91 0.00 0,00 839.91 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net S2830 STRYKER SALES CORP 839.91 0.00 0.00 839.91 file:///C:/Users/ltrevinolepsi/memmed.cpsinet.comlu&& 125/data_5/tmp_cw5report223636... 7/ 13/2023 Page 16 of 17 Vendor# Vendor Name Class Pay Code 12704 TEXAS BURNER & BOILER SERVICES V/ Invoice# Comment Tran Dt Inv Dt Due or Check D Pay Gross. Discount No -Pay Net 23-3304 „/ 07/11/20 05125/20 06/23/20 1,954.00 0.00 0.00 1,954.00 tf HVAC BOILER -- �0-AU_ Vendor Totals Number Name Gross Discount No -Pay Net 12704 . TEXAS BURNER & BOILER SERVICES 1,954.00 0.00 0.00 1,954.00 Vendor# Vendor Name Class Pay Code 13880 TEXAS SELECT STAFFING ,/ Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 0022482-51-079 ✓ 07/1212006/2912007/01/20 4,070.00 0.00 0.00 4,070.00 " BRANDON BATES W/E 6/24/23. 0022508-51-079 �/ 07112/2007/0012007/07/20 4,097.50 0.00 0.00 4,097.50 BRANDON BATES Vendor Totals Number Name Gross Discount. No -Pay Net 13880 TEXAS SELECT STAFFING 8,167.50 0.00 0.00 8,167.50 Vendor# Vendor Name Class Pay Code 10985 THE COMPLIANCE TEAM, INC "r Invoice# �omment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0037681 07/12/20 06106/20 06/07120 4,650.00 0.00 0.00 4,650.00 ACCREDITATION CONTRACT ODS8225 ,/ 07/12/20 07/11/20 07/12/20 2,137.50 0.00 0.00 2,137.50 -i ACCREDITATION CONTRACT Vendor Totals Number Name Gross Dlaeount No -Pay Net 10985 THE COMPLIANCE TEAM, INC 6,787,50 0,00 0.00 6,787.50 Vendor# Vendor Name Class Pay Code 13224 TORCH Invoice# , Comment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 2229930 /2�00�6,1,2}912007129120 07/12A*" 3,922.78 0.00 0.00 3.922.78 MAY EXPENSES A* "� lW%"kvM t "49 d 311.13 Vendor Totals Number Name Gross Dlsceunt No -Pay Net 13224 TORCH 3,922.78 0.00 0.00 3,922,78 Vendor# Vendor Name Class Pay Code T3130 TRI-ANIM HEALTH SERVICES INC M Invoice# Comment Tran Ot Inv or Due 01 Check D Pay Gross Discount No -Pay Net 65570984 -/ 07/1PJ20 06/28/20 07/23/20 137.99 0.00 0oo 137.99 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net T3130 TRI-ANIM HEALTH SERVICES INC 137.99 0.00 0.00 137A9 Vendor#Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC' Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Not 2921007693. „ / 07/12/20 07/03/20 07/28/20 2,258.31 0.00 0.00 2,258.31 ,,, / LAUNDRY 2921007694 ✓ 07/12/20 07/03120 07/28/20 61.43 0.00 0.00 61.43 ✓` LAUNDRY 2921008082 07/12/20 07/06/20 07/31/20 200.24 0.00 0.00 200.24 J LAUNDRY 2921008077f 07112120 07106/20 07/31120 91.28 0.00 0A0 91.28 LAPNDRY 2921008084 / 07/12120 07/06/20 07131 /20 150.60 0.00 0.00 150.60 ✓ file:///C:/Users/Itrevino/epsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report223686... 7/13/2023 Page 17 of 17 LAUNDRY 2921008078 r,/ 07/12/20 07/06120 07131120 1,748.19 0.00 0.00 1,748A9,% LAUNDRY 2921008081 ✓l07/12/20 07/06/20 07/31120. 21.3.06 0.00 0.00 213.06 ✓ LAUNDRY 2921008080 , / 07/12/20. 07/06/20 07/31/20 234.61 0.00 0.00 234.61 LAUNDRY 2921008083 ✓ 07/12/20 07/06/20 07/31/20 78.69 0.00 0.00 78.69 ✓ LAUNDRY 2921008339,/`� 07/12120. 07110/2008104/20 1,955.34 0.00 0.00 1,955,34 LAUNDRY 2921008340 V 07/12/20 07/10/20 08/04/20 61.43 0.00 0.00 61.43 ✓' f LAUNDRY Vendor Totals Number Name Grass Discount No -Pay Net. U1064 UNIFIRST HOLDINGS ING 7,053.18 0.00 0.00 7,053.18 Vendor# Vendor Name Class Pay Code 12400 UPDOX LLC ,%l invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net INVO0430098 ,�,06/30/20 00/30/20 07/30/20 1,497.61 0.00 0.00 1,497.61 J'} FAX INVO0423645 y,✓'� 07/12120 05/31/20 06/30120 1.410.81 0.00 0.00 1,410.91. FAX Vendor Total: Number Name Gross Discount No -Pay Net 1.2400 UPDOX LLC 2,908.42 0.00 0.00 2,908.42 Ventlor# Vendor Name Class Pay Code 13048 US MED-EQUIP, LLC Invoica# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net. R512114 / 07113/2005/31/2006/30/20 975.00 0.00 0.00 975.00 ter` v FETAL MONITOR R515138, / 07113/20 06/30/20 07/30/20 975.00 0.00 0.00 975.00 FETAL MONITOR Vendor Totals Number Name Gross Discount No -Pay Net 13048 USMED-EQUIP, LLC 1,950.00 0.00 0.00 1,950.00 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9111351054 ,f 07/11 /20 07/05/20 07/30/20 179.09 0.013 0.00 179.09 ,. SUPPLIES 9111341687,.01 07/12/20 OW14/2007/09120 1,571.67 0.00 0.00 1,571.67 CONTRACT Vendor TotalsNumber Name Gross Discount No -Pay Net 11110 WERFEN USA LLC 1,750.76 0.00 0.00 1,750.76 Report Summary Grand Totals: Gross Discount No -Pay Net 635,079.26 0.00 0.00 635,079.25 0•C <-13B0'`F Jq, �t-bdre el'1JY1 63 5 • L'i `-' - 2 % ' APPROVED 01I a1t1^Ub - 91 6. 9 6 t 1�1P 1 3 ?E12� $►a3ra25. lw 55 Ue - T ASP 001ON-1 ,( i7F file:///C:fUsers/Itrevino/epsi/metnmed.cpsinet.com/u88l25/data 5/tmp_ew5report223686... 7/13/2023 ® By THE ..Niom TIME: 12:02 JUL 13 2023 PATIENT ,:.►j...�... MEMORIAL MEDICAL CENTER PAGE 1 EDIT LIST FOR PATIENT REFUNDS ARID=0001 APCDEDIT PAY PAT AMOUNT CODE TYPE DESCRIPTION ARID=0001 TOTAL 1488.99 -------------------------------------------- ------------------------- ................................ .............................. TOTAL 1488.99 JUL 1 3 FlECEVED D7 THE "OU6rr E 1Wtif(r�h Oh: ,(J� i?d GC1UP1 hl,l cXF15 CITIBAW CORPORATE CARD Account Statement CamMOR6ICM4A4CaaM AoInquiries: ROSHAWASTHOMAS Tol Flee: 1-(8W)-248-0555 InternaltannI: i-(SR-954-7314 Account Number: XXXX-XXXX-XXXX-9457 TDD/T7Y; 1-(8T7)-505-7276 (Summary of Account Activity Not an Invoice. For yourrecords only. I TaIaIACINII7 SVIZ08 Send Notice of611ing Errors and Customer Service Ingo'a'tes to: CITIBANK, N.A„ PO BOX 6125. SIOUX FALLS SO 57117-6125 creaiLLlmtt S151000 Cash Advance Umil SO Statement Closing. Date 07103/2023 Oaye in Billing Period 30. Transactions """"""`•'•'•"' NOTICE MEMO FrEM(S) LISTED BELOVV- ..... .....••••••• 06W 06105 9399 05134373167600036959333 1 NPOS NPOB.HRSAGOV FAIRFAX VA 22033 USA N95546320 145,00 M06 O11105 9399 05134373157600036959416 2 NPDS NPDB.HRSA.GOV FAIRFAX VA 22033 USA N95546420 J j 05106 0610E 9399 05134373157500036950580 3 NPCB NPDB.HRSAGOV FAIRFAX VA 22033 USA 1/2.50 N95546717 DEW M07 7032 5543288315OW5251348767 4 WPY'STRAC 856-B893729 TX 70227 USA /53300 \ MO8 06107 366E 55436873159101696442371 5 HAMPTONINNS PORT LAVACA TX 77979 USA -Ifffi.94. -. ODS52916 CHECK IN: 0610S12023 00962918 / W09 0=8 2640 82704873159722SON07978 6 HYATT HILL COUNTRY RES SAN ANTONIO TX 782SI USA ` 45137301 yr�l424 CHECK IN: 0B/1912W3 OFJ12 06109 3670 52704873160722600823581 7 HYATTHILLCOUNTRY RES SAN ANTONIO TX 73251 USA va 45142856 'Ozn CHECKIN:06119n023 06112 06/09 8062 554573731612CO37360MIS 8 TEXAS HOSPITAL ASSOC AUSTIN TX 787M USA ' OEM 06113 8062 5545737316MOUB739MO31 9 TEXAS HOSPITAL ASSOC AUSTIN TX 73701 USA �A500 v""!3GOD CR MIS O6g3 BD52 55457373165200873800015 10 TEXASHCSPITALASSCC AUSTIN TX Ta101 USA ,�IGGM 0611E M14. 3665 5543887316010166572MS 11 HAMPTON INNS PORT LAVACA TX 77979 USA .6 1129 0094221li d CHECK IN: M10712023 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION _ptj. POBO 15 NA `(L`r'A PO BOX fii25 SIOLIX FALLS SO S7117-6125 ROSHANDA S THOMAS 202S ANN ST PORT LAVACA TX 77979.4204 Paget and Account Number XXXX-XXXX-XXXX-9457 Statement Closing Date. July 03,. 2023 00007905040 Not an huce. Poryourrecordsonlq. F Account: XXXX-)0=.,,e=.g4s7 Transactions (can't) ..u... ...<. aaru aceuVC731737n60E696193 12 HYATT HILL COUNTRY RES SANANTONIOTX 78251 USA .AZ$.02 /./ 45137301 CHECK IN: Ofv1912023 06123 06r21 3640 62704873173722606724151 13 HYATT HILL COUNTRY RES SANANTONIO TX 78251 USA A368.04 45142856 CHECK IN:. 0SIIM023 O6/28 Ofif27 9399 55488723179081275002695 14 TXDPS CRIME RECS AU"N TX 78762 USA 3.63 ;' . .......... ......... r..r.� ....... .__..._..!`_ Page 3 of 4 • aeparra[asywr5fden CamlmmoYhfelY: CYOWIepMnGlMmarz Open away day ]d nWrsa 11ay. a111111Y NGICmM SaN1.0 2011 Te rlurllMa $apea iedM lbw ad the Solemnl la holon.a Radar md.h calarwou. CNE. 4avo daf CarrollLiner EWh Crrhafar has On mddtlud Csma Urea ppakn 0I ymkh may 1W used nor Cmb NMnms). "Ich h Me maimum wmWnt that the Call,LSlrcan Nmpe alany Ume Thaec01" Cad In n "On, lim tone Ca511 Wnh. E a Un 6 tlN3lA:nM 6y Ma Csmpnmy noel b Y pGINn EI Ira [alai Campiny GtllLinC. • FE MYmdae aramllmeld a t AMSSny on-almig ChCrbip-oke Cand any &h dl Old ciwnam m. Naafi 4M. by , a'. CM Carpemle cam Cuflamaa EYN'aCd Car dd on n arm me open ne f tlay. N hours a tlay at the leldphpne numhN spmMnlan MsbOMMUIe Mdlemenl. Poynlmu: VOU m3Y melee ao. a. to your YltlktluallytllladCNda[munlCMYo a. dfing CMNanw,ln. land. 01.1 n t doKybders IJO3 paying i n01 n hall. LN:nam. Wire pa•)maM fILVd. 5npa w kF CTMIICIEG t o Or by f,oaaf the Nlaw SUIfKfenllNllillg lLTG EIe35e Wf yaYldemMtnYmb¢r Cn 11N IlOMOt 115¢GM1Kk Fci rfntrallyhelMaz<Wnt; pIWe3 G: 6U1e 10 Sv`ndon Camparry [reckon Prymen! rna3Cardlleldgf hllanms Ilvrcrir'sivn ym[malea prynan:k ry'eper 1pmaC pvr pmp0v^Ma lacuily by E;M Pm Ea tam Time, it Mil On Eredied as nr that ea, loan[ liGand140 he halen.Oalf anfa nnh lr an th In t 0jhr, noWVanfar duroel d0alh and Nllar m9lnEde. G' II IM nLmEar an the don[ d Yi4 dakmpnl I0r CC41iL^. y1 JMIAy anardireanr EY as pdymmtn am(pme h0cono and1011m!<oauno MC G.tnpany: W MMm UIe cHalltal PpplptlEn fbr Ma Acmunl end Me w ftua of MI pCrsm3 o Adeum tr for the orms 01 TheliW.and(Itl(nid Aasen-0 by all w al Me w0han YtlY IM1C krm3 al h.0 fclyale Card AtreemaM by all aMtlhnd'h to v.TW Carts ore bored. Mall(wnal CnNbddb The Canaan, may f.,WI applicwims le' awd..l . Sandal InAdmlaWn an ClCh /droners Camn.jd s may, ono COIN daYaW 8 aer tfia,[Ca kmdonsrnrtmtpe hWOodlar'hyynadinyCan Caradrale Cald£arlr.a. Our lelephrhe lhm are open The CamhelEefs Cash M'mnm Lnk 0 a Fowl Cl the QhAVdWS Tool Nwday. 2ahWfS atlay at the kleaWne numbar apdWyed an Iho rlmt Of I ClmbLlne It h cat am "national tine Or cedR ablement. LAW. one CM CNparale Cam per QndhNEer. For Ush Maarrcm M1nn Paid, a Npeale Ponanal mmmlol#n F Ca. condom CamtanoW Numbar(FIN) B hadiled IM dacbay putpreed felal,Clllnlana CRAanfle NO. 1". anmamaeyour CNNanaaLi aM?R Ieg. GGI:aNGnr anablda yaV 1a mana9C lal p,-'. V(Per v you 0. ttem amlrAlermo. ca. ar, ,ell dcFef R— W.hmpbela de, Te"Ie calk Nod online m NCII m Gmtfiml nrmunl Wand To rdIn ", plaGnla Irq m to svxn.Gbimnrvsw.Nmtontaand an MC 'Sell an ragountane, r , kooll. llM nor Ca1MWltlem' Iink FlW Ilona. IMw+IFR pOmpL^ le eSdtlkh Ycw aamUEL • la Case W Eemrs or QWIICW MOW Your any: Yon me mspaW:Oe lal forery Me dblTe mmlUtatpraCes IYWr AO.rd dmmeM6nUebnaas MOtyW. beliase am uno lr-n dd, a:m n"All hr mannardee III Ins not FRbn Idde . at far hooch dmartllananai VoV Char,dim 0-atama arcane' 1. hand been amunem ..dk an. W rnWR-swChaTe crto cthe ilpine Iyouhoe Caen La, Ve Naab nnp, h twl 'harm. TO bean Me tlisFuk M'Clrlkn pmwm, Ydt einmdmaacmmnmar • Yen may claw dwaum a tmnanban by ymdna m M. You mny afte to Ya on a upmme'heal 01 aM oarless."and on Ile hml cl Nis and." m scan an p641Wa. POOOSO na*be M Won Mar MdaR and, Me data al nle halan Whirl, the In. QW, Nmmnl Cl MC eN meted andy. • Cescdle Meenar and a'plain the... tar Me an, a came tnbnralan Ion pendent a IMUt an 3Cm. plmsC da dm id e h t0 Ya. • bkmhanl Mpuks. II be Campany b WraMltler xna una aped, W Yet. Page 2 of4 Account: XM-XXXX-XXXX 9457 Page 4 of 4 a MEMORIAL MEDICAL, CENTER ]PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361) 552-6713 PHONE: (361) 552-6713 FAX: (361) 552-0312 FAX:p(361) 552-0312 �j y Vendor Name: ,� �, Date: 1 1 l 1 pao),3 Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account# . Initiated Date Required ExpenseW Department DeliverTo rormx>vvi Line No. Qty. Catalog Number Description Unit Cost Unit Extended Iicost p� 2 ✓ Nt PM )c q rpyo V t��"7 r NpL-)[)J X I mAZr a.�o a wpr�Y�G — r 9 aL t V t✓ v. r Y � t v VM 'V ,ya Est. Freight Est. Total ost TOTAL COST 5 MG Contact: Date: Dept. Director Quoted By. Dir. Nursing Buyer. E.T.A.. Dir. Clinical Services Administrator HE Bill To: S 15 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361)552-6713 FAX:(361)552-0312 Vendor Name: Vendor Address: Vendor Phone #: Vendor Fax M MEMORIAL MEDICAL, CENTER PURCHASE ORDER Ship To: 815 N. VIRGINIA ST, PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (361) 552-0312 Date: -I I + 1 ;*a!5 P.O. # Account # Initiated Date Required Expense Department Delr*M n 14U Iiver To Line No. Qty. Catalog Number Description Unit Cost Unit Mws. Extended l v Y 1{Xi�- "'✓ -'Vli� �� 1 aCost 6 a�e I d^ z rp - " M� 3 / ✓(�t/�I/1�91rtiiV �l'v�J 4t�(/ �Q� c- , 016 or - 6 NJ r f2b&il..�, D ' i`t-� 1"�'v�""�l✓'�� 7 g emS G-"kpvt_ �9 �C:C6L SS U"' t"`6ih �d5t'aNty to ._.a � �S F-En�sDG• �� bY) � QIrj.®C 'Ttl ar/1 �c.vv tavv - Est. Freight Est. Total Cost TOTAL COST �rn Aa nrnmce. —7�1' 9P—i�.__L .= Contact: Date: Quoted By: Buyer: E.T.A. Dept Director Dir. Nursing _ Dir. Clinical Services MEMORIAL MEDICAL CENTER �__/ PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA ST. PORT LAVA -CA, TX 77979 PORT LAVACA, TX 77979 PHONE: (361)552-6713 PHONE: (361)552-6713 FAX: (361)552-0312 gam,,,,,, g7 FAX: (361)552-0312 Vendor Name: lip-yp�/i/Y �9 ` Date: Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account# Initiated By:_ _ Oate Required ExpenseM Department Deliver To FormM9401 Line Qty. Catalog Number No. Description p Unit Cost Unit Extended Nim. Cost 2 _ Rpr �C f/1/j� W D ®ij llu— �i Ixr s t 4 �Ii H/VWGC e HOW 6 .. �. -l�.v✓v'PoG 1 `r `'i irry �/ Q/�. l ,; 1.u- i'Ylr•h� d d� ✓ r �sc.i[� �' vim-+ $ h t r P 1 k/7" 5 CH tp w-12eC5� to Est. Freight Est. Total Cost NOTES: TOTAL COST Aj Fi +`Y. 0 Contact: Date: Dept. Director Quoted DT. Die Nursing Buyer. E.T.A. Dir. Clinical Services CFO Administrator i `� ti RECENEDOYTHE Page I of I caumv AUDITOR ON 'JUL 14 2023 MEMORIAL MEDICAL CENTER ��nnzz��:OS TEXAS CR11101n1 0 11:05 AP Open Invoice List ep_open invoice.tempiate Oates Through: Vendor# Vendor Name / Class Pay Code C1048 CALHOUN COUNTY y/ . W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount NwPay Net -62683397> 07/12/20 06/23/20 07/23/20 8.47 0.00 0,00 _&47, ELECTRICITY P}([SAjKAA 6AikbW kiJ-- 425Z8818o 07/12/20 06/23/20 07/23/20 18.05 U0 0.00 —48r85-. ELECTRICTY 6a 11 62678UQ 07l12/20 06/23/20 07123/20 33,377.47 0.00 0.00 43,89747. ELECTRICITY u It ZZW844 0711PJ2006/23/2007/23/20 1,661.06 0.00 0.00 +6E1z06, ELECTRICITY u t t -621578268 07112/2006123/2007423120 531.08 0.00 0.00 .531.,08.1 ELECTRICITY " ev 071423 07/14/20 07/14120 07119/20 150,000.00 0.00 0.00 150,000100, LOAN REPAY , VendorTotals Number Name Gross Discount No -Pay Net. 01048 CALHOUNCOUNTY -f85,--598:99. 0.00 UD _85,596,83 Report Summary Grand Totals: Gross Discount No -Pay Net 48549"3 0.00 0.00 JISSAM23 APPROVED ON 8r rouijn AUX;r,U fite:///C:lUserslitrevinolcpsilmemmed.cpsinet.coralu88125/data_S/tmg_cw5report330309... 7/14/2023 MEMORIAL MEDICAL CENTER CHECK REQUEST P CALHOUN COUNTY Date Requested: 7/14/2023 A Y lV ROVED ON E JUL 14 2023 E rn?ungOUNTY Dl�q AMOUNT $150,000.00 FOR ACCT. USE ONLY ❑Imprest Cash E]A/P Check nMafI Check to Vendor Return Check to Dept Q' L NUMBER: 20410000 EXPLANATION, REPAYMENT OF LOAN DATED NOVEMBER 30, 2022 —PAYMENT 1 OF 18 REQUEST ED BYr ANDY DE LOS SANTOS AUTHORIZED --i l 21-5 Memorial Medical Center Calhoun County Line Of Credit Loan Repayment Schedule Date Of Request: November 17, 2022 Loan Amount: $3,000,000.00 Loan Payment Term (in Months):18 Months Payment Frequency: Monthly Beginning / Remaining Payment # Payment Due Date Repayment Amount Balance 0 $3,000,000.00 1 7/15/2023 $150,000,00 $2,850,000.00 2 9/15/2023 $150,000.00 $2,700,000.00 3 9/15/2023 $150,000.00 $2,550,000.00 4 10/15/2023 $150,000.00 $2,400,000.00 5 11/15/2023 $150,000.00 $2,250,000.00 6 12/15/2023 $150,000.00 $2,100,000.00 7 1/15/2024 $150,000.00 $1,950,000.00 8 2/15/2024 $150,000.00 $1,800,000.00 9 3/15/2024 $150,000.00 $1,650,000.00 10 4/1S/2024 $150,000.00 $1,500,000.00 11 S/15/Z024 $150,000.00 $1,350,000.00 12 6/15/2024 $150,000.00 $1,200,000.00 13 7/15/2024 $200,000,00 $1,000,000.00 14 8/15/2024 $200,000.00 $800,000.00 15 9/15/2024 $200,000.00 $600,000.00 16 10/15/2024 $200,000.00 $400,000.00 17 11/15/2024 $200,000.00 $200,000.00 18 12/15/2024 $200,000.00 $0.00 CO,: e000 MEMORIAL MEDICAL CEITIM AP 815 N VIRGINIA STF4iEf MITT LAVACA TX 77979 STATEMENT ANT DUE REMITTED VIA ACH DST Statement for information only As of: 07/1a2023 Page: 002 To ensure moFer orearc to year e«wm, delaeti and Mum this Mub with your resultants nC: Bt 15 As al: 07/1412023 Page: O02 Mall I. Came: 8000 Territory: AMT DUE REMITTED VIA ACH DEBIT Customer. 632536 Statement for Information only Date: 0711512O23 Curt: 632536 PlEA6E CHEDK ANY Date; 071IS12023 ITBAS NOT PAID (s) 911:9 Due Receive,, atom A<C9wa 9jjyi6 Cash Amount P Amount P Receivahh Date Date Number Refereme Description DisoouM times) F (net) F Number PF column hill P - Not Due Item, F = Fmure Due Item, blank = Current Due Item TOTAL• National Aed 632536 MWORIAL MEDICAL CENT9i Bubtalals: 10.379.45 USD Future than Past Oue: Last Payment 06/9T/2O17 s 6sa _ A?Pi1OVE-) OIN! JUL l 1 iAT�f G M �t^F i , TEX`S 0.00 It Paid By 07/1812023, 0.00 Pay This Amount: 2.451.97 It Pald After 07/1812023, Pey this Amsum: Due N Paid On Tlme: USD 10.171.85 ✓ 10,171.85 USD Diva had 8 Pald We. 207.6O Due If Paid late; 10.379.45 USE) USU 10,879.45 W 41U.'LC.I.Jr.ii-ylti 4s'rf.`c� For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT As d: 07/14/2023 Page: 001 TA ensue proper our fecio to your rt ael elan aemur8. and his mme:ey. ecoo nub way; your em8enae WALMART 1098IMM MED PHS ANT DUE REMITTED VIA ACH D®IT MEMORIAL MEDICAL CENT61 Statement for information only KALISIX 15 815VICN VI�INtA ST PORT tAVACA TX 77979 DC: 6115 Tem,ory: 7001 Cattleman. 256342 Dale: 07/15/2023 A. of: 0711412023 Page: 001 Mail I. Comp: 8000 AMT DUE PITTED VIA ACH DEBIT Statement for information only Cud: 256342 PLEASE CHECK ANY Data: 07/16/2023 RBAS NOT PAID (A) aging Due Dale Date ReceNable ellorwl Account Wgsy96 Numbw We... Description Deal, Dunstan A.UM P (9rosa) F Amount P Rxelvebb treat) F Number Customer alumina, 256342 WALMART 1098/MBA MED 07110/2023 07/18/2023 7429844666 PHS 80614509 1151nedoe 0.25 12.29 12.04v/, 7429844660 07/10/2023 07/18/2023 07/1012023 0711 W2023 07/10/2023 07/18/2023 07/10/2023 07/18/2023 07/10/2023 07/18/2023 7429844657 7429844669 7429858805 7430045150 7430045151 80654596 00729116 80622263 80770234 80698695 11 tim"olce 11 smvde0 1151nv01ce 1951nvaice 1951nveice 12.34 5.15 6.16 0.01 0.50 016.92 307.44 307.44 0.63 25,20 604.58✓ 7429844667 301.29✓ 7429844669 301.29 //742985890S 0,62 ✓/ 743004515D 24.70/ 7430045151 07/1012023 07/18/2023 07M912023 07/18/2023 7430045152 7430045153 OW73977 80625405 1151nvalce 1151nv01aa 0.01 0.01 0.32 0.32 0.31 7430045452 0.31� 7430045153 07M1/2023 071IM023 7430248032 U0926223 1151nv0ice 6.15 307.37 301.22 7430248039 07/12/2023 07/18/2023 7430605643 81015025 1951nvoice 0.26 13.23 12.97✓ 743060S643 07/12/2023 07/18/2023 7430747116 340b_100211 I SInsmee. 81.36 4,067.54 3,988.1g✓ 7430T41118 07/15/2023 07/1812023 7430792421 81216742 115Immure 12.30 614.88 602.58 6 7930792421 07/13/2093 07/18/2023 7430792422 81216742 1151nvoice 0.02 0.96 0.94 7430792422 07/13/2023 07018/2023 7430792423 81208720 11510v0ice 18.45 922.32 903.87 f 7430792423 07/74/2023 07118/2023 7431061069 81257133 I shumiae 16.68 784.19 768.51 f 7431061068 0711412023. 07/18/2023 7431001069 6125T133 1151nv0ice 2.36 117,99 115.63 f 743t061069 07/14/2022 07/18/2023 7431061070 B1257133 t151m0ice 13.69 684.72 671.03 ,r'/ 7431061070 07/14/2923 07/18/2023 7431228129 81263464 1951nvolce 1.47 73.71 72.24 7431225129 y PF autumn legand: P = Pan Due Item, F = Fulum Due item, Hank = Commit Dix Item TOTAL Custa,nar Number 256342 WALMART 1098/MEM MM PHS SaMmmin, 8,857.47 USD Future Me: 0,00 Due If Paid On Time: It Paid By 07/18/2023, USD 8,680.32 ✓J Past Due: 0.00 Pay This Amours: 8,680.32 LED Dim lost 8 paid late: 177.15 Led Payman, 7.532.00 it Paid After 07/1 amo23, Due N Puts late: 07/10/2023 Pay this Award: 8,857.47 LED USO 8.857.47 AWP'SOVED 4iro AIL 1 ! 9? S / Tz. For AR Inquiries please contact 800-867-0333 m=IICJ,V 1Y STATEMENT As of: 07/14/2D23 Papa 001 To ensure proper asset to your aCCUMt, dearth small Blum this Co., esoo sorb with your remlllanm Dc: 0115 As ol: 07/14/2023 Page: 001 CVS PHCY 8923/MM MC PHS qMT DUE REMITTED VIA ACH DEBIT Territory: ]001 Mae to: Camp: 000 M B.1OflIAL MEDICAL CEI41'9i Slalement for information only ANT DUE REWITTfD VIA ACH DEBIT VICKY KALISEK Customer 835434 Du43 statement. for Information only 815 N VIRGINIA ST Cs: 07/15/2 23 PORT I.AVACA TX 77979 Cos: 835434 I LEASE CHECK ANY Dsa: 07/15/2023 ❑MS NOT PAID (�) 910rg Due R NabyNatbmwl Aa manit MIr3S Cash Amount P Amount P Reeeivabb Oete Data Number Relereaes Dewor"fon Dlxount (grew) F (not) F Number Cuatams Number 835434 CVS PNCY 892311WEM MC PNS 07/12Y6023 07/18/2023 7430568384 2524454 1151mmice 6.00 07112MO23 07/16/2823 7430568385 2524454 1151nvolce 18AS PF ookmm legend: P = Pas Due Item, F = Mon: Due Item. blank = Current Due hem TOTAL Customer Number 835434 CVS Riley 8923/M6A MC PHS SUMser. 1,222.15 USD Future Due: 0.00 If PaM fly 0711012023, Past Due: 0.00 Pay This Amount: 1,197.70 USD tas Payment 7.532.00 If Pap After 07/1812023, 07/10/2023 Pay this Amount: 1.222.15 USD APPROVED ON AIL 1 i yT7 t o 1 0T1` 1� Rf$M i ai kr ^;1t tin'S 299.83 293.83.E/ 7430568364 922.32 903.87 ✓ 7430568385 For AR Inquiries please contact 800-867-0333 Due If Mr1 On Time: l USD 1,197.70 Dix bet 6 P W late: 24.45 Due it PaIB late: Uso 1.222.15 -7 t123 MSKESSON STATEMENT A. n'07/14/2023 Page: 001 To.DMae proper areAt is your account, Onxh at return Ole rAmwnr: s000 stub soh your remMs. DC: 8115 As of: 07/14/2023 Page: 001 CVS PHCY 7475/MEIN MC PHS ANT DUE VIA ACH D®R TerrOory: 7001 Ma"to: Comp: B000 MEMORIAL MEDICAL CENTER for information Statement for inlarmation only AMT DUE RENUTTED VIA ACH DEDIT VICKY KALISD( 835438 Cus. Statement for Information only 815 N VIRGINIA ST 07/me. ne: O]/ 15/2023 PORT LAVACA TX 7]9]9 Custr 835438 C SE CHECK ANY Date: 07/15/2023 ITEMS NOT PAID (1) DtM ReceNayfiellonel Aeccunt i96 Cash Amount P Amount laHkohmi able 01 Gale Date Number Reference Deemiption Discount (gross) F (not) F Number Customer Number 835438 CVS AHCY 7475/M@M MC PHS 07/12/2023 07/18/2023 7430689010 2524455 1151nvoice 6.00 299.83 293.83 �/ 7430689010 O W unseen IegerW: P = Pan Due Item, F = Future Due Item, blank = Comes, Due Item TOTAL Customer Number 835438 CVS PHCY 7475IMEIM MC PNS SumnaW 299.83 USD Auturs Due: 0.00 Due H Pakl On Time: D PoM By 0711812023, USD 2933.83/V Net Due: 0.00 Any This Amount: 293.83 USD Dix Ion 8 paid let$: 6.00 test Payment 23.996.37 8 Pad After 07/1812023, Due 8 Raw Leta: 07/03/2023 Pay this Amount: 299.83 USD USDty[ 299.33 1 li.NtaUTt„ f(�,:G+�LV.:�C�0:41 �tt7 APPROVED Ciu 11 3 7 -:o rotGgUa.Ga ,!,r^era For AR Inquiries please contact 800-867-0333 ns STATEMENT Statement Number: 65542065 1 Of 1 ID1ff1E:fISOUfCE?B@fg13f1' Date: 07-14-2023 AMERISOURCEBERGEN DRUG CORP WALGREENS a1Z494 MOB 12727 W. AIRPORT BLVD. MEMORIAL MEDICALCENtER t 100IM2841037MR168 SUGAR LAND TX 7747"101 1302 N VIRGINIA ST PORT LAVACA TX 77979-2509 Sat- Fri Due IN days OFA: RA0289276 866-451-9665 AMERISOURCEBERGEN PO BON MU23 Nat YQ Due: 0.00 CHARLOTTE NC 28290-S223 CunmL. 531.61 Past Due:. 0.00 Total Due: 531.61 A fount Balenca: SM.61 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 07-10-2023 W-21-2023 3139249708 1715H Invoice 4624 0.00 A6.24 07-10-2023 07-21-2023 31M249700 171559 Invoice 270 0.00 2.70 07-10.2023 07-214023 3IN351458 171560 Invoice 9&00 0.00 9&00 07-10.2023 07-21-2023 3139355306 111606 Invoice to&48 0.00 185.48 07-10.2023 07-21-2023 31393BOMT 171507 India 15.78 0.00 15.7E 07-11-2023 07121-2W3 3139519584 171613 Invoice 7&15 0.00 73.15 07-11-2023 m31.2023 313951905 171614 1.1. 2.06 0.00 2 03 W-12.2023 07-21-2023 3139679026 171619 imaice 2.01 0.00 2.01 07-142023 07-21-2023 3130969971 70D1974982 Invoice 10&19 0.00 10&19 Current 1.16 Days 16-30 Days 31-60 Days 61-90 Days 91-120 Days Over 120 Days 531.61 0.00 0.00 OLD 0.00 0.0o 0.00 Thank You for Your Payment Date Amount 07-14-2023 (4.260.53) APPROVED Oh' 3Y C ,mv 11,7v7'"0;1 i Hal_ 1AI �:'P i1�M1 'cS.♦"_% Reminders Due Dale Total Due: �fu� kz3 cMWT TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) ED"ENTER 9-DIGITTAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGITTAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER E] ENTER: 0 $ g33,075.31 1 $ 6F,098.fl6 $ 15,458.38 $ 50,518.87 CHECK S CALLED IN BY: CALLED IN DATE: CALLED IN TIME: JAP-Paymll FIIe5XPayr011 Taze512023bf15 R1 MMC TAX DEPOSIT WORKSHEET 7.13,23 711712023 941 REC/TAX DEPOSIT FOR MMC PAYROLL REVISED 3'1612014 "WERVOIO WKNEM➢VENUMBER- PAYPERIOD: BEGIN 613M2023 VOIDED CK n1 VOIDED CK r21 ADOITIONALCKm AoomoNALCKIII TOTALS PAY PERIOD! END 7M3(2023 PAY DATE: 71=2023 GROSS PAY: $ 697,412.86 $ - $ 667,412.86 DEDUCTIONS: AIR S 35400 S 350.0 ADVANC $ BOOTS 5 SUNLIFE CRITICAL ILLNESS S 1,228.63 _ L_2$ 43 SUNLIFE ACCIDENT $ 749.24 7c37z SUNLIFE VISION $ s- SUNLIFE SHORT TERM DIS S 1,943.16 LB-b 1'0 BCBS VISION S 990.37 S 998.37 CAFE-D S 1.660.13 5 1.560.18 CAFE-H 5 23,567.66 $ 23,567.65 5 g S $ CAFE-P 5 CANCER $ CHILD 5 161.19 $ 161.12 CLINIC 5 165.00 5 165.00 COMSIN 5 271.83 S 271.03 CREOUN 5 - $ DENTAL DEP-LF 5 SUNLIFE TERM LIFE 5 941.44 5 941.44 SUNLIFE HOSP INDEM S SS1.96 S 691.95 FED TAX S 50,518.877 S 50,518.87 FICA -TA S 7.729AS S 7,729.19 FICA-O S 33.049.03 5 33.114103 FIRST C $ FLEX S $ 3.200.33 S 3.200.33 FLX.FE S - 5 GIFT S S 35.99 5 35,99 GRP.IN $ _ GTL g HOSP-I g _ LEGAL 5 1,043.61 $ 1,043.61 OTHER S 611,54. S 611.54 NATIONAL FARM LIFE_ S 1.611.57 S iL511.57 MED SURCHARGE S 420.00 S 420,00 PR FIN S - S _ RELAY $ REPAY g STONEDF $ 1,116.86 S 11115.86 STONE g STONE $ STUDEN 5 - TSA-R S 39.285,65 5 32,285.65 UWIHOS S - S , TOTAL DEDUCTIONS: 5 171,250.19 S - 5 - 5 - S 5 171.250.19 A439618 "AgU11WSS .WICYtMEWXI�„&IgROl1A1D111ElWR�NdRG WSCIFREB1iRS^'AMCl6C1NIGRHPBKI� NET PAY: $ 1 2.67$ S $ S $ 396,762.87 -mesowroeMEwnr -�ia�maBr-snasowroEneawl--�nalwutimRENoar-arwaowicElre�am TOTAL CAFE 125 PLAN! S 34,363-32 Less Exempt: AXABLE PAY: 633,049.64 $ 533,049.64 "CALCULATED" FEvm MMCIUM" Difference ICA - MED (ER) usn 3 7.729.22 ICA- MED(EE) usw $ 7.729.22 8 7,729.19 S D.W ICA -SOC SEC(ER) Ezms $ 33.049.07 ICA - SOC SEC (EE) NhNE $ 33,D49.07 $ 33,049.03 $ 0.04 ED WITHHOLDING S SOS78.87 5 50,51SA7 TAX DEPOSIT: S 132D75.45 $ 132,075.31 FICA -MEDICARE zBox $ 15,4$8.44 $15.456.38 FICA -SOCIAL SECURITY ,:.B,,. $ 66,098-14 $66.098.06 PREPARED BY: FED WITHHOLDING $ 60,518.87 $50,518.87 PREPARED DATE: TOTAL TAX: $ 132,075.46 $132,075.31 $ 0.14 Exempt Amt: Employees over FICASS Cap: 5 - PayeodeS-Employee Relmh.: TOTAL: $ Caitlin Clevenger 711712023 419 R1 MMC TAX DEPOSIT WORKSHEET 7.13 23: TAX DEPOSIT WORKSHEET M707023 Run Date: 07J17/23 ML%ORIAL MEDICAL CENTER Pace 1I1 Tina: lC:l? FayroP_ Register aj.Rseelq } P2fiEG Fay Period OWV23 - 07/:3/23 Rcr.; Fire: Svmry -- P a y C o d e S a c r, a r y-•••__._.____________........ .......... _. e d u C t: o r. a S c n n a t I ._._._------_- PayCd Description Mrs j07jsgjwEj HOjCBj Grass I Coie Amwt 1 RECV.AF PAY-51 1 REGULAR PAY-Sl R£GLT..A.Y PAY-S1 1 REGULAR PAY-S1 2 REG'.PiAB PAY-S2 2 UG7LkR PAT-S., 2 REGULAR PAY-S2 3 13GU12R PAY-51 3 ?LGU.AR PAY-S3 3 REGULAR PAY-S3 CALL RACK PAY 4 CALL BACK PA7 CAL: RACE PAY CALL RACE PAY CALL BACK PAY C CAL:, PAY G DOLFE TII•IE D DOUBLE TIME I DOLTE TI!- D DOUBLE 71PIE DODELE TIME B DOUBLE :I: c E EX?PA WAGES E EX7n7. NAG3E F FUNERAL LEVVE I 'NSE.RVICE E BXT3NDL-ILLNESS-BANK P PAID -TIME -OFF P PAID_7--m-OFF X CALL PAY 2 Y YMCA/CURVES E GALL PAY 3 p PAID TIME O.F - PROBAFIOII 3P66.0c N Y 17 1522.50 N N 11 N 255.0C N N ? 317.50 Y N N 2412.50 N N N 16:.75 .. N . lel.50 Y N IT 1427.'G S 9 N 11950 1C4.v'C Y 7 11 42,25 I2. s G Ir 2 N u Y I.75 :150 Y 2 W IT 1 25 Y 3 N 11 Y 2349.50 N 1 N N 75.00 N 1 N N 51.jP N 2 N N Lib N 2 R. - 16.Ce N 3 N N 7, 7j N 3 N Y 2.SC Y 2 N II N N N N N 1 N 11 N 16.00 N 1 N N 13.50 9 1 N N IC5.Pi 154.00 11 N N N 2223.00 N I N N 172.CC N 1 :. 72.0-5 N L II L 60.00 N 1 N N ....... _______IE--_.._....._._..__ 20E0SE.52 A/P, 33 0OSL}./F1 A/R3 11690.92 ADVANC AWARDS BCBSVI 56;5,79 B03I3 CAFE R CA2E-1 11,94.05 CAFE.2 CA, -.-I CAEEi 51'23.05 CAFE-5 735L:4 CA"-.-F CA?3-F. 2350, /CAPS -I 7535.53 CAFE-L CAFE-P CANCER 5033.76 CMI1D 162.:S�LINIC 155. 304mm, 623i.S4 CRETTI DD ACV DENTAL 546i.94 DEP-LF DIS-IF 1H3.53 E.ATCSH /F£7TA:X i051E.87:CA-R 1'44.53 FICA-0 33049.ONFIRSTC FVX S :90.73 F11. F£ t RT D F7.1 113.2fi ELI' S 35.9 SAW GAF-7 20.55 GTL HOS?-I TEL 4E59.00 LEn7 LEGA:,_3M35:. 5233.45 HEALS 611.54 FE77IS M1SC 3594.40 M:SCI KCSB3 NATFIu 433.i2 ZHU.. FB1 FHI`,, 1264.33 PR FIN RELAY REPAY ?60.C7 SAMS SCP.'UBS S�`GNON 352.35 S`_-TX S70 F 1115. BEt67.G:1E 27016.47 S70.M yIWEN �ONECC 2201.55 S711IL1 122E.5 `IIRIXU 591. £: UNLIF 35836 SURSID '-943.i4m.IS SURCBG 453.07 TSA-1 ISA-2 QV2.45 TSA-? ISA-R 392Si.65XI-CCON 4443.26 L0IIF03 U'd/K05 51805.3i 344.00 45.00 a6.06 1281.26 --------------------- Graid :aa:s: 207E9.25 ....... . Gross: 567412.85 Checks Cowt:- FT 201 PT 13 Other 36 Ferale 228 Male 25 Credit 998.37✓ 13 ✓ 271.33✓ 7725.:9 ✓ 120C.13 / ✓ 37C.$1. / 1511.57,/ 749.24✓ 5et,a4✓ 420.00 3eductim,E: 11'250.19 Net: SULS6T 1.: OverAmt 14 Urdu Term iota!: 253 f ................................................. Rva Dare: 07/17/23 MEMORIAL MEDICAL CENTER Time: 12:47 Check Register .v*. Pay Period CE/30/23--07113123 type=NMI 10000061 OPERATING BI-WEEKLY Page I P2DISIP Run Date: 07/17/21 F.EMORIAL MEDICAL CENTER BI-NEEKLI' Pace 2 Time: 12:41 ++++ Check Resister ++++ P20ISTP oY Pericd 05130/11--p7/13/23 Ran: '. type=NET 1DOOODD1 OPERATING - PROSPERITY No Name Aacln CEECK RUM DATE 02415 JANELLE SCOTT 1551,77 DD 07121,123 02535 STEFANIE M SOLTZ 755.77 DD 07/21/23 0255E VERONIC4 RAGUIN 1957.01 DD 07/21/73 02622 JESUSA MARIE VILLARP.EAL 1082.67 00 07/21/23 02685 JOLIAVA TORRES 462.33 DD 07/21!23 02701 HONDA DAWNEELLE GORLKE 3092.41 DO 07/21/13 02719 DASH M MCCLELLNNO 2051.3D DO 07121/23 02720 ELDA M LONNA 1139.98 On 07121/23 0273E ROBIN N PLEDGER 2802.55 DO 07l21/23 02715 ZAYDRA A GARCIA 378.30 DO 0712112E 0276E JESSICA MARQUEZ 2171.83 DO 07/21/2i 02794. 3EATNER L NUTCILER 1976.92 DO 01/22/23 02812 BRITTANY N RUD➢ICK 1933.17 D➢ 07/21/23 02907 MARIA F LONGORIA 1252,82 DD O7/21,123 0292' MICEAEL L GAINES 12950.25 DD 07fv 123 02963 DOROT:HY J RENDON 1137.62 DD O71W23 02970 DIANNE G ATKINSON 2233.66 DO 07/21/25 03864 JACQUELINE R HERR.ERA 1390.68 ➢O 07/21/22 05003 COURTNE 0 TRIN.KILL 4959.21 ➢O 07/21/23 65DO6 REGINA A SARTINEZ 2996.61 ➢O 0I/21/23 05345 ERICA NGUMI 1097.53 DD 07!21/23 35P41 AMAND. R KEY 2539.49 DJ 0712112 05757 SHARON T HOLDER 2055,35 DD 07/21/23 17007 URSULA, S BRYAN 385.95 DO 01/21123 07121 CYN HIA GUERRA 1562.95 DD 07/211'23 07147 CHAD A 1'ORCE 2'.191.33 DD 07/21/23 01VO DIANA C SAUCECA 1161.85 D➢ 07/2i/23 11197 CATHERINE A SAENZ 2940.31 ➢➢ 07121123 11412 COURTNEY L MORF.OVSNY 1326.08 DD 0712112E 12011 KIMEERLY J PSYNA 170.61 DO 07/21/23 12115 LISA J EIIi0J0SF. 973.65. DO WWI, 12123 M1,31E1, READIES 1803.85 DD 07/21/23 15097 KYLE L DANIEL 3439.69 DD 07!211e3 15131 SAVANNAH EARLEY 1573.91 D➢ 07/21/23 15139 KRIETEN NICOLE BALLARD 2037.04 DO 07/21/23 15163 KELSEY EEINOL➢ 5219.40 0D 07/21123 15171 JESSICA BARREN 1734.86 OD 07/21/23 1528d DAWN M MAREE 2157,78 DO G7/21/23 15555 STEPHANIE MARTIN 1172,51 CO 07/21/43 15909 JULIE NGUYEN 2324.58 CO O7,I21,123 15515 BRINNN! J KEY i39B.03 ➢D 0 t23123 29102 MAYA HAWKINS 1303.58 ➢D 07/21/23 20112 V'JL1Y PATRICA RO➢RIGUEZ 1551.0E ➢➢ 07121/23 20132 ALEKIS CARREON 363.63 ➢O 07121123 20144 SOPRIE M PECENA 535.92 D➢ 07/21/23 20156 ERIN AS.HLEY WISDOM 2723.55 DD 07121/23 20168 JOSHUA PEPPERS 763.95 OD 07/21/23 20176 AMY GARCIA 126.64 CC 07/21/23 20184 14RLISSA ZAMOP.ANO 695.93 DO 07/21/23 262DE 13LLT E GOFF 1620.57 ➢➢ 07l21/23 2020i SEANNA G ECRTL 2791.46 DD 07/21/23 2M43 MELANIE CORTEZ 394.22 CO 07/21/23 20272 AIIGEU, YDAGER 2265.89 DG D7121/23 20294 JESSICA D WF:,T3E9 858.97 DD 07/21/23 Pa. Date: D7/17/23 MEMORIAL MEDICAL CENTER BI=HEEZLY Page 3 Time: 12:47 ++• Che& Register ++++ P2➢ISTP Pay Period 06/30/21--07/13/23 Run: 1 T1Pe=NET 10OUDD1 OPERATING - PROSPERITY :Imv. Name Am0'JNt 7HECE HUM DATE 2G324 PATP,ICIA STRI2LEY 2127,76 DD 07121/23 20343 SAV;UIW N SOCARRA5 1057..00 DD 07/21/23 20351 MADISON N MEADE 799.12 DD 07/21123 20419 KAREN N M:EUEN 318.30 DD 07121/Z1 20456 SAYDI A ST CLAIR 579.25 DD 07/21123 20650 JOSEPH ORUSU BOURNE 693.25 DD 07/21/23 20759 JAMIE SADLER 786.71 DO 07/21/22 20788 JAYLIN RAHIREZ 102.42 DO 07/21/23 20797 RETRAIN H DIGGS 1771.90 DO 07/21123 20917 CHERYL L TESC3 1933.53 DD 07/21/22 20980 SAVHJA LE31L0 710.58 D➢ 07/21123 21450 DI.ANA E LEAD 1609.61 DO 07/21/23 26186 J.AMET CRUM 2923.15 DO 07/21123 28034 XURTIM A BURGER S75.72 OD 07/21/23 28120 JESSICA V SELVERA 1508.71 DD 07/21/23 29199 BELLY A SCHOTT 1914.19 ➢D 07/21/23 3103E STACIE L 2PLEY 2405,76 DD 07/21/23 31D54 LORA L WMADEN 555.91 DO 07/21123 31099 ARACELY Z GARCIA 2153.66 DD 07/21/23 31219 LALREN PHILLIPS 1143.62 DO 07/21/23 31251 CYA?i!IA L WAS 2425.77 DD 07/21/23 31313 KATHERINE LINN JIME!JEZ 1999.85 DD 07/21/23 31319 BTA.CY L FARMER 1523.07 DD 07/21/23 31463 BURRO E :aFILreA 2830.40 C➢ 0712V23 31509 RACHEL A HEFFNER 2251.13 DD 07121/23 31823 MYLA M ALVAREZ 1578.19 C'D 1,7/21123 11832 SHARE D RFPSTA 829.21 CD 07/21/23 39118 RRYSTELIA F RISTA9 1035.76 DO 07/21/23 32168 -MEGAN M CAVO 71i.72 TO G7121123 38188 -YADEL71TE AMEREC9 95L.55 LD 0/21/23 38702 AM14 VANESSA PENNELL 3010,40 ➢D 07121/23 41112 ANASTASIA L PEREZ 575,50 GD 01!21/23 41171 TOMMIE M TR VINO 526.87 O➢ 07!21i23 412DE JEANETTE ALVARADO 745.00 GD 07/21121 4122E LESLIE A CRAIGEN 1690.70 DO 07/21/23 41216 PAMEIA R VANNOY 1577.81 DO 0'•121/23 41251 SA.RA 300 799.ID DD 0-1/11/23 41261 BERNICE AGUILaB. 966.33 DD 07/21/23 41274 RAREM CASH 98E.95 OD 07123/21 41279 PAMELA R HARMON 758,10 DO D7/21,123 41347 ADRIANNA D STRAROS 8@.89 DO 07/21/23 41419 AKGEL M CASSEL 965.00 DO 07/21/23 41506 JCSEeA7 LUGO TORRES 629.53 DD 07/21/23 41G12 SCNJA A GVAJARDO 828,84 DD 07121/23 41617 JAWLIAR M MARTINEZ 959.17 DO 07/21/23 4109E RIGOR MICHELLE EVERY 625.95 OD 07/21/23 41897 RO.mm; 1"ONOZ 880.43 DO 07/21/23 4190L MMITA R MILLER 1207,73 DD 07/21/23 4210E ^RPISTY EILVAS 3IO i, 09 ➢G 07/21/23 42132 So -Rip, C GC!7ZALES 076.63 DO 07/21/23 42122 LEI AAA Ci.AVANA 1739.26 DD 07/21/23 42125 LUCY CALZAOA 783,44 DD 07/21/23 42304 pm;3 r 1JJj7EJJ 2135.88 DD 07/21/23 42536 MARIAH A SOCARRAS 72035 DD 07/21/23 Run Date: 07117/23 MEMORIAL MEDICAL CENTER BI-WEEKLY Page 4 Tire: 12:47 k•'t Check Recister ' ' ?2DISTP Pal Period 06/30123--67113/23 Run: L Type=NET 1000/001 OPERATING - PRCSPERITY Mum. Nam Amoant CRECK MGM DATE 4162D MARIA C CiAVEZ 1100.78 00 07/21/23 42842 SHA = S 0 DONNELL 3283.75 DD 01/21/23 50019 MICHELLE M MORALES 1425.23 GO 07/21/23 50012 REGINA A dO3I1SCN 1099.23 GO 0?/21/23 50148 PENNY GOULDEN 3337 A7 DO 07/21121 50161 BRITINci MICHELLE WORK 238.77 DD 07/2/123 5024E MCKFNAA VILLECAS 457.71 CD 07l21/23 50242 JACOB W HAMI-LION 2565.46 DO 07/21/23 50310 JASN'NE GRIGSBY 746.37 CG 071:1/23 5D546 MELANIE K SAMnYOA 2121.48 DO 07121/23 5D573 DEANA R DAVIS 1533.58 DO 07/21/23 50596 BETTY S 1;V1S 1931.27 DC 07% ilil 50119 DEBRA K MUSTERED 2360.95 ➢D 071II123 50928 AOINA RODRIGUEZ 730.24 D➢ 07/21/23 53541 JAMYN 8 RARTL 1623.40 DD 01/21/23 54024 MONICA A ESCAUJITE Ii87.45 DO 07/21!23 55026 3RFNE B PEREZ 644.01 CD 0 /21!23 55127 APRIL N :OIEALA 2395.93 CD 07/21/23 55382 SHAIRION JACILDO 677.25 OD 07/21/23 55658 WEAN WILKE 802.22 DD 07/21/23 55945 KATIE L RODDY 1017.7; DD 07/21!23 58115 BECKY MARIE SALINAS $03.84 ➢O 01/21!23 58510 RITA L POLENSKY 900.57 ➢D 07/21/23 60112 ROBERT A RDDRIQLEZ 1969.51 DD 01/21/23 60131 NCRA OVA.LLE 500.43 DD 0.7121!23 60156 DANIELLE M NALISEK 1217.50 DD 07/21/23 60165 TERESA A BENITEZ 1785.85 DD 07/21/23 60412 CRRISTOeBCR GALINDO 1169.31 OD 071,11123 60616 DOEOTEY A LONCORIF. 994.99 CD 07/21,727 62322 ALAN KtIIGH? 1384.41 CD C7!21/23 63124 SWUM M GARCIA 1491.08 DD 07/21/23 63193 MICiAEL SCCAIBLAS 779.61 GO 01!21123 E5100 FELICITA EONIZ 706.17 CD 07!21123 6512E MARINA CLT4PEAI1 E48.18 CD 07/21/23 65121 VERONICA ORTIZ 084.39 DO 07/21/23 65'-16 TINA.. K030N"eK 1130.16 DD 07/21/23 6E148 MARTA. INIGUEZ 782.36 DD 07121/23 65151 ELIA OLACHIA 1132.74 DD 07/21/23 65168 NORA MIRFLES L165.45 DO 07/21/23 SEIB9 FLVIRA SANCSEZ 896.36 DO 07121/23 65205 JU2L", SAINTILIAN 892.5E DC 0i121j 23 65213 LEE SIMERLY 1029.1. 00 07/21123 65269 NATALIE BARMFIELC 966.8E 00 07/21/23 653-93 RAMONA A PEREZ L249.63 CO 07/21/23 63453 AMALIA L FLORES 1179.51 DC 07/21/23 65463 MARIA I VELOZ $15.30 DD 07/21/23 $5466 ROSA RODRIGUEZ 915.91 DD 07/21/23 65513 MARIA MORALES 988.67 DD 07/21/23 65765 OCMI7ILA IERREPA 989.4E DC 07/11/13 6E715 MARIA R GOMEZ 951.79 DD 071ei/23 6586E MARIA F LEDEZMA 821.77 DD 07/21/23 603ES DGMITIIA GA.RCIA 320.06 ➢O 07/21/23 655E6 C6RISIOPSER RUTHRRFORD 105;.57 DD 07/21123 6E792 NAZA.RIO DI;Z HFRY?ST1EZ 4040.29 DD 07/21/23 R'y1 Date: 07/17/23 MEMORIAL MEDICAL CENTER EI-NEEELY Time: 12:47 •••+ Check Register •••• Pay Period 06/30/23--07/13/23 Ru: 1 T'Mzb''ET. 10000001 OPERAIING - PROSPERITY Nam. Nave Aownt C1ECR NEM LATE 70119 SAFA N BLEDSOE 2486.33 D'' 07/21/23 73749 GWRIA N R"c-D 2547.66 DD 07/21/23 74159 CAROL VILLARREAL 1296.10 OD 07/21123 75190 RIBA MILLER 1993.66 OD O7(Slhi 76003 IRMA DELEON 677.60 DO 07/21123 16115 JENNLFER R CARLCCR 644.8C ➢0 07/21/23 76129 RACDEL CANALES 1271.3E DO 07/21/23 76138 RAREN D GARCIA 639.69 ➢O 07l23123 76156 ➢.EBECCA MURRAY 917.15 ➢O 07/21/23 76210 EOE VILLARREAL 900.92 DO 07/21/23 %309 AIDA. JIMENEZ 1257.31 BD 07/21/23 16313 PARFLA L BARTON 034.63 DD 07/:1123 76403 KATRINA A PORLDCA 1256.30 DO 07/21!23 76647 CNERYL A SEE 1040.15 ➢O 07/21/23 76706 GREGORY E MORALES 145.68 DD O7/21/23 76554 MARY PATTERSON 817.75 DD G7121l23 76985 VANESSA TRISTAN 451.07 ➢D 07/21/23 77646 PA.REN A GCNZALES 1094.47 ➢D 07121/23 78020 MISTY R PASSMORE 2901.36 D➢ 07/2i"^, 16071 DONNA M RAWLINGS 1153.81 OD 07/21121 78128 ALE%A OCINIANILL4 791.55 DD v/21123 38186 ANDREA F COOK 324.86 DD 07/21/23 78287 NARISSA D ALMiiNZAR 2651.69 D➢ 07/11/23 78336 JESSICA L CLOVER 1R51.9L GD C7(21123 78566 MELISSA N GEE 703.6E GO 07/21123 78764 ASRLEY ➢ KABLEY 2153.83 DD D7!21/23 78181 KRISTEN R RkCEICEE 2752.57 DO 97/21/23 78737 FAME I JAI.E 2707.36 DO 0 !21123 7589i ➢AYLE J ROBINSON 68L.15 ➢D 07/21%23 90008 ADAM D BESIO 2751.60 ➢D 07/21/23 80141 JEANNIE ORTA 1783.09 DD 07!21/23 92227 CAITLIN A CLEVENGER 1301,27 DD 071121123 86452 FAC1' EL1EDGE 552.09 DO D'/21/23 96482 MEGAN 77 RARFER 624.76 OD 07!21/23 86576 ELSA 11ERRE14 818.03 DO 07/21123 88125 LISA M TRE1130 11'2.42 DD 07121/23 88321 ANDRE'd OE LOS SANTOS 265153 DO 07/21123 9032D ROSRAIR)A S TROMAS 5609.22 ➢D 071,21/23 93231 ANDRIE M FLORES 1369.92 DD 07/21/23 98756 ADRIANNA M GALVAN 1622.13 DO 01/21/23 396162.67 Pace 5 P2DISIP Date Bank Descriptions 7/14/2023 PAY PLUS ACHTRANS 451S79291101000699894243 7/14/2023 AMERISOURCE BERG PAYMENTS 0100007768 2100002 7/13/2023 PAY PLUS ACHTRAN5452579291 101000699078709 7/12/2023 PAY PLUS ACHTRAN5452579291101000698130003 7/11/2023 PAY PLUS ACHTRAN5452579291101000697044749 7/11/2023 MCKESSON DRUG AUTO ACH ACHOSS69975 910000130 7/10/2023 PAY PLUS ACHTRANS 452579291101000696001725 7/10/2023 CLEARGAGE LUC CLEARGAGE, 824WE8U32YEOUSH 242 7/10/2D23 TSYS/JRANSFI RST DISCOUNT 393009825416166110 7/19/2023 TSYS/TRANSFIRST DISCOUNT 413998013918376110 7/10/2023 TSYS/TRANSFIRST DISCOUNT 413998013323936110 7/10/2023 TSYS/TRANSFIRST DISCOUNT 413998013324016110 7/10/2D23 TSYS/TRANSFIRSF DISCOUNT 413998013323856110 7/10/2D23 TSYS/TRANSFIRST DISCOUNT 413998013324196110 7/10/2D23 TSYS/TRANSFIRST DISCOUNT 41399801368397 6110 7/10/2023 TSYS/TRANSFI RST O ISCOUNT 39300982599WG 6110 7/10/2D23 IRS USATAXPYMT 270359125003565 6103601002593 PROSPERITY BANK FOR OPERATING ACCOUNT —July 20, 2023 - July 16, 2023 MMCNotes - 3rd Party Payer Fee - 3400 Drug Program Expense 31d Party Payer Fee - 3rd Party Payor Fee - 3rd Parry Payor Fee - 3400 Drug Program Expense -3rd Party Payor Fee - Patient Financing Service - Credit Card Processing Fee - Credit Card Processing Fee -Credit Card Processing Fee - Credit Card Processing Fee - Credit Card Processing Fee -Credit Card Pmces,mg Fee Credit Card Processing Fee -Credit Card Processing Fee -Payroll Taxes 1�Oc 1� �� (`:;rA r�gfy'. �_ July 17, 2023 ANDREW DE LOS SANT05 Memorial Medial Center -9Y�YpUN,�4�,sS 0-L PROSPERITY BANK k, "'fY""` 01.05'29 LL, ELECTRONICTRANSFERS FOR OPERATING ACCOUNT -- ESTIMATED ACHS net. Description 7/20/2023 ACH Payment WEBFILE TAX PYMT 00 MIMIC Notes Sales Tax �+ W July 17, 2023 ANDREW DE LOS SANTOS )1f+p{b6�(!yJ L.Y1Y: Memorial Medial Center lAi4 yfi1 Y Ilrf/y,. Vim 7%-1J6 A•31 - 104.3i - c 7.511 Amoun _, Yt09J 0. 411 4,260.53* 831, Ckarf4gc 3 1 1 .9. e l , 7.532.00,t 1Cp40- %ti _. 938Jt7� 9 5 i • 11 1 259D• 1.12529 k070.36. 1,82++-Z. r 483.86 276' bb 266-SO u6s6i.1a 266 5ti 129•l11I 133,689.50 19Y-69 1IR^d1.1 5,OIH-yc , i*5Jl4"b� - Amount 1,773.67 5, y.,4 ..y' 5 4-$'; ll•Uu .. A COMPTROLLERJEXAS.GOV Q Confirmation: You Have filed Successfully Sales and Use Tax Period Ending06/30/2023 (2306) Taxpayer ID. " Taxpayer Name: / Entered By: User to: MEMORIAL MEDICAL CENTER J Email Address: Reference Number: Taxpayer Address: Date and Time of Filing: 815 N VIRGINIA ST PORT LAVACA, TX Telephone NumbeC (361) 552.0342 07111/2023, 09:18:17 AM 779793025 IP Address: PAYMENTSUMMARY Electronic Check Payment Reference Number: Type of Bank Account: Checking. State Amount: $1,343.691/ Trace Number: Accountholder Name: Local Amount;$429.98 i , _ _.... 4 Amount to Pay: 81,773.67 Bank Routing Number: *+*" Electronic Check: 81,773.67 / Bank Account Number:+'++^'•+++++ Payment Effective Date: 07/20/2023 CREDIT SUMMARY Credits Taken Are you taking credit to reduce taxesdue on this return? No Licensed Customs Broker Exported Sales Did you refund sales tax for this filing period on items exported outside the United States based on a Texas Licenced Customs No Broker Export Certifications? LOCATION SUMMARY Total Texas Taxable Subject to State Subjectto Loce Taxable Sales State Tax Due Local Tax Rate Lotal Tax Due Sales Purchases Tax lRate.0624) LocalTax 00004 21607 21607 0 21607 1350.44 21607 0.02 432.14 SubTotal 21607 21607 0 21607 1350.44 21607 432.14 Total Tax for Locations $1,782.58 Total Tax Due, $1,782.58 Timely Fling Discount: • $8.91 Balance Due: S1,773.67 Pending Payments: • 50.00 /,,////// Total Amount Due and Payable: $1,773.67 „F / ( State amount due is 81,343.69) ( Local amount due Is S429.98 ) MMC SALES AND USE TAR REPORTING 2023 DUE EACH 2OTH OF THE MONTH 2023 SUBMITTED DATE: Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Reporting Month Jan Feb Mar Apr May Jun July Aug Sept Oct Nov Dec Acct 4203000 G Ending Balance 3.190.49 1.596.82 1,827,62 1,825A6 1,825.91 1,732.60 DMIOE BY: 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% 8.25% TOTALTAXABLESALES 38.672.61 19,355.39 22,152.97 22.126.79 22,132,24 21,607.27 - _ - STATE TAX SATE 0.0625 2,417.04 1,209.71 1,384,56 1,382.92 1,383.27 1,350.45 LOCAL TAX RATE 0.02 773.45 387.11 443.06 442 54 4a7 A4 TOTALTAX DUE 3,190.49 1,596.82 1,827.6I 1,825.46 1,825.91 1,782.60 RCT DATE: 07111/23 HR6ORCd-19EC=C, CEIKER PAGE 1 DIE: 09:14 GL SINGLE A.000GNP MAIL RE -.PORT MAD FOR: CS/C_i21 - 06)30i23 ALLOW,- MIRER L DESCRIPTION SATE Rk.'C ?iE'aRRI"S O C�S;;C CSIT".4 BA:CH ESQ. ;Y.M T 20300000 ACCR STATE SALES TAX -ACCRUED BEOINI9: BA:Z.CE AS OF: 06/01/23 06/2!(23 AE3F3LE TAX PYNT A1^ 7ff1O6 CC 06/30/23 RSCEIKS 06/30123 CR HOC ACT-:'77/2rC -1,623.91 74 672 1,525.3E 74 635 AS-1,782.57 -1,782.60 R20iGG E.A[.VE:-1,732.6G Page 1 of 1 RECEIVED BY THE COUNTY AtUD}TOR ON JUL 13 29Z3 07/13/2023 CALttO1.WPQOJJNTY, TEXAS MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Vendor# Vendor Name ,/ Class Pay Code 11820 FORTBEND HEALTHCARE CENTER ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 070623 07/12/20 07/06/20 08/06/20 1,400.00 TRANSFER NN '1V11t►'VW to p3Wt diV4Gt}cA 1m'1-1 071223 07/13/20 07/12/20 08/12/20 1,785.00 TRANSFER u Vendor Totak Number Name Gross 11820 FORTREND HEALTHCARE CENTER 3,185.00 Report Summary Grand Totals: Grass Discount 3,185.00 0.00 1'd_1L 1 3 _ a ap_open invoice.template Discount No -Pay Net 0.00 0.00 1.400.00 WITIWL qft". -116 0.00 0.� 1,785.00 c/ N Discount No -Pay Net 0.00 0.00 3,185.00 No -Pay Net 0.00 3,185.00 file:///C:iUsers/ltrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report231023... 7/13/2023 Page 1 of 1 RECEPIED at 7iiE COUWV AUDrrCq OA, JUL ! 3 2023 07/13/2023 MEMORIAL MEDICAL CENTER 0 CALHGUk1'&n�lYW( TEXAS AP Open Invoice List ap_open_invoice.template ' Dates Through: Vendor# Vendor Name Class Pay Cade 11836 GOLDENCREEK HEALTHCARE ✓ Involcelt Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Nat 071023 1/2007/10/2008110,//2.y0 8,100.89 0.00 0.00 8,100.89 �0/711 1 TRANSFER M f IffiV"LL QjiN dq;0,,j-V tt. IlWt jiL'W OfW-h 071123A 07/13120. 07/11/20 08/11/20 395.00 0.00 0. 395.00 ✓ TRANSFER 9 0 071123 07/13/20 07/11/20 08/11/20 43,808.13 0.00 0.00 43,808.13 es' TRANSFERtt it Vendor TotalaNumber Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 52,304.02 0.00 0.00 52,304.02 Report Summary Grand Totals: Gross Discount No -Pay Net 52,304.02. 0.00 0.00 52,304.02 1.XPOFICNH) 4-11V D� r 3lYs,-P n k r pli a4 file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.cornlu88125/data_5/tmp_cw5report420118... 7/13 /2023 RECEIVED By THE COUNN AUWOR ON ��77 JUL 22 13 ?023 C'iff 7i3M0Ct1UP1rl t, TEXAS 11:58 Vendor# Vendor Name 12696 GULF POINTE PLAZA MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code 0 ap_open_invoice.template Page 1 of 1 Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 071123A 07,J/111i13/2007/11/2008111120 1,785.00 0.00 0.00 1,785.00 1,785.00 TRANSFER W11 1ft Ilt Pt d 1iU{7S61Ew_ IPA ')w%kL Vy�rL�tl 071123 07/13120 07111120 08/11120 4,039.23 0.00 4,039.23 TRANSFER 'l tr . Vendor Total: Number Name Gross Discount No -Pay Net 12895 GULFPOINTEPLAZA 5,824.23 0.00 0.00 5,824.23 Report Summary Grand Totals: Gross Discount No -Pay Net 6,624,23 0.00 0.00 5,824.23 file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report845054... 7/13/2023 Page 1 of 1 RECEIVED We THE OUNrv{AUDIT0R ON '�, 127A no�2 �2 11:59 �iV1.tF0libi CO31Yki°d,'fE,*4p.4 Vendor# Vendor Name 13004 TUSCANY VILLAGE MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code 0 ap_open_invoice.template Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 070623 07/11/20 07/06/20 08/06/20 9,322.47 0.00 0.00 yy TRANSFER V" ifti1 U_ QJM4 cA )r4 WO -A- p1pf"W.^,�y 071023 07/11/20 07/10/20 08/10/20 6,650.00 0.00 0:@0 TRANSFER 4 tr 071023A 07/12/20 07/10/20 08/10/20 400.00 0.00 0.00 TRANSFER It it 071023B 07/13/20 07/10120 08/10/20 10,080.00 0.00 0.00 TRANSFER nt U 071123 07/13/20 07/11/20 08/11/20 3,000.00 0.00 0.00 TRANSFER It +° 071123A 07/13/2007111/2008/11/20 770.00 0.00 0.00 TRANSFER it Vendor Total: Number Name Gross Discount No -Pay 13004 TUSCANYVILLAGE 30,222.47 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 30,222R7 0.00 0.00 - Kn Net 9,322.47 6,650.00 .r1� 400.00 10,080.00�t" 3,000.00 770.00 t, Net 30,222.47 Net 30,222.47 file:///C:/Users/ltrevino/epsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5reportl98821... 7/13/2023 Page 1 of 1 REC€iVtD BY IHE +rJ93pT�k PI ON ' yy,AUDITOR 2023 MEMORIAL MEDICAL CENTER 07�i3{2j.13 11 AP Open Invoice List 0 �:.=itvOUm 0O4%/•97`l. "E%fA`i Dates Through: oL ap_open_invoice.template Vendor# Vendor Name Class Pay Code 12792. BETHANY SENIOR LIVING Invcicelt Comment Tran Dt Inv Dt Due Dt Check 0- Pay Gross Discount No -Pay Not 070623 07/11/20 07/06120 08/06/20 5,80p0p.00 0.00 0.00 / 5,800.00 to/ TRANSFER ri ►itluatru. p,� 9�L{hdL1I'itu� 'bl.-tt 0@YAts}"t 070723B 07/11/2007/07/2008/07/20 4.909.42 0.00 0 4,909.42 +� TRANSFER N tt 070723 07111120 07/07120 08/07120 22.20 0.00 0.00 22.20 TRANSFER 1t at 070723A 07/11120 07/07/20 08/07/20 4,180.40 0.00 0.00 4,180.40 � TRANSFER it is 070723D 07/11120 07107/20 08/07120 1,000.00 0.00 0.00 1,000.00 TRANSFER " I ' 070723C 07/11/20 07/07/20 08/07/20 3,400.00 0.00 0.00 / 3,400.00 V' TRANSFER Y tt 071023 07111/2007/10/2008110/20 3,842.09 0.00 0.00 3,842.09 TRANSFER 11 tr 071123 07/13/20 07/11/20 08/11/20 16,135.65 0.00 0.00 16,135.65 TRANSFER tl rI Vendor Totals Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 39,289.76 0.00 0.00 39,289.76 Report Summary Grand Totals: Gross Discount No -Pay Net 39,289.76 0.00 0.00 39,289.76 A-PPROVED ON file:!/!C:/Users/ltrevino/cpsi/memmed.cpsinet.com/u88125/data 5/tmp_cw5report515924... 7/13/2023 Memorial Medical Center Nursing Home UPI. 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UNCCOMMYNIIY PI HCCWMPMi id6M3011910000 1485.05 - 14J7315 i/la/1023 UHC<OMMUNITV IINCCWMPMi 146MJd119100M 1i9.61 - 2,U5.05 7/14/2M3MUMRNIIMSWRH MPWZ4991623UMM5617 1L431R2 - t)962 I/I4(ML>l NM0,1/9bNIFa "AYKtkWt"tn$EillW THREE" - TotLm).R0 t1,N3.32 7/141ZQB MRPSuppla-UHCMIMPMC746003411124384 - 2MOO 7111whis WAS, VU12013 WMEOVi UNTd HfALMUPECEMif0.5 pl U2,21599 2... 7/15MB DMTFOXEAt7HPHCMIMPRIT I2113M9W17789 - 2JL40 )/12/2023 2L9 5,314,30 - 231.0 701=23T IMANGI)11P31RNouNMM'PSMG160f10690i6 - 4AW-4 tM100 Sfaa� � _ 3SE30- 7I12/201)MXB-[<HONCMIMeMfT4BM341l4iMM3M3i4 - M95 71IV2021 UNC COMMONM ILHCCMWW?46W3411910OM E5f0.20 I(1J/$O21 XHB- (CNONCCUIMPMf YdNO3dllad00002519R5 - 5]9.50 - 8.ISM10 50.30 111MA023 HUMANAIN5C0 XCCUIMIMTN65691983MO1i1132 LL850A0 - SMS4 HYM MMi - 3,55500 - LI,BSO.N 7/W302) DHEALTUMNCMIMPMT 12110 NB 7/11/1M! OEVOTEO HEALTHPNCCUNAMST 12110492IMM 9045.M 3,555.00 7/11/1oll OfWTFO HFPLTIIPNCMIMPMT 1231m]91i0K33. - 18150.M 9.045GO )/11/20]30EW11EONfILTHP16CWMPMT 11114039239631 R0500 - 13,SM.06 7/13/MI BURP SUPPleme0T2 HCMIMPMt] NON 111241" I,OM.dO - 4g930M 7110PNI MR -ECHO KCUIMPMT74KMGI1 UN02m183 � tl,93i3d - I,OM.M 7/10/1023 HH0-ECNONCMLWMT]16M1411mMM}M)64 11869.91 - 11937.9E 1 [1MOL 12p.Si039 / 13),IOZOI _/ ILS'M.93 Lm7J1 - ••M1' •••^••• _ . MMCPORNOH k$ IPInlICMluI Tnmfer-n QIM/CPmpl NP➢/UmP2 GIPP/U 3 OIM/WmPKIaPv OIPPrt "'ORTIM t/10/3923 XNB-[CHOHC[LAIMPMi746M3431MMOM6Mp /ld/SOU UNC COnN1UNI7YPix[MIMpMT )36M3d1191CM0 164.99 PA84." I61.99 MOM$ UHCWMMVXIWPLHCCWAAUW74MM41191CN0 - I,90Z10 2LOBISS 7/11/NII RMkRN1OUR-COMOCAIRM[fITERIn1W JI30M 121"Ma Ll�Si t,K)m - Z90Z19 7/33/E023 WIREOUTCAMERHMTHCARECEM(RSIII 28.653.is Jr'OLi1P 1/22/1021 21S 9.51169 - - TIE2fSM3,MpIN4NGl1HCNLNouwM1MMSEw�2000G,e1; - rKIA EA.SR 7/WMMW 20}3 UHCCOUNITY PLHCCMPRR]@MM1191,C,, `iR1L.K 39}2P 2lPwR9p 60dM _. AIN 71141ZQ13 HNB•CCNONUWMPMTle6MlgIJg400002maJ> 706/1023 HN8•FCNOHCMIMPMi ZI6M34lINMM26m3] 7/16/ZQ?3 UHCCOMMUNIJYP2HCODUMIMT746Ml4lI9WM0 71141ID23 UHCCOMMUNITYA,NCCLVWW )4S6OMjJlIWW 7/24/l023 UMCOMMUNIIYft HCLLSIMPRR]4K0341191MM 7/14/2021 HUWFIACHA0156HUU1MPW21M0304a0M016 7131/MIi AMEMBIIOUPCpIPO[POYMEXEYESI4MISI JiMM 711-17021 MHP WpplPmmta NCMIMPMHg6Mlglf Si�3m 7113120B W RCOUTUNRRIIUtiNURCCPNTENIN ]/13/20}3 UngeeXeLlhl a HCCU1MIMT 74600H113743U 711211021 ld)1 ]AI/10I3 MOIININFALTI/CAR�AOIIlYg00Jagycummou6 2/tLa011 HNB-tCHOHCMIMP1111111111 1311 11111 1/t37}M3 AmerlJr9up 03C MC[ULMIfA33E136M1}6 {{!OM m.Mg9d../ 4LLl59,f Li.1W10 141111 U.t3933 34.453#y( MMC90PTION IL#IUSRSQrj OR,m OIMIC4m91 MPP/C0.,2 OVPIC0"3 COMO 916Y Opp 1 "MAIRM 26..39 - 2639 - 26.19 - 29.979.16 2959 - 1.535.55 N.97916 4056.M - 153533 51135OR - 4175830 mil" 1MLtl9 J:411.BG 5.1E5N 6.616.W 64000 5'M:9: I.EZU'74 RMAI1 - .6NIOO 9.09169 % x 4,J161t 7411t 1.5i0at 19.K7.M 5.eS0M 4�11�1 HIM - 1$68107 3:\Xu PH.] 7/12/1023 UK COMMUNIT FL HCCUUMPMIMM1411910000 - 11p10. No - 11.010.16 ]/l2/M23HUL)X HUM..NNCH000MMPM) 174HEN113007 L - 1j30.30 - 1.23030 7/11/2023 MANAG NONE)1]19MNS PMNTOMU0IXV0160201 WON 5M,00 7/142023 HUMAN4INSCO KC UHPW2QW3))9930N05432 - Ims 00 - 3,19LM 7/3012013 HNB- ECHO100070095 - %MS4 - 5,293.N _ la>33u3 ./ 31LN1.99 J` 13,s».N L3'N.N UD15e MAIe� TOTALS SN.N3m 5029N.03 Kan..'s Am", 99:)21.33 Y3160.R 7/17/2023 Accounts Ov15iNxC1 + "t9':m Account Balances (,m59ea )aYevlew Search Accounts Steen Venn ceM1a1}ne. n,[w,: Munlm -,1-[en:lnli 3/Lyle n MEMORIAL MEDICAL CENTER - OPERATING'4357 (ufrenl all... s1.591.fi9i59 t<.Iti[a5 P!.'ar(t S: i•41[9i ni 1ubn'.e9auete f:.ui.Y::a `t verCq.3a ancx 5: _12L4: 3: MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING -4373 emrem eat,nre u32.85 ev'epm Ba a,pr 1_12Y5 -vmla: e6..nw .3155 .rs 11, Barn-,. 14:].ai MEMORIAL MEDICAL CENTER / NH BROAOMOOR-4403,/ Current Ham— 51LbA3ll c. eCeC YJa4c P�[p3 is 111 aHd:A':P 511i'1i5: Paa:IL]Ynan:e MEMORIAL MEDICAL CENTER/ SOLEERAAT WEST HOUSTON*4438 ✓ CYrcenl Ballnae S11)AB).6511f Co're[:e�0aa+ae SI•_2E.'64 pauap•e 0alae[e 513/91Y7? Pnor pa/9a'xn[e 151,pb it MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE *4454 Cunene Bulan[e t16.629.W colleted duar[e 516.5Pu 11,1411e11ae<e S:EAGG GI.µ OJY `4S`Y Vo[ 37 21 MMC-NH GULF POINTE PLAZA - MEDICARE/MEDICAID05441 [urrtnt ealanre 551,SOS.11 Cn lemn Baa^n tit.=05 :1 -.,'am. emt.rr Ss1.56i.11 )rrr c,r7 a,e-;e MIMIC -NH TUSCANY VILLAGE *3407 <ueetn[0.11an[e nsn.s. ti0;1[yled Ja'.,,[e 35)915 `+: n,a ...et•J,':o 153.035i 1.t 011 9, ante ttt:f%ia MMC -MONEY MARKET FUND -2998 mrrtn: aaln[e s2ansz9n rn. e::.n B,v-.. Incns_va -..r to. is ae:n s20rL5r4,] MOrp,1Y9JYe:r ILY]1.5:6Y Treasury Online _MaEe lnrpal.wtmew eB Prm[ .wwraoae .sear<n- ym.r.4n..are q ', n: wy e,m:e 'm•tze5amn:e <1eapl. ea,rre -r•..r. se,et $4,336,845.27 S4,560,877.94 S5.214,242.39 I $4,560,877.94 MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014'4365 Cu,IPnt S.lt!nee i51t66 C[lu,te]ba`an<! St1t 5n .n, _v.e9a arc U31c- Ane GrN.3ann 5�;;,[_ MEMORIAL MEDICAL CENTER / NH AASHFORD -4381✓ enrranlem.n<e Sn9.lwnt,/ m. .rJ m:ar<e I'711 1 V 170l Qs,E a:Pl0,, errs I6as"61 MEMORIAL MEDICAL CENTER / NH CRESCENT '4111 / 44"amt"_,n 1111.1..07J CR.1..[en ba ar<e 3']I,Ipq]7 n.a 4de EJYr<E 5I52,71376 Pr rI., U-,a S5A 21aN MEMORIAL MEDICALCENTER/ NH FORT SEND'4446 / evlrnni fldanee sN,V3s2! (an@[ep E:arse .. •_.. b:e latla Balnr;e fup aC35: Pnur paq Baavcv is 1:1,16 MMC-NH GULF POINTE PLAZA- PRIVATE PAY'5433 Curnn3 Bapn[I Si5.69524 Culeuni afun[t H[65529 =d11,5.. vU,:Va ar2e. n95"9.9 MMC -NH BETHANY SENIOR LIVING'5506 CurrcniBAanre 133.05130 cnl!erte]Bn.rrry S]3047.39 si;v_-Is 1nn1.1, 111[e o;esz?c. MMC-BETHANY SR LIVING - DACA'3660 eu,rcm &llnm slvpvv a-1,nev wgn:e v; ap -ve...rt bt a^:e 1`0.:40. rnr 3a, 0.ra•:.e 3!L,i.Cp https:/tprosperity.olban king,cornicorporatelapp/accounts 1/1 Memorial Medical Center Nursing Home UPL Weekly Neaion Transfer Prosperity Accounts 7/17/2023 A¢aune NurYn Home numbs WAMPUM P.euldus 6eelnnlne 130.09.22 a M,,892.11V/ 18.422.07 Nam:Onrybakncea djorn$SWOwalbe fmmferrcd m the nenlnphamr. Now 2: Ecohacawnr hoed betebaknmof UW rhnrMM[depaNtedro apen account. C.wo s a":AU too l i .LL 4, 5 �-aTN Taday'a8lpinninp Ampun[408frram4lrtld [d NNNne 18,62944 eant8a)enm 18,629,44 Vadanv boos In Babnce 100.00 ApdIM.Mn 39.02 May lnleren 46:M 1.ne I.M. 2"? AdlYrteelannRriMlcAmty MpeF ip. 23A2 •aamrca:�l�y a tr.. ill^r , 4n ANOREw0EL0$Surt05 2/1)/2023 I:\NN WeeMlVtumltta\NH UPLTnnalar SummaN\36231NN YPlegnsler3ummiry].1].13 3/14/ID33 TSISR NSTIRSTCRCD0UH3lMS5507651793 7/141M 7 HNG ECHO HCCUIMPMT 74 34114300W26MU '3/xMOU WIREOUTNUIONNEALTHG/b/1GQWEN0EER HC x/132021 TSVW"NUTAST OR CO 0EP S436&1USOM1391 WWI. HEATHHUWNSVCHCMIMPMT314W0341130112 x/11/2033 GOLDENCREERHEAETMERCOEP 122035G91IXO01779 TnOa023 T6W NS STCRCODEP543661555R1691x91 ]/10/202x OOLDENCREEEHEALTMERCOEPIIID35691 W 464 mmc O 3ON QUT/O.4 T ,Hft On uj TgnSladn vpp/Cempl Qilp/Cpmp2 Q4p/Wgp3 6YOH WPAV NHpO]IOV 002.4] - 001A] 1.049A6 - LW9.]6 12.,,WZA5 1.300.00 - MOON - 5.033.54 5,033.H - 4a%aa a.296.0 28598 5.6]510 - 3.635.10 IIB,B9EJ5 . A13.01. 711712023 Accounts pmn Vln': r•+�••m.n se y¢,:"r r.,n,.w Account Balances umn,w t,m,nm Search Accounts s,i,aww: select qce ns31Sl DDA (15) c:c>on m..nmv MEMORIAL MEDICAL CENTER - OPERATING+4357 Currtni 0abnce [1,697A9069 ec IDc:!^e.•en:r 11 "I Ili 1; ,•.a��a:meaggce Sili i.4.ff .n:-Gl G'a�', S1 E1'. e.3 L' MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING *4373 eunum ¢aa.[e wads cc :.e 3.,,:. "n 6a 5..,aaa'.e 6a neat U-128s 1, v 11,45 MEMORIAL MEDICAL CENTER/ NH BROAOMOOR *4403 Cuerenl B0lan[e s106,W3.9x [mmnv uax: f1[rio33s nvybv4 eva.ro Snfi.nl97 Mor6ay Gan;e f9•f.90>]J MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON -4438 CLneR Balaoty [Srz em.Os I.. 9a ena 1, 12 1H a.m e116.1an:e sla7411, 1-1 h, all V:u':[, 561[v 2- MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE '4454 - X Curmn30abnty [I016M.V epl,eeuamanor. "E.5l9m A., IlflSll, M41D.60 G, tr Wr V]'a.+:e 51C072! MMC-NH GULF POINTE PLAZA- MEDICARE/MEDICAID'S"Il Currem 6alan[e. 11,M1, IN 15,_4511 ar: D,Il,":a SG.96•'3'. MMC-NH TUSCANY VILLAGE •3407 el,mmealalrm ss3.e135D h"m,rz wa,.:e s3[6:3Sa AvdNhle Babae 553b1i 5D YnarRUY 9ga,Y fl;1494a, MMC-MONEY MARKET FUND n2999 Cu111R Gland 32071.530.47 a- "I 40: LS:U aI A,.,!d...G are. 32971520.1 1,., n, Ed.a...! Treasury Online .— mroe+duu view. $ vnm a VO.vnloa0 -, slnnn � n.mwl x_,name 0 a r nrOa Ra An[a ::amen el.—L, avera:uexanr.I n.... .. el—, $4,335.845.27 S4,560,877.94 $5.214.242,39 1 S4,560,977.94 il, 01111Nam, MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014 n4365 cun,n: Bala... 107.66 CPIr-!o-]Ba'an;e > 17 ".a1Si, 5a'-11':e 553:At G'n; 0,"l, e53 MEMORIAL MEDICAL CENTER / NH ASHFORD l`4381 Current Balance 3179.19717 .0 ase ¢accx i¢ft5S3i Gnc. D.Y=era.+cu 350.5056: MEMORIAL MEDICAL CENTER / NH CRESCENT n4411 0.11. :, Wc. 3141.1060i "I'll 'I"". V11"9g." Ava.laple¢abnce 31"34.74 vnar W,Rl ... faAY.f :f MEMORIAL MEDICAL CENTER/ NH FORT BEND t4446 cu,rtncB,l . 1M.U152 Cdleun BuVn.0 n0.91?S ..-[W,6Sa,: c, Sc51alw G„rz, D,B,lim MMC -NH GULF POINTE PLAZA - PRIVATE PAY *5433 fu1rtn10ubnt! i95.895.29 C.:111!n I'll— 45.B45.79 4aral:'<tli:gt fi5.9tOb r¢,W'i Oa'arztt 134.aii]3 MIMIC -NH BETHANY SENIOR LIVING •5506 Cuvent Balance 133 C,1.30 CcI—,6+anca ni937.:: ...na..r..a a..t 3Grc,c,a '. MIMIC -BETHANY SR LIVING -OACA t3660 cu,rtm Bawnm 110M :cnprwa ilI, 31en f.•i ,a3_w, G11arce 1146.ng Vna, Da3BJ1., fI0lI C9 https:(/prosperity.olbanking.comlcorporate/app/accounts Ift Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Acmunts 7/17/2023 ( Pm t NYNn[Xame ! XunOer Pandlne B+nka+hn« Vmu le<v<M B+lann <5.8MO loom AprUntenm It M<Ylntarym ILEI lYm lntenrt f01 00unBtl+n«pramWAmt �sdwa< / 4moumm8< PrMau+ Amowtm0e A<taunt p4lnnLy pend4.( Trjnlhmdln NYMV NPme Nwa.. Bahnn nnhrOYl hdluleHn [ST eantl pa t+ daY X( pP,4)9 E5 � Be.T1402 k/` 6{.]aa.]p U � - - SLSOS.11 $S.T3T.30 f l- Bank Babn[ sLSCi1E Vmla�[e Nwe:0.Mveaknm a/evwfS.CWwJFpevvm! mdlo UenYmneAome. PoFC 2: F<tAd<Mumhm <EveGnbnttNfIC011w[ MMCd<wntroropym Y<taunl I..—Bau— Its" ,impmmento dmMMC &IMI ff apollnl<nn 1<.I1 MaYlnleml 1E16 IYnelnt<n<1 I1Ip ndjYn OWn<e/Ir+n[f<Idm< 5 2)T.Ip TOTNTNWSFEXS .9LW234. NXe0.EW pEm55RXT05 /I�2I l:1HH WFXTtAlsf <IHHN<Lr+ndn Wmm+M12J21WH Nt hndvSUmm+X 7.17 ZI MMCPORTION QIPF/Comp QIPP/CemPl ;y Tramler-Out Tr 51920..ln OJPP/Comp& 2 QIPPfCOm03 &lapse QIPP TI NH PORTION 7/13/1023 HNS-EC INS COHCCIAT 746 03991T640300005624 0 5,923.52 - 5,92600 7/12/2023 HNB-ECHO HCCNIMPMT 74SM3411440000215816 0 23.5E - 623.52 9.93 7/12/2023 HNBANA CHA OEM NCMTIhlPMT 2414400C4NOW2 0 380A3 - 4W..93 )(11/2023 HUMANACHACI6261210MPMTABA292 SWEEP FR 2 0 25,358.17 35.358.17 7/11/2023 NOS SWEEP PACH26123004600MIl440NN0S23 0 15,1310 - 25132.0 7/12/2023 HNB. ECHO HCCIAIMPMT]480034114400W252S]S 0 1326) 132 fi) )/1]/2023 XNB-ECHO XCCIAIMPMT]4600341144CWB$52$]5 Q /� 411E � 4L13 / 45.216.OSJ 453280S P 7/14/2023 HNB-ECHOHCMIMPMT]M60034l1440000163903 7/13/2023 WIRE OUT HMO R4dXft SNF, LP - Commerical 7112IM23 MERCHANT BANKCO OEPOSIT496428518989910W01 7/12/2023 CENTENE CORP HCCIAIMPMT 53101128354984 7/10/2023 MERCHANTBANKCO OEPOSIT49647851883991=1 7/30/2023 HNB-ECHO HCCIAIMPMT 74600341100000204783 MMCPORTION QIPP/Comp QIPP/Cpmp4 TnMn-OAe TranAer-In OIPP/Camps 2 QIPP)Cpmp3 &lame QIPPTI 1 NHPORT10N S2120 - S14.10 89,72A02 - 220.00 220.00 - 1,233.14 - 2,233.14 5,62S03 - 51625.02 • 43,753.92 / - 43,xS1.92 89.720.02J /5235a.xa.f v 5199 xe ' 89.72"02 96,990.3E 96d8033 7M 7/2023 Accounts alccvirn ia95a:CE]Sau3C 63Nu::E:.^.CS Account Balances core 3vnw r,moh<w Search Accounts ku<,uew fierce *yun x.a<mam46y TJ6e a.!:rFev r Aiui DDA (15) A[Gcun[NumCer MEMORIAL MEDICAL CENTER - OPERA7ING'4357 Cu11e61 WWI. 11.69i.693.69 Cd!le[I10 B,Yn<e t161,"1.6l .•1.i31 e 3l Jnte 1i:36.at 1 c-1p4 9,VVY 1152]0419] MEMORIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING'4373 m.rencanann u3z66. Cc nu uz•:-[. u3sss <vn.lnce ed•a+oe s.11 as 11-01, a.ra:» s_NA9 MEMORIAL MEDICAL CENTER / NH BROADMOOR 64403 emrenc WldJGe 110.333.92 Cu!rttasaJ'<l Slea alai s-a•wez ¢aan[c L15.Oa6> w:crp•„idb,re d5Y9e].Y MEMORIAL MEDICAL CENTER / SOLERAAT WEST HOUSTON'4438 Current BahnGe S113.B67.6E Co'et[eJ WOnae nl gtiE1.55 MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE w4454 Cl:rren[WIanGP 918,639.41 (u.?GrfJW-1,, 3:Ea aw0:1e Wwn[e WAN 6a erm•0up¢o4n:e 3ri6912r MMC -NH GULF POINTE PLAZA- MEDICAREIMEDICAID +S441 awemWldn[. ssts66+1. ,%ne-ee aAA,re sysa5a ..va..dnlesAianrt t51.5ai11 rn^r pa)EaIA•:e tSG,'1°a.91 MMC -NH TUSCANY VILLAGE'3407 Cunma Wldna fs3,evsa eareulu Wanle 153Zll 0 ..e,J a tld:,eu a='..-e13.5o en.. py G:o-_e V9. 10 ea MMC -MONEY MARKET FUND *2998 muenl9,mrca sz6ns39a] cceeM1v e,:,,;r f:.graur hull,I 111. a s2mts]ed] rnnruav B.nanle 12 ml sdl Treasury Online p nclxemy Wrauv mew a 6nnG s pwvnpda �, seaan AGrolrervmxnnme prm pdr Ed nc[e Cn+raee e,mn[e ava•wroe sa.... I c,"."BUAnr. 84,336,845.27 $4,560,877.94 SS,214,242.39 $4.560,877.94 ... vsrdymr^e - MEMORIAL MEDICAL CENTER- CLINIC SERIES. 2014.4365 SurreR Babn<e IBT66 [.Menlo 91bn<6 I53].Gf rdatG'e 9S,:`.;a 1.: 66 m,11, a=.-e MEMORIAL MEDICAL CENTER / NH ASHFORD •4381 arr.n:Wbn<n sn4o].ar cgaaled a,wm rvgla;a; MEMORIAL MEDICAL CENTER / NH CRESCENT"4411 eurrvrt naWnm 5111d0.07 euumaeo uJVwe s,:.1Lcm sl6azle]r, 9nJ. nor Wuda s!az3n s, MEMORIAL MEDICAL CENTER / NH FORT BEND w4446 Curr mBJbn S.Y,L].53 [ol:e[Irtt 9l:erne N¢.AA3 •i] -.N`Le Edmcan SaJa3 is rv: 0.v 3, n+:e tU.1E: la MMC-NH GULFPOINTE PLAZA, PRIVATE PAY-5433 / %/ c Cearcnt WW.11 145.395,39J Cn l:. 11b11n 53565 ArJ:JY' v B dldn_l 1`91 a9] ":a.", Eu'u:'{! tl"r9ic_l9 MMC-NH BEfHANYSENIOR LIVING a5506 tu,r.l, Clu.. "3W].v rev B,aar, N3 e57to valibk ellale 3J5.U1M Ooe1, 11.,,. IUyj7.W MMC-BETHANY SR WING - DACA 63660 eurrem Hahn.. Ilenaa %11eueanan:d dram https:/Iprasperilyolhanking.cam/corpomietapp/accounts 1/1 Memorial Medical Center Nursing Home UPL Meekly Tuscany Transfer Prosperity Accounts 7/27/2023 paerrorr P[munt Bapnnlry note:. Each Mmmafora MSVW Rd!6enmWfttro ffdm=Bb M NReL[P[6p[[oxtt M1erab+[sM!vn<e%SIOONot MMfdepmrtNm Weno[munl. JUL 177 Ce+4.iHICllJt ''.L''4�)sri F.'A" &n0eahnce Vanm¢ leareln Nlma NwnVpup Miy MaOna May PmauMtueR n.mnm.eto 53.eu.5p �i6.IM.39 F SSAU50 3f Idjuu Rna[ne``eRvand�)aa Mn 1FAWe.f PPPmveE.9 YiY.�'V NY" rl. ♦'.�iFS�� a�]/1]/]p33 NIpREW pFlp53Pn5tIF _ MMC PORTION QIPP/Comp QIPP/Comp QIPP/Camp TmmfeLOut TmmW-In 3 QIPP/Camp2 3 4&Upm QIPP Ti NHPORTION 7/14/2023 HNB- ECHO HCCIAIMPMT 746003411 00000263903 - 1586292 15,862.92 7/1412023 AMERIGROUPCOBPOE-PAYMENTEE526181551110W. / - f 28:790:95 16,19860 ;5B35 17AW..78 1,291.19 7/13/2023 PURE OUT UNBAR ENTERPRISES, LLC 113.38179 7/12/2023 1129 17,874.13� - - - 7/12/2023 MOUNAHEALTHCARMOUNAA00120579242MM18 - I0,034.09 EMUS 1�3$951 9,339.33 694.76 7/11/2023 HNB- ECHO MCCUlMPMT74600341144MM252575 9.035.54 - 9,035.54 7/1712023 Accounts Ou19kY� -ii^Sa[�J]SuBL[ ECiup'y.Ilia: Account Balances care vrew rapre¢ew Search Accounts tea. n..r. .nec r6r.: Psal!51 DDA(15) MEMORIAL MEDICAL CENTER -OPERATING '4357 Cunen]Balarlce f1.69],693.69 ca!gnEtl E]!a+te ]i.fi9].44-s f4 omUole Bman[e fZ336:414.ii Ynor paYtlav+n:e fLeZ]AE3.63 MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING •4373 [unetll BolaKa ]E12tl5 wv— Sa5395 armyp'b are MEMORIAL MEDICAL CENTER / NH BROADMOOR •4403 Cuuent BUWn[e 510433.93 UJeaeGca : S1C4li3 ix a.a.a !-haran[. $115„aIar.. ryi..e ]Sa4u]3! MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON *4438 cunem e,urrca vrl,tlfiLps .-... n1Lsp�s ba nse Yder ra f1:g3te xl aas pov 3aiauaa .U.Ca}: MEMORIAL MEDICAL/ NH GOLDEN CREEK HEALTHCARE•4454 emrem wWrce ne.6x9.9a m:mrteo w.Jnte nBn9e <wdaple paWn[e sid,a)bfi0 Rro-0aY BaW^[e )IEL9r9 MMC -NH GULF POINTE.PL47A- MEDICARE/MEOICAID *5441 Cunem Bekn¢ 151.505.1, Critraea Eaanr! ssti9in Arauanle Bnlan[e e51,5C4.11 I'r.e: psYEe!an.e Si•29£1.51 MMC -NH TUSCANY VJLLAGE *3407 e Wr¢c ts].tl[1q:/ f ti:,Jnce Faa 3:• ' b. p Ian,e filglDy Gro. MMC -MONEY MARKET FUN D'2998 er,r.em smaaee• S3671.5360 Cr. r.cl.a sam.:a r..l^ CJ: 529r1..1141 P..m CaY E.1!eca Sl i•.i3i.. Treasury Online p ruYe my ouaulrv.ew a9nm ! p9wnibaa . xarrn - a•ph E:aa. ^p roue3mar<e 1w.y01a Ea.a.:a Lrrta 9aivm $4,336,84S.27 S4,560.877.94 SS,214.24239 54,560,877.94 ,a.. pJ9!a5 name MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014 v'4365 Cu—, UB rte 533].66 0o144nen BarantE a53]5G Avav`a4re pnra.r:a )91.54 anv pep 8a'a-n M3>r✓. MEMORIAL MEDICAL CENTER / NH ASHFORD •4391 Current Galan¢ SI i9.14],V rurlxleulAYnt4 599:6}ar MEMORIAL MEDICAL CENTER / NH CRESCENT *4411 Cwrinttlllau:e 1141,10007 1d'H1ea .15, p] n.a e'ie Hara•:a nF223e -5 anEr idr'Eaoe[e ]68::0 tl MEMORIAL MEDICAL CENTER / NH FORT BEND *4446 Cotten[&Wnv IMA152 CarmnYn E,sn:e Sab Jai f: ..a..Ne p4Jm_e ljlyjS F.., p'&— 46,IEJ. 1, MMC-NH GULF POINTE PLAZA- PRIVATE PAY •5433 emMn[Wlante fax01k39 Coneav`Y u:Wnn uSn5 ia'rap'eliJtn.;e N5.>rC.9:' arAr LVv wran[e SSY,9]9 YA MMC -NH BEFHANY SENIOR LIVING `5506 CwanS paranEe 133.OV 30 M.—IBelana s33.CB7.iC walanre En6m:e )a3:"i1J.15 N..'Day E9aeen ]a3 P87.K MMC-BEFHANY SR LIVING • DACA t3660 a [w a Anon. c. !u'J .. smpm hltps:/Iprospenty.oibanking.comlcorporatelapp/accounts 1!1 Memorial Medical Center Nursing Home UPL Weekly HSLiransfer Prosperity Accounts 7/17/2023 rmta.. Aemune 4gnnN{ Nalr Onryths.. ofavn53.000 Wilbe hamfared to Ih.n.1 near.. hb:e]: Each almwr has a bole hohurO, InJtho[MMCd maoM Moen a..owt. a r F Ja 1 7 26211 reward M.JfGtt Wntwbna Nmlre. W..In will" Amu.nlme. ss.abrsb Icon J I.-lmrtn[ 4111 f Mitts 3.1 .R Ill., ]Abbslc Y (;may ANn' A�ossnrnof— ry„nAa IANN Ii lrmdm invl,'—an'5--hUi Y)l ir.ntNrSumm III II ,. mmcPomWw nj(a adut n�v^ OIH/fnmi gIPP/CpmPP OIH/CpmP3 CUP/Co... QIP NH SEDITION 7//312023 WIPE OUIPORTUVACANH.UC InAS .00 ✓ , 7/13t2m NNB ECHO HCCUMPM 74RM3411 46010225816 11<.50 1L50 7/13/2012 IRS ECHO XCCUIMWAC)V6W-`U`" 225816 68.91 )/13/10}3 WUITASSOLUHON HCCUIMPMT6)610I62W W1S9 43]8.91 66.91 )/ly}0}3 N0NTA5IDlUilONION MM16WWI53 /^f 4,6]0.I5 4326 93 )/11/20}3 dt35] 183.00 0.6203f )/I1/1013 OeWsit 16,1fiSUI _ _ 1MA5..W 7/11/2023 INNIR l 3,fB5.i2 % },60S.2i _ _ 2326W.W ./ lZ96406./ imaliss 711712023 Treasury Online Accounts QuWymv L'an as en 9e+r. 65rg9nr Gpy0a Account Balances eamvlev, reNt,,. Search Accounts ❑M,ke m9 write w.r, 0e1.1 .00wnlo.,a .. s[n..5. se.ea Y.. ,.Int T,,. n(ewt111. ".Dune 110,11m[ in A"ut e. Say', 7mn 11aaIS3 DDA(15) P•n•oay za n"n• celaameawrz[ A.umw.B.lam. r"r1[et 9Fln... 54,336,84527 $4,560,877.94 55,214,24239 I54.560,877.94 .e, onaarmlme =' MEMORIAL MEDICAL CENTER- OPERATING *4357 MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014*4365 Cunene Bala". 11.11".1169 l.`I[][n. e, sl S47 i%iS Currnne Bala... M766 C.V.Cle 91'11t[ SSIik, 1r01181bn11 IZ23601111 Iner 0, Halee:e tI,0 AF3.C2 +m 1111Ui, $W116. 11.oil Bfa, 151, Lr. MEMORIAL MEDICALCENTER- PRIVATE WAIVER CLEARING*4373 MEMORIAL MEDICAL CENTER/NH ASHFORO*4381 Cu.a rn Behn u3105 c:L-.Na_. 6ui55 eu„e"e aa4t9 nte f1.111.47 C, iee Ja.'Jnu .wlereeeana Sat BE Frmr D, 0, ee:2,55 -w". a B1.11. S:(!:.52_2, ra. oY 0, MEMORIAL MEDICAL CENTER/ NH 840ADMOOR•4403 MEMORIAL MEDICAL CENTER/NH CRESCENT*4411 Current ealen[t 9104.033.92 _:,AJ 0J.e„. uM: 1.1ic 4u11C 64unu 1.1,w0A7 Dien"OJ.x:c 3'4uCC.e7 xu,:a0:e gala":e111L'155-1 "e, 01, Baolee u:-0. I. v:. ealan:z I112.23f -e c^roar Ba a. 11• tin nr MEMORIAL. MEDICAL CENTER/ SOLERA AT WEST HOUSTON*4438 MEMORIAL MEDICAL CENTER/NH FORT BEND*4446 Currie, Bal.1n. 1112587.BS Gclinuxl 6..n¢[ .,•1 E57 e: Current earance 10m),5: c--er.e Y:a^an v,ue'G 9a'arne 513: 4a:) -nor p.y&la: <e :fl?053_ .1,_u0ao:ee s-3.4:15] G'e, 0"Eu'J'in SB'bP 14 MEMORIAL MEDICAL NH GOLDEN CREEK HEALTHCARE*4454 MMC-NH GULF POINTE PLAZA -PRIVATE PAY*5433 Curvenl Balance sls.m.. Ccittr*0 Wu -a it5.4.4J Cunt., 0.1ince 115.0529 rJl.ceel tlelan¢ NS.M.2; Arr,acle J4bn[e f3a3GS9 ace. BJYva'ea:e-,e6371 aila".e Y3.91Gi7 ..y MYOst•.Cu s3;,:]j5 MMC-NH GULF POINTE PLAZA- MEDICARE/MEOICAID*5441 MMC-NH BETHANY SENIOR LIVING*5506 Couln1941an. 151,505.11 Cn.;11e61 111:1 5s1, 54511 Current mince, 1)),0113, 1 r.urtlei Be,.... $3309730 ..a..aa:I Bnnln. 151,9511 ar 41 GY Eatn:[ SSJ v°L.51 "a 11:. RJWn:e 34(r:tIs Ric, 0aY E'+l1no•' s))03]50 MMC -NH TUSCANY VILLAGE *3407 MMC-8ETHANY SR LIVING - DACA *3660 a,r[.t&flmce 553AI3.56 W tlG0 w14+1, el, .15.9 emmmeabn.e IMnit celd"il etlmm avrp FvJ 1,r01GCJ:aY! 55M,3% MnGa C]r ea:an:. MAr:9.0'. iW 1aR,etlaun;. SIMP0 P... W, Oy,n.e 51C4G: MIMIC -MONEY MARKET FUND *2998 wrnmB4lae. 110715)a.41 C.nn.n An a4. 5-'an5:un ,. a a.., 6a inn. 1 ?11520-1 ngr'y I,,rn 51ff,1.a111.4. https:!/prosPerity olbanking.urom/corporate/app/accounts 111 8X~KX0Ri A LL &01 E D 1/`A I {,rK]TUR MM[ -------- -�-- Oa-iFRequested: 7/17/I3 FOR ACCT. USE ONLY -4,PpR0VE[)8N� F]/mprcsCash jM[ I � A/D�`|`cck �-------�-----'--^-`-------'--^ 7�A��] L�^ - I7��ai!Ch*chozYpndo, U //cn�l.d�tuDep, __-_--�------_-'-_-_�- / A FV!OUk7 44,214.52 10255040 Amer1gnoupand Molina May Payment i----------�------'--^-~~--------~��-- i ^ |! U[1T��by� ��|in[�ven�e, ��TkC,|i|ZF5BY� ^-- '� ---�--�----- ----- - --- �'� �-�--�----- 7�----�- MMC 14OUieT 16,355.67/ ate requested: 7/17/23 FOR ACCT. USECiDiLy 0)r LImprestCasn AA 1 7 1,1u7 , FIA/P Check 11Muil Check m Vend:)r ;Apsl J'r e,OU% nc`A+YS JR'ci.th �a:,a: LU IJCpP C/L P[UWBFR: 10255040 eXP+AN;?TIOI: Amerigroup and Molina May Payment Caitlin Clevenger MMC Uat= Requested: 7/17/23 1Oli ACCT. USE ONLY F''p?]L1E6:t'7l; �ImprEst cash A%P Check Mail Check to Vendor 'Return shed: to Depi AMOUNT 12,085.26 j/ _ G,IL PLUMBER: 10255040 0'/ EX,PLAttiai.QN: Amerigroup and Molina May Payment 4F iTLfi 3 Caitlin Clevenger .fil-'VRI'F� MEMO RIAL MEDICAL CEN-IFEIR MMC 7/17/23 A FOP, ACCT, USE ONLY y 17imprest C3sh E AIL I -I 11AjP Check Mail Check to Vendor E ,,UD "I COUN-41 L Return 0��ck Lo Dew AMOUNT 13,836.33 GA NUMBER: 10255040 C, X P LA P.' A, - i 0 -Nt: Amerigroup and Molina may Payment Rk OUFSTH, BY: Caitlin Clevenger AUTHfjM7FD BY: MEMORIAL MKREQUEEDICAL CENTER T CHEC1z i p MMC Uatf-,. Request.ed: 7/17/23 F. AMOUNT 13,231.53 EXPLANAT�QNI: Amerigroup and Molina May Payment F- -j BY Caitlin Clevenger gv FT! .AU DMOR H7, N FOR ACCT. USE ONLY Dirnprest Cost, F]A/P Check 11 Via I I Check to Vendor FiReWrn Cl.cd-L) Depi: G/L VUIV18PR: 10255040,// -2-3 V Nii :IVlOROAL PtAEDI! A1_ I FibTER REQUEST F MMC / iiar= Requested: 7/17 23 FORACCT.USE UP!IY ^� Cheek Mail Check to Vendor �Return Check to Danz AMOUNT 26,829.11 „%' G; L NUMBER: 10255040 ,/ Amerigroup and Molina May Payment -D Sy. Caitlin Clevenger -U. �LUl�izi'� Ci: l •� P MIVIC A ECK REC'! 1 1-n5" 31t if- PcAr-- t&M Dal- Reqwes,ed: 7/17/23 Y ��.PpFff)v`rD 040 iln I I )tlf?', -V� AMOUN7 116.98 / G/I MUMBFF.: 1-,XPLANATIO,1�1: Claim payment owed to MMC ND S,,' Caitlin Clevenger FOR ACCT. USE ONLY 1:11mprestCash F]A/R,—he,!c Mail Cheek to Vendor Recurn Chr-Lk Lu Depi: Electronic Payment Clearinghouse Settlement Cenifientinn Draft S U.R N.: 10795529" Cloamd: 04102023 Oat. Im.d: 0410512023 iti tue: Cleared Am 5115Ae unh ✓/ Payee: MEMORIAL MEDICAL CENTER,/ PO BOX 25015 N VIR PORT LN,%CA TX M79 Remarks: 1 j! 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