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2023-11-22 Final PacketNOTICE OF MEETING—11/22/2023 November 22, 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 Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: I. 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 10:00am 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. Karen Lyssy presented a Certificate to Judge Meyer and Commissioner Behrens. Commissioner Reese wished everyone a Happy Thanksgiving. Page 1 of 5 NOTICE OF MEETING—11/22/2023 5. Hear a presentation from a representative of Southern Software regarding software for Calhoun County Constables to be complaint with state regulations to submit monthly reports of the Texas Department of Public Safety. Mark Jones with Southern Software gave a brief; presentation. 6. Consider and take necessary action to approve the updated estimates from G & W Engineers, Inc. regarding Bid Phase Services for the Memorial Medical Center Roof and HVAC project. (DEH) Scott Mason with G&W Engineers explainedthe need for the increase offunds srequested. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to approve the GLO — Certificate of Construction Completion (COCC) to the Drainage Improvements in Alamo Beach for Calhoun County, Texas — TX GLO Contract No. 201-065-064-C182 and authorize the County Judge to sign all necessary documents. (DEH) Scott Mason with G&W Engineers explained the Certificate of Construction Completion contract'. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER; Vern Lyssy, Commissioner Pct 2 AYES. Judge Meyer, Commissioner Hall; Lyssy, Behrens, Reese 8. Consider and take necessary action to remove from Precinct 3 R & B inventory asset #23-0257, a Norman Motor Grader to be used as the trade-in for new equipment. (JMB) 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 5 NO-FICF OF MEETING — 11/22/2023 9. Consider and take necessary action to approve the lease -purchase agreement with Welch State Bank for the purchase of a 2020 John Deere 672 Motor Grader, serial number IDW672GPCLF703140 from Anderson Machinery for Precinct 3 R & B and authorize the County Judge to sign all necessary documentation. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: = Joel Behrens, Commissioner Pct 3 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to transfer Precinct 4 R & B asset number 24-0441, a Military Cargo Truck, to the Seadrift Fire asset list. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to authorize the Port O'Connor Community Center Board of Directors to enter into an agreement with Lauger Companies, Inc. for the Pavilion improvements. (GDR) pass 12. Consider and take necessary action to extend the feasibility contract with Texas A & M AgriLife to January 31, 2024. There is no additional cost associated with this extension. (RHM) APPROVED [UNANIMOUS] Vern Lyssy, Commissioner Pct 2 )ER Joel Behrens, Commissioner P..ct 3 1i irina Mavar f nmmiccinnar Will I-:vcca Rahranc-Rooca- 13. Consider and take necessary action to name the Calhoun County EMS Director as General Contractor over the construction of the First Responder Training Facility and grant him authorization to sign on behalf of the County on items pertaining to its construction. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 5 NOTICE OF MEETING—11/22_/2023 14. Consider and take necessary action to authorize the EMS Director to sign the Mueller, Inc. Sales Agreement Quote #93273810. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER:. '- Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Consider and take necessary action to authorize a loan in the amount of $36,000 from the General Fund to the Boggy Bayou Nature Park capital fund for the CMP Cycle 26 Contract approved in Commissioners' Court of November 8, 2023. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: 'Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 16. Consider and take necessary action to declare the attached list of furniture from the Code Enforcement department as Waste. (RHM) RESULT: APPROVED [UNANIMOUS], MOVER: Gary Reese, Commissioner Pct 4 SECONDER. Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 17. Consider and take necessary action to declare the attached list of furniture from the Calhoun County Museum as Waste. (RHM) Commissioners agreed to send furniture to auction. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER; - Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy,. Behrens, Reese 18. Consider and take necessary action to declare the three (3) pickup trucks on the attached Fixed Asset List as Surplus/Salvage and remove them from the Road & Bridge Precinct 2 Fixed Asset List. (VLL) Joel to Gary Judc :D [UNANIMOUS] ms, Commissioner Pct 3 e, Commissioner Pct 4 4eyer, Commissioner Hall, Page 4 of 5 NOTICE OF MEETING—11/22/2023 22. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct,2 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese, i. Justice of the Peace, Precinct 3 — October 2023 RESULT: APPROVED [UNANIMOUS] MOVER:, Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer,. Commissioner Hall, Lyssy, Behrens,'Reese Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] , MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Oct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 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 Adjourned 10:41am Page 5 of 5 MU 10111" I. I. I I I�_ - I lDoi All Agenda Items Properly Numbered Contracts Completed and Signed All 1295's Flagged for Acceptance (number of 1295's _) All Documents for Clerk Signature Flagged (All documents needing to be attested to need to be signed day of Commissioner's Court.) On this 2I Hk, day of 114-VK4 v 4-V 2023, the packet for the ZZnk of / Iry '(� 2023 Commissioners Court Regular Session was submitted from the Calhoun County Judge's office to the Calhoun County Clerk's Office. -&LOC1,11 Ca oun County 3udge/Assistant C:\Users\Maebelle.Cassel\Desktop\Agenda Templates\PACKET COMPLETION SHEET.Docx AGENDA i Richard ]H . Meyer County judge David Hall, Commissioner, Precinct. II. Vern Lyssy, Commissioner, Precinct: 2 Joel ]Behrens, Commissioner, Precinct 3 Cary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, 'Texas will meet on Wednesday, November 22, 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. AGENDA. The subject matter of such meeting is as follows: Call meeting to order. NOV 17 21145 r� / 6Y U TI EtTRl ALIT IU��' or r r; L2/Invocation. �� u 3/Pledges of Allegiance.. K General Discussion of Public. Matters and Public Participation. Hear a presentation from a representative of Southern Software regarding software for Calhoun County Constables to be complaint with state. regulations to submit monthly reports of the Texas Department of Public. Safety. Consider and take necessary action to approve the updated estimates; from G & W Engineers; Inc. regarding Bid Phase. Services for the Memorial Medical Center Roof and HVAC project. (DEH) ,/ 7o Consider and take necessary action to approve the GLO — Certificate of Construction Completion (COCC) to the Drainage Improvements in Alamo Beach for Calhoun County, Texas —TX GLO Contract No. 201-065-064-C182 and: authorize the County Judge to sign, all necessary documents. (DEH) 8 Consider and take necessary action to remove from Precinct 3 R & B inventory asset #23-0257, a Norman Motor Grader to be used as the trade-in for new equipment. (JMB) Page 1 of 3 I NOTICE OF MEETING — 11/22/20?3 Consider and take necessary action to approve the lease -purchase agreement with. Welch State Bank for the purchase of a 2020 John Deere 672 Motor Grader, serial number IDW672GPCLF703140 from Anderson Machinery for Precinct R & B and ,authorize the County Judge to sign all necessary documentation. (JMB) I0. Consider and take necessary action to transfer Precinct 4 R & B asset number 24-0441, a Military Cargo Truck, to the Seadrift Fire asset list. (GDR) 11. Consider and take necessary action to authorize the Port. O'Connor Community Center Boardof Directors to enter into an agreement with Lauger Companies, Inca for the. Pavilion improvements. (GDR) t2/.. Consider and take necessary action to extend the feasibility contract with Texas A & M. Agri Life to January 31, 2024. There is no additional cost associated with this extension. (RHM) T3/. Consider and take necessary action to name the Calhoun County EMS Director as ' General Contractor over the construction of the First. Responder Training Facility and grant him authorization to sign on behalf of the County on items pertaining to its ��construction. (RHM) i4. Consider and take necessary action to authorize, the' EMS Director to sign the Mueller Inc. Sales Agreement Quote #93273810. (RHM) 15. Consider and take necessary action to authorize a loan in the amount of $36,000 from, the General Fund to the. Boggy Bayou Nature Park capital fund for the CMP Cycle 26 Contract approved in Commissioners'' Court of November 8, 2023. (RHM) Consider and take necessary action to declare the attached list of furniture from the Code Enforcement department as Waste. (RHM) Consider and take necessary action to declare the attached list of furniture from the! Calhoun County Museum as Waste. (RHM) 78. Coonsider and take necessary action to declare the three (3) pickup trucks on the: attached Fixed Asset List as Surplus/Salvage and remove them from the Road & Bridge: Precinct 2 Fixed Asset List. (VLL) i9. Approve the: minutes of the November 8, 2023 meeting. 20. Accept Monthly Report from the following County Office:T.Justice of the Peace, Precinct 3 — October 2023 21 Consider and take necessary action on any necessary Budget adjustments. (RHM). Page 2 of 3 22. Approval of bills and payroll. (RHM) 9ZL41 �� --) Richard H. Meyer, County Judge Calhoun County, Texas A, copy of this Notice has been. placed on the outside bulletin board of the Calhoun County Courthouse,.211 South Ann Street,. Port Lavaca, Texas, which is readily accessibleto thegeneralpublic at al l times. This Notice, shallremain: posted continuously for at least 72.hours preceding the scheduled meeting time. For your convenience,you may visit the county's.website at www.calhouncotx.oreunder"Commissioners' Court Agenda" for any official court. postings.. Page 3 of 3 # 04 NOTICE OF MEETING - 11/22/2023 November 22, 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 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 10:00am 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. Karen Lyssy presented a Certificate to Judge Meyer and Commissioner Behrens. Commissioner Reese wished everyone a Happy Thanksgiving. Page 1 of 19 Calhoun County Commissioners Court Public Participation Form NOTE: This Public Participation Form must be presented to the County Clerk or Deputy Clerk prior to the time the agenda item (or items) you wish to address are discussed before the Court. Instructions: Fill out all NAME: ADDRESS: i TELEPHONE: 3 L EMPLOYMENT TELEPHONE: blanks. Please print or write legibly. S5fl, . r u 11her h/ tl 6'4e zn 36 l- /1, 017L%7`V �f 77v- Do you represent any particular group or organization? YE NO (Circle one) If you do represent a group or organization, please provide the name, address and telephone number of the gro or o ganiz ttiion: .Ct S f 1`�l '31I 1 car- (/ -- i re � � �� R l � 7, Which agenda item (or items) do you wish to address? In general, are you for or against the agenda item (or items)? 7" '00'0�� 1 I hereby swear that any statement I make will be the truth, and nothing but the truth, to the best of my knowledge and ability. Signature: # 05 NOTICE OF MEETING — 11/22/2023 5. Hear a presentation from a representative of Southern Software regarding software for Calhoun County Constables to be complaint with state regulations to submit monthly reports of the Texas Department of Public Safety. Mark Tones with Southern Software gave a brief presentation. Page 2 of 19 # 06 NOTICF. OF MEFTING - 11/22/2023 6. Consider and take necessary action to approve the updated estimates from G & W Engineers, Inc. regarding Bid Phase Services for the Memorial Medical Center Roof and HVAC project. (DEH) Scott. Mason with G&W Engineersexplained the need for the increase of funds requested. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner' Pet 4 AYES: Judge Meyer, Commissioner Hall,,Lyssy, Behrens, Reese, Page 3 of 19 Mae Belle Cassel From: Arnold.Hayden@calhouncotx.org (Arnold Hayden) <Arnold.Hayden@calhouncotx.org> Sent: Thursday, November 16, 2023 1:22 PM To: smason@gwengineers.com;'Richard Meyer' Cc: 'Mae Belle Cassel'; 'Glynis King' Subject: RE: MMC Hospital Roof We could go with: • Consider and take necessary action on updated cost estimates from G&W Engineers, Inc. regarding Bid Phase Services for the Memorial Medical Center Roof and HVAC project. Arnold Hayden Assistant Criminal District Attomey Calhoun County CTii Anil District Anorney's Office 211 S_ Ann St., Ste. A- 2 Port Lavaca, Texas 7/797/'9 (361)553-4422 (361) 553-4421(facsinaiIle➢ The in*ormatlon cortal[red In shis trnnsrr l,sion may be strictly confirdentlaI Ifyou are not the rnrended rec pima ur I11fc Ir -, ,roc a I c Ii ice( that you may not disc lore, print, copy or dlsser nl naLe this Infra ruction, ;f you hale , eceiveo this tiai isn union in eiror, please i cply and noc ff i h: sender (only) and delete the message. Unauehori Ln interception ofthis e-mail ira% be a diolatiou n[ iininal law. From: smason@gwengineers.com <smason@gwengineers.com> Sent: Thursday, November 16, 2023 1:11 PM To: 'Richard Meyer' <richard.meyer@calhouncotx.org> Cc:'Mae Belle Cassel' <MaeBelle.Cassel@calhouncotx.org>;'Glynis King' <gking@gwenginee rs.co ni 'Arnold Hayden' <Arnold.Hayden @calhouncotx.org> Subject: MMC Hospital Roof CAUTION: This email originated from the sender and know the content is safe. Judge, Do not click links or open attachments unless I would like to request an agenda item to further clarify the professional fees associated with this approval to move forward. We were approved to move forward with the bid phase (see attached email). However, G&W wants to be upfront about the costs associated as we have gotten deeper into the bid package. We are asking for approval to have a not -to -exceed amount approved of $50,000.00 for this phase of the project. Not sure how this should exactly be worded for the agenda item. I can explain in court the cost and reasons. # 07 NOTICE OF MEETING - 11/22/202:3 7. Consider and take necessary action to approve the GLO — Certificate of Construction Completion (COCC) to the Drainage Improvements in Alamo Beach for Calhoun County, Texas — TX GLO Contract No. 201-065-064-C182 and authorize the County Judge to sign all necessary documents. (DEH) Scott Mason with 4&W Engineers explained the Certificate of Construction Completion contract. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 19 Mae Belle Cassel From: smason@gwengineers.com Sent: Thursday, November 16, 2023 1:17 PM To: 'Richard Meyer' Cc: 'Mae Belle Cassel'; 'David Hall'; 'Katy Sellers' Subject: Request for Agenda Item for Alamo Beach CDBG-DR Project Attachments: doc07166720231019094203.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Judge, As discussed, Katy is in need of this document to be signed in order to get reimbursement for the final pay application. We are requesting an agenda item to approve of signing. • Consider and take necessary action to approve GLO - Certificate of Construction Completion (COCC) to the Drainage Improvements in Alamo Beach for Calhoun County, Texas —TX GLO Contract No. 20-065-064-C182 and authorize County Judge to sign. Thank you, 5t oft P. Mayo w, P.E. Lead Project Engineer G&W Engineers, Inc. 1 COMMUNITY DEVELOPMENT & REVITALIZATION The Texas General Land Office Certificate of Construction Completion Subrecipient: Calhoun County Contract #; 20-065-064-C182 Date: 10/16/2023 This is to certify that a final Inspection of the project described below was conducted on 4/26/2023 Contract was entered Into on 4/13/2022 between the city/county of Calhoun County and Lester Contracting, Inc. for the construction of Drainage and Sewer Improvements in Alamo Baseh This is to further certify that: 1. The work has been completed In accordance with the plans and specifications and all addenda, change orders, and supplemental agreements thereto, with the following exceptions: None 2. The sum of Zero , deducted from the final payment to the Contractor Is a fair and equitable settlement for the foregoing excepted work 3. The Contractor has presented on behalf of itself and Its sureties, satisfactory evidence that he or she will repair, replace or make good any faulty workmanship and/or materials discovered in the work within a period of 112 Months from this date, as provided in the Contract. 4. Amount of Original Contract: 1,046,011.50 Cumulative Change Orders: -12,416.00 Final Amount of Contract: Less Previous Payments: 930,235.94 Less Deductions (from #2 above): FINAL PAYMENT (Balance): 103,359.56 5. The Final Payment in the amount above is now due and payable. 6. Final Quantities: I fYB Y41, }is l 4'-Y' e'[:N Aokivity Rogwtoroptl� 1 E" spy°firoJea�NatnA o ci3 iio e f4� tan Bt r� ar } .K e" 'ii',; F'��,.rtii`4c✓i,Yk:.# -oesfitlapt (�Vh f Tsk Gf v1 }"t �U �tl >� - drep4 )' 5 - Flood and Drainage Facilities Alamo Beach Dainage &Sewer Im Regrade Exist Ditch 24862 Linear Feet 5 - Flood and Drainage Facilities Alamo Beach Drainage &Sewer Iml Install 18' HDPE Pipe 2536 Linear Feet 5 - Flood and Drainage Facilities Alamo Beach Dainage &Sewer Iml Install 24' HOPE Pipe 2892 Linear Feet 5 - Flood and Drainage Facilities Alamo Beach Dainage &Sewer Im Install 36' HDPE Pipe 1125 Linear Feet 5 - Flood and Drainage Facilities Alamo Beach Dainage &Sewer Im Install 48' HDPE Pipe 60 Linear Feet 5 • Flood and Drainage Facilities Alamo Beach Dainage &Sewer Im Modify Oufall Structure 1 # of Public Facilities 5 - Flood and Drainage Facilities Alamo Beach Dainage &Sewer Im Install Outfall Structure 3 # of Public Facilities Effective June 2020 Page 1 of 2 /r( COMMUNITY DEVELOPMENT & REVITALIZATION The Texas General Land Office Certificate of Construction Completion Project Name Description Activity Code (dropdown) (from Performance Standard) (What is your Activity?) Quantity Metric (dropdown) 5 - Flood and Drainage Facilities D Beach Dainage &Sewer Improvry Hydromulch. Seeding 24862 Linear Feet. 5- Flood. and Drainage Facilities D Beach Dainage&Sewer Improva Disposal. of Spoils. 24862. Linear Feet. Certified by : a f -' ,' to meers bignacure wuoaeiv, ..,,a„ Scott P. Mason, P.E., Project Engineer Ken. Lester, Jr., President. Richard H. Meyer, County Judge Engineer's Name and Title (Printed) Contractor's Name and Title (Printed Subrecipient Name and Title (Printed) I G&W Engineers, Inc. I Lester Contracting, Inc. ICalhoun County Disclaimer: The Texas General Land office has made every eJ/brt to ensure the information contained on this form is accurateand in compliance with the most up-to-date CDBG-DR and/or CM-MlTfederal rules and regulations, as applicable, ltshould be noted that the Texas. GeneralLand Office assumes no liability or responsibiiit y far any error or omission on this form that may resuitfrom the interim period between the publicationof amended and/or revised' federal rules and regulations and the Texas General Land Office's standard review and update schedule. Effective June 2020 Page 2 of 2' 0 ro 16 I NOTICE OF MEEI-ING--11/22/202 3 8. Consider and take necessary action to remove from Precinct 3 R & B inventory asset #23-0257, a Norman Motor Grader to be used as the trade-in for new equipment. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens,, Reese Page 5 of 19 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172-Olivia, Fort Lavaca,. Texas.77979 - Office (361) 893-5346 - Fax (361) 893-5309 Email: ioel.behrensacalhouncotx.ar8. Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for November 22, 2023. Consider and take necessary action to remove from Precinct 3, R & B inventory asset # 23-0257 a 2017 Norman motor grader to be used as trade in for new equipment. Sincerely, Joel Behrens Commissioner Pct. 3 Calhoun County, Texas SURPLUS/SALVAGE DECLARATIONREQUEST FORM' Department Names Road & Bridge 560 Pct. #3 Requested By: Commissioner Joel. Behrens Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration 23-0257 2017 NORMAN MOTOR 65ET-10192 USE AS TRADE IN GRADER # 09 NOTICE OF MEETING - 11/22/2023 9. Consider and take necessary action to approve the lease -purchase agreement with Welch State Bank for the purchase of a 2020 John Deere 672 Motor Grader, serial number 1DW672GPCLF703140 from Anderson Machinery for Precinct 3 R & B and authorize the County Judge to sign all necessary documentation. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6of19 Joel Behrens Calhoun County Commissioner} Precinct 3 24627 State Hwy. 172-Olivia,Fort Lavaca,. Texas 77979 -Office (361) 893-5346 -Fax (361) 893-5309 Email: iceL.behrems(okaLMouacoMorg Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for November 22, 2023. Consider and take necessary action to approve lease purchase agreement with Welch State Bank for purchase of 2020 John Deere 672 motor grader SN#IDW672GPCLF703140 from Anderson Machinery, and authorized Judge Meyer to sign all necessary documents. Sincerely, Joel Behrens Commissioner Pct. 3 114MV98se-9 7OU 'ZU JSqUJaAQN:j0 SB !PO4!Ba aessel sle f4,unq3iuno4ja3 Ulu liessq se lules"0424SIPlam JUSON40,q fpue As I3 M V 3SV'HDndsip iN3iNdiint)3 EQUIPMENT LEASE -PURCHASE AGREEMENT This. EQUIPMENT LEASE -PURCHASE AGREEMENT (the "Agreement'), datedas,of November 22, 2023;,and enters6rita between Weich State Bank„PO Box 129 ,Welch; Oil 7430("Lessor),and3CalhounsCounty 211 S. Anna Street, Fort Lavaca; TX 77979 ("Lessee:: h a,00lifeal+subdivision[dbivoreanizedianddexisfnmundertha;laws ofthe:State ofTexas PStafe"It WITNESSETHt WHEREAS, Lessor, desiresto;lease the Egpipmentr, as; hereinafter described, inExhib,t "A", to.Lesse% and Lesseedesires to lease the Equfpment from Lessor;,subJectto.the:terms and.conditions,of'andlforthepurposes setforth.in this Agreement;, an' WHEREAS; Lessee:is autnodzed�under the Constitution.andllaws:of:'the,State:ofTexas to -enter Into thisAgreementforthe. purposes set, herein? NOW„THEREFORE, tnicansiderationsoftne:premisesandthe mutual! covenants.andiagreements herelruset forth, Lessor and', Lessee. do hereby, covenant andlagree asfollowsr ARTICLEI. Secfion1.01".aefiiiitlonsi The;follow,ng;terms will have#fie meanings indicated' below unlesa.tha centext.cfeerfy, requires:othervf'se . "Agreement' means,thiSL Egpipment.Lease-Purchase,Agreementandiany'schedule;or, exhibit Made a parthereofby theparttes hereto;, together withanyamendments.to)t e,Agreementmadepursuant toSection13.03,and13506; "Code"'means.the:fnternallRevenue Code,of"1'986 ,as.arnended . "Commencement Date" is the:date�whenthe.termief thfsAgreementand,Lessee% obligationtapay, renttcommences;.,whtch date shalli be the date frst:abovewritten:_ °Equipment' means -the propertyrd'esedbedtihlkhibit'A"; EgpipmentDesedpfont,andallirepfacementsi, repahs, restorations;, modifications,andfmprovementssthereeforthereto,made:pursuant.to,Sectron5SO4 or Article VllL 'Event ofDefaulf meansmnyevent efdefaaltdescdbedltnFSectfon 17.0.11_ "fssuance Year,'meansthe:cal'endar year, tn;whfchAhisAgleementwaa;enteredInto�by!Lesseeand,Lessor. "Lease;T.erm" meansthe 0dgjnal,Tenn:and alliRenewallTerms: "Lessee°'meansthe entdy dbsodbed,,as such inithe:frstparagraph,ofrthrs,Agreement, its successors and its assigns.. Commencement Date., 'Political., Subdivision) means; andshalf inclbda; but not be limitedto;,municipalilles of the"State" and2entii%s created by)those municipalities, LessevsI budget year., "RentatPayments"'meens thebasidrent8lipayments payable by, Lessee pursuentto Secfon4.01t "Rents[PsymentDate" means tlhe,date upomwhich.anylTentellPayfnent is,due,andpayabie..es;providediinEkhibi&. "State means tf re++State of..Texas.. °vendors"means;themanufactureroftheEgpipmenteswelLasagent,ordealers:ofthemanufacturerfromwhom:Lessor purchased or is purchasing the,Equipment ARTICLE.lk Ssction2Asll.Representations .and, Covenants of Lesses. Lessee represents,,covenents:andwartants fort) e, benefit -of Lessor, as follows:: (a); Lessee is.a:politicalsubdivisionoftheStatedulylorganfzed;and:existing,und'erthe:Constitutionand': laws,ofthaZtatewithfullf powerand+authority to;enter intaAhis Agreements,asspecRedlinSta Texas,tutes, andlthe:transacbons;contemplatedEhereby- andto pedorm�all,ofits obligadonshereunder. (bj (d) (e) No,eventor conditienithat:consftutes,.orwithithe gjvfng of notice or the: lapse of lima or bath woul6constitute,,an Event of Default -exists ;atthe: date, hereof Lessee has, ihaccordance withithe requifementsoflaw, fully,bud'9eted and�appropdatedsuffictent:funds for the current bude yearto make_the Rentaf Paymentsschedufedtoicome,due dtiringlthe current ludgetypar;,and to meetits otherQbllget�o,asi the current budget year, andlsuch,funds;have not, been., expended4or other, purposes. Lessee w,ill!do,or causeta,,bedoneali;things.necessarytapreserve and keepInifullforce and effectitsexistence;,as;apubl% body corpo rate and, politic;, Lease-#" 26It4 (f) Lessee has. complied�withsuchpublic.bidding,,requirementssas, may be•appAsabletathis.Agreement.andstheacgtrfsitionby Lessee of the Equipment. (g) During the Lease Term , the Equipment, will! be, used! by Lessee,,only,.Jor the purpose, of performing, essenfiallovemmental, or' proprietary functions of Lessee consistent with the permissible scope of Lessee's.authodty:. The Equipment will: have awseful, life in: the .hands,ofLessee ,in! excess.ofthe, Odgihaitl%rmiand all iRenewallTerm& (h) Lessee witf. annually, provide Lessor: withicurrent.fiheneialistatements, budgets,. proofs of appropriationforthe, ensuIngbudget . year and other suchfinanciall information relating; to the abilityrofLessee to,continue this, Agreement as may be, requested byr Lessor. Should'Lessorassiomthit,Acreement. Lessee will orovide;uodated certificates reawdinn theu,se nftt,p F—mdnmpntan (i) Lessee will comply wfth allapplicable provisions of the Coda, including withoutlimitation Sections 103!and 148.thereof, andithe applicable regplationsefthe,TreasuryiDepartmenttojmaihtatnitheexciusionofthe�interestcomponants.;of Rental Payments; from gross; income taxatiom (j) Lesseewill'useahe,proceedsiofthisAgreement.assoonas,practicableandlwithall reasonabledispatch:forthe,purposefor whichithe, Agreement has; beenenterediihto, Nopartofthe proceeds -of the,AgreementshalPbeinvestedinany, securit'es;, obligations or, other, used, at anytime,directlyorindirectly, inn manner which, if such,usehad'been,.reasonably antbipatedionthedate.ofissuence•ofthe;Agreement;woufdlhave;caused�anyrporfion ofthe:Agfeementto=become,"arhif ga, bonds" within#tie meaning;)ofSection:108(b)(2),ocSecfion 14ofthe Code,and!the appltcabfe regulations ofthe Treasury; Department: M issuance nano is.not:reasonaoryexpectea to)exceeo;YiflUIUUOt00.U!. Lessee:andlallisuberdiaate entiUertharpnf WW,4nfdsm P,im: Section.2;O2:_C'ertiFcationas,ttxAubitrage:. Lesseeherebyrepresentsas,follows: (ay. The Equipment has, beenordere&onisexpectedlto=.be,orderedwithin,sixmonthr Equipment fsexpected forbe:deiivemdiaadiinstalied,,and.the Vendbn fullypafdr I (b) Lessee has not, createdlorestablished; anddoes,not:exoecttocreate,orestebli! Is. reasonably, expectedto,beusedtapaythe:RentaRPay ments;;or, (H)Ahatmaybawsedtsoletyta preventa defauIt, ih.tbe:` payment of the Renta[ Payments: (c) (d) ARTICLE IT Section 3 0,11. Lease of, Egpipmeni.. Lesson hereby, demises, leasesand lets ta,Lessee; and; lessee; rents, feases and! hiresfrom ;Lessor,theEquipmentinaccordancewiththis,Agreementfonthe (LeaseTem.L Thfs.Agresmerrtshaftbeih�effeet. andshalllcommence:asofthe- Commencement Date: TheLeasaTerm?maybe,continuedi,sofelyatthe.opfionof;Lessee; atthe,er of the OdginalrTermon any Renewal,Ternrfor an additional,RenewafTo=up;to the.,maximum1ease Term+set forth inExhibitS hereto. Atthe endo€the Origina1,Tarm,andatthe end'iofrea&RenewalTerm untilA ha maximum, Lease T,erm>has.beemcompfetec Lesseeshaltbe deemed=to have,exercisedlitsoption,ta,contnue this,AttreementforthenexteRenewal Term,, f:Lessae.hinrftaptc ane terminated this Agreement pursuanttaSection 10.011.. The4ermsand€conditansdurfng,anyRanewaCTerm>shalf be-,ihe;sameas. theterms and�canditions dUdhgthe,OdginalTemr, exceptthatthe,RentaLPaymentsshall beasprovided-on ExhiblT.R�heretot. Section102. Continuationof'LeaseTerm Itis,theintentof, Lessee:to.continue.thaLeaseTermthrough,theOdginal=Termand' all, RenewalTermsandtopay,thesRental;Payments.hersunder. Lessee+ reasonably believes that legally avaifablefunds:iman amountsuf icientta=make aliiRentallPayments;dUring;the,entlretLeaseTemueanbe=obtained:. Lessee!and lessoracknowledgg!tfiat appropriation for Rental,, Payments; isa.gpvernmentallfunctionwhichiLessee, cannotcontractuallycommit:itseffinadvamae�to> perform and, this Agreementdoesnotconsfitute such a commitment. However, Lessee reasonably,believes;that moneys in ans amountsuffrcienfto,make all+Rental,Payments;can:arrdwrlltlawfully.+tieapprapriatedlandmadeavailhbie to per,, it.Lessee!s continuedi utilization of the Equipment imihe;performanceofits essentialifunctforts:during the. Lease Temr:, Lessen wlluse funds; appropdatedlfarthis,Agrcement:fornaotherpurposethento.paythe.Rental,Paymentsand:otheramounts,due hereunder:. SectiorO.03. Nbriappropr'ration. Lessee is obligated! only to,paysuchi Rental,Payments under this-Agreerrient.as, mayJawfJyo be made from fundsbudgeted', andappropdatedforthatpurpose dudngiLessed§ thencunentbud'getyeam Should1esseefaiL13, Lease:# 126714� Term, Lessee agreesto failure:to,give such notice shaltnot exteindtheterrnbeyondsuchOdg naf Term,orRenewal Term. If this,Agreementia,termin accordance with�this,Secdbrit Lessee°:egreesto.peaceably,vdeliver,the;Egpipment,,,at Lessee's.sole expense; to�Lessorat'the., locations) to be speciffedibyLessor. ARTICLE.W., Section4.011.. Rental' Payments. Lesseeshall;promptly, payRental; Payments ,ta;Lessor;,exslusivelyfrom+Iegaily available. funds, in lawfuhmoney+of the Unitedi'States of'America, without notice,ordemand, in such amounts;and on or before the applicable Rental PaymentDatesset forthionExhibit& hereto, atthe address. setforth ontherfrst page hereof or. sucti,cther address as Lessor or its assignsrnayfmmitimetotme+regpestmiwdting, Lessee,shallpay, Lessor interestonany,RentW,Paymer less,fromsuch4atee Aportioncfeach RentePaymentispaidias,andirepresentt�paymentof,,interest;,aessetforthonExhibit B; hereto. Sectfon4.02. Rental Payments to ConstitutezCurrent Expense,of Lessee.. Lessor and,Lessee understand:andirntendithat. theobligation�offL,essee topayRental'Pay,ments hereundershaliieonstitute a currentexpenseoflesseeandlshall notih.anyway be construed,tabeadebtofi Lessee rn comraventionofranyiapplicable,constitutibnal or statutory iimitationorrequirementgpvernin( the,creation ofindebfedness byiLessee;,norshal,anything;containedihereinconstitute a)pled9e, ofthe.general tax revenues, fund's or monies of Lessee; Section4:03. RENTAL PAYMENTSTOZE'UNC©NDITIONAL. FXCEPTASPROVIDED,INSECTION:3;03,THE, OBLIGATIONS' OF LESSEE T04MAKE REN AL PAYME :, iS ANDITO: PERFORNIANDiOBSERVE THE OTHER COVENANTS: AND:AGREEMEN.TiS.CONTAINED HEREINNSHALL BEA'BSOLUTE AND" UNCONDRIONAL.IN.ALL' EVENTS WITHOUT' ABATEMENT.;,DIMINUTION,DEDUCTION;,SET-JIFF ORDEFENSE;,FORANYREASOMLINCLUDING:W,ITHOUT LIMITATION: ANY FAILURE OF TiHE EQUIPMENT"TO' BEDELIVERED" OR.INSTALA' LED;,ANYDEFECTSi.. MALL FUNCTIONSi, BREAKDOWNS; OR INFIRMITIES IXTiHEEQUIPMENTOR, ANYACC@ENT, CONDEMNATIONlORUNFORESEEN CIRCUMSTANCES- ARTICLEV. Section,5:011s. Delivery,;,Installation+,andAcceptance:ofthe@gpipment[ LesseeshalLorderthe Equipmentand: causethe Equipment to bedeliveredandiinsfelledlattheloeationspecified'on ExhibitrA, Wnenthe Equipmenthas beerrdellvered+ andiinstalled, Lesseeshalfimmediatelyaeceptthe,,Equipment andlev'rdence said. acceptancebyexecufinganddeliveringto Lesser anacceptance,ced frcateacceptebletbiLessor.. Sectfon,5.02: EnioymentoflEquipment. Lessor shalEprovide,Lesseewith,quiet useandenjoymentofthe. Equrpmentduring,tile Lease Term, and LesseeshaOlpeaceably;and:quieffyihave; hold andienjoythe Equipment during the LeaseTeim, withoutsuit: Sectfon;103`: Loeatian;,inspactibm LessorshallhavetherightatalBreasonablbctimesdudng;regular businesshourstoenter fmc and! upon the propertyof. Lessee:forthe purpose of inspectingthe,Equipment. Section 5,04, Use andlMaintenence ofithe:Egyipmenti, Lessee.withnot install] use;,operate;or maintainths Equipment, improperly, carelesslyi inviolatlon of, any applicabledaw orinatmarinercontrary, tiothat,wntemplated bythisAgpeement-, Lessee: shalliprovideallpermits,andilicenses; ifany„necessary'fortthe, installabon and�operation ofithe,Equipment., Imadditiom Lessee egrees.to comply,injail�respects;withialf applicablelaws,regulatens;and,rulingp;ofianyl'egrslattve, executive„administratfveor j4diciai'body-, provid'edthatLessee, maycontest in gpodfaithithe:valldityor applteationofany such, aw., regulation.or ruling many reasonable manner that does not idtheopinionofiLessor;.,adversely-affectthe:InterestofLessorin and too-theEquipmentorrits interest, or rights under,thisAgreement. Lesseeagreesthatitwilli,at,Lessee'sown,costandfexpense,.maihtaini,preserveandIkeep+ the Equipment irugoodirepair andworking order, Lesser shell! have, no;responsibilityto maintain;; repair'ormake improuements;or additionstotheEquipment. UpontherequestofLessor;, Lessee ,will ?enter inlo,a,maintenance,contractfor the Equipmentwiffone; or more Vendors:. ARTICLEML Section0401..Title,to-the.EgptpmenL Upon acceptance, oftheEquipment byLessee, title;tothe,Equipmeatshall: vestih Lessee subiectto,Lessofts n'ghts underthisAgreement:. Once+aliiofthe,rental paymentssare mada.by:Lessee;,Lessoris divested ofalfdgfit,titIeand'ihterestintheegpipment,.andlvested inLessee; Additionagyupon:suchinstance,the,terms.ofthe tease-purchaseagreementare+fully,performed;all;oolfgatibnsofthe:partbs,hereunderareterminated: Title shall. thereafter,, Immediately andlwithout anyraction byLessee vest in; Lessor, and, Lessee,shall,immediatelyrsurrenderpossession ofthe;Equipment to Lesscrupon (a) any,,terminationiofthis;Agreementother,thanterminationpursuantto,Sectibn, IOLtl1 or (b)Itheoccurrence of an automEdcallywitnoutthe.necessityafrany:billiotsale,;eertificate,oftitle;or,otherinstrumentofconveyance:. Lesseeshal; nevertheless, execute and�dbliver,.any, such:instruments,as�,Lessormay,irequesttafevidence suchtransfer, Upon termination of this Lease in: accordance wb,,Artiofes3and12hered attheelactibrrof Lessor ands uponLessoftwrittsnnoUix to1essse;,fullfandi unencumbered legaiiti#le,and!ownershipief the Equipment, shall pass to;Lessor, Lessee shall: have no+further interest therein,: and Lease#126714�- Lessee shall, execute,anddeliver to; Lessor such d'ocuments,as.Lessormay,requestto,evidencethe passagpWlegal titieand ownership to Lessorand.termihabon,ofrLessee's interest inkthe Equipment: Section6.02o Security. -,Interest(:, Tosecuresthe payment ofsalLofLessee'ssobligptonsunderthis Agreement, Lessee hereby, grants to Lessor assecuritydnterest constituting: a first lien onthe Equipment and onall'additions,,attachments and accessions theretolsubstftutlonsthereforand6proceeds,tnerefromr. Lessee=agrsesto execute; suchi additional documents; m formsatisfiaatory to Lessor, which Lessor d'eems necessary, or fmform;satisfactory, to Lessor,,which<Lessor deems necessary or appropriate to estabrsh,and' maintain, itssecu6t feinterestiandlthesecurity,interestof, anyassigneeofLessor in, the Equipment. Section 6.01 Personaf Propertyc The, Equipment is,andiwilliremainpersonal'propertyr TherEgpfpmentwillsnotbe,deemedtotie hereafter become in. any, manner physicallyaffixedlor attached to, suchi reall estate or any!buildingAhereont Upontherequestof Lessor, LesseewilfIj all Lessee's expense;, famish,awaiver of anyinterest inithe Equipment from�any. pertyhaving,an ihterest in any such reatestate or building, ARTICLE VIL S coon 7:041. Liens, Taxes; Gther Govermmentatl Charges,and%U Uliity, Charges Lessee. shalf keep -the Equipment free of aft levies,,liens,andsencumbrancesexceptthose:!createdsbythis Agreement, The partiesothisAgreement: contemplate thatthe Equipmentwillibeusedlfor a,govemmentalior preprietary,,purpose,ofiLessee and:thatthe Equipmentwiift thereforebeexempt:fimmsafilproperty;taxes: ffitheuse;,possessionrorracquisitlon,oftheEquipmentbyLesseeisnevertnefess determrned'to besueject fo;taxationt Lessee shall paywi endue aIhtaxes andlgpvemmental chargeflawfullyassessed or levied Section,7.02t.lnsurance Atiitsownexpense,Lessee;shalllcausecasualty;,publicaliabilityand.propertyrdamag�-.,fnsuranceth,be carried'andmaintainediintheamountsandlforthecoveragfisetforthfnExhibitG: All'insuraneeproceedsfromcasualtylosses, shalttiepayable;asshereinafterprovidedlinthfs.Agreements Lessee�shallifumishttb Llessorrcerrificates,evitlencing suehseoverage. throughouttheLease:Term: Altemativeljt;,LesseemeyinsuretheEquipmentundera,blanketfnsurence:policyorpolftiea;which: cover notonlythe, Equipment hut other properties. .Alilaue insuranceshallibewith.insurers-thatare. acceptabletoEessorshalfl namerLessee.andlLessorasmsureds andishallconfeih,a provisiontosthe effecttl attsuch insuranceshalf riot becancelfedor modification. Allisuch casualty insurance shall! containaprovislibmmaking, anylbsses payable to1lessee.and,Lessoras;their respecfive fnterestsmayappear:, Wfthwrittenconsentof.Lessor„ Lesseemay,satisfythe,insurance requirements ofthis:Secrfcn 7.02 byself-insurance::_ Sectien7.00L Advances, Ih the eventLessee shalt faillto+either maintainthe insurance regpire&by. this Agreement or keep, the, Equipment In good' relpait-andworking order„Lessor may.-;,butshallibe;undernmobligation to .purchase the-requiredibsurance and'. pay thecostofthepremfumsthereetandlmaintainand:repairth&Equipmentand';paythecostthe[eof. Alt'amouFltssoadvancedoy such. amounts.so,advanceditiWLessorwithunterestthereonifrom.the,duedate untildpaidjattherate of 1.2% perannum orthez maximum amount, pennittedbylaw; whichever, is less. ARTIELEVIIL Section,&011 Damages.Destrucfion;and!Condemnation:, in whole:or fn parf,,or is damanedi by fireorother casualty or (MititleAm or, th snail Da tawenunder the.,exerciseor threat ofthe powerof eminentdomainby/anyogovermnental.bodyorbyany person,fiim:or corporation acting;pursuentto,gavemmentallauthority,;,Lesseeand€L+essorwilllcausethe Net. Proceeds ofany insuranceclaim condemnation award orsale�under threatofzcond' mnafisn to,beappliedlto)the: prompt replacement, repair,resmratfon modifiicatibn %01.. Any balance:ofthe Net Proceedsremafning;aftersuchwerk hes.tieemcompleted+shall be pattl to:Lessee. Forpurposes.of thie Article, the term,"Net Proceede shalllmeen the:amount temaihing,fromsthegress proceedsof, anyfnsmranceclafm;, condemnationsawardicrsale•underthreatofcandemnatonafterdeducting alllexpenses, includingiaftomeys°tees,,fncurred fntfte; collection,thereof: Sectfont&02. Insufficiency of; NetProceeds. lithe Net Proceeds,are insufficientto pay in, . ll'the cost of any repel r;:resforat om, modification, or Improvement referedtoifnSection)&011%,Lessee,shall4ther(aycompletesuohreplacementt,repair,restoration„ modIficationi or improvement andlpay any, costsfftereofimexcess;ofthe amount of the NaUProceed5, or(bypumhase;Lessor.is fnterestfntheEqulpmentpursuantto,Seetioni10'.01'. The:amountoEthe, Net, Proceeds, ifany;.remaining, aftercompletfngsuch repair, ,restorations;modificationorimprovementor, after purchasitta�Lessoea-,irterestihdthaEouihmentshanitherPtarnt*ciEn,rnP� w nor shalliLessee ARTICLEI1t: SectionU1.DISCLAIMER OFWARRANTIES, Lesseeacknowledgesand,agreesthattheEquipment is,of, &size„ designiandcapacity>selected, by Lesseeandlthat; Lessor isneither>almanufacturer nor alvendoratsuch,Equipment, LESSOR. MAKES :NO y�IARRANTY OR REPRESENTATION;, EITHER. EXPRESSOR, AS TO,THF VALUE,, DESIGN; CONE TION'„ Leasp#r126714. MERCHANTABILITY OR FITNESS&FORPARTICULAR PURPOSE ORUSE OF THE EQUIPMENT OR ANKMANUFACTORER'S, OR VENDOR'S:WARRANT.YWITHiRESPECTTHEREM�. WNC+EVENT SHALL LESSOR ,BELIABLE .FOR ANY,"INCIDER7,AL, INDIRECT, SPECIAL ORCONSEQUENTIAL DAMAGE [NfCONNECTi[ON:WITiHiOR'ARISIN.,G OUT OF TWIS,AGREEMENT'OR' THE EXISTENCE;, FURNISHING; FWN CTIONf WiORL ESSEE!.&USE:OF ANY ITEK1, PRODUCT, OR SERVICE PROVIMED:FOR' IN THIS.AGREFMENT. Section g.02,ViandoWWarranties: Lessor, hereby, irrevocably, appoints. Lessee itsagsnt and: attomeyrin4act.duning, the Lease Term,, so -long) as Lesseezhall) not. be indeisulthersunder,,to,assertfrom,fimetc))fihie:whatever claims andi right, (iftfudingwithout limitation warranties) related1ortheEriulomentthat Lessor may haveagainstth0,endors. Lessee's,representaffbn:sha[I)be,agpinst, the Vendors of the Equipment and) not agpinst1l essor. Anysuchimatter shalinot-have: anyeffect whatsoever on the!rfghtsand obligations;of. Lessor witft, respect toAhf&Agreemsnt,,, fncludirigths, (igoto)receive!ftjlllandtimelyrpayments:hereunderI Lessee• expressly acknowledges thatl1essor makes, andl has: made;, no,representdons,or-werrantes,whatsoever as to,,the-exislance,,or the availability of`such,warrantes:by,,theVendors,ofthe Equipment. ARTICLEX. Sectiom.1010t1h. Purehase,Opflom, Lessee;shallftve the optionA6purchase,Lessoes interest ihthe,Eouipment'. upon! givingwrittem: notice, to Lessor at feast, 60'days.befbr&tKe,datLe:of, purchase,excepttKefinaliRental'tPtyment Defe,, attfte: 2 jollbwingifimes,andiuponfthe,fbIloVing,iterms, (a) Onithe Rental! Payment Dates specified n; Exhibit Bi.upon payment inifullWthe) Rental PaymentsAhen due, hereunder plustftes then applicabia,Purchase PHceAo1esrsor,,'.or (b) InIhe event ofsubstanfiaidamagefo>or, destrLfcton:op,cond6mnatoniotsubstantially,allof the Equipment on,the day Lessee payment ln,ful[of, the, Rentah PaymentsIhenidue7hereundbr. plUs.the,then iapplibabIO)Purcbase,Price lto;Lessor:. ARTICLEY0. Sectioni%ft'. Assionment by, Lessor. Liessees,dght1,tgb;andilfiterest,!iTtoiandlunddrith!&Agreement,.and�the, mortgages SectirmA1.01. Assig;iment'andFSub[tesing,,by,kessee:, None ,of Lessee%,dgitttifleand, interest in„jD)and"u ndorythis., areaioT,iax-exempo.mun[Cipat;obilgpons:saflsfactery,,to;kessor that suchisubl'easlhg;willrnotadversel.y,+affect.the.exclbsibr.t ofthe� Inter,est,components,of,the,Rental':Payments,fr.om,grossimemeibrfedbraU!ncome,taxpurposes; except, where,the%sub-lessee. isa, recognite(imunicipatittafthe;'StaW"., Anysuch+sublesseof,-aii,orpertofthe Equipmentshall be.subjectibithisAgreementLand.the rights of Lessor in, tarandWridOrthis,Agreentent and1h&Equipment. ARTICLE XIL Section,1211". Evenfs4f.Defkult.Dafined: SUbjpctto+the-provisibnsofi&ecffon,3,.03,,any of the faHowing.,events, shalliconstituts ani"Eventot'Default" 'under thisAgyeement, (a) Failure by,LssseeAo)payany,R1antaF, Payment or, other payment reripfred4o, be paidj hereunder atthetlme specifiedhereik., (b) FallUre,by/Lessee:to,mainta[n)requited;insuranc&coverageorto,observeland)'peddrm,any.,other,covenant,,,condiribn.or agreement on,fts partto,beobservedjor per�formedi,otherthenias�referred,,to?in�subparagTaph� , (a), above., for a:perfodV,3Mdsy,.s, after written notice specifyingsuch;Wilbr.e:anclireqpesthg�,thatitbe, remedi'edlj§ gjVen401essee�,by,,LesSor' Unlessl%'zssorshalr! agree in-w6ting;ltoian.,extensioRof,such ;tme;prfor-taits,expiratbn,,,:ifthefiailure,stated,lhthe,,noftee.ear.inotbecor.rected%vijth[nth.F-� applicable: period!, Lessormfl[noUnreasonable withhold1s. consentto,�amextension; of'suchIlimeff corrective.actionis rhstituite& by Lesaee%WitNnitheiapplibable-,per!Od;andYdil[gpnfiy,,pur.suedluntillthedefaLitis,corrected: (ol Anystatements,,r.epmsentaf(ensorwarrantyimade,,byLessee:iMiorpursuantto)this�A'greementorits.-execut!On,,,,delfveryLor, performance shall!prove.to,havebeenfalse,,,incorrect;,misieadingiorbr.eache,d;in,anyr materiali respect om: theedatewhert, madel (d) Any provision, ofttufsAgreement shag) beatanytlma for any,,reasonqceasato)beivalidand�birtding,on, Lessee;,or. shal4 be, declareditoibenul[and,voidl,orthe)va0d'ity,,orenforceability,,ther,eofshallibe.contested�by=Lessee.,aany,lgpv,ernmentaliagpricyor. authority,, if the loss ofsuchi prov.ision,wouldimate6a]ly,,,,ad.versely,,affect, the? rigMsor security of Lessor, or Lessee.shall.denyt lbat it has any, further liability, orobligatlem under this, Agr.eement;, (p), Lessee shelf (i) apply for, an conseritto1he appointmentat a, receiver, trustee,, custadianor liquidator of Lessee,, or of, all.or a, substantial; part oftheassets of Lessee,, (!Qi be,unableJaiiijor. admit iniwrting; its fnability?gpnerallyto,,pay.ifts.debts:as,they, become due, (iii), make a. generaE assigrimentfor the, benelitof credhors,, (lv))have.an�order for rellefentered against it under applicable, federal, bankruptry,law,.or (,y,)'tfil6,aiv.oluntaiy,,petifioninibankruptry,,iora,pettlonor aniansweriseeking,,reorgami mfibn orran, Lowe # 1267% arrangement with, creditors or taking advantag&of any -insolvency law, or any answer admitting the materiaiiallegafloneofa petftiorr. filed against Lessee fh any bankruptcy, -%,reorganization or insolvencyproceeding;,or (f) An order, judgment or.decree,shall!beentered[ byanycourt ofcompetent jurfsdictfon,approving;aipetition orappointing;ar receiver, trustee, custodfamorliquidator ofLessee orof,alt or a,substantiabpart ofrthe assets,ofLessee, in each casewithioufits application, approvator oonsent'; andssuchorder judgmentor decreeshallicontnue unstayediand in effect,for any period;of.3Q consecutive days. Section12.0Z Remedies.onDefaulL. Whenever anyEventof Default exists, Lessor shallihave theright, at its:sole.'aptlomwithou during th&0riginalkor shallr be immediately,due and'ipayable;,andr (byWith,orwfthout'.terminatiomotthfs;Agreement, Lessor, may enter the,premiseswherethe:Equipment:isafecated.anddisabfetne, Equipment to, preventfurther use thereofby, Lessee: Inadditonor alternatively„Lessor maytake possessfortof'anyof:af1;of+the take thereto, durfngthe•Fiscal`Yeartheniih,effect. (cp If Lessor termihatesthis,Agreementandtrmftsdiscretion incurred imsecuring; possession (d) hereunder. Section:12.M, Returnof Equipment;;Releasesof Lessee's.lnterest;. use,by.Lesseeand (fifLessee:shall' omerservicepersonasissatistactoryto:Lessoranflg), deliver th&Equipmentto�alocation,specifiedbyLessor, freightand?, insurance prepaidbyLessee.. If Lessee,refuses,to:deliven the. Equipment inithe manner designated, Lessor+may repossess:ttle Equipment andlchaMo to,Lessee the costs,ofsuch, repossession,: Sectlon9244, No,RemedW Ekelusive. No,remedyrhereinsconfernediupon orreservedto Lessor is ihtended�to,be;exciusive and` hereafter, right or power, orshall be construed;to,be, awaiver thereof;, but, anysuch,right or power, may be, exercised [from dme,toAmeand as often as:may bedeemedexpedient. Iniordertaentitte,Lessor toiexercise.any, remedyreserved;to it,in,thisAgreement itshaltnot b Sect on12.06i, FerceMajeure , Ifbyany/ reeson.ofiFores MajpureLessee is unableJniwhole:orin parttacarryrout its,agreemeu.t on its part hereincontafaedi,other, thamthe,obligationsomtiSe part of Lesseecontainedtin.Article IVandSection TA2)hereof,, Lessee, shall not be deemed'fndefaultduring,the:conthuanceofsuch,inability, The,term,"ForceMaieure"as,usedhereinshall@mean;, Mthout limitafion„the following: Acts,of God„strikes, lockouts.orother,indUstdalidisturbances; acts of publio enemies . orders or restraints of any kind!of gouemmentof the�Uhited)Statesof Amedca,entheiStateir,any oftheir departments, a9encies,or oificielsu orany civil, or military, authority;,insurrections;,riots;;landtfides, earthquakes;;fires;:storms; drougbts; floods; oc explosions. ARTIfCLEXUL S'ection,130:1', Notices. AlUnotices,,C shall! be desmedigiven,whemdelivered'ormailedto the, atitsaddress,as:kappears;on:the registrationbooks;maintainediby;;Lessee:. Seciiow13.02. Release;andlIndemnifcationi To,the extent permitted bylaw; Lessee shafl,indemnify, protect,,hold hamuess;, save and�keep•harmless, Lessor fir andagainstanyanda0ihabTty; obligation~ loss claim, tax and damagewhatsoever;, regardless of causeahereof, and! allexpensesin connection therewitni( hcluding!without limitationcounselifees andlexpenses.and' Lease;#1Ze714: penalties connected:therewithimposed on interestreceived) arisingout of or as:tlhe result operafion� use, conditionwpossessioni storage or refum,ofianyitem4eftM Egpipmentnasulting;ierdamage to property, orihjury to,oc death to, anvnersomand/or,fellthabreachofanwrovenant'hereibtoranwmateriall misreoresent'atloncontaihedhereim The; t under this Agreement or,the.-termination•.ofthe,LeaseTermifor, any, reason. Section,13M EhtiteAgTnement. This;Agreementsconstitutes,the:entiteagreementbetweemLessor an6LIessee.,Thereare,no- understandings, agreements, representationsor warranties,,express;or implied;, not.specffiedf herein regarding.this-Agreement or the Equipment leased; hereunder,. Any,teffns.andl condlitions,ofrany/purchase;ord6r, or, other document submitted; by. Lessee, irn connection withthis,Agreementwhich+arerihsaddition to;oa inconsistentwithithe�termsand''conditionsof thi's,AgreernerrE'.will not'ba binding,on,Lessor andwillinotapply>toatnis.Agreement Lessee byt*sigpature;belbw;ofitsauthorizedsrepresentative acknowledges that ithasreadithis,Agreement;,understandsigandiagreestabe:boundby,its,terms.andconditions. Ko�waiuer consent; amendment, madiffeatori),orchange,oftLrms;ofthit,Agreementst.mlllbind'efthen partruniessin+writing,signed:by,,W, . parties; andithensuchiwaiver,,,consent, amendmenk,modificatfoniorchange shalllbe:effective,only;in.the:specffic instance>and:for tlhespecific purpose given SectfonI&O4. Binding Effect: ThisAgreementshall! fhure.tothecbenefiitof, and'sha4bebindingupon, Lessorand. Lessee,and) their respective: successors; andi assigns: Section t3.05. Severability:. ltutheeventany provisioniot this<Agreementshall be held invalydtor unenforceable byanycouri of competentjurisdiction,,suchiholding,sihallinot ihvalidate>er render, unenfomeableany-other provision hereof, - Section.13A6,. Amendments,,Changes;andiMbdifica lent. This.Agreementmay,;be amended�byLessorand:Lessee:. Section1107. ExecutionaimCbunterperhss. This,Agreement maybeasfmultaneouslyexecuted'in severalcounterparfs;,each off which, shall, be ansoriginal andlalllofwhich,shaillconstltute;but onerandithe same;instrument. 5ectforn13.0&: Applica{ lbAawr• This Agreement.shallgbe�governed':by andiconstmed ihaceordance w@h!the.lawsofthe State of Texas: Section110SL Captions, The;eaptionsorheadingaAnthfsAgreementarefor convenience,onlyandit noway define;,limitor IN WITNESS,WHEREOVLessor. has,executedthisAgreement in:,its:corporate;na attested -by its,dulyauthorizedtofficers, and,Lessee:hascausedithisAgreementto, by its duly, authorizediof icers as,of thedate wntten above:. LESSOR: Welch; State Bann.. By. Print :Nam e: Sherri:. Mount? Titter S'enkorVice:President, (SEAL)> ATTEST. By. Print Name:. KelhiLanaley, Title: Notary. Public:. LESSEE' Calhoun Cou n By. r Print'Name: Rlcnardl Meyer 3�n Print Name:: AlmwGoodmam a,'1,. •' Titter_ fio tv%Clerk. Lease# 1267144 EXHIBIT A TO)EQUIPMENT LEASE -PURCHASE AGREEMENT Dated Navember22,.2623'BetweenWelchiState Bank as,LessorandlCathowCouniyasLessee.. The following Equipment descriptiomisthe supjectof, the+attacl edlEquipment Lease«Purcl ase A'gteementt. Qtv- Description+ 1 202&JbhmDeerw672 Grader SN# 1D.W672GPCLF7,03T* togpther withsalliequipment;, accessions;,additions.andiattachments;themto. The Equipment is:focatediatt: Precinct#1 Lessee hereby certifies that.the;descrtptian�oftheEquipmentsetforthiaboveconstitutesan accuratedesoriptiomofthe. "Equipment ;as.defined•itrthe:attachediSquipment:Lease-PurchaseAgreementi. STATEMENT QF ESSENTIAL USE'. Please state below .oronthe 1etterhead4stationay, of CalhouniCourrty; a..briefistatementaboutwhy the eq, ipmentJisted4ih Exhibit"A"'has,beemacquiredi. This,,staternentshoutdiaddtessthe,,foliowingkquestionsr 1., Whatistheessentiallfunedon(s);to;beperformed;bytheeggipment7 Mnwrengidoyou,expectitwifl�beused'f 2. Does it replaceequipmentfhat.pedbrmedlthis(these))samefunetion('s)p Ifso,howmany,,yearswas;theprevmus; equipment ins use?,, * Wasthisatipipmentchosenthrough, corn, petitivebidding.orbyanthermethod? * Which: intwnatfundiwillibeusedRtomakethe+tease payments7 In answerto.theabove theaibitowinglis.submittedr Calhoun 1 iyr By: Richard Meyer T.itle:_ CountvJirdaia Lease412671.4 EXHIBIT'B'TQEQUiPMENT LEASE -PURCHASE AGREEMENT LEASE N0:126714 Dated, November 22; 2023, BetweemWelck State, Bankas Lessor and; Calhoun County, as Lesse%: RENTAL PAYMENT SCHEDULE' RATE. 5'.811/6 Equipment Cost$2fi5,80K.Q0iLE53 T,r�d�:AObwance $101,000:00i* Doc Fee$300.0(Y,= $t7511ft.Oa Data, Payment Interest Principal' Balance Loan; 11/22/2023, 175,161r.W 1 11122/2024 50134$21 10)220154 4011,27.67, 135 03133• 2 111/22/2025 50;34&211 7,857:59i 4Z4.90,62. 92,542 71 3: 11/22/2026 50;348.21 51585106, 44,961.1 , 47,579i56 4 11/22/2027 50 3482.11 2';76&65 47'.57156 0:0& Grand,Totals. 208,392:84' 26i231.84 175,16,1;.00,' Final: payment mayvary dhreto�tlhe actualldate•Payments were;receiuedt Calhoun County I By: Ri 1ards,Meyer Title:_ _ County,Judae, Lease.*1267T4,. EXHIBIT CTO)EQUI IPMENT LEASE -PURCHASE AGREEMENT ACCEPTANCE! CERTIFICATE; Welch State Bank PO Box 129 Welch, OK. 74369 Re: Equipment.Lease-Purchase Agreement, doted November 2r2,.,2023�(the oAgieemenr) between=Welch State Bank ("Lessor') andCalhoun County("Lessee"} Ladies and; Gentlemen: In accordaneewiththe,Agreements the undersigpedLessee herebyeertifies and:represents-to ,and.iagrees with, Lessor as -follows, (1) All oftheEquipment:(; &dsfinedifhthe Agreement)", has beenideliveredl.installedtand?accepted.omthe date Hereof:'. (2� Lessee:hasconductedsuchiinspeation,andlorfestingjofthesEqufpmentasitdeems;necessary andappropriate;andlherebi, acknowledgps thatIt accepts the,Equipmentfarall purposes, (3) Lessee is:currentiymaintaining€the mquirediihsurance,coveragp:. (4) Noeveritorcondifionthat, constitutes, orwith, notce.orlapse:oftime,orboth: would+constituteas;Eventofidefoultr(as defined in the Agreement))exist&aRhe date hereofi Acceptance Date: Equipment Description, 2020MJohniDeere672GraderSN#1DW672GPCLF70314,0!togetherwithiah!equipment,,aecessions adiiftionsandsattachments thereto,. Calhoun, County r By: RichardiMsyer, Titles: CountvJudae Lea se,;fT2671'4. EXHIBIT DTiDE4WIPMENT LEASE -PURCHASE AGREEMENT OPINIONiOF COUNSEL. (OniCounseflstetterhead)S Welch State Bank. PG Box129: Welch, OK 74369 As counsefffor, the: Calhoun County, ("Lessen,)ib hawexamIned4tilyjexecutedf originals of the Equipment Lease -Purchase; Agreement (the Rgreemenir).)dhted� November 2>2„202,3i by andihetween:LesseeandWeldhStaYe Bank (%essor")c,the, proceedings .taken7byLessee to;authorize>andiexecuteithe;Agreementtogytherrwi'thiotherrefatedidocuments, andttre Coni of the, State -of, Texas the,(°Statbl)a&presentylenactediand,construed,. B'asedluportsafdsexamihaffon.andlupomsuch;other examination as Lhavedeemedcnecessaiy,+eaappropdbte,itiis myiopinibndhatt; The.Agreementis.a legoll,valid, pursuant.to)Constiturional; stafutorpandforhome rule fn the event?Lessor int;Lessee ,VAR b& them to holdthe.,offfees.setfortfi,below4heir names'. Lessee is ajpolitfcafisubdivfsion,within tine meaninglof;Sectioro103;oftielhtemaliRsvenu&Code;and the; relatsd'ragufations and rulings: The Lessee has,, milts Resolution; designatedithe Agreement as;a,"gpalifieditax-exemptobligationi under Seetion,26&(b)(3)!cttiie, IntemalRevenue•Codeof1986i,as amendedL Signature; 'e Printed Name: ArAv Ld L4. Address. Zif Al K 771799 Telephone: 741 - 553 ^ i(V2,'Z Date: 7/ �2ff%23 Lease-41204; EXHIBIT E TO EQUIPMENT LEASE -PURCHASE AGREEMENT Dated!November, 22, 202&BetweemWeIchiState Bank,as,Lesser and?Caihoun, County., mliessee,: CERTIFICATE OF CLERK OR'SECRETARY OF LESSEE: of Lesseefas stated9 beneathihis.or her signatureandihasibeen:authariaed!to;execute theforegoingAgreementombehalf ofLessee and(ii),tthatthebudggtyearot; Lessee is from Ltatedt � 2 2 By; Annalvitnan, Title: im4ti+;Clerk. Lease#1267-14. EXHIBIT ! F TO EQUIPMENT LEASE-PURCHASE:AGREEMENTi Dated November 22; 2021Between Welch,State Bank asLessor andrCalhoun County,asLessee: At a duly called: meetingofthe,gpvemingbody°of tha;Calhoun County,+(the,'Lessee )�heldion November 22u2023, the following, resolufi'on was introduced!ancradoptedi, RESOLVED, whereas the gpwemingibody,ofLessee hasdetsrminedlthat astrue and very/real, need exists:fontheracquisition of 2020 John Deere 672'Grader SN# 1DW672GPCL' F703140'ohe='Equipment),,Lessee;desires;to financethe,Equipment,byenferiggirnto an Equipment Lease-Purchase,,AgraementwthWelahs.State;Bankas,LessonandlCalhoun,Countgas.Lessee,(the Agreemenf),, according to•the,terms setforthi ih<the BidProposal from; Welch,State Bankcrated, presented'aftheboardl meeting; andthe Equipmentwilllb&usediby Lesseeforthepurposeoft RESOLVED, whereas the gpvemingbody,,ofLessee hastaken;the,necessarysteps, including any legallbidaing requirements,, underapplicable law, te arrangaldr,theacquisihon otsuch;equipment,, RESOLVED; whereasthe,gpverning;bodyhereby directsrits regalloounserto reviewtheAgreementandrnegotiate appropriate: modifications: to said iAgreementseas to,assureicompliance withistate!lawandllocahstatutory,law; pr ortarexecutiomcftNie- Agreement by, these, persons, so,authorizedbythe-govemingbodyforsuch,purpose„ BE IT RESOLVED' bythegpverningbody;of'Lesseethati The terms of said'Agpeemenfcare, in the -best, ihterests,ofi Lessee for the,acquisitiomot such Equipment and:the governing; bod}yof Lessee desfgnatesand confitmsthe followingjpersons to,executerandldeliver,,and';to,erattesti,respeetivaly,the,A'greementandlany related�documenfs,necessary/to,the:consummatlon,afthe ttansacfions,centemplated,bythe,Agreement Name: and. Title of Persons to�EzecuteandAttestAgpeement: Richard Meyer,, County, Judga, RESOLVED, Lessee:covenants.thatitwdliperformiall+acts withini portiomof the Rental: Payments;comingldueunderthe Agreemen the rawsand reoulations oftlie Unitedifttes,nfAmP.&iR;as,nrae under The undersigned further, cerifies,that the above,reso[Ofion.has notbeeni repealed oramendedYand remainsin full.forne. and effect. and,further certifies,thatthe,,aaove andlforegping;Agreement is,the:same as presentediat saidi meeting;of the governfng bodyof' Lessee. 11 Anna�seadtnarr,: �Gq f mi� �„ Secretary/Clerk of Lessee; o"#rq yt Attachments: RelateclZoarcr Minutes Lease#126714 EXHIBIT G TO, EQUIPMENT LEASE' -PURCHASE AGREEMENT Dated November 22, 202,3 Between Wel'ehsState:. Bankas, Lessor and Calhoun County as Lessee: In accordance with, the, Equipment Lease -Purchase Agreement requirements, for insurance coveragp; the Lessee? has: instructed the insuranceagpntao,issue:: a. All RiskPhysicahDamage Insurance onrthe leasedEgpipment:as;defihedinithe,Agreement;.and fn an,amount,at, Ieastegaalito,the then,applicahie!Purchase,Price of the Egpipmentk,evidenceddby-aCert'iticate of Insurance, and, n Additionall Insureddandlwithtihe fbltowinglmihimum, coverages, "Lessor andloritsrAssigns!'RaLam Equipment Deseriptionr: 20201Jbhn,Deare: 672 GraderSN#I IDWS7(2GPCLF703-14Q togptherwitht all equipment; accessions; additions and attachments thereto: EquipmentVaiues $275,881'.QOi $500;p0000, per person: $500 000'inaggregpte bodfly,fnjunyllaf ihty+ $300 000t00.property damage liability, Insurance Agent:(providt+name; addtess;andltelephone number), Texas Association of Counties, PGBoss 21311 Austih TX:78788 512-478=875& Proof of insurance:coveragew &"Self Insurance`Letter must tie providedto,Lessor prior.. to,tha,timethe,Egpipment,Fa derivered EXHIBIT'FBWE4IUIPMENT LEASE'-PURCHASE'AGREEMENT Dated; November 22, 2023' BetweenWelcn; State Bank, as Lessorand Calhoun,County: as.Lesse& CERTiIPICATE QF BANK ELIGIBILITY This Certiffcate of Bank Eligibility, is,enteredtintojand,executed bythe:Calhoun County as,Lessee; supplementing•and'adding, to the. Equipment Lease-PurchaseAgreament(the:"Agreement'); Lessee: hereby,�cedfiesthatitthas,notissuedoreffscteditheissuance:o6;andireasonably,arnfcipatesthatit'�dii.t su6ordimata entities shall not issue or, effactthe issuance::ofi more: thnnBanimi9lnn,(inllarc rRlninnn nnn,.nni,ns+nr_ono",�e,,.,i,rr,.,�f�, . a,m;....• fkt Lessee: Calhoun:, County, i By., Richard: Meyer Tide: County Judge Leasel126714 Form 803&G Bn'formationi Return for Tax -Exempt Goverrnmentail, Bonds. ' Do Under IMemel RtevenueCbde section.149(e)j tRev:.Octaber 2021) h See: separate. instructions; OM&NO. 1545•0047 Department ofthe Treasury Cauti Iftheissue p6ce4sunden$100)000,use Form:8036-00:. IntemaMweaus Service Ill Go to,wwnaiiagov/F80Ci86;foninstructionaarditNedBtal information:. E Issuer's. name: �2. Issuer's employeniderntificattbnioumfiac(EIN):; Calhoun:county,: 7"001923: 3s,Name:ofperson (otherthan,issuer)!wiN whorl IRsmaycemmumcateabouttliis return (see instructions) 35,TL4bpnonenumberof.otner'persomshawnorc3a 15 4 Number andstieal P.O_box,ff maifiis not deliverl stroaaddreas)'�. iRoom/suke Report: number(For'IRB.'(JseOrr/y), 211, S.A rm:Street 3,F IF 6 City, town, or post office,state. and0Pcode Z Date ofissue' Port L.avacal, TX. 7+7979: 1.i1/22/2023: a. Nameoflesue- e, CUSIPaumberr. Lease/Purchase: 10aName .and :title ofofficerorotlneremployee ofthe:issuerwhorl IRS may call: for mom Intonation 110b,Telephonanumbwofoft:ecor:other emplbyeeshowri 10h: Anna,coadmanl..CounSyCler.[t I� 36P553.44141 11 Education.. ,. .. .. . _ .. . .. .. .. . .. .. .. .. .. .. ., .. .. , .. .. .. irp . 12 Realth and hospil ll. .. .. . .. .. .. .. .. .. _ .. , .. .. .. ,. ., _ .. ", 12t 13, Transportation:. . . .. .. .. .. .. .. . .. .. .. .. .. . .. .. .. .. .. .. .. .. .. 11s, 14 Publicsafety'. . .. . . .. .. .. . ., . .. .. . .. .. .. .. _ .. .. .. .. .. .. .. .. I td : 15 Environment(inclUdingiisewagebonds)) .. .. _ ., .. . . . .. .. . ... . ... .. .. 16 Mousing; . .. . .. _ .. . .. .. _ .. .. .. . .. .. .. . .. _ .. .. . .. .. . .. . .. .. 16d 17 Utilities .. .. .. .. . .. _. .. . .. .. .. .. .. .. ... ., .. .. .. .. ,. .. 17' 16 Other, Descl Lease/Purchase . 18,, ? 195,16110M 19a If, bonds are T.Nets,or RANsi,check only L4ox.19a... .. _ .. .. . .. .. .. ... .. .. . . til" ❑ b If bonds ara,BAWs, check.only box 19b. ... .. .. .. .. .. .. ... .. . . .. .. .. .. . Be, ❑;, 20,, If, bonds areih,theform-,of)lease:orinstditnentsal$I,checkbox.. .. .. .. .. . .. .. (al Final•mawntydat. (ti1,LRsua:price : 11 (e),Statediredemptlon, III (d)IWeighted'. pdceat:maturity- I average maturity 22 Proceeds usedfor accruediinterest; .. ._ .. .. . _... .. .. .. 23. .. lssuepriceoftentitarssue:(enteramountfromiline:2:7J,column•(6)): .. .. .. ... ... .. .. .. .. .. .. ... .. ... 24 Proceeds uselbondrSSUancecosts;(Including,underwriters"discount). 25' Proceeds used;for credit. enhancement _ .. , :25; < 26 Proceeds :allocatedto�:reasonably,/ragwiredlreserve orreplacement fund' i26; 1i 27 Proceeds wseciltcurefUndpiriortax-exempt bomdS:.Complete-PaItV-., 28. Proceeds osedltorefund? prior, taxable :bonds.Complete partV' .. ,. .. ... 128; 29 Total: (add:lines.24 through=.28) (b)7Wteld' 31, Entartheremaining,weightedlavarage,matuntyof)thetax-exempt'.bonds :to;tieirefundedl. . IIr- years, 32 Enterthe,remaining,weightediaverage,maturityofthetaxable:6ondstobe,,refunded': .. , . it yearn: 33, Enter the last date on whlchitherefunded+ta)hexempt bonds.willsbe called(MM/DDMY.Y,Y,);, R,- For Paperwork Reduction Art Notice; see:separate instruations., Cat. No. 63773S. Page z 35 Entertheamount.ofthe state volume cap,allbeated1to,the issue under section 141(b)(5) . . . . 35;` 36a, Enter the, amount. of gross proceeds invested orrtn,be invested inia guaranteed! investment, contract, (Gl%See .Instructions . ... .. .. .. ., .. .. ... .. .. .. . .. '136a '. b, Enter the finaf.,maturity,date:ofthe,GIGPI(MMJDDNYY)3):, c Emer the name of the GIC,providerfh 1 37 Fooledffnancings: Enter theamount of, the proceeds of this issue that areto,beusedto, make loans: I1 to other govemmemallunits.:.. .. .. .. .. . .. .. .. .. .. .. ... _. .. _ 36a If this issueis:a.loanimade -.from, the proceeds of, another tax-exempt issue, .check boxli ❑ and4enter.thefollowing,.information: b: Enter the :date :ofthe master,.poolibond*(MM/DDZYYYY.);; c Enter the EIN-. of, the issuer ofthe master pooh bond* d. Enterthename -of the issuerofthesmasterpool,bondll� 39 If the issuer has ,designatedthe4ssue:undersection exception),check :box. _ ... .. p !.. 40 Ifthe•issuerhas.electedito, pay,apenaltyinHem of, arbitragerebate,checkbox : ... _. .. .. .. ,.. .. . .. .. .. .. G" ❑'.. 41a Ifthalesuerhas:identlfied:ashedg%.check here-* ❑i.andlenterthe. following!:information¢. b Name- ofhedge. providerl� c Type ofhedge •0 d Term :.of -hedge to 42 If the issuer has: superintegrated1theledge, check box . .. .. ... .. _ .. _ _ .. .. .. .. _. .. . .. .. _. .. IF ❑': 43 If the) Issuer has. established! written, proceduresto ensure that alli nonqualified.! bonds, of this, issue,. are: remediated!i accordingitetherequirements.underthe :-Code,andRegulations:(aeeinstructions),cheekbox • ., .. .. .. _ _ (f ❑, 44s If the issuer has:establishedwrittenproceduresto,monitor therequirememsofsectionl:46,checkbox;.. . .. .. lF ❑.. 4Sa. . it some.portionof theproceeds,was;ueedito,reimburse.expendltwres, checkd• ❑ here* of reimbursement. .. _. .. .,... .. .. ... .. .. .. .. R b Enterthe�date the:nfficiallfnte.nt wac oH. �t.,tir. mnxmmn ,n- - , Signature and: Consent. Paid' Preparer use. Only to-2o21Y.; #10 I NOTICE 01- MEE I ING 11/2212023 10. Consider and take necessary action to transfer Precinct 4 R & B asset number 24-0441, a Military Cargo Truck, to the Seadrift Fire asset list. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER:' Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner`Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens 'Reese Page 7 of 19 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 16, 2023 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for November 22, 2023. • Consider and take necessary action to transfer from Precinct 4 R&B asset list to Seadrift Fire asset list, Asset No. 24-0441, Military Cargo Truck. Sincerely, Gary!�eese CDR/at P.O. Box 177 — Seadrill, Texas 77983 —email: earv.reesena calhouncom.org — (361) 785-3141 —Fax (361) 785.5602 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: Commissioner Reese Inventory Number Description Serial No. Transfer From/To Department 24-0441 Military Cargo Truck AT5491ECDF Transfer from Pct.4 R&B (Dept. 570). to Seadrift Fire (Dept. 690') #11 NOTICE OF MEETING - 11/22/2023 11. Consider and take necessary action to authorize the Port O'Connor Community Center Board of Directors to enter into an agreement with Lauger Companies, Inc. for the Pavilion improvements. (GDR) pass Page 8 of 19 Gary D. Reese County Commissioner County of Calhoun Precinct 4 November 16, 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 November 22, 2023. • Consider and take necessary action to authorize the Port O'Connor Community Center Board of Directors to enter into an agreement with Lauger Companies, Inc. for the Pavilion improvements. Sincerely, Gary D. Reese GDR/at P.O. Box 177 - Seadrift Texas 77983 -email: aarv.reese tot ccalhouacotx.ore - (361) 785-3141 - Par (361) 785-5602 ri Companies. C. Port O'Connor Community Center Fund Association. PO Box812 Port O'Connor. TX 77982 Proposal For Addition Board of Dircca,rs, NOVEMBER 7,2023 V c propoSe ia) add approxilmnuh a t(i foor .addition to the existing; building. This will alllow for 3' new toilets on the hldc'ti tide PILLS one ADA toilet. We willchange one toilet on the teen's side to. rxr11) an:inals and then ;add one more UVIM11, rare ioilecs and one ADD toiler. t1G'e propose to move die emnun,t; (wCrlle 1d dour to the back a.db of the addition. AAII construction willmatch the existing in df sipel and finishes. • General Conditions: includes supervision; demolition; general liability insurance; workers compensation insurance; truck; tools,. and haul off.. • Demolition: Remove CMU walls, doors, toilets, and toilet partitions as required • Concrete: pour new slab to match existing elevation. • Masonry: install exterior split face CMU, interior install four- and eight -inch block in restrooms to match existing. • Carpeniry: Wood framing, partitions, countertops, roll up food service door; insulation, and gypsum board ceiling • Sealed concrete: floors with epoxy paint • Painting: paint walls ceilings and flooring to match existing. • Plumbing: Commercial toilets, urinals, vanity sinks, 3 bay sink, bar sink. • Electrical: Change fluorescent fixtures to LED in bar area: FOR A TOTAL SUM OF $165,456.00 plus exempt from sales tax I(c�pccttullt sadmuttcaC. t Ca'xiu L,rut;ei. frc�idcttr Lau.CrCotnpanies Inc \ccepted, jin1 (.nolel', Dired(W fair fowl i. I't Awaor (:ouun mitt (:enter Fund Association PQ Box 2146 ♦ Vtc,rourn, TY 77402 1 (361) 576-0003 ♦ (361) 578-1626 F>nt V.Y K• _ ISW INa• �1 1 ____________________ I RW[MLNOIfS f CdntlWbnMtll&p. wSmIWMNIpgoN11M1emlmebW:y f XMbYk MISNIMmM11m11WG1fNM'f. _ N[pxYCSY1IYM.OmiNWipnpRMP�pIl1®IWnly W y PeeetlmkOm�NFrt1RMmL P Nw SNINmSYNINImM W.pM1IW4iY1. gq y 0N4WNq WnkPmvblmbmemXlYmmMml NlnemeikL P(B PYmkOmbtlryOMwllR mvmm NYnadaulNnmlmd 6Gp36 Btlm NvtlkGmr3MIRMV IMIaIMUNNNpuneL ngNOE PNNPMM<nP1a9wFmIXM1 aMmamNSalNmApMlNumlmll. Ptlm M1xnNlNNmmKNltlen.utlr�lwk'BamwM.OWWm. APPkwlpemmmlMmnMbvxmrwpplW XeMSMbr. 3A ' xrtcxm+ noRARP N .1EItaMtivYk•OkIq FlFimgn3. I i MSIPmWriA'Mpbd WfmmummlmFln. ..�_ MS.NwY1XON11PMYMNS1p.k. Y.YPry11pSIWpFNNW. Rs{Yu I fhbR In CIt W n pN Mb It0. ' .16lSnWlLWNINIgtiMumlYMMxWlkmel /— ��•••••_ IMObMfmnMi / m s.ftM1EHk.bRNl .k 063 MCSmw114'Wp 4. tlJsunkwro ... AWfmwXM4ukNN. ' AaefrNw.N•XPrmm NWFXnmemkW muknnrgw Nak. A¢NSR ON d r � Pxlmxaw.ulR ✓��n tq NBWX•BMITBA " ® 6 //l761 1L ® \ 1 NPW 4' MNPARMON wool V ... ® WWI8N8Rl6fNCON .YA' I 14J• I ISV• �O NOTI(T OF MEFTING—1.1/22/2023 12. Consider and take necessary action to extend the feasibility contract with Texas A & M AgriLife to January 31, 2024. There is no additional cost associated with this extension. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens; Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 19 # Zz #13 NOTICE OF MEE I-ING—11/2212023 13. Consider and take necessary action to name the Calhoun County EMS Director as General Contractor over the construction of the First Responder Training Facility and grant him authorization to sign on behalf of the County on items pertaining to its construction. (RHM) RESULT: APPROVED [UNANIMOU,S] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall; Lyssy, Behrens, Reese Page 10 of 19 Mae Belle Cassel From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins)<Dustin.Jenkins@calhouncotx.org> Sent: Friday, November 10, 2023 3:37 PM To: Mae Belle Cassel Subject: Fwd: RE: Mueller Quote Training Building PO Mae Belle, Please put an item on the next available Commissioners Court agenda to: Consider and take necessary action to name the Calhoun County EMS Director as General Contractor over the construction of the First Responder Training Facility and grant Him authorization to sign on behalf of the County on items pertaining to its construction. Please see forwarded email below. Very Respectfully, Dustin From: "candice.villarreal@calhouncotx.org (Candice villarreal)" <candice.villarreal@calhouncotx.org> To:<Dustin.Jenkins@calhouncotx.org> Date: Thu, 9 Nov 2023 16:57:33 -0600 Subject: RE: Mueller Quote Training Building PO Dustin, -- - As we discussed, please place an agenda item through Commissioners Court ming you as General corotractor over the Fonstruction of the new training building and this will give you the authorization needed to sign off on items related to the construction. I guess similar wording would need to be part of the agenda item giving you authorization to sign for the County on all of these types of things. Also, we do not have an "information sheet"' so you can fill out the information needed. #14 NO FICF. OF MEETING - 11/22/2023 14. Consider and take necessary action to authorize the EMS Director to sign the Mueller, Inc. Sales Agreement Quote #93273810. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER David Hail, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, zReese Page 11 of 19 Mae Belle Cassel From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins) <Dustin.Jenkins@calhouncotx.org> Sent: Wednesday, November 15, 2023 2:37 PM To: Mae Belle Cassel Cc: Candice Villareal; Arnold Hayden Subject: Commissioners Court Item Attachments: Mueller_Quote_Updated_2023.pdf Mae Belle, Please add the following to the Next Commissioners Court Agenda: Consider and take necessary action to allow the EMS Director to sign the Mueller, Inc. Sales Agreement Quote #93273810. Very Respectfully, J. Dustin Jenkins, DMin, MBA, LP Director of Emergency Medical Services 705 Henry Barber Way Calhoun County, TX dustin.jenkins@calhouncotx.org (361)571-0014 Calhoun County Texas #15 NOIIC:E OF MEETING-11/22/2023 15. Consider and take necessary action to authorize a loan in the amount of $36,000 from the General Fund to the Boggy Bayou Nature Park capital fund for the CMP Cycle 26 Contract approved in Commissioners' Court of November 8, 2023. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner:Pct 4 "ES:'I Judge Meyer, Commissioner Hall; Lyssy, Behrens, Reese Page 12 of 19 Mae Belle Cassel From: candice.villarreal@calhouncotx.org (candice villarreal) <ca nd ice.vi I I a rrea I @ ca I ho u ncotx.o rg> Sent: Tuesday, November 14, 2023 1:39 PM To: maebelle.cassel@calhouncotx.org Cc: richard.meyer@calhouncotx.org; david.hall@calhouncotx.org; vern.lyssy@calhouncotx.org; joel.behrens@calhouncotx.org; gary.reese@calhouncotx.org Subject: Agenda Item - Loan from General Fund MaeBelle, Please add to the next available agenda: • Consider and take necessary action to authorize a loan in the amount of $36,000 from the General Fund to the Boggy Bayou Nature Park capital fund for the CMP Cycle 26 Contract approved in Commissioners Court 11/8/23. Thank you, C°ranSice 74ffiiyeaf Calhoun County-Audagy- Caftioun Couaaty,lu:&or's Offwe Tort Lavaca,'Er77979 Those (361� 53-4b11 Calhoun County Texas #16 NOTICE OF MEETING - 11/22/202-3 16. Consider and take necessary action to declare the attached list of furniture from the Code Enforcement department as Waste. (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 13 of 19 Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: p� Requested By: 4x - Inventory Number Description Serial No. pReason for Waste Declaration �avv � # 17 NOTICE OF MEETING - 11/22/202:3 17. Consider and take necessary action to declare the attached list of furniture from the Calhoun County Museum as Waste. (RHM) Commissioners agreed to send furniture to auction. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese,, Commissioner, ;Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 14 of 19 Calhoun County, Texas SURPLUSISALVAGE DECLARATION REQUEST FORM Department Namk ae:/kt jtu ,A Requested By: d- Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration NONE MENNEN -MINES! IMMEMMEM MEN INS MMMMIMM MMMM1- MMMMMMMM IMMEMMI IMMEMEN MMMMMMMM INS IMMMINIM � �� #18 NO FICF OF MEETING--11/22/2023 18. Consider and take necessary action to declare the three (3) pickup trucks on the attached Fixed Asset List as Surplus/Salvage and remove them from the Road & Bridge Precinct 2 Fixed Asset List. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 15 of 19 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 November 13, 2023 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda • Consider and take necessary to Surplus/Salvage 3 pickup trucks and remove from Road & Bridge, Pct. 2 Fixed Asset List. 565-0635 - 2009 Dodge Ram 1500 (VIN 1 D3HB1 8P1 9S761598, LP 134-6044), 505-0027 - 2004 Chevrolet Silverado with lift gate (VIN1 GCGC24U74Z160778, LP 131-7843) and 22-0232 - 2004 Chevrolet Silverado 4X4 (VIN 2GCEK19T341149628, LP 131- 7825). Sincerel , Vern Lyssy Commissioner. Pct. 2 VL/lj Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: Road & Bridge, Pct. 2 Requested By: Vern Lyssy Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration 565-0635 2009 Dodge Ram 1500 Pickup 1 D3Hl318P19S761598 No longer needed 505-0027 12004 Chevrolet Silverado w/lift gate 1 GCGC24U74Z160778 No longer needed 22-0232 2004 Chevrolet Silverado 2GCEK19T341149628 No longer needed #19 I NOTICE OF MFFTING—11/22/2023 19. Approve the minutes of the November 8, 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 16 of 19 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, November 8, 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. t l Richard H. Meyer, unty Judge Calhoun County, Texas Anna Goodman, County Clerk ^ u. a d 4,' y" Deputy Clerk /4- 7- Date f � A Date Page 1 of 1 NOTICE OF MEETING- 11/8/2023 November 8, 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 Halt 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 10:00am by Judge Richard Meyer 2. Invocation. Commissioner Joel Behrens 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Commissioners' welcome Candice Villarreal, Calhoun County Auditor. 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report for September 2023. Page 1 of 5 I NOTICE OF MEETING -11/8/2023 6. Consider and take necessary action to approve the contract documents between Constar Construction and Calhoun County for the Brighton Road wooden bridges replacement and authorize all appropriate signature. (DEH) 7. Public Hearing regarding a Request to Vacate Tracts 1108, 1109, 1110, 1111, 1187, 1188, 1189, 1190, 1259, 1260, 1261, and 1262 in the American Townsite Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. Publlc Hearing opened at 10.18am Terry Ruddick explained request.to. vacate _ Public Nealrmg closed at 1020am 8. Consider and take necessary action to approve a Request to Vacate Tracts 1108, 1109, 1110, 1111, 1187, 1188, 1189, 1190, 1259, 1260, 1261, and 1262 in the American Townsite Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) RB ULT, APPROVED [UNANTMO1 5] MOyERr Vein tygsy Commissioner Pct z SE&ONkE 3oel Behrens, commissio: r Pct AY<rS Judge Meyer, CoM u9sioner=Hall, Lyssy, �ehrert's, Reese 9. Consider and take necessary action to accept GLO Contract No. 24-089-000-E345, Coastal Management Program - Cycle 26 Contract (Boggy Bayou Nature Park Improvements, Phase II) and authorize the County Judge to sign all documents. (GDR) RESULT: APPROVED [(JIVt�"NIMOUS] =ER: Gary.ReeseCommissioner Pet4 Jodl-Behrens,4mTt5sioner.Pct 3 AYES Judge Meyer, CpmnYiSsI n:e" Hall, Lys§ys Behrens, Reese Page 2 of 5 NOTICE Or MEETING— _11/8/2023 10. Consider and take necessary action to authorize Commissioner Reese to fund the 40% local match of $24,000 for the Texas GLO CMP Cycle #26 grant, Contract No. 24-089- 000-E345, from the County's GOMESA funds. (GDR) RESULT kkokOV�b [UNhNXMOUSj _ MOMrER. Vern Lyssy; Commissioner _%t 2 SECONDER; Joel Behrens, Commissioner Pct3 A1fE$ = Judge Meyer,.Gommissronr Heil, Lyss"y, Behrens, Meese 11. Consider and take necessary action to approve the FY 24 Feld Agreement with the Texas Agrilife Extension Service — Wildlife Services for Wildlife Damage Management and Predator Control and authorize the County Judge to sign the agreement. (RHM) RESULT APPROVES [l{NA!!IiMOU9:] MOVER ,VOrn Lyssy; Commissioner Pet 2 S. ECO 46Ei p ; Gary`Reese, Commissioner P.ct 4 AYES; -- Judge Meyer, Commissioner -Hall; Lyssy, Behrens, Reese. 12. Consider and take necessary action on the ballot for the election of the (5) five member Calhoun County Appraisal District Board of Directors, and authorize County Judge to sign the Resolution. (RHM) 13. Consider and take necessary action to approve the estimate for Constable, Precinct 1, to purchase CopSync to be compliant with state regulations to submit monthly reports to the Texas Depart of Public Safety. (RHM) pass 14. Approve the minutes of the October 25, 2023 and November 1, 2023 meetings. RESULT. ARPROVD EUNANIMOUSj MOVERry Vern L'y- Commissioner s t SSCpN113ER: -Joel Behrens, Commissioner;Pct 3. AYES: judge Meyer, CommissionerHall, Lyssy, Behrens, Reee? Page 3 of 5 NOTICE OF MEETING.- 11/8/2023 15. Consider and take necessary action to remove the LPR VIN 1M9U50813HD597037, purchased with OSG funds from the Sheriff's Office fixed asset records. (RHM) RESULT. g A:PPROVE D [UNANIMOUS MOVER Gary Reese, ComMjf loner Pct 4 SECONDER. Ji el Behrens, coma Honer AESv Judge Meyer, commissioner Hall, Lyssy, Behrens; Rees= 16. Consider and take necessary action to accept insurance proceeds in the amount of $52,908.00 to be deposited into the operating budget to purchase OSG equipment and cover the tow bill from the accident with the LPR. (RHM) RE§ULTn APPROVED [lJNAN-MQUS MOVER' `: Vern Ly$sy Commissioner Pct 2 - SECONDER ; David Hall, Commisionor- PctF1 AYES Judge Meyer, Gomfts3oner j all, Lyssy, Behreti ., Reese; 17. Accept Monthly Reports from the following County Offices: L Floodplain Administration - October 2023 il. Justice of the Peace, Precinct 1- October 2023 M. Justice of the Peace, Precinct 2 - October 2023 iv. Justice of the Peace, Precinct 5 - October 2023 v. Sheriff's Office - October 2023 RESULT• = -APPROVED UNANIMOUS] MQVER. Vern Lyssy, Commissioner:Pct 2 SECONDEii Gary Reese, Commissioner Pct 4 A1`ES: Judge. Meyer, Commissioner Hall, Lyssy, Behrens, Reese: 18. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT'-:,' . APPROVED [UNANII�OU.t� MOVER: Gary -.Ruse, Gornrnisslorfer Pct-4 SECONDER Joel Behre.1' Commission Pet 3 ALES. :Judge Meyer, Coma u5sioh ('Hall, LysSy,.Be. revs, Reese, Page 4 of 5 NOTICE OF MEETING —1.1/8/2023 10 AnnmvA of hilic and nnximll tPWM) l � -#'tSUL� APPRoVEYnL'V-M' 2 VOW _Zff -'g` David 'Id, ERi t - n— r. -ysCommis .......... . . . . . . . . . . . . . . . . . . 5 ,5;s6.n0fPct..-2 Ju c ge--- eyerorn - BehYei?, Reese: SUPPLEMENTAL AGENDA The subject matter of such meeting is as follows: 20. Consider and take necessary action to accept insurance proceeds from TAC in the amount of $2,805.00 for damages to a Road and Bridge, Precinct #2 vehicle on September 22, 2023. (RHM) APPROVED -x 1 Q1.-avid HaU- lwo ner,R I -0 Joel el-B hrp miss 3; IfJdge Me..ssloa1lL lR- ehren s ease 21. Consider and take necessary action to approve the Final Plat of Driftwood Estates. (GDR) Adjourned 10:41am Page 5 of 5 # zo NOTICE OF MEF_TING — 7.1./22/2023 20. Accept Monthly Report from the following County Office: i. Justice of the Peace, Precinct 3 — October 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 17 of 19 4 ENTER COURT NAME' (ENTER MONTH OF REPORT JUSTICE. OF PEACE NO. 3 - OCTOBER ENTER YEAR :OF REPORT 2022-. " 2023 CODE AMOUNT CASH. BONDS REVISED 02/02/2021 ADMINISTRATION FEE -ADMF 'BREATH ALCOHOL TESTING BAT CONSOLIDATED COURT COSTS -CCC 301.01 STATE CONSOLIDATED' COURT COST-2020 636.99 LOCAL CONSOLIDATEDCOURT COST-2020 143.84 :COURTHOUSE SECURITY' CHS 30.10 CJP CIVIL JUSTICE DATA REPOSITORY FEE CJDR 0.50 :CORRECTIONAL MANAGEMENT INSTITUTE -OMI CR CHILD SAFETY.- CS -.. CHILD SEATBELT FEE CSBF :ICRIME VICTIMS COMPENSATION -CVC. DPSC/FAILURE TO APPEAR !-OMNI-DPSC 20.13 - ADMINISTRATION .FEE FTA/FTP;take OMNI)- 2020 32.24. ELECTRONIC: FILING FEE - EEF -FUGITIVE APPREHENSION - FA GENERAL. REVENUE :-GR CRIM -IND LEGAL SVCS.SUPPORT -OF 15.05. JUVENILE :CRIME & DELINQUENCY -JCD JUVENILE CASE MANAGER FUND -JCMF 39.36 JUSTICE COURT. PERSONNEL TRAINING - JCPT JUROR SERVICE FEE-:JSF 30.11 LOCAL ARREST FEES - LAP 45.00 LEMI LEOA LEOC OCL PARKS WILDLIFE ARREST FEES PWAF 2.62 STATE ARREST FEES -SAF 41.37 ` SCHOOL. CROSSINGICHILD:SAFETY FEE - SCF SUBTITLE C SUBC 150.00 STATE TRAFFIC -FINES -EST 91.19-:STF 277.06 TABC ARREST FEES TAF TECHNOLOGY FUND-TF 30.10 :TRAFFIC TFC 15.00 ' LOCACTRAFFIC FINE-. 2020 16.63 TIME: PAYMENT TIME 13.13 TIME PAYMENT REIMBURSEMENT FEE-2020 'TRUANCY PREVENTION/DIVERSION FUND TPDF 15.05 LOCAL & STATE WARRANT FEES WRNT 694.78 COLLECTION SERVICE FEE-MVBA CSRV 1,151.31 DEFENSIVE DRIVING: COURSE DOC DEFERRED FEE -'DFF 'DRIVING'EXAM.:FEE- PROV DL FILING FEE -. FFEE STATE CONSOLIDATED CIVIL FEE -2042 126.00 LOCAL CONSOLIDATED CIVIL FEE -2022 198.00 FILING FEE SMALL CLAIMS -. FFSO -"JURY FEE Jr' COPIES/CERTIFED COPIES CC INDIGENT FEE CIFF or INDF JUDGE PAY' RAISE FEE -JPAY 46.15 SERVICE FEE SFEE OUT -OF -COUNTY SERVICE FEE ELECTRONIC FILING FEE EEF,CV EXPUNGEMENT FEE EXPG EXPIRED RENEWAL EXPR ABSTRACT OF JUDGEMENT-AOJ ALLWRITS WOP/WOE DPS:FTA FINE DPSF LOCAL FINES -FINE 2,633.64 ' LICENSE&WEIGHT FEES -LWF .PARKS &WILDLIFE FINES -PWF 50.00 . SEATBELT/UNRESTRAINED CHILD FINE -:SEAT J- JUDICIAL& COURT PERSONNEL TRAINING-JCPT 'OVERPAYMENT -:(OVER $10)-OVER ' OVERPAYMENT ($10 AND LESS) - OVER RESTITUTION - REST -PARKS & WILDLIFE -WATER SAFETY FINES-WSF MARINE SAFETY PARKS &:WILDLIFE 'MSO TOTAL ACTUAL MONEY RECEIVED < 8;754:17 TYPE:. AMOUNT TOTAL WARRANT. FEES 694.78 ENTER LOCAL WARRANT FEES 228.11.. RECORQON TOTAL PAGEOF HILLCOUNTRY SOFTWARE MO. REPORT STATE WARRANT FEES 466.67 RECDRDON TOTAL PAGEOF HRLCOUNT"SOFTWARE MO. REPORT DUE. TO OTHERS: AMOUNT DUE TO CCISD--50%. Of Fine on JV Lases 0.00. PLEASE INCLUDE DR REQUESTING DISBURSEMENT DUE TO DA RESTITUTION FUND : 6.60 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT REFUND OF OVERPAYMENTS 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT OUT -OF -COUNTY SERVICE FEE 0.00 PLEASE INCLUDE DR. REQUESTING DISBURSEMENT CASH: BONDS 0.00" PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT (IF REQUIRED) TOTAL DUE TO OTHER&. 0.00. - TREASURERS RECEIPTS FOR MONTH AMOUNT CASH, CHECKS, M.O.s&CREDIT CARDS. Calculate from ACTUAL Treasurer's Receipts . ' TOTAL TREAS. RECEIPTS:... 0.00 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 11/212023 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: OCTOBER YEAR OF REPORT: 2023 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45013 FINES 2,641.14 CR 1000-001-44190 SHERIFF'S FEES 681.64 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 31.63 ADMINISTRATIVE FEES 32.24 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44363 TOTAL ADMINISTRATIVE FEES 63.87 CR 1000-001-44010 CONSTABLE FEES -SERVICE 0.00 CR 1000-001-44063 JP FILING FEES 0.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,151.31 TOTAL FINES, ADMIN. FEES & DUE TO STATE $4,537.96 CR 2670-001-44063 COURTHOUSE SECURITY FUND $72.92 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $7.53 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $71.20 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $39.36 CR 2730-001-44063 LOCAL TRUANCY PREVENTION & DIVERSION FUND $51.37 CR 2669-001-44063 COUNTY JURY FUND $1.03 CR 2728-001-44063 JUSTICE COURT SUPPORT FUND $150.00 CR 2677-001-44063 COUNTY DISPUTE RESOLUTION FUND $30.00 j CR 2725-00144063 LANGUAGE ACCESS FUND $18.00 STATE ARREST FEES DPS FEES 101.61 P&W FEES 0.52 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 102.13 CR 7070-999-20610 CCC-GENERAL FUND 30.10 CR 7070-999-20740 CCC-STATE 270.91 DR 7070-999-10010 301.01 CR 7072-999-20610 STATE CCC- GENERAL FUND 63.70 CR 7072-999-20740 STATE CCC- STATE 573.29 DR 7072-999-10010 636.99 CR 7860-999-20610 STF/SUBC-GENERAL FUND 7.50 CR 7860-999-20740 STF/SUBC-STATE 142.50 DR 7860-999-10010 150.00 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 11.08 CR 7860-999-20740 STF- EST 9/1/2019- STATE 265.98 DR 7860-999-10010 277.06 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 11/2/2023 COURT NAME: JUSTICE OF PEACE NO.3 MONTH OF REPORT: OCTOBER YEAR OF REPORT: 2023 CR 7950-999-20610 TP-GENERAL FUND 6.57 CR 7950-999-20740 TP-STATE 6.56 DR 7950-999-10010 13.13 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 1.51 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 13.54 DR 7865-999-10010 15.05 CR 7970-999-20610 TL/FTA-GENERAL FUND 6.71 CR 7970-999-20740 TL/FTA-STATE 13.42 DR 7970-999-10010 20.13 CR 7506-999-20610 JPAY- GENERAL FUND 4.52 CR 7505-999-20740 JPAY - STATE 40.63 DR 7505-999-10010 45.15 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 3.01 CR 7857-999-20740 JURY REIMB. FUND- STATE 27.10 DR 7857-999-10010 30.11 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.05 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 0.45 DR 7856-999-10010 0.50 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 7.53 7998-999-20701 JUVENILE CASE MANAGER FUND 7.53 DR 7998-999-10010 15.05 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 126.00 TOTAL (Distrib Req to Oper Acct) $6,711.67 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISO 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENT; 0.00 OUT -OF -COUNTY SERVICE FI 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 42.50 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $42.50 TOTAL COLLECTED -ALL FUNDS $6,754.17 LESS: TOTAL TREASUER'S RECEIPTS $0.00 REVISED 02/02/2021 OVER/(SHORT) ($6,754.17) Page 2 of 2 #21 NOT ICF OF MEETING—1.1/22/2023 21. 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 18 of 19 Z Z LL Z LL J cr 2 uj (z g Z Z N N N W W m 6 Q N N p YpY� fA M` a�r��Fn �p ,O 6 CO H ; a Z W W 000 L eS iJ i� �W iZ ;W W iy j Z 'O Z Z K W F 0Q z z i� Z :O C e �0 0 W z a IY W i O iW O = z i rL '�iD Q w Z 0 a a ° z EZ W W W � a � � W a w :d ZC zro N C9 C fl :w C In � Q w F Z Z 0 a m V Q O O O N of w Q 0 r 0 O V W J 0 xU F Z S 0 U 0 z z § � � § � � @ � I U ALu & � § F. § 0 � # z §aa000c ■§/2a= §� ■ (H§ § ( lw �&\\§ < 0 w L Of w < a,. ( \ § � § 2 § �K 0 � §2a §■ al §� )� 21 al �) ;o :z :§ :L :§ _ _ _ — W O -T Z =0 _ Z =Z LL = Z =W ='L = H =d =W V V C C Wy! 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W LL HN QZ F w W F w 0 # 22 I NOTICE OF MEETING 11/22/202:3 22. Approval of bills and payroll. (RHM) MIMIC Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Oct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills . RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:41am Page 19 of 19 MEMORIAL MEDICAL CENTER COMMISSIONERSCOURTAPPROUAL,L-ISTFOR--`--November 22'2033 by:DC INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES HEB Pharmacy (Medimpact) Pharmacy Reimbursement 34.71 MMCenter (in -patient $oi Out -patient $t,t 91.3o i ER $o) 1,191.30 Memorial Medical Clinic 80.00 SUBTOTAL 1,306.01 Memorial Medical Center (indigent Healthcare Payroll and Expenses) 4,166.67 Subtotal 5,472.68 Co -pays adjustments for October 2023 I 124 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 $5,452.6; approved by Commissioners Court on ,1:0M/$023 1000-001-46010 October, 31, 2.D23Interest ($15.99) $5,436.69 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 ABO O ; GATION. BY: 11/16/2023 APPROVED ON NOV 17 2023 JSijDiTCIIt' rvu urtna� C i a DEPARTMENT HEAD DATE ®IHs Source Totals Report Issued 11/09/23 Calhoun Indigent Health Care Batch Dates 11/01/2023 through 1110112023 For Vendor: All Vendors Source Description Amount Billed 02 Prescription Drugs„ 34.71 08 Rural Health Clinics 80.00 14 Mmc - Hospital Outpatient 2,165.00 Expenditures 2,287.71 Reimb/Adjustments -8.00 Grand Total 2,279.71 Expenses Co -Pays APPRDyW (.N NOV 15 2023 BY COUNTYAU011fsii CALHOUN Cotgt:• s�:3rt; Amount Paid 34.71 86.00 1,191.30 1,314.01 -8.00 1,306.01 4,166.67 < 20.00 > 5,452.68 OIHs Source Totals Report Issued 11/09/23 Calhoun Indigent Health Care Batch Dates 02/01/2023 through 11101/2023 For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 1,795.00 89.29 01-2 Physician Services -Anesthesia 1,265.00 230.39 02 Prescription Drugs 261.63 261.63 08 Rural Health Clinics 753.00 591.62 14 Mmc - Hospital Outpatient 21,619,01 10,610.50 15 Mmc - Er Bills 7,794.00 3,511.80 Expenditures 33,526.87 15,334.46 Reimb/Adjustments -39.23 -39.23 Grand Total 33,487.64 15,295.23 Expenses 41,667.70 Co -Pays < 110.00 > 56,852.93 MEMORIAL MEDICAL CENTER CHECK REQUEST p CALHOUN COUNTY INDIGENT ACCOUNT Date Requested: 11/7/23 A FOR ACCT. USE ONLY Y llImprestCash E APPROVED ON ❑A/PCheck NOV 13 2023 ❑Mail Check to Vendor F � Return Check to Dept OAUIOUN COUN'fY,ITEXAS AMOUNT $20.00 G/LNUMBER: 50240000 EXPLANATION: TO TRANSFER INDIGENT CO -PAYS FROM OPERATING ACrnUNTTO TNF iNrnr,FNT REQUESTED BY: Caitlin Clevenger AUTHORIZED BY:— RUN DATE: 11/07/23 MEMORIAL MEDICAL CENTER PAGE 16D TINS: 08:37 RECEIPTS FROM 20/01/23 TO 10/31/23 ROMP GA RECEIPT PAY CASH RECEIPT DISC COLL GL CASH NUMBER DATE -------------- ----- USHERS TYPE PAYER ---------------------------- AMOUNT AMOUNT NUMBER NAME DATE INIT CODE ACCOUNT 50240.000 10/11/23 679077 VI -..................... 10.00 ---------- --------------------_-----------------------......-- 10.00 00/00/00 PLB 2 50240.000 10/18/23 679843 VI 10.00 10.00 00/00/00 PIE 2 **TGTAL** 50240.000 COUNTY INDIGENT COPAYS 20.00 50460.000 10/11/23 679055 CH CENTERS MANAGEMENT 5232.12 5232.12 00/00/00 PLB 2 **TOTAL** 50460.000 RAPPS - OTHER REV 5232.12 50510.000 10/02/23 677908 CA CAFE 478.36 479.36 00/00/00 RAH 2 50510.000 10/02/23 677909 VI CAFE 520.93 520.93 00/00/00 SAN 2 50510.000 10/02/23 677910 MC CAPE 336.39 336.39 00/00/00 EAU 2 50510.000 10/02/23 677911 AS CAFE 10.45 10.45 00/00/00 RAN 2 50510,000 10/02/23 677912 US CAFE 105.59 105.59 00/00/00 RAH 2 50510.000 10/19/23 679849 CA CAPE 296.26 296.26 00/00/00 EAN 2 50510.000 10/19/23 679850 OT CAFE 75.41 75.41 00/00/00 RAH 2 50510.000 10/19/23 679851 VI CAFE 202.92 202.92 00/00/00 RAN 2 50510.000 10/19/23 679852 MC CAFE 88.38 88.38 00/00/00 RAH 2 50510.000 10/19/23 679053 AE CAFE 3.13 3.13 00/00/00 RAM 2 50510.000 10/19/23 679854 DS CAFE 12.37 12.37 00/00/00 RAN 2 50510.000 10/30/23 680881 CA CAPE 325.65 325.65 00/00/00 SAN 2 50510.000 10/30/23 680882 OT CAPE 44.57 44.57 00/00/00 RAIL 2 50510.000 10/30/23 680883 VI CAPS 574.04 574.04 00/00/00 RAN 2 50510.000 10/30/23 680884 MC CAFE 121.94 121.94 00/00/00 SAM 2 50510.000 10/30/23 680885 AR CAFE 11.89 11.89 00/00/00 SAE 2 50510.000 10/30/23 680886 US CAFE 64.01 64.01 00/00/00 MAN 2 50510.000 10/03/23 678096 VI CAPE 276.80 276.80 00/00/00 PLB 2 50510.000 10/03/23 678097 MC CAFE 167.71 167.71 00/00/00 PLE 2 50510.00D 10/03/23 678098 DS CAFE 11.89 11.89 00/00/00 PLB 2 50510.000 10/03/23 678099 GP CAFE 38.17 38.17 00/00/00 PLB 2 50510.000 10/03/23 678100 CA CAFE 292.06' 292.06 00/00/00 PLB 2 50510.000 10/04/23 678242 VI CAPE 306.37 306.37 00/00/00 PLE 2 50510.000 10/04/23 678243 MC CAFE 186.83 186.83 00/00/00 PIS 2 50510.000 10/04/23 678244 AS CAPE 16.92 16.92 00/00/00 PLB 2 50510.000 10/04/23 678245 DS CAFE 34,56 34.56 00/00/0O PLB 2 50510.000 10/04/23 678246 OT CAFE 176.38 176.38 00/00/00 PLB 2 50510.000 10/04/23 678247 CA CAFE 362.03 362.D3 00/00/00 PLB 2 50510.00D 10/04/23 678251 VI CAFE 306.37- 306.37- 00/00/00 PLB 2 50510.000 10/04/23 678252 MC CAFE 186.83- 186.83- 00/00/00 PLB 2 50510.000 10/04/23 678253 AS CAFE 16.92- 16.92- 00/00/00 PLB 2 50510.000 10/04/23 678254 DS CAFE 34.56- 34.56- 00/00/00 PLB 2 50510.000 10/04/23 678255 OF CAFE 176.38- 176.38- 00/00/00 PIE 2 50510.000 10/04/23 678256 CA CAFE 362.03- 362.03- OD/00/00 PLB 2 50510.000 10/04/23 678258 VI CAFE 306.37 306.37 00/00/00 PIG 2 50510.000 10/04/23 678259 MC CAFE 186.83 186.03 00/00/00 PLB 2 50510.000 10/04/23 670260 AS CAFE 16.92 16.92 00/00/00 PLB 2 50510.000 10/04/23 678261 US CAFE 34.56 34.56 00/00/0D PLB 2 50510.000 10/04/23 678262 OT CAFE 176.38 176.38 00/00/00 PLB 2 50510.000 10/04/23 678263 CA CAFE 343.68 343.60 00/00/00 PLE 2 50510.000 10/OS/23 678428 VI CAFE 328.25 328.25 00/00/00 PLB 2 50510.000 10/05/23 678429 MC CAFE 258.14 258.14 00/00/00 PLB 2 50510.000 10/05/23 670430 DS CAFE 49.04 49.04 00/00/00 PLB 2 50510.000 10/05/23 678431 OT CAPE 165.58 165.58 00/00/00 PLB 2 MEDICAL / j CEN`I`ETZ Bill To: Calhoun County 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Date: 11/7/2023 Invoice # 389 For: Oct-23 Dl*$CFtli?flt iY, 4M5001' Funds to cover Indigent program operating expenses. $ 4,166.67 Andrew De Los Santos Controller Total $ 4,166.67 NOV 15 M3 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS 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 0 3 0 3 6 August 1 1 0 4 6 September 0 2 0 4 8 October 0 8 0 4 4 November December YTD 6 28 4 31 54 Monthly Avg 1 3 0 3 5 December 2022 Active 1 Number of Charity patients 218 Number of Charity patients below 50% FPL 124 Number of Charity patients who meet State Indigent Guidelines 115 Calhoun County Pharmacy Assistance Patient Caseload 2023 Approved Refills Removed Active Value January 0 2 0 5 $1,667.46 February 0 21 0 14 $14,786.76 March 1 3 0 16 $2,460.00 April 3 12 0 22 $11,674.00 May 1 3 0 24 $2,954.67 June 2 9 0 29 $5,673.30 July 3 11 0 29 $6,159.99 August 1 3 0 29 $2,445.75 September 5 4 0 32 $2,954.67 October 0 0 0 33 $0.00 November December YTD PATIENT SAVINGS $50,776.60 Monthly Avg 2 7 23 $5,077.66 December 2022 Active 55 vW416 v w PROSPERITY BANK? THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13435 10/01/2023 Beginning Balance 3 Deposits/Other Credits 0 Checks/Other Debits 10/31/2023 Ending Balance Total Enclosures 10/19/2023 Deposit 10/25/2023 Deposit 10/31/2023 Accr Earning Pymt Added to Account gDate Balance 10-01 $12,534.91 10-19 $12,544.91 Interest Paid This Period 'o Interest Paid YTD 3� ..� o � 31 Days in Statement Period Date Balance 10-25 $12,594.91 10-31 $12,610.90 " Below is an itemization of $15.99 $54.11 Statement Date Account No Earnings paid this period. " Annual Percentage Yield Earned Days in Earnings Period Earnings Balance 10/31/2023 ""4551 Page 1 of 2 $12,534.91 $75.99 $0.00 $12,610.90 2 1.51 % 31 $12,550.39 MEMBER FDICNYSENYSE Symbol"PB" W"M MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 22, 2023. TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROEL,AND ELECTRONIC '.BAN,K PAYMENTS 9438E 85. TOTAL'r,RAN5FtR543ET'wgENFUNDSi $ 14T98E32. TOTAL, Ni1RSIIV6��tOMtE UPL EXPENSES TOTAL,INTER•GOVERNMEFl7'TRANSEER$ _ GJtAND TOTI,ILpESBCfRSEIIdEN'FS APPRL3VEIl.Nevem6er 22; 80?3 $ 2,t7(►;2tl2.88 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---November 22 2023 PAYABLES AND PAYROLL 11/1612023 Weekly Payables 389,913.63 11/2012023 Citibank Credit Card -see attached 2.563.06 1112012023 McKesson-3408 Prescription Expense 12,898.53 11/2012023 Amensource Bergen-340B Prescription Expense 1,463,1:6 11/2012023 Payroll Liabilities -Payroll Taxes 124,911..66 11120/2023 Payroll 396,868.60 Prosperity Electronic Bank Payments 1111512023 Credit Card & Lease Fees 285,82 11/1312023 Debt Management Services -wage garnishment 1.75.45 11/13-11117/23 Pay Plus Patient Claims Processing Fee 220.92. TOTAE;�PAYA6LES, PAYROLL AptD ELEt"�TRONIC 6ANK PA`CMENFS $ ',924,300.85i TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 11116/2023 MMC Operating to Crescent, -correction of NH insurance payment deposited. 4„140.00 into MMC Operating in error 11/1612023 MMC Operating to Golden Creek -correction of NH insurance. payment 91,669.32 deposited Into MMC Operating in error 1111612023 MMC Operating to Gulf Pointe Plaza. -correction. of NH insurance payment 1.,754.56 deposited into MMC Operating 1111612023 MMC Operating to Tuscany Village -correction of NH insurance payment 2,400.00 deposited into MMC Operating 1111612023 MMC Operating to Bethany -correction of NH insurance payment deposited. into 48,004.44 MMC Operating TQTAL°TRANSF ERS,�BETWEEN'FUNDS, S 147,11 2+ NURSING HOME UPL EXPENSES 11120/2023 Nursing Home UPI.-Cantex Transfer 388,39€09 11120/2023 Nursing Home UPL-Nexion Transfer 125,805.20 11/20/2023 Nursing Home UPL-HMG Transfer 6,923.17 11/2012023 Nursing Home UPL Tuscany Transfer 79,22723 11/20/2023 Nursing Home UPL-HSL Transfer 184,944.73 NURSING HOME BANK FEES 11/1512023 Ashford -Enhanced ana[ysis fee 74.25 1111512023 Solera-Enhanced analysisfee 83,08- Nursing Home Electronic Bank Payments 11/15/2023 Golden Creek -returned check paymentfor resldent 1,59200. QIPP CHECKS TO MMC I V2012023 Ashford 2%0911_86 1112012023 Broadmoor 13,475.07 11/2012023 Crescent 11,236.799 1112012023 Fort Bend 14,013.23s 11120/2023 Solera 8,726,73 11120/2023 Golden Creek 56,556.43 11/20/2023 Tuscany 39,27t62 11/2012023 Bethany 40,122.25 TRANSFER OF FUNDS BETWEEN NURSING HOMES 11/2012023 Crescentic, Tuscany -Tuscany insurance payment deposited into Crescent in 22,500.00 error 7QTAL IURSINfa`Ht11>AEUPI.EXPE14SES 1nQ�Caki2 T31 INTER -GOVERNMENT TRANSFERS 1112012023 IGT CHRIP to be paid November 17, 2023 71,899.00 TQT11` S''IHTEJR-G VEftNMENTTftA"SFFR8 $ `T't.399 fFw I39ANDTOTAL,piSB(JOEMENTS'APPitOVE[1`NOVeth4eh2 202 , 6 2;ti7tt,� Page I of 15 RECEIVED By 7K CAt.f ", AUDIJOR ON NOV 16 2023 MEMORIAL MEDICAL CENTER 11/16/2023 0 .rtiCF401111*UJfTY''BF.4A3 AP Open Invoice List ap_open_invoice.template. Due Dates Through: 1210812023. Vendor# Vendor Name Class Pay Code f 11283 ACE HARDWARE 15521 i/ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 093023 1111612009/30/2010125/20 1,350.81 0.00 0.00 / 1,350.81 ✓ SUPPLIES .. 103123 11/1612010/3l/2011/25/20 1,297.91 0.00 0.00 1,297,91 SUPPLIES .. Vendor Totals Number Name Gross Discount No -Pay Net 11283 ACE HARDWARE 15521 2,e48.72. 0.00 0.00. 2,648..72. Vendor#Vendor Name Class Pay Code A1680 AIRGAS USA, LLC-CENTRALDIV ✓f M Invoice# Comment Tran Dt Inv Dt Due Dt Check orPay Gross. Discount No -Pay Net 5503364413 v/ 11/16/20 10131/2011/25/20 561.27 0.00 0.00 561..27 .F OXYGEN Vendor Totals Number Name Grosse Discount No -Pay Net: A1680 AIRGAS USA, LLC -CENTRAL DIV 561.27 0.00. 0-00'. 561.27 Vendor# Vendor Name Class Pay Code / ✓' A1705 ALIMED INC. M Invoice# Comment: Tran Dt Inv Dt Due Dt. Check D Pay Gross Discount No -Pay Net RPSVO4120289 .1" 11/1512011/0312011118/20 1.91.07 0.00 0100 191.07 ✓"( SUPPLIES ,. VendorTotalsNumber Name. Gross Discount: No -Pay Net A1705ALIMED INC. 191.07 0.00 0.00 191'..07 Vendor# Vendor Name Class Pay Code 14028 AMAZON CAPITAL SERVICES r/f Invoice# Comment Tran Dt Inv Dt Due Dt Check OPay Gross Discount No -Pay Net 1TYD-MTIQ-FQ6N / 11/15/2011/0112012/01/20 123.92 100. 0.00 123.92 SUPPLIES 1 FHX.W6V4-L4QL ✓1 11/15/20 ll/02/2012/02/20 267.55 0100 0.00 267.55 SUPPLIES i DVN-G9QC-19LG �i 11/16/2011/0212012/02120 278,21: 0.00 0�00 278.21 SUPPLIES 1 PHM-ODFK-YHDS / 11/15/2011/1412012105120 185.13 0.00 0100 185.13 ✓'� SUPPLIES Vendor Total,. Number Name Gross. Discount No -Pay Net 1402E AMAZON CAPITAL SERVICES 864.81 0.00 0.00 854-81. Vendor# Vendor Name Class. Pay Cade 11632 AMERICAN CONSTRUCTION ✓ Invoice#Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net. 1209 �/ 11/15/2011/0912011110/20 1,260.00 OAO 0,00 1,260,00 a/r FAN MOTOR Vendor Totals Number Name Gross Discount No -Pay Net 11632. AMERICAN'CONSTRUCTION 1,260.00 0.00 0.00 1.260.00' Vendor#Vendor Name Class Pay Code - A2150 ANNOUNCEMENTS PLUS TOO AGAIN y.% W Invoice# ,- Comment Tran Dt Irm Ot Due Ot Check D Pay Grosse. Discount No -Pay Not 4531 lol 11/14120 04114120 04/24120 1.0.00 0,00' 0.00 10.00, STICKERS .. file:IIIC:lUserslItrevinolcpsilmemmed.cpsinet.comlu881251data_51tmp_c W5report3)7181... 11 /16/2023 Page 2 of 15 Vendor Totals Number Name Gross. Discount No -Pay Net A2150 ANNOUNCEMENT$ PLUS TOO AGAIN 10.00 0.00 0.00 10.00 Vendor# Vendor Name Class Pay Code 11756 AYA HEALTHCARE INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grosse Discount No -Pay Net - 3683242./ 1111512011109/2012105/20 2,976.76 0.00 0.00 2,976.75 KARIANN ❑UNN. 10/27-10/29/23) .. VendorTotalE Number Name Gross Discount. No -Pay Net 11756 AYA HEALTHCARE INC 2,976.75 0.00 0.00 2,976.75 Vendor# Vendor Name Class Pay Code B1150 BAXTER: HEALTHCARE y/' W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grosse. 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No -Pay Net C1325 CARDINAL HEALTH 414, INC'. 666.24 0.00 0.00 666.24 Vendor# Vendor Name Class Pay Code. 14236 CARRIER CORPORATION Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net 90320146 ✓ 10/31/2010/30/2011130120 12,830,00 0.00 0.00 12.8,90.00 CHILLER 81141-WlG ,. Vendor Totals Number Name Gross Discount No -Pay Net 14236 CARRIER CORPORATION 12,830.00 0,00 0.00- 12,830.00 Vendor# Vendor Name Class Pay Code. / C1992 COW GOVERNMENT, INC. ✓ M. Invoice# Tran Dt Inv Dt Due Ot Check O Pay Grosse. Discount No -Pay Net ,rComment MV30593 11/15/2010/3112011130/20 111.01. 0.00 0.00 1.11.01. SUPPLIES MW16711 11115120 11/02/20 12102/20 254.44 0.00 0.00 254,44 . SUPPLIES .. Vendor Totals Number Name Gross Discount No -Pay Net. C1992 CDW GOVERNMENT, INC. 365.45 0,00 0.00 365'AS Vendor#Vendor Name Class Pay Cade C1600 CITIZENS MEDICAL CENTER ✓ W Invoice# Comment Tran Dt. Inv Dt Due D1 Check 0` Pay Gross Discount. No -Pay Net 2023-14 / 1013112010/31/2012/02/20 51,817,95 0.00 0.00 54,81,7.95 Y CRNA OCT 23 COVERAGE (tat-Ha�3tl'23j Vendor TotalsNumber Name Gross Discount No -Pay Net C1600 CITIZENS MEDICAL CENTER 51,81T95, 0.00 0.00 511,817.95 Vendor# Vendor Name Class Pay Code C1970 CONMED CORPORATION. v� M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 10301836 ✓/11/15/20 11/06/201Z06120 1.07,53 0.00 0.00 107.53 f' SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 01970 CONMED CORPORATION 107.53 0.00 0.0D 107.53 Vendor# Vendor Name Class Pay Code / L1430 CONMED LINVATEC ,f M Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No-Psy Net 4268307�/ 11101/20 101W20 11/01120 W04 0.00', 0.00 05.04 t/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net file:///C:/TJsers/Itrevino/cpsi/menimed.cpsinet.com/u88125/data-5/tmp_cw5report37181... 11/16/2023 Page 4 of 15 L1430 CONMED LINVATEC 95.04 0.00 0.00 95.04- Vendor# Vendor Name Class Pay Code 14400 CULINARY CONCESSIONS LLC I/ Invoice# Com ant Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net. INV000(X_ 11/14120 10/31/20 11/30/20. 34,383.92. 0.00 0.00 34,383.92 CONTRACT FEES _ Vendor TotalsNumber Name Grass Discount No -Pay Net 14400 CULINARY CONCESSIONS LLC 34,383.92 0.00 0.00 34,383.92 Vendor#Vendor Name Class Pay Code ,+ f` 10060 DETAR HOSPITAL ICP Invoice# Com ant TranDt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net DTR2300019 ,/' 11/15/20 09/01120 10101/20 51.0.70 0.00 0100 510.70 LAB SERV .. 093023 11/15/20 09130/20 10130/20 646.37 0.00 0.00 046.37. LAB SERV DTR2310019 J 11/15120 11113120 12/01120 33.27 0.00 0.00 33.27 LAB SERV Vendor TotalsNumber Name Gross Discount: No -Pay 10060 DETAR. HOSPITAL 1,1.90.34 0,00 0.00 Vendor# Vendor Name ,+ Class Pay Code 103138 DEWITT POTH&SON �r Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 735521-0 V/1 1111512011102/20 11/27/20 157.56 SUPPLIES 736232.0✓ 11/t5/20 11(07/20 12/02120 454.32. Net 1,190.34 Discount No -Pay Net. f, 0.000.00 457.56 0A0 0.00 454.32 V`F SUPPLIES 736359-0 / 11/15/20 11/09/20 12/01/20 1.8.01 0,00 0.00 113.01'. SUPPLIES 736232-1 11(15/2011/09/20 12 (14120 5.05 0.00 0.00 5.05. SUPPLIES .. Vendor Totalf Number Name Gross Discount No -Pay Net. 10368 DEWITT POTH&SON 634.94 0.00 0.00- 634,94 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 427014-11/15/20 1111512011/25/20 40,002.50 0.00 0.00 40,062.50 PHYSICIAN. SERV 11-IM) Vendor TotalsNumber Name. Gross Discount No -Pay Net 1.1284 EMERGENCY STAFFING SOLUTIONS 40„062.50. O.OD 0.00 40,062.50 Vendor#Vendor Name Class Pay Code 14708 EQUALIZE RCM SERVICES .''f Invoice# Comment Tran Dt Inv Dt Due Dt Check OrPay Gress Discount. No -Pay Net 533314 .'� 1.1 11:512011/01/2012101120 5,500.00 0.00 0.00 5,500.00 W/ KPl NOV 23 AR. FEE/REVENUE , .633315. 1.1/1512011101/2012/01/20 2,052.00 0-00. 0.00 2,052.00 AR. 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A2311061378�/ 1111512011106/2011/07/20 10,757.00 SOFTWARE SUPPORT/MONTI, T2311081378 ✓ 11/15/2011/08/2011109/20 10,799.49 CODINGIBUSINESS SERV Vendor Totals Number Name Gross. C2510 EVIDENT 29,556.49 Vendor# Vendor Name Class. Pay Code 10689 FASTHEALTH CORPORATION Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grosse. 11A23MMC✓}11/15/20 IV01/2011116/20 545,00 WEBSITE Vendor Totals Number Name Gross 10689 FASTHEALTH'. CORPORATION 545.00 Vendor# Vendor Name Class Pay Code. Ft 100 FEDERAL EXPRESS CORP. yr W Invoice# Comment Tran. Dt Inv Dt Due Dt Cheek D Pay Grosse. 8-290-90565 ✓ 11/14/20 1011.9/2R11/13/20 15.77 FREIGHT 8.297.80975 11/14/2010/26/2011/20/20 27.29 FREIGHT 8.304.94284 ✓r' 1111.4/2011/02/20 11/27120 22.81. FREIGHT 8-276-80102 k% 11/16/20 10/05/20 10/30/20 66.82'. FREIGHT Vendor Totals Number Name Grosse F1100 FEDERAL EXPRESS CORP. 132.69 Vendor# Vendor Name Class Pay Code 13496 FERGUSON ENTERPRISE LLC 061 ✓ Invoke# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross. 1238807-1 y/ 11/01/2011/2912012/29/20 29.22 SUPPLIES Vendor Total¢Number Name Gross. 13495 FERGUSON ENTERPRISE LLC #61 29.22 Vendor#Vendor Name Class Pay Coda 10003 FILTER TECHNOLOGY CO,. INC ✓/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Grosse 119806 f 11/01/20 10/09/20 11/08/20 1,346.17 r 0.00 0.00 10.99 ,f Discount No -Pay. Net 0.00 0.00 10.99 Discount No -Pay Net. 0.00. 0.00 37.20 r„r` Discount No -Pay Net. 0.00 0100 37.20 Discount No -Pay Net. O.DO. 010Q 18,757.00 ✓' Mo 0.00 10,799'A9 Discount No -Pay Net 0.00 0.00 29,556,49 Discount. No -Pay Net 0.00 0.00 546.00 Discount No -Pay Net 0.00 0.00. 545.00, Discount No -Pay Net 0.00 0'.00 16.17 0.00 0,00 2729 0.00 0.00 22.81 t/ 0,00 Mo 66.82'. yr` Discount No -Pay Net. 0.00, 0.00 132.69' Discount No -Pay Net 0.00' o-oQ 2922 r i' Discount No -Pay Net 0.00 0.00 29.22' Discount No -Pay Net. 0.00 0.00 1,34617 file:/llC.lUserslltrevino/epsi/memnied.cpsinet.coinlu88125/data_5ltmp_cw5report37181... 11/16/2021 Page 6 of 15 SUPPLIES VendorTotale Number Name Gross Discount No -Pay Net 10003 FILTER TECHNOLOGY CO, INC 1.346.17 0.00 0.00 1,346..17 Vendor# Vendor Name Class Pay code F1403 FISHER & PAYKEL HEALTHCARE ✓" M Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net. 92294125 f 11/15/201110912012101/20 62.40 0.00 0.00 62.40 ✓ SUPPLIES Vendor Totals Number Name Gross Discount. No -Pay Net. F1403. FISHER & PAYKEL HEALTHCARE 62.40 0.00 0.00 62.40 Vendor# Vendor Name Class Pay Code 11183 FRONTIER ,f Invoice# Comment Tran. Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net 110223 11/1512011/02/2011127/20 1.;218.24 0.00 0.00. f 1,218.24 4,,✓` PHONE Vendor Totals Number Name Gross Discount No -Pay Net. 11183 FRONTIER 1,218.24 0.00 0.00 1..21.8.24 Vendor# Vendor Name Ctass Pay Code 12404 GE PRECISION HEALTHCARE, LLC ,i Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6002527848 ✓ 11/14/2011/01/2012/01/20 3,588.56 0.00 0.00 3,586.68'. IMAGING CONTRACT 6002527849 yr{ 11/14120 11101120 12101/20 86.67 0.00 0.00 86.67 ✓' IMAGING CONTRACT ., 6002527850 P/ 11/14/20 11/01/20 12/01/20 2,422.50 0.00 0.00 2:422.50 IMAGING CONTRACT - 6002527851 1/ 11/14/20 11/01/20 12/01/20 61.67 0,00- 0.00 61.67 w�" IMAGING CONTRACT .. 6002527865,/11114120 11101/20 12101/20 51665,83 0.00 Q,QO 5,66aaa IMAGING. CONTRACT 6002527960 ✓A11114/20'. 11101/2012101/20 8110.28 0.00 QAO 810,28. w" IMAGING CONTRACT 6902528132. �/ ` 11/15/20 11101/2012101/20 204.83 0.00 0.00 204.83- MEDRAD Vendor Total-sNumberName Gross. Discount No -Pay Net 12404 GE PRECISION HEALTHCARE, LLC 12,840.36 0.00 0.00 12,846.36 Vendor# Vendor Name Class Pay Code 10653 GLOBAL EQUIPMENT CO. INC. �l Invoice# Comment. Tran Dt Inv Dt Due Dt Check DPay Gross Discount. No -Pay Net 121185281 f I V15/20 1 11OW90 12105/20 242.99 0.00 oleo 242.99 SUPPLIES. Vendor Totals Number Name Gross Discount No -Pay Net 10653 GLOBAL EQUIPMENT CO. INC. 242.99 0.00 0.00 242.99 Vendor# Vendor Name Class Pay Code 12948. GREAT AMERICA FINANCIAL SVCS v/ Invoice# Comment Tran Dt. Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 35211634/ 11115/20 11/01120 11/80/20 10,473.26 0.00 0.00 10,473,26 .r COPIER. LEASE Vendor Totals Number Name Gross. Discount. No -Pay Net 12948 GREAT AMERICA FINANCIAL SVCS 10,473.26 0.00 0.00 110-,473.26 Vendor# Vendor Name Class Pay Code file:///G:/Gsers/ltrevino/cps mernmed.cpsinet.com/u88125/data 51tmp_cw5report37181... 11/16/2023 Page 7 of 15 01210 GULF COAST PAPER COMPANY ,% M Invoice# Comment Tran of Inv Dt Due Ot Check 0-Pay Gross. Discount No -Pay Net 2466237 ✓�, 1111512011/0712012101/20 72.38 0.00 0.00 72.38 ,SUPPLIES 2466244 ✓ 11/15/20 11/07/20 12/01/20 793.93 0.00 0.00 793.93 VI/ SUPPLIES Vendor Total -Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 866.31 0.00 0.00 866.31 Vendor#Vendor Name. glass Pay Code 10804 HEALTHCARE CODING & CONSULTING ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /. 14427 r! 11/15/2010/31/2011130/20 437,00 0.00 0.00 437,00 1/ OCT 23 CHARTS , Vendor TotalsNumber Name Gross Discount No -Pay Net 10804 HEALTHCARE CODING & CONSULTING 437.00. 0.00 0.00 437.00 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES ✓ Invoice# Comment Tran Ot Inv Dt Due Dt Check DPay Grass Discount No -Pay Net 100816851 �/ 11/14/2010127/2012/01/20 4,610.52 0.00 0.00 4,610.52,,,' LEASE 100820337 v1 11/16/2011/06/2012/01120 1,797.44 0.00 0.00 1..,797A4 LEASE Vendor Total Number Name Gross. Discount No -Pay Not 11552 HEALTHCARE FINANCIAL. SERVICES 6,407.96 0.00 0.00. 6,407.96 Vendor# Vendor Name I Class Pay Code H1227 HEALTHSURE INSURANCE SERVICES , Invoice#/- Comment Tran Dt Inv Dt Oue Dt Check D Pay Gross. Discount No -Pay Not 4442 ✓ 11/15/2011/09/2012/01120 500.00 0.00 0.00 500.00. 6X BOND RENEWAL VendorTota4.Number Name Grosse Discount No -Pay, Net H1227 HEALTHSURE INSURANCE SERVICES. 600.00 0.00 0.00 500,00 Vendor# Vendor Name Class Pay Code H1269 HENRY SCHEIN INC. „// Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net /Comment 61234997 11/15/20 11/09/20 12105/20 ✓ 34.13 0,00. 0.00 34.13 '✓ SUPPLIES Vendor TotaitNumber Name Grass. Discount No -Pay Net H1269 HENRY SCHEIN INC. 34.1.3 0.00 0.00 34A3 Vendor# Vendor Name Class: Pay Coda H0416 HOLOGIC INC Invoice# Comment Tran Dt Inv Ot Due Ot Check D Pay Gross Discount No -Pay Net . ( 10725903 rr 1111612010/3112012/OS120 472.50 0.00 0.00 472.50, ✓`� SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net. H0416 HOLOGIC INC 472'.50 0.00 0.00 472.50, Vendor# Vendor Name Class Pay Code 10922 HUNTER PHARMACY SERVICES r/ Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net � f/ 5719 ✓ 11114120 10/31120 11120/20 14,738.75 0.00: 0.00 14,73&75 nl PHARMACIST SALARY ,. Vendor Totals Number Name Gross Discount No -Pay Net. file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u881251data_51tmp_cw5ceport37191... 11/ 16/2023 Page 8 of 15 10922 HUNTER PHARMACY SERVICES 14.738.75 OAO 0.00 14,738,75 Vendor# Vendor Name Class Pay Code 14976 INOVALON PROVIDER INC. V" Invoice# Com/rt�ent Train Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net. 23M-0159676 V 1.1/16/2011/03/2012103120 701.84 0.00- 0.00 701.64 SCHEDULING Vendor Total, Number Name Gross Discount No -Pay Net 1.4976 INOVALON: PROVIDER INC.. 701.84 0.00 0.00 701.84 Vendor# Vendor Name Class Pay Code / L0700 LABCORP OF AMERICA HOLDINGS ✓ M Invoice# ¢'omment Tran Ot Inv Dt Duo of Check. DPay Gross Discount No -Pay Net 78234391 r„A 11/14120 10123/20 11122/20 48.30 0.00. 0.00 48.30 LAB SERV :. Vendor TotalsNumber Name Gross. Discount No -Pay Net L0700 LABCORP OF AMERICA HOLDINGS 48.30 0.00 0.00 48.30 Vendor# Vendor Name Class Pay Code 15068 LRS HEALTHCARE Invoice# Comment. Tran Dt Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 642084 ✓ 10/241201U/20/2012/04/20 3,078.00 0.00 0.00 3,078.00- + ^ DELICIAM.. GARCIA`Teel VvjI*5*Sj 173 Vendor TotalsNumber Name Gross Discount No -Pay Net 15068 LRS HEALTHCARE 3,078.00 0.00 0.00 3.078.00 Vendor# Vendor Name Class Pay Code 11141 MEDICAL DATA SYSTEMS, INC. ./' Invoice# Comment Tian Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 186479 v/ 1 t/15/20 10/3112011125/20 105.24 0.00 OAD 1,05.24 ✓ COLLECTION FEES .. Vendor Totals Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC. 1.05.24 0.00 0.00 105.24 Vendor# Vendor Name Class Pay Code 12588 MEDICAL TECHNOLOGY ASSOCIATES / Invoice# C/pmment Tran. Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV-223460✓ 11/0112009/1212010107120 1,467.75. 0.00 0,00 1„467,75 6,.^"` MAINT/VACUUM SYSTEM Vendor Totals Number Name Gross Discount No -Pay Net 12586 MEDICAL TECHNOLOGY ASSOCIATES 1.,467.7E 0.00 0.00 1,467.75. Vendor#Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC' �/"M Invoice# Comment Tran. Dt Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 2285496181./ 11101120 09120120 10129120 128.92 0.00, 0.00 128.92 SUPPLIES ,. 2293051672 ✓ 11/1512011/06/1912/01/19 -282.79 0.00 0-.00 -282.79 c/ CFjEDIT f 2292162011 11115/2010/31/2011 /25/20 142.68 0.00 0`.00 142.60 ✓`� SUPPLIES 22921.62012.1/ 11115/2010131/20j11125/20 29.99 0-00 0.00 29.99 SUPPLIES 6.1� 'WVr iLs ! 13.-$7 frraudj'`'� 2292162013 / 11115120 10131/20 11125/20 59.4E 0.00 0100 59.48. a SUPPLIES "�','�,Nr'� SJ�VjA1�cs''Lf•'dl Fraejk 2202345230 V1 11115120 11101/20 11/26/20 193.95 0.00 0.00 193,98 '✓' SUPPLIES file:!//C:/Users/ltrevino/epsilmemmed.cpsinet.cotn/u88125/data_5/tmp cw5report37181... 11/16/2023 Page 9 of 15 2292345232 ✓ 11/15/20 11101/20 11/26/20 33.17 0.00 0.00 33.17 yi SUPPLIES �y,GJIB CUrp'4it-S 12.7-V? F 66JK4 2292346234 w' 11/15/2011/0112011/26/20 2450 0.00 090 24.50 ✓f SUPPLIES 2292345237u,/ 11115120 11101120 11/26/20 6,630,19 0.00 0.00 6,630.19 V` SUPPLIES 2292346238 -f 11/15/20 11101/20 11126/20 242.31. 0.00 0.00 242.31. s.f" SUPPLIES 141.0'j sUVPDcas jll-gfe Fwve jkk 2992345228 f 11/1512011/01/2011/26/20 68.68 MID 0.00 66.68 V" SUPPLIES V34D eaarir6a 1 6.14 FwL�-J � 2292345235 ✓'r 11115/20 11101/20 11/26120 1,436.13 0.00 0.00 11„436.13. -Z SU/pPLIES 2292345233 ✓ 11116120 11/01/20 11126120 75.00 0.00 0.00 75.00 a✓ SUPPLIES .. 2292345236 11(15/2011/01/2011/26120 26.32 0.00 0.00 26.32. SUPPLIES 1,4E Swp VVhd& 11--t,u Fv-Lc�O- 2292519624 ✓± 11(16/201 110PJ20 11/27120 35.64 0.00 0.00 35,54 SUPPLIES 11.3& "F jleA 12-1 is Fre:,.Ooa 2292519626 ✓J 11115/2011102/2011)/27/20 23.78 0.00 0.00 23.78. SUPPLIES 1.1.36 a4'Vr'tw A 1.1,41 Fw*4g)w ' , 2292519625 ." 11115/2011/02120111/27/20 23.76 0.00 O.00 23.78 SUPPLIES 11-34 SrV(1Ga= 1 &v4-3k.4- 2292990982 1/ 11115/2011106120 12(01/20 47,58 OM 0.00 47.58 ✓ SUPPLIES �+ 2292990981 e/ 11/15/2.011/0612012/01/20 47.58 MO 0.00 47.58 '✓� SUPPLIES 2293191253 / 11/15120 t1/07/2012/02120 26,34 0.00- 0100 20.34 SUPPLIES 2,43 &'frlia ) IA -Al Irrvi.. awk 2293191252 ✓ 11/15120 11/07/20 12102120 9.36 0.00 0.00. 9.36', SUPPLIES ,. 2293191254 YU15/2011/07/2012/02/20 25,09 0.00 0.00 25.09 SU/p. PLIES Ul9 �"VV1(-AI VJ-3k ft'6DW- 2293382036k 11/15/2011/0812012/03120 246.19 O.W 0.90 246,19'✓' SUPPLIES 2293382037�/'U 11/tSI2011108/2012103120 282.79 0.00 0.00 28219 ✓ SUPPLIES 2293382038' „% � 11115/20 1110812012103120 208.27 0.00 0.00 208.27 SUPPLIES 2293382035 11/15/2011108/20 12 O3120 83.01 0.00 0.00 83.01. ,,,f SUPPLIES r)lg-g"i tnfplia j1^N-t?. 2293382034 ✓ 11115/2011/6812012/03/20 127.12 0.00 0.00 127.12'. SUf PLIES 2293382041 .✓J 11ft5/2011/08/2012/0320 4,266.44 0.00 0.00 4,266.44 ✓f SUPPLIES , 2293382032 J'" 11/45/2011/08/2012/03/20 7.14 0.00 0.00 7.14 �+' S PPLIES 2293382040. 293382040 11/15120 11108/20 12/03120 1,415.78 0.00 0.00 1,415.78 ✓- SUPPLIES 2293382045 j( 11/15/201 t/08/2012/03/20 57.00 0.00 0.00 57.00 ✓"' 7PLIES 2293554975 i'111512011/09/2.012104120 51.63 0.00 0.00 S11.63' file:///C:/Users/itrevinolepsilmemmed.cpsinet.coralu88125/data_5/tmpicw5report37181... 11 /16/2023 Page 10 of 15 8l1PPLIES .. 2294237960 �/' ti 115/20 11114120 12/05/20 2435 0.00 0..00 24.66 SUPPLIES Vendor Totals Number Name Gross Discount. No -Pay Net: M2470 MEDUNE INDUSTRIES INC 15,817.53 0.00, 0.00 15,817.53. Vendor# Vendor Name Class Pay Code 10904 MERCK SHARP & DOHME CORP y/ Invoice# Cc ment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net. 70165606 - ✓ 11116/201110912012109/20 2,376.65 0.00 0.00 2,376.65 v""f INVENTORY Vendor Totals Number Name Gross Discount No -Pay Not 10904 MERCK SHARP&DOHME CORP 2376.65 0.00 0.00 2,376,65 Vendor# Vendor Name Class Pay Code M2685 MICROTEK MEDICAL INC ✓` M Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount No -Pay Net 6338747722 11/01/20 06107/20 07/07120 380.24 0.00 0.00 f 380,24 1--' SUPPLIES 6,940717001 -/ 1.1/01/20(19/1312010101/20 380.24 0.00 0,00 380.24 SUPPLIES 63416348441/ 11/0112010131/2011130/20 380.24 0.00 0.00 380.24 SUPPLIES. Vendor Totals Number Name Gross Discount No -Pay Net M2685 MICROTEK MEDICAL INC 1.,140.72 0.00 0.00 1,140.72'. Vendor#Vendor Name Class Pay Code 10536 MORRIS & DICKSON'. CO, LLC 1 Invoice# Tran Dt Inv Dt Due Dt Check D,Pay Gross. Discount No -Pay Net /Comment 1260499 ./ 11114/2011/0812011,18120 4,20830 0.00 0.00 4,208.70 ✓'`. JINVENTORY - 1264739 ✓ 111141201110812011/18120 232.99 0.00 0.00 232.99 .111' ,)INVENTORY 1266676 ✓ 1 1/14120 11109/20 11/19/20 64.66 0.00 0.00 64.66 ✓` INVENTORY 1266517 tJ,/1111412011f0912011f19120 81.50 0.00 0.00 81.50 INVENTORY 1269509t//11114/2011109f2011119/20 310.72 0.00 0,00 31.0.72.e/f /INVENTORY 1266618 ✓ 11/14/20 11/09120 11/19/20 96.97 0.00 0'.00 96.97 INVENTORY d 1269510 ,/ 11/1412011/0912011/19/20 t40.89 0.00 0.00 140.89'� INVENTORY 1269511 f 11114/20 11109/20 11/19120 662.32 0.00 0.00 662.32 ✓ INVENTORY CM73123 ✓ 11 fl4120 11/10/20 11/20/20 -10.13 0,00 0.00 -10.13 tl. ,(CREDIT 1274429 �f 1111412011112120 11/22/20 3,45191 0.00 0.00 3,453-.91'. INVENTORY 1275617 y/ 11/1412011f12/2011122/90 26.54 0.00 0.00 26.54 ✓` /INVENTORY 1275618 r'- 11114/20 11/12/20 11/22120 6,250.58 0.00 0100: 6,250,58 yr" INVENTORY 1281351 J 11114/20 W13/2011/23120 293.10 0.00 0,00 293.10�/'' file:HIC:/Userslltrevinolepsilmemmed.cpsinet.comlu88125/data 5(tmp_cw5report37181... 11/16/2023 Page 1 I of 15 INVENTORY 1278282 ,1 11/141201111312011/23/20 205.55 0.00 0.00. 205.55 /INVENTORY 1281350 ✓ 1111412011/13/2011/23/20 66.97 0.00 0.00 66.97 INVENTORY 1278281 11114/20 11/13/2011/23/20 6.63 0.00 0.00 6.53 ,rINVENTORY / CM73454 11/15/20 11/13/20 11/23/20 -259.25 0-.00 0.00 -259425 CREDIT CM73455 v1 11/15/2011/13120 11/23/20 -77.23 0.00 0.00 -77.23 CREDIT 1279509 �,/� it/15/2G11/13/20 11/23/20 425.95 0.00 0.00 425.95 ✓`� INVENTORY 1286528 ,.� 11116/2011/1412011124/20 809.23 0.00 0.00 809.23. Iy�1VENTORY ,. 1283711 h✓ 1111.5/20. 11/141PO 11/24/20 468.65. 0.00 0.00 468.65'..% INVENTORY ,. 1286529 11/15/2011/14/2011/24/20 328.08. O'-00 0.00 328.08: bf INVENTORY r� 1283714 11115120 11/14/20 11/24120 152.44 0.00 0.00 152.44 c+'r fINVENTORY 1285305 ✓ 11115/20. 11/1'4/2011/24120 135.19 0.00 0.00. 135.19 r✓f INVENTORY/ 1286176 ,/ 11115120 11/14/20 11124/20 US 0:00 0,00 2.55 ✓ JNVENTORY, CM7400fi 11/15/2011I14/20 11/24/20 -2,65. 0'.00 0.00- -2.65: CREDIT Vendor Totals Number Name Gross Discount No -Pay Net.. 10536 MORRIS & DICKSON CO, LLC 18,074.86 0.00 0.00 18,074.86 Vendor# Vendor Name Class Pay Code 12096 NEOGENOMICS IABORATORIES ,/"r Invoice# pomment Tran Dt Inv Dt Due Dt Check. D Pay Gross Discount No -Pay Net 6925554 1/ 11/15/20 10131/20 1.1/30/20 2,846.00 O'.00 0.00: 2,646.00 f LAB SERV Vendor Totals Number Name Gross Discount No -Pay Net 12096 NEOGENOMICS LABORATORIES 2,846.00. 0.00 0.00: 2,846.00 Ventlor# Vendor Name j' Class Pay Code 11472 OCCUPRO. LLC � Invoice# Comment Tran Dt Inv Dt Due Ot Check 0Pay Gross. Discount No -Pay Net. 33069 11/1.512011107/2012/01/20 472.50 0.00 0.00' 472.50' MONTHLY LICENSE Vendor Totals Number Name Gross. Discount No: -Pay Net 11472 OCCUPRO LLC 472.50 0.00 0.00 472.50 Vendor# Vendor Name�± Class Pay Code 11155 PARAREV u` Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross. Discount. No -Pay Net 908801 f/ 11/15/20 11/01/20 12/01/20 3,064.00, 0100 0.00 3,084.00 i REVENUE INTEGRITY PROW Vendor Totals Number Name Gross Discount No -Pay Net 11155 PARAREV 3.084,00 0.00 0.00 3,084.00. Ventlor# Vendor Name Class Pay Code file:IHC:/Userslltrevinolcpsilmemmed.cpsinet.comlu881251data_51tmp_cw5report37181... 11116/2023 Page 12 of 15 11932 PRESS GANEY ASSOCIATES, INC. ✓/ Invoice# Comment Tran Ot Inv Dt Due or Check D Pay Gross Discount No -Pay Net IN000610969 / 11/14120 09/30/20 10/30/20 2,729.72 0.00 0.00 2,729.72 Vendor TotalsNumber 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 14544 PRINT. RITE: INC. Invoice# Comment Tran Dr-- Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net . f 23540 11/1512011109/2011/29120 240.76 V 0.00 0.00 240.76 ' SUPPLIES ,. Vendor Tota4 Number Name Gross Discount No -Pay Net 14544 PRINTRITEINC. 240.76 0.00 0.00 240.76 Vendor# Vendor Name Class Pay Code 11080 RADSOURCE „/ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay Net SC32091223 ,/ 11/15120 i 1/12/2012/07/20 1,781.67 0.00 0.00 1.,791.67 BERV Vendor TotalsNumber Name Gross Discount No -Pay Net 11080 RADSOURCE 1,791..67 0,00 0.00 1,791,.67 Vendor# Vendor Name Class Pay Code 11764 ROBERT RODRIQUEZ: ✓/ Invoice# Comment Tran Ot Inv Dt Due Dt Cheek D Pay Gross Discount No -Pay Net 111323 111/16/2011113/201112y0/20 71 A9 0.00, 0.00 71 .49 TRAVEL REIMB' VAV l +, pid�N .rS .Upa Etl,o"K,+ din, AJp'2 -FW Vendor Totals Number Name. CXLAjv of eu+taue Swse fW elvasc idr�ss Discount No -Pay Net. 11764 ROBERT RODRIQUEZ 71.49 O.OG 0.00 71,49 Vendor# Vendor Name Class Pay Code 10927 ROSHANDATHOMAS Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross. Discount No -Pay, Net 111623 1..1/16/201111:.6/2011/25/20 168.37 0.00 0.00 166.37,W--^``� TRAVELREIMB.-WA11d1 -11N "(1pS6ttiretl{' ON 114y 14.01.5 , Vendor Totals Number Name Gross Discount No -Pay, Net 1�0927 ROSHANDA THOMAS 166.37 0.00! 0.00 166.37 Vendor# Vendor Name / Class Pay Code 10936 SIEMENS FINANCIAL SERVICES y,r Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gmss. Discount No -Pay Net 56382400006055 11114/20 10/25120 11/14/20 4,038.24 0.00 0.00 4,038.24 ✓`' LEASE Vendor Totals Number Name Gross Discount No -Pay Net 10936 SIEMENS FINANCIAL SERVICES 4,038.24 0.00 0.00 4,038.24 Vendor# Vendor Name Class Pay Code 12288 SPBS CLINICAL EQUIPMENT SRVC ✓,r Invoice# Comr9ent Tran Dt Inv or Due Dt Check Dr Pay Gross Discount No -Pay Net INVO19731123 J 11/14/20 11/01/2011/02/20 0,458.59 0.00 0.00 9,456.59 CONTRACT Vendor Total$ 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 Code S3960 STERICYCLE,INC J Invoice# Comment Tran or Inv Dt Due Ot Check. D Pay Gross Discount No -Pay Net file:///C:/Users/Itrevino/epsi/memmed.cpsinet.com/u881251data 5/tmpiew5report37181... 11/16/2023 Page 13 of 15 800,9012852 ✓ 11116/20 10/18120 11/17120 2,795.69 0.00 0.00 2,795.69 WASTE Vendor Totals Number Name Grass Discount. No -Pay Nat S3960 STERICYCLE, INC 2,795.69 0.00 0.00 2,795.69 Vendor# Vendor Name Class Pay Code S3940 STERIS CORPORATION M Invoice# C�gmment Tran Dt Inv Dt Due Dt Check D Pay Gross. Discount No -Pay Net 11669790 n 11/15/2010113/2011ID7120 2,235.86 0,00 0.00 2,235.66'�r`` SS PPLIES 11687594 ,J 11115/20 10119/20 11/13/20 199,90 0.00 0.00. 199.9O SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net. S3940 STEMS CORPORATION 2,435.56 0.00 0.00 2,435.56 Vendor# Vendor Name I Class Pay Code 10735 STRYKER SUSTAINABILITY ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4836749 i„/ 1111512011107120 1PJ07120 2.224.64 0.00 0.00 2,224.64 ✓` SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABILITY 2-,224.64 0.00 0.00 2,22444 Vendor# Vendor Name Class Pay Code 14564 TRANSCAT INC Invoice# Oomment Tran Dt Inv Dt Due Ot Check Dr Pay Gross Discount No -Pay Net 11.803885 "`� 11/01120 09/15/2010115/20 1,267.29 0.00 0-00. 1,267.29' TRAVEL/PARTS , 3101482. of 11./01/2009/21/2010121/20 505.00. 0.00 0.00: 505.00 N` CALIBRATION 11803964 ✓/11/01/2009/21/2010121/20 1.740.00 0.00 0.00. 1,74000' PARTS/ONSITE SERV FEE ,. 3118075 f 11/011201010412011/04/20 530.00 0.00 0.00 530.00 CALIBRATION Vendor Totals Number Name Gross Discount No -Pay Net 14564 TRANSCAT INC 4,04229 0.00 0.00 4,042.29 Vendor# Vendor Name Class Pay Code 13616 TRIOSE, INC ,f Invoice# Comment Tran. Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Not TRI161152 ✓ 1.1/14/2.008123/2009/07/20 172.48 0,00 0.00 1,72.48 ..✓ FREIGHT TRI104376 f 11114/20 09/27/20 10112120 258.13 OM 0.00 FREIGHT TRI164896 11114/20 10103120 10/18/20 69.29 0.00. 0.00 69,29, FREIGHT / TRI65460 / 11114/2010110/2010126/20 46.79 0.00 0.00 4619✓f FREIGHT TRI16603P Z 11/14/20 10/17/20 11101/20 77.93 0.00 0.00 77.93 ✓r. FREIGHT TRI167729 11 /14120 11/02120 11117/20 450.29 0.00 0.00 450.29,✓ FREIGHT TA1168048 ✓ 11/14120 11/07/20 11/22/20 70.00 0.00 0.00 70.00 FREIGHT Vendor Total=_Number Name Grass Discount No -Pay Net file:///C:/Users/ltrevino/cpsi/memmed.cpsinet.com/it881251data_5Amp_ew5report37181... 11 /16/2023 Page 14 of 15 13616TRIOSE, INC 1,144.91 0.00 0.00 1,144.91 Vendor#Vendor Name ,.,/ Class Pay Code 11067 TRIZETTO PROVIDER SOLUTIONS "" Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 35FK1123001/ 11/15120 11101/20 11126120 1,475.80 0,00 0.00 1,475.80 STATEMENTS/ANNUAL FEE , Vendor Total: Number Name Gross. Discount No -Pay Net 11067 TRIZETTO PROVIDER SOLUTIONS 1,475.80 0.00 0.00' 1,475.80' Vendor# Vendor Name Class Pay Code / U1064 UNIFIRST HOLDINGS INC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 2921017469 ✓ 11/14120 11/02/20 11127/20 244.19 0.00 0.00 244..19 f.. LAUNDRY 2921017464 ,// it/1412011/02/2011127/20 1.04,00 0.00 0.00 104.00 t/" LAUNDRY 2921017465 / 1.1/1412011/02/2011/27120 222.15 0.00 0.00 222.1.5 ✓`�R LAUNDRY 292t017471 V 11/1412011/02/2011/27/20 102.46 0.00 0.00 1OZ46' ✓'f LAUNDRY 2921017466 V,r 11/14/20 11/02/20 11127/20 2,319.10 0,00 0.00 2,31.9.10 t,/ LAUNDRY 2921017466 1111412011102120 11/27/20 298.08 Oleo 0.00 298.08 �6 LAB NORM 2924017487 k,/ 11/14/2011/02/2011/27J20 29.95 0.00 0.00 29,95 LAUNDRY 2921017470 ✓ 11114/2011102/20 11/27/20 228.21 0.00 0.00 / 228.21. J LAUjJDRY ,. 2921017661 V/ 11/1412011/06/2012/O1/20 91.80 0.00 0.00 91.:80 g,✓.°'� LAUNDRY 2921017660 .// , 11/14/20 11/06/20 12/01/20 2,749.55 0.00 0.00 2,749.55 ,/' LAUNDRY 2921017984 „/ 11/14/201110912012/04/20 191.38 0.00. 0.00 199'..38 LAUNDRY 2921.017989 "'� 11/1.4/2011/09/20 12/04/20 228.21 0.00 0.00 228.21 LAUNDRY 2921017983 ✓ 11/14/2011/0912012104/20 109,05 0'.00. 0.00 109.05 LAUNDRY 2921017988 ,i 11/14120 11/09120 12104120 244.19 0,00 0.00 ,. 244.19.."` LAUNDRY 2021017986 y// 11/14/201.1/09/2012104120 29.95 0-.00 0.00 29'.95. LAUNDRY 2921017985✓ 1111412011109/2012104/20 2,209.38 0.00 0.00 2,209.38 LAUNDRY // 2921017990 11/14/20 1110912012/04/20 102.46 0,00 0,00 102R,6 LAUNDRY 2921017987 ✓/ 11114/2011/09/2012/04/20 298,08'. 0.00 0100 298.08, L'_' LA NDRY 2921018182 11 /14/20 111131012/08/90 121.02 0.00 0.00 121'..02 LAUNDRY 2921018181 ,i/ I I/W2011/1312012J08/20 2,696.73 0.00 0.00 2,696.73 LAUNDRY file:///C:/Userslltrevinolcpsilmemmed.cpsinet.comlu88125/data 5!tmp___cw5report37181... 11/16/2023 Page 15 of 15 2921005837 / 11/15/200610812007/03/20 188.64 0.00 0.00 188.64,�✓ LAUNDRY 2921008079 f 11/15/20 07/06/20 07/31/20 29.75 0.00 0.00 29.75 LAUNDRY 2921008965 y/ 11115/20 07/13/20 08/07/20 29.75 0.00 0.00: 29.75 _ ' LAUNDRY .. 2921009483/ 11/1612007/20/2008/14/20 29.75 0,00 0.00 29,75, LAfUNDRY 2921010039 11/15/20 07/27/20 08121120 ✓ 39.35 0.00 0.001 39.35 Lll`' LAUNDRY 2921010578✓/ 11/15/2008/03/2008128/20 31.85 0'-OQ 0.00 3Y'..85✓! LAUNDRY / 2921011102. 11/16/20 08/10/20 09/04/20 63.40 Q.00 Q.00 83AO LAUNDRY / 2921011650 �,+ 11/1512008/17/2009/11/20 29.96 0.00 0.00. 29.96 ✓J LAUNDRY .. 2921012180 ,/✓11115/20 08/24/20 09/18/20 43.32 0.00 0,00 43,32 LAUNDRY 2921012658 f 11/15/20 08/31 /20 09/25/20 29.75 0',00. 0.00 1 29.75.,/ LAUNDRY 2921013204 1! 11115/20 09107/20 10/02120 29.75 0.00 0.00 29.76 LAUNDRY ,. 2921013762 ✓ 11/15/2009l14/2010/09/20 29.75 0.00 0,00 29.75 11/ LAUNDRY r 2921.01430t . 11/15/20 09/21/20 10/1.6/20 61.73 0.00 0.00 61.73 LAUNDRY 2921014820 f 11115/20 09128/2010/2320 34.26 0.00- 0.00 34.26 ✓� LAUNDRY 2921015353 ✓f11/15/20 10/05120 10/30120 62.91 0.00 0-00 62'.al LAUNDRY Vendor Total: Number Name Gross. Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 13,373.86 0.00 0.00, 13.373.86: Vendor# Vendor Name Class. Pay Code V1471 VICTORIA RADIOWORKS, LTD Uf W' Invoice# Comment Tran DL Inv Dt Due. Dt Check D-Pay Gross Discount No -Pay Net / 23100170 d 11116120 10/31/20 11/30/20 160.00 0.00 0.00 160.00 V ADVERTISING .. Vendor TotalE Number Name Gross. Discount No -Pay Net V1471 VICTORIA RADIOWORKS, LTD 160.00 0.00 0.00 160.00 Vendor# Vendor Name Class Pay Code / 11018 WEBPT, INC rJ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV-452620✓ 11/15/20 11/12/20 1111'3/20 9,342.00- 0.00. 0.00 9,342.00 ,- PROVIDER. SUBSCRIPTION .. Vendor Totale Number Name Gross. Discount No -Pay Net. 11018 WESPT.INC 9,342.00 0.00 0.00 9,342.00 Report Summary AWAGM am Gross Discount No -Pay Net NOV 16 2023 389,913.63 0.00 0.00 38%Q13.63 CALlHou% Ct1VYNTM: �ENAS file:/1/C:lUserslltrevinolcpsilhemmed,cpsinet.comlu881251data_51tmp_cw5report37181... 11/ 16/2023 8, 704 4, 8°LA1,t, 4'= CITIBA 2 5 7 • 5 I_I ati Date Date WICG Reference Number 'CARD Account Statement commercial cars mmunt COWI;CALHOUN.CCIINTYMNC Account Inquiries: Tall Free: 1 jBWj-248-0653. International 1-(E04)-954-7314 AccountNumber: TonrrrY: 1-(M-5t15.7278 I Invoice# 36131104084 Pest DueAmount Oiepulcd Amount Amount over Credit Limt fanlmum Payment Due. Send Notice of Billing. Emors and Customer5ervi.m Inquiries for CITISANK. N.A., PO BOX 6125,SIOUX FALLS SU 57117-6125. Cardholder Transactions Account XXXX•XXXXXXXX.9467 ROSHANOASSHOMAS Total Activity:.$2,117.73 Post Trans Date OaW MOO Referame Number 11N04 10103 9399 (1St3437327760W, N1000M978 1N04. 1N04 8999 55432863277205554578391 2 ANIA-CREDENTIAUNG 800.6214MSIL 1010E 10194 9399 05134373278601)(06196423 3 NPOBNPI)BARSA.GOV FAIRFAX VA N100054680. 10l06_ PF VA,,ftNail7X HOSPITALASSOC AUSMN. TX 8r'704.4r_ - f C ~ . Ij v 'J1 '" AN119davi 4 44 4 5 ' 3 S•3 Page of4 . _NOTICE: nstJs i ke a4*41asv a by 0 tTe� 8,446.5,_ , Number atAccount 1 8 7 - Z, Payment Due. Date. 0 13 IrMSiv 1 8 - 8 5 PoE'+Vu+ 25.7., 51 T PHo -li, dool y 4 4 5 3 3 CC001 CALHOUN COUNTY MMC RHONDA KOKENA STE A 202 S ANN. 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N100277822' 10112 1CM1 4722 5E432863284200953813165 9 OrbA27267M85166415 ORBITZ.COM. WA. 98119: USA. 41A4.. 10112 1MI 5912 B543E87328516285730335 10 [aWRIMISRX503B LEDGEWOOD NJ USA 370.00. 1824819 10N2 lafl2 8999 6543286328E20100M55351 11 AMA'CREDENTIAUNG.. 800-621-MMIL SM11 USA 88.00' 1011E 10H1 3001 55417343287872873344460 12 AMER ODISMOSS98f1.SEAME WA. 85034 USA, 568A0 RSHERK7IRISTOP DEPARTURE: 10/1723 OKCAA. G DFWAA G CRPAA G DFWAA G OKC 10F16 10M3 9399 051343732876=39432752 13 NPDBNPDB.HRSA.GOV FAIRFAX VA 22M3 USA. 67.50. NIOM700 10116 10113 9399 051343732876COM9432836 14 NPDB NPDS.HRSA.GOV FAIRFAX. VA 22033. USA 2.90 N1003629M 10t19 10118 3665 5543E873292162924574910 15 HAMPTON INNS PORT LAVACA TX 77979 USA 134.47 009822M CHECKINAW1712023 00962250 1023 1020 8699 75266863293587CO2974324 16 TEXAS MEDICAL ASSOCIAT 512370-1492 TX 78701 USA 300.00. AHEAFC4ECE6 1027 1=8 9399 051343733006=7422220 17 NPDBNPDBJiRSA.GGV FAIRFAX VA 22033. USA 2.50 N100730886 1=7 1W27 8999 654328SM0020M1460447 18 AMA-CREDENTNLING 800Q14OXIL W61.I USA 44.00 1=1. 10131 8999 55432863304206B09459422. 19 ABA-CREDENTIALING 8004121.83%IL 506" USA 44.00 1IM2 11A11 3685 5543687330lMM2750257 20 HAMPTONINNS PORT LAVACA. TX 77979. USA 134.47 00wol l CHECK IN. IMI2023 '. - --. _ 00957011 FINANCE CHARGE SUMMARY YcurAnnual. Percentage Rate(APip is. the annual interest rateonyoun a unl. TyPeo}Balanoe Annual Percentage Rates PerladicMe" Batimoe Suh)eetta.FinanaeCharge9 PURCHASEANOFEES 10.25% 0.8542%(M) $0100, CASH 10.25% 0.8542%(M), %00, -(D)Dally Rsm (MI t4aMIYRaN Page 3 of 4 Account, XXXX-)O=-XM-2799 Page 4 of 4 CITIBANKBIL CORPORATE CARD Account Statement CanmarcialdN'Acmunt R03HANOA87110MA6 Account Inquiries: p4�,srJ III p� Toll Free: 1-(800) 2AS46M :1 H:rN Intomotional: i-(904).Q.7314 ,Account Num6eT:: XXXX-XXXX-XXXX- 4457 TDDMTY: 1-(8T7)•5053727S '.. �coen aayanaumri ... ,_. SC Send Notice N, .. PO B X 61 5, S Customer Service 17.612E to: boys In rentCfosing Date _ tU_08/2523 CITIBANKNK N,A, PO BOX 6125, SIOUX FALLS SD 571174i125 boys fn Sllhn9Penad ....-..31 Transactions Part Trans nate Data MCC Reference. Number Descrip6aMLacation Amount ............ ...... • NOTICE MEMO ITEM(S) LISTED BELOW '...... • 1504 1OF03 9395 M134373277600037086941 1 NPOS NPDS.HR9A.GOV FAIRFAX VA 22039 D9A. '•/ NIODM9879 a,/?:0 MINI 10104 893E W4MBEW720M46711391 2. AMACREOENTIALING 8005214IMS A. 80611. USA Vi011 ` 10105 11904 939E C5124373278SM6398423 3 NPOS NPDBJIRSA.GOV FAIRFAX'. VA 22033 USA f 2SO w IWO 11104 8062 654673TW78200873000024 N10ON4580 219.95 4 TEXASHOSPITALASSOC AUSTIN TX 78701 USA. y 10109 10/OS 9399 05134373I80Sa0039250177 5 NPOBNpomREA.GOV FAIRFAX VA 22033. USA �J 91 -' N1OM25299 ! TOM 101077 8999 55432663280209486444202. 6 PMA'CREDENTIAUNG B00-6214B335It. 60511 USA 10/12 WIT 9392 051343732856ODD3763301S 7 NPDB NPDB.HRSA.GOV FAIRFAX VA. 220M USA -14441 ,r.%!St -. N700277657 10112 10111 9399 051343732856=7633197 6 NPOB NP0RHRSA.GOV FAIRFAX VA 22033 USA ✓7 �i' N100277922 102 IWI 4722. 5543286378420095W13165 9 OrbilS`726753851S6415 ORSITZ.COM WA 98110 USA. ,�1.44. 1/2 IUM2 IWI1 5912 554368732661628S7303335 10 IMPRIMISRX.5mB LEDGEW000. NJ USA u070.00: `-Wl 1824919 10M2 1LV72 8999 E54329632852010D6365351.. it AMR•CREOENTNLING 600-621ffiAS'.IL 60611'. USA 10716 WIT MOT 55417343ZS787287334446D 12 AMERICAN 0018039090811 SEATTLE WA 86034. USA falAD. ,r nSHER7CHMSTOP DEPARTURE: TW17r2a OXOAA G DFMAA G CRPAA G DFWA4 G OKC % 1N16 10t13 0399 0134373267MM39432752 13 NPOBNPOB.HRSAGOV FAIRFAX VA 22033. USA J 6150 NTC03827o9 10116 IOM3 9399. 05124373287500039432836 14 NP05 NPnB,HREA,GOV FAIRFAX VA 22033 USA .,1'z.m ' � NSC036Z908 _... NOTICE.SEE REVERSE SIDE FOR IMPORTANT INFORMATION s`o CITIBANK, N.A. (�' PO BOX W25 "�� SOUX FALLS SO 57117-5125 ROSHANDASTHOMAS 202SANN ST PORT IAVACA TX 779794204 Pagel a14 Account Number XXXX-XXXX-XXXX-9457' Statement Closing Date November03,.2023 000079050'40 Not. antnudce,. Foryourrecordsonly.. • RemrtaK tm Stdar CardMmldylddy: puralepliorm Mwae open"q day. • Paymmfa:.Velmpy molmapa(mmdbywr MdWNudlybdlodmdaaawkmlha 24liamcaday. pltMOCultomorgmvao WnMKa6nUMlmraPedptd an theharld usiHH Mange. RHOm Hand Metaarea agammidas do natMue Me Cmaeaager Me sdamantta repo{ a fan craden CHI Caryomx bud. mMe payment fwbde ambled Wr oorlhddem: M payngby WW,,. Hanle WtW anaoientwaasiend. obwa reeyaurausnntnuMMo,. na MmtrClMNxk. Par Knhagyhdled'aa4Ymd,DIBOM. PM'wm Mmne to real'an CadpanyNQCka . CenlAoldocGRtlltLMer EarhbduholtlaMson bgAiJUWndt Glge(e padion ar WallWMndderbalalcea. If. w... rentim ynemm Pmpa'Wm aaur' "loh may be used far Caah Arlmacebl. xhkh. a Me mabnum amount Met Uv labcoaamg fads$ by p.m Eaam Mae, it vell be crNitedas of Mot day,. 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Femmany fdawme, pranpM to ad - a m ywf ewwm • Nb,r�d6mora Or p(galPlb Pam,l YwfpN: YOY Ma AepenaAl6br NIMMM • a..ImlamrW Yaaeaaa'Bryla N.anaa0.MB.a6pNainQNaf6YmaM8 tlm lapummmdtl hadMXaaMyanachumtku,ban1. net moo o. orMm ahempt ond! HeMelwtdwtheat2dh.alCIrdold. We o11 as o'lannad aµ. lawfrw4 dOloolo "rawx Ma Ices Ant been. atmtrca, ri for bnahad, end.. mud. ul W...by Mo Mavrtlud Camholda_ WavAll heann" 110'.ahardae.lbluMame'a, nehmdit,He Ift, Weheyou,mebaa, MampR It W. aodood mad Ntidaurdrods Mmd, ftl He Mt Mela tlaryeaaa aWlLMxnknasekon pvcnsy, Manuel . It you rdumed mednandta mdmOehM ndetlRnpP.xnlrh bosndynt Uedt alp,. 6 ml Slmxa.. To begin Me dapae Ia9duMlr Prowm,. dcM been pmad, Vaaae alnM'.Atlaralmn.Medalo..Ifwas:LbuN.If It Mond NMamnamnman(n bmnPmhe.MMeAcmuntbytlpn.ldrvanlampyNanuadksliMadn m Ra2e2Mf4 Account., XXXX-XXXX XXXX.9457 Transactions (can't) Post Trons ...._.:... .... ....... ' Daro Odle MCC Refe[ence Nµmhnr DescljptloNLomhan Amount 10M9 10178 9665 55C1667329215P924574970 15 NINNS PORT LAVACA TX-llll 77979 USA �•, 134.47 009622 CHECKI CHECK IN:70ry7/2023 MIMED 16/23 10120 8699 75265863293687002874324 16 TENASMEDICALASSOCIAT 512J70.1492TX: 78701. USA mom, ,6' ' AIIEAFC4ECE8 10W 10126 9399 05134373300800037422220 17 NPDBNPOS.HRSAGOV FAIRFAX VA 22033 USA Z50pf�%�' N1007306SS 1N27 10127 8999 55932863300205581450447 18 AMA'OREDENTL LNG 600.6214MS IL 60611 USA.. 44.00Y -,' , 10131 10131 6999 554329633042OM9459422 19 AMA'CREOENOIWNG 800-621.83351L 60611 USA. 44.00 11/02 11/01 3666 5543ES73306163WZ750M 20 HAAPTON INNS PORT LAVACA TX 77979 USA 134.47�y.;' 00957011 CHECK IN: IQG112023 CA7GNQGlrxL�g�W�l��7&h9; Page 3 of 4 Account: XXXX-)=-XXXX•9457 Page 4 of 4 I 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) 5552-0312 . FAX: (361) 5(f52-0312. Vendor Name:' , 13�`l't Date: Vendor Address: Vendor Phone #: Vendor Fax #: P.O. # Account # Initiated By: coon rfY4V1 bate Required FxperiscH Department Deliver To line No. Qty. Catalog Number Description Unit Cost Unit meas. . Extended Cost g''} `•� ,, �` z C 4 5 ' r w _ N Pb i r� G F 4 aut r --'• t r^ v.1:6 1M%t1:. tL:r- v p Qp vll : — uv r. i Est. Freight t. Total Cost TOAL EINT NOTES: 1 t Contact: Date: Dept. Director Quoted By: Dir. Nursing: Buyer. ET.A. Dir. Clinical Services CFO Administrator &� 7,017-v MEMORIAL MEDICAL CENTER PURCHASE OPMER Bill To: 815 N. VIRGINIA ST PORT LAVACA, TX 77979 PHONE: (361)552-6713 FAX: (361) 552-03I22 . Vendor Name: C `f rb�/t Ill V4 - Vendor Address: Vendor Phone #: Vendor Fax #: Ship To: 815 N. VIRGINIA ST.. PORT LAVACA, TX 77979 PHONE: (361)552-6713 FAX'. (361) 552.0312 Hate: ( � �;)v P.O. # Account# Initiated B, Daft Required Expense# Department Deliver To. Form#9401 Line Qty. Catalog Num6a Description No. Unit Cost Unit. Extended. Meas. Cosl MOM. @ 2"ra-"tJ f)-- ' 4 3 €€rr77 yyyy} SZ 9 L<Yt �1 tlY avvwv. telt, �U'9'hi� r3 t L to Est. Freight Est. Total Cost NOTES: TOTAL COST Comact: Date: Dept Director Quoted By: Dir. Nursing Buyer. E.T.A Dir. Clinical3ervices i I I Administrator MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 8I5 N. VIRGIMA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX:' (361)552-0312 Vendor Name:, { •((A2— Vendor Address: Vendor Vendor Ship To, 815 N. VIRGINIA ST, PORT LAVACA, TX 77979 PHONE: (361)552-6713 FAX-- (361)552-0312 Date. P.O. # Account# Initiated B Date Eteg ? 9t.' Expense# Department Deliver To Form:N9401 _ 9 t •J „ �. it. .r Cr � 2 ,jtI .Ijr a 6 et " h I' Line No. Description �•-, Unit Cost Unit. Extended Cast. t fff '.E. CV✓�/2}��( :- --✓ /��jF' �'�ft:' V .'30,( l"11Y SF_i...•IL..'." ��-1 `. .".''"d'..i�Y:•�%' . 3 �1'`r,)t/'' [t bl /� },,,/// /) 1% try, NIPD6 �� 1 �f f{•il r/ 1"r�. `G! iP'7) ` 1. i V1 f !$Gf.1 : l..Y/° 1 �... �,<X �`4'F.ti :!t` 6 -4V)tt) It � e _ 25t} j C1 H I t ! r 2 5 'L Y v W"''6b{ `' s 1�A A'i 10 Est. Freight Est. Total Cost TOTAL. COSTS l�-. 1i 11"1" Contact: Date: Dept. Director Quoted By. Div. Nosing Buyer. E.T.A. Mr. Clinical services Administrator ..§� \{04 ■ § ri ■§a. �i / •}��-_ �22 .A ®® noA mvi _ ,. s ma _a Ao # dqo r sou 9 , "r,mw Mw, k. a . s e ®s VN aj�so. # K■ i l2R-xa . 5.ur - & . . !D r ¥. ,,.u, - 35 t-I a u 2 4&,. 3 : RECEIPT NENOAIA7. =IC= CENTER ' Bis D PROW= PORT LAVACA TX 77979-3026 DATE RECEIPT N ZRI OP PAYMENT AM imm 11/16/23 662731 1 PAY M-NATTER C :3IL� CR XT ACCOONT M. ACCOCNT RA}R. MOUNT OPPi 40600041 TRAVEL - E 126.68 608OOOSY'' T=S IE YOUR RECEIPT PLEASE REEP YOR YOGA. RECORDS PLH 120.63 RECEIPT MEMORIAL MEDICAL CENTER 015 N VIRGINIA PORT LAVACA TX. 77979-3025 I S DATE RECEIPT NUMBER TYPE OF PAYMENT PAYOR NAL� 11/16/23 _ I 682716 PAYMENT-CKECK. MOTCRLSR. REATRER; 40600041 1 TRAVEL - M F. 35.00 THIS IS YOUR RECEIPT :.,..� 35.0.0. PLEASE KEEP FOR YOUR RECORDS RECEIPT NENORYAL MEDICAL CENTER 815 N VIROINIA PORT LAVACA TX 77979-3025 PLEASE KEEP FOR YOUR RECORDS. NE6IOitIAL=MEDICAL CENTER '`. 815 N.VIRBIHIA 4-ICEIPT PORT U.MACA 77979-3025 DAT .: RECRTPT NOMBER '. .. TYPE OF PAYMENT PAYOR NAM 11/16/23 682730 PAYMENT -VISA NGOYEN N11y2.' cuanuu av ser XUA ZYUH LtriCuV s PLE RECEIPT MEMORIAL MEDICAL CENTER 815 N VIRGlNXA PORT LAVACA TX 77970-1025 DATE RECEIPT mmra I TYPE OF PAYMENT I PAYOR. NAME. 11/2023 682986 1 PAYMENT -CHECK I COPFE WIMEn LLC'. ACCOUNT NO. ACCOUNT NAM AMOUNT OPPICE USE.., 40600090 TRAVEL. -A 35.00 40600090 THIS IS YOUR RECEIPT 35..00 PLEASE SEEP FOR YOUR RECORDS ME COFFEE BARREL, LLC IOO E HUTCHINSON Bi-AMB BEEVILLE, TX 7ato.V- 07 is .-o !: 2856 My aa-Mwflsl� -- $ 91� s- MSKESSON STATEMENT As of: 11/17/2023 Page: 002 To enmse proper cre6R to your aeeav"t. eeMoh am .1. this amrsr:. sans atub w8F Your mmbtanas MENOPML MEDICAL CQJTE9rED DC: 8115 Customer INV Su ID: PP As P1. 11117/2023 Pegs: 002. 11m1 tv: 118000 After DUE P VIA ACH OMIT Tertiary: AP Statement far inlormalion. only r inform AMT DUE flEMITTm VIP ACH 0®IT N VIMIAVAC IA 632536 Cate, Statement tar information, only MI X 779 Poln LAVACA i% ]]9]9 Oate:. t i/1 B/2023 I t Cade 632536 @EASE CHECK ANY Data: 11/18/2023 IrWS NOT PAID Iv) ®IR1g Oue ational Account 6 Pscalvabi� t3 Cash Amsura P Amount P flauive8le Dale Date Number Merenoe Description Dis.oum (gross) F (rMJ. F Numbm PF .slum. fegenri: P = Pare 0. Nem, F = Mma Due Item, blank = Current Due Item TOTAL Natorul Ac.t 632539 MEMORIAL MEDICAL CEMEP Sublotalat 13,161.78 USD Future Due: 0.00 Dun It Paid.. On Time:. �/ If PoiO By 11/21Yd023, USD 1.2.898.53 /" Past D. 0.00 PaY Thls Amount: 12.898.53 USDA 01. lost. K Pai6. Nu: 263.25 tact Payment 2.451.97 K Paid Alter 11f21/2023, Due It Paid late:. 08/07/2017 Pay this Ammmt: 13.t61.78 USD USD 13.161..78 I/'U1 7 51S'a3 , 6'14 + t..�=Sv18-•:rs ... APPR&jW ON �rNDtOY 2 0 ca6;PIEy 2yCZ33 p Ctntt®tElit�48 For AR Inquiries please contact 800-867-0333 MEXESSON company.. evvv WALMART 1098IMEM MM PHS MEMORIAL MEDICAL CENI@y VICKY KALISE1 ✓ 815 N VIRGINIA ST PORT LIVACA TX 77979 STATEMENT ANT DUE REMITTED VIA ACH DEBIT Statement for information only As o1:: 11/1W2023 Page: 001 To am. proper ends to your account,. dataea. and Mum this stub wfh your mmlttance DC: Bits CustomerIN Custtory: 70 SupplD: Aa l t 11/17/2023. 001 Mail. to: Territory: 7001 mpm Came: 8000 AMT DUE REMITTED VIA ACH DEBIT Customer. 256342 Statement for information only Dale: 11/18/2023 Cust:. 256342 PIGASE CHECK ANY Oster 11/18/2023 ITEMS NOT PMO (s) 6181n9 Due. Pkreivablt'Msonal. Account �Tm'536 Date Date Number Caeh Amaunl P Amount P Recaivabk Refamulca Desel�tkn OixouM (Bross/ F' (rMl F Numb[ Customer Number 256342 WAUMART 10islai. M® PHS 11/13/2023 11/21/2023 7457348438 95228701 1151naalca L34 66.99' 11113/2023 112I/2023 ]45]552876. 952.40522 1151nvoice 0.03 G5.85✓ ]957348438 1 ill 412023 11 J21/2023 7457690083 95561917 1151mmica 16.03 1.27 1.24✓/ 7451552878 11/14/2023 11/21/2023 7457884440 95394704 1151nvoice 1.03 801.74 51.39 785 ?1✓ g52690063 11/15/2023 11/21/2023 7451966243 95655089 1151nvvice MOO 799.03 50.36.% ✓ 7:15 4441 I Ill SlI I23 11/2U2023 7457866244 95725662 1151nvolce 2.59 1',29.70 783.83: 745]966243. 11115/2023 11/21/2023 7458129798 95661802 1951nvaice 0'.03 12].tt,.r` 7457966244 fl/1512023 11/21/2023 7458129799 95503022 116Immnca 0.68 1.27 1.24'.� 7458t29798 11/15/2023 11/21 M023 7463130300 95668203 11 slnvoice 0.01 33.04 38'.16✓� 7"5 29799 11/16/2023 11I21/2023 7458260930 95796469 11 Slovaks 0.03 DA2 1.31. ur ✓ 7458180000. 11/16/2023 I1/2H2O23 745a260932 95869245 IISInvolce 7.38 1.27 369.09 1.24 36t.791. 7458260930- ' 11116/2023 11/21/2023 7458260938 95869245 115lnvolce 0.01 0.32. 7450260232 11/17/2023 11121/2023. 7458524857 95920640 11 sinvotee 56.91 0.31 7458200933 11/17/2023 11/21/2023 7458683794 95927403 1951nvoico 0.05 2,846.51 2.53 2.708.60,✓ ✓ 7458524857 11/17/2023 1112112023 745868379E 95933863 1151nvvice 2.48 7458683794 7.63 381A9 374.06 7458683795 PF cohmm le9mmd: P e Pass Due Ilan, F = Fmure Due Item, blank = Comes s Due had TOTAI: Custamx Number 2563a2 WAIMART 1098Rd@A M® pHs Subtotal.. 5.486..76 USO future Due: Past Due: last Payment 11/13/2023 APPROM ON 00y 2 0 2023 0.00 N Paid BY 1112112023, 0.00 PaY This Amount: 11,739.80 If PeM After 1112112023, Pay this Amours: Due. K Palaan. That: USO 5.377.01 ✓✓ 5.377.01 USD Disc last 8 paid: Ire:. 109.75 Dud N Paid late:. 5,486.76 USO Uso 6,466.76 au W20123 C:42HEllIAaW COUPfe1+: AE6 For AR Inquiries please contact 800-867-0333 MSKESSQN STATEMENT Dan BOOD CVS *ICY 8923/MEM MC PHS AMT DUE REe11TTED VIA ACH DEBIT MEMORIAL MEDICAL CENTER - Statement for Information only VICKY KALISEK ✓! 815 N VIRGINIA ST PORT LAVACA TX 77979 As at: 11/17/2023 Page: 001 To ensure I moer erect to your .count,. dstaelN and W. this. stub wan your lemMmos. OC: 8115 Customer INV SUPPID: As af:. 11/17/2023. Pages 001. Malt to: Comp. 8000 Territory: 7001 AMT DUE REMITTED VIA ACH. DEBIT Customer.. 835434 Stalement for information. only Date: 1111 W023 Cum: 635434 PLEASE CHECK ANY Dale: 11/1812023. RB,iS NOT PAID tr1 Siting Due R ivabltml9ml Account WE Cash Amount . P Amount. P Necdea8l,. Deta Date Numhm Relemnce DescriptionDiscount(groom. F mmtt F Number Custaowr Number 835434 CVS PNCY 8923/101510 MC PHS I III W2023 11/21/2023 74580175652831976 1151nvoke 153.37 7,,668.65 7.515.28 of 745601.7585 O PF Column b9mil: P = Poet Due ItwrU. F = Flddm. D. Item, bbnk = Comm. Duo Rom TOTAL Customer Number 835434 CYS PNCY 8923/MEM MC PNS Slnma o 7,668.65 USO Futum Due: 0.00 0. N Paid On. Time: It IRM By 11/21/2023, Uso 7.515.28 „F Pam Dum 0,00 Pay This Ameum: 7,615.28 LED Of. lost 8 pald ble:. tam Payment 11,739.00 If Poll After 11/21/2023,. - D. IT Paltl Late: 53.37 11/13/2023 fey this Arnim: 7.668.65 USD QQ�,;''��yy��((��ff��IIUSE) 7,658.66 Vt-tUL4uwk:"�'ee h5h 1 %IZo 1-2-3 APPAMw ON 40Y 8 02p23 W82 CAAWCC !-j4 Ti &S For AR Inquiries please contact 800-867-0333 MSKESSON t STATEMENT As of: 11/17/2023 Page: 001 To wat. prefer cool to ywc eccount,deleoh and nowt Into am,eom. a000 stub With yaw rere8tauce. OC:. 841E CVS MCY y416/MBA MC MS Customer INV SuPPID: As of: 11/11/2023 page:001. Mall. I. Camp:; 8000- MEMOHAL MEDICAL CENT AMT DUE REMITTED VIA ACH DEBIT Territory: 7001 VICKY KAUSGK Statement for information only ANT DUE RBdITTED VIA. ACH. DEBIT 815 N VIRGINN BIT Customer.. 83543] Statement for information only POU LAVACA TX 77979 0019: 1111W2023 Cum:. 835437 PLEASE CHECK. ANY Dole:. 11118/2023. ITEMS NOT PAID (✓) 61111W Due Recelaabl%Ielisnsl Account WP6. Dean, Dole Data Numberre Hefesa Dila saltan Discoed Present (foass) P Amawt P RBcefvebN F (nal). F NVmllar Customer Number 835437 CVS MCY 7416IMM MC MS I VIS12023 11/21/2023 7458162914 2829726 11 Stromme 0A3 6.37 6.24 aF 7450162914 O PF column legend: P = Past Due Item, F = yVwo, Owe two, blank = Current Due Kam TOTAL Customer Numb, 835437 CVS MCY 7416/A18M NO MS Subtends, 6.37 USD Fevre Due: 0.00 Due N PtldOn now: If Met Ey 1112112023, USO 6.24 Pat Dur. 0.00. Pry This Present: 6.24 USD Dlae load. K Pahl. late: Lot Payment,0.00 If PoM After 11/21/2023, 0.13 Duc If PaPo late: Pay this Amount: 6.37 USD USE 6.37 U3RaY.� wuF?-o ON CACRINOW96 For AR Inquiries please contact 800-867-0333 AmensourceBer en" STATEMENT Statement Number: 66334614 g Date: 11-17-2023 loft ABC DC SDGARLAND WALGREENS #12494 340B 100135284f 037028186. 12727W.AIRPORTBLVD. MEMORIALMEDICALCENTER / SDGAR.LANDTX 77478-610t 1302 N:VIRGINIA ST ✓ PORT LAVACA TX 77979-2609 Sal - Fri'Due. N.7days DEA: RA0289276 666-451-9655 ANIERISODRCESERGEN PO Box 905293 NOi: vat a ; 0.00 CHARLOTTE NC 28290.5223 Cunenl:: 1,463.18 Pas40ue.. 0.00. Talal'.Dne: 1,463.18 Account Maros: 1,463.18. Account Activity Document Due Reference Purchase Order Document Original. Last. Receipt Amount Received. Balance Date Data Number Number Type Amount. 11-13.2023 11-24-2t123 31OW7687 7004700062 Invoke 7289 0:00 72.89 e 11-13-2023 11-24.2023 3108576U 7W4714193 Invoice 86.39 0100. 85.39. . 11-13-2023 11-24 023 3163962172 7004726159 Invoice 92.05 0100 92:06. 11-10.2023 11-20.2023 3154148147 70W735479 Invoice 10644 0.00: 1a0.44' 11-14-2023 11-24-2023 355423099 170428 Invoice (378.64) 0100 (378.5,1) 11-142023 11-242023 /55424200 170428. Invoice 376.19 0.00. 376.19 (''. 11-14-2923 11-2a2023 355424406 171276 Invoice (378.54) 0.00 (378.5,1) 11-14-2023 114&2023 35rH24407 171276 Invoice. 376.19 0.00'. 376a9,. 11AS-2023 11-24-2923 31U306877 70(14744939 Invoice 6.26 u00 a..26 11-16-2023 11-24-2023 315/473755 7004756734. Invoice. 221.10 0.00. 221.10 11-17-2023 11-24= 3IMS32175 uG95a1202 Invoice 30.16 0.00. 30.16 11-17-2023 11-24-2023 3164627414 7004768112 Invoice 85359 000. 853.69 Current 1.15 Days 16-30 Days 31.60 Days 61-90 Days 91-120 Days Over 120 Day ' 1,463.iB 0.W I 0.00.1 0.00I 0.00 L.. 0.00 0.00 Thank You for Your Payment Reminders. Date Amount Due Date Amount 11-1] (*) (2,593,35). 11-24-2023 1,453.18 Total Duer. 1d631@, NOV 2 o aaza TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-BOD-572-8683) O"ENTER 9-DIGITTAXPAYER IDENTIFICATION NUMBER" a"ENTER YOUR 4-DIGIT PIN" 0"MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" 7"ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR -09 (SEPTEMBER) -July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OFTAX 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 CALLED IN BY: CALLED IN DATE: CALLED IN TIME: #pit# ENTER: ### 0 941 # �� 1 $ 63,489.46 $ 15,421.80 $ 46,000.40 3 BAP -Payroll Flles\Payroll Taxes@023W24 R1 MMC TAX DEPOSIT WORKSHEET 11.16.23.xis 1112012023 941 RECITAX DEPOSIT FOR MMC PAYROLL •11 PAY PERIOD: BEGIN 111312023 _vq PAY PERIOD: END 1111612023 PAY DATE: IIIZW2023 GROSS PAY: S 563,621.65 DEDUCTIONS: AIR $ 260.00 ADVANC BOOTS SUNLIFE CRITICAL ILLNESS S 1,200.16 SUNLIFEACCIDENT $ 786.88 IRSTAX $ 117.00 SUNLIFE SHORT TERM DIS $ 1,968.40 BCBS VISION $: 1,032.36 CAFE-D 5 1,608.93 CAFE-H 6 23,243.39 $ S CAFE-P CANCER CHILD $ 579.89 CLINIC $ COMBIN $ 271.83 CREDUN $ DENTAL $ DEP-LF SUNLIFE TERM LIFE $ 1,063.06 SUNLIFE HOSP INDEM S 739.47 FED TAX $ 46,000.40 FICA-M $ 7,671.89 FICA-0 $ 31,744.73 FICA-M ADDITIONAL S 78.02 FIRST C FLEX S S 3,447.31 FLX-FE $ GIFT S S 217.03 GRP•IN GTL HOSP-I LEGAL $ 1,034.64 OTHER $ 1,837.98 NATIONAL FARM LIFE $ 1,523.92 MEDSURCHARGE $ 360.00 PR FIN $ RELAY REPAY STONEOF $ 1,115.86 STONE STONE2 STUDEN TSA-R $ 30,862.96 UWIHOS $ TOTAL DEDUCTIONS: $ 156,752.95 S NET PAY: S 398 808A0 I $ TOTAL CAFE 125 PLAN: 5 34.526.43 .L1 REVISED 3H&2014 INAL CKxn TOTALS $ - ) $ 563,521AS $ 250.00 $ S 1,206.28 $ 786.88 S 117.00 $ 1,968AO 1,042.38 § 1,608.93 $23,243.39 5 S - S - $ 570.69: $ 271.83 It S - $. 1.063.06. $ 739.47 $ 46,000.40 $ T,871.89 S 31,744.73 S 78.02 S 3,447.3.1 9 $ 217.03 S It $ 1,034.54 $ 1,837.96 S 1,523.02 $ 360.00 It s - $ 1,115.86 $ 38,862.96 § 188,762.95 $ 3961866.60 TAXABLE PAY: $ 529,095.12 S" - 61 011.64 Exempt.Amk ••CALCULATED•• From MMC Ron Difference Employees -.over FICA•S$ Cop:' FICA - MED(ER) ,..ax 5 7.671.88 Rcahande:Thomas' $ 5.669.25 FICA - MED(EE) v.e, $ 7,671.88 $ 7.671.89 S (0.01) MId1i89t6Gains$ $' - 8,414.26 FICA -500 SEC (ER) axon S 31,744.72 - FICA -SOC SEC(EE) eam S 31,744,72 $ 31,744.73 S (O.Ot) PEycodo S-Employee>Relm6.: FED WITHHOLDING S 46.000.40 S 46,000.40 TOTAL: TAX DEPOSIT. S 124.833,60 S 124.M3.64 FICA -MEDICARE awx $ 15.343.76 $15.343.78 FICA -SOCIAL SECURITY ,xex 5 63.489.44 $63,48OA6 PREPARED BY: Andde Flores. FED WITHHOLDING - $ 44,000.40 $46,000.40 PREPARED DATE: 11120120233. TOTAL TAX: $ 124.833.60 $124,833.64 $ (0.04) 424 R1 MMC TAX DEPOSIT WORKSHEET I IAS.M xlv; TAX Run Date: 11/20/23 MEMORIAL MEDICAL CHUTER Page 1D7 Time: 09:04 Payroll Register I B1-Weekly P2REG Pay Period 11/03/23 - 11116/23. We 1 Final S:Amwry *-- P a y C o d e S u. m m a r y------------------ ---------------------- +-- D e d u c t i o. n. S S u. a. m a r ----+ PayCd Description Mrs IOTISHIWBIHOICEI Dross I Code Amount. 1 REGULAR. PAY-S1 9946.50 H N N 234342,11 A/R 250.00. A/R2 A/R3. 1 REGULAR PAY-S1. 1945,50 N N N N 94344,29 AMC AWARDS SCREW 1D32.38 1 REGULAR. PAY-S1 374.09 Y N N 12543.45 BODES CAFE H CAPS-1. 2 REGULAR PAY-82 2728.75 N N N 75470.64 CAFR-2 CAPE:-3 CAPE-4 2 REGULAR PAY-82 IOS.00 Y N N 4505.61 CAFE-5 CAFE-C CAPE-D: 1608193. 3 REGULAR PAY-83 1571.75 N N N 54439.36 CAPS-S CAFE-H 23243.39 CAPS. -I. 3 REGULAR PAY-83 101.25 Y N N 5293.90 CAFE-L CAFE-F CANCER 4 CALL BACK PAY 20.75 N 1. N N Y 901.09 CHILD 570.69 CLINIC cow 271.83. 4 CALL BACK PAY 10.50 N 2 N N Y 785.31 CUM DO'ADV DENTAL. 4 CALL BACK. PAY .25 Y 1 N N Y 17.99 DEP-LF DIS-LF SAT' 4 CALL BACK PAY 1.50 Y 2 H N Y 104.41 EATCSH FROM 46000.40 FICA-M 7749.,91. C CALL PAY 2274.75 N I N N 4549.50 FICA-0 31744.73 FIRSTC FEE S 3447.31 D DOUBLE TIME 19.75 N 1 N N 1307,0 FIX FE FORT D FUTA D DOUBLE TIME 12.00 N 2 N N 1093.81 GIFT S 217.03 GRANT GRP-IN D DOUBLE TIME 2.00 N 3 N N 241.52 GTL HOSP-1 IDTFT D DOUBLE TIME 5.50 Y 3 N N 996.27 IRSTAX 117.00 LEAF LEGAL. 200,51 E EXTRA WAGES N N N H 14320.43 MASA 534.00 HEMS 1837.98 HEMS E EXTRA WAGES N 1 H N N 2456.45 RISC H1Sel KKCSKK P £UNSEAL LEAVE 24.00 N 3 N M 850.08 NATPML 1523.92 OI- R. PHI.. I INSERV[CE 25.75. P 1 N N 3169.71 PHI+++ PR F3 RELAY I INSERVICE 2.00 Y 1 H H 111.12 REPAY SAi4E. SCROAS N 154.00 N 1 N N 4738.22 SIM ST=T% STONDP 1115.86 M MEAL. REIMBURSEMENT N N N N 106.03 STONE STONS2. STUDER P PAID -TINE -OFF 273.72 N N N N 12400.79 MCC 736.90 SUNILL. 1206.28 SUM 739.17 P PAID-TIMR-OFF 1100 S0 N 1. N N 35905.04 9011LIF 1063.06 SUNSTD 1961.40 SUMS X CALL PAY 2 IWO N 1 N N 288.00 SURCHG 260.00' TSA-3. TSA-2 Y YMCA/CURVES R N N N 45.00 TSA-C TSA-P TSA-R 38862.95 E CALL PAY 3 96.00 N 1 N N 285.00 TWICE UHIFOR UN1H05. +-------------------- Grand Totals: 2a947.72 ------- ( GEMS: 563621.55 Deductions: 156752.95 Net. THHE.6G �l Checks Count:- FT 204 PT 14 Other 34 Female 224 Male 27 Credit OverOmt 13 ZeroNet Term Total: 251 =11r*1611 Run Date: 11/20/23 MEMORIAL MEDICAL CENTER BIWEEKLY Time: 1D:13 ++.. Cketk Register *-+t Pay Period 11/03/23--11116/23 Run:. 1 Type-IM 10000101 OPERATING - PROSPERITY Num. Name Amount CHECK KIM DATE 02620 IVOIW AVILES 327.62 00063356 11/24/23 0233E RAM M GOOD 55.41 00063357 11124/23 02963 DOROTHY J SIM3ON 1523.64 04063356 11124/23 20012 ALBKIS LORBW 979.17 H063359 11/24/23 38428 JOLIAN NEYSQOIRRGO 832.81 0/063360 11/24/23 00041 am LEE RING 2465.99 DD 11121/23. 00083. SYLVIA A VARGAS 997.28 DO 11121123 00094 SYLVIA A XMM74 957.28 DO 11/24/23 00113 JACLYN. CAARHG' 1138.13 DO 11/21/23 00132 SANDRA A BRAON 895.31 00 11/21/23 00192 BR12MA D PENA 1819.05 DD 11/24/23 00344 SAN➢RA LEE RUD➢ICK 2911.66. DD 11/24/23 00387 BILLIE F WCKWORTB. 2425.62 ED 11/24/23 00352 MONICA T MR 1224.15 DD 11/24/23 00399 LINDA J TIJBRINA 2461.57 DO 11124/23 00401 VELMA J PINA 1698.16 DD 11124/23 00417 SHERRY L KING ZS7I.10 OD 11124/23 00423 GONE V STRINGO 2012.20 OD 11/24/23 00482 PAM FIKAC 1431.38 DD 11/24/23 00581 CYNTHIA L RUSHING 1674.59 DD 11/14/23 00661 RILL& REM WOOD 1.737.13 DD 11/24123 00697 MARIA C FAKIRS 1194.64 DO 11124/23 00707 KIMBERLY BERMDEZ 1744.95 DD 11124/23 00995 EMILIE. DIANE WILKEY 630.03 DD 11/24/23 01015 SOSAN B SWAIM 2253.08 DD 11/24/23 01191 SHARON M SPARKS 507,39 DO 11124/21 01234 JEWISH N SVETLIK 2407.54 DD 11124/21 01241 MANDY MACE 2007.58. ➢O 11/14/21 01367 MARILYN A SANDERS 1758.50 SO 11/24/21 01451 JENNIFER L ZISSA 407.09 DD 11/24/23 01791 RADSHANAR J MONDAY 7131.71. ➢D 11/24/23 02011 GRIN R CLEVBNORK 9807,40 DO 11/24/23 02014 AGAPITA C CANTO 694.29 DD 11/24/23 02021 ERIKA OSORNIA-SAKCHEZ 142.00. DD 11124/23 02022 AMMA J GRIGGS, OTR 2551.06 DD 11124/23 02064 IM DADRA GARCIA 1170..95 DD 11/24/21 02099 TRACI M SIAFCIK 2151.46 DO 11/24/23 02112 LESLIE THOMAS 3698.61 DD 11/24/21 02132 JASMINE ROIZ 1735.54. DD 11124123 02135 NORM ALLISON 1573.93 DD 11/24123 02136 TAW ESOOIVEL $17.86 DO 11124/23 02154 JOSTINB. STRWYK 1617.23 DO 11/24/21. 02162 MIRIAM PALOKA 1442.22 DO 11/24123 02168 JBNSICA WHET 3147.89 DO 11/24123 02193 TIKI VENGLAR 1411.17 DO 11114/23. B2202 SHNON I SANCNEZ 83..64 DO 11124/23 02271 DANK J BOBESIK 2292.01 DD 11124/23 02301 HICOL45 TIJERIMA 2351.79 DD 11/24/23 02302 CATSSRINE. 2ASIK DECILOS 82.53 DD 11/24/21 02303 COMB M LONA 2227.22 DD 11124123 02315 NINA M GREEN 2332.20 ➢O 11124/23 02322 RICK OSORNIA 315.79 D➢ 11/24/23 02331 JESSICA R NIPPLE 1080.75 DO 11/24/23 Page 1 72DISTP Ron Date: 11/20123 MMRIAL MEDICAL CENTER BI-WEEKLY Page 2 Time: 1O 113 •••• Check Register •••• P2DISTP Pay Period 11/03/23--11/16/23 Run: 1 Type=NET 10000001 OPERATING - PROSPERITY Num, Name Amount CHECK HUM DATE 02346 JEANSCEE L FALCON 2064.46 DD 11/14/21 02416 JPABLLS SCOTT 1887.15 ON 11/24/23 02535 STEFANIE M SOLIZ 377.81 DD 11/24/23 02552 VBRE.MIM RAG08IN 1954.81 ED 11/24/23 02678 MELISSA NE5LONEY 1485.11 DD 11/24/23 02685 JULIANA TORRES 233.42 DD 11/24/23 02701 IMDA DAMI2ELLE GOHLKB 2341.12 ➢D 11/24/23 02719 DANK M MCCLHLLM 2055.14 D➢ 11124123 62720 ELBA M LUERA 2039.13 ED 11124/23 02733 DEATH N PLEDGER 2464.78 DO 11/24/23 02763 JRSSICA HARQUEZ 1874.35 DO 11/24/23 02791 HEATHER L MUTCMER 1923.46 DD 11/24/23 01112 BRITTANY N RUDDICK. 1805.52 DD 11/24/13 02907 MIA LOWGORIA 1211.01 DD 11/24/23 02927 HICHAEL L HAYNES 6425.21 DD 11/24/23 0200 DIM .G ATKINSON. 2233,66 E➢ 11/24123 03964 JACQUELINE R REDEEM 1504.73. DD 11/24/23 05003 WURTNB D T99RLKILL 3225.52 DO 11/24/23 05006 ANGINA A MARTIRBZ 2803,62 DO 11/24/23 05122 MARISSA RANGEL 829.98 DO 11/24/23 05345 ERICA RGOYBN 1851.81 DD 11/24/23 U5641 ARM A KEY 1930.72 DD 11/24/23 05157 SHARON T ROLOER 2013.69 DD 11/24/23 07123 CITYCHIA GUERRA 1599.55 DD 11/24123 07147 CHAD A VORCE 2445.76 DD 11/24/23 01078 DIM C SAQCHDA. 1161.95 ➢D 11/24/23 11197 CATHERINE A SAB14I 2772.27 DD 11124123 11412 COURTESY L HOAFAVSKY 1397.92 ➢D 11/24/23 12011 KINNERET J REM 1002.15 DD 11/24/23 12115 LISA J HIhwOSA 1001.07 DD 111ZV23 12129 4HCNAEL HERMES 1440.13 DD 11/24/23 15097 KYLE L DANIEL. 3261.78 DD 11/24/23 15131 SAVANNAH HUM 1555.16 OD 11/24123 15139 KRISTEN NICOLE BALLARD 1721.26 ED 11/24123 15163 MINY HEINOL➢ 4318.34 ED 11/24123 15286. DAWN M MAAEE. 2133.23 ED 11/24/23 15555 STEPHANIE MARTIN 785.81 DD 11124123. 15909 JULIE NGUYEN 2078.19 ON 11/24/23 15915 BRIANIIE J KEY 2692.58. OD 11/24/23 20156 SKIN ASKILRY WISDOM 2248.66 DO 11124/23. 20160 JOSHVA PINHEAD 811.65 DO 11/24/23 20170 MY GRRCIA. 3440.01 DO 11/24/23 20104 MISSA ZAMORAHO 945.79 DO 11/24/23 20206 KELLY B GOEF 2482.16 DO 11124/23 20207 SIERRA G HAM, 10 2645.69 DD 11/21/23 20243 HELMET CORTEZ 924.34 DO 11/24/23 20272 ANGELA EWER 1816.14 DD 11/24123 20294 JESSICA. D ML74ER 095.60 DO 11/24/23 20324 PATRICIA STRIBLEY 22711.07 DD 11/21/23 2D343 SAVANNAH 14 SOCARRAS 547.07 ED 11/24/23. 20456 SAYDI A ST CLAIR 746M DD 11/24/23 20484 BRIANNA S PASSMORE 401.15 DO 11/24/23 20759 JANIE SADLER 1194.05 DD 11/24/23 20788 JAILIR RAMIREE 383.64 DO 11/24123 Run Date: 11/20/23 MEMORIAL MEDICAL CENTER BI-WEEKLY Page. 3. Time: 10:13 Check Register •-•a P2DISTP Pay Period 11/03/23--11/16/23 Run: 1 Type -EST 10000001 OPZRATIHG - PROSPERITY No. Name boot CHECK MUM DATA 20797 SSTHANN M DIMS 2135.31 DD 11/24/23 20517 CHERYL L TESCH 2760.56 DD 11/24/23 20980 SAVANA LENTO 704.26 D➢ 11/24123 21450 DIM E. LEAL 1567.40 OD 11/24/23 21629 JACOBY R CRAWFORD 1612.70 OD 11/24/23 22616 HEATHER L LOPEZ 386.20 OD 11/24/23 28034 HRISTINA A ROHNGER 1108.47 DD 11/24/23 28120 JESSICA.V SELVENA 953.01 DD 11/24/23 29199 KELLY A SCHOTT 2392.22. DD 11/24/23 3I015 STACIR L EPLEY 2704.20 DO 11/24/23 31054 LORA. L LAMM 955.91 OD 11/24/23 31219 L49RU PHILLIPS 1552.20 DD 11/24/23 31241 MONICA SALAZAA 612.42 0O 11/24/23 31251 CYNTHIA L HIM 1821.66 DD Il/Z4/23 31313 RATHXRTNE LYNN JIMENEZ 2000.46 DD 11/24/23 31319 STACY L PARMBR 1833.44 DD 11/24/23 31463 EDWARD H MATOLA 2552..17 DO 11/24/23 31508 RAM A EF0NER 2015.67 DO 11/24/23 31021 KAYLA.V. ALVAREZ 1663.66 DO 11/24/2) 38118 HRYSTHLLA F KISIAR 1059.57 DO 11/24/23 3SiBE MADELINE ANDERSON 813.19 DO 11/24/23 41112 ANASTASIA L PEREZ 739.51 DO 11/24/23 41171 TOWS M THUM 069,67 DO 11124/23 41213 GDADALUPE. OLANDT,Z 178.15 DO 11/24/23 41225 LESLIE A CRAIGEN 1413.31 DO 11/24/23 41236 PAMELA. K VANNOY 1495,30 DD 11/21/21 41251 SARA YBARSO 830.25 ➢D 11/24123 41261 BERNICE AGUILAR 831.90 DO 11/24/23 11269 BERENICE LOGO 746.09 DO 11124/23 41274 KAREN GANN 1165.95 DD 11/24/23 41279 PAMELA R DAEMON 931.52 OD 11124/23 41347 ADRIANNA.D STRANDS 797.07 DO 11/24/23 41418 ANGEL M CASSSL 969.33 D➢ 11/24/21 41426 TAS@1 NORM 3504.10 OD 11/24123 41506 JOSRPAT LOGO TOWS. 821,28.. DO 11/24123. 41612 SONJA A GUAJARLO 1108.54 DO 11124/23 41617 JACQUELINE M MARTINEZ 905.05 DO 11124/23 41896 BEHAR HICHBLLE MAY 606.48 DD 11124/23 41897 ROXARNA MUNOZ 019.65 DD 11/24123 41901 JUANITA R MILLER 1326.37 DD 11124/23 41953 KAYLEIN7 TREVINO 782.88 DD 11/24/23 42106 CHRISTY SILVAS 965.21 DD 11/24/23 42112 SOCORRD C GONZAISS 1013.37 DO 11/24/23 42122 LEI ANA CHAVARA 1757.73 DO 11/24/23 IZ125 LUCY CRIMA 951.18 DO 11/24/23 42304. MIMI T KOM 2235.95 DD 11/24/23 42536 NEAR A SOCARRAS 69135 DD 12/24/23 42820 BEA D CHAVEZ 059.90 ➢D 11/24/23 42842 SOMA S 0 DONNELL 12124.46 DD 11/24123 50018 MICHELLE M MORALES 1472.92 DO 11/24123 50148 PENNY SECURE 3461.85. DO 11/24/23 50161 BRITTNSY MICHELLE ZAMORA 461.02. DO 11124/23 50250 SUMMER E NICHOLSON 770.73 On 11/24/23 $0282 WON W HAMILTON, PT,. DPT 2627.60 DO 11/24123 Run Date: 11/20/23 MANORIAL MEDICAL CENTER BI-WEEKLY Page 4 Time: 10:13 ..0 Check Register -I-- P2DISTP Pay Period 11/03/23--11/16/23 Run; 1 Type=NET 10000001 OPERATING - PROSPERTTY Kum, Name Amount CHECK. NOW DATE 5031D JASMINE GRIGSBY 754.60 D➢ 11/24/23 50546 MELANIE K SAMAYOA 2135.84 DO 11/24/23 50573 OEM R DAVIS 1594.20 DO I1/24/23 50596 SPITE S DAVIS 2057.30 DD 11124/23 50719 DOM K MUSTERED 2366.57 DO 11/24/23 50920 ADM RO➢RIGUEZ 727A9 DD 11/24/23 53541 JACLYN B PARTL 1623.40 DO 11/24/23 54024 MONICA A ESCALANTS 1117.35 DO 11/24/23 55025 IRA C MISUSES 1411.48 DO 11124/23 SSD26 IRENE B PEREZ 803.56 DO 11/24/23 55127 APRIL N KOSALA. 27DO.91 DO 11/24123 55371 HIM WISMAR 4D1.69 DO 11/24/23 55382 SHANNON JACILDD 747.71 DO 11/24/23 55158 LAJUAN WILKE 775.74 DO 11/24/23 58510 RITA L POLENSKY 816.43 DO 1I/24123 60112 RUPERT A RODRIQUEZ 1968.91 DO 11/24/23 60131 NORA OVALLE 569.42 DO 11/24/23 60156 DANIELLE M %ALISEK 1081.38 DD 11/24/23 6QI65 TERESA A BENITEZ 1530.01. ➢O 11/24/23 6US87 MCI S GRAM 776.25 DO 11/21/23 6D589 JASON J LOYA 1052.64 ON 11/24/23 60616 DORDTWY A LONGORIA 1065.62 DO 11/24/23 62322 AIM KNIGIT 1614.00 DO 11/24123 63124 SANJUAN M GARCIA 991.81 DO 11/24/23 63193 MICHAEL SOCAARAS 978.32 DO 11/24/23 63458 VIRGINIA C BERNAROINO 966.92 DO 11/24/23 6510D PELICrTA BONUS 674.62 DD 11/24/23 65125 MARTIA CNMPEAM 839.21 US 11/24/23 65127 VERONICA ORTIZ 719.64 DO 11/24/23 65136 TINA K0RAN8K 961.02 DO 11/21123 65146 MARTA INIGUEZ 744.34 DO 11/24/23 65151 ELIA OLACRIA 1069.49 DO 11/24123 65169 ELVIRA SANCHEZ 73D.80 DD 11/24/21 65205 JUANA SAKTILLAN 756.22 DO 11124/23 65213 LES SIMBRLY 1154.00 DO 11/24/23 65269 NATALIE RAREFIELD 960,91 DO 11/24/21 65315 ELVA RODRIGUEZ 937.14 DO 11/24/23 65393 RAMO.NA A PEREZ 1136.42 DO 11124/23 65453 MIA L FLORES 1258.40 DO 11/24/23 65463 (ARIA I VBWZ 171,18 00 11/24/23 65486 ROSA R0➢RIGM 170.54 DO 11/24/23 65513 MARIA MORAL38 996.D9 DO 11/24/23. 65705 DOMITIL.A NERRBRA 1053.31 DO 11/24/23 65715 MARIA R GOMEZ 951.79 DO 11/24/23. 65865 MAMA F LEMZMA 846.72 DO 11/24/23 66368 DOMITIIA GARCIA 416.50 DO 11/21/23 66568 CMRIST0PM ROTNERFORD 915..63 DO 11/24/23 68792 RASHID ➢IAZ HERNANDEZ 2097.47 DO 11124/23 7D119 SARA N BLEDSOR 2285.62 DD 11/24123 72727 CMRISANDRA LYNN KOVARBK 68.28 OD 11/24/23 73749 GLORIA N REID 2269.79 DO 11/24/23 74159 CAROL VILLAR.RBAL 3241.28 DO 11124/23. 75150 RIKA MILLER 2017,41 DD 11/24/21 76003 IRMA DELIUS 72D.45 DO 11/24/23 Run Date: 11/20/23 MEMORIAL MEDICAL CENTER BI-WEEKLY Page 5 Time: 10:13 +«t Check Register '--I P2DISTP Pay Period 11/03/23--11/16/23 Run: 1. Type=NET 10000601 OPERATING - PROSPERITY Ram. Name Amount CSBCR NUM DATE 76115 JENIFER R CARLDCK e01.67 DO 11/24/23 76120 RACHEL CARRIES 1248,63 DO 11/24/23 76138 YAM D GARCIA 749.79 DO 11/24/23 76210 ZOE VILLARREAL 527.64 DO 11/24/23 76300 AIDA JIMMZ 831.38 DD 11124/23 76313 PAMELA L BARTON 830.99 DO 11/24123 76403 KATRINA A POBLUDA 1256.24 OD 11/24/23 76647 CHERYL A SEE 1070...14 DD 11/24/23 76706 GREGORY E MORALES 820.61 DO 11/24/13 76851 BABY PATTERSON 1069.35 M 11/24/23 76985 VAMESSA TRISTAN 148.22. DD 11/24123 77646 FARM A DOMES 1094,47 DD 11/24/23 78020 MISTY R PASSMORE 1594.14 DO 11/24/21 79058 BYANN J POWER. 289.26 DO 11/24/23 76072 DONNA M: RAWLINGS 1539.61 DO 11/24/23 79129 ALEKA QDINTANILLA 851.63 DO 11/24/23 78207 MARISSA D ALNANZAR 2221.40. M 12/24/23 78336 JESSICA.L GLOVER 1740.46 M 11/24/23 78566 MELISSA M ONE 050.18 DD 11/24/23 78764 ASHLEY D HADLEY 2017.18 DD 11124/23 78781 KRISTEN R NACHICBH 2533.40 DO 11/24/23 76707 FARAB I JANAK. 2513.60 DO 11/24/23 70897 DAYLE J ROBINSON 646.21 DO 11/24/23 60001 ADAM D ESSIG 2432.64 DO 11/24/23 80141 JEAME ORTA 1616.08 DD 11/24/23 80928 BRYN HOBGMD 1908.35 DO 11/24/23 82227 CAITLIN A CLEVENGER 1205.07 ➢O 11/24/23 06482 MDGAti W HARPER BD9.54 DD 11/24/23 86576 ELSA SERUM 701.93 ➢O 11/24/23 80125 LISA M TREVINO 1171.83 ➢O I1/24123 8814E HICHRLDE LTHRERIA D 2151.83 DO 11/24/23 48321 AIDREW DE LOS SAM 2651.53 DD 11/24/23 88435 JOB GARCIA 1840.96 DO 11/24/23. 90329 ROSHANDA S THOMRB 6136.03 M 11/24/23 90929 STEVE HROCK 4923.14 DO 11/24/23 93231 AMRIR M PIABES 1830.89 M 1194/23 90156 ADRIANNA M GALVAN 1634.43 M 11/24/23 396868.60 Date Bank Description 11/17/2023 STATE COMPTRLR TEXNET 07919702/311162100002 11/17/2D23 PAY PLUS ACHTrans 000000006845372 2010MG955 11/17/2023 AMERISOURCE BERG PAYMENT$. 01000077692100DO2 11/16/2023 PAY PLUS ACHTrans 0000000067161171010006944 11/15/2023 PAY PLUS ACHTnna 0000000064873111010006933 11/15/2023 TEXAS COUNTY DRS RECEIVABLE 0419 21000025421 11/15/2023 FDMS FDMS PYMT 052-1737276-0UD 41DO012386386 11/1512023 FDMS FDMS PYMTT 052-1743548-0004100012389357 11/15/2023 FDMS FDMS PYMT 052-2100911-000 41000123892S6 11/15/2023 MOMS HEMS PYMT 052-1743547.000 41000123S6923 11/14/2023 WEBFILE TAX PYMT OD 902/7397221921WO025579 11/14/2D23 PAY PLUS ACHTrans MM00006375111 I010006921 11/14/2023 MCKESSON DRUG AUTO ACH ACH05741203 920MI39 11/13/2023 OEBTMGMTSERVICES PAYMENT0000 41036048226230 11/13/2023 PAY PLUS ACHTrans 000000006271226101MOSS02 11/13/2023 IRS USATAXPYMT 270371780222160 6103601003143 MEMORIAL MEDICAL CENTER PROSPERITY BANK FOR. OPERATING ACCOUNT— Nov 13, 2023-Now 19, 2023 MMC Notes -CHIRP IGT - 3rd Party Payor Fee - 340B Drug Program Expense -3rd Party Payer Fee - 3rd Parry Payor Fee: Retirement Funding -Credit Card Processing Fee - Credit Card. Processing Fee - Credit Card. Processing Fee Credit Card Processing Fee. Sales Tax - 3rd Party Payer Fee - 3408 Drug Program Expense -Wage Garnishment 3rd Party Payor Fee Payroll Taxes —likIB,M November 20, 2023. ANDREW DE LOS SANTOS �P Memorial Medical Center "{G��NBlVeci �"E°y''C-1.see, PROSPERITY BANK ,4':- i Nd_.»Vlavr{ 69. 04 ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT. -ESTIMATED ACHS Data Deudotion LA-f1�9..s3 �.l�k.�l.']INN. I November 20, 202S ANDREW OE LOS SANTOS Memorial Medical Center 41 nw, 52.5 , 25.I1, I04 -u,� g, . Amount S emB6 T 5 2 063.60-W 1. $ nniy L,0.0: !, , 5 11739.80. s �� RI4n� Ilwl�wc-N-.. 5. 117,6Z3.43s,[.r' I: f b • 4 5 397,243.30 RUNIC Notes Applamm NOV 2 p K23 010yal owl Amount 2 9 1 , = 4 ' - .. r2,,di.I . t3 L Transaction Summary Transaction Complete Trace #: Texas Health and Human Services Commission Memorial Medical Center Operating County Payment Total $71,899.00 Bank Routing and Account Number 11/17/2023 Settlement Date CHIRP Amount $71,899.00 Entered By Andrew De Los Santos Page No:1 of 1 Run. Date: 11/7/2023 Run Time: 10:04:08 Page 1 of 1 RECEwED ay THE f.,,0'd1�iN" AuSowe On N11/1V8/I § 2023 MEMORIAL MEDICAL CENTER 0 AP Open Invoice. List oou0,y11I`TfYr15 Dates Through: ap_open_invoice.templete. Vendor# Vendor Name / Class Pay Cade 11824 THE CRESCENT r/ Invoice# Comment Tran Dt Inv Dt Due Dt Check 0 Pay Gross Discount No -Pay 110923 11/1412011/0912012/09/20 4,140.00 0.00 0.00 TRANSFER ON 'InSairkK C ?t5rA4 t ,F0j f A rrq-, W&N. 4901L' inj Vendor Total; Number Name Gross Discount. No -Pay 11824 THECRESCENT 4,140.00 0.00 0.00 Grand Totals: NOV 16 2023 Report Summary Gross Discount No -Pay 4,140.00 0.00 0.00 Net 4,140.00 V/ Net 4.140.00 Net 4,140,00 file:///C:/Userslltrevino/cpsi/memmed.cpsinet.comlu881251data_51tmp_cw5report48147... 11/16/2023 Page I of t RFCEIv 31 BY THE : )u 4iY A�S1,8 M,wmi3 NO 16 Z023 MEMORIAL MEDICAL CENTER 11/16/2023 0 AP Open Invoice List ap open invoice.template Dates Through: Vendor# Vendor Name ` Class Pay Code 11836 GOLDENCREEK HEALTHCARE V Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 111323A 6,004yy.95 0.00 6,004.95 ��1pp1�y/11Y51201111=01g2�/pt13/20 .1 g�� gg TRANSFER Aso ifflU'iYT11Q, World Afts,t' 1i I�0.00- Nr-V.`1y �,i�oax,. 9U�J,Y'1I`tni 111323 11/15120 11/13/20 12/13120 889.28 0,00 0.00 889.28 TRANSFER n to .. 111023E 11/15/20 11110120 12/10/20 20,175.01 0.00 0.00 20,175-.01. TRANSFER V `% 111023 11/15120 11110120 12/10/20 3,181.76 0.00 0.00 3.181..76Y TRANSFER 1 flN .. 111023A 1111512011/10/2012110120 61,418.32 0.00 0.00 61.41.8.32 TRANSFER ra 11t Vendor Totals Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 91,669.32 0.00 0.00 91,669.32 Report. Summary Grand Totals: Gross Discount No -Pay Not 91,669.32 0.00 0.00 91.669.32. 3N %O A� n�AFfatl ':eY9iP file:[//C:/Users/ltrevinolcpsilmemmed.cpsinet.com/u88125/data_51tmp_cw5report42981_.. 11 /16/2023 Page I of 1 RECEIVE) BYT81E COL7WP(.AsUW()q Ml 1Y61J0f1202-1 09:59 Vendor# Vendor Name 12696 GULF POINTE PLAZA MEMORIAL MEDICAL. CENTER AP Open Invoice List. Dates Through: Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 110623 "�11/14)2011/06/2012/09/20 209.30 TRANSFER OVI p'd9gYUA&LA f jtfBOijej p'1R+ 110723 11/14/2011107/201.2109/20 213.60 TRANSFER i' 110823 11/14/2011108/2012109/20 437.36 TRANSFER "' 111023A 11/15/20 11/10/20 12/10/20 224.35 TRANSFER. tc 111023 11/15/20 11110120 12110/20 228.17 TRANSFER `4 111323 11/15/20 W13/20 12/13/20 441.78 TRANSFER v4 Vendor Totals Number Name Gross 12696 GULF POINTE PLAZA 1,754.51 Grand Totals: ReportSummary Gross Discount 1,754.56 0100 0 ap_ppen_i nvoicetemplate. Discount No -Pay Not 0.00 0.00 209.30 0.00 0.00 21.3.60 e,d uP 0.00 0.00 437.36 0.00 0.00 224.35 rfi 0.00 0,00 228.17 w/ v 0.00 0,00 441.78 Discount No -Pay Net 0.00 0.00 1.,764.56 No -Pay Net 0.00 1,754.56 tile:(//C:/Userslitrevinolcpsilmemmed.cpsinet.comlu881251data_51tmp_cw5report74512... 11 / 16/2023 Page 1 of 1 RECEWED EWTHE ,aas�r� raurs oar Ploy 16 z023, 11/16/2023 MEMORIAL MEDICAL CENTER 0 ,-;;nL1.{(j , •gt�ny -fr'x AP Open Invoice List . ap_opennvoice.template Dates Through: Vendor# Vendor Name f Class Pay Code 13004 TUSCANY VILLAGE C/' Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net 110823 11/1412011108/2012109/20 2,400.00 0.00 0.00 2,400.00 TRANSFER OVI'jnStB*AU 'f5ib-4 t gV,;itcA jet-* '[KW�L P6J)PIm-K! Vendor Totals Number Name. Gross Discount No -Pay Net 13004 TUSCANY VILLAGE 2,400.00 0.00 Uo 2,400.00 Report Summary Grand Totals: Gross Discount No -Pay Net 2,400.00 0.00 0.00 2,400.00 gn,pow ON 140, 16 Z023 culf"D iE3t=� CA file:///C:/Userslltrevino/cpsi/memmed.cpsinet.com/u88l25/data_5/tmp_pw5report52669... 11 /16/2023 Page 1 of 1 AECEwED SYTHE C,DUNN AUMOR 014 1, 2®Z3 MEMORIAL MEDICAL CENTER 1B 2J2# 0 AP Open Invoice List ppdg'�656g +.�ffiiDiF;Lt COD'1T V -"%°�A.S. ap_open_invoice.template. 1 Dates Through: Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran. Dt Inv Dt. Due Dt Check DPay Gross Discount No -Pay Net 110623 11/14/20 11/00/20 12/09/20 162.26 0.00 0.00 162.26 TRANSFER �A 'PASDW'dEWItt f qk�j rIlgVi.Aaj'e.j m A.'IRI, dd'fW6Y 110723 11/14/2011/07/2012(09/20 155.59 0.00 0.001g 155.59 11 TRANSFER 111023A 11/15/2011/10/2012110/20 23,752.15 0.00 0.00 w 23,752.15 TRANSFER to nt 111023E 11115/2011110120 12/10/20 9,483.21 0.00 0.00 9,483.21. TRANSFER 1% g.; 111023 1.1/15/2011/10/2012/10120 464.31 0.00 U0 464.31 TRANSFER e "0 111323 11/15120 11113/20 12/13120 10,670.34 0.00 0.00 r 10,670.34 we{ TRANSFER 110823 11/1612011/08/2012/00120 3,315.58 0.00 0.00. 3,31'.6.58 ✓ TRANSFER 1` p .. Vendor Totals Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 48,004.44 0.00 0.00 48,004.44 Report Summary Grand Totals: Gross Discount. No -Pay Net. 48,004A4 0.00 0.00 48,004.44 file:///C:/Users/ltrevinolepsilmemmed.cpsinet.com/u88125/data 51tmp_cw5report44375... 11/16/2023 M.mgmlM.mw]c.m.. 14wWnS Name UPL Weeklq WAC. 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Dept AMOUNT: $ 13,475.07 / G/LNUMBER: 10255040 EXPLANATION: Molina Y6Q4 and Amerigroup Y6Q4 REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: 1 U26 P MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Date Requested: A Y E E APPFAWM yp mm�ON .-��p V 20 zon 11/20/2023 FOR ACCT USE ONLY ❑. Imprest Cash. A/P Check ❑. Mail Check. to Vendor Return. Check to Dept AMOUNT: $ 11,236.79 ,/ GA NUMBER: EXPLANATION: Molina Y6Q4 and Amerigroup Y6Q4 REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: 10255040 Ic Ca0d-13 MEMORIAL MEDICAL CENTER Memorial Medical Center A Y E E AMOUNT: EXPLANATION: REQUESTED BY: 3 CHECK REQUEST Date Requested: GAS/" & � 14,013.23 ✓ G/L NUMBER: 10255040 11/20/2023. FOR ACCi USE ONLY Imprest Cash ❑ A/P Check ❑ Mail Check to. Vendor Return Check. to Dept Molina Y6Q4 and Amerigroup Y6Q4 Caitlin Clevenger et17r9?3 P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER. Memorial Medical Center CHECK REQUEST Date Requested: 11/20/2023 NOV 2 0 2023 FOR ACCT USE ONLY ❑ Imprest Cash. ❑.A/P Check ❑ Mail. Check to Vendor ❑. Return Check to Dept $ 8,726.73 , G/L NUMBER: 10255040 EXPLANATION: Molina Y6Q4 and Amerigroup Y6Q4 REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: ra., 2y � 1s— 2 B (r�2qzi 23 P A Y E E IL0d011MIS MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center EXPLANATION: Date Requested: 11/20/2023 FOR ACCT USE ONLY ❑. Imprest Cash ❑ A/PCheck ❑ Mail Check. to Vendor ❑ Return Check. to Dept $ 55,556.43 ✓ G/L NUMBER: Superior y6g5 and y7 september REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: 10255040 Lt c2012- MEMORIAL MEDICAL CENTER CHECK REQUEST G Memorial Medical Center A Y Date Requested: 11/20/2023 EAPPPAWM ON NOV 2 0 2D23 c S AMOUNT: EXPLANATION: $ 39,271.62 / Molina Y6Q4 and Amerigroup Y6Q4 FOR ACCT USE ONLY ❑ Imprest Cash. ❑.A/P Check Mail Check. to Vendor ❑ Return.. Check to Dept G/L NUMBER: 10255040 REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: V/ 0 MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Date Requested: 11/20/2023 A Y E E APPROVED O0 NOV 2 Q 2923 FOR ACCT USE ONLY ❑ Imprest Cash. ❑A/P Check ❑' Mail Check to Vendor ❑'. Return Check to. Dept AMOUNT: $ 40,122.2 G/LNUMBER: 10255040 EXPLANATION: Superiory6g5 and y7 september REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: P Tuscany A Y E MEMORIAL MEDICAL CENTER CHECK REQUEST Date Requested: ON E C / AMOUNT: EXPLANATION: 11/20/2023 FOR ACCT USE ONLY ❑' Imprest Cash ❑. A/P Check ❑'. Mail Check to Vendor ❑ Return Check to Dept $ 22,500.00 ✓ G/L NUMBER: 21400007 Claim payment owed to Tuscany REQUESTED BY: Caltlin Clevenger AUTHORIZED BY: l kt2o ro b N W N N 10 Ut O r N N O M N N O1 III QI 'i t` L` cX L` O Ifl 61 b VI Vl N O Q 01 .+. 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