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2024-04-10 Final PacketI NOTICE OF MEETING - 411.012024 h April 10, 2024 MEETING yo o MINUTES �C 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 CountyJudge Vern Lyssy Commissioner Pct 1 Joel Behrens Commissioner Pct 2 Gary Reese (ABSENT) Anna Goodman Commissioner Pct 3 Commissioner Pct 4 By: Kaddie Smith County Clerk The subject matter of such meeting is Deputy Clerk as follows: 1• Call meeting to order. Meeting was called to order at 10am 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. Richard Perish invited the public to attend the Area Go Texan cookoff. Cindy Krause gave her condolences for passing of Mae Belle. Ron Langford spoke briefly regrading scammers after Veterans. Judge Meyer reminds public of Mae Belle's service. Page 1 of 9 NOTICE OF MFFTING -- 4/10/2024 S. Approve the minutes of the April 3, 2024 regular meetings. (RHM) RESULT: APPROVED MOVER: [UNANIMOUS] SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: David Hall, Commissioner Pct 1 Judge Meyer, Commissioner ' Hall, Lyssy, Behrens, Reese 6• Hear Report from Calhoun County Agril-ife Extension Agents. Emiiee DeForest (RHM) their re Karen Lyssy, RJ Shelley and Haile Ports' y Hayes gave 2• Consider and take necessary action to allow 5D Steakhouse Sharkies Bar & Grill to sell Malt/Beer/Wine duringto sell mixed beverages and Countyg sign , 2024 at Kingfisher Beach in Port O'Connor, the annual POC Crawfish Festival & Judge to si n letters of approval to the TABC. (GDR) TX and authorize MPartY T: APPROVED : [UNANIMOUS] DER: Gary,Reese, Commissioner Pct 4 Vern Lyssy Commissioner Pct 2 Judge Meyer Commissioner $• nd take necessary Hall, Lyssy, Behrens Reese 3rd Pre Hospital Integ Integration', approve and have the EMS Director sign the ESO Pass agreement, to integrate Pulsara and ESO. (RHM) 9• Consider and take necessary action to a maintenance contract and authorize the Calhoun County approve the Stryker 1 Year for to preventative RESULT; EMS Director to sign. (RHM) MOVER: APPROVED [UNANIMOUS] SECOND Joel Behrens, Commissioner Pet 3 AYES ER: David Hall Commissioner mmissioner Pct I g Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to a Maintenance Service Agreement with CFI Mechanical, Inc. for maintenance of approve the High Performance Preventative maintenance mechanical systems related to the heating 9 at 302 W, Live Oak St pott planned preventive 3-2 conditioning ondit onin and have Jude Lavaca g, ventilating and air 7797e (Contract Date: 3-30-2024 — 9 Meyer sign all related documents. RESULT: APPROVED (RHM) MOVER: Vern Lyssy, [UNANIMOUS] SECONDER: y y, Commissioner Pct 2 AYES: Gan' Reese, Commissioner Pct 4 Judge Meyer, Commissioner Hall Lyssy, Behrens, Reese i NOTICE OF MEE I ING — 411012024 11. Consider and take necessary action to proclaim the month of April, 2024 as Fair Housing Month. (RHM) ACcIui APPROVE[ Richard Mey DER: Vern Lyssy, Judoe MPi/A, wIMARIMOUS] r, County Judge Dmmissioner Pct 2 Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to declare Inventory No. 512-0165 — Washer as Surplus/S Inventory a No. 512-01 all Inventory. and Inventory O2- Machine g ry. (RHM) ry No. 512 0158 RESULT: gppROVED MOVER: [UNANIMOUS] SECONDER: David Hall, Commissioner Pct 1 AYES: Joel Behrens, Commissioner Pct 3 Judge Meyer, Commissioner Hall L ss Behrens, Reese 13. Public Hearing regarding amending the 2023 and 2024 Calhoun Co Closed regular session at 10:51 County Budgets. (RHM) Candice read the amendments Opened regular session at;11:09 14. Consider and take necessary action to amend the 2023 and 2024 Calhoun Budgets. (RHM) County RESULT: APPROVED MOVER: Vern L ss Commis - MOus] SECONDER: y Y Commissioner Pct 2 AYES; David Hall, :Commissioner Pct i Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Consider and take necessary action to authorize a loan in the amount of 97,540 from the general fund to the grants fund for the 2023 Operation Stone Garden - eGrant Award # 3192809. (RHM) RESULT: APPROVED MOVER: Gary Reese, Comm Ssioneripcf 4 SECONDER: David HaII, Commissioner Pct 1, AYES: Judge Me er Y , Commissioner Hall, Lyssy; Behr7Reese Paaa 2 . rn I NOTICF O( MEE PING — 4/1.0/2024 16. Consider and take necessary action to approve payment of $9 316.45 to Inc. due to ordering by mistake as Colorado Materials, LTD has the bid for Precinct Inc. Quality Hot Mix, nct 2. RESULT: APPROVED MOVER: [UNANIMOUS] SECONDER: David Hall, Commissioner Pct 1 ; AYES: Gary Reese, Commissioner Pct 4 Judge Meyer, Commissioner Hal(L ss 17. Consider and take necessa Y Y, Behrens, Reese Coun ry actiio toapprove Change Order No. 8 for the Calhoun County Combined Dispatch Facili Project for Calhoun County, County Judge to sign. (DEH) Texas and authorize Scott Mason e:31i e change order, RESULT: VED MOVER:[UNANIMOUS] SECONDER:rens, Commissioner Pct 4AYES: ll, Commissioner Pct 1 yer, Commissioner Hall L ss 18. Consider and take necessaryy y� Behrens, Reese Documents for Bid Number 2024.07 Magnolia Beach — pprove the Specifications and Contract Replacement Project for Calhoun Con and the Countyty, Texas and to OceanDrive &uW Engineers, am, Tuesday, Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 Y, April 30th, 2024 at the Pct. No. 1 Commissioner's OCe Engineers, Inc. scheduled to be due before 2:00:00 pm, Thursday, Office. (DEH) y, May 23, 2024 at the CountylBids are Srnt+ iu___ s Judge's 'Nitl specifications and contract documents. RESULT: APPROVED MOVER: [UNANIMOUS] SECONDER: David Hall, Commissioner Pct i AYES: Vern Lyssy, Commissioner Pct 2 Judge Meyer, Commissioner Hall L ss 19. Consider and take necessaryY Y, Behrens, Reese action to approve the Preliminary Megan Wright Subdivision. (DEH) ry Plat and Drainage Plan of E::: :es eliminary plat and drainage plan. D [UNANIMOUS] Commissioner Pct 1 Commissioner Pct 2 er, ommissioner Hall L ss C Y y, Behrens, Reese Paaa d -ra NOTICE OF MEETING.-4/10/2024 20. Consider and take necessary action to declare Asset No. 24-0416 - A/C System as Waste and remove from Precinct 4 R&B Inventory. (GDR) LT: APPROVED [UNANIMOI R:' Joel Behrens,.Commissionf 4DER. Gary Reese, Commissioner Judge Meyer, Commissions IS] r Pct 3 Pct 4 r Hall, Lyssy, Behrens, Reese 21, Public Hearing concerning Petition to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) L gular session closed at 11:2Q rry Ruddick explained the petition to vacate. gular session opened at 11:22 22. Consider and take necessary action to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 23. Consider and take necessary action to approve the Final Plat of American Townsite Subdivision Tracts 452X and 453X, Resubdivision No. I. (GDR) RESULT: APPROVED MMOVER: Gary Reese, SECONDER: JoelBehrens,3 AYES: Judge Meyer,l, Lyssy, Behrens, Reese 24. Consider and take necessary action to approve the Final Plat of the Cady Subdivision, (Replat of Lot 11008 of the Replat of Lot 1100 of the American Townsite Company Subdivision - Slide 696A of the Calhoun County Plat Records) Basibio Maldonado Survey, Abstract No. 19 Calhoun County, Texas. (GDR) FRESULT: explained final plat. APPROVED[UNANIMOUS] Gary Reese, Commissioner Pct 4 Joel BehrensCommissioner Pct 3 : Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 9 I NOTICE OF MEETING — 4/10/2024 25. Consider and take necessary action to approve the Final Plat of the Replat of Lots 6 & 7 Of Marlin Adul Villa's, Port O'Connor Townsite, Santiago Gonzales Survey, Abstract No. 19 recorded Slide No. 650a of the Calhoun County Plat Records. (GDR) Henry Danysh explained the final plat. RESULT: APPROVED [UNANIMOUS] MOVER:: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 26. Consider and take necessary action to authorize Kelley Ashley, the Calhoun County Children's Librarian to apply for the $500 HEB grant for the Summer Reading Program. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall. I vccv Rey . 27. Consider and take necessary action on Amendment No. 2 to Matagorda Bay M ltigation Trust Contract 031 to fund the additional engineering services for the Green Lake Park Development Phase 1 project, increase budget amount by $5,900 for a revised contract amount of $289,150 and authorize Judge Meyer to sign contract. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hail, Lyssy, Behrens, Reese 28. Consider and take necessary action on additional scope of work services from Stantec Consulting Services for the Port Alto Shoreline Permit -Amendment #2 in the amount of $21,274.00 to be paid out of GOMESA funds and authorize Commissioner Behrens to sign the agreement. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hail, Lyssy, Behren7Reese Page 6 of 9 NWICF OF MEFTING - 4/10/2024 29. Accept Monthly Reports from the following County Offices: i. Floodplain Administration — March 2024 ii. County Clerk — March 2024 iii. County Treasurer — December 2023 iv. County Treasurer — January 2024 v. County Treasurer — Investment Report — 4th Quarter 2023 vi. County Treasurer — Quarterly Statement of Balances - 4th Quarter 2023 vii. Justice of Peace, Precinct I — March 2024 Ali. Justice of Peace, Precinct 2 — March 2024 ix. Justice of Peace, Precinct 5 — March 2024 X. Sheriffs Department — March 2024 ULT: APPROVED [UNANIMOUS] FER: Vern Lyssy, Commissioner Pct 2 )NDER: David Hall, Commissioner Pct I Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 29. Consider and take necessary action on any necessary budget adjustments. (RHM) 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12024 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 7 of 9 NOTICE OF MEETING-4/10/2024 31. Approval of bills and payroll. (RHM) MIMIC 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 SUPPLEMENTAL AGENDA 32. Public hearing on Petition to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. (VLL) Regular session closed at 11:31 Henry Danysh explained the petition to vacate. Regular session opened at 11:32 33. Consider and take necessary action to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume z, Page 35 of the Calhoun County Plat Records. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 9 ' NONCE OF MEETING-4/10/2024 34. Consider and take necessary action to approve the Final Plat of Chavana Subdivision. (VLL) Henry Danysh explained final plat. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 35. Consider and take necessary action to approve the Final Plat of Thigpen Subdivision. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 11:33 Page 9 of 9 AGENDA I NOI ICf 01 iVIf [ 1ING 1I/10/1.01<t Richard H. Meyer County judge dge David Hall, Commissioner, Precinct 1 Vern dyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, April 10, 2024 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 I (� The subject matter of such meeting is as follows: AT V U 33 F�oC OCK__d4_M I. Call meeting to order. G�qqR qq0 5 2pp0MM24 2. Invocation. CouN CLERKNCALHOS#AN COUNTY, TEXAS 3. Pledges of Allegiance. oewn:GG�� 4. General Discussion of Public Matters and Public Participation. S. Approve the minutes of the April 3, 2024 regular meetings. (RHM) 6. Hear Report from Calhoun County AgriLife Extension Agents. (RHM) 7. Consider and take necessary action to allow 5D Steakhouse to sell mixed beverages and Sharkies Bar & Grill to sell Malt/Beer/Wine during the annual POC Crawfish Festival & Cookoff to be held April 27, 2024 at Kingfisher Beach in Port O'Connor, TX and authorize County Judge to sign letters of approval to the TABC. (GDR) 8. Consider and take necessary action to approve and have the EMS Director sign the ESO "3rd Party Pre -Hospital Integration" agreement, to integrate Pulsara and ESO. (RHM) 9. Consider and take necessary action to approve the Stryker 1 Year Procare preventative maintenance contract and authorize the Calhoun County EMS Director to sign. (RHM) 10. Consider and take necessary action to approve the High Performance Preventative Maintenance Service Agreement with CFI Mechanical, Inc. for planned preventive maintenance of mechanical systems related to the heating, ventilating and air conditioning at 302 W. Live Oak St, Port Lavaca TX 77979 (Contract Date: 3-30-2024 — 3-29-2025) and have Judge Meyer sign all related documents. (RHM) Page 1 of 3 N()IICLOf MI[T1NG-4/10/2074 11. Consider and take necessary action to proclaim the month of April, 2024 as Fair Housing Month. (RHM) 12. Consider and take necessary action to declare Inventory No. 512-0165 — Dish Machine with heat booster, Inventory No. 512-0157 — Washer and Inventory No. 512-0158- Washer as Surplus/Salvage and remove Jail Inventory. (RHM) 13. Public Hearing regarding amending the 2023 and 2024 Calhoun County Budgets. (RHM) 14. Consider and take necessary action to amend the 2023 and 2024 Calhoun County Budgets. (RHM) 15. Consider and take necessary action to authorize a loan in the amount of $97,540 from the general fund to the grants fund for the 2023 Operation Stone Garden - eGrant Award # 3192809. (RHM) 16. Consider and take necessary action to approve payment of $9,316.45 to Quality Hot Mix, Inc. due to ordering by mistake as Colorado Materials, LTD has the bid for Precinct 2. (VLL) 17. Consider and take necessary action to approve Change Order No. 8 for the Calhoun County Combined Dispatch Facility Project for Calhoun County, Texas and authorize County Judge to sign. (DEH) 18. Consider and take necessary action to approve the Specifications and Contract Documents for Bid Number 2024.07 Magnolia Beach Ocean Drive Bulkhead Cap Replacement Project for Calhoun County, Texas and to authorize G & W Engineers, Inc. and the County Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 am, Tuesday, April 30th, 2024 at the Pct. No. 1 Commissioner's Office. Sealed Bids are scheduled to be due before 2:00:00 pm, Thursday, May 23, 2024 at the County Judge's Office. (DEH) 19. Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Megan Wright Subdivision. (DEH) 20. Consider and take necessary action to declare Asset No. 24-0416 - A/C System as Waste and remove from Precinct 4 R&B Inventory. (GDR) 21. Public Hearing concerning Petition to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) 22. Consider and take necessary action to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) 23. Consider and take necessary action to approve the Final Plat of American Townsite Subdivision Tracts 452X and 453X, Resubdivision No. 1. (GDR) Page 2 of 3 Nod i T of IIVI 11ING 4/10/2024 24. Consider and take necessary action to approve the Final Plat of the Cady Subdivision, (Replat of Lot 1100B of the Replat of Lot 1100 of the American Townsite Company Subdivision - Slide 696A of the Calhoun County Plat Records) Basibio Maldonado Survey, Abstract No. 19 Calhoun County, Texas. (GDR) 25. Consider and take necessary action to approve the Final Plat of the Replat of Lots 6 & 7 of Marlin Adul Villa's, Port O'Connor Townsite, Santiago Gonzales Survey, Abstract No. 19 recorded Slide No. 650a of the Calhoun County Plat Records. (GDR) 26. Consider and take necessary action to authorize Kelley Ashley, the Calhoun County Children's Librarian to apply for the $500 HEB grant for the Summer Reading Program. (RHM) 27. Consider and take necessary action on Amendment No. 2 to Matagorda Bay Mitigation Trust Contract 031 to fund the additional engineering services for the Green Lake Park Development Phase 1 project, increase budget amount by $5,900 for revised contract amount of $289,150 and authorize Judge Meyer to sign contract. (GDR) 28. Consider and take necessary action on additional scope of work services from Stantec Consulting Services for the Port Alto Shoreline Permit -Amendment #2 in the amount of $21,274.00 to be paid out of GOMESA funds and authorize Commissioner Behrens to sign the agreement. (JMB) 29. Accept Monthly Reports from the following County Offices: i. Floodplain Administration — March 2024 H. County Clerk — March 2024 iii. County Treasurer — December 2023 iv. County Treasurer — January 2024 v. County Treasurer — Investment Report — 4th Quarter 2023 vi. County Treasurer — Quarterly Statement of Balances - 4th Quarter 2023 vii. Justice of Peace, Precinct 1 — March 2024 viii. Justice of Peace, Precinct 2 — March 2024 ix. Justice of Peace, Precinct 5 — March 2024 X. Sheriff's Department — March 2024 30. Consider and take necessary action on any necessary budget adjustments. (RHM) 31. Approval of bills and payroll. (RHM) r Richard H. Meyer, County Ju Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.calhouncotx ore under "Commissioners' Court Agenda" for any official court postings. Page 3 of 3 I NOII(E UF, SUFI'Lf'"1 P1fAI A(,[ NDA Richard H. Meyer (C®unffnty Judge David Hall Conunissioner, Precinct 1 Vern Lyssy, Cosninissioner, Precinct 2 Joel Behrens Commissioner, precinct 3 Garyy Reese,' Conunissioner, Precinct 4 5gJ][ P L]EM ENTAL NOTICE OF MEETING The Cor024 atnissioners' Court of Calhoun county, April 1®, 2®24 at b0:� aY, Texas will 'n. ui the CoCrnimiasioners' Courtroom in rneet on Wednesday, 211 S. Ann Street Suite nlr Port Lavaca Cthe County , Courthouse at _ Calhoun County, '�.,___ Texas. SUPPLEMENTAL AGENDA The additional subject matter of such meeting is as follows: 32. Public hearing on Petition to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. (VLL) 33. Consider and take necessary action to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. (VLL) p 34. Consider and take necessary action to approve the Final Plat of Chavana Subdivision. (VLL) 35. Consider and take necessary action to approve the Final Plat of Thigpen Subdivision. (VLL) AY D.� FILED O'CLOCK_M APR R 5 2R24 couw c "ci�°o°��n(�c" NTY. T,s �f�,r.'� Richard Meyer, C my Judge Calhoun County, Texas Page 1 of 2 I NOTICE OF MEETING-4/10/2024 April 10, 2024 MEETING MINUTES OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING AT 10:00 A.M. IN THE COMMISSIONERS' COURTROOM IN THE COUNTY COURTHOUSE AT 211 S. ANN STREET SUITE 104 PORT LAVACA, CALHOUN COUNTY, TEXAS. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Joel Behrens Gary Reese (ABSENT) Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Cali meeting to order. CountyJudge Commissioner Pct 1 Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at 10am 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. Richard Perish invited the public to attend the Area Go Texan cookoff. Cindy Krause gave her condolences for passing of Mae Belle, Ron Langford spoke briefly regrading scammers after Veterans. Judge Meyer reminds public of Mae Belle's service. Page 1 of 32 I 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 appropriate blanks. Please print or write legibly. NAME: /)D2C&aWJ ", ®/7�If/QIYA- ADDRESS: % a. 420 4V 3 /Lift lC0 - Ty '?79 o TELEPHONE: 7— C3 G / j 3 5 b: D� ✓/� PLACE OF EMPLOYMENT: ,Q- EMPLOYMENT TELEPHONE: Do you represent any particular group or organization? ES NO (Circle one) If you do represent a group or organization, please provide the name, address and telephone number of the group or organization: 469tir awsv cv, a4/fiR' GD�e x� Which agenda item (or items) do you wish to address? /V IA - In general, are you for or against the agenda item (or items)? /� f I hereby swear that any statement I make will be the truth and nothing but the truth to the best of my knowledge and abillty. Signature: Calhoun County Commissioners Court' Public Participation Form Court. Instructions:: Fill out all appropriate blanks. Please print or write legibly. NAME: t ; , A (A K lrri .I cce ADDRESS: TELEPHONE: 3(e l • - \ 2b . t W PLACE OF EMPLOYMENT: EMPLOYMENT TELEPHONE: Do you represent any particular group or organization? YES 0 (Circle one) If you do represent a group or organization, please provide the name, address and telephone number of the group or organization: Which agenda item (or items) do you wish to address? In general, are you for or against the agenda item (or items)? best of mllknowledae and ability P Signature: (A ( #5 i NOTICE OF MEE-I ING — 4/10/2024 5. Approve the minutes of the April 3, 2024 regular meetings. (RHM) RESULT; ' APPROVED [UNANIMOUS] MOVER: Vern:sy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 32 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 ofr Calhoun County, Texas met on Wednesday, April 3, 2024, at 1®:0o a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. Richard Meyer, Coun udge Calhoun County, Texas Anna Goodman, County Clerk Deputy Clerk Page 1 of 1 I NOTICE OF MEETING-4/03/2024 April 3, 2024 MEETING,MINUTES ° C 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 i Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at 10am 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, Shane Veach expressed his concerns about his neighbor opening an RV Park. Page 1 of 3 NOTICE OF MEETING—4/03/2024 5. Approve the minutes of the March 27, 2024 regular meetings. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Prt 2 Si David Hall, Comi ssiioner PCt 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 6. Memorial Medical Center Report. (RHM) RosharrldaThomas gave the rep, ortfor February 2024. 7. Consider and take necessary action on insurance proceeds check from TAC in the amount of $50,494.51 ($52,994.51— $2,500.00 deductible) for damages to a Sheriff Office Vehicle on 01/03/24. (RHM) 8. Consider and take necessary action to authorize the Calhoun County Judge and EMS Director to sign the DSHS Provider License Declaration Form (notarization needed). (RHM) RESULTi.,APPROVED [UNANIMOUS] MOYER: Gary Reese; Commissioner Pct 4 SECONDER 7oel Behrens, Commmissioner Pet-3 AYES Judge Meyer, Cornmissioner Hafl, LySsy, .Benreps, Reese 9. Consider and take necessary action to appoint William Crowley, D.O. as the Memorial Medical Center Chief of Staff for the April, 2024 — March, 2026 term, along with the MMC Board Members approved at the March 27, 2024 Commissioners Court Meeting. (RHM) Page 2 of 3 I NOTICE OF MEETING —4/03/2024 10. Consider and take necessary action on any necessary budget adjustments. (RHM) 11. Approval of bills and payroll. (RHM) Mmc, Bill -Is T� RESULT A V ,,-MOVEW avid H . 611, SECONDER :'-�,`-�4, A-1 Vof Y Judge' eyej pCt 3 Hall, BehnansR Reese Corrimjssoner Hell, LysSY';.8e-heehs7. 11166se Adjourned 10:16 Page 3 of 3 #6 I NOIICEOEMEErING-4/1.0/2024 6. Hear Report from Calhoun County AgriLife Extension Agents. (RHM) Fmilee DeForest, Karen Lyssy, R.7 Shelley and Hailey Hayes gave heir reports. Page 3 of 32 Mae Belle Cassel From: ellen.heiman@ag.tamu.edu (Ellen M. Heiman) <ellen.heiman@ag.tamu.edu> Sent: Monday, April 1, 2024 10:58 AM To: Mae Belle Cassel Cc: Karen P. Lyssy; Emilee S. DeForest; debbie.vickery@calhouncotx.org Subject: Agenda Item for April 10, 2024 CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe_ Good morning! Can you please put the Extension Agent Interpretation on the agenda for April 10, 2024. Hear report from Calhoun County AgriLife Extension agents. Also, can you please add me to the agenda email list that is sent out every week? Please let me know if you have any questions. Thanks! Ellen Heiman Calhoun County Office Manager Texas A&M AgriLife Extension 311 Henry Barber Way Suite 1 Port Lavaca, TX 77979 361-552-9747 work TEXAS A&M 0101 l f t! 1-Y A N 17 S 'Z t 4-H M �GR UFE t.j�xemuvi❑+.i u GROINS ram EXTENSION Texas AT TExAe Texas VGRSI'PY NOTICE OF MEETING-4/10/2024 7. Consider and take necessary action to allow 51) Steakhouse to sell mixed beverages and Sharkies Bar & Grill to sell Malt/Beer/Wine during the annual POC Crawfish Festival & Cookoff to be held April 27, 2024 at Kingfisher Beach in Port O'Connor, TX and authorize County Judge to sign letters of approval to the TABC. (GDR) ESULT: APPROVED [UNANIMOUS] OVER: Gary Reese, Commissioner Pct :CONDER: Vern Lyssy, Commissioner Pct 2 (ES: Judge Meyer, Commissioner Ha } Page 4 of 32 Port O'Connor Chamber of Commerce P.O. Box 701 Port O'Connor, Texas 77982 www.r)ortoconnorchamber.com April 4, 2024 Calhoun County Commissioners Court Commissioner Gary Reese, Precinct 4 211 S. Ann St. Port Lavaca, Texas 77979 Dear Commissioner Reese: The Port O'Connor Chamber of Commerce would like to revise our prior request for permission to use King Fisher Park on Saturday, April 27, 2024 for the 12'h Annual POC Crawfish Festival and Cookoff. I. We respectfully request that 5D Steakhouse have permission to use the property for the sale of mixed beverages. This license would be held from Friday, April 26, 2024 from 7:00 am through Saturday at 10:00 pm, which includes the time for set up, deliveries, and clean up afterwards. 5D Steakhouse would be selling alcohol and will have insurance and permits in place per requirements of Texas State Laws and TABC. We would respectfully request a letter from the County for 5D Steakhouse for use of the property, to obtain a temporary license from TABC. 2. We respectfully request that Sharkies have permission to use the property for the sale of malt/beer/wine beverages. This license would be held from Friday, April 26, 2024 from 7:00 am through Saturday at 10:00 pm, which includes the time for set up, deliveries, and clean up afterwards. Sharkies would be selling malt/beer/wine beverages and will have insurance and permits in place per requirements of Texas State Laws and TABC. We would respectfully request a letter from the County for Sharkies for use of the property, to obtain a temporary license from TABC. Sincerely, /s/ Darla Parker Darla Parker, President Port O'Connor Chamber of Commerce Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 4, 2024 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 April 10, 2024. • Consider and take necessary action to allow 51) Steakhouse and Sharkies Bar & Grill to sell mixed beverages during the annual POC Crawfish Festival & Cookoff to be held April 27, 2024 at Kingfisher Beach in Port O'Connor, TX and authorize County judge to sign letters of approval to the TABC. Sincerely,, 1 J. Gary Dleese� GDR/at P.O. Box 177 - Seadrift, Texas 77993 , email: a .rees na c Ih uncotx or - (36I) 785-3141 -Fax (361) 785-5602 Owner of Property Authorization Letter Date: April 10, 2024 Texas Alcoholic Beverage Commission 2820 S. Padre Island Dr., Suite #120 Corpus Christi, TX 78415 (361) 851-2531 Organization Name: SD Steakhouse I hereby authorize 5D Steakhouse to sell alcohol/mixed beverages at the following: Event Description: Crawfish Fest Date(s) of Function: April 26 - 28, 2024 Time(s) of Function: 7 am —10 pm Location Address: 409 Park Avenue, Port O'Connor, TX 77982 Print Name of Property Owner: Calhoun County Name and Title: R' rd Meyer, County Judge Signature: Phone Number: (361) 553-4600 Owner of Property Authorization Letter Date: April 10, 2024 Texas Alcoholic Beverage Commission 2820 S. Padre Island Dr., Suite #120 Corpus Christi, TX 78415 (361) 851-2531 Organization Name: Sharkies Bar & Grill I hereby authorize Sharkles Bar & Grill to sell Malt/Beer/Wine at the following: Event Description: Crawfish Fest Date(s) of Function: April 26 - 28, 2024 Time(s) of Function: 7 am —10 pm Location Address: 409 Park Avenue, Port O'Connor, TX 77982 Print Name of Property Owner: Calhoun County Name and Title: 1ch d Meyer, County Judge c Signature: a Phone Number: (361) 553-4600 I NOTICE OF MEETING—4/10/2024 8. Consider and take necessary action to approve and have the EMS Director sign the ESO "3rd Party Pre -Hospital Integration" agreement, to integrate Pulsara and ESO. (RHM) pass Page 5 of 32 eso CUSTOMER CONTACT Customer Calhoun County EMS (TX) Name Dustin Jenkins Email dusdn.jenkins@calhouncotx.org Phone 361-552-1140 BILLING CONTACT Payor Calhoun County EMS (TX) Name ERIKA ROJAS Email erika.rojas®calhouncotx. org Phone (361) 482-9528 Quote Date: Customer Name: Quote #: Quote Expiration Date: ESO Account Manager: Address Billing Frequency Initial Term End Date 02/28/2024 Calhoun County EMS (TX) Q-1516O3 06/30/2024 Wade Estes 216 East Mahan Port Lavaca TX, 77979 Annual 12-31-2024 $395.00 Recurring Annual Recurring Fees $ 395.00 One -Time Fees $ 0.00 TOTAL FEES g 395.00 For EHR, the following payment terms apply: Fees are invoiced at the Billing Frequency 15 days after the Effective Date, with recurring fees due on the anniversary. eso Quote Date: 28/2024 Customer Name: Calhoun County EMS JX) Q-1 Quote #: Q-151603 Quote Expiration Date: 06/30/2024 ESO Account Manager: Wade Estes TERMS AND CONDITIONS: 1. If the Customer indicated above has an ESO Master Subscription and License Agreement (MSLA) dated on or after February 20, 2017, then that MSLA will govern this Quote. Otherwise, Customer intends and agrees that this Quote adopts and Incorporates the terms and conditions of the ESA and associated HIPAA business associate agreement hosted at the following web address, and that the products and services ordered above are subject thereto: httos://www.eso.com/legal-terms/ 2. The Effective Date of this Quote shall be the date of Customer's signature. 3. For the Initial Term, Customer shall pay a prorated amount of the Total Annual Recurring Fees based upon the Effective Date. Customer shall paythe Total Annual Recurring Fees (subject to any Fee increases in accordance with the Agreement) thereafter. 4. Customer is responsible for the payment of all Fees shown. ESO will accept Fee payment from a payor (if indicated above) if ESO has an appropriate agreement with the Payor. 5. ESO reserves the right to not accept any Quote signed after the Quote Expiration Date. Calhoun County EMS (X) Signature: Print Name: Title: Date: eso Quote Date: 02/28/2024 Customer Name: Calhoun County EMS (TX) Quote #: Q-151603 Quote Expiration Date: 06/30/2024 ESO Account Manager: Wade Estes DocuSign Envelope ID: 88FB5EE3-8808.47A7-A8EA-7977B32753E2 e4W50 Please fill in your contact information below: Name Primary Business Contact Invoicing Contact Legal Contact Software Administrator Contact Privacy HIPAA Contact Tax Exempt I YES OR NO Purchase Order I YES OR NO Required? Email Phone If YES, return Exempt Certificate with Agreement If YES, return PO with Agreement � Request for Taxpayer Form (Rey. October2018) Identification Number and Certification Give Form to the requester. Do not Department of the Treasury Internal Revenue Service ► Go to www.im gov/FormW9 for instructions and the latest Information. Send to the IRS. 1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blank. ESO Solutions, Inc. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to following seven boxes. certain entities, not individuals; sea a p ❑ Individual/sole ra rtetor or Corporation proprietor C Co ❑ S Corporation ❑ Partnership ❑ Trust/estate Instructions on pegs 3): rn c single -member LLC Exempt payee code (if any) 5 ❑ Limited liability company. Enter the tax classlfloation (C=C corporation, S=S corporation, P=Partnership) ► `0 2 T� Note: Check the appropriate box In the line above for theta classification of the single -member owner. Do not check LLC If the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC Is Exemption from FATCA reporting another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that code (if any) Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. ❑ Other law instructions)► gppw• ronccounnmvmmn.naurcme are usl y 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) y PO Box 679449 e City, state, and ZIP code Dallas, TX 75267-9449 7 List account numbers) here (optional) Number IT Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). If you do not have a number, sea How to get a TIN, later. Note: if the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (a) the IRS has notified me that I am no longer subject to backup withholding; and S. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form Of any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part II, later. Signature of Here U.S. Person ► ic-.G,,,:.L Date► 1/5/2023 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number QTIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (Interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (Including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Form W-9 (Rev. 10.2018) By signing the filled -out form, you: 1. Certify that the TIN you are Exam /e. Article 20 of the U.S: China Income tax tree Fsee 2 number of be issueda subject to is correct (or you are waiting fora exemption from tax for scholarship income received by a Chinese 2. Certify that you are not subJect to backup withholding, or student temporaril ry allows an student will became arresltlenttal en fo to pueposesdif his orfher stay in 3. Claim exemption from backup withholding if you are a U.S. exam t Payee. If applicable, the United States exceeds 5 calendar years. However, allocable share t1 anyou are also certifying that as a U.S. person, P the first Protocol to the U.S: China tree hip Incom of not subject n the wf hholding tax on foerelon a U.S. Your the provisions of Article 20 to continue to edati d Paragraph 2 of effectively connected incOme, and trade or business student bsomes a resident alien of the United States A CFrhi Chinese ss 9 partners' share of student who qualifies for this exception (under 4. Cerf that FATCA code(s) entered on this form if an that you are exempt from the FATCA reporting, is correct. See What is W-9 a statement that includes the Information described above o Protocol) and Is relying on this exception to claim an exemption from tax Paragraph 2 of the first ( y) indicating on his or her scholarship or fellowship income would attach exemption Form FATCA reporting, later for further information. Note: If you are a U.S. person and a requester gives you a form other s If port are aort that exemption. alien or a foreign anti than Form W-9 to request your TIN, you must use the requester's form if If completed Form W- it is substantially similar to this Fo Y � W-9• 9 entity, give the requester the Definition of a U.S. Person. For federal tax Purposes, 8 or Form 8233. considered a U.S. person If you are: You are Backup Withholding is • An individual who Is a U.S. citizen or U.S. or a resident alien; What sttun ecertain conditions withhold and Pay to the IRS 24% of such • A pa divide ,on, backup withholding? Persons making certain payments to you organized in the Um d States Or�under the laws ssOcof iation created or United States; Payments. This is called "backup subject to backup withhold ng nude Interest, tax-exempt Payments that may be • An estate (other than a foreign estate); or dividends, broker and barter exchange transactions, rents, royalties, • A domestic trust (as defined In Regulations section 301.7707_7), interest, nonemplaye pay, payments made in settlement of payment card and Special rules for partnerships. Partnerships that conduct a trade or third Party network transactions, and certain business in the United States are operators. Real estate transactions are not subject totbackup�shing boat tax under section 74a6 on any foreign required to pay a withholding Withholding. connected taxable Income from su h business. FurthePartners, share r, in effectively cti certaincases where a Form W_9 has not been received, the rules under section case You will not be subject u backup withholding on require a Partnership to receive if you give the requester your correct TIN, mPayments ke rye tsdou Pay the section rasp toPrwithholding that a Partner is a foreignPerson,tax return. certifications, and report all your taxable interest and dividends onryour that is a tax. Therefore, if You r e a .S. person and partner in a Partnership conducting a trade or busin ss in hePayments United States, Provide Form W_9 to the partnership to establish your You receive will be subject U.S. status and avoid section 1446 withholdingon 1 •You do not furnish your TIN to the equesterrp whhholding if: partnership income. your share of 2. You do not Certify In the cases below, the followingPart if for details), your TIN when required (see the Instructions for partnership for purposes of establihirng Its U.S.muststatus and avoiding ive Form W-9 to a 3. The IRS tells the requester that you furnished an incorrect TIN, withholding on its allocable share of net Income from the conducting a trade or business in the United States. 4. The IRS tells you that you are subject to backup partnership because you did not report P withholding • In the case of a disregarded entity with a U.S, owner, the U.S. owner P all Your interest and dividends on your tax return (for reportable interest and dividends only), or of the disregarded entity and not the entity; 5. You do not certify to the • In the case of a grantor trust with a U.S. grantor or other US. owner, backup withholding under 4 above (for rrepotrtable interest and dividend generally, the U.S. grantor or other U.S. owner of the grantor, trust and accounts opened after 1983 only). not the trust; and • In the case of a U.S. g See ExemCertain pt yes and payments are exempt from backup withholding. trust (other than a rancor trust), the U.S. trust Requester of Form W- (otherthan agrantor trust) and not the beneficiaries of the trust. Ra F pays code, later, and the separate Instructions for the S. branch of a Foreign person, If you are a foreign e U Also see Spec/at rule forOreinformation. foreign bank that has elected to be treated as a U.S. person, do not use partnerships, earlier. Form 15, Instead, use the appropriate Form W- What is FATCA Reporting? Pub. W- Withholding of Tax on Nonresident Aliens and Foreignm 8233 (see The Foreign Account Tax Compliance Act (FATCA) requires a Entities). Nonresident alien who becomes Participating foreign financial institution toreo are nonresident alien individual may use he terms olf a tax treaty to reduce reporting coaccount lder la eat and the A reporting for the R states Persons. Certain specified report all United States or eliminate U.S. tax on certain Payees are exempt from FATCA reportin . types of income. However, most tax W-9 for more information. g See Exemption from FATCA treaties contain a provision known as a "saving clause." Exceptions Specified in the saving clause ma Requester of Form continue for certain y Permit an exemption from tax to Updating become a U.S. resident alienincome n o� even after the Payee has otherwise 9 Your Information If you are a U.S, resident alien who s relying on an exce lion You must Provide updated information to an contained in the saving clause of a to treaty to claim an exemption claimed to be an exemptY Person to whom you from US tax tax on certain p and anticipate Payee if you are no longer an exempt to Form W_ types of income, person. Foraexam example you payments in the future rpayee 9 that specifies the following five items t attach a statement P You inthis 1. The tree count y y You are a C corporation that electsto bto Provide an IS corporation, information if country.Gene address! from ,this must be the same treat under the name orer are changes for the account; for example, a the grantor if a which you cis med exemption from tax e s nonresident alien. Pt. In addition, you or if you no 2. The treaty article addressing the Income. y must furnish a new Forth W_91f 3. The article number (or location) in the to treaty that contains the grantor trust dies. saving clause and its exceptions. Penalties 4. The type and amount of income that qualifies for the exemption from to. Failure to furnish TIN. If you fail to furnish our 50 5. Sufficient facts to juatfty the exempt requester, you are subject to a penal y correct TIN to a the treaty article. Ptfon from t unless your (allure (s due to reasonable cause and not to wfor each illful neglect tax under the terms of Civil penalty for false Information with respect to withholding. make a false statement with no reasonable basi backup withholding, you are subject to a $500s that results in no penalty. if you Form W-9 (Rev. 10-2018) Page 3 Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties IF the entity/person on line Misuse of TINs. If the requester discloses or uses TINS in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9. a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note: ITIN applicant: Enter your Individual name as It was entered on your Form W-7 application, line la. This should also be the same as the name you entered on the Form 1040/1040A/I 040EZ you filed with your application. b. Sole proprietor or single -member I.I.C. Enter your individual name as shown on your 1040/1040All 040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single -member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from Its owner Is treated as a "disregarded entity." See Regulations section 301.7701-2(c)(2)(Iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name Is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 Instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN. Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3. 1 is THEN check the box for... Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you. Exempt payee code. • Generally, individuals (Including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. • Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. • Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space In line 4. 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment trust 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 Form W-9 (Rev. 10-2018) Page 4 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for ... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Barter exchange transactions and Exempt payees 1 through 4 Patronage dividends Payments over $600 required to be Generally, exempt payees reported and direct sales over 1 through 5' $5,000 Payments made in settlement of Exempt payees 1 through 4 Payment card or third party network transactions 1 See Form 1099-MISC, Miscellaneous Income, and Its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attomeys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes Identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if You are only submitting this form for an account you hold In the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code. A —An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or instrumentalities C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as descdbed in Regulations section 1.1472-1(c)(1)(i) E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(c)(1)(i) F—A dealer in securities, commodities, or derivative financial Instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G—A real estate investment trust H—A regulated Investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I —A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Note: You may wish to consult with the financial Institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. if a new address is provided, there is still a chance the old address will be used until the payor changes your address in their records. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an MN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. If you are a single -member LLC that is disregarded as an entity separate from Its owner, enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations. How to get a TIN. if you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.Irs.gov/Buslnesses and clicking on Employer Identification Number (EIN) under Starting a Business. Go to www.Irs.gov/Forms to view, download, or print Form W-7 and/or Form SS-4. Or, you can go to wwwJrs.gov/OrdsrForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 business days. If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note: Entering "Applied For" means that you have already applied for a TIN or that you Intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise. For a joint account, only the person whose TIN is shown In Part I should sign (when required). In the case of a disregarded entity, the Person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier. Signature requirements. Complete the certification as indicated in items 1 through 6 below. Form W-9 (Rev. 10-2018) Pace $ 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out Item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" Include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). S. Mortgage Interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester ror true type or account: I Give name and SSN of: 2. Two or more individuals iloint account) other than an account maintained by an FFI 3. Two ar more U.S. persons goint account maintained by an FFI) 4. Custodial account of a minor (Uniform Gift to Minors Act) 5. a. The usual revocable savings trust (grantor Is also trustee) b. So-called trust account that Is not a legal or valid twat under state law 6. Sole proprietorship or disregarded entity owned by an individual 7. Grantor twat filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.6714(b)(2)(i) The actual owner of the account or, if combined funds, the first Individual on the account' Each holder of the account The minors The grantor -trustee' The actual owner' The owners The grantor- une .ype or account: Give name and ON oh 8. Disregarded entity not owned by an The owner Individual 9. A valid twat, estate, or pension trust Legal entity° 10. Corporation or LLC electing The corporation corporate status on Form 8832 or Form 2553 11. Association, club, religious, The organization charitable, educational, or other tax- exempt organization 12. Partnership or multi -member LLC I The partnership 13. A broker or registered nominee The broker or nominee name and Agriculture In the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural Program payments 15. Grantor twat filing under the Form I The twat 1041 Filing Method or the Optional Fan 1099 Filing Method 2 (see ' List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. ' Circle the minor's name and furnish the minor's SSN. ' You must show your Individual name and you may also enter your business or DBA name on the "Business nameldisregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. " List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships, earlier. *Note: The grantor also must provide a Form W-9 to trustee Of trust. Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer, if your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039, For more information, see Pub. 5027, Identity Theft Information for Taxpayers. Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAB) assistance. You can reach TAS by calling the TAS toll -free case intake line at 1-877-777-4778 or TTYfrDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websltes designed to mimic legitimate business smalls and websites. The most common act Is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. Form W-9(Rev. 10-2018) The IRS does not initiate contacts with taxpayers via emaiis. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access Information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing®im.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (fIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at spam®uce.gov or report them at www.ftc.gov/complaint. You can contact the FTC at www.ffc.govfidtheft or 877-IDTHEFT (877-438-4338). If you have been the victim of identity theft, see www.ldentityTheft.gov and Pub. 5027. Visit wwwdrs.govIldendtyTheft to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report Interest, dividends, or certain other income paid to you; mortgage Interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the Information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The Information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent Information. #9 ' NOTICE. OF MEETING -- 4/10/2024 9. Consider and take necessary action to approve the Stryker 1 Year Procare preventative maintenance contract and authorize the Calhoun County EMS Director to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 32 Stryker 1 YEAR PREVENT Quote Number: 10894737 Version: 1 Prepared For: CALHOUN COUNTY EMS Attn: GPO: CUSTOMER CONTRACT Quote Date: 03/26/2024 Expiration Date: 06/24/2024 Contract Start: 04/01/2024 Contract End: 03/31/2025 Delivery Address Name: .... _... __..-. _...... _ -. CALHOUN COUNTY EMS Account#: -- 20145708 _-_ -- Address: ---_ — — ----- -- 705 HENRY BARBER WAY PORT LAVACA- -- Texas 77979- --. - 5743 ._..__. - PrOCare Products: Rep: Tim Garza Email: Phone Number: Service Rep: Jason Evans Email: jason.evansl@stryker.com Bill To Account Name: CALHOUN COUNTY EMS Account#: 20145708 Address. --_--- -- 705 HENRY BARBER WAY - PORT LAVACA Texas 77979-5743 - "--- 2.0 POWERLOAD-PROCARE PROCARE-SVC-POWER-LOAD 12 _.... 6 $2,273.00 E-SVC-POWERPRO _ -. . -- _._- 3.0 POWERPRO•PROCARE PRocAR 12 1 $305.00 4.0 STR-CHAIR-PROCA _ -- 10.0% $1,439.10 $10,073.70 - 10.0 i $2,045.70 $12.274.20 $305.00 $305.00 RE PROCARE-SVC-STAIRCHAIR _ 12 6 $30500 _..0 o 1.0% $27450 $1,847.00 5.0 POWERLOAD-PROCARE PaocgRE-Svc-PowER LOAD ---- -- _... 12 1 $2,273.00 10.0% $2,045.70 _-. -.... -- - $2,045.70 Price Totals: ProCareTotal: Grand Total: $26,345.60 $26,345.60 1 This is not an Invoice stryker 1 YEAR PREVENT Quote Number: 10894737 Version: 1 Prepared For: CALHOUN COUNTY EMS Attn: GPO: CUSTOMER CONTRACT Quote Date: 03/26/2024 Expiration Date: 06/2412024 Contract Start: 04/01/2024 Contract End: 03/31/2025 Rep: Tim Garza Email Phone Number: Service Rep: Jason Evans Email: isson.evansl@strykeccom Timothy Garza 4/3/2024 —J N 4/3/2024 Authorized Customer Signer (Printed) Date Stryker Authorized Signature (Printed) Date -r, -L),, Authorized Customer Signature Date 6VZ ()I//()—bey'"E Purchase Order Number vzy Service Terms and Conditions: The Terms and Conditions of this quote and any subsequent purchase order of the Customer are governed by the Terms and Conditions located at https://techweb stryker.com The terms and conditions referenced in the immediately preceding sentence do not apply where Customer and Stryker are parties to a Master Service Agreement. 2 This is not an Invoice - .nw..��-avu-ruwenrno 180339718 PROCARESVC POWERPRO 150240734 PROCARE-SVC POWERPRO 160742044 PROCARESVC POWERPRO 130241046 _ PROCARE-SVC POWERPRO 14074090 48 - _ PROCARE-SVC-POWERPRO 121040419 PROCARESVC-POWERPRO 130339316 2.0 PROCARE-SVC POWER -LOAD 160641332 2.0 ROCARESVC POWER -LOAD _._... - 1901003400141 2.0 _ _... PROCARE-SVC POWER -LOAD _..__. -__ _ 171239644 _..__ 2.0 --.— —._ PROCARE-SVC POWER LOAD -___-_-__.._—.-.- ______— 1903003400243 2.6 _. PROCARE-SVC POWER-LOADAD 130240666 2.0 PROCARE-SVC-POWER-LOAD - - - 171239368 -- -__... PROCARESVC POWERPRO 2312020700052 4.0 CARE-SVCSTAIR-CHAIR 1904010000162 PROCARE-SVC STAIRCHAIR 2304010000155 40 -_-" - ----- --- -- PROCARESVCSTAIRCHAIR .----- 2304010000154 40 PROCARE-SVC STAIR CHAIR4.0 2110010000276 -_"- "" - ---- PROCARE-SVC STAIR -CHAIR - -' _"- 140739187 _ .—__ PROCARESVCSTAIR CHAIR - _ ...___ -- --- 2201010000107 5.0 "'----- PROCARE-SVC-POWER-LOAD -- - _ --_ ---- ---- 1110124001AF cl Purchase Order Formo Account Manager >4e lr r� Cell Phone �5 A / 570 eolY Check box if Billing same as Shipping allRn Account Num Company Name Contact or Department Street Address Adel Address tine Sal STZIP ---- Phone -- —�"—~ Authorized Customer Initials Purchase Order Date Expected Delivery Date Stryker Quote Number stryker 7�17 SixSSllfr1. o Num_ IpPne 4 M.:: rr - r •: Co Name Company Name Contact or Department Street Address Addt'i Address Line -- -------- CIty,STZIP-- Phone —��— Authorized Customer Initials DESCRIPTION QN TOTAL REFERENCE QUOTE u Accounts Payable Contact Information Name %Aen, /` I C. Email ole', A'.// e.,A euNCn A'.O rq" Phone _'j 9/— j' j Q —// 0 J Authorized Customer Signature Printed Name 1 J S Yr✓ True r."Nt 5 .Ht2L<G ry fe Slgnature Date�� 1yOZ Attachment Stryker quota Number Stryker Terms and Conditions wylw.sUykeccomisfno `Sales., use taxes on domestic (USA( deliveries will be involved in addition to the price of the goods and services on the Stryker Quote. Form W-9 Request for Taxpayer Give Form to the (Rev. October 2018) Identification Number and Certification requester. Do not Department o/the Treasury Intemal Revenue Service ► Go to www.1rs.g0v/F0rmW9 for instructions and the fatest information. send to the IRS. t Name (as shown on your income tax retumi Nam. i• _ n.ew ..-..,_ „__.._ _ _.. ... .. 11 —• rt•u"muisregaroao ennry, name, If different from above Stryker Sales, LLC m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. 4 Exemptions (codes apply only to a o ElIntlivitluel/sole proprietor or ❑✓ C Corporation ❑ 3 Corporation ❑ Pannership ❑TrusVestate certain entities, not Individuals; see Instructions on page 3): ai c single -member LLC 4''a o ❑ Limited liability company. Enter the tax Exempt payee code (f any) 5 E classification (C=C corporation, S=S corporation, P=Partnership) ► Note: Check the appropriate box in the line above for the tax classification of the single Co` C tl -member owner. Do not check LLC if the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC Is another LLC that Is not disregarded from the for Exemption from FATCA reporting o owner U.S. federal tax purposes. Otherwise, a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classification of Its cotle Ofany) E aOther owner. (see Instructions) 0- w 5 Address(number,street, and apt. or suite no.) See Instructions. Npp'•ro"Oonb "'•roa°OO u^• in• usl y1941 STRYKER WAY Requester's name and address (optional) 6 City, state, and ZIP code PORTAGE, MI 49002 7 List account number(s) here (optional) enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get TIN, later. Note: If the account is in more than one name, see the Instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. J©o©on©©oe unaer penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding. because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (a) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form Of any) indicating that I am exempt from FATCA reporting is correct. Certfifilcadon instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement I other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See theinstruct instructions for llParrtt II later. Sign Here I Signature of U.S. person► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormWg. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an Information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) Date► 1/2/2024 • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be sub/ect to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos. 1- 4 and 6 it there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's. place of business. 2024-1139891 Stryker Sales, LLC Portage, MI United States Date Filed: 03/27/2024 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County EMS Date Acknowledged: 3 Provide the Identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Stryker EMS Contract EMS Service Contract for Stretchers, Loading System, and Stair Chairs 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is Timothy Garza and my date of birth is 10/11 /1986 My address is 1118 Shepherd Oaks Drie Houston TX 77018 USA (street) ) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Harris County, State of Texas on the 27 day of March 2024 (month) (year) -1 Signature of authorized agent of contracting business entity (Dedemnt) Pnrmc orovided K" 7-- c.r.:..� r........,.-_:__ ,'••'-•__- �, �-A �.,,,eu t-om ssMi. www.etnres.state.tx.us Version V3.5.1.505d027 # io NOTICE OF MEETING — 4/1012.024 10. Consider and take necessary action to approve the High Performance Preventative Maintenance Service Agreement with CFI Mechanical, Inc. for planned preventive maintenance of mechanical systems related to the heating, ventilating and air conditioning at 302 W. Live Oak St, Port Lavaca TX 77979 (Contract Date: 3-30-2024 — 3-29-2025) and have Judge Meyer sign all related documents. (RHM) 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 32 HIGH PERFORMANCE PREVENTIVE MAINTENANCE AGREEMENT PREPARED FOR Everett Wood CALHOUN COUNTY 211 S. ANN PORT LAVACA, TX 77979 PROPOSED BY Matt Solomon CFI MECHANICAL, INC. 6109 BRITTMOORE HOUSTON, TEXAS 77041 EQUIPMENT LOCATION CALHOUN COUNTY JAIL Date: 3-7-24 Effective Contract Date: 3-30-24 — 3-29-25 CONTRACT NUMBER: 2024-1MS i MECHANICAL -PREVENTIVE MAINTENANCE PROGRAM SECTION I INDEX ARTICLE TITLE I • Introduction 2. Scope of Work 3 • General 4. System Operation 5. Replacement Parts Components & Equipment 6. Routine & Service Emergency Calls 7. Owner/Contractor Responsibilities 8• Preventive Maintenance Log 9. Duration of Preventive Maintenance Contract 10. Termination 11. Annual Contract Price Adjustment 12. Payment 13. Acknowledgement ART. I. INTRODUCTION A. These contract documents cover a Service Agreement between CFI Mechanical, Inc., the Contractor and Calhoun County, the Owner, for planned preventive maintenance of Mechanical systems related to the heating, ventilating, and air conditioning at 302 W. Live Oak St, Port Lavaca, TX 77979. ART. 2. SCOPE OF WORK 7 A. The scope of this contract shall be a preventive maintenance for equipment described below B. The maintenance service contract shall include: SCREW CHILLER— ANNUAL PM (1) 1. Check and verify power supply to unit and unit operates 2. Record equipment operating hours and recent alarms 3. Check and tighten all electrical connections and inspect relays and contactors 4. Visual check for oil and water leaks. Perform refrigerant leak check with electronic leak detector 5. REMOVE OIL SAMPLES TO SEND IN FOR ANALYSIS 6. Secure any loose tubing and wiring to protect from chafing 7. Megger all motors, as per manufacture 8. Change oil filter on the screw chiller. Check the temperature drop on the liquid line driers. 9. Check and clean condenser coils with water, no pressure washing or chemicals applied 10. Check crankcase and barrel heaters for proper operation 11. Check and verify compressor volts and amps 12. Check and verify condenser fan motor volts /amps and rotation, if applicable 13. Measure and verify water flow through evaporator / Delta T 14. Measure and verify condenser and evaporator pressures, as required 15. Check all operating and capacity controls for proper operation 16. Check and verify all safety control settings 17. Check temperature control system for proper operation 18. Check refrigerant condition, moisture indicator and sight glass 19. Check and tighten starter/VFD electrical connections and clean the cabinets. 20. Verify unit operating requirements 21. After 30 minutes of operation, check oil, as per manufactures recommendations 22. Check for unusual noise and vibrations 23. Perform any other tests or checks specific to equipment 24. Check cabinetry hardware and structural integrity of unit 25. Inform customer of any problems found or work needed 26. Follow up with report of oil sample analysis SCREW CHILLER— QUARTERLY PM (3) 1. Check and verify power supply to unit and unit operates 2. Record equipment operating hours 3. Check coils 4. Visually check for oil, refrigerant and water leaks 5. Measure and verify water flow through evaporator / Delta T 6. Measure and verify condenser and evaporator pressures, as required 7. Check all operating and capacity controls for proper operation 8. Check all chiller pressure/temperature readings 9. Check temperature control system for proper operation 10. After 30 minutes of operation, check oil, as per manufactures recommendations 11. Complete a chiller log sheet CHILLED WATER PUMP — ANNUAL AND QUARTERLY PM (4) I . Measure and verify water flow through pump 2. Check for abnormal operation or vibration 3. Check electrical connections 4. Record voltage and amp readings 5. Lubricate as needed 6. Check for water leakage and seal condition 7. Check VFD/Starter for faults and proper operation 8. Complete log sheet C. Items not included in maintenance service contract. (1) Building Automation System troubleshooting/repairs (2) Water Treatment. (3) Component repair/replacement (4) Overtime (5) System design (6) Refrigerant (7) Electrical disconnect switches and breakers (8) Gas, water and drain piping (9) Equipment replacement (10) Service repairs due to neglect or misuse by others (11) Non -Moving parts. ART. 3. GENERAL A. The maintenance service program shall be arranged to maintain all systems and equipment in their original specified condition and shall include all preventive maintenance labor. Should corrective measures or repairs be required during inspection a report will be furnished to Calhoun County with recommended actions. Service Inspections shall be ART. 4. ART. 5. ART. 6. provided quarterly, but does not provide for repairs, replacement parts, materials, and refrigerant or compressor oil. B. SERVICE RATES Straight Time $120.00/hr. Overtime $180.00/hr. (M-F after 4:00 pm & Saturdays) Double Time $240.00/hr. (Sunday & Holidays) SYSTEM OPERATION A. All systems covered under this contract shall be operated by the owner. B. The Owner may make changes which affect a specific system or its operation. The contractor will be notified in writing of any such changes or revisions. These changes or revisions affecting equipment or systems under this contract shall become a part of the contract. C. The responsibility of the contractor shall be to maintain and service all systems included in this contract in efficient operating condition for continued operation by Owner personnel. REPLACEMENT PARTS COMPONENTS AND EOUPMENT A. All system components replaced by the contractor shall be with components of the same manufacturer where possible. When conditions require replacement components to be of a different manufacturer, the contractor shall notify the Owner prior to replacement. ROUTINE AND EMERGENCY SERVICE CALLS A. The contractor shall report to the Owner's designate at the start and end of each job visit. The contractor shall indicate whether the visit is for a scheduled maintenance inspection or as a result of an emergency call for service. B. A written report of the status of each visit will be made by the technician and left with the owner's designate. Emergency calls or routine calls which result in the discovery of emergency or potential emergencies are to be reported immediately to the Owner's designate. The satisfactory conclusion of each emergency call shall be reported and defined in writing to the Owner's designate. C. All planned preventive maintenance service shall be performed during the contractor's normal working hours of 7:00 a.m. to 4:00 p.m. Operating equipment shutdown, required for the performance of routine inspection and maintenance, shall be held to minimal periods of time. Shut down of critical systems such as air-cooled chillers shall be scheduled with the advance knowledge and approval of the owner. D. Regular maintenance and/or inspections of system servicing executive areas, lecture rooms, meeting rooms and similar areas shall be scheduled during "non -occupied" periods. E. When equipment must be shut down for repairs, the owner shall be notified immediately of the delay and measures being taken to put the equipment back in service. ART. 7. OWNER/CONTRACTOR RESPONSIBILITIES A. The Owner will provide access to all devices that are to be serviced. The Contractor shall be free to start and stop all primary equipment incidentals to the operation of the mechanical system(s) as arranged with and directed by the Owner's maintenance representative or his duly authorized representative. B. Except when specifically defined in these documents, the Owner, under this contract, shall not require the contractor to add to, extend or cause revisions to existing equipment and systems from the present design intention. Such work, if performed by the contractor at the request of the Owner, shall be reimbursed at the current prevailing rates. C. The Owner shall provide ready and unencumbered access for the contractor's service personnel to enter and leave the premises. All applicable rules and regulations of Calhoun County concerning personnel registration, parking, identification, and the like, will be followed by the Contractor. D. The Owner shall provide a suitable, secure area for storage of frequently used service parts by the contractor. ART. 8. ART. 9 EVINWI E. The contractor shall not be liable for any loss, delay, injury, or damage, whether direct or consequential, that may be caused by conditions beyond the contractor's direct control. F. The Contractor shall advise the Owner of work outside the scope of this agreement that requires maintenance (i.e. replacement or repair of damaged utility services, defective or damaged power wiring, renovations, and alterations to improve the system). This report shall be in writing. PREVENTIVE MAINTENANCE LOG A. Throughout the term of this agreement, the contractor shall record in a neat and legible manner all pertinent data relevant to each item of equipment included in this program to provide a comprehensive history for the specific equipment or system. B. This data or historical information will be maintained on Preventive Maintenance Log Sheets/Service Orders. C. The type of data and information recorded shall include, but not necessarily be limited to, the following: (1) Type of maintenance (preventive or emergency repair) (2) Date of service (3) Description of work done (4) Resultant effect in operating condition, if any (5) Proposed follow-up, if any (6) Name of repairman (7) Time involved for repair work (8) List any parts, name and number installed DURATION OF PREVENTIVE MAINTENANCE CONTRACT A. The preventive maintenance contract shall be in effect between the dates of 3-30-24 — 3-29-25. This contract shall be automatically renewed annually upon the anniversary date unless 30 day written notice is given by either party. TERMINATION 7 A. Either party may terminate this maintenance contract at any time by giving the other party at least thirty (30) days prior written notice during each 12- month period. ART. 11. CONTRACT PERIOD PRICE ADJUSTMENT A. The contract price shall be adjusted each contract period for the next year by the increase in labor costs for the past year. The adjustments shall be submitted to Customer within thirty (30) days prior to the start of a new contract period. ART.12 PAYMENT A. The AGREEMENT PRICE in year one shall be $8,865.00, payable at $2,216.25 per quarter at time of service, plus applicable taxes. ART.13. ACKNOWLEDGEMENT Calhoun County ate: 2 4/��D� Accepted by: CFI MECHANICAL INC. SPECIFICATIONS SECTION II II►1101 ARTICLE TITLE 1. Chiller 2. Chilled water pump Date: 3-7-24 8 3. Terms and conditions ART.1. CHILLER A. The contractor shall perform all inspection services required to assure efficient continuing operation of the chilled water pump. Preventative maintenance shall be as recommended by the manufacturer and the attached scope ART. 2 CHILLED WATER PUMPS A. The contractor shall perform all inspection services required to assure efficient continuing operation of the chilled water pump. Preventative maintenance shall be as recommended by the manufacturer and the attached scope ART. 3 TERMS & CONDITIONS A. This proposal is furnished to you for your evaluation of our concepts and pricing. There is no cost or financial obligation associated with the proposal. We do wish to point out, however, that the concepts and information contained herein are proprietary to our firm and are offered solely for your own use and evaluation. We intend to maintain the confidentiality of any information or data you have supplied to us. We therefore ask that this proposal be kept in confidence and that it not be disclosed to any outside party for any other purpose. B. Our pricing is based upon all work being performed during the normal working hours for the trades involved, assumes for taxation purposes that this is a capital improvement and excludes from it's scope our involvement with asbestos or any other hazardous materials. We will maintain the pricing quoted herein for a period of thirty (30) days. Our customary terms of payment are monthly progressive billings due net Thirty (30) days. C. We will make every effort to perform our work in a timely manner. We cannot, however, be liable for damages consequential to any delay that might occur. E Schedule A EQUIPMENT LIST 1 Carrier 30XV 160 chiller 2 Chilled water pumps * Equipment list will be updated each inspection until current. Any equipment found and not covered on this list can be added at an extra cost. 10 „Q Request for Taxpayer Give Form tothe Form Y (Rev. oclober2019) Identification Number and Certification requester. Oonot send to the IRS. InIMW ROVMue Semceury ► Go to www.im.gov/FormW9 for instructions and the latest information. 1 Name (as shown an your income lax reluml. Name Is required an this line: do not leave this line blank. CFI Mechanical Inc. 2 Business name/disregarded entity name, if different from above a 3 Check appropriate box for federal lax classification al the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to following seven boxes. certain entities, not individuals: see n p ❑ IntliuitluaVsole proprietor or ElCCorparelian El Corporation (3 Partnership ❑ TmsVeslele Instructions an page 3): ti5ingle•ember LC Exempt payee code If any) ag � ❑ Limited liadlily company. Enter the lax classification (C:C corporation, S=S corporation. P=Partnership) P `o Note: Check the appropriate box in the line above for the In classification of the single -member owner. Do not check Exemption from FATCA reporting 2 e u LLC it the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal lax purposes. 01horwise, a single -member LLC that 'ode (if any) .1 _ is disregarded from the owner should check the appropriate box for the tax classification of Os owner. u is ❑ Other (see Insinuations) fMN..,e.ccv„mm rt,xmeuraewusr y 5 Address (number. street, and apt. or sulle no.) See instructions. Requester's name and address (optional) w � 6109 Brittmoore Rd. 6 City, stale, and ZIP code Houston Texas 77041 7 List account number(s) here (optional) Enter your TIN in the appropriate box, The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number(EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am walling for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longersubject to backup withholding; and 3. 1 am a U.S, citizen or other U.S. person (defined below); and 4. The FATCA cartels) entered on this form (if any) indicating that) am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above it you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax relum. For real estate transactions, item 2 does not apply. For mortgage interest paid. acquisition a abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. Sea the instructions for Part II, later. za19N I Signs ignaual '7 Here U.S. person !/OGIZi� T General Instructions Section references are to the Internal Revenue Code unless otherwise noted, Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/Form WA Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (RIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT(nterest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Farm 1099-MISC (various types of income, prizes, awards. or gross proceeds) • Form1099-B (stock at mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Farm 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person ffncluding a resident alien), to provide your correct TIN. If you do not retum Form W-9 to the requester with a TIN, you might be subject to backup withholtl/ng. See What is backup withholding, later. Cat. No. 1023 ix Farm W-9 (Rev. 10-2018) CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties, CERTIFICATION OF FILING Certificate Number: 2024-1142474 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. CFI Mechanical Inc Houston, TX United States Date Filed: 04/04/2024 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Courthouse Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2024-1MS HVAC & Plumbing Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary CFI Mechanical Inc. Houston, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is Roy CIzmar and my date of birth is 09/24/1956 My address is ,' 0--JEU- (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of on the _day of , 20_ (month) (year) Signature of authorized agent of contracting business entity (Declarant) Uuns piwiueu by Texas Ethics Commission www.etmcs.state.tx.us Version V3.5.1.5b35d027 #11 NOTICE OF MEETING--4/1.0/2024 11. Consider and take necessary action to proclaim the month of April, 2024 as Fair Housing Month. (RHM) RESULT: APPROVED EUNANIMOUS] MOVER: Richard Meyer, County Judge SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 32 4/10/2024 Richard H. Meyer County judge David Hall, Commissioner, Precinct I Vern Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 Calhoun County ]Fair Housing Month Proclamation WHEREAS Title VIII of the Civil Rights Act of 1968, as amended, prohibits discrimination in housing and declares it a national policy to provide, within constitutional limits, for fair housing in the United States; and WHEREAS The principle of Fair Housing is not only national law and national policy, but a fundamental human concept and entitlement for all Americans; and WHEREAS The National Fair Housing Law, during the month of April, provides an opportunity for all Americans to recognize that complete success in the goal of equal housing opportunity can only be accomplished with the help and cooperation of all Americans. NOW, THEREFORE, WE, Calhoun County, do proclaim April as Fair Housing Month and do hereby urge all the citizens of this locality to become aware of and support the Fair Housing law. IN WITNESS WHEREOF we have affixed our signatures and seal on this the 10th day of April 2024. It is so proclaimed this the 10th day of April 2024. PASSED AND APPROVED BY THE CALHOUN COUNTY COMMISSIONERS' COURT this loth day of April, 2024. Page 1 of 2 4/10/2024 O Richard H. Meyer, Co Judge David Halp Calhoun County Commissioner Precinct 1 Joel Eiehrens Calhoun County Commissioner Precinct 3 Anna Goodman, County Clerk aI T W-. • - ern Lyssy Calhoun Count Commissioner Precinct 2 Gary ee e Calhoun ounty Commissioner Precinct 4 Page 2 of 2 #12 N011C F 01- MF_ETING — 4/10/2024 12. Consider and take necessary action to declare Inventory No. 512-0165 — Dish Machine with heat booster, Inventory No. 512-0157 — Washer and Inventory No. 512-0158- Washer as Surplus/Salvage and remove Jail Inventory. (RHM) RESULT:APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 9 of 32 Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: �AiI 11/f�� Requested By: �,(/ GL to Atal'�00 I1{�' � N #13 ' NOTICE OP MEETING - 4/10/2024 13. Public Hearing regarding amending the 2023 and 2024 Calhoun County Budgets. (RHM) Closed regular session at 10:51 Candice read the amendments - Opened regular session at 11:09 Page 10 of 32 1 P118,11CIIIAHNIN(--ZJ/Io0o.2q Richard H. Meyer C®u my Judge David Hall, Commissioner, Precinct 1 Vern 1Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF PUBLIC HEARING n== � uamrnassaoners' Court of Calhoun County, Texas wall meet on Wednesday, April 10, 2024 at 10:00 a.na. in the Commissioners' 211 S Courtroomin the County Courthouse, Ann Street, Suite 104, Port JLavaca, Calhoun County, Texas. NOTICE IS HEREBY GIVEN that the Calhoun County Commissioners' Co hold a Public Hearing in the Commissioners' urt will Courtroom, 211 S. Ann Street, Suite 104, will in Port Lavaca, Texas, on April 10, 2024 at 10:00 a.m. regarding amending the 2023 — 2024 Calhoun County Budgets. This notice is in accordance with Section 111.007 and Section 111.0075 of the Texas Local Government code. 1 Richazd Ii. Meyer, County Ju e Calhoun County, Texas A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www CalhOunCOtX Ong under "Commissioners' Court Agenda" for any official court postings. FILED AT 0� o,cLOCKM APR D 5 2024 COUNTY CLE^RKKCALHOUN rCOUNTY,TEXAS ey: cln�� U U&M Page 1 of I #14 ' NO -I -ICE Of MEFTING—4/10/2024 14. Consider and take necessary action to amend the 2023 and 2024 Calhoun County Budgets. (RHM) RESULT:: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 11 of 32 �I a z z: w U z = z �.w 6 z g w Q go o'gco -moo) p v �..MN \�� \ \GOD � « \ o § \� \ E »C U \ d� z}k \ 7 � , 2 Is WI C.� Q m a C 0' C4 �I O O O O O O 4 w `c c p 6 5 x W con C N 0 O Q uj W o,LUU fA GOD = J �3 U c.a p O z Z ' Z 40 t0 N 9 2 Z O 34 GOD CL iRLU a, N LU n y 3 J� 0 C F t9 U l� aaZ W � 2 T s 2� i I 1 L LLJ N V O Cr v_ Q y a y 0 o 0a ! c yto d-;Y GOD W '�3 0 o I- vc o g 4a' W t LLJ .i 5 ■ § i 04 i } 2 � \M \ 2 2» � «=1 \� % Md »m / \ \ LU \O \\ \�� \ j� .?«��■ <\2[ N O r. 0 � m I O 'Z Q Z u al z �I I� O f N 1~ O 2 conCOD — W Ma,a GOD O W uj a.' g ' Q Z N N C U C'a CO y d c � 2 � O Co ma !, t� > Z 1 W �g W!2 t i 2l. N lu � V p N m Z Z ... V_� U. r NEW M n N g Z 2 �I N Z Z ac mp i MS M n N g Z J co 04 N Ems �I �I N C r G W G e 'M� CW d G u C J INC d #15 NOTICE OF MEETING — 4/1.0/2024 15. Consider and take necessary action to authorize a loan in the amount of $97,540 from the general fund to the grants fund for the 2023 Operation Stone Garden - eGrant Award # 3192809. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 32 Mae Belle Cassel From: Sent: To: Cc: Subject: Attachments: MaeBelle, Erica.Perez@calhouncotx.org (Erica Perez) <Erica.Perez@calhouncotx.org> Monday, April 1, 2024 10:56 AM maebelle.cassel@calhouncotx.org;'Richard H joel.behrens@calhouncotx.org; 'Gary Reese' candice.viIlarreal@calhouncotx.org Agenda Item - Loan for OSG 2023 OSG Grant FY 2023.pdf Please place the following on the next Commissioners Court agenda: Meyer'; 'David Hall'; 'vern lyssy'; • Consider and take necessary action to authorize a loan in the amount of $97,540 from the general fund to the grants fund for the 2023 Operation Stone Garden - eGrant Award # 3192809. This grant was approved in Commissioners Court 1/17/24. Thank you, Best regards, Erica Perez First Assistant Auditor Calhoun County 202 S. Ann, Suite B Port Lavaca, TX 77979 Phone: 361. 553.4463 Fax: 361.553.461 Calhoun County Texas 4/l/24. 10:39 AM eGrants - Project Summary (MAKE SURE YOU CLOSE THIS PAGE 111) Print This ,Page' Agency Name: Calhoun County Grant/App: 3192809 Start Date: 3/l/2024 End Date: 2/28/2025 Project Title: Calhoun-2023 OPSG Status: Active Grant Budget Details Information Budget Information by Budget Line Item: f CATEGORY SUB CATEGORY DESCRIPTION — OOG CASH MATCH IN - KIND GPI TOTAL UNIT/% MATCH Enhanced Border Security Operational Operations — Calhoun Overtime for County SO (Officers) - Personnel Law Overtime according to local OT policy - With an $71,347.00 $0.00 $0.00 $0.00 $71,347.00 100 Enforcement (Organization) estimated fringe rate of 21.2 /o up to a total of $71,347. 04HW-02- RFID CCSO:04HW-03-NETD Equipment Devices, Radio Yearly Service Agreement/Maintenance/Air $16,653.00 $0.00 $0.00 $0.00 $16,653.00 1 Frequency Card (1 @ $16,653) Identification Vehicle Supplies and Operating Cost (e.g., Calhoun County SO —Actual Direcfuel fuel, costs pro -rated for the Opera Operating lubricants, hours deputies work on $9,540.00 $0.00 $0.00 $0.00 $9 540.00 0 Expenses maintenance, grunt paid overtime for an storage) estimated total up to $9,540. (Organization) — You are logged in as User Name: candicevillarreal https://egrants.gov.texas.gov/app/projectIGrantPrintableSummary.aspx?PrintCode=8&gh=OD-64-95-6D-1 F-33-21-57-79-25-86.57;64.1C-43-2D&Print... 1/1 #16 I NOTICE OF MFETING .4/10/2024 16. Consider and take necessary action to approve payment of $9,316.45 to Quality Hot Mix, Inc. due to ordering by mistake as Colorado Materials, LTD has the bid for Precinct 2. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Gary Reese, Commissioner`Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 13 of 32 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 April 2, 2024 Honorable Richard Meyer Calhoun County Judge 211. S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the next Commissioners' Court Agenda • Consider and take necessary action to approve payment of $9,316.45 to Quality Hot Mix, Inc. due to ordering by mistake as Colorado Materials, LTD has the bid for Precinct 2. Sincerely,'` Vern Lyssy VL/Ij I CER OUTIF R80E PO El Cai 979-5 II or", I � - 0.15 #17 NOTICE OF MEETING—4/10/2024 17. Consider and take necessary action to approve Change Order No. 8 for the Calhoun County Combined Dispatch Facility Project for Calhoun County, Texas and authorize County Judge to sign. (DEH) Scott Mason explained the change order. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 14 of 32 Mae Belle Cassel From: Sent: To: Subject: Sent from David's iPhone David Hall Commissioner Precinct 1 Calhoun County Office 361-552-9242 Cell 361-220-1751 Begin forwarded message: David.Hall@calhouncotx.org (David Hall) <David.Hal l@calhouncotx.org> Tuesday, April 2, 2024 11:25 AM Mae Belle Cassel Fwd: Request for Agenda Item 04-10-24 From: smason@gwengineers.com Date: April 2, 2024 at 11:24:10 AM CDT To: David Hall <David.HaII@calhouncotx.org> Cc: "demi.cabrera" <demi.cabrera@calhouncotx.org>, angela.torres@calhouncotx.org, Anthony Gohlke <anthonyg@gwengineers.com>, Glynis King <gking@gwengineers.com>, candice villarreal <ca n d i ce. v i l l a r re a l@ c a l h o u n c o tx. o rg> Subject: RE: Request for Agenda Item 04-10-24 CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. David, We need to request the following for the change order number 8 to be approved in court. For your information, this is not a project total $$$ increase, as we are using money from the $35k allowance that was included in the bid. Consider and take necessary action to approve Change Order No. 8 for the Calhoun County Combined Dispatch Facility Project for Calhoun County, Texas and authorize County Judge to sign. (DH) I will send the paperwork this week. Catching up from Easter break. Just wanted to get this going. Thank you, Scoff- P. Ma oo- , P.E. Lead Project Engineer CHANGE ORDER No. Eight (8) PROJECT CALHOUN COUNTY COMBINED DISPATCH FACILITY DATE OF ISSUANCE 04/02/24 EFFECTIVE DATE 04/10/24 OWNER CALHOUN COUNTY OWNER's Contract No. N/A CONTRACTOR BLS CONSTRUCTION, INC. ENGINEER G & W ENGINEERS, INC. Job# 5310,020 You are directed to make the following changes in the Contract Documents. Reason for Charge Order: Change Order for adding electrical scope requested by County. See Attached. Contractor is ordered to use the allowance budget for this Change Order request. Overal Contract Price to remain the some. Attachments (List documents supporting change) Original Contract Price $ 1,877,350.00 Contract changes from previous Change Orders No. 1 to No. $ 12j"j0 Changes to Cont. Allowance fiom Previous C.O. No. 3 to 7 $21,918.86 Allowance Budget Prior to this Change Order $13,081.14 C.O. No. 8 approved amount $3,815.46 Contract Price prior to this Change Order $ 1,889,537.30 Net Increase (deerease) of this Change Order $ From Allowance Contract Price $ 1,889,537.30 0 / Engineer(Audimudgignah )i W Engineers, Inc. IM BLS Construction Change Order Request Original Contract Times Substantial Completion: 280 Ready for final payment: May 27, 2024 dayamdonas Net changes from previous Change Orders No. 1 to No, 7 37 Days dais Net Cont. Allowance Changes from C.O. Numbers 3 to 8 S25,734.32 New ContigeneyAllowance Budget $9,265168 Contract Times prior to Utis Change Order Substantial Completion: 317 Ready for final payment: July 3, 2024 daraaadams Net Increase (deerease) of this Change Order 0 Contract Timesnvith all approved Change Orders Substantial Completion: 317 Ready for final payment: July 3, 2024 days o,dares O,ma (Alhmized aipialme) Calhoun County By: o i oar( added Signaiuo) B ons ruction, Inc. Date: P , OZ. 2-4 Date: _._ Dater 4.3.2024 FACILITIES PLANNING . DESIGN . CONSTRUCTION 207 Fahrenthold Street, El Campo, Texas 77437 Office: (979) 543-2696 . Fax: (979) 543-5006 00INISTRUC;TION www.blaconstruction.com Project Names: Calhoun County Dispatch Building Location: 312 Live Oak St., Port Lavaca, Texas 77979 a Ls PPA No.: Proposal Request No.: 9 Contractor: BLS Construction Date: 3.27.2024 Address: 207 Pahrenthold, EI Campo, Texas 77437 Phone: C-rii-w 979.543.2696 C+. o. 8 _ The Contractor is hereby directed to make the following changes in the Contract: WN/UNIT COSTS ITEM DESCRIPTIONIUNITBRE7(Stranded) NO. (indicate Critical Path Schedct for each item) COST (Indicate+or -)Suppyan nsta oc Ingin t e Ispatter sout v✓a . T e oc ngwill be 1'-0" above electrical outlets anbelow outlets for a total of 3'0 blocking in each cavity. This blockingrun the length of the southwall.$ 754.00Supply and Install (1) 4'x 8'3/4" fire plyon the east end of the northwall. Plywood is to be vertical and the edge shall be 6" AFF.3 Relocate (3) each 20 am quads from telling FF, N. Wall, Server RmProvide (2) each 20 amp dedicated quadAFF, N. Wall, Server RmProvide $ 2,630.00 (1) each #6 ground from Server trical Rm (Stranded) P&P _ Y Change In Contract Duration/Time by This Change Order: (No Change) (Increase) (Decrease) Decrease BY (0) CALENDER DAYS, NEW CONTRACT COMPLETION DATE: No change ✓ 4-10 — zo Date Date ®= �° 1 .may MINIM o:RCtALCONTRAC 011 Integrily • ILcliabilisy • Fxr,crience Project: 234113 - Calhoun County Combined Dispatch Building Contract#887 Contract Date: 6/21/2023 1. Change Order#03 Customer: BLS Construction, Inc. 207 Fahrenthold Street El Campo TX 77437 Description of Change: Change Order #03 - Scope is as follows: Change Order #3 Prepared By: Chris Robbin Chris@KandPConst.com 3/26/2024 $754.00 -Supply and install blocking in the dispatch center south wall. The blocking will be 1' above electrical outlets and 2' below outlets for a total of 3' blocking in each cavity. This blocking shall run the length of the south wall. - (1) sheet of 4'x8' - 3/4" fire plywood on the east end of the north wall. Plywood is to be vertical and the bottom edge shall be 6" AFF. Plywood Scope - $7S4.00 We hereby agree to make the changes specified for Total Price listed above. CONTRACTOR: Leta AbAf& 3/26/9094 ACCEPTED BY: K&P Construction Services BLS Construction, Inc. K&P Construction Services • 9949 Clodine Road • Richmond, TX 77407 Hobo Electric, LLC P.O. Box 431 El Campo, TX 77437 Quote ADDRESS BLS Construction 207 Fahrenthold El Campo, TX 77437 DESCRIPTION SHIP TO BLS Construction 207 Fahrenthold El Campo, TX 77437 Re: Calhoun Co. Dispatch. (CHANGE ORDER #2) -Relocate three (3) as 20 amp quads from cing to 8' AFF, N Wall, Server Room. -Provide two (2) ea 20 amp dedicated quads at 8' AFF, N Wall, Server Room -Provide one (1) ea #6 ground from Server to Electrical room (stranded ok) Complete Bid SUBTOTAL TAX TOTAL Accepted By Accepted Date We appreciate your business. 979-541-3799 info@hoboelectric.com QUOTE # 24049 DATE 03/27/2024 AMOUNT 2,630.00 2,630.00 0.00 $2r630.00 u In wo NOTICE OF MEETING—4/10/2024 18. Consider and take necessary action to approve the Specifications and Contract Documents for Bid Number 2024.07 Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project for Calhoun County, Texas and to authorize G & W Engineers, Inc. and the County Auditor to advertise for bids. A pre -bid meeting shall be held at 10:00 am, Tuesday, April 30th, 2024 at the Pct. No. 1 Commissioner's Office. Sealed Bids are scheduled to be due before 2:00:00 pm, Thursday, May 23, 2024 at the County Judge's Office. (DEH) Scott Mason explained the specifications and contract documents. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 15 of 32 CONTRACT DOCUMENTS FOR THE BID NUMBER 2024.07 MAGNOLIA BEACH - OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS APRIL 2024 G&W ENGINEERS. INC. 205 W. Live Oak 9 Port Lavaca, TX 77979 9 361-552-4509 CONTRACT DOCUMENTS FOR THE BID NUMBER 2024.07 MAGNOLIA BEACH - OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT rM9. CALHOUN COUNTY, TEXAS APRIL 2024 Prepared by: G & W ENGINEERS, INC. 205 WEST LIVE OAK PORT LAVACA, TEXAS 77979 (361) 552-4509 G & W Engineers, Inc. Texas Registered Engineering Firm F-04188 Project No. 9115.029 Approved By: * * .....................::... SCO17 P. MASON OVrzt� Scott P. Mason, P.E. Texas Serial No. 127893 Date: FORMS AND CONDITIONS FOR BID DOCUMENTS/CONSTRUCTION CONTRACTS 1. Advertisement and Invitation for Bids 2. Instruction to Bidders for Construction 3. Bid Form 4. Specification Notes 5. Bid Bond 6. Statement of Bidder's Qualifications 7. Affidavit 8. Certification of Bidder Regarding Civil Rights Laws and Regulations 9. Conflicts of Interest — Compliance with Copeland "Anti -Kickback" Act 10. Certification Regarding Debarment & Suspension and other Responsibility Matters 11. Certification Regarding Lobbying 12. Disclosure of Lobbying Activities and Instructions 13. House Bill 89 Verification Form 14. Residence Certificate 15. Section 504 Certification 16. System of Award Management (Sam.gov) 17. Certificate of Interested Parties - 1295 Form 18. Equal Opportunity Guidelines for Construction Contractors 19. Standard Form of Agreement (Construction Contract Agreement Form) 20. Corporate Certifications 21. General Contract Conditions 22. Calhoun County, Texas General Conditions 23. Attorney's Review Certification 24. Payment Bond 25. Performance Bond 26. Certificate of Liability Insurance 27. Technical Specifications *Items 3-16 are to be provided to and/or completed by all bidders and included with submission of bid. Please provide one (1) USB flash drive and one (1) original and four (4) copies of the complete bid schedule and required forms. Advertisement and Invitation to Bids Notice is hereby given that the Commissioners Court of Calhoun County, Texas will receive bids for Bid Number 2024.07 — Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project The Project consists of a new 482 LF Ocean Drive bulkhead cap replacement. The structure of the bulkhead cap replacement will be a 24"x18" concrete cap and an adjacent 3' sidewalk. The other components of the bulkhead cap replacement project will be periodic PVC drains that transverse through the concrete cap, minor grading of the site to accommodate the improvements, installation of new deadman tie -back rods and the replacement of existing timber whalers. The Instructions for Bidders, Bid Form, Specifications, and other Contract Documents may be examined at G&W Engineers, Inc. at 205 W. Live Oak, Port Lavaca, TX 77979 and obtained from www.CivcastUSA.com. There is no charge to view or download the documents. Addendums and other announcements will be distributed via CivCastUSA to all plan holders. A Pre -Bid Conference will be held at 10:00 AM, Tuesday, April 30, 2024. Meeting location will be at Precinct 1, 305 Henry Barber Way, Port Lavaca, Texas 77979. Potential bidders are strongly urged to attend. Bidders must submit with their bid a bid bond, issued by an acceptable surety, or a certified check, payable to Calhoun County, in the amount of not less than five percent (5%) of the total bid submitted. Bids submitted without the required security will not be considered. All contractors and subcontractors must be cleared (not suspended or debarred) prior to any formal action authorizing the award of a contract to the contractor and for the duration of the project. Sealed Bids may be hand delivered or mailed to: Honorable Richard H. Meyer, County Judge Calhoun County Courthouse 211 South Ann Street 3rd Floor, Suite 301 Port Lavaca, TX 77979 All bids must be delivered to the Office of the Calhoun County Judge in a sealed 9 x 12 or larger envelope and clearly marked on the outside of the envelope, or the UPS/FedEx/other Delivery Service envelope: Sealed Bid — Bid Number 2024.07 Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project. Sealed Bids consisting of one (1) USB flash drive and one (1) original and four (4) printed copies of the complete bid and required forms are DUE BEFORE 2:00:00 PM local time, THURSDAY, MAY 23, 2024 in the County Judge's office, Calhoun County Courthouse, 211 South Ann Street, 31d Floor, Suite 301, Port Lavaca, Texas. At this time, all bids will be publicly opened and read aloud in the conference room located in the County Judge's office. It is the responsibility of the submitting bidder to ensure that their sealed bid is received in a timely manner. Calhoun County does not accept faxed or emailed bids. Calhoun County accepts no financial responsibility for any cost incurred by any bidder in the course of responding to the bid. Bids received after the date and time the bids are due will not be accepted and will be returned unopened, regardless of whether or not the delay was outside of the control of the submitting bidder. The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative will be the official clock that shall be used in determining the time the bid is received and the 2:00:00 PM deadline. Calhoun County reserves the right to reject any or all bids or to waive any informalities in the bidding and to award to the responsible bidder submitting the best qualified acceptable bid who, in the opinion of Calhoun County, offers the bid in the best interest of the County. Bids may be held by Calhoun County for a period not to exceed thirty (30) days from the date of the bid opening for the purpose of reviewing the bids and investigating the bidder's qualifications prior to the contract award. The successful bidder will be required to purchase and furnish a Performance Bond and a Payment Bond, each in the full amount of the contract, written by a responsible surety company authorized to do business in the State of Texas, as required by Article 5160, V.A.T.C.S., as amended by H.B. 344, passed by the 56th Legislature, Regular Session, 1959. The successful bidder shall begin work on receipt of the Notice to Proceed and shall complete the work within the Contract Time. Work is subject to liquidated damages. Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of age, race, color, religion, sex, sexual orientationgender identity, national origin, handicapped status or limited English proficiency in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises and Labor Surplus Area Firms are encouraged to submit bids. Candice Villarreal County Auditor Calhoun County, Texas INSTRUCTION TO BIDDERS FOR CONSTRUCTION The Calhoun County is hereby referred to as County. 1. Use of Separate Bid Forms These contract documents include a complete set of bid and contract forms which are for the convenience of the bidders and are not to be detached from the contract document, completed or executed. Separate bid forms are provided for your use. 2. Interpretations or Addenda No oral interpretations will be made to any bidder. All questions about the meaning or intent of the Bidding Documents are to be submitted to the ENGINEER IN WRITING and must be received in the office of the ENGINEER no later than 5:00 pm, May 6, 2024. Such questions may be submitted on www.CivcastUSA.com Questions and Answers (Q&A). It is the Bidder's responsibility to verify receipt of such questions by the ENGINEER. Interpretations or clarifications considered necessary by ENGINEER in response to such questions will be issued by Addenda and distributed via CivCastUSA to all plan holders. Addenda may also be issued to modify the Bidding Documents as deemed advisable by OWNER or ENGINEER. Any oral and other interpretations or clarifications provided by ENGINEER or OWNER at the pre -bid meeting will be without legal effect until a formal written Addenda is issued by ENGINEER. 3. Inspection of Site Each bidder should visit the site of the proposed work and should become acquainted with the existing conditions and facilities, the difficulties and restrictions pertaining to the performance of the contract. The bidder should thoroughly examine and become familiar with the drawings, technical specifications and all other contract documents. The contractor by the execution of the contract shall in no way be relieved of any obligation under it due to failure to receive or examine any form or legal document or to visit the site or the conditions existing at the site. The County will be justified in rejecting any claim based on lack of inspection of the site prior to the bid. 4. Alternate bid items No alternate bids or bid items will be considered unless they are specifically requested by the bid proposal and/or technical specifications. a. All bids must be submitted on the forms provided and are subject to all requirements of the Contract Documents, including the Drawings. b. All bids must be regular in every respect and no interlineation, excisions or special conditions may be made or included by the bidder. C. Bid documents, including but not limited to the bid, the bid bond(s), the contractor's certifications, Certification of Bidder Regarding Civil Rights Laws and Regulations, Conflict of Interest Questionnaire, Affidavit, Certification Regarding Lobbying, Certification Regarding Debarment & Suspension and other Responsibility Matters, Disclosure of Lobby Activities and Instructions, House Bill 89 Verification Form, Residence Certificate, Section 504 Certification, System of Award Management (Sam.gov) and the Statement of the Bidder's Qualifications, shall be sealed in an envelope and clearly labeled with the words "Bid Documents", the project number, name of bidder and the date and time of bid opening. d. The County may consider as irregular any bid on which there is an alteration of or departure from the bid form and, at its option, may reject any irregular bid. e. If a contract is awarded, it will be awarded to a responsible bidder on the basis of the lowest/best bid and the selected alternate bid items, if any. The contract will require the completion of the work in accordance with the contract documents. 6. Bid Modifications Prior to Bid Opening Any bidder may modify its bid by submitting a modification or supplemental bid at any time prior to the scheduled closing time for receipt of bids, provided such modification or supplemental bid is received by the locality prior to the closing time. The modification or supplemental bid should not reveal the original bid price but should provide only the addition, subtractions or other modifications to the original bid so that the final prices or terms will not be known by the locality until the sealed bid is open. 7. Bid Bond a. A bid bond in the amount of 5% of the bid issued by an acceptable surety shall be submitted with each bid. A certified check, payable to Calhoun County, may be submitted in lieu of the Bid Bond. b. The bid bond or its comparable, will be returned to the bidder as soon as practical after the opening of the bids. 8. Statement of Bidders Qualifications Each bidder shall submit on the form furnished for that purpose a statement of the bidder's qualifications. The County shall have the right to take such steps as it deems necessary to determine the ability of the bidder to perform its obligations under the contract, and the bidder shall furnish the County all such information and data for this purpose as it may request. The right is reserved to reject any bid where an investigation of the available data does not satisfy the County that the bidder is qualified to carry out properly the terms of the contract. 9. Unit Price The unit price for each of the several items in the bid shall include its pro rata share of overhead so that the sum of the products obtained by multiplying the quantity shown for each item by the unit price bid represents the total bid. Any bid not conforming to this requirement may be rejected as informal. Special attention is drawn to this condition, as the unit prices will be used to determine the amount of any change orders resulting from an increase or decrease in quantities. 10. Corrections Erasures or other corrections in the bid must be noted over the signature of the bidder 11. Time for Receiving Bids Bids received prior to the advertised hour of opening shall be kept securely sealed. The officer appointed to open the bids shall decide when the specified time has arrived and no bid received thereafter will be considered. 12. Opening of Bids The County shall, at the time and place fixed for the opening of bids, open each bid and publicly read it aloud, irrespective of any irregularities therein. Bidders and other interested individuals may be present. 13. Withdrawal of Bids Bidder may withdraw the bid before the time fixed for the opening of bids, by communicating its purpose in writing to the County. Upon receipt of such notice, the unopened bid will be returned to the bidder. The bid guaranty of any bidder withdrawing his bid will be returned promptly. 14. Award of Contract/Reiection of Bids a. The contract will be awarded to the responsive, responsible Bidder submitting the lowest/best bid. The bidder selected will be notified at the earliest possible date. The locality reserves the right to reject any or all bids and to waive any informality in bids received where such rejection or waiver is in its interest. b. The County reserves the right to consider as unqualified to do the work any bidder who does not habitually perform with his own forces the major portions of the work involved in construction of the improvements embraced in this contract. 15. Execution of Agreement/Performance and Payment Bonds a. Performance Bonds - Requires all prime contractors which enter into a formal contract in excess of $100,000 with the State, a county, or a municipality; a department, board, or agency of the state, a county, or a municipality; and a school district or a subdivision thereof, to obtain a Performance Bond in the amount of the contract before commencing with work b. Payment Bonds- Requires all prime contractors which enter into a formal contract with the State, a county, or a municipality; a department, board, or agency of the state, a county, or a municipality; and a school district or a subdivision thereof, to furnish to the governmental entity a payment bond in the amount of the contract. The payment bond must be filed within 30 days from the date of the Notice of Award: Municipalities: If the contract is in excess of $50,000, a payment bond is required. Counties: If the contract is in excess of $25,000, a payment bond is required. C. The failure of the successful bidder to execute the agreement and supply the required bonds within fifteen (15) business days from the date of the notice of award -or within such extended period as the locality may grant, shall constitute a default and the locality may, at its option either award the contract to the next lowest responsible bidder, or re -advertise for bids. In either case, the locality may charge against the bidder the difference between the amount of the bid, and the amount for which a contract is subsequently executed irrespective of whether this difference exceeds the amount of the bid bond. If a more favorable bid is received through re -advertisement, the defaulting bidder shall have no claim against the locality for a refund. 16. Wages and Salaries — DBWR not applicable 17. Equal Employment Opportunity Attention is called to the requirements for ensuring that employees and applicants for employment are not discriminated against because of race, color, religion, sex, sexual identity, gender identity, or national origin, and other civil rights requirements. 18. Certification Regarding Lobbying Contractors who apply or bid for an award of $100,000 or more shall provide the required certification that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer of employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC § 1352. f3X PROJECT NAME: Bid Number 2024.07 — Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project DUE DATE: fl rsday , May 23, 2024 before 2:00:00 p.m., NAME: BASE WORK SCOPE is Bids are invited for items and quantities of work generally as follows: a new 482 LF Ocean Drive bulkhead cap replacement. The structure of the bulkhead cap replacement will be a 24"x18" concrete cap and an adjacent 3' sidewalk. The other components of the bulkhead cap replacement project will be periodic PVC drains that transverse through the concrete cap, minor grading of the site to accommodate the improvements, installation of new deadman tie -back rods and the replacement of existing timber whalers. Item Quantity Unit Unit Price Total Bid Price 1. Furnishing all necessary equipment, 1 LS materials, and labor for Mobilization, demobilization, barricades, insurance, and bonds as per plans and specifications 2. Furnish all necessary materials, equipment 1 LS and labor for the demolition and removal of approximately 482 LF timber cap, 92 tie- back rods and 482 LF timber wailer in accordance with the drawings and specifications. 3. Furnish all necessary materials, 482 LF equipment, and labor for the installation of reinforced concrete bulkhead cap with periodic PVC drains approximately every 10 fit in accordance with the drawings and specifications. 4. Furnish all necessary materials, 482 LF equipment, and labor for the installation of a 3' wide sidewalk alongside the proposed concrete cap with minor grading of the produced cut material in accordance with the drawings and specifications. 5. Furnish all necessary materials, 92 EA equipment, and labor for the installation of stainless -steel tie -back rods connecting existing Deadman to propose cap in accordance with the drawings and specifications. 6. Furnish all necessary materials, equipment, 482 LF and labor for the installation of a timber wailer in accordance with the drawings and s ecifications. TOTAL BASE BID $ SPECIFICATION NOTES Calhoun County is receiving Bids for items and quantities of work generally as follows: Bids are invited for items and quantities of work generally as follows: A new 482 LF Ocean Drive bulkhead cap replacement. The structure of the bulkhead cap replacement will be a 24"x18" concrete cap and an adjacent 3' sidewalk. The other components of the bulkhead cap replacement project will be periodic PVC drains that transverse through the concrete cap, minor grading of the site to accommodate the improvements, installation of new deadman tie -back rods and the replacement of existing timber whalers. County to provide: 1. Unsecured place to store contractor equipment and vehicles 2. Unsecured area to store excess materials required for construction. The BIDDER, in compliance with the invitation for bids for Bid Number 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project, having examined the plans and specifications with related documents and the site of the proposed work, and being familiar with all of the conditions surrounding the construction of the proposed project, including the availability of materials and labor, hereby proposes to furnish all labor, materials and supplies in accordance with the contract documents, within the time set forth herein. These price(s) are to cover all expenses incurred in performing the work required under the contract documents, of which this proposal is a part. These price(s) are firm and shall not be subject to adjustment provided this Proposal is accepted within thirty (30) days after the time set for receipt of proposals. BIDDER hereby agrees to commence work under this contract on or before a date to be specified in a written "Notice to Proceed" to be issued by the County and to substantially complete within F consecutive calendar days as stipulated in the specifications. BIDDER further agrees to pay as liquidated damages, the sum of $300.00 for each consecutive calendar day. I hereby acknowledge the receipt of the following addenda: OA SUBCONTRACTORS. The undersigned BIDDER proposes that he will be responsible to perform major portions of the work at the project site with his own forces and that specific portions of the work not performed by the undersigned will be subcontracted and performed by the following subcontractors. to the work covered by th Bidder Name: Address: Phone: EIN or Tax ID No.: Signature: Name and Title: Email Address: BID BOND KNOW ALL MEN BY THESE PRESENTS, that we the undersigned, as PRINCIPAL, and CALHOUN COUNTY, TEXAS hereinafter called the "Owner", in the penal sum of re held and firmly bound unto Dollars, ($�), lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the Principal has submitted the Accompanying Bid, dated , Bid Number 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project for Calhoun County, Texas. NOW, THEREFOR, if the Principal shall not withdraw said Bid within the period specified therein after the opening of the same, or, if no period be specified, within thirty (30) days after the said opening, and shall within the period specified therefore, or if no period be specified, within ten (10) days after the prescribed forms are presented to him for signature, enter into a written contract with the Owner in accordance with the Bid as accepted, and give bond with good and sufficient surety or sureties, as may be required, for the faithful performance and proper fulfillment of such contract; or in the event of the withdrawal of said Bid within the period specified, or the failure to enter into such Contract and give such bond within the time specified, if the Principal shall pay the Owner the difference between the amount specified in said Bid and the amount for which the local Public Agency may procure the required work or supplies or both, if the latter be in excess of the former, then the above obligation shall be void and of no effect, otherwise to remain in full force and virtue. IN WITNESS THEREOF, the above -bounded parties have executed this instrument under their several seals this day of , the name and corporate seal of each corporate party being hereto affixed and these present signed by its undersigned representative, pursuant to authority of its governing body. (SEAL) Attest: By. (SEAL) Affix Corporate Seal Attest: By: Attest: Countersigned By `Attorney -in -Fact, State of A Affix Corporate Seal CERTIFICATE AS TO CORPORATE PRINCIPAL I, , certify that I am the , Secretary of the Corporation named as Principal in the within bond; that who signed the said bond on behalf of the Principal was then of said corporation; that I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed, and attested to, for and in behalf of said corporation by authority of this governing body. Corporate Seal Title: Power -of -attorney for person signing for Surety Company must be attached to bond. STATEMENT OF BIDDER'S QUALIFICATIONS All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he/she desires. Name of Bidder: Address: Date Organized` Date Incorporated: Number of Years in contracting business under current name: CONTRACTS ON HAND: Contracts Type of work performed by your company: Have you ever failed to complete any work awarded to Have you ever defaulted on a contract? Dollar Amount Completion Date List the projects most recently completed by your firm (include project of similar importance): Project Dollar Amount Mo/Yr Completed Major equipment available for this contract: Attach resume(s) for the principal member(s) of your organization, including the officers as well as the proposed superintendent for the project. Credit available: Bank reference: The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the in verification of the recitals comprising this Statement of Bidder's Qualifications. Executed this by: day of 20_. (Signature) (Title) STATE OF TEXAS {} COUNTY OF ( iype or Print Name) the of (Type or Print Title) principal address at AFFIDAVIT being first duly sworn, deposes and says: that he or she is (Type or Print Name of Company/Firm) having its (Type or Print Physical and Mailing Address) who submits herewith to Calhoun County the attached bid/proposal; that he or she is the person whose name is signed to the attached bid/proposal; that said bid/proposal is genuine; that the same is not sham or collusive; that all statements of fact herein are true; and that such bid/proposal was not made in the interest or behalf of any person, partnership, company, association, organization or corporation not herein named or disclosed. Affiant further deposes and says: that the bidder/proposer has not directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interests of Calhoun County, or of any other bidder/proposer, or anyone else interested in the bid/proposal contract; and that the bidder/proposer has not in any manner sought by collusion to secure for himself/herself/itself/themselves an advantage over any other bidder/proposer. Affiant further deposes and says: that prior to the public opening and reading of bids/proposals, said bidder/proposer: a) did not, directly or indirectly, induce or solicit anyone else to submit a false or sham bid/proposal; b) did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder/proposer or anyone else would submit a false or sham bid/proposal, or that anyone should refrain from submitting a bid/proposal or withdraw their bid/proposal; c) did not, in any manner, directly or indirectly, seek by agreement, communication or conference with anyone to raise or fix the bid price/proposal of said bidder/proposer or of anyone else, or to raise or fix any overhead, profit or cost element of their price/fee or of that of anyone else; d) did not give, offer to give, nor intends to give at anytime hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to any official, employee or agent of Calhoun County in connection with the submitted bid/proposal; and e) did not, directly or indirectly, submit their bid/proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative hereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent, thereof, to any individual or group of individuals, or to any official, employee or agent of Calhoun County prior to the official opening of this bid/proposal. Affiant further deposes and says: that the bid price(s) or proposed fees contained in this bid/proposal have been carefully checked and is submitted as true and correct, agrees to furnish any and/or all items/services upon which bid prices or proposed fees are awarded and upon the conditions and requirements contained in the bid/proposal. Signature of Affiant Printed Name and Title of Affiant SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this day of Notary Stamp/Seal Signature of Notary Public 20 CONTRACTOR CERTIFICATIONS CERTIFICATION OF BIDDER REGARDING CIVIL RIGHTS LAWS AND REGULATIONS INSTRUCTIONS CERTIFICATION OF BIDDER REGARDING Executive Order 11246 and Federal Laws Requiring Federal Contractor to adopt and abide by equal employment opportunity and affirmative action in their hiring, firing, and promotion practices. This includes practices related to race, color, gender, religion, national origin, disability, and veterans' rights. NAME AND ADDRESS OF BIDDER (include ZIP Code) CERTIFICATION BY BIDDER Bidder has participated in a previous contract or subcontract subject to Civil Rights Laws and Regulations. ❑ Yes ❑ No The undersigned hereby certifies that: ❑ The Non -Segregated Facilities clause (Section 109 provision) is included in the Contract. No segregated facilities will be maintained as required by Title VI of the Civil Rights Act of 1964. ❑ The Equal Employment Opportunity clause is included in the Contract (if bid equals or exceeds $10,000). ❑ The Affirmative Action for Handicapped Workers clause is included in the contract. ❑ The Exhibit B — Assurances for Construction Programs is included in the Contract. ❑ The Exhibit D — State of Texas Assurance is included in the Contract. Have you ever been or are you being considered for sanction due to violation of Executive Order 11246- Equal Employment Opportunity, as amended? ❑ Yes ❑ No NAME AND TITLE OF SIGNER (Please type) SIGNATURE DATE INSTRUCTIONS FOR CONFLICTS OF INTEREST QUESTIONNAIRE [Form CIO] H.B. 914, passed during the 2005 Texas legislative session, as amended by H.B. 1491 passed in 2007, requires certain persons who wish to conduct business or be considered for business with a County to file a "conflict of interest questionnaire." The Texas Ethics Commission (TEC) created the conflict of interest questionnaire (FORM CIQ). These laws are codified in Chap. 176 of the Texas Local Government Code. What vendors/persons are subject to Chapter 176? • The word "person" includes a partnership, corporation or other corporate body, including those performing professional services. Such partnerships or corporations act through individuals, but it is the partnership or corporation that would be seeking to do business with the County. • Any "person" who contracts or seeks. to contract for the sale or purchase of property, goods, or services with a local governmental entity • An agent of a person who contracts or seeks to contract for the sale or purchase of property, goods, or services with a local governmental entity • A vendor shall file a completed conflict of interest questionnaire if the person has a business relationship with a local governmental entity and: (1) has an employment or other business relationship with an officer of that local governmental entity or a family member of the officer that results in taxable income exceeding $2,500 during the 12 month period preceding the date a contract is executed or a contract is being considered; or (2) has given an officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value of more than $250 in the 12 month period preceding the date a contract is executed or a contract is being considered What triggers the requirement to file a "conflict of interest questionnaire"? When a person begins (1) contract discussions or negotiations with the County or (2) submits an application, response to request for proposals or bids, correspondence, or another writing related to a potential agreement, Form CIO must be completed. Whether the person initiates the discussion or the County initiates the discussions, Form CIO must be completed. Even if the vendor has no affiliation or business relationship with an officer or employee of the County, Form CIO must be completed and submitted To what type of contracts does the bill apply? Any written contract and any implied contract, such as purchase orders, procurement card purchases, utility purchases, or any exchange of money or other consideration for some service or property. The monetary amount or value of the contract/purchase does not matter. When must a vendor file the conflict of interest questionnaire? No later than seven days after the date the person: (a) begins contract discussions or negotiations with the County, or (b) submits an application or response to a request for proposals or bids, correspondence, or another writing related to a potential agreement with a County, or (c) becomes aware of an employment relationship with a local government officer or family member of the officer, or (d) becomes aware of a qualifying gift. What has to be revealed? Section 176.004 requires disclosure of a person's employment or business relationships. This includes each employment or business relationship with a corporation or other business entity with respect to which a local government officer services as an officer or director or holds an ownership interest of 10% or more. How do I go about filling out the Conflict of Interest Questionnaire form? Each number below corresponds with the number on FORM CIO 2: 1. Fill in the full name of the person who is trying to do business with the County. If the person. is a corporation, partnership, etc., then it is the name of that corporation, partnership, etc., that is required on Form CIO. 2. Check box if the form is an update to a form previously completed. Updates are required by the 7th business day after an event that makes a statement in a previously filed questionnaire incomplete or inaccurate. Updates are also required by September 1 of each year in which the person submits proposal, bid or response to the County or begins contract discussions or negotiations with the County. 3. Complete this Section by listing the name of the local government officer (member of County Court or County Manager) with whom there is an affiliation to or business relationship and you checked the "Yes" box in Section 3 A, B, or C. If there is more than one local government officer (County Court or County Manager) with whom there is an affiliation or business relationship, more than one page two may be needed to provide information on each local government officer. 4. State whether the local government officer named on the form receives or is likely to receive taxable income, other than investment income, from the vendor filing the questionnaire. 5. State whether the filer receives or is likely to receive taxable income, other than investment income, from or at the direction of the local government officer named on the form AND the taxable income is not received from the local governmental entity. 6. State whether the filer is employed by a corporation or other business entity with which the local government officer serves as an officer or director or holds an ownership interest of 10% or more. 7. Describe each employment or business relationship with the local government officer named on the form. 8. Signature box. Person completing form must date and sign the form. If the form is being completed for a corporation, partnerships, etc., the person signing should be someone who is authorized to act on behalf of the corporation, partnership, etc. A signatureis required in box #4 regardless of any other entry on the form A copy of Chapter 176 of the Texas Local Government Code can be found at: htto://www.statutes.legis.state.tx.us/SOTWDocs/LG/htm/LG.176.htm 8/03/2011 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with Chapter 176, Local Date Received Government Code by a person who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person meets requirements under Section 176.004(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.004, Local Government Code. A person commits an offense if the person knowingly violates Section 176.004, Local Government Code. An offense under this section is a Class C misdemeanor. 1. Name of person doing business with local governmental entity. RFB / RFP / Contract 2. ❑ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3. Name of local government officer with whom filer has employment or business relationship. Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? ❑ Yes ❑ No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? ❑ Yes ❑ No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? ❑ Yes ❑ No D. Describe each employment or business relationship with the local government officer named in this section. 4. Signature of person doing business with governmental entity Date Signed DEBARMENT & SUSPENSION Executive Order 12549--Debarment and Suspension Source: The provisions of Executive Order 12549 of Feb. 18, 1986, appear at 51 FR 6370, 3 CFR, 1986 Camp., p. 189, unless otherwise noted. By the authority vested in me as President by the Constitution and laws of the United States of America, and in order to curb fraud, waste, and abuse in Federal programs, increase agency accountability, and ensure consistency among agency regulations concerning debarment and suspension of participants in Federal programs, it is hereby ordered that: Section 1. (a) To the extent permitted by law and subject to the limitations in Section 1(c), Executive departments and agencies shall participate in a system for debarment and suspension from programs and activities involving Federal financial and nonfinancial assistance and benefits. Debarment or suspension of a participant in a program by one agency shall have government -wide effect. (b) Activities covered by this Order include but are not limited to: grants, cooperative agreements, contracts of assistance, loans, and loan guarantees. (c) This Order does not cover procurement programs and activities, direct Federal statutory entitlements or mandatory awards, direct awards to foreign governments or public international organizations, benefits to an individual as a personal entitlement, or Federal employment. Sec. 2. To the extent permitted by law, Executive departments and agencies shall: (a) Follow government -wide criteria and government -wide minimum due process procedures when they act to debar or suspend participants in affected programs. (b) Send to the agency designated pursuant to Section 5 identifying information concerning debarred and suspended participants in affected programs, participants who have agreed to exclusion from participation, and participants declared ineligible under applicable law, including Executive Orders. This information shall be included in the list to be maintained pursuant to Section 5. (c) Not allow a parry to participate in any affected program if any Executive department or agency has debarred, suspended, or otherwise excluded (to the extent specified in the exclusion agreement) that party from participation in an affected program. An agency may grant an exception permitting a debarred, suspended, or excluded party to participate in a particular transaction upon a written determination by the agency head or authorized designee stating the reason(s) for deviating from this Presidential policy. However, I intend that exceptions to this policy should be granted only infrequently. See. 3. Executive departments and agencies shall issue regulations governing their implementation of this Order that shall be consistent with the guidelines issued under Section 6. Proposed regulations shall be submitted to the Office of Management and Budget for review within four months of the date of the guidelines issued under Section 6. The Director of the Office of Management and Budget may return for reconsideration proposed regulations that the Director believes are inconsistent with the guidelines. Final regulations shall be published within twelve months of the date of the guidelines. See. 4. There is hereby constituted the Interagency Committee on Debarment and Suspension, which shall monitor implementation of this Order. The Committee shall consist of representatives of agencies designated by the Director of the Office of Management and Budget. Sec. 5. The Director of the Office of Management and Budget shall designate a Federal agency to perform the following functions: maintain a current list of all individuals and organizations excluded from program participation under this Order, periodically distribute the list to Federal agencies, and study the feasibility of automating the list; coordinate with the lead agency responsible for government -wide debarment and suspension of contractors; chair the Interagency Committee established by Section 4; and report periodically to the Director on implementation of this Order, with the first report due within two years of the date of the Order. See. 6. The Director of the Office of Management and Budget is authorized to issue guidelines to Executive departments and agencies that govern which programs and activities are covered by this Order, prescribe government -wide criteria and government -wide minimum due process procedures, and set forth other related details for the effective administration of the guidelines. Sec. 7. The Director of the Office of Management and Budget shall report to the President within three years of the date of this Order on Federal agency compliance with the Order, including the number of exceptions made under Section 2(c), and shall make recommendations as are appropriate further to curb fraud, waste, and abuse. Implementation in the SRF Programs A company or individual who is debarred or suspended cannot participate in primary and lower -tiered covered transactions. These transactions include SRF loans and contracts and subcontracts awarded with SRF loan funds. Under 40 C.F.R. 32.510, the SRF agency must submit a certification stating that it shall not knowingly enter into any transaction with a person who is proposed for debarment, suspended, declared ineligible, or voluntarily excluded from participation in the SRF program. This certification is reviewed by the EPA regional office before the capitalization grant is awarded. A recipient of SRF assistance directly made available by capitalization grants must provide a certification that it will not knowingly enter into a contract with anyone who is ineligible under the regulations to participate in the project. Contractors on the project have to provide a similar certification prior to the award of a contract and subcontractors on the project have to provide the general contractor with the certification prior to the award of any subcontract. In addition to actions taken under 40 C.F.R. Part 32, there are a wide range of other sanctions that can render a party ineligible to participate in the SRF program. Lists of debarred, suspended and otherwise ineligible parties are maintained by the General Services Administration and should be checked by the SRF agency and all recipients of funds directly made available by capitalization grants to ensure the accuracy of certifications. Additional References C 40 C.F.R. Part 32: EPA Regulations on Debarment and Suspension. CERTIFICATION REGARDING DEBARMENT & SUSPENSION AND OTHER RESPONSIBILITY MATTERS In accordance with the Executive Order 12549, the prospective primary participant certifies to the best of his / her knowledge and belief, that its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; b. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offence in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction or records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification. d. Have not within a three-year period preceding this application / proposal had one or more public transactions (federal, state, or local) terminated for cause of default. e. Acknowledge that all sub -contractors selected for this project must be in compliance with paragraphs (1) (a— d) of this certification. Name and Title of Authorized Agent Signature of Authorized Agent I am unable to certify to the above statements. My explanation is attached. Date CERTIFICATION REGARDING LOBBYING (To be submitted if the bid or offer exceeds $100,000) The undersigned certifies, to the best of his or her knowledge and belief, that (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (c) The undersigned shall require that the language paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 at seq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official Printed Name and Title of Contractor's Authorized Official Date INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, County, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, County, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, County, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503 Approved by OMB 0348-0046 Disclosure of Lobbying Activities Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure) 1. Type of Federal Action: 2. Status of Federal 3. Report Type: a. contract Action: a. initial filing b. grant a. b. material change c. cooperative bid/offer/application agreement b. initial award d. loan c. post -award e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Prime Subawardee Enter Name and Address of Prime: Tier , if Known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 7. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying b. Individuals Performing Services (including Registrant address if different from No. 10a) (if individual, last name, first name, MI): (last name, first name, MI): 11. Information requested through this form is authorized by title 31 U.S.C. section 1362. This Signature: disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction Print Name: was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1362. This Title: information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the Telephone No.: Date: required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97) HOUSE BILL 89 VERIFICATION FORM Certification Required by Texas Government Code Section 2270.001 The 85'" Texas Legislature approved new legislation, effective September 1, 2017, which amends Texas Local Government Code Section 1, Subtitle F, Title 10, Government Code by adding Chapter 2270 which states that a government entity may not enter into a contract (which includes contracts formed through purchase orders) with a company for goods or services unless the contract contains a written verification from the company that it: 1) Does not boycott Israel; and 2) Will not boycott Israel during the term of the contract Pursuant to Section 2270.001, Texas Government Code: 1. "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes; and 2. "Company" means a for profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or any limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of those entities or business associations that exist to make a profit. I, (authorized official) , do hereby verify the truthfulness and accuracy of the contents of the statements submitted on this certification under the provisions of Subtitle F, Title 10, Government Code Chapter 2270 and that the company named below: 1) Does not boycott Israel currently; 2) Will not boycott Israel during the term of the contract; and 3) Is not currently listed on the State of Texas Comptroller's Companies that Boycott Israel List located at https://comptroller.texas.gov/purchasing/publications/divestment php Company Name Signature of Authorized Official Printed Name of Authorized Official Title of Authorized Official Date RESIDENCE CERTIFICATION Pursuant to Texas Government Code §2252.001 etseq., as amended, Calhoun County requests Residence Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of governmental contract; pertinent provisions of §2252.001 are stated below: Sec. 2252.001 (3) "Nonresident bidder" refers to a person who is not a resident. (4) 'Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state. D 1 certify that (Company Name) is a "Nonresident Bidder" of Texas as defined in Government Code §2252.001 and our principal place of business is D I certify that (City and Shale) (Company Name) defined in Government Code §2252.001. Signature of Authorized Agent Printed Name and Title of Authorized Agent Date is a "Resident Bidder" of Texas as SECTION 504 CERTIFICATION POLICY OF NONDISCRIMINATION ON THE BASIS OF DISABILITY The does not discriminate on the basis of disability status in the admission or access to, or treatment or employment in, its federally assisted programs or activities. (Name) (Address) County State Zip Telephone Number ( Voice TDD nondiscrimination. has been designated to coordinate compliance all Federal statutes relating to Insert System for Award Management (SAM) Record Search for company and company principal(s). Include a printout of the search results that includes the record date and verification that the Company, Corporation, Firm or Partnership's principles are not listed (are not debarred) through the System for Award Management CERTIFICATE OF INTERESTED PARTIES FORM 1295 A business entity will generate Form 1295 online after notification of award and submit with their signed contract. Form 1295 must be filled out and submitted online, printed, complete #6, signed and returned with the Agreement, Contract, or Lease. See Calhoun County, Texas - Policy of Compliance TO FILL OUT FORM 1295: Go to: hftps://www.ethics.state.tx.us/File 1. If you have an account, log in and proceed with the process or if you do not have an account, follow the instructions to set up an account and then proceed with the process. 2 Submit and'print a copy of the form which will contain a unique certification number and date submitted in the upper right hand box that is marked "Office Use Only". 3. The Respondent or an authorized agent of the Respondent must sign and date the printed copy of the form (making sure all of #6 is completed). 4. The completed Form 1295 must be included with your Agreement, Contract or Lease, when it is submitted to Calhoun County. For help in fillina out the form: #1 Name of Business Entity filing the form, and the City, State and Country of the Entity's place of business #2 Calhoun County, Texas (Also, if applicable, insert name of County Department) #3 Bid Number 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project On #4 and #5, complete only the one that applies to you #4 Fill in the correct information if this applies OR #5 Mark an X in the Box if this applies #6 Fill in the correct information, submit and print After printing, the respondent or an authorized agent of the respondent must sign and date (making sure all of #6 is completed) When you print you should see a Certificate Number and Date in the upper right hand box that is marked "Office Use Only". CERTIFICATE OF INTERESTED PARTIES FORM 1295 OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. 4`V / 1 Name of business entity filing form, and the city, state and countryof the business entity's place of business. ` 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. 3 Provide the identification number used by the governmental entity or state agency to t ko itlentify the contract, and provide a description of the services, goods, or other property to be provided` UA,e contract. V 4 Name of Interested Party City, State, Country ( ature of Interest (check applicable) Intermediary (place of business) rControlling Aso IV 5 (� Check only if there QQ Interested Party. a UNSWORNDEC41t� N'•/\� My name is ` andmy date of birth is My addre.�,� AA ri(street) (city) (stale) (zip code) (country) �LEa�I!lI der penalty of perjury that. the foregoing is true and correct. Executed in County, State of , on the day of , 20_ (month) (year) Signature of authorized agent of contracting business entity (Declarant) ADD ADDITIONAL PAGES AS NECESSARY Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1222(2017 Calhoun County, Texas POLICY OF COMPLIANCE SECTION 2252.908 TEXAS GOVERNMENT CODE Approved by Commissioners Court January 28, 2016 Amended by Commissioners Court January 31, 2018 and September 14, 2022 BACKGROUND Section 2252.908 was added to the Government Code by the 84t" Texas Legislature through the adoption of House Bill 1295. The law states that the County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) is provided to the county at the time the contract is considered for action by Commissioner's Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract. The law does not apply to a contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within 30 days of approving a contract with a business entity. Governmental transparency is the objective of the law. Senate Bill 255 adopted by the 85th Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal https://www.ethics.state.tx.us/whatsnew/elf info_form1295.htm. A business entity will generate Form 1295 online. Calhoun County will acknowledge online the receipt of Form 1295 after a contract is executed. Within seven business days, Form 1295 will be available for public viewing on the Commission's website. COMPLAINCE Calhoun County Commissioners Court will not consider for action any contract with a business entity unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than 30 days after Commissioner's Court approves a contract with a non-exempt business entity, the County Clerkwill file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. EQUAL OPPORTUNITY GUIDELINES FOR CONSTRUCTION CONTRACTORS 1. What are the responsibilities of the offeror or bidder to insure equal employment opportunity? Opportunity Construction Contract Specifications." The offeror or bidder must comply with the "Equal Opportunity Clause" and the "Standard Federal Equal 2. Are construction contractors required to insure a comfortable working environment for all employees? Yes, it is the construction contractor's responsibility to provide an environment free of harassment, intimidation, and coercion to all employees and to notify all foremen and supervisors to carry out this obligation, with specific attention to minority or female individuals. 3. To alleviate developing separate facilities for men and women on all sites, can a construction contractor place all women employees on one site? No, two or more women should be assigned to each site when possible. 4. Are construction contractors required to make special outreach efforts to minority and female recruitment sources? Yes, construction contractors must establish a current list of minority and female recruitment sources. Notification of employment opportunities, including the availability of on-the-job training and apprenticeship programs, should be given to these sources. The efforts of the construction contractors should be kept in file. 5. Should records be maintained on the number of minority and females applying for positions with construction contractors? Yes, records must be maintained to include a current list of names, addresses and telephone numbers of all minority and female applicants. The documentation should also include the results of the applications submitted. 6. What happens if a woman or minority is sent to the union by the Contractor and is not referred back to the Contractor for employment? If the unions impede the construction contractor's responsibility to provide equal employment opportunity, a written notice should be submitted to the Texas Division of Emergency Management's Hazard Mitigation Grant Program. 7. What efforts are made by construction contractors to create entry-level positions for women and minorities? Construction contractors are required to develop on-the-job training programs, or participate in training programs, especially those funded by the Department of Labor, to create positions for women and minorities and to meet employment needs. 8. Are any efforts made by the Contractor to publicize their Equal Employment Opportunity (EEO) policy? Yes, the construction contractor is responsible for notifying unions and sources of training programs of their equal employment opportunity policy. Unions should be requested to cooperate in the effort of equal opportunity. The policy should be included in any appropriate manuals, or collective bargaining agreements. The construction contractor is encouraged to publicize the equal employment opportunity policy in the company newspaper and annual report. The Contractor is also responsible to include the EEO policy in all media advertisement. 9. Are any in-service training programs provided for staff to update the EEO policy? At least annually a review of the EEO policy and the affirmative action obligations are required of all personnel present, subject matter discussed, and disposition of the subject matter should be employees of a decision -making status. A record of the meeting including date, time, location, persons maintained. 10. What recruitment efforts are made for minorities and women? The construction contractor must notify, both orally and in writing, minority and female recruitment sources one month prior to the date of acceptance for apprenticeship or other training programs. 11. Are any measures taken to encourage promotions for minorities and women? Yes, an annual evaluation should be conducted for all minority and female personnel to encourage these employees to seek higher positions. 12. What efforts are taken to insure that personnel policies are in accordance with the EEO policy? Personnel policies in regard to job practices, work assignments, etc. should be continually monitored to insure that the EEO policy is carried out. 13. Can women be excluded from utilizing any facilities available to men? No, all facilities and company activities are non -segregated except for bathrooms or changing facilities to insure privacy. 14. What efforts are made to utilize minority and female contractors and suppliers? None, however records are kept of all offers to minority and female construction contractors. 15. If a construction contractor participates in a business related association that does not comply with affirmative action standards, does that show his/her failure to comply? No, the construction contractor is responsible for its own compliance. 16. Will a construction contractor be in violation of EEO policy and affirmative action if he sets up one set of goals to include minorities and women? Yes. There is a separate goal for minorities and a separate single goal for women. The construction contractor is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female, and all women both minority and non -minority. 17. Can a construction contractor hire a subcontractor who has been debarred from government contracts pursuant to EEO? No. The construction contractor must suspend, terminate or cancel its contract with any Subcontractor who is in violation of the EEO policy. 18. What effort has been taken by the construction contractor to monitor all employment to insure the company EEO policy is being carried out? The construction contractor must designate a responsible individual to keep accurate records of all employees that includes specific information required by the government. STANDARD FORM OF AGREEMENT FOR MATERIALS CONTRACT THIS AGREEMENT made this the day of , 2024, by and between (a corporation organized and existing under the laws of the State of (a partnership consisting of ) (an individual trading as ) hereinafter called the "Contractor", and CALHOUN COUNTY hereinafter called the "County." WITNESSETH, that the Contractor and the County for the considerations stated herein mutually agree as follows: ARTICLE 1. Statement of Work. The Contractor shall furnish all supervision, technical personnel, labor, materials, machinery, tools, equipment and services, including utility and transportation services, and perform and complete all work required for the construction of the Improvements embraced in the Project; namely, Bid Number 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement PEgIgSt, for the Coun , all in strict accordance with the contract documents including all addenda thereto, numbered , dated and all as prepared by G&W Engineers, Inc., acting and in these contract documents preparation. ARTICLE 2. The Contract Price. The County will pay the Contractor for the performance of the Contract in current funds, for the total quantities of work performed at the unit prices stipulated in the Bid for the several respective items of work completed subject to additions and deductions in amount of Dollars ($_ ). ARTICLE 3. The Contract. The executed contract documents shall consist of the following components: a. This Agreement b. Addenda c. Invitation for Bids d. Instructions to Bidders e. Signed Copy of Bid f. General Conditions g. Calhoun County General Conditions h. Special Conditions i. Performance Bond j. Payment Bond k. Technical Specifications I. Drawings m. Other ( ) ARTICLE 4. Performance. Work, in accordance with the Contract dated shall commence on or before as established in an official letter notification to the contractor called "Notice to Proceed" and Contractor shall complete the WORK within consecutive calendar days thereafter. The date of completion of all WORK is therefore established by the Notice to Proceed Letter. This Agreement, together with other documents enumerated in this ARTICLE 3, which said other documents are as fully a part of the Contract as if hereto attached or herein repeated, forms the Contract between the parties hereto. In the event that any provision in any component part of this Contract conflicts with any provision of any other component part, the provision of the component part first enumerated in this ARTICLE 3 shall govern, except as otherwise specifically stated. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed in triplicate original copies on the day and year first above written. (The Contractor) CALHOUN COUNTY (County) Name/Title Name/Title: Richard H. Meyer. County Judge Corporate Certifications 1, , certify that I am the of the corporation named as Contractor herein; that who signed this Agreement on behalf of the Contractor, was then of said corporation; that said Agreement was duly signed for and in behalf of said corporation by authority of its governing body, and is within the scope of its corporate powers. Corporate Seal (Corporate Secretary) Please indicate above with N/A to all blanks above if LLC and authorized person signature at Corporate Secretary. GENERAL CONTRACT CONDITIONS FOR EQUIPMENT AND MATERIALS 1. Contract and Contract Documents (a) The project to be constructed pursuant to this contract will be financed with ACND funds and is subject to all applicable laws and regulations. (b) The Plans, Specifications and Addenda shall form part of this contract and the provisions thereof shall be binding upon the parties as if they were herein fully set forth 2. Definitions Whenever used in any of the Contract Documents, the following meanings shall be given to the terms here in defined: (a) The term "Contract" means the Contract executed between the Calhoun County, hereinafter called the "County" and (Name of Construction Co.), hereinafter called "Contractor", of which these GENERAL CONDITIONS, form a part. (b) The term "Project Area" means the area within the specified Contract limits of the Improvements contemplated to be constructed in whole or in part under this contract. (c) The term "Contract Documents" means and shall include the following: Executed Contract, Addenda (if any), Invitation for Bids, Instructions to Bidders, Signed Copy of Bid, General Conditions, Special Conditions, Technical Specifications, and Drawings (as listed in the Schedule of Drawings). 3. Supervision By Contractor (a) Except where the Contractor is an individual and personally supervises the work, the Contractor shall provide a competent superintendent, satisfactory to the County, on the work at all times during working hours with full authority to act as Contractor's agent. The Contractor shall also provide adequate staff for the proper coordination and expediting of his work. (b) The Contractor shall be responsible for all work executed under the Contract. Contractor shall verify all figures and elevations before proceeding with the work and will be held responsible for any error resulting from his failure to do so. 4. Subcontracts (a) The Contractor shall not execute an agreement with any subcontractor or permit any subcontractor to perform any work included in this contract until Contractor has verified the subcontractor is eligible to participate in County Bond funded contracts. (b) No proposed subcontractor shall be disapproved by the county except for cause (c) The Contractor shall be as fully responsible to the County for the acts and omissions of his subcontractors, and of persons either directly or indirectly employed by them. (d) Nothing contained in the Contract shall create any contractual relation between any subcontractor and the County. 5. Fittin-g and Coordination of Work The Contractor shall be responsible for the proper fitting of all work and for the coordination of the operations of all trades, subcontractors, or material suppliers engaged upon this Contract. 6. Payments to Contractor (a) Partial Payments 1) The Contractor shall prepare the requisition for partial payment as of the last day of the month and submit it, with the required number of copies, to the County and Engineer for approval. The amount of the payment due the Contractor shall be determined by adding to the total value of work completed to date, the value of materials properly stored on the site and deducting (1) ten percent (10%) of the total amount, to be retained until final payment, and (2) the amount of all previous payments. The total value of work completed to date shall be based on the estimated quantities of work completed and on the unit prices contained in the agreement. The value of materials properly stored on the site shall be based upon the estimated quantities of such materials and the invoice prices. Copies of all invoices shall be available for inspection of the County. 2) Monthly or partial payments made by the County to the Contractor are advanced for the purpose of assisting the contractor to expedite the work of construction. The Contractor shall be responsible for the care and protection of all materials and work upon which payments have been made until final acceptance of such work and materials by the County. Such payments shall not constitute a waiver of the right of the County to require the fulfillment of all terms of the Contract and the delivery of all improvements embraced in this Contract complete and satisfactory to the County in all details. (b) Final Payment 1) After final inspection and the acceptance by the County of all work under the Contract, the Contractor shall prepare the requisition for final payment which shall be based upon the careful inspection of each item of work at the applicable unit prices stipulated in the Contract. The total amount of the final payment due the Contractor under this Contract shall be the amount computed as described above less all previous payments. 2) Before paying the final estimate, County shall require the Contractor to furnish releases or receipts from all subcontractors having performed any work and all persons having supplied materials, equipment (installed on the Project) and services to the Contractor. The County may make payment in part or in full to the Contractor without requiring the furnishing of such releases or receipts and any payments made shall in no way impair the obligations of any surety or sureties furnished under this Contract. 3) Any amount due the County under Liquidated Damages, shall be deducted from the final payment due the contractor. (c) Payments Subject to Submission of Certificates Each payment to the Contractor by the County shall be made subject to submission by the Contractor of all written certifications required of it and its subcontractors. (d) Withholding Payments The County may withhold any payment due the Contractor as deemed necessary to protect the County, and if so elects, may also withhold any amounts due from the Contractor to any subcontractors or material dealers, for work performed or material furnished by them. The foregoing provisions shall be construed solely for the benefit of the County and will not require the County to determine or adjust any claims or disputes between the Contractor and its subcontractors or material dealers, or to withhold any moneys for their protection unless the County elects to do so. The failure or refusal of the County to withhold any moneys from the Contractor shall in no way impair the obligations of any surety or sureties under any bond or bonds furnished under this Contract. 7. Chan-ges in the Work (a) The County may make changes in the scope of work required to be performed by the Contractor under the Contract without relieving or releasing the Contractor from any obligations under the Contract or any guarantee given pursuant to the Contract provisions, and without affecting the validity of the guaranty bonds, and without relieving or releasing the surety or sureties of said bonds. All such work shall be executed under the terms of the original Contract unless it is expressly provided otherwise. (b) Except for the purpose of affording protection against any emergency endangering health, life, limb or property, the Contractor shall make no change in the materials used or in the specified manner of constructing and/or installing the improvements or supply additional labor, services or materials beyond that actually required for the execution of the Contract, unless in pursuance of a written order from the County authorizing the Contractor to proceed with the change. No claim for an adjustment of the Contract Price will be valid unless so ordered. (c) If applicable unit prices are contained in the Contract, the County may order the Contractor to proceed with desired unit prices specified in the Contract; provided that in case of a unit price contract the net value of all changes does not increase the original total amount of the agreement by more than twenty-five percent (25%) or decrease the original the total amount by eighteen percent (18%) for Counties and 25% for municipalities but only with the contractor's written consent. (d) Each change order shall include in its final form: 1) A detailed description of the change in the work. 2) The Contractor's proposal (if any) or a confirmed copy thereof. 3) A definite statement as to the resulting change in the contract price and/or time. 4) The statement that all work involved in the change shall be performed in accordance with contract requirements except as modified by the change order. 5) The procedures as outlined in this Section for a unit price contract also apply in any lump sum contract. 8. Claims for Extra Cost (a) If the Contractor claims that any instructions by Drawings or otherwise involve extra cost or extension of time, he shall, within ten days after the receipt of such instructions, and in any event before proceeding to execute the work, submit his protest thereto in writing to the County, stating clearly and in detail the basis of his objections. No such claim will be considered unless so made. (b) Claims for additional compensation for extra work, due to alleged errors in ground elevations, contour lines, or bench marks, will not be recognized unless accompanied by certified survey data, made prior to the time the original ground was disturbed, clearly showing that errors exist which resulted, or would result, in handling more material, or performing more work, than would be reasonably estimated from the Drawings and maps issued. (c) Any discrepancies which may be discovered between actual conditions and those represented by the Drawings and maps shall be reported at once to the County and work shall not proceed except at the Contractor's risk, until written instructions have been received from the County. (d) If, on the basis of the available evidence, the County determines that an adjustment of the Contract Price and/or time is justifiable, a change order shall be executed. 9. Termination. Delays, and Liquidated Damages (a) Right of the County to Terminate Contract for Convenience County may at any time and for any reason terminate Contractor's services and work at County's convenience upon providing written notice to the Contractor specifying the extent of termination and the effective date. Upon receipt of such notice, Contractor shall, unless the notice directs otherwise, immediately discontinue the work and placing of orders for materials, facilities and supplies in connection with the performance of this Agreement. Upon such termination, Contractor shall be entitled to payment only as follows: (1) the actual cost of the work completed in conformity with this Agreement plus (2) such other costs actually incurred by Contractor as are permitted by the prime contract and approved by County. There shall be deducted from such sums as provided in this subparagraph the amount of any payments made to Contractor prior to the date of the termination of this Agreement. Contractor shall not be entitled to any claim or claim of lien against County for any additional compensation or damages in the event of such termination and payment. (b) Right of the County to Terminate Contract for Cause In the event that any of the provisions of this contract are violated by the Contractor, or by any subcontractors, the County may serve written notice upon the Contractor and the Surety of its intention to terminate the contract. The notices shall contain the reasons for such intention to terminate the contract, and unless such violation or delay shall cease and satisfactory arrangement of correction be made within ten days, the contract shall, upon the expiration of said ten (10) days, cease and terminate. In the event of any such termination, the County shall immediately serve notice thereof upon the Surety and the Contractor. The Surety shall have the right to take over and perform the contract. Provided, however, that if the Surety does not commence performance thereof within ten (10) days from the date of the mailing to such Surety of notice of termination, the County may take over the work and complete the project by bid/contract or by force account at the expense of the Contractor and his Surety shall be liable to the County for any excess cost incurred. In such event the County may take possession of and utilize in completing the work, such materials, appliances, and plant as may be on the site of the work and necessary therefore. (c) Liquidated Damages for Delays If the work is not completed within the time stipulated in the applicable bid for Lump Sum or Unit Price Contract provided, the Contractor shall pay to the County as fixed, agreed, and liquidated damages (it being impossible to determine the actual damages occasioned by the delay) the amount of $300.00 for each calendar day of delay, until the work is completed. The Contractor and Contractor's sureties shall be liable to the County for the amount thereof. (d) Excusable Delays. 1) The right of the Contractor to proceed shall not be terminated nor shall the Contractor be charged with liquidated damages for any delays in the completion of the work due to: 2) Any acts of the Government, including controls or restrictions upon or requisitioning of materials, equipment, tools, or labor by reason of war, national defense, or any other national emergency; 3) Any acts of the County; 4) Causes not reasonably foreseeable by the parties to this Contract at the time of execution which are beyond the control and without the fault or negligence of the Contractor, including, but not restricted to, acts of God, terrorism, war, acts of another Contractor in the performance of some other contract with the County, fires, floods, epidemics, quarantine, restrictions, strikes, freight embargoes, and weather of unusual severity such as hurricanes, tornadoes, cyclones and other extreme weather conditions. 5) Provided, however, that the Contractor promptly notifies the County within ten (10) days in writing of the cause of the delay. Upon receipt of such notification, the County shall ascertain the facts and the cause and extent of delay. If, upon the basis of the facts and the terms of this contract, the delay is properly excusable, the County shall extend the time for completing the work for a period of time commensurate with the period of excusable delay. 10. Assignment or Novation The Contractor shall not assign nor transfer, whether by assignment or novation, any of its rights, duties, benefits, obligations, liabilities, or responsibilities under this Contract without the written consent of the County. No assignment or novation of this Contract shall be valid unless the assignment or novation expressly provides that the assignment of any of the Contractor's rights or benefits under the Contract is subject to a prior lien for labor performed, services rendered, and materials, tools, and equipment supplied for the performance of the work under this Contract in favor of all persons, Contractors, or corporations rendering such labor or services or supplying such materials, tools, or equipment. 11. Technical Specifications and Drawings Anything mentioned in the Technical Specifications and not shown on the Drawings or vice versa, shall be of like effect as if shown on or mentioned in both. In case of difference between Drawings and Technical Specifications, the Technical Specifications shall govern. In case of any discrepancy in Drawings, or Technical Specifications, the matter shall be immediately submitted to the County for review. Contractor shall be liable for any issues or expenses in the event the discrepancy is not submitted to the County. 12. Shop Drawings (a) All required shop drawings, machinery details, layout drawings, etc. shall be submitted to the Engineer in 3 copies for approval sufficiently in advance of requirements to afford ample time for checking, including time for correcting, resubmitting and rechecking if necessary. The Contractor may proceed, only at Contractor's own risk, with manufacture or installation of any equipment or work covered by said shop drawings, etc. until they are approved and no claim, by the Contractor, for extension of the contract time shall be granted by reason of his failure in this respect. (b) Any drawings submitted without the Contractor's stamp of approval will not be considered and will be returned to him for proper resubmission. If any drawings show variations from the requirements of the Contract because of standard shop practice or other reason, the Contractor shall make specific mention of such variation in his letter of transmittal in order that, if acceptable, suitable action may be taken for proper adjustment of contract price and/or time, otherwise the Contractor will not be relieved of the responsibility for executing the work in accordance with the Contract even though the drawings have been approved. (c) If a shop drawing is in accordance with the contract or involves only minor adjustment in the interest of the County not involving a change in contract price or time, the engineer may approve the drawing. The approval shall not relieve the Contractor from responsibility to adhere to the contract or for any error in the drawing or shop drawing review/approval. 13. Requests for Supplementary Information It shall be the responsibility of the Contractor to make timely requests of the County for any additional information which should be furnished by the County under the terms of this Contract, and which is required in the planning and execution of the work. Such requests may be submitted from time to time as the need approaches, but each shall be filed in ample time to permit appropriate action to be taken by all parties involved so as to avoid delay. Each request shall be in writing, and list the various items and the latest date by which each will be required by the Contractor. The first list shall be submitted within two weeks after Contract award and shall be as complete as possible at that time. The Contractor shall, if requested, furnish promptly any assistance and information the County may require in responding to these requests of the Contractor. The Contractor shall be fully responsible for any delay in his work or to others arising from his failure to comply fully with the provision of this section. 14. Materials and Workmanship (a) Unless otherwise specifically provided for in the technical specifications, all workmanship, equipment, materials and articles incorporated in the work shall be new and the best grade of the respective kinds for the purpose. Where equipment, materials, articles or workmanship are referred to in the technical specifications as "equal to" any particular standard, the Engineer shall decide the question of equality. (b) The Contractor shall furnish to the County for approval the manufacturer's detailed specifications for all machinery, mechanical and other special equipment, which he contemplates installing together with full information as to type, performance characteristics, and all other pertinent information as required, and shall likewise submit for approval full information concerning all other materials or articles which he proposes to incorporate. (c) Machinery, mechanical and other equipment, materials or articles installed or used without such prior approval shall be at the risk of subsequent rejection. (d) Materials specified by reference to the number or symbol of a specific standard, shall comply with requirements in the latest revision thereof and any amendment or supplement thereto in effect on the date of the Invitation for Bids, except as limited to type, class or grade, or modified in the technical specifications shall have full force and effect as though printed therein. (a) The County may require the Contractor to dismiss from the work such employee or employees as the County may deem unqualified. 15. Samples. Certificates and Tests (a) The Contractor shall submit all material or equipment samples, certificates, affidavits, etc., as called for in the contract documents or required by the County, promptly after award of the contract and acceptance of the Contractor's bond. No such material or equipment shall be manufactured or delivered to the site, except at the Contractor's own risk, until the required samples or certificates have been approved in writing by the County. Any delay in the work caused by late or improper submission of samples or certificates for approval shall not be considered just cause for an extension of the contract time. (b) Each sample submitted by the Contractor shall carry a label giving the name of the Contractor, the project for which it is intended, and the name of the producer. The accompanying certificate or letter from the Contractor shall state that the sample complies with contract requirements, shall give the name and brand of the product, its place of origin, the name and address of the producer and all specifications or other detailed information which will assist the County in making a prompt decision regarding the acceptability of the sample. It shall also include the statement that all materials or equipment furnished for use in the project will comply with the samples and/or certified statements. (c) Approval of any materials shall be general only and shall not constitute a waiver of the County's right to demand full compliance with Contract requirements. After actual deliveries, the County will have such check tests made as he deems necessary in each instance and may reject materials and equipment and accessories for cause, even though such materials and articles have been given general approval. If materials, equipment or accessories which fail to meet check tests have been incorporated in the work, the County will have the right to cause their removal and replacement by proper materials or to demand and secure such reparation by the Contractor as is equitable. (d) Except as otherwise specifically stated in the Contract, the costs of sampling and testing will be divided as follows: 1) The Contractor shall furnish without extra cost, including packing and delivery charges, all samples required for testing purposes, except those samples taken on the project by the County; 2) The Contractor shall assume all costs of re -testing materials which fail to meet contract requirements; 3) The Contractor shall assume all costs of testing materials offered in substitution for those found deficient; 4) The County will pay all other expenses. 16. Permits and Codes (a) The Contractor shall give all notices required by and comply with all applicable federal and state laws, ordinances, and codes of the Local Government. All construction work and/or utility installations shall comply with all applicable ordinances, and codes including all written waivers. Before installing any work, the Contractor shall examine the drawings and technical specifications for compliance with applicable ordinances and codes and shall immediately report any discrepancy to the County. Where the requirements of the drawings and technical specifications fail to comply with such applicable ordinances or codes, the County will adjust the Contract by Change Order to conform to such ordinances or codes (unless waivers in writing covering the difference have been granted by the governing body or department) and make appropriate adjustment in the Contract Price or stipulated unit prices. (b) Should the Contractor fail to observe the foregoing provisions and proceed with the construction and/or install any utility at variance with any applicable ordinance or code, including any written waivers (notwithstanding the fact that such installation is in compliance with the drawings and technical specifications), the Contractor shall remove such work without cost to the County. (c) The Contractor shall at his own expense, secure and pay for all permits for street pavement, sidewalks, shed, removal of abandoned water taps, sealing of house connection drains, pavement cuts, buildings, electrical, plumbing, water, gas and sewer permits required by the local regulatory body or any of its agencies. (d) The Contractor shall comply with applicable local laws and ordinances governing the disposal of surplus excavation, materials, debris and rubbish on or off the Project Area and commit no trespass on any public or private property in any operation due to or connected with the Improvements contained in this Contract. (e) The Contractor will be required to make arrangements for and pay the water, electrical power, or any other utilities required during construction. (0 During construction of this project, the Contractor shall use every means possible to control the amount of dust created by construction. Prior to the close of a day's work, the Contractor, if directed by the County, shall moisten the surrounding area to prevent a dusty condition. 17. Care of Work (a) The Contractor shall be responsible for all damages to person or property that occur as a result of its fault or negligence in connection with the prosecution of the work and shall be responsible for the proper care and protection of all materials delivered and work performed until completion and final acceptance. (b) In an emergency affecting the safety of life, limb or property, including adjoining property, the Contractor, without special instructions or authorization from the County is authorized to act to prevent such threatened loss or injury. Contractor shall follow all instructions of County. (c) The Contractor shall avoid damage as a result of his operations to existing sidewalks, streets, curbs, pavements, utilities (except those which are to be replaced or removed), adjoining property, etc., and shall be responsible for completely repairing any damage thereto caused by the operations. (d) The Contractor shall shore up, brace, underpin, secure, and protect as maybe necessary, all foundations and other parts of existing structures adjacent to, adjoining, and in the vicinity of the site, which may be in any way affected by the excavations or other operations connected with the construction of the improvements included in this Contract. The Contractor shall be responsible for the giving of any and all required notices to any adjoining or adjacent property owner or other party before the commencement of any work. The Contractor shall indemnify and save harmless the County from any damages on account of settlements or the loss of lateral support of adjoining property and from all loss or expense and all damages for which the County may become liable in consequence of such injury or damage to adjoining and adjacent structures and their premises. 18. Accident Prevention (a) No laborer or mechanic employed in the performance of this Contract shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health or safety as determined under construction safety and health standards promulgated by the Department of Labor. (b) The Contractor shall exercise proper precaution at all times for the protection of persons and property and shall be responsible for all damages to persons or property, either on or off the site, which occur as a result of his prosecution of the work. (c) The Contractor shall maintain an accurate record of all cases of death, occupational disease, or injury requiring medical attention or causing loss of time from work, arising out of and in the course of employment on work under the Contract. The Contractor shall promptly furnish the County with reports concerning these matters. (d) The Contractor shall indemnify and hold harmless the County from any claims for damages resulting from property damage, personal injury and/or death suffered or alleged to have been suffered by any person as a result of any work conducted under this contract. (e) The Contractor shall provide trench safety for all excavations more than five feet deep prior to excavation. All OSHA Standards for trench safety must be adhered to by the Contractor. (f) The contractor shall at all times conduct work in such a manner as to ensure the least possible inconvenience to vehicular and pedestrian traffic. At the close of the work each day, all streets where possible in the opinion of the County, shall be opened to the public in order that persons living in the area may have access to their homes or businesses by the use of the streets. Barricades, warning signs, and necessary lighting shall be provided to the satisfaction of the County at the expense of the Contractor. 19. Sanitary Facilities The Contractor shall furnish, install and maintain ample sanitary facilities for laborers. As the needs arise, a sufficient number of enclosed temporary toilets shall be conveniently placed as required. Drinking water shall be provided from an approved source, so piped or transported as to keep it safe and fresh and served from single service containers or satisfactory types of sanitary drinking stands or fountains. All such facilities and services shall be furnished in strict accordance with existing and governing health regulations. 20. Use of Premises (a) The Contractor shall confine equipment, storage of materials, and construction operations to the contract limits as shown on the drawings and as prescribed by ordinances or permits, or as may be desired by the County and shall not unreasonably encumber the site or public rights of way with materials and construction equipment. (b) The Contractor shall comply with all reasonable instructions of the County and all existing federal, state and local regulations regarding signs, advertising, traffic, fires, explosives, danger signals, and barricades. 21. Removal of Debris, Cleaning, Etc. The Contractor shall, periodically or as directed during the progress of the work, remove and legally dispose of all surplus excavated material and debris, and keep the'Project Area and public rights of way reasonably clear. Upon completion of the work, he shall remove all temporary construction facilities, debris and unused materials provided for work, and put the whole site of the work and public rights of way in a neat and clean condition. 22. Inspection (a) All materials and workmanship shall be subject to inspection, examination, or test by the County and selected Engineer at any and all times during manufacture or construction and at any and all places where such manufacture or construction occurs. The County shall have the right to reject defective material and workmanship or require its correction. Unacceptable workmanship shall be satisfactorily corrected. Rejected material shall be promptly segregated and removed from the Project Area and replaced with material of specified quality without charge. If the Contractor fails to proceed at once with the correction of rejected workmanship or defective material, the County may by contract or otherwise have the defects remedied or rejected materials removed from the Project Area and charge the cost of the same against any Monies which may be due the Contractor, without prejudice to any other rights or remedies of the County. (b) The Contractor shall furnish promptly all materials reasonably necessary for any tests which may be required. All tests by the County will be performed in such manner as not to delay the work unnecessarily and will be made in accordance with the provisions of the technical specifications. (c) The Contractor shall notify the County sufficiently in advance of back filling or concealing any facilities to permit proper inspection. If any facilities are concealed without approval or consent of the County, the Contractor shall uncover for inspection and recover such facilities at Contractor's expense, when so requested by the County. (d) Should it be considered necessary or advisable by the County at any time before final acceptance of the entire work to make an examination of work already completed, the Contractor shall on request promptly furnish all necessary facilities, labor, and material. If such work is found to be defective in any important or essential respect, due to fault of the Contractor or subcontractors, the Contractor shall defray all the expenses of such examination and of satisfactory reconstruction. If, however, such work is found to meet the requirements of the Contract, the actual cost of labor and material necessarily involved in the examination and replacement, shall be reimbursable and if completion of the work of the entire Contract has been delayed, a suitable extension of time will be approved. (e) Inspection of materials and appurtenances to be incorporated in the improvements included in this Contract may be made at the place of production, manufacture or shipment, whenever the quantity justifies it, and such inspection and acceptance, unless otherwise stated in the technical specifications, shall be final, except as regards to: (1) latent defects, (2) departures from specific requirements of the Contract, (3) damage or loss in transit, or (4) fraud or such gross mistakes as amount to fraud. Subject to the requirements contained in the preceding sentence, the inspection of materials as a whole or in part will be made at the Project Site. (f) Neither inspection, testing, approval nor acceptance of the work in whole or in part, by the County or its agents shall relieve the Contractor or its sureties of full responsibility for materials furnished or work performed not in strict accordance with the Contract. 23. Review by County The County and its authorized representatives and agents shall have access to and be permitted to observe and review all work, materials, equipment, payrolls, personnel records, employment conditions, material invoices, and other relevant data and records pertaining to this Contract, provided, however that all instructions and approval with respect to the work will be given to the Contractor only by the County through its authorized representatives or agents. 24. Final Inspection When the Improvements included in this Contract are substantially completed, the Contractor shall notify the County in writing that the work will be ready for final inspection on a definite date which shall be stated in the notice. The County will make the arrangements necessary to have final inspection commenced on the date stated in the notice, or as soon thereafter as is practicable. 25. Ownership and Use of Documents All documents prepared by the Contractor in connection with this Agreement are the property of the County. The contractor will deliver its records and supporting documentation relating to this agreement to the County upon close-out of the projects and the County shall thenceforth be responsible for the maintenance of such records and documents. 26. Deduction for Uncorrected Work If the County deems it not expedient to require the Contractor to correct work not done in accordance with the Contract Documents, an equitable deduction from the Contract Price will be made by agreement between the Contractor and the County and subject to settlement, in case of dispute, as herein provided. 27. Insurance The Contractor shall not commence work under this contract until all required insurance under this paragraph has been secured and approved by the County. These minimum insurance coverage requirements supercede the Calhoun County, Texas General Conditions minimum insurance cover requirements. (a) Worker's Compensation Insurance: The Contractor shall procure and shall maintain during the life of this contract Worker's Compensation Insurance as required by the State of Texas for all of his employees to be engaged in work at the site of the project under this contract and, in case of any such work sublet, the Contractor shall require the subcontractor similarly to provide Worker's Compensation Insurance for all of the employees to be engaged in such work unless such employees are covered by the protection afforded by the Contractor's Worker's Compensation Insurance. (b) Contractor's Public Liability and Property Damage Insurance and Vehicle Liability Insurance. The Contractor shall procure and shall maintain during the life of this contract Contractor's Public Liability Insurance, Contractor's Property Damage Insurance and Vehicle Liability Insurance in the following amounts: (b)1. CONTRACTOR shall have, (or purchase) and shall maintain in force during the duration of the Work, coverage for the hazard of explosion, collapse and underground shall be included. Coverage for independent contractor's liability, contractual liability, products/completed operations liability, personal injury and broad form property damage shall also be included. Completed operations liability shall be kept in force for at least one (1) year after the date of final completion. Coverages shall have at least the following limits. A. General Aggregate $2,000,000 B. Products -Completed Operations Aggregate $1,000,000 C. Personal and Advertising Injury $1,000,000 D. Each Occurrence $1,000,000 E. Fire Damage $ 50,000 (b)2. ADDITIONAL Insured ALL POLICIES (Except for Workman's Compensation/Employers Liability) will name Calhoun County as an additional insured for all insurance requirements, by policy endorsement, along with County's Employees and OWNER's Engineer as ADDITIONAL INSURED and must provide coverage to the maximum extent permitted by law. The additional insured endorsements shall be on the ISO CG2010 11185 form or CG 2010 (10/93) in combination with CG 2037 of CG 2033, or suitable form equivalent. (b)3. Automobile Liability CONTRACTOR shall have (or purchase) and shall maintain in force, for the duration of the Work, coverage cars and trucks owned, rented, hired, or leased, and others of non - ownership nature used by employees in and around or in connection with the particular Contract. Coverage shall have at least the following limit Combined Single Limit (b)4. Builders Risk Insurance $1,000,000 CONTRACTOR shall have (or purchase) and shall maintain in force during the duration of the Work, coverage for, but not limited to, fire, lightning, windstorm, tornado, hurricane, and hail. Coverage shall be in the amount of 100 percent complete value basis on the insurable portions of the project for the benefit of OWNER, CONTRACTOR, and all subcontractors, as their interests may appear. (b)5. Deductible No deductible on any coverage in excess of $500.00 per occurrence is acceptable. (b)6. In the event OWNER is notified of cancellation of all or any part, OWNER may stop all Work on the Contract or secure insurance at its will and charge CONTRACTOR the cost thereof deducting the cost from CONTRACTOR's funds. (c) Proof of Insurance: The Contractor shall furnish the County with certificates showing the type, amount, class of operations covered, effective dates and date of expiration of policies. Such certificates shall also contain substantially the following statement: 'The insurance covered by this certificate will not be canceled or materially altered, except after ten (10) days written notice has been received by the County." 28. Warranty of Title No material, supplies, or equipment to be installed or furnished under this Contract shall be purchased subject to any chattel mortgage or under a conditional sale, lease -purchase or other agreement by which an interest is retained by the seller or supplier. The Contractor shall warrant good title to all materials, supplies, and equipment installed or incorporated in the work and upon completion of all work, shall deliver the same, together with all improvements and appurtenances constructed or placed by Contractor, to the County free from any claims, liens, or charges. Neither the Contractor nor any person, firm, or corporation furnishing any material or labor for any work covered by this Contract shall have any right to a lien upon any improvement or appurtenance. Nothing contained in this paragraph, however, shall defeat or impair the right of persons furnishing materials or labor to recover under any law permitting such persons to look to funds due the Contractor. The provisions of this paragraph shall be inserted in all subcontracts and material contracts and notice of its provisions shall be given to all persons furnishing materials for the work when no formal contract is entered into for such materials. 29. Warranty of Workmanship and Materials Neither the final certificate of payment nor any provision in the Contract nor partial or entire use of the improvements included in this Contract by the County or the public shall constitute an acceptance of work not done in accordance with the Contract or relieve the Contractor of liability in respect to any express warranties or responsibility for faulty materials or workmanship. The Contractor shall promptly remedy any defects in the work and pay for any damage to other work resulting therefrom which shall appear within a provided warranty period from the date of final acceptance of the work. 30. Job Offices (a) The Contractor and its subcontractors may maintain such office and storage facilities on the site as are necessary for the proper conduct of the work. These shall be located so as to cause no interference to any work to be performed on the site. The County shall be consulted with regard to locations. (b) Upon completion of the improvements, or as directed by the County, the Contractor shall remove all such temporary structures and facilities from the site, and leave the site of the work in the condition required by the Contract. 31. Partial Use of Site Improvements The County may give notice to the Contractor and place in use those sections of the improvements which have been completed, inspected and can be accepted as complying with the technical specifications and if in its opinion, each such section is reasonably safe, fit, and convenient for the use and accommodation for which it was intended, provided: (a) The use of such sections of the Improvements shall in no way impede the completion of the remainder of the work by the Contractor. (b) The Contractor shall not be responsible for any damages or maintenance costs due directly to the use of such sections. 32. Local Program Liaison For purposes of this Agreement, the County Commissioner Pct f and County Judge will serve as the Local Program Liaison and primary point of contact for the Contractor. All required progress reports and communication regarding the project shall be directed to this liaison and other local personnel as appropriate. 33. Equal Opportunity Clause During the performance of this contract, the Contractor agrees as follows: (a) The Contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The Contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (b) The Contractor will, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive considerations for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (c) The Contractor will not discourage or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. (d) The Contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (e) The Contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, "Equal Employment Opportunity," and of the rules, regulations, and relevant orders of the Secretary of Labor. (f) The Contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (g) In the event of the Contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (h) The Contractor will include the portion of the sentence immediately preceding paragraph (a) and the provisions of paragraphs (a) through (h) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, That in the event a Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the Contractor may request the United States to enter into such litigation to protect the interests of the United States. 34. Affirmative Action for Workers with Disabilities The Contractor will not discriminate against any employee or applicant for employment because of disability in regard to any position for which the employee or applicant for employment is qualified. The Contractor agrees to take affirmative action to employ, advance in employment and otherwise treat qualified individuals with disabilities without discrimination based upon their disability in all employment practices such as the following: employment, promotion, demotion or transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. 35. Section 109 of the Housing and Community Development Act of 1974 No person in the United States shall on the ground of race, color, national origin, or sex be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with funds made available under this title. 36. Non Segregated Facilities The Contractor certifies that he does not and will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not and will not permit his employees any segregated facilities at any of his establishments, or permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. As used in this paragraph the term "segregated facilities" means any waiting rooms, work areas, rest rooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise. 37. Contract Documents and Drawings The County will furnish the Contractor without charge up to 3 copies of the Contract Documents, including Technical Specifications and Drawings. Additional copies requested by the Contractor will be furnished at cost. 38. Contract Period The work to be performed under this contract shall commence within the time stipulated by the County in the Notice to Proceed, and shall be fully completed within calendar days thereafter. 39. Liquidated Damages Since the actual damages for any delay in completion of the work under this contract are impossible to determine, the Contractor and his Sureties shall be liable for and shall pay to the County the sum of Three Hundred Dollars 300.00 as fixed, agreed and liquidated damages for each calendar day of delay from the above stipulated time for completion. 40. Aae Discrimination Act of 1975 Contractor shall comply with the Age Discrimination Act of 503 which provides that no person in the United States shall on the basis of age be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance. 41. Resolution of Program Non -Compliance and Disallowed Costs In the event of any dispute, claim, question, or disagreement arising from or relating to this Contract, or the breach thereof, including determination of responsibility for any costs disallowed as a result of non-compliance with federal, state or local program requirements, the parties hereto shall use their best efforts to settle the dispute, claim, question or disagreement. To this effect, the parties shall consult and negotiate with each other in good faith within 30 days of receipt of a written notice of the dispute or invitation to negotiate, and attempt to reach a just and equitable solution satisfactory to both parties. If the matter is not resolved by negotiation within 30 days of receipt of written notice or invitation to negotiate, the parties agree first to try in good faith to settle the matter by mediation administered by the American Arbitration Association under its Commercial Mediation Procedures before resorting to arbitration, litigation, or some other dispute resolution procedure. The parties may enter into a written amendment to this Contract and choose a mediatorthat is not affiliated with the American Arbitration Association. The parties shall bear the costs of such mediation equally. (This section may also provide for the qualifications of the mediator(s), the locale of meetings, time limits, or any other item of concern 42. Program Fraud and False /Fraudulent Statements or Related Acts The Contractor acknowledges that 21 U.S.0 Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. 43. Retention of Records. (a) The Contractor shall retain all required records for three years after the County makes its final payment and all pending matters are closed. (b) Contractor shall include the substance of this clause in all subcontracts it awards 44. Access to Records. (a) The contractor agrees to provide the County, the Comptroller General of the United States, the Texas State Auditor, or any of its duly authorized representatives, access to any books, documents, papers, and records of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access to the non -Federal entity's personnel for the purpose of interview and discussion related to such documents. (b) Contractor shall include the substance of this clause in all subcontracts it awards (c) The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. (d) The contractor agrees to provide the County or his authorized representatives access to construction or other work 45. Section 504 Rehabilitation Act of 1973, as amended. The Contractor agrees that no otherwise qualified individual with disabilities shall, solely by reason of his/her disability, be denied the benefits of, or be subjected to discrimination, including discrimination in employment, under any program or activity receiving federal financial assistance. 46. Gender Neutral - Gender References When necessary, unless the context clearly requires otherwise, any gender -specific or gender -neutral term in this Contract (for example, he, she, it, etc.) is to be read as referring to any other gender or to no gender. 47. Conflicts of interest. (a) Governing Body. No member of the governing body of the County and no other officer, employee, or agent of the County, who exercises any functions or responsibilities in connection with administration, construction, engineering, or implementation of award between the County, shall have any personal financial interest, direct or indirect, in the Contractor or this Contract; and the Contractor shall take appropriate steps to assure compliance. (b) Other Local Public Officials. No other public official, who exercises any functions or responsibilities in connection with the planning and carrying out of administration, construction, engineering or implementation of the award between the County, shall have any personal financial interest, direct or indirect, in the Contractor or this Contract; and the Contractor shall take appropriate steps to assure compliance. (c) The Contractor and Employees. The Contractor warrants and represents that it has no conflict of interest associated with the award between the County or this Contract. The Contractor further warrants and represents that it shall not acquire an interest, direct or indirect, in any geographic area that may benefit from the award between the County or in any business, entity, organization or person that may benefit from the award. The Contractor further agrees that it will not employ an individual with a conflict of interest as described herein. 48. Certification Regarding Lobbying Certification for Contracts, Grants, Loans, and Cooperative Agreements (See attached certification regarding lobbying). Contractor shall file the required certification. The undersigned certifies, to the best of his or her knowledge and belief, that: No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. 49. Assignability. The Contractor shall not assign any interest on this Contract, and shall not transfer any interest in the same (whether by assignment or novation), without the prior written consent of the County thereto: Provided, however, that claims for money by the Contractor from the County under this Contract may be assigned to a bank, trust company, or other financial institution without such approval. Written notice of any such assignment or transfer shall be furnished promptly to the County. 50. Civil Rights Act of 1964. Under Title VI of the Civil Rights Act of 1964, no person shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. 51. Section 503 Handicapped (if $2 500 or Over) Affirmative Action for Handicapped Workers (a) The Contractor will not discriminate against any employee or applicant for employment because of physical or mental handicap in regard to any position for which the employee or applicant for employment is qualified. The Contractor agrees to take affirmative action to employ, advance in employment and otherwise treat qualified handicapped individuals without discrimination based upon their physical or mental handicap in all employment practices such as the following: Employment, upgrading, demotion or transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. (b) The Contractor agrees to comply with the rules, regulations, and relevant orders of the Secretary of Labor issued pursuant to the Act. (c) In the event of the Contractor's noncompliance with the requirements of this clause, actions for non- compliance may be taken in accordance with the rules, regulations, and relevant orders of the Secretary of Labor issued pursuant to the Act. (d) The Contractor will include the provisions of this clause in every subcontract or purchase order of $2,500 or more unless exempted by rules, regulations, or orders of the Secretary issued pursuant to Section 503 of the Act, so that such provisions will be binding upon each subcontractor with respect to any subcontract or purchase order as the Director of the Office of Federal Contract Compliance Programs may direct to enforce such provisions, including action for non-compliance. 52. Solid Waste Disposal Act Contractor must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. 53. Byrd Anti -Lobbying [For Contracts that exceed $100,0001 Contractor shall file the required certification: The undersigned certifies, to the best of his or her knowledge and belief, that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. 54. Verification No Boycott Israel As required by Chapter 2271, Government Code, CONTRACTOR hereby verifies that it does not boycott Israel and will not boycott Israel through the term of this Agreement. For purposes of this verification, "boycott Israel' means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes. 55. Foreign Terrorist Organizations. Pursuant to Chapter 2252, Texas Government Code, [Company] represents and certifies that, at the time of execution of this Agreement neither [Company], nor any wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of the same (i) engages in business with Iran, Sudan, or any foreign terrorist organization as described in Chapters 806 or 807 of the Texas Government Code, or Subchapter F of Chapter 2252 of the Texas Government Code, or (ii) is a company listed by the Texas Comptroller of Public Accounts under Sections 806.051, 807.051, or 2252.153 of the Texas Government Code. The term "foreign terrorist organization" in this paragraph has the meaning assigned to such term in Section 2252.151 of the Texas Government Code. 56. Nondiscrimination Contractor will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681 1683, and 1685- 1686 and 44 C.F.R. Part 19), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29) U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; i) any other nondiscrimination provisions in the specific statue(s) under which agreement for Federal assistance is being made; and Q) the requirements of any other nondiscrimination statue(s) which may apply to this agreement CALHOUN COUNTY, TEXAS GENERAL CONDITIONS General Conditions apply to all advertised Invitations to Bid (hereinafter called Bid), Request for Proposals (hereinafter called RFP), Request for Qualifications (hereinafter called RFQ), Contracts/Agreements/Leases (hereinafter called Contract); however these may be superseded in whole or in part by the scope, special requirements, specifications or special sections of Texas Government Code and/or Texas Local Government Code. Governing Law: Bidder/Vendor is advised that the Bid, RFP, RFQ, and/or Contract shall be fully governed by the laws of the State of Texas and that Calhoun County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney concerning any portion of the Bid, RFP, RFQ, and/or Contract. All parties agree that the venue for any litigation arising from this Bid, RFP, RFC, and/or Contract shall be held in Port Lavaca, Calhoun County, Texas. Completion of Bid, RFP. RFQ, and/or Contract Forms: Once the Bid, RFP, RFQ and/or Contract is released for bidding, Calhoun County will not answer any questions except through an addendum that has been approved by Calhoun County Commissioners Court or at a mandatory pre -bid meeting. Complete, sign, and return to the Calhoun County Judge's Office the required number of Bid forms, RFP forms, RFQ forms, and/or Contracts, and any other required information by the day and time the Bid, RFP, RFQ, and/or Contract is due. The Bid, RFP, RFQ, and/or Contract must be signed and dated by an officer, employee or agent who is duly authorized to execute this Bid, RFP, RFQ and/or Contract, and affirms that this company, corporation, firm, partnership or individual has not prepared this Bid, RFP, RFQ and/or Contract in collusion with any other bidder/vendor or any official or employee of Calhoun County, and that the contents of this Bid, RFP, RFQ and/or Contract as to prices, terms or conditions of said Bid, RFP, RFQ, and/or Contract have not been communicated by the individual signing nor by any employee or agent to any other person engaged in this type of business orto any official oremployee of Calhoun County priorto the official opening of this Bid, RFP, RFQ, and/or Contract. The use of liquid paper or white out is not acceptable and may result in the disqualification of the bidders/vendors Bid, RFP, RFQ, and/or Contract. If an error is made, the bidder/vendor must draw a line through the error and initial each change. All responses typed or handwritten in ink must be clear and legible. Submission of Sealed Bid, RFP, RFQ, and/or Contract: All Bids, RFPs, RFQs, and/or Contracts must be delivered to the County Judge's Office in a SEALED envelope. When submitting a SEALED Bid, RFP, RFQ and/or Contract the envelope must be taped and/or glued closed in order for it to be accepted as a SEALED Bid, RFP, RFQ and/or Contract. The bidder/vendor must submit the original and required number of copies of their completed Bid, RFP, RFQ and/or Contract and any additional required information/forms in a SEALED envelope to the Calhoun County Judge's Office, Calhoun County Courthouse, 211 South Ann Street, 3'' Floor, Suite 301, Port Lavaca, Texas. The Bid, RFP, RFQ, and/or Contract will specify the date and time due. The cell phone in the County Judge's office or the cell phone of the County Auditor's Representative is the official clock that will be used in determining the time the Bid, RFP, RFQ and/or Contract is received and the time deadline that the Bid, RFP, RFQ and/or Contract will be opened. A late delivery with an early postmark or delivery of the Bid, RFP, RFQ, and/or Contract to the wrong office will not suffice. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be considered for award, regardless of whether or not the delay was outside of the control of the submitting bidder/vendor. The door to the County Judge's office will be closed once the due date and time has been reached and no other bids will be accepted. Calhoun County will not be responsible for the delivery of your Bid, RFP, RFQ and/or Contract to the office of the Calhoun County Judge. Calhoun County is not responsible for late deliveries due to postal mail or other mail delivery services delays. Calhoun County is not responsible for the delivery of the Bid, RFP, RFQ, and/or Contract to the wrong office. Calhoun County does not accept faxed or emailed Bids, RFPs, RFQs, and/or Contracts. If the bidder/vendor would like to confirm the delivery of their Bid, RFP, RFQ, and/or Contract, the bidder/vendor may call the Calhoun County Judge's office at 361-553-4600. Late Bids, RFPs, RFQs, and/or Contracts will not be accepted. Bids, RFPs, RFQs, and/or Contracts received after the deadline will not be opened and shall be considered void and unacceptable. Bids, RFPs, RFQs, and/or Contracts must be submitted in a SEALED 9 x 12 or larger envelope, addressed as follows: Richard H. Meyer, County Judge, Calhoun County Courthouse, 211 S. Ann St., Suite 301, Port Lavaca, TX 77979. The outside of the SEALED envelope must be clearly marked: SEALED BID (RFP, RFQ, or Contract) and the name of the Bid, RFP, RFQ or Contract. If the Bid, RFP, RFQ and/or Contract is sent by UPS, FeclEx or other delivery service, the outside of this envelope must be clearly marked: SEALED Bid (RFP, RFQ, or Contract) and the name of the Bid, RFP, RFQ or Contract. Withdrawal of Bid, RFP, RFQ, and/or Contract: A bidder/vendor may withdraw their Bid, RFP, RFQ, and/or Contract before Calhoun County's acceptance of the Bid, RFP, RFQ and/or Contract without prejudice to the bidder/vendor, by submitting a written request for its withdrawal to the Calhoun County Judge and mail or hand deliver to the address the Bid, RFP, RFQ, and/or Contract was submitted to. A Bid, RFP, RFQ, and/or Contract that was opened are not subject to amendment, alteration, or change for the purpose of correcting an error in the Bid, RFP, RFQ and/or Contract price. Bids, RFPs, RFQs, and/or Contracts containing an error may be offered as is" or withdrawn by the bidder/vendor in accordance with applicable State Laws. Opening and Award of Bid, RFP. RFQ, and/or Contract: Bidders/vendors are invited to be present at the opening and awarding of the Bid, RFP, RFQ and/or Contract. Governing Forms: In the event of any conflict between the terms and provisions of these conditions, the Bid, RFP or RFQ specifications or contract, if applicable, shall govern. In the event of any conflict of interpretation of any part of this overall document, Calhoun County's interpretation shall govern. Addendums: When specifications are revised, the Calhoun County Auditor's Office will send each bidder/vendor that received a Bid, RFP, RFQ and/or Contract packet the addendum once it has been approved by Calhoun County Commissioners Court. No addendum can be sent out until Calhoun County Commissioners Court has approved the addendum or approved the addendum to be sent out by the Engineer with the approval from the County Commissioner or County Department in charge of the project. Indemnification/Hold Harmless: The successful bidder/vendor shall defend, indemnify and hold Calhoun County and its officials, agents, and employees harmless from all suits, actions, orfor personal injury, death and/or property damage arising from any cause whatsoever, resulting directly or indirectly from bidder's/vendor's performance. Bidder/vendor shall procure and maintain, with respect to the subject matter of this Bid, RFP, RFQ, and/or Contract, appropriate insurance coverage including, as a minimum, general liability and property damage, workers' compensation, employer's liability and auto insurance with adequate limits to cover bidder's/vendor's liability as may arise directly or indirectly from work performed under terms of this Bid, RFP, RFQ, and/or Contract. Certification of such coverage shall name, by policy endorsement, Calhoun County as an additional insured and be provided to Calhoun County upon request. _Waiver of Subrogation: Bidder/vendor and bidder's/vendor's insurance carrier shall waive any and all rights whatsoever with regard to subrogation against Calhoun County and its respective officials, employees, and insurers as an indirect party to any suit arising out of personal or property damages resulting from bidder's/vendor's performance under this Bid, RFP, RFQ, and/or Contract. Insurers and all policies of insurance provided shall contain a provision and/or endorsement stating that the insurance carriers and underwriters waive all rights of subrogation in favor of Calhoun County and its respective officials, employees, and insurers. Bonds: If the Bid, or RFP, requires submission of bid or proposal guarantee and performance bond, there will be a separate page explaining those requirements. Bids or RFPs submitted without the required bid bond or cashier's checks are not acceptable. Taxes: Calhoun County is exempt from all sales tax (state, city and county sales tax) and federal excise taxes under Section 151.309 of the Texas Tax Code. Tax exempt forms will be furnished upon request to the bidder/vendor. Tax exempt forms can be obtained from the Calhoun County Auditor's Office. Bidder/vendor is to issue its Texas Resale Certificate to vendors and subcontractors for such items qualifying for this exemption, and further, bidder/vendor should state these items at cost. Pricing: Prices for all products/goods, services, and/or contracts shall be firm for the duration of the Bid, RFP, and/or Contract and shall be stated on the Bid, RFP, and/or Contract form. Prices shall be all inclusive. All prices must be written in ink or typewritten and must be legible. Pricing on all transportation, freight, and other charges are to be prepaid by the bidder/vendor and included in the Bid, RFP, and/or Contract prices. If there are any additional charges of any kind, other than those mentioned above, specified or unspecified, bidder/vendor must indicate the items required and their costs or forfeit the right to payment for such items. Additional charges added to the Bid, RFP, and/or Contract prices may void the Bid, RFP, and/or Contract. Where unit pricing and extended pricing differ, unit pricing prevails. Inspections, Calhoun County reserves the right to inspect any products/goods or service location for compliance with specifications and requirements and needs of the using department before accepting them. When applicable, Calhoun County reserves the right to enter upon any County leased premises at any time to inspect said premises. Testing: Calhoun County reserves the right to test equipment, supplies, materials, and products/goods bid, proposed, and/or agreed upon for quality, compliance with specifications and ability to meet the needs of the user. Should the equipment, supplies, materials, products/goods and/or services fail to meet requirements and/or be unavailable for evaluation, the Bid, RFP, and/or Contract is subject to rejection. Material Safety Data Sheets: Under the "Hazardous Communications Act", commonly known as the 'Texas Right To Know Act", a bidder/vendor must provide to Calhoun County with each delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the bidder/vendor to furnish this documentation will be cause to reject any Bid, RFP, and/or Contract applying thereto. Awards: Calhoun County reserves the right to award this Bid, RFP, RFQ and/or Contract on the basis of lowest and/or best Bid, RFP, RFQ and/or Contract that met specifications in accordance with the laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one bidder/vendor, to reject any or all Bids, RFPs, RFQs, and/or Contracts and to be the sole judge in determining which Bid, RFP, RFQ, and/or Contract will be most advantageous to Calhoun County. Calhoun County will evaluate and may award a Bid, RFP, RFQ, and/or Contract based on lowest and/or best Bid, RFP, RFQ, and/or Contract meeting specifications. "Lowest and/or best Bid, RFP, RFQ, and/or Contract" means a bid or offer providing the best value considering associated direct and indirect costs, including transport, maintenance, reliability, life cycle, warranties, the county's past experience with the bidder/vendor and customer service after a sale. Calhoun County reserves the right to accept and/or reject any/all of the options Bid, any/all of the RFPs, any/all of the RFQs, and/or any/all of the Contracts as it deems to be in the best interest of the County. An award is final only upon formal execution by Calhoun County Commissioners Court. Per Local Government Code, Sec. 262.027, Calhoun County reserves the right to reject all Bids, RFPs, RFQs, and/or Contracts and to go out for new Bids, RFPs, RFQs, and/or Contracts. In the event of tie Bids, RFPs, RFQs, and/or Contracts, the winning Bid, RFP, RFQ and/or Contract is determined per the Texas Local Governmental Code 262.027(b). Calhoun County, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit Bids, RFPs, RFQs, and/or Contracts. Assignment: The successful bidder/vendor may not assign, sell, sublease or otherwise transfer the Bid, RFP, RFQ, and/or Contract without first obtaining the written approval of Calhoun County Commissioners Court. A change in ownership or management shall cancel the Bid, RFP, RFQ and/or Contract unless a mutual agreement is reached with the new owner or manager to continue the Bid, RFP, RFQ, and/or Contract under the awarded provisions and approved by Calhoun County Commissioners Court. Term of the Bid, RFP, RFQ, and/or Contract: If the Bid, RFP, RFQ, and/or Contract is intended to cover a specific time period, said time will be given in the specifications, instructions, and/or contracts. Obligation of the Bid, RFP, RFQ, and/or Contract: Bids, RFPs, RFQs, and/or Contracts are awarded only upon formal execution by Calhoun County Commissioners Court. If a contract is required, the Calhoun County Judge or other person authorized by Calhoun County Commissioners Court must sign the contract before it becomes binding on Calhoun County. No person is authorized to sign contracts until authorized by Calhoun County Commissioners Court. Calhoun County is not responsible for any contract signed without Commissioners Court approval. Delivery All items shall be shipped F.O.B. inside (or site location) delivery unless otherwise stated in the specifications. Default in promised delivery (without accepted reasons) or failure to meet specifications, authorizes Calhoun County to purchase supplies from the next lowest bidder/vendor that met specifications. Resections: Articles not in accordance with samples and specifications must be removed by the bidder/vendor at the bidder's/vendors expense. All disputes concerning quality of equipment, supplies, materials, products/goods, and/or services delivered under this Bid, RFP, RFQ and/or contract will be determined by Calhoun County Commissioners Court or their designated representative. Termination: Calhoun County reserves the right to terminate the Bid, RFP, RFQ, and/or Contract for default if the bidder/vendor breaches any of the terms therein, including warranties of bidder/vendor or if the bidder/vendor becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper products/goods and/or services within the proper amount of time, and/or to properly perform any and all services required to Calhoun County's satisfaction and/or to meet all other obligations and requirements. Bids, RFPs, RFQs, and/or Contracts may be terminated without cause upon thirty (30) days written notice to either party unless otherwise specified. The bidder/vendor or Calhoun County must state therein the reasons for such cancellation. Calhoun County reserves the right to award cancelled Bid, RFP, RFQ, and/or Contract to the next lowest and best bidder/vendor that met specifications and is deemed to be in the best interest of Calhoun County. Delinquent Property Taxes: Calhoun County reserves the right to reject any Bid, RFP, RFC, and/or Contract submitted by a bidder/vendor owing delinquent property taxes to Calhoun County, Texas. If the bidder/vendor subsequently becomes delinquent in the payment of Calhoun County taxes this may be grounds for cancellation of the Bid, RFP, RFQ, and/or Contract. Despite anything to the contrary, if the bidder/vendor is delinquent in payment of Calhoun County taxes at the time of invoicing, bidder/vendor assigns any payments to be made under this Bid, RFP, RFQ and/or Contract to the Calhoun County Tax Assessor Collector for the payment of delinquent taxes. Certificate of Interested Parties — Form 1295 Section 2252.908 was added to the Government Code by the 841h Texas Legislature through adoption of House Bill 1295. Senate Bill 255 adopted by the 85th Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 ofthe Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal: https://www.ethics.state.tx.us/whatsnew/elf—info—forml295.htm. The law states that a County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) has been completed and provided to the County at the time the contract is considered for action by Commissioners Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract (Bids, RFPs, and/or RFQs also require Form 1295). The law does not apply to a Bid, RFP, RFC, and/or Contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within thirty (30) days of approving a contract, and/or awarding a Bid, RFP, RFQ, and/or Contract with a business entity. Governmental transparency is the objective of the law. A business entity must generate Form 1295 online. A business entity must use the application at the Texas Ethics Commission website to enterthe required information on Form 1295 and print a copy of the completed form, which will include a certification of filing that will contain a unique certification number and date filed in the box marked "Office Use Only" located at the top right hand corner of the form. An authorized agent of the business entity must sign and complete the bottom portion of the printed copy of the form affirming under the penalty of perjury that the completed form is true and correct. Calhoun County Commissioners Court will not consider for action any Contract with a business entity unless it is accompanied by completed and signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. A business entity will generate Form 1295 online after notification of award and submit with their signed contract. (See Attachment A to General Conditions) No later than thirty (30) days after Calhoun County Commissioners Court approves a contract with a business entity, the Calhoun County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. The Texas Ethics Commission will post the completed Form 1295 to its website within seven (7) business days after Calhoun County acknowledges receipt of the form. Debarment: Bidder/vendor certifies that at the time of submission of its (their) Bid, RFP, RFQ and/or Contract, the bidder/vendor, as well as the bidder's/vendor's principals, are not on the federal government's list of suspended, ineligible or debarred bidders/vendors and that the bidder/vendor and its (their) principals have not been placed on this list between the time of the Bid, RFP, RFQ and/or Contract submission and the time of execution of the Bid, RFP, RFQ and/or Contract. A print out of the search results that includes the record date showing that the Company, and its Principals, if any, have an active registration with the System for Award Management (www.SAM.gov) AND are not debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM) must be included with the bidder's/vendor's Bid, RFP, RFQ, and/or Contract. If bidder/vendor or its (their) principals are placed on this list during the term of the Bid, RFP, RFQ, and/or Contract, the bidder/vendor shall notify the Calhoun County Auditor. False certification or failure to notify may result in termination of the Bid, RFP, RFQ, and/or Contract for default. Invoices and Payments: All invoices are subject to approval by the Calhoun County Auditors Office. Invoices shall be billed to Calhoun Countyto the attention of the County Department that the invoice pertains to and, if applicable, have all necessary backup information needed. Invoices shall be itemized (detailed) and free of sales tax (state, city and county sales tax) and federal excise taxes, if applicable. Invoices that are not billed to Calhoun County to the attention of the County Department that the invoice pertains to, not itemized(detailed) and/or free of sales tax (state, city and county sales tax) and federal excise taxes, if applicable, may be returned to the bidder/vendor for corrections. Calhoun County will not incur any fees and/or charges for this request and/or delay in payment of the invoice(s) that was originally submitted incorrectly. Approval of payment of all invoices will be made once the purchase order and invoice(s) are properly and timely submitted to the Calhoun County Treasurers Office by the appropriate County department. Each County department is responsible for submitting their purchase orders for payment to the Calhoun County Treasurers Office by the deadline time and date set forth by the Treasurer's office. No payment can be made or mailed out until approved by Calhoun County Commissioners Court. Purchase order due dates/times and Commissioners Court dates/times are subject to change. Calhoun County's obligation is payable only and solely from funds available for the purpose of this purchase. Lack of funds shall render the order null and void to the extent funds are not available and any delivered but unpaid goods will be returned to the seller by the county. Gratuities: Calhoun County may, by written notice to the bidder/vendor, cancel any order and/or service without liability, if it is determined by Calhoun County that gratuities, in the form of entertainment, gifts, or otherwise were offered or given by the bidder/vendor, or any agent or representative of the bidder/vendor to any official, employee, or agent of Calhoun County with a view toward securing a Bid, RFP, RFQ Contract, order, and/or service. In the event a Bid, RFP, RFQ, Contract, order, and/or service is canceled by Calhoun County pursuant to this provision, the County shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by bidder/vendor in providing such gratuities. _Warranty Product: Bidder/vendor warrants that products/goods sold to and/or services provided to Calhoun County shall conform to the highest commercial and/or professional standards in the industry and laws established bythe U.S. Department of Labor, U.S. Department of Homeland Security, Occupational Safety and Health Administration and OSHA Act of 1970. In the event products/goods sold and/or services provided do not conform to OSHA Standards, where applicable, Calhoun County shall return the product/item for correction or replacement at the bidder's/vendors expense. In the event that services do not conform to OSHA Standards, Calhoun County may immediately stop the services and seek reimbursement for said services at the bidder's/vendors expense. In the event the bidder/vendor fails to make the appropriate correction within a reasonable time, correction made by Calhoun County shall be at the bidder's/vendor's expense. Bidder/vendor shall not limit or exclude any implied warranties and any attempt to do so shall render this Bid, RFP, RFQ, and/or Contract voidable at the option of Calhoun County. Bidder/vendor warrants that the products/goods and/or services furnished and/or performed will conform to the specifications, scope of work, general conditions, drawings, and/or descriptions listed in the Bid, RFP, RFQ, and/or Contract and to the sample(s) furnished by bidder/vendor, if any. In the event of a conflict between the specifications, scope of work, general conditions, drawings, and/or descriptions, the specifications shall govern. All products/goods must be new, in first class condition, unless otherwise specified. The design, strength and quality of materials must conform to the highest standards of manufacturing practice. Products/goods, and/or services supplied and/or performed under this Bid, RFP, RFQ, and/or Contract shall be subject to Calhoun County's approval. Successful bidder/vendor shall warrant that all products/goods and/or services shall conform to the proposed specifications and/or all warranties as stated in the Uniform Commercial Code and be free from all defects in material, workmanship and title. Any products/goods and are services found defective or not meeting specifications shall be picked up and promptly replaced or corrected to Calhoun County's satisfaction by the successful bidder/vendor at no expense to Calhoun County. Cancellation: Calhoun County shall have the right to cancel for default all or any part of the undelivered portion of an order and/or services if bidder/vendor breaches any of the terms hereof including warranties of bidder/vendor, or if the bidder/vendor becomes insolvent or files for protection under the bankruptcy laws. Such rights of cancellation are in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Calhoun County shall not incur any fees and/or charges related to the cancellation. The bidder/vendor shall be responsible for any fees and/or charges that are related to the cancellation. Force Maieure: Force Majeure means a delay encountered by a party in the performance of its obligations under this Bid, RFP, RFQ, and/or Contract, which is caused by an event beyond the reasonable control of that party. Without limiting the generality of the foregoing, "Force Majeure" shall include but not be restricted to the following types of events: acts of God or public enemy; acts of governmental or regulatory authorities; fires, floods, epidemics or serious accidents; unusually severe weather conditions; strikes, lockouts, or other labor disputes; and defaults by subcontractors. In the event of a Force Majeure, the affected party shall not be deemed to have violated its obligations under this Bid, RFP, RFQ and/or Contract, and the time for performance of any obligations of that party shall be extended by a period of time necessary to overcome the effects of the Force Majeure, provided that the foregoing shall not prevent this Bid, RFP, RFQ, and/or Contract from terminating in accordance with the termination provisions. If any event constituting a Force Majeure occurs, the affected party shall notify the other parties in writing, within twenty-four (24) hours, and disclose the estimated length of delay, and cause of the delay. Waiver: No claim or right arising out of a breach of any Bid, RFP, RFQ, and/or Contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. Applicable Law: To the extent it is applicable, this Bid, RFP, RFQ and/or Contract shall be governed by the Uniform Commercial Code. Whenever the term "Uniform Commercial Code" is used it shall be construed as meaning the "Uniform Commercial Code" as adopted in the State of Texas as effective and in force on the date of this Bid, RFP, RFQ, and/or Contract. Otherwise, Texas state and federal law shall apply. Prohibition against Personal Interest in Bids. RFPs. RFQs. and/or Contracts: No official, employee, or agent of Calhoun County shall have financial interest, direct or indirect, in any Bid, RFP, RFQ, and/or Contract with Calhoun County, or shall be financially interested, directly or indirectly, in the sale/lease to Calhoun County of any land, materials, supplies, or service, except on behalf of Calhoun County as an official, employee, or agent. Any willful violation of this section shall constitute malfeasance in office, and any official, employee, or agent guilty thereof shall be subject to disciplinary action under applicable laws, statutes and codes of the State of Texas. Any violation of this section, with the knowledge, expressed or implied of the company, corporation, firm, partnership, or individual contracting with Calhoun County shall render the Bid, RFP, RFQ, and/or Contract involved voidable by the Calhoun County Commissioners Court. Insurance: Proof (copy of bidder's/vendor's current insurance) of the below listed insurance may be required to be returned with the Bid, RFP, RFQ, and/or Contract. As additional security for Calhoun County and as separate obligations of bidder/vendor not in conjunction with any other provisions of the Bid, RFP, RFQ, and/or Contract, bidder/vendor agrees to carry and maintain during the term of the Bid, RFP, RFQ, and/or Contract the minimum insurance coverages stated below. Before commencing work, the successful bidder/vendor shall be required, at his own expense, to furnish the Calhoun County Auditor within ten (10) days of notification of award with a certificate(s) of liability insurance (Form ACORD 25 or equivalent) showing, at least, the following minimum insurance coverage to be in force throughout the term of the Bid, RFP, RFQ, and/or Contract. Higher rates and/or additional coverage may apply depending upon type of Bid, RFP, RFQ, and/or Contract. o General Liability ($100,000/$300,000 or greater) o Workers' Compensation (at Statutory Limits) o Employer's Liability ($1,000,000 or greater) o Auto Insurance ($100,000 BIPP/$300,000 BIPO/$100,000 PD or greater) o Professional Liability Insurance (if applicable) o Farm Liability Insurance (if applicable) Coverages shall apply on an occurrence basis. The certificate(s) must reflect, by policy endorsement, that Calhoun County, Texas is an additional insured on all required policies. Each certificate of liability insurance (Form ACORD 25 or equivalent) to be furnished by successful bidder's/vendor's insurance agent shall include, by endorsement to the policy, a statement that a notice shall be given to the Calhoun County Auditor by certified mail thirty (30) days prior to cancellation, material change, or non -renewal in coverage. Calhoun County's receipt of or failure to object to any insurance certificates or policies submitted by the bidder/vendor does not release or diminish in any mannerthe liability or obligations of the bidder/vendor or constitute a waiver of any of the insurance requirements for the Bid, RFP, RFQ and/or Contract. Replacement certificate(s) of liability insurance (Form ACORD 25 or equivalent) evidencing continuation of such coverage and naming, by policy endorsement, Calhoun County as an additional insured, shall be furnished to the Calhoun County Auditor's office prior to the expiration of the current policies. Should bidder/vendor at any time neglect, refuse to provide, or cancel the insurance required, Calhoun County shall have the right to terminate the Bid, RFP, RFQ and/or Contract or pursue any remedy available by law. The insurance coverage requirements in the Bid, RFP, RFQ, and/or contract will in no way be construed as limiting the scope of indemnification. OSHA Requirements: Bidder/vendor must meet all Federal and State OSHA requirements. The bidder/vendor hereby guarantees to Calhoun County that all materials, supplies, equipment and/or services listed on the Bid, RFP, RFQ Contract, Purchase Order or Invoice shall conform to the requirements, specifications and standards promulgated by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970, as amended and in force at the date hereof. Protest Procedures: All protests and disputes will be held in Port Lavaca, Calhoun County, Texas. Any actual or prospective bidder/vendor who believes they are aggrieved in connection with or pertaining to a Bid, RFP, RFQ, and/or Contract may file a protest. The protest must be delivered in writing to the Calhoun County Auditor's Office, in person or by certified mail return receipt requested prior to award. The written protest must include: o Name, mailing address and business phone number of the protesting party; o Appropriate identification of the Bid, RFP, RFQ, and/or Contract being protested; o A precise statement of the reasons for the protest; and o Any documentation or other evidence supporting the protest and any alleged claims. The Calhoun County Auditor's Office will attempt to resolve the protest, including at the County Auditor's option, meeting with the protesting party. If the protest is successfully resolved by mutual agreement, written verification of the resolution, with specifics on each point addressed in the protest, will be forwarded to Calhoun County Commissioners Court. If the Calhoun County Auditor's Office is not successful in resolving the protest, the protesting party may request in writing that the protest be considered by Calhoun County Commissioners Court. Applicable documentation and other information applying to the protest will be forwarded to Calhoun County Commissioners Court, who will promptly review such documentation and information. If additional information is required, Calhoun County Commissioners Court will notify the protesting partyto provide such information. The decision of Calhoun County Commissioners Court will be final. Public Information Act: All governmental information is presumed to be available to the public. Certain exceptions may apply to the disclosure of the information. Bidder/Vendor waives any obligation to the release to the public of any documents submitted in accordance with the Bid, RFP, RFQ, and/or Contract. Governmental bodies shall promptly release requested information that is not confidential by law, either constitutional, statutory, or by judicial decision, or information for which an exception to disclosure has not been sought. CALHOUN COUNTY AUDITOR To request information from Calhoun County, please contact: Calhoun County Auditor Calhoun County Courthouse Annex II 202 S Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-553-4614 The Packet, Invitation for Bids, Request for Proposals and/or Request for Qualifications are posted on Calhoun County's website, www.calhouncotx.org, under Public Notices, Bid Notices and Results. ATTACHMENT A CALHOUN COUNTY, TEXAS GENERAL CONDITIONS CERTIFICATE OF INTERESTED PARTIES FORM 1295 A business entity will generate Form 1295 online after notification of award and submit with their signed contract. Form 1295 must be filled out and submitted online, printed, complete #6, signed and returned with the Agreement, Contract, or Lease. See Calhoun County, Texas —Policy of Compliance TO FILL OUT FORM 1295: Go to: https'//www.ethics.state.tx.us/File I. If you have an account, log in and proceed with the process or if you do not have an account, follow the instructions to set up an account and then proceed with the process. 2. Submit and print a copy of the form which will contain a unique certification number and date submitted in the upper right hand box that is marked "Office Use Only". 3. The Respondent or an authorized agent of the Respondent must sign and date the printed copy of the form (making sure all of #6 is completed). 4. The completed Form 1295 must be included with your Agreement, Contract or Lease, when it is submitted to Calhoun County. For help in filling out the form: #1 Name of Business Entity filing the form, and the City, State and Country of the Entity's place of business #2 Calhoun County, Texas (Also, if applicable, insert name of County Department) #3 • Contract number, if not given, can be the year or dates associated with the Agreement, Contract, Lease or if for a Bid, RFP, or RFQ the Bid, RFP, RFQ number and dates the Bid, RFP, RFQ pertains to • Description is description of Agreement, Contract, Lease or name of Bid, RFP, RFQ On #4 and #5, complete only the ant that aaalies to you #4 Fill in the correct information if this applies OR #5 Mark an X in the Box if this applies #6 Fill in the correct information, submit and print After printing, the respondent or an authorized agent of the respondent must sign and date (making sure all of #6 is completed) When you print you should see a Certificate Number and Date in the upper right hand box that is marked "Office Use Only". CERTIFICATE OF INTERESTED PARTIES FORM 1295 OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. ♦`Q% 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. 3 Provide the identification number used by the governmental entity or state agency to tJJJ+++iii��k p Identify the contract, and provide a description of the services, goods, or other property to be provided ue contract. 4 Name of Interested Party City, State, Country /�� ♦ ature of Interest (check applicable) (place of business) v1 ✓ Controlling Intermediary ♦ 5 Check only if there' I terested Party. El 6 UNSWORN DE[C1_L1@ N My name is `` , and my date of birth is My addre. (street) (city) (state) (zip code) (country) nder penalty of perjury that the foregoing is true and correct. 0Executed in County, Stale of , on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) ADD ADDITIONAL PAGES AS NECESSARY Form provided by Texas Ethics Commission w ,,ethics.stale.tx.us Revised 12/22/2017 Calhoun County, Texas POLICY OF COMPLIANCE SECTION 2252.908 TEXAS GOVERNMENT CODE Approved by Commissioners Court January 28, 2016 Amended by Commissioners Court January 31, 2018 and September 14, 2022 BACKGROUND Section 2252.908 was added to the Government Code by the 84th Texas Legislature through the adoption of House Bill 1295. The law states that the County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) is provided to the county at the time the contract is considered for action by Commissioner's Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract. The law does not apply to a contract between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within 30 days of approving a contract with a business entity. Governmental transparency is the objective of the law. Senate Bill 255 adopted by the 85th Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal https://www.ethics.state.tx.us/whatsnew/elf_ info_form1295.htm. A business entity will generate Form 1295 online: Calhoun County will acknowledge online the receipt of Form 1295 after a contract is executed. Within seven business days, Form 1295 will be available for public viewing on the Commission's website. COMPLAINCE Calhoun County Commissioners Court will not consider for action any contract with a business entity unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than 30 days after Commissioner's Court approves a contract with a non-exempt business entity, the County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. ATTORNEY'S REVIEW CERTIFICATION BID NUMBER 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project I, the undersigned, of CALHOUN COUNTY, do hereby certify as follows: the duly authorized and acting legal representative I have examined the attached contract(s) and surety bonds and am of the opinion that each of the agreements may be duly executed by the proper parties, acting through their duly authorized representatives; that said representatives have full power and authority to execute said agreements on behalf of the representative parties; and that the agreements shall constitute valid and legally binding obligations upon the parties executing the same in accordance with terms, conditions and provisions thereof. Attorney's signature: Print Attorney's na Texas State Bar Number: PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that: and (Name of Contractor or Company) (Address) hereinafter called Principal, (Corporation /Partnership) of Surety Company) (Address) hereinafter called Surety, are held and firmly bound unto of Hecipient) (Recipient's hereinafter called OWNER, in the penal sum of $ Dollars, $ in lawful money of the United States, for this payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. THE CONFIDENTIALITY OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER, dated the day of a copy of which is hereto attached and made a part hereof for the construction of: Bid Number 2024.07 - Maanolia Beach — Ocean Drive Bulkhead Cap Replacement Project for Calhoun County. Texas (Project Name) NOW, THEREFORE, if the Principal shall promptly make payment to all persons, firms, SUB- CONTRACTORS, and corporations furnishing materials for or performing labor in the prosecution of the WORK provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and coke, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such WORK, and all insurance premiums on said WORK, and for all labor, performed in such WORK whether by SUB -CONTRACTOR or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in counter -parts, each on of (Number) which shall be deemed an original, this the _ day of ATTEST: (Principal) By (Principal Secretary) (SEAL) (Witness as to Principal) (Address) (Address) ATTEST: 0 (Surety) (Witness as to Surety (Attorney in Fact) (Address) (Address) (s) NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that: (Name of Contractor or Company) (Address) hereinafter called Principal, and (Name of Surety Company) (Address) hereinafter called Surety, are held and firmly bound unto Calhoun County. Texas (Name of Grant Recipient) 211 South Ann Street, Third Floor, Ste. 301, Port Lavaca. Texas (Grant Recipients Address) hereinafter called OWNER, in the penal sum of $ Dollars ($ _) in lawful money of the United States, for the payment of which sum well and truly to be made we bind ourselves, successors, and assigns, jointly and severally, firmly in these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER dated the day of a copy of which is hereto attached and made a part hereof for the construction of: Bid Number 2024.07 - Magnolia Beach — Ocean Drive Bulkhead Cap Replacement Project for Calhoun County, Texas NOW THEREFORE, if the Principal shall well, truly and faithfully perform its duties in all the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the OWNER, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the OWNER from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may incur in making good any default, then this obligation shall be void, otherwise to remain in full force and effect. PROVIDED FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PROVIDED, FURTHER, that no final settlement between the OWNER and the Principal shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, this instrument is executed in each one of which shall be deemed an original, this the ATTEST: (Principal) By (Principal Secretary) (SEAL) (Witness as to Principal) (Address) ATTEST: (Address) (Surety) By (Witness as to Surety) (Attorney in Fact) (Address) (Address) counterparts, day of _ NOTE: Date of BOND must not be prior to date of Contract. If PRINCIPAL/CONTRACTOR is Partnership, all partners should execute BOND. [INSERT Contractor's Liability Insurancel TECHNICAL SPECIFICATIONS FOR THE BID NUMBER 2024.07 MAGNOLIA BEACH BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS APRIL 2024 Prepared by: G & W ENGINEERS, INC. 205 WEST LIVE OAK PORT LAVACA, TEXAS 77979 (361) 552-4509 G & W Engineers, Inc. Texas Registered Engineering Firm F-04188 Project No. 9115.029 Approved By: .............. ............... SCO17 P. MASON 0yorv� Scott P. Mason, P.E. Texas Serial No. 127893 Date: TABLE OF CONTENTS TECHNICAL SPECIFICATIONS: DIVISION 1 - GENERAL REQUIREMENTS: 01025 Application for Payment Requirements 01340 Shop Drawings, Product Data, and Samples 01410 Inspection, Testing, and Guarantee 01500 Temporary Facilities 01700 Contract Closeout Requirements DIVISION 2 - SITE WORK: 02050 Demolition 02111 Clearing, Rough Grading, Compaction and Finish Grading 02457 Timber for Structures DIVISION 3 - CONCRETE: 03100 Concrete Formwork 03200 Concrete Reinforcement 03300 Cast -In -Place Concrete 03342 Finishing, Quality Control, Tolerances DIVISION 5 - METALS: 05500 Miscellaneous Metal END OF TABLE DIVISION 1- GENERAL REQUIREMENTS SECTION 01025 - APPLICATION FOR PAYMENT REQUIREMENTS In order for CONTRACTOR to receive Progress Payments under the Contract, the following items shall be submitted to ENGINEER for review. a. An Application for Payment, certified and sworn as correct by CONTRACTOR, in accordance with Article 14.02.A.I of the General Conditions, unless otherwise amended by the Supplementary Conditions, b. A sworn certification of no claims and appropriate waivers of liens in accordance with Article 14.02.A.2 of the General Conditions, unless otherwise amended by the Supplementary Conditions. Such certification and waivers shall be as found herein as the "CONTRACTOR's CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT", and if applicable, the "SUBCONTRACTOR's CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT". 01025-1 THE STATE OF TEXAS § COUNTY OF § Project: BID NUMBER 2024.07 —MAGNOLIA BEACH— OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS Job No. 9115.029 On receipt by the signer of this document of a check from CALHOUN COUNTY (maker of check) in the sum of $ payable to and when the check has been properly endorsed and has beby the bayk on which itee or payees is drawn) en paid this document becomes effective to release any as lien right, any right arising from a payment bond that complies with a state or federal statute, any common law payment bond right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has on the property or easements of CALHOUN COUNTY (owner) located at Magnolia Beach — Ocean Drive, Port Lavaca, Texas to the following extent: BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS (job description). This release covers a progress payment for all labor, services, equipment, or materials furnished to the property or to CALHOUN COUNTY (person with whom signer contracted) as indicated in the attached statement(s) or progress payment request(s), except for unpaid retention, pending modifications and changes, or other items furnished. Before any recipient of this document relies on this document, the recipient should verify evidence of payment to the signer. The signer warrants that the signer has already paid or will use the funds received from this Progress payment to promptly pay in full all of the signer's laborers, subcontractors, materiahnen, and suppliers for all work, materials, equipment, or services provided for or to the above referenced Project in regard to the attached statement(s) or progress payment request(s). 01025-2 (CONTRACTOR'S NAME) Signed By: Print Name: SUBSCRIBED AND SWORN TO BEFORE ME by on 20_, to certify which witness my hand and seal of office. Notary Public, State of Texas 01025-3 THE STATE OF TEXAS COUNTY OF Project: BID NUMBER 2024.07 -MAGNOLIA BEACH —OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS Job No. 9115.029 On receipt by the signer of this document of a check from of $ payable to (maker ofcheck) in the sum ayee or Payees of check) and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a state or federal statute, any common lawpayment bond right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has on the property or easement of CALHOUN COUNTY (owner) located at Magnolia Beach — Ocean Drive, Port Lavaca, Texas (location) to the following extent BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS (job description). This release covers a progress payment for all labor, services, equipment, or materials furnished to the property or to with whom signer contracted) as indicated in the attached statement(s) or progress payment request(s), except for unpaid retention, pending modifications and changes, or other items furnished. Before any recipient of this document relies on this document, the recipient should verify evidence of payment to the signer. The signer warrants that the signer has already paid or will use the funds received from this progress payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work, materials, equipment, or services provided for or to the above referenced project in regard to the attached statement(s) or progress payment request(s). 01025-4 (SUBCONTRACTOR'S Signed By: Print Name: Title: SUBSCRIBED AND SWORN TO BEFORE ME by on , 20_, to certify which witness my hand and seal of office. Notary Public, State of Texas END OF SECTION 01025-5 DIVISION 1- GENERAL REQUIREMENTS SECTION 01340 - SHOP DRAWINGS, PRODUCT DATA AND SAMPLES .01 GENERAL: a. Submit shop drawings, product data and samples required by specification sections. b. Shop drawings, product data and samples are not considered a part of Contract Documents. C. Schedule submissions at least 10 days before reviewed submittals will be needed. .02 CONTRACTOR RESPONSIBILITIES: a. Review shop drawings, project data and samples prior to submission. b. Verify: 1. Field measurements. 2. Field construction criteria. 3. Catalog numbers and other data. 4. Conformance with submission requirements. C. Coordinate each submittal with Contract Documents and the work requirements to prevent any delay in the work. d. CONTRACTOR's responsibility for errors and omissions is not relieved by ENGINEER's review of submittals. e. At time of submission and in writing, notify ENGINEER of submittal deviations from Contract Documents. f. CONTRACTOR's responsibility for deviations from Contract Documents is not relieved by ENGINEER's review of submittals, unless ENGINEER gives written acceptance of specific deviations. g. Begin no Work related to submittals until return of submittals with ENGINEER's stamp and initials or signature indicating review. h. Distribute copies after ENGINEER's review. 01340-1 .03 ENGINEER'S DUTIES: a. Review submittals with reasonable promptness to prevent any delay in the Work. b. Review for conformance with: Design concept of project. 2. Contract Documents. C. Review of a separate item does not constitute review of an assembly in which the item functions. d. Return to CONTRACTOR those submittals which do not meet the requirements and require correction and resubmission. e. Affix stamp and initials or signature certifying review of submittal. f. Return reviewed submittals to CONTRACTOR for distribution. .04 PREPARATION REQUIREMENTS: a. Shop Drawings: 1. Preparation by a qualified detailer. 2. Sheet size same as Contract Drawings. 3. Identify details by reference to sheet and detail numbers on Contract Drawings. 4. Include on the drawing all information required for submission or prepare a transmittal letter. 5. Prepare one reproducible transparency and one opaque print of each shop drawing. b. Product Data: 1. Modify manufacturer's standard schematic drawings to delete or supplement information as applicable. 2. For manufacturer's catalog sheets, brochures, diagrams, schedules, performance charts, illustrations and other descriptive data: (a) Clearly mark each copy to identify pertinent materials, products or models. (b) Show dimensions and clearances required. 01340-2 (c) Show performance characteristics and capacities. (d) Show wiring diagrams and controls. 3. Include on the data all information required for submission or prepare a transmittal letter. 4. Prepare number of copies which the CONTRACTOR requires for distribution plus two copies to be retained by ENGINEER. C. Sams: 1. Obtain office samples of sufficient size and quantity to clearly illustrate: (a) Functional characteristics of products or materials with integrally related parts and attachment devices. (b) Full range of color samples. 2. Erect field samples and mock-ups at the project site in an acceptable location. Construct each sample complete, including work of all trades required in finished work. 3. Include on transmittal letter all information required for submission. 4. Prepare the number of samples specified in specification sections. .05 SUBMISSION REQUIREMENTS: a. Submit shop drawings, product data and samples in the form and quantity specified. b. Accompany submittals with a transmittal letter in duplicate, as required. C. Include the following information for each submittal: 1. Date and revision dates. 2. Project title and number. 3. The names of: (a) ENGINEER (b) CONTRACTOR (c) Subcontractor (d) Supplier (e) Manufacturer (f) Separate detailer when pertinent. 01340-3 4. Identification of product or material. 5. Relation to adjacent structure of materials. 6. Field dimensions clearly identified as such. 7. Specification section number. 8. Applicable standards, such as ASTM number or Federal Specification. 9. A blank space, 4" x 4", for ENGINEER's review stamp. 10. Identification of deviations from Contract Documents. 11. CONTRACTOR's stamp, initialed or signed, certifying review of submittal, verification of field measurements and compliance with Contract Documents. .06 RESUBMISSION REQUIREMENTS: a. Shop Drawings: 1. Revise initial drawings as required and resubmit as specified for initial submittal. 2. Indicate on drawings any changes which have been made other than those requested by ENGINEER. b. Product Data and Samples: Submit new data and samples as required for initial submission. .07 DISTRIBUTION AFTER REVIEW: a. Distribute copies of shop drawings and product data which carry ENGINEER's stamp to: 1. CONTRACTOR's file 2. Job site file 3. Record document file 4. Other prime CONTRACTORS 5. Subcontractors 6. Supplier 7. Fabricator b. Distribute samples as directed. After review, samples may be used in construction. END OF SECTION 01340-4 DIVISION 1 - GENERAL REQUIREMENTS SECTION 01410 -INSPECTION TESTING AND GUARANTEE .01 GENERAL: These requirements supplement those provided under Article 13 of the General Conditions. .02 INSPECTION: a. Ins ector: A representative of ENGINEER or OWNER will be assigned authority to observe and inspect the Work. b• Working Days: Inspectors are not required to work on Saturdays, Sundays or legal holidays. If CONTRACTOR plans work on a Saturday, Sunday or legal holiday, prior arrangements should be made for an inspector not later than 48 hours on the working days before the Saturday, Sunday or legal holiday. C. Uninsne�cted Work: Any Work performed on Saturday, Sunday, or a legal holiday without benefit of any inspection may require removal and replacement if directed by ENGINEER. Removal and replacement will be completed at no additional cost. .03 TESTING: a. The cost of preparing and testing, and the cost of other laboratory services required for establishing the concrete mix, and redesigning the mix, if necessary, shall be borne by CONTRACTOR. These tests shall also include, but not necessarily limited to: Compaction Testing, Concrete Strength Testing, Concrete Slump Testing, Subgrade Stabilization Depth Testing, Subgrade Gradation Testing, Base Material Testing, Asphalt Placement Testing and Density Testing. b. CONTRACTOR shall fumish at his own expense, suitable evidence that all the materials he proposes to incorporate into the Work are in accordance with the Specifications. Mill tests for reinforcing steel and cement will be acceptable if it is definite that the test sheets apply to the material being furnished. Manufacturer's or supplier's test results will be acceptable for such items as pipe and fittings, when it is definite that the materials being furnished is that to which the test results apply. Should CONTRACTOR fail to provide the above information, ENGINEER shall have the right to require tests to be made by OWNER's laboratory to obtain the information and the cost therefore shall be borne by CONTRACTOR. 01410-1 03/30/21 C. In any event, ENGINEER may have further tests made by commercial laboratory, or may make tests himself, to ensure that the Specifications are complied with by CONTRACTOR. Costs of these tests will be borne by CONTRACTOR. Should OWNER wish to have a third -party testing performed to confirm test results supplied by CONTRACTOR then those tests shall be paid for by OWNER, unless those results come back with unsatisfactory construction and/or materials. Should results come back unsatisfactory then the cost associated with the OWNER's testing shall be paid for by CONTRACTOR and retested at CONTRACTOR's expense. Work shall not commence further until OWNER and ENGINEER are provided evidence showing that unsatisfactory results and areas have been addressed and receiving passing results. .04 GUARANTEE: a. CONTRACTOR shall deliver to ENGINEER upon completion of all Work under the Contract his written guarantee, in the form of SECTION 01700 - CONTRACT CLOSEOUT REQUIREMENTS, made out to OWNER, guaranteeing all of the Work under the Contract to be free from faulty materials in every particular and free from improper workmanship; and against injury from proper and usual wear; and agreeing to replace or to re -execute without cost to OWNER such Work as may be found to be improper or imperfect; and to make good all damage caused to other Work or materials, due to such required replacement or re -execution. This guarantee shall be made to cover a period of one (1) year from the date of completion of all Work under this Contract, as evidenced by ENGINEER's final certificate. This guarantee must be furnished to ENGINEER and approved by ENGINEER before acceptance and final payment is made. b. CONTRACTOR shall provide OWNER with copies of all guarantees or warranties which have been made to CONTRACTOR by suppliers or subcontractors as required hereunder, together with an assignment of such warranties and guarantees to OWNER; however, such assignment shall not relieve CONTRACTOR of the responsibility (stated in subparagraph a. above) in case of failure of subcontractors or suppliers to fulfill the provisions of such warranties or guarantees. C. Neither the final certificate, nor payment, nor any provision in the Contract Documents shall relieve CONTRACTOR of responsibility for neglect of faulty materials or workmanship during the period covered by the guarantee. END OF SECTION 01410-2 03/30/21 DIVISION i - GENERAL REQUIREMENTS SECTION 01500 - TEMPORARY FACILITIES .01 FIELD OFFICE: If CONTRACTOR is required (or is so inclined) to provide a Temporary Field Office, said office shall be placed, unless otherwise approved in writing, at a site selected by CONTRACTOR and approved by ENGINEER. The building shall be weatherproof and be provided with doors and locks, electric illumination and adequate ventilation. The floor of the building shall be raised above the ground. A complete set of Contract Drawings and Specifications shall be kept in the temporary office throughout the construction period and shall be accessible for use by OWNER and ENGINEER. The building shall be maintained in a clean condition throughout the Contract period and shall be removed from the site upon completion of all Work. .02 SANITARY FACILITIES: CONTRACTOR shall make all arrangements and furnish all materials required to obtain any needed sanitary facilities and to satisfy the requirements of local or state health authorities, ordinances, and laws. .03 STORAGE OF MATERIALS: a. No materials shall be stored nor shall any equipment be parked on adjacent property without the expressed consent of owner of the property concerned. b. Secure and watertight storage facilities of suitable size with floors raised above the ground shall be provided for materials liable to damage from exposure to the weather. Other materials shall be stored on blocks off the ground. Materials shall be so placed as to permit easy access for inspection and identification. Any material which has deteriorated, become damaged, or otherwise unfit for use, shall not be used in the Work, and shall be immediately removed from the site by CONTRACTOR. Upon completion of all Work or when directed, CONTRACTOR shall remove storage facilities from the site. .04 TEMPORARY UTILITIES: CONTRACTOR shall arrange for and secure all temporary connections for water, electricity, gas and other services needed by him for the proper execution of his operations. Costs for these services shall be paid for by CONTRACTOR. 01500-1 .05 BARRICADES AND WARNINGS: a. The safety of the public shall of primary importance during construction. In all respects provisions for public safety shall be CONTRACTOR'S responsibility. b. Should conditions be such that the public safety is involved, the Contractor shall provide warning lights which shall be kept burning between the hours of sunset and sunrise. Barricades and warnings shall be in accordance with Item 502, "Barricades, Signs and Traffic Handling" of the Standard Specifications for Construction and Maintenance of Highways, Streets, and Bridges, as adopted by the Texas Department of Transportation (November 2014 edition). END OF SECTION 01500-2 DIVISION 1 - GENERAL REQUIREMENTS SECTION 01700 -CONTRACT CLOSEOUT REQUIREMENTS Before final acceptance by OWNER, the following items must be submitted and accepted by ENGINEER: a. Final Inspection completed b. Bound manuals of servicing or operating instructions with recommended lubricants for all equipment C. CONTRACTOR's Guarantee. CONTRACTOR shall deliver to OWNER, upon completion of all Work, his written guarantee, found herein as "CONTRACTOR'S GUARANTEE". This guarantee shall be made to cover a period of one (1) year from the date of completion of all Work, and must be furnished to and approved by OWNER before acceptance and final payment is made. Neither the final payment, nor any provision stated above, shall relieve CONTRACTOR of responsibility for neglect of faulty materials or workmanship during the period covered by the guarantee. d. All other guarantees and warranties properly assigned to OWNER CONTRACTOR shall provide OWNER with copies of all guarantees or warranties which have been made to CONTRACTOR by suppliers or subcontractors, together with an assignment of such warranties and guarantees to OWNER; however, such assignment shall not relieve CONTRACTOR of the responsibility (stated in his guarantee) in case of failure of subcontractors or suppliers to fulfill the provisions of such warranties or guarantees. Neither the final payment, nor any provision stated above, shall relieve CONTRACTOR of responsibility for neglect of faulty materials or workmanship during the period covered by the guarantee. e. CONTRACTOR's Conditional Waiver and Release on Final Payment CONTRACTOR shall deliver to OWNER, upon completion of all Work, a final sworn certification of no claims and waiver of liens in accordance with Article 14.07 of the General Conditions, unless otherwise amended by the Supplementary Conditions. Such certification and waiver shall be found herein as the "CONTRACTOR's CONDITIONAL WAVIER AND RELEASE ON FINAL PAYMENT", and if applicable, the "SUBCONTRACTOR'S CONDITIONAL WAVIER AND RELEASE ON FINAL PAYMENT". f. Final Application for Payment. 01700-1 I, being of (hereinafter called "CONTRACTOR"), do hereby make the following statements to CALHOUN COUNTY (hereinafter called "OWNER") in relation to the completed project known as BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS. I guarantee... That all of the completed Work is free from faulty materials in every particular, That all of the completed Work is free from improper workmanship, and That no injury will occur from proper and usual wear, That OWNER has been assigned all guarantees and/or warranties originally made to CONTRACTOR by suppliers and subcontractors, if any. (Such assignment does not relieve CONTRACTOR of the responsibility stated in each guarantee and/or warranty in case of failure of suppliers or subcontractors to fulfill the Provisions of such guarantees and/or warranties.) I agree... That the execution of the final certificate or the receipt of the final payment does not relieve CONTRACTOR of the responsibility for neglect of faulty materials or workmanship during the period covered by this Guarantee, To replace or to re -execute without cost to OWNER such Work as may be found to be improper or imperfect, and To make good all damage caused to other Work or materials, due to such required replacement or re -execution. This Guarantee is in effect as of the day of cover a period of ONE (1) FULL YEAR from said effective date. 20— and shall (CONTRACTOR) Signed By: Print Name/Title: Date: 01700-2 CONTRACTOR's CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT THE STATE OF TEXAS § COUNTY OF § Project: BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS. Job No. 9115.029 On receipt by the signer of this document of a check from CALHOUN COUNTY (maker of check) in the sum of $ payable to (payee or payees of check) and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a state or federal statute, any common law payment bond right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has on the property or easements of CALHOUN COUNTY (owner) located at Magnolia Beach — Ocean Drive, Port Lavaca, Texas (location) to the following extent: BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS. (job description). This release covers the final payment to the signer for all labor, services, equipment, or materials furnished to the property or to CALHOUN COUNTY (person with whom signer contracted). Before any recipient of this document relies on this document, the recipient should verify evidence of payment to the signer. The signer warrants that the signer has already paid or will use the funds received from this final payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work, materials, equipment, or services provided for or to the above referenced project up to the date of this waiver and release. 01700-3 (CONTRACTOR) Signed By: Print Name Title: SUBSCRIBED AND SWORN TO BEFORE ME by on 20� to certify which witness my hand and seal of office. Notary Public, State of Texas My Commission Expires: 01700-4 SUBCONTRACTOR'. CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT THE STATE OF TEXAS § COUNTY OF § Project: BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS. Job No. 9115.029 On receipt by the signer of this document of a check from $ payable to (maker of check) in the sum of (payee or payees of check) and when th paid by the bank on which it is drawn, this document becomes effective to e check has been properly endorsed and has been release any mechanic's lien right, any right arising from a payment bond that complies with a state or federal statute, any common law payment bond right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has on the property or easements of CALHOUN COUNTY (owner) located at Magnolia Beach — Ocean Drive, Port Lavaca, Texas (location) to the following extent: BID NUMBER 2024.07 - MAGNOLIA BEACH — OCEAN DRIVE BULKHEAD CAP REPLACEMENT PROJECT FOR CALHOUN COUNTY, TEXAS (job description). This release covers the fmal payment to the signer for all labor, services, equipment, or materials furnished to the properly or to (person with whom signer contracted). Before any recipient of this document relies on this document, the recipient should verify evidence of payment to the signer. The signer warrants that the signer has already paid or will use the funds received from this final payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work, materials, equipment, or services provided for or to the above referenced project up to the date of this waiver and release. 01700-5 (SUBCONTRACTOR) Signed By: Print Name Title: SUBSCRIBED AND SWORN TO BEFORE ME by on 20_, to certify which witness my hand and seal of office. Notary Public, State of Texas My Commission Expires: END OF SECTION END OF DIVISION 01700-6 DIVISION 2 - SITE WORK SECTION 02050 - DEMOLITION .01 GENERAL: The Work covered under this Section shall be as indicated on the Drawings and as specified herein. Demolition required for this Work includes, but is not limited to: a. Constructing temporary barriers around objects designated to remain. b. Demolition and removal of structures. C. Disconnecting and removing existing utility lines on the site except those designated to remain. d. Removal of debris. .02 JOB CONDITIONS: a. Burning: On -site burning will not be permitted. b. Protection: Use all means necessary to protect existing objects designed to remain and, in the event of damage, immediately make all repairs and replacements necessary to the approval of ENGINEER at no additional cost to OWNER. .03 MATERIALS: All materials, required for proper completion of the Work of this Section, shall be selected by CONTRACTOR subject to the approval of ENGINEER. .04 PREPARATION: a. Notification: Notify ENGINEER at least two full working days prior to commencing the Work of this Section or as indicated on plans. b. Site Ins ection: 1. Prior to all Work of this Section, carefully inspect the entire site and all objects designated to be removed and to be preserved. 02050-1 2. Locate all existing utility lines and determine requirements for disconnecting and capping. 3. Locate existing active utility lines traversing the site and determine the requirements for their protection. C. Clarification: 1. The Drawings do not purport to show all objects existing on the site. 2. Before commencing the Work of this Section, verify with ENGINEER all objects to be removed and all objects to be preserved. d. Scheduline: 1. Schedule all Work in a careful manner with all necessary consideration for neighbors and the public. 2. Avoid interference with the use of, and passage to and from, adjacent buildings and facilities. e. Disconnection of Utilities: Before starting site operations, disconnect or arrange for the disconnection of all utility services designated to be removed; performing all such Work in accordance with the requirements of the utility company or agency involved. £ Protection of Utilities: Preserve in operating condition all active utilities traversing the site and designated to remain. .05 DEMOLITION OF STRUCTURES: Demolish all buildings designated for demolition, pulling out all foundations and concrete slabs; remove all existing pavement designated to be removed. .06 OTHER DEMOLITION: Pull out all existing utility lines designated for abandonment, and all other objects designated to be removed. .07 CONSTRUCTION OF BARRICADES: a. Materials: Unless otherwise specifically approved by ENGINEER, use only new and solid lumber of Utility grade (or better) to construct temporary barricades around the objects designated to remain. 02050-2 b. Lavout: At all objects designated to be preserved, construct a temporary barricade. 2. Make barricades at least three (3) feet high, consisting of 2" X 4" (or larger) posts, set at least 18 inches into the ground at not more than six (6) feet on centers, joined at the top by 1" X 6" (or larger) boards firmly nailed to the posts. C. Protection: 1. Take special care, in setting posts, to not damage tree roots. 2. Do not permit stockpiling of materials or debris within the barricaded area, nor permit the earth's surface to be changed in any way except as specifi- cally approved by ENGINEER. .08 REMOVAL OF DEBRIS: CONTRACTOR shall be responsible for removal and disposal of all debris from the site, and leave the site in a neat and orderly condition to the approval of ENGINEER. END OF SECTION 02050-3 DIVISION 2 - SITE WORK SECTION 02111— CLEARING, ROUGH GRADING, COMPACTION AND FINISH GRADING .01 GENERAL: The Work covered under this section of the Specifications shall include furnishing all labor, materials and equipment and performing all operations necessary to complete all clearing and grubbing, disposal of surplus materials, rough grading, compaction of embankments, finish grading, and the performance of all other miscellaneous sitework operations required to complete the project as shown on the drawings and specified herein. .02 SITE CLEARING: a. Clearing: All areas of new construction shall be cleared of all brush, weeds, rubbish, wire, debris and all other objectional matter to a line five (5) feet outside the proposed Work. b. Stripping: Remove all topsoil and organic materials within areas to be excavated and/or areas to receive embankment, for a depth of at least six (6) inches, or until bottom of existing topsoil layer is reached. Topsoil material shall be stockpiled separately and spread at locations and finished to grade. C. Grubbing: Remove all stumps, roots, etc., within the areas to be excavated to a depth of at least one (1) foot below the existing ground surface. In areas to receive embankment, remove all stumps, roots, etc., to a depth of at least one (1) foot below the existing ground surface. All holes remaining after clearing and grubbing shall be backfilled and the entire area bladed to prevent ponding of water and to provide drainage, unless otherwise directed. .03 PROCESSING OF CLEARED, STRIPPED AND GRUBBED MATERIAL: a. Stockpiling: Excavated material which is to be used for backfilling and grading may be deposited in storage piles at points convenient for rehandling. Location of storage piles shall not endanger the Work, obstruct roads and driveways, or restrict drainage channels, and will be acceptable to ENGINEER. Topsoil to be used for finish grading shall be stockpiled separately from other materials. b. Disposal of Excess and Unsuitable Materials: All suitable excavated materials in excess of that needed in the formation of embankments shall be disposed of at designated spoil disposal areas within the limits of the project. Material shall be placed in a uniform layer not to exceed twelve (12) inches thick over the entire designated area, graded and shaped to drain. Unsuitable unclassified excavation 02111-1 shall be known as "waste" and shall be disposed of by CONTRACTOR. The waste shall be disposed of in such manner as to not create a public nuisance, and disposal shall conform to State laws. CONTRACTOR may not utilize any public rights -of -way or public lands for waste disposal. .04 ROUGH GRADING AND COMPACTION: a. Material Furnish approved material capable of forming stable fill from required excavation within the agreed mitigation pending area. b. Construction Backfill tree -stump holes or other minor excavations with approved material and tamp. Restore the ground surface, including any material disked loose or washed out, to its original slope. Compact the ground surface by sprinkling in accordance with the current TxDOT Item 204, "Sprinkling," and by rolling using equipment complying with the current TxDOT Item 210, "Rolling," when directed. Scarify and loosen the unpaved surface areas, except rock, to a depth of at least 6 inches, unless otherwise shown on the plans. Bench slopes before placing material. Begin placement of material at the toe of slopes. Do not place trees, stumps, roots, vegetation, or other objectionable material in the embankment. Simultaneously re -compact scarified material with the placed embankment material. Do not exceed the layer depth specified in "Compaction" herein. Earth fill is mainly composed of material other than rock. Construct fill in successive layers, evenly distributing materials in lengths suited for sprinkling and rolling. Construct the fill in layers approximately parallel to the finished grade for the full width of the area, unless otherwise shown on the plans. Construct the fill to the grades shown on the plans. Ensure that each section of the fill conforms to the detailed sections or slopes, if any. Move the material dumped in piles or windrows by blading or by similar methods and incorporate it into uniform layers. Featheredge or mix abutting layers of dissimilar material for at least 100 ft. to ensure there are no abrupt changes in the material. Break down clods or lumps of material and mix embankment until a uniform material is attained. Apply water free of industrial wastes and other objectionable matter to achieve the uniform moisture content specified for compaction. Roll and sprinkle each layer in accordance with "Compaction" herein. 02111-2 C. Compaction Compaction of the material shall be provided by sheep -foot rollers or other approved method. Begin rolling longitudinally at the sides and proceed toward the center, overlapping on successive trips by at least 1/2 the width of the roller. Alternate roller trips to attain slightly different lengths. Do not allow the loose depth of any layer to exceed 8 inches, unless otherwise approved. Provide a uniform compaction of 95% modified density in accordance with ASTM Standard 1557 at a moisture content between optimum moisture and five (5) percent above optimum moisture. .05 FINISH GRADING: a• Grade all areas indicated on drawings or as required to suit construction Operations. b• Grading shall be carefully finished at elevations shown against building and other structures. C. In ungraded areas, backfill shall be placed around outside of structures to approximate level of adjacent ground but modified to assure positive drainage away from structures. d• A qualified engineer shall set lines, batterboards and grades. e• Grading changes shall be even between indicated finish elevations and contours, without sharp breaks, low spots, etc., to provide positive drainage. .06 UNDERGROUND UTILITIES: Determine location of underground utilities before doing any excavation work. If a live Utility line is damaged, the proper utility shall be notified immediately for required action. CONTRACTOR is responsible for repair to the line, at no cost to OWNER. .07 CLEANUP: Prior to final acceptance of the complete project, remove all tools CONTRACTOR shall , scaffolding, temporary structures and debris from the site and areas ll the Work. Any washes, ruts or other depressions that have occurred shall be leveled to give ll aareas where the Work was accomplished a smooth finish and neat appearance. END OF SECTION 02111-3 DIVISION 2 - SITE WORK SECTION 02457 — TIMBER FOR STRUCTURES .01 DESCRIPTION: Furnish and place lumber and timber. .02 MATERIALS: Furnish materials in accordance with details shown on the plans. All material must bear the grade mark of an approved American Lumber Standards Committee agency or the identification mark of a state -approved inspection agency. A grade mark or identification mark must be on the timber before treating. a. Finish: Provide material for railings, and flooring that is surfaced on 4 sides. Dress other timber as indicated on the plans. b. Timber and Lumber: Use No. 1 Southern Pine or other materials required by the plans. Use the stress grade indicated on the plans. Timber grade designations refer to standard designations of the Southern Pine Inspection Bureau Standard Grading Rules. Use grading methods and general requirements that confirm the "General Requirements for Stress Grades" in ASTM D 245. .03 EQUIPMENT: Use slings or other approved equipment for handling. Do not use equipment that may damage the surface of the wood. .04 CONSTRUCTION: Construct timber structures in accordance with requirements of Section 02458, Timber Structures. END OF SECTION 02457-1 DIVISION 3 - CONCRETE SECTION 03100 - CONCRETE FORMWORK .01 GENERAL: a. Description This section shall govern all formwork for cast -in -place concrete with shoring, bracing and anchorage, openings for other work, form accessories and form stripping. b. References 1. ACI 347, Recommended Practice for Concrete Formwork 2. ACI 301, Specifications for Structural Concrete for Buildings, Chapter 4 3. ACI 318, Building Code Requirements for Reinforced Concrete 4. PS-1, Construction and Industrial Plywood C. Design Requirements Design, engineer and construct formwork, shoring and bracing to conform to code requirements listed in references; resultant concrete to conform to required shape, line and dimension. d. Submittals 1. Submit under provisions of Section 01340, Shop Drawings, Product Data, and Samples. 2. Indicate pertinent dimensions, materials, bracing, and arrangement of joints and ties on Shop Drawings. C. Quality Assurance 1. Perform Work in accordance with ACI 301, 318, and 347. 2. Maintain one copy of each document on site. £ Regulatory Requirements Conform to applicable code for design, fabrication, erection and removal of formwork. 03100-1 .02 PRODUCTS: a. Wood Form Materials Plywood Douglas Fir species; APA high density overlaid or APA B-B Plyform Class I Panels; sound, undamaged sheets with clean, true edges. 2. Lumber Southern Pine species; No. 2 grade; with grade stamp clearly visible. b. Prefabricated Forms - Preformed Steel Forms Minimum gage matched, tight fitting, stiffened to support weight of concrete without deflection detrimental to tolerances and appearance of finished surfaces. C. Formwork Accessories 1. Form Ties Snap -off type, galvanized metal, adjustable length, cone type, with waterproofing washer, 1 in. back break dimension, free of defects that could leave holes larger than 1'/4 in. in the concrete surface; Penta-Tie manufactured by Burke or approved equal. 2. Form Release Agent Colorless mineral oil which will not stain concrete, absorb moisture or leave a film which will inhibit subsequent finish work; Burke Release manufactured by Burke or approved equal. 3. Corners Chamfered, wood strip type; 3/4 x 3/4 in. maximum possible lengths. 4. Nails, Spikes, Lag Bolts, Through Bolts, Anchorages Sized as required, of sufficient strength and character to maintain formwork in place while placing concrete. .03 EXECUTION: a. Examination Verify lines, levels, and centers before proceeding with formwork. Ensure that dimensions agree with Drawings. 03100-2 b. Erection - Formwork 1. Erect formwork, shoring, and bracing to achieve design requirements in accordance with requirements of ACI 301 and 347. 2. Provide bracing to ensure stability of formwork. Shore or strengthen formwork subject to over -stressing by construction loads. 3. Arrange and assemble formwork to permit dismantling and stripping. Do not damage concrete during stripping. permit removal of remaining principal shores. 4. Align joints and make watertight. Keep form joints to a minimum. 5. Obtain approval before framing openings in structural members which are not indicated on Drawings. 6. Provide chamfer strips on external corners of pile caps, retaining walls and other exposed corners. C. Application - Form Release Agent 1. Apply form release agent on formwork in accordance with manufacture's recommendations. 2. Apply prior to placement of reinforcing steel, anchoring devices and embedded items. 3. Do not apply form release agent where concrete surfaces will receive applied coverings which are affected by agent. Soak inside surfaces of untreated forms with clean water. Keep surfaces coated prior to placement of concrete. d. Inserts, Embedded Parts, And Openings 1. Provide form openings where required for items to be embedded in or passing through concrete work. 2. Locate and set in place items which will be cast directly into concrete. 3. Coordinate Work of other sections in forming and placing openings, slots, reglets, recesses, chases, sleeves, bolts, anchors, and other inserts. 4. Install accessories in accordance with manufacturer's instruction, straight, level, and plumb. Ensure items are not disturbed during concrete placement. 5. Provide temporary ports or openings in formwork where required to facilitate cleaning and inspection. Locate openings at bottom of forms to allow flushing water to drain. 03100-3 6. Close temporary openings with tight fitting panels, flush with inside face Of forms, and neatly fitted so joints will not be apparent in exposed concrete surfaces. e. Form Cleaning 1. Clean and remove foreign matter within forms as erection proceeds. 2. Clean formed cavities of debris prior to placing concrete. 3. Flush with water or use compressed air to remove remaining foreign matter. Ensure that water and debris drain to exterior through clean -out ports. f. Formwork Tolerances Construct formwork to maintain tolerances required by ACI 301 and Section 03342, Finishing, Quality Control, Tolerances 9. Field Quality Control 1. Inspect erected formwork, shoring, and bracing to ensure that supports, fastenings, wedges, ties, and items are secure. 2. Do not reuse wood formwork more than three times for concrete surfaces to be exposed to view without written approval from OWNER. Do not patch formwork. h. Form Removal 1• Do not remove forms or bracing until concrete has gained sufficient strength to carry its own weight and imposed loads. 2. Loosen forms carefully. Do not wedge pry bars, hammers, or tools against finish concrete surfaces scheduled for exposure to view. 3. Store removed forms in such manner that surfaces to be in contact with fresh concrete will not be damaged. Discard damaged forms. 4. Forms and supports shall remain in place under pile caps for at least seven days and on the sides of pile caps, rail pads and walls for at least three days. END OF SECTION 03100-4 DIVISION 3 - CONCRETE .01 GENERAL: a. Description This section shall govern the furnishing and placing of all reinforcing steel bars, wire fabric and accessories for concrete incorporated in the Work. b. References 1. ACE 301, Structural Concrete for Buildings. 2. ACI 318, Building Code Requirements for Reinforced Concrete. 3. ACI SP-66, American Concrete Institute, Detailing Manual. 4. ANSI/ASTM A 82, Cold Drawn Steel Wire for Concrete Reinforcement. 5. ANSI/ASTM A 185, Welded Steel Wire Fabric for Concrete Reinforcement. 6. ANSI/AWS D1.4, Structural Welding Code for Reinforcing Steel. 7. ASTM A 615, Deformed and Plain Billet Steel Bars for Concrete Reinforcement. 8. ASTM A 706, Low -Alloy Steel Deformed Bars for Concrete Reinforcement. 9. ASTM A 775, Epoxy -Coated Reinforcing Steel Bars. 10. CRSI, Concrete Reinforcing Steel Institute Manual of Practice. 11. CRSI 63, Recommended Practice for Placing Reinforcing Bars. 12. CRSI 65, Recommended Practice for Placing Bar Supports, Specifications, and Nomenclature. C. Submittals 1. Submit under provisions of Section 01340, Shop Drawings, Product Data, and Samples. 2. Shop Drawings Indicate bar sizes, spacings, locations, and quantities or reinforcing steel and wire fabric; bending and cutting schedules; and supporting and spacing devices. 03200-1 .02 3. Submit mill certificates for each heat of steel to be furnished indicating strength and chemistry. 4. Submit qualified welding procedure for welding of reinforcing steel. Include in submittal all items contained in Appendix A of AWS D1.4. 5. Submit copies of manufacturer's data for bar chairs, bolsters, spacers, etc. d. Quality Assurance 1. Perform work in accordance with CRSI 63, 65, and Manual of Practice, ACI 301, ACI Sp-66, and ACI 318. 2. All welding procedures and welders shall be qualified in accordance with AWS DIA by an AWS-certified welding inspector approved by OWNER. Full section tension and macro -etch tests shall be conducted in accordance with AWS DIA, Chapter 6. 3. Production welding shall not commence until a qualified welding procedure has been established and approved by OWNER. PRODUCTS: a. Reinforcement 1. Typical Reinforcing Steel ASTM A 615, 60 ksi, yield grade, deformed steel bars, plain finish. 2. Reinforcing Steel for Welding ASTM A 706, 60 ksi, yield grade, deformed low -alloy steel bars, plain finish. 3. Epoxy Coating Scotchkote Brand Fusion Bonded Epoxy Coating 213, manufactured by 3M, St. Paul, Minnesota, applied by electrostatic spray method in strict accordance with ASTM A 775, except that the thickness of the coating shall be not less than 6 mils (150 microns) nor greater than 11 mils (275 microns). b. Accessory Materials 1. Tie Wire Minimum 16 gauge, annealed type. Use plastic coated wire with epoxy coated reinforcing. 2. Chairs, Bolsters, Bar Supports, Spacers Sized and shaped for strength and support of reinforcement during concrete placement conditions. 03200-2 3. Special Chairs, Bolsters, Bar Supports, and Spacers Adjacent to Epoxy -Coated Reinforcement or Weather Exposed Concrete Surfaces, use plastic coated, steel type or plastic type; size and shape as required. C. Fabrication 1. Fabricate concrete reinforcing in accordance with ACI 318. 2. Weld reinforcement in accordance with ANSI/AWS DIA. 3. No splices in reinforcing, except where specially called for on the drawings, will be permitted without prior written approval from OWNER. 4. Sheared ends of epoxy coated reinforcing and/or epoxy coating that is damages shall be repaired with a compatible epoxy coating conforming to ASTM A 775 in accordance with the manufacturer's recommendations prior to installation. d. Delivery Bundles of reinforcing bars shall be delivered to the site with tags showing quantity, grade, size, and suitable identification to allow checking, sorting and placing. 2. Store all reinforcing steel off ground on protective cribbing and protect from oil, grease, dirt, or other deleterious materials. 3. Epoxy coated reinforcing shall be covered after delivery to prevent exposure to sunlight until needed for use. .03 EXECUTION: a. Placement Place, support and secure reinforcement against displacement. Do not deviate from required position. 2. Accommodate placement of formed openings. Where epoxy -coated reinforcing is required by the drawings, all handling and hoisting shall be done by nylon lifting slings or padded wire rope slings; bundles of bars shall be lifted to prevent bar -to -bar abrasion; spreader bars shall be used for lifting bundles, or the bundles shall be lifted at the third points with nylon or padded slings. Bundling bands shall be padded or made of nylon. Coated bars shall be padded or made of nylon. Coated bars shall be stored on padded or wooden cribbing bars or bundles of bars shall not be dragged over the ground or over other bars. 4. Plastic coated tie wire shall be used for tying epoxy coated rebar. 03200-3 5. Vertical stirrups shall always pass around the main reinforcement and be attached securely thereto. 6. Reinforcing steel shall be spaced its required distance from the form surface by means of approved hot dip galvanized metal spacers with plastic coated tips or plastic spacers. 7. All reinforcing steel shall be tied at all intersections; except that where spacing is less than 1 ft. in each direction, alternate intersections only need be tied. 8. Reinforcement shall be supported and tied in such a manner that a sufficiently rigid cage of steel is provided. If the cage is not adequately supported to resist settlement or floating upward of the steel, overturning of truss bars or movement in any direction during concrete placement, permission to continue concrete placement will be withheld until corrective measure are taken. Sufficient measurements shall be made during concrete placement to ensure that the reinforcement remains in the proper position. 9. Mats of wire fabric shall overlap each other sufficiently to maintain a uniform strength and shall be fastened securely at the ends and edges. Lap ends and edges a minimum of one square. b. Tolerances Unless otherwise shown on Drawings, dimensions shown for reinforcement are to the centers of the bars. 2. In the plane of the steel parallel to the nearest surface of concrete, bars shall not vary from plan placement by more that 1/12 of the spacing between bars. 3. In the plane of the steel perpendicular to the nearest surface of concrete, bars shall not vary from plan placement by more than 1/4 in. 4. Cover of concrete to the nearest surface of steel shall meet the above requirement but shall never be less that 3 in. unless otherwise shown on Drawings. C. Welding 1. All welding of reinforcing steel shall be performed in accordance with AWS DIA. 2. Welding process used to place welds shall be either shielded metal are (SMAW) or flux cored arc (FCAW) welding. 03200-4 d. Cleaning Reinforcement 1. Reinforcement shall be cleaned of all rust, mill scale, oil, paint or other deleterious materials prior to placing concrete. 2• All damaged epoxy coating shall be repaired with a compatible epoxy coating conforming to ASTM A775 prior to pouring concrete. e. Field Quality Control Testing (a) CONTRACTOR shall provide, at no cost to OWNER, one welded connection sample for full section tension tests in accordance with AWS D1.4 for every 200 production connections. OWNER will pay for all tests which pass. Failure of production weld samples to meet tension test requirement shall be cause for automatic rejection. (b) All rebar welds shall be inspected and tested by OWNER before acceptance. CONTRACTOR shall remove all slag from each weld at no cost to OWNER. Any rebar weld which, in the opinion of OWNER, appears faulty shall be removed and the bar rewelded at no cost to OWNER. CONTRACTOR, at his option, may choose to have such rejected welds examined by a certified testing agency. If examination indicates acceptable quality, the defective welds shall be removed and replaced by CONTRACTOR at no additional cost to OWNER. 2• Reinforcement shall be inspected by OWNER's representative prior to placing concrete. Provide a minimum of 24 hours advance notice of completion of reinforcement placement to OWNER for scheduling of field inspection. END OF SECTION 03200-5 DIVISION 3 - CONCRETE SECTION 03300 - CAST -IN -PLACE CONCRETE .01 GENERAL: a. Description This Section shall govern all work necessary for providing materials, mixing, proportioning, testing, placing, finishing, and curing of all plain and reinforced cast -in -place normal weight concrete. b. Quality Assurance Material and Work shall conform to the requirements of standards, codes, and recommended practices required in this Section. In conflicts between industry standards, required standards and this specification or this specification and the local building code, the more stringent requirement shall govern. C. Applicable Standards and Test Methods The following documents are referred to in this Section and shall be available at the project site: 1. ACI 301-84(R-88), Specifications For Structural Concrete For Buildings 2. ACI 304 R-85, Guide For Measuring, Mixing, Transporting, And Placing Concrete 3. ACI 305 R-77 (82), Placing Concrete In Hot Weather 4. ACI 306 R-88, Placing Concrete In Cold Weather 5. ACI 309 R-89, Guide For Consolidation Of Concrete 6. ACI 318-89 (R-89), Building Code Requirement For Reinforced Concrete 7. ASTM C 31-84, Making And Curing Concrete Test Specimens In The Field 8. ASTM C 33-86, Standard Specifications For Concrete Aggregates 9. ASTM C 39-86, Standard Test Method For Comprehensive Strength Of Cylindrical Specimens 10. ASTM C 94-86, Standard Specifications For Ready -Mixed Concrete 03300-1 11. ASTM C 138-81, Standard Test Method For Unit Weight, Yield, And Air Content (Gravimetric) Of Concrete 12. ASTM C 143-78, Standard Test Method For Slump Of Portland Cement Concrete 13. ASTM C 150-85, Standard Specification For Portland Cement 14. ASTM C 171-69el, (Reapproved 1980) Standard Specifications For Sheet Materials For Curing Concrete 15. ASTM C 173-78, Standard Test Method For Air Content Of Freshly Mixed Concrete By The Volumetric Method 16. ASTM C 231-81el, Standard Test Method For Air Content Of Freshly Mixed Concrete By The Pressure Method 17. ASTM C 260-86, Standard Specification For Air -Entraining Admixtures For Concrete 18. ASTM C 309-81, Liquid Membrane -Forming Compounds For Curing Concrete 19. ASTM C 494-86, Standard Specification For Chemical Admixtures For Concrete d. Submittals 1. Concrete Mixing Design (a) CONTRACTOR shall submit, at least ten working days in advance of placing concrete, a mix design for each type and strength of concrete specified which is prepared by a reputable testing laboratory. (b) Include copies of test reports showing that the mix has been successfully tested to produce concrete with the properties specified and will be suitable for the job conditions. 2. Submit name and location of sources of cement, aggregates, chemical admixtures and fly ash propose for use on this project. 3. Submit independent laboratory reports or manufacturer's certification that all other concrete materials proposed for used on this project meet the requirements of Article .02 of this Section. 03300-2 .02 PRODUCTS: a. Concrete Materials Portland Cement (a) Portland cement Type I or Type II conforming to ASTM C 150, including the low alkali provisions of Table IA of that specification. In addition, the tricalcium aluminate content of Type I cement shall not exceed 12 percent. (b) Type I or Type II cement, at CONTRACTOR's option, may be used for nonhydraulic abovegrade structures. (c) For all hydraulic and belowgrade structures and sewers, use Type II cement. At CONTRACTOR's option, fly ash may be used in combination with any cement as long as all requirements of these Specifications are met. The fly ash may be combined at the batch plant or during the production of the cement (Type IP cement). For the combination fly ash and cement, the cement and fly ash shall comply with these Specifications. 2. Fly Ash (a) The pozzolan to be used in combination with cement, as previously specified for use in all hydraulic and belowgrade structures and sewers, or in combination with cement or other structures, shall be Class F fly ash conforming to ASTM C 618-87. (b) Pozzolan shall be tested in conformance with ASTM C 311. The analysis, shall show those items pertinent to this Specification. Source acceptance shall be at the discretion of ENGINEER based on data submitted. Continuing quality analysis shall be submitted throughout the life of the project from the source approved. Under no circumstances shall the pozzolan source be changed without the retesting and providing of new submittals for ENGINEER's review. The Supplier shall certify that all shipments meet the conditions of this Specification. 3. Aggregates shall conform to ASTM C 33-86, "Standard Specification for Concrete Aggregates". 4. Water shall be clean and free from deleterious materials, drinkable. 03300-3 5. ' Air -Entraining Admixtures (a) Conforming to the requirement of ASTM C 260-86, (b) "Standard Specification for Air -Entraining Admixtures for Concrete", "Micro Air" or "MB-VR", manufactured by Master Builders shall be used. (c) The air -entraining admixture shall provide a total air content as specified in Article .02 of this Section. b. Selection Of Proportions Concrete shall be composed of portland cement, fly ash fine aggregate, coarse aggregate, water and, as specified, Master Builders' Micro -Air or MB-VR air - entraining admixture. Proportions of ingredients shall produce concrete that will work readily into corners and angles of forms, bond to reinforcement, without segregation or excessive bleed water forming on the surface. Proportioning of materials shall be in accordance with ACI 211.1-89, "Recommended Practice for Selecting Proportions for Normal and Heavyweight Concrete", except as modified herein. C. Concrete Qualities Required 1. All concrete incorporated in the Work shall have the minimum 28-day compressive strength of 4000 pounds per square inch (PSI). Unless otherwise noted on the drawings. 2. Minimum cement or combined cement plus fly ash content when fly ash is used for performance and durability, regardless of design strength, shall be 517 pounds per cubic yard for concrete with 1-1/2-inch maximum size aggregate, 540 pounds per cubic yard for 1-inch maximum size aggregate. CONTRACTOR shall increase cement content or the combined cement plus fly ash content, when fly ash is used, as required to meet strength requirements. 3. The amount of fly ash used shall not exceed 25 percent or be less than 15 percent of the total weight of fly ash plus cement. 4. Minimum cementitious material requirements shall be as follows: (a) For 4000 PSI (f,) at 28 days (1) Maximum water/cementitious ratio = .48 (2) Minimum cementitious - 517# 03300-4 (b) For 5000 PSI (f,) at 28 days (1) Maximum water/cementitious ratio = .40 (2) Minimum cementitious - 611# (c) For 6000 PSI (f,) at 28 days (1) Maximum water/cementitious ratio = .40 (2) Minimum cementitious - 658# 5. Proportions of ingredients shall be selected by past field experience or in lieu of past performance, laboratory trial mixes to produce placability, slump, specified strength and properties specified. 6. Determinations of required average strength (fc,) shall be in accordance with ACI 318-89, "Building Code Requirements for Reinforced Concrete", and evaluations of compressive strength results of field concrete shall be in accordance with ACI 214-77 (Reaffirmed 1989), "Recommended Practice for Evaluation of Strength Test Results of Concrete". 7. Average strength shall exceed specified compressive strength as required in accordance with ACI 318-89. 8. Concrete shall be air -entrained and the total air content required (air - entrained and entrapped air) shall be: Nominal Max. Size Coarse Aggreeate Total Air Content 1-1/2" 4-1/2%+- 1% NOTE: Air -entrainment shall not be required when Class "F" fly ash is used in the concrete mix design on projects south of IH-20, Texas Department of Transportation Standard Specifications, Item 420. 9. The Concrete shall be proportioned and produced to yield the following slumps when placed: Type of Construction Slump Tolerance Reinforced Foundation Walls & Footings 3 in. f 1 in. Columns, Beams, Walls, Structural Slabs 2 in. t 1 in. Slabs -On -Grade Roadways 2 in. t 1 in. Heavy Mass Construction 1 %2 in. t %2 in. Drilled Piers 6 in. t I in. 03300-5 .03 EXECUTION: a. Production Of Concrete 1. Concrete shall be ready -mixed, batched, mixed and transported in accordance with ASTM C 94-86, "Specification for Ready -Mixed Concrete". 2. Plant equipment and facilities shall conform to the "Checklist for Certification of Ready -Mixed Concrete Production Facilities" of the National Ready Mixed Concrete Association. b. Placing 1. Preparation CONTRACTOR shall provide access for delivery provide sufficient equipment and manpower to rapidly place all concrete. (a) Work shall be in accordance with ACI 304R-89 'Recommended Practice for Measuring, Mixing, Transporting, and Placing Concrete". (b) Formwork shall be completed and snow, ice, water, and debris removed from within forms. (c) Expansion joint material, anchors, and all embedded items shall have been positioned. (d) Subgrades shall be sprinkled sufficiently to eliminate water loss from concrete. (e) Concrete shall not be placed on frozen ground. 2. Conveying Concrete shall be placed rapidly by methods to prevent segregation or loss of quality. 3. Placement (a) Concrete shall be deposited continuously or when continuous placement is not possible, construction joints shall be located as approved by OWNER. Concrete shall be placed as nearly as possible to its final position. Avoid rehandling. (b) Concrete shall be consolidated by vibration, spading, rodding or tamping, as stated in ACI 309R-87, "Guide for Consolidation of Concrete". Work concrete around reinforcement, embedded items and into corners; eliminate air or stone pockets and other causes of honeycombing, pitting, or planes of weakness. 1 11 c C. Weather Conditions Cold Weather Concrete shall conform to ACI 306R-88 "Standard Specifications for Cold Weather Concreting". A non -chloride accelerator may be used with ENGINEER's approval. Non -chloride accelerator shall be Pozzutec 20, manufactured by Master Builders. 2. Hot Weather Concrete shall conform with ACI 305R-89 on "Hot Weather Concreting". (a) Provisions shall be made for windbreaks, shading, fog spraying, sprinkling or wet cover when necessary. (b) Use an evaporation retardant and finishing aid, "Confilm", by Master Builders. (c) Maximum concrete placing temperature when used in a bridge slab or in top slab of a direct traffic culvert shall be 8f F and the maximum concrete placing temperature when used in other applications shall be 9f F, Texas Department of Transportation Standard Specifications, Item 420. d. Finishing 1. Finish concrete materials as specified in Section 03342, Finishing, Quality Control, Tolerances. 2. For curing methods, field quality control, and tolerances, refer to Section 03342, Finishing, Quality Control, Tolerances. END OF SECTION 03300-7 DIVISION 3 - CONCRETE SECTION 03342 - FINISHING. QUALITY CONTROL, AND TOLERANCES .01 GENERAL: a. Description This Section shall govern all work with respect to finishing, quality control, and tolerances for all concrete surfaces of the type and grade of concrete being placed. b. Applicable Standards and Test Methods The following documents are referred to in this Section and shall be available at the project site: 1. ACI 301-84(R-88), Specifications For Structural Concrete For Buildings 2. ACI 318-83 (R-86), Building Code Requirement For Reinforced Concrete 3. ASTM C 31-84, Making And Curing Concrete Test Specimens In The Field 4. ASTM C 39-86, Standard Test Method For Comprehensive Strength Of Cylindrical Specimens 5. ASTM C 138-81, Standard Test Method For Unit Weight, Yield, And Air Content (Gravimetric) Of Concrete 6. ASTM C 143-78, Standard Test Method For Slump Of Portland Cement Concrete 7. ASTM C 171-69el, (Reapproved 1980) Standard Specifications For Sheet Materials For Curing Concrete 8. ASTM C 173-78, Standard Test Method For Air Content Of Freshly Mixed Concrete By The Volumetric Method 9. ASTM C 231-81el, Standard Test Method For Air Content Of Freshly Mixed Concrete By The Pressure Method 10. ASTM C 260-86, Standard Specification For Air -Entraining Admixtures For Concrete 11. ASTM C 309-81, Liquid Membrane -Forming Compounds For Curing Concrete 03342-1 .02 EXECUTION: a. General Finish Requirements Unless otherwise specified, the finish of all exposed concrete surfaces shall be what is generally termed a plywood finish, which means a finish which will normally be obtained when well -designed, mortar -tight plywood forms are used. Repairing of surface defects and hand rubbing will be required on all exposed surfaces only where patching of honeycomb is necessary or where form design or construction or general workmanship produce gradual surface defects exceeding 1/4 in. in a 10-ft. straightedge or abrupt defects exceeding 1/8 in. Offsets caused by displaced or misplaced form sheathing or form sections, by loose knots in forms, or by otherwise defective form lumber will be considered as abrupt surface defects. 2. Concrete surfaces, both above and below the backfill, shall have all metal form ties removed not less than 3/4 in. back from the faces of the concrete. The holes shall be cleaned and wire brushed to remove laitance, form oil, and other foreign material; and then shall be filled with non -shrink grout. 3. Slabs -on -grade shall have a broom finish, unless otherwise specified, and formed sides. This finish shall be applied immediately behind the bull float operation. Curing shall begin immediately after texturing. 4. Dusting freshly placed concrete surfaces with cement or a mixture of sand and cement before or during the finishing operations is strictly prohibited. b. Pier, Foundation, and Wall Top Finishes Unless otherwise specified, the tops of column piers, small equipment foundations and similar foundations are to be grouted, scored, and all laitance, grease, dirt, or other deleterious materials removed. 2. The surface elevation shall be checked and additional concrete removed, if necessary, to allow for the specified thickness of grout. 3. The tops of all concrete walls shall be given a wood float finish. 4. In areas where a greater degree of finish is specified, it will be necessary to allow the concrete to begin to set before finishing. C. Concrete Curing and Protection 1. General The freshly placed concrete shall be protected from premature drying and excessive cold or hot temperatures. Curing shall start immediately after placing and finishing, and shall continue for not less than 28 days. 03342-2 2. Curing Methods (a) Perform curing of concrete by use of curing compound, by moist curing, by moisture -retaining cover, or by combinations thereof. Material and method of curing shall be approved by ENGINEER. (b) Apply curing compound as soon as finish is completed. (c) On formed surfaces a curing method shall begin immediately upon form removal. (d) Approved methods for Rheoplastic Concrete include: Ponding or continuous sprinkling, continuous wet mats, sand kept continuously wet and liquid membrane -forming compounds. (1) Application of waterproof sheet material shall conform to ASTM C 171-69 (Reapproved 1986), "Standard Specification for Sheet Materials for Curing Concrete". (2) Applications of membrane -forming compounds shall conform to ASTM C 309-81, "Standard Specification for Liquid Membrane -Forming Compounds Curing Concrete". (e) The type of curing and procedure utilized shall be verified in the Preconstruction Meeting. d. Field Quality Control 1. Materials and operations shall be tested and inspected by CONTRACTOR as work progresses. Failure to detect defective work shall not prevent rejection when defect is discovered, nor shall it obligate OWNER for final acceptance. 2. The following testing services shall be performed by a testing service approved by OWNER: All costs associated with these testing services shall be borne by CONTRACTOR unless otherwise noted. (a) Secure composite samples in accordance with "Standard Method of Sampling Fresh Concrete", ASTM C 172-82. (b) Mold and cure four specimens from each test required in accordance with standard "Method of Making and Curing Concrete Test Specimens in the Field", ASTM C 31-85. (c) Test specimens in accordance with "Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens," ASTM C 39-86. Two specimens shall be tested at 28 days for acceptance and two shall be tested at 7 days for information. (d) Make one strength test for each 50 cu. yd. or fraction thereof, and for each mix design of concrete placed in any one day. 03342-3 e. (e) Determine slump of normal -weight concrete sample for each strength test in accordance with "Standard Test Method for Slump of Portland Cement Concrete", ASTM C 143-76. M Determine total air content of normal -weight concrete sample for each strength test in accordance with "Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method", ASTM C 231-82 or "Standard Test Method for Air Content of Freshly Mixed Concrete by the Volumetric Method", ASTM C 173-78. 3. CONTRACTOR shall provide an area of protection for the test specimens free from damage or vibration at the job -site for the first 24 hours. 4. CONTRACTOR shall provide an enclosed, insulated box for immediate test cylinder storage after manufacture at the job site. 5. The manufacturer of (3) 6" X 12" test cylinder may be required by ENGINEER. Utilize procedure for manufacture according to ASTM C 31-84. The time of test and frequency shall be dictated by ENGINEER. These specimens shall be used to perform AASHTO T-277-83, "Standard Method of Test for Rapid Determination of the Chloride Permeability of Concrete". Tolerances Formwork shall be constructed in such a manner as to produce concrete surfaces that conform to the established dimensions, grades, and lines within the limits specified in Table below: TOLERANCES FOR FORMED SURFACES Variation from the plumb: In the lines and surface of columns, walls and in equip- ment foundations. ii. For exposed corner columns, control joint grooves, and other conspicuous lines Variation from the level or from grades shown on Drawings, except for grout caps and slabs Variation from the level or from grades shown on Drawings for grout caps. 03342-4 In 10 ft. 1/4 in. In any story of 20 ft. max 3/8 in. Maximum for entire height 1 in. In 10 ft. 1/4 in. In any bay of 20 ft. max. 1/2 in. In 10 ft. 1/4 in. In any bay of 20 ft. max. 3/8 in. Maximum for entire length 3/4 in. 1/16 in. TOLERANCES FOR FORMED SURFACES (cont.) Variation of the linear building lines, or equipment foundations, from established position in plan and related position of columns, walls and partitions. Variation in cross -sectional dimensions of columns and beams, equipment foundations, and in the thickness of slabs and walls. Footings: i. Variation of plan dimensions ii. Misplacement or eccentricity iii. Reduction in thickness Variation in the sizes and locations of floor openings and wall openings. Variation in location of sleeves, waterstops, expansion joints, and other inserts. Variation in steps: In any bay of 20 ft. max. 1/2 in. Maximum for entire length 1 in. -1/4 in. +1/2 in. Concrete only. (Does not -1/2 in. apply to anchor bolts, +2 in. dowels, or reinforcing.) 2% of footing width in the direction of misplacement but not more than 2 in. max. (concrete only). Does not apply to anchor bolts, dowels, or reinforcing. Portion of specified -5% thickness. ±1/4 in. ±1/4 in. i. In a flight of stairs Riser t1/8 in. Tread fl/4 in. ii. In consecutive steps Riser t1/16 in. Tread f1/8 in. 03342-5 Unless otherwise specified, anchor bolt centers may vary up to 1/8 in. from the locations shown on Drawings; however, the variation in the dimension measured from center to center of any two bolts in an anchor bolt group may not vary more than 1/8 in. An anchor bolt group is defined as the set of anchor bolts which receive a complete equipment base assembly or a single fabricated steel shipping piece. The location of inserts, such as waterstops, and expansion joints, may deviate from that shown on the drawing by 1/4 inch. Tolerances shown on Drawings shall take precedence over the tolerances specified in this Section. Permissible surface defects of exposed concrete surfaces are specified in Article .02 this Section and are to be distinguished from the tolerances described above. END OF SECTION END OF DIVISION 03342-6 DIVISION 5 - METALS SECTION 05500 - MISCELLANEOUS METAL .01 GENERAL: This work includes furnishing all materials and equipment, and performing all operations necessary as indicated on the drawings and as specified herein. a. Scone: Include fabricated steel items of thickness greater than 18 ga. sheet metal that are not part of other metal systems. Include non-ferrous items listed, and light gauge structural framing. b. Shop Drawings: Submit for review. Completeness shall be sufficient to indicate compliance with the Contract Documents and to correlate with other materials. .02 MATERIALS: (STEEL) a. Structural Shapes, Bars: New billet, medium grade ASTM A 36. b. Bars, Plates: Same except cold -rolled, ASTM A 180. C. Structural Tubular: Square or rectangular, ASTM A 501; pipe, ASTM A 120. d. Sheets: Cold -rolled, ASTM A 366. e. Bar -Size: Hot rolled, ASTM A 575. f. Tubing: Cold -Drawn, ASTM A 512. g. Steel Joists: As indicated on drawings. .03 STEEL SHOP PRIMER: a. Locations: Typical. Unless otherwise noted on the drawings. b. Minimum Preparation: Remove loose mill scale, loose rust and other foreign materials to the standards SSPC SP-2 and SP-1. C. Acceptable Primers: Any primer that meets Federal or SSPC specifications for use over the specified preparation. Two such primers are Fed. Spec. TT-P-86 Type I or Type II, SSPC-Paint 4-64T or TT-P-636c iron oxide zinc chromate alkyd primer. d. Primer Thickness: 2.0 mils dry film thickness, except for minor deficiencies. END OF SECTION 05500-1 .03 MATERIALS a. All structural shapes, plates and angles shall conform to the requirements of ASTM A 36 unless noted otherwise on the drawings. b. All bolts shall meet the requirements of ASTM A 325 unless noted otherwise on the drawings. C. All hardware, fasteners, nuts, bolts and washers shall be hot dipped galvanized after fabrication in accordance with ASTM A 153. d. Touch-up for damaged hot -dip galvanized coatings shall be an approved cold zinc galvanizing compound conforming to ASTM A 780. .04 FABRICATION a. All items to be fabricated shall be fit and shop assembled in the largest practical sections for delivery to the job site. b. Butt joints shall be made tight and flush before welding. All exposed joints shall be ground flush and smooth with adjacent finished surfaces. All sharp edges shall be ground smooth. C. Welded joints shall be continuously sealed by seal weld where structural welds are not specified. d. All fabrication, grinding and preparatory work shall be completed before galvanizing or coating any fabricated item. e. Dimensions which my affect the fitting of the fabrications shall be checked by CONTRACTOR in the field before fabrication in the shop. CONTRACTOR shall be responsible for fitting the fabrications in the field to the lines and grades shown on the plans. .05 FINISHES a. Unless otherwise indicated on plans, all metal fabrications shall be hot -dip galvanized after fabrication in accordance with ASTM A 123. b. Items not galvanized shall be sandblasted in accordance with SSPC SP10, near white finish, and coated with paint system indicated on the drawings. END OF SECTION END OF DIVISION 05501-2 p ti �w sa33aisu3 N1'8 �Nm.,. ~ I iLO Ntl3 OO 'V39 tlIlON'JtlW 103fOtld 1N3W3OVld3Nl dVO OV3mins NO NV300• HOV3S vnONOVW E9€Ev�E 9esE so �o °° °®m °' '1°° ME p� 4,. jai sassrvioas M>$ K F�.AC ■W v Y ry8 z 20 du oec U „ $oR $ 9 his a" I Na Y U *:S w f'�. t- � 23 GI az U 41 'dm w Q W \ 5� ' U (Epp H H 3"a w u x�R;g jig! jil o� 4 w� oe. 6g 9 s� H is o. L "- wig, 3 �` #19 ' NOTICE OF MEETING—4/10/2024 19. Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Megan Wright Subdivision. (DEH) Terry Ruddick explained Preliminary plat and drainage plan. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 ' AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 16 of 32 • • U81 Land Surveying+Aerial Imaging since 1991 April 3, 2024 David Hall County Commissioner Precinct #1 305 Henry Barber Way Port Lavaca, TX 77979 RE: Megan Wright Subdivision Dear Commissioner Hall, Please consider this letter as my request to have the following item placed on the April 10, 2024 Commissioner's Court agenda: Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Megan Wright Subdivision. If I can provide additional information, please do not hesitate to contact me. Sinc rely, Te y T. Ru ick, R.P.L.S. C.E.O. (526350) Victoria Ben Antonlo Cuero 2004 N. Commerce Victoria; TX 77901 12661 Silicon Drive San Antonlo,TX 78249 104 E. French Street Cuero, TX 77954 urbansurveying.corn 381-570-9837 210-267-8654 361-277-9061 Firm 9: 10021100 Firm 9: 10193843 Firm 9: 10021101 j emxs§ BE O-! sk" Wdgp V�$ Hill xis € '1�°a�e. g ¢ 4s- off; H Rzg33 :s �e@Pa _ 9 �wa Y es2 c€w;� 4 e"sg Y o a I. H e'E's� � oa a��°s rt_ .� F" _.3., I m # 20 NorlcE OF MEETING — gJ10/7024 20. Consider and take necessary and remove from Precinct 4 R Invento ry action to declare Asset No. 24-0416 A/C System as Waste E ULT: �'• (GDR) ERq APPROVED[UNANIMOUSOND Joel Behrens, Commissioner ct 3ER: Gary Reese: , Commissioner Pct 4 Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 4�QS.TATE OFT {9 N Gary A Reese County Commissioner oFcnv� County of Calhoun Precinct 4 April 2, 2024 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 April 10, 2024. • Consider and take necessary action to declare Asset No. 24-0416 - A/C System as Waste and remove from Precinct 4 R&B Inventory. Sincerely, n 0.sGary D: Ree GDR/at P.O. Box 177 - Seadrift, Texas 77983 , email: Rary reesek,calhooncoa - —�b - (36I) 785-314I -Fax (36I) 785-5602 INVENTORY NUMBER SYSTEM CALHOUN COUNTY, TEXAS WASTE DECLARATION REQUEST FORM DEPARTMENT NAME: Precinct 4 R & B REQUESTED BY: Commissioner Reese FOR #21 I NOIICE.OFMEETING-4/10/2024 21. Public Hearing concerning Petition to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) :d at 11:20 ned the petition to vacate. ied at 11:22 Page 18 of 32 PllE3fiClIf:!\RINC7 ,�/IO/'7��G Richard H. Meyer County Judge David Hall, Commissioner, Precinct I Vern 1Lyssy, Commissioner, Precinct 2 Gap ]Sabres, Commissioner, Precinct 3 Yy Reese, Commissioner, Precinct 4 NOTICE OF PUBLIC HEARING The Commissioners' Court of Calh Aprd d®, 2024 at oun County, Texas will meet on Wednesday, 211 S. Ann Street, ffi in thetreet, Suite I rn'ssaoners' Courtroom in the County Courthouse Lavaca , 04, Port , Calhoun County, tY, Texas. ' 1 • NOTICE IS HEREBY GIVEN that the Calhoun County Commissioners' hold a Public Hearing in the Court will Port Lavaca, Texas, on April Commissioners' Courtroom, 211 S. 104, in 10, 2024 at 10:00 a.m. regarding Public Hearing Subdivision as recorded in Volume Z, page 2 concerningPetition to Vacate Tracts 452X and 453X of the American To site Company of the plat Records of Calhoun County, Texas. This notice is in accordance with Section 111.007 and Section 111.0075 of the Texas Local Government code. Richard H. Meyer, Co ud e Calhoun County, Texas g A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www,calh-X orz under "Commissioners' Court Agenda" for any official court postings. AT 10:0 O'FILED CLOCK M APR 0 5 2024 COUNTY CLEF2'KNACq WOUN COUMY Tey,AS ar._ L�� —F 6 Pave 1 of 1 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 2, 2024 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 April 10, 2024. • Public Hearing concerning petition to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. Sincerely, ' 9 Gary D Rees CDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: ar .reese rr oalhouncotx.or — (361)785-3141 — rim (361) 785-5602 • G'�O�`tTi� [� • use Land Surve in + MAR 05 2024 Y 9 Aerial Imaging CALHOUN COUNTY CLERK Slnca19B1 PETITION TO VACATE Tracts 452X and 453X American Townsite Company Subdivision THE STATE OF TEXAS} THE COUNTY OF CALHOUN} KNOW ALL MEN BY THESE PRESENTS: That he undersigned the 453X, American Towns t gCompan designated Subdivisont of asthe owners r recorded in f the VolumZ. P Calhoun County, Texas do hereby property described as Tracts 452X and at Records of land, in accordance with Sections 206 and 207 of the Subdivision Regulations and Recreational age 2 of the lVehicle Park y petition the Calhoun County Commissioner's Ccurt to Vacate said tracts of Regulations Ad2007. opted by Calhoun County Commissioner's Court on November 29, 2004 and amended on Regulations Adopted The property is proposed to be re -platted in accordance with a plat submitted to the Calhoun County Commissioners Court. The petition will be considered by the Calhoun County Commissioner's Court on April 10, 2024 at 10;00 am. [uu4 N. Commerce Victoria, TX 77901 361-578-9837 Victoria San Antonio 2004 N. Commerce 12661 Silicon Drive Cuero Victoria, TX 77901 San Antonio, TX 78249 104 E. French Street 381-578-9837 210_267-8654 Cuero, TX 77954 Firm k:10021100 Firm 10183843 381-277-90e1 tirlialiSurveyi11tg,Cpn, H: Firm N: 10021101 /(�/j� ry��YYRRuueeppjy yT�,.yJ��{ # zz I NOTICE OF MFETING - 4/10/2024 22. Consider and take necessary action to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. (GDR) APPROVED [UNANIMOUS] Gary Reese, Commissioner Pct 4 )ER. Joel Behrens, Commissioner Pct 3' Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 19 of 32 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 2, 2024 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 April 10, 2024. • Consider and take necessary action to Vacate Tracts 452X and 453X of the American Townsite Company Subdivision as recorded in Volume Z, Page 2 of the Plat Records of Calhoun County, Texas. Sincerely, Gary D. Rees CDR/at P.O. Box 177 — Seadrift, Texas 77983 —email: garv.reeseacalhn h or — (361) 785-314I —Fax (361) 785-5602 # 23 I NOTICE OF MEETING — 4/10/2024 23. Consider and take necessary action to approve the Final Plat of American Townsite Subdivision Tracts 452X and 453X, Resubdivision No. 1. (GDR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Mevor_ rnmm. Page 20 of 32 Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 2, 2024 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 April 10, 2024. • Consider and take necessary action to approve the Final Plat of American Townsite Subdivision Tracts 452X and 453X, Resubdivision No. 1. Sincerely, Gary D. Reese CDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: mi:eesencalhouncotx org — (361) 785-3141 — Fax (361) 785-5602 f� e o n \Ui 1 n \ \ \ Q \ \ 4 k7� p E yeu .v a#� i \ \ j\ ma� of �a ooLL O Z Z O U) m m LU E X 3 o' 06 s s -- ------- -- -- -- X v =o � v At ¢ ~ Z Z ££ k rc ; gg g w3p a kz 1 mZ m 3. GE � a Qi ' rnLU a 2 z a ey o° 10 ax O o f geeLU � i 1 U_ sg leg ��9 5F 4 w wEl,e iss a�o K x a.s88�� Mew =s€ g p B� �& S ry 30 �n gi yY°� iR e 6^n a do 8io Ep a LL$ 4 ion. �og A�g� G K z i n7 �7�2 ti p� y w z Gary D. Reese County Commissioner County of Calhoun Precinct 4 April 4, 2024 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 April 10, 2024. • Consider and take necessary action to approve the Final Plat of the Cady Subdivision, (Replat of Lot 1100B of the Replat of Lot 1100 of the American Townsite Company Subdivision - Slide 696A of the Calhoun County Plat Records) Basibio Maldonado Survey, Abstract No. 19 Calhoun County Texas. Sincerely, A -% 1) 1\ Gary D.'Reese GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: oarv.rem a calhoutx o -( .. (36I) 785-3141 —Fax 361) 785.5602 .• 0 r AMERCIAN r TOWNSITE r O D O H 3 H H / c~O D t�0 end COMPANY tO SUBDIVISION C0 A' 55rMo' w 335.59LOT 11OOA fl`3 IL i i3e.L l]I.I a' ii 161.50'i r0 •, Rda ' '2[rN61eiw'uIL-3 NiEu ay 324.E _ _ _ _ _y'p E §N ¢jA �y 4 £ O tlG � E 'N� 3i � tl y �1 8 m 5 rP � F6 n 11.1 2l o••B1' —OV0.00'099 3 21,01, N 121383N1iIM--- ]p VOLUME Z, PAGE 2 a e s r0 m a 3 H H m Do o C. C. P. R. I �mc &$ yy] y j gg qq fapya g qgQ gq] sF C] .9 qq § B iy� ggNR q� yLmCO Nix I � �E�c-m n it { m y g M �•i e m�j'� (.0 P � ��tV a9•.e O 9 a n ax g y O CO0-4 I 9 " larc mnx C_ FC-1 a O•aw V1 RomCi a O O il on vil l §;g a $e, soon %1912 p5�anX fall I Aft 9 s Ali a 5,0 9� p� G& W ENGINEERS, INC. - s . c ��{ o m m • ENGINEERING • SURVEYING • PLANNING • o `n" g a s x b Pa a ROS W NYE OA'f S1REEl, Ppti LAVACA, EMS 77979 . r MPELS NPM NO.: IN22100 FINAL PLAT (MI) 592-4509: PORT IAVACA (979) 323-0100: BAT Cltt < b # 25 NOTICE OF MEETING - 4/1012024 25. Consider and take necessary action to approve the Final Plat of the Replat of Lots 6 & 7 of Marlin Adul Villa's, Port O'Connor Townsite, Santiago Gonzales Survey, Abstract No. 19 recorded Slide No. 650a of the Calhoun County Plat Records. (GDR) my Danysh explained the final plat. SULT: APPROVED [UNANIMOUS] )VIER: Gary Reese, Commissioner Pct 4 CONDER; Joel Behrens, Commissioner Pct 3 Page 22 of 32 Gary D. ,Reese County Commissioner County of Calhoun Precinct 4 APB 4, 2024 Honorable Richard Meyer Calhoun County]udge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please Place the following item on the Commissioners' Court Agenda for April10, 2024. • Consider and take necessary action to approve the Final Plat of the Replat of Lots 6 & 7 of Marlin Adul Villa's, Port O'Connor Townsite, Santiago Gonzales Survey, Abstract No. 19 recorded Slide No. 650a of the Calhoun County Plat Records. Sincerely, Gary D1Reese GDR/at P.O. Box 177 - - Seadrift. Texas 77983 - email: a reese0ea11101HIGON.Or (361) 785.3141 -Fax (361) 785-5602 wa ere ROIL-SZC (s<s) W VAVl lead 1091-Z99 (wc) sere< srxat vovnvitey d 133mSdNvo a n M SOZ F O m E M 3g $aagg3� 3 'd�Pe6� 1N3W3SV3 .UJILLfI me"' LeLr SS300V 31VARId - F p_________________ __ F E! 0 O F .] O Ela o .a # 26 i NO -I ICE OF MEETING —4/10/2024 26. Consider and take necessary action to authorize Kelley Ashley, the Calhoun County Children's Librarian to apply for the $500 HEB grant for the Summer Reading Program. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 23 of 32 Mae Belle Cassel From: dsanchez@cclibrary.org (Dina Sanchez) <dsanchez@cclibrary.org> Sent: Tuesday, April 2, 2024 10:51 AM To: Mae Belle Cassel Subject: Commissioner's Court Agenda CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless Lou recognize the sender and know the content is safe. Good morning, can you please add this item to the agenda: Consider and take necessary action to authorize Kelley Ashley, the Calhoun County Children's Librarian to apply for the $500 HEB grant for the Summer Reading Program. Thank you, Dina Sanchez Calhoun County Library Director (361) 552-7323 Calhoun County Texas I # 27 NOTICE OF MEETING -- 4/10/2024 27. Consider and take necessary action on Amendment No. 2 to Matagorda Bay Mitigation Trust Contract 031 to fund the additional engineering services for the Green Lake Park Development Phase 1 project, increase budget amount by $5,900 for a revised contract amount of $289,150 and authorize Judge Meyer to sign contract. (GDR) 1S] Pct 2 Oct 4 Page 24 of 32 Gary A Reese County Commissioner County of Calhoun Precinct 4 April 4, 2024 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 April 10, 2024. Consider and take necessary action on Amendment No. 2 to Matagorda Bay Mitigation Trust Contract 031 to fund the additional engineering services for the Green Lake Park Development Phase 1 project, increase budget amount by $5,900 for a revised contract amount of $289,150 and authorize Judge Meyer to sign contract. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: &M.reese@caIhoum;mx om - (361) 785-3141 — Fax (361) 785-5602 AMENDMENT — NUMBER TWO (2) CONTRACT No. 031: Green Lake Park Development CONTRACT AMENDMENT BETWEEN MATAGORDA BAY MITIGATION TRUST AND CALHOUN COUNTY, TEXAS CONTRACT PERIOD: June 1, 2022 through December 31, 2024 FUNDING AMOUNT: $5,900.00 EFFECTIVE DATE: April 1, 2024 For and in consideration of the mutual covenants and obligations expressed in this Contract Amendment, the parties hereto agree to the following Contract adjustments: 1. The purpose of this Amendment is to add supplemental environmental services for the Phase I development of Green Lake Park. 2. The contract amount is increased by $5,900.00 for a revised contract amount of $289,150.00 3. The scope of work for the supplemental environmental services is included in Attachment A and the revised budget is included in Attachment B. 4. Any and all expenditures of funds under this Amendment shall comply with all requirements under the original Contract, the terns and conditions herein, and the attachments hereto. No other changes are made to this Contract. The Matagorda Bay Mitigation Trust and Calhoun County (Recipient) hereby accept and confirm by their signatures below, that they will abide by the full terms and conditions of this Amendment and the original Contract. Except as amended herewith, all of the terms and conditions of the original Contract shall remain in full force and effect. All oral or written agreements between the parties hereto relating to the subject matter of this Contract Amendment which were made prior to the execution of this Contract and Amendment have been reduced to writing and are contained herein. This Contract Amendment shall not be binding until signed below by the authorized representatives of the parties hereto. MATAGORDA BAY MITIGATION CALHOUN COUNTY TRUST BY: NAME: Steven J. Raabe TITLE: Trustee DATE: April 4, 2024 t BY: NAME: Richard H. Meyer TITLE: Calhoun County Judge DATE: L/—/a— z�y Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT A STATEMENT OF MITIGATION PROJECT Calhoun County, Texas ("Recipient") 211 S. Ann Street Port Lavaca, Texas 77979 The Green Lake Park Development Project Phase 1 Supplemental Environmental Services include: I. Cultural Resources Services 1. Administrative time required for plan reviews, meetings, mobilization, and reporting. Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT B BUDGET Calhoun County ("Recipient") 211 S. Ann Street Port Lavaca, Texas 77979 Contract Budget Direct Salaries Taxes and Benefits Administrative Overhead Construction Consultants/Contractual $ 289,150.00 Insurance Permits Supplies/Materials Travel -Mileage Total Contract Budget $289,150.00 RECIPIENT WILL SUBMIT INVOICES TO TRUST (mark appropriate option): OR X Monthly Quarterly f:l Matagorda Bay Mitigation Trust ("Trust") ATTACHMENT C INVOICING INSTRUCTIONS Below are the instructions on how to complete and submit your invoice. All invoices must be submitted electronically. You do not need to submit a hard copy unless specifically requested to do so. Invoices that don't balance or that lack proper supporting documentation will be delayed, so please ensure that your invoice is in order prior to submission. The Recipient's Contract includes the budget and invoice form (Attachment C). The Contract's budget is tracked in two ways: Budget by Contract Category and Budget by Task. Each invoice submitted for payment must track the project costs in compliance with the Recipient's Contract as outlined in Attachment C. Each field at the top and bottom of the Invoice form must be completed and the invoice must be signed and dated by the person authorize to certify that the invoice is true, correct and complete and in accordance with the Contract. Each invoice should have the amounts being billed for the current billing period ("This Invoice" columns) and the accumulated amount billed for this Contract to -date, including the current billing period ("Contract To -Date" columns). Please take special note that the two budgets — Budget by Contract Category and Budget by Task — must always equal. Supporting documentation must be attached to the invoice for each line item being billed in the sequence such items appear in the Budget by Contract Category section. Each supporting document must be clearly labeled and in the proper budget sequence in order allow our audit of the invoice and its approval for payment. Failure to properly label or sequence the supporting documentation will cause a rejection of the invoice, so this is very important. All invoices are to be submitted electronically (email) to: Trustee@mbmTrust.com. If a Recipient has any questions whatsoever about invoicing procedures, please feel free to contact the Trust office at 361-200-1456 or write to Administrator@mbmTrust.com. Effective Date: June 1, 2020 Invoice to Matagorda Bay Mitigation Trust Date of Invoice: Recipient Name: Calhoun County Billing Period This Invoice: Contract#: 031, Amendment 2—Green Lake Park Development From To Contract Amount: $ 289,150.00 Payment Request No: Invoice Amount: $ Is this a final payment application? BUDGET BY CONTRACT CATEGORY ,IYV VII.0 RC1.XY� This This Contract Total BUDGET BY TASK Category Direct Salaries/Payroll To-Date Budget Task This Invoice Contract To -Date Total Budget Taxes and Benefits Phase 1 Services 289,150.00 Admin Overhead Construction Consultants/Contractual Insurance 289,150.00 Permits Professional Services Su lies/Materials Travel & Mileage Total 289,150.00 *Please see Involving instructlens Remittance Address: TOW I 289,150.00 Name of Payment Contact Person and contact information: Carl tIPn: I c i h t the amounts being invoiced are true, correct, and complete inevery material yrespect. Signature and Tdle of Authonzed Repq native Y ,1t�/n1 Date Signed 1 P�l�r 1 `�� Far OrRce Use Only Print Nameand Title NAuthonzed Representative 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of 1 Complete Nos. 1-4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2024-1142770 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Matagorda Bay Mitigation Trust Poth, TX United States Date Filed: 04/04/2024 2 Name of governmental entity or state agency that is a party to the contract for which t e forms being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. Green Lake Park Phl Supplement Green Lake Park Phl Supplemental Cultural Resources Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Raabe, Steven Poth, TX United States X Aguirre, Robert Pipe Creek, TX United States X Wood Boykin Wolters Corpus Christi, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is �!-Ee/t'1 —�'. (`G+-liLt�l� and my date of birth is My address is LDS jjt (street) (city) (state) (21P cede) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Wr Count , State of �Z"` i Y , on the day of ^J , 20 �• (month) (year) Signattx6 o uthorized agent of contracting business entity (Declarant) C�•mn ,...u1d..A L.. Tom..__ •••^- r..... www.etnics.stace.a.us Version V3.51.5b35d027 # 2s u l l.r l r lvlCr_ I IVu - 4J.1 U/LUL4 28. Consider and take necessary action on additional scope of work services from Stantec Consulting Services for the Port Alto Shoreline Permit -Amendment #2 in the amount of $21,274.00 to be paid out of GOMESA funds and authorize Commissioner Behrens to sign the agreement. (JMB) RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 25 of 32 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. I72--Olivia, Port Lavaca, Texas 77979 —Office (361) 893-5346 —Fax (361) 893-5309 Email: io_el.behrensncalhou cotxore 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 April 10, 2024 Consider and take necessary action on additional scope of work services from Stantec Consulting Services for the Port Alto Shoreline Permit -Amendment #2 in the amount of $21,274.00 to be paid out of GOMESA funds and authorize Commissioner Behrens to sign the agreement. Sincerely, Joel Behrens Commissioner Pct. 3 Stantec Consulting Services Inc. 1905 Aldrich Street, Suite 300 Stantec Austin TX 787233544 April 3, 2024 Commissioner Joel Behrens Calhoun County 211 S. Ann Street Suite 104 Port Lavaca, TX 77979 Reference: Port Alto Shoreline Permit— Amendment #2 Dear Commissioner Behrens, We are requesting a scope amendment for the preparation of a Biological Assessment (BA) for the U.S. Army Corps of Engineers' (USAGE) permit amendment process. On March 6, USAGE notified us that they would be consulting with National Marine Fisheries (NMFS) and U.S. Fish and Wildlife (USFWS) regarding effects to critical habitat and threatened and endangered (T&E) species and therefore would be requiring that the permit applicant submit either a Biological Evaluation or Biological Assessment for use in this consultation process. The BA is a formal document used by the federal agencies, which evaluates the short-term (construction related) and long-term effects of the proposed permit actions on T&E species and critical habitats for these species. The primary species of concern include the Piping plover, Red knot, and Eastern black rail for consultation with USFWS. The primary species of concern for consultation with NMFS are the Green sea turtle, Loggerhead sea turtle, and Kemps ridley sea turtle. In addition, the project area is within Green sea turtle proposed critical habitat which will be considered within consultation with NMFS. Stantec proposes the following additional efforts: Task 3; Regulatory Coordination (Additional Fee) Stantec and its subconsultant Triton Environmental Services (Triton) will develop a draft BA report in support of Section 7 compliance with the Endangered Species Act (ESA) and submit to the USAGE for review and comment The draft BA will include a list of threatened and endangered species that occur within Calhoun County shorelines and evaluate potential effects of the proposed action on these species and/or their critical habitats known to occur within the proposed project review area (i.e., action area). The draft BA will also include proposed conservation measures to minimize impacts to threatened and endangered species and their habitats resulting from the proposed action. These requested actions are now standard of practice for the federal agencies on coastal projects. Once the USAGE reviews the draft BA and provides comments, we will incorporate their requested recommendations and submit a Final BA to USAGE for their submittal to USFWS and for review and consultation. Desicn with community in mind August 21, 2023 Commissioner Joel Behrens Page 2 of 2 Reference:- Port Mansfield Dredging and Beneficial Use Regulatory Coordination Amendment #2 • Stardec Proposal and Scope of Work Stantec is prepared to begin work on this effort upon approval and contract execution. All work is proposed to remain on a time and materials basis in accordance with Stantec's Standard Terms and Conditions. The estimated non -to -exceed fee for this work is $21,274.00. Task Description l#mendment2pmount' Regulatory Coordination Thank you for the opportunity to support your needs on this project Please don't hesitate to contact us if you have any questions. Sincerely, STANTEC CONSULTING SERVICES INC. Stephanie Rogers PE Senior Coastal Engineer Phone: 512-236-6844 Mobile: 361-522-8349 stephanie.rogers@stantec.00m Desiur with communii� in rnind Juan Moya Ph.D., PG Texas Coastal Lead Phone: (512) 236-6829 Mobile: (512) 977-8013 juan.moya@stantec.com CIL ® Stantec AUTHORIZATION FOR ADDITIONAL SERVICES Date 3 April 2024 "Stantec" Stantec Consulting Services Inc. Stantec Project# 177311818 Stantec Pipeline # 950582 1905 Aldrich Street, Suite 300, Austin TX 78723-3544 Ph: (512) 265-8461 email: stephanie.rogers@stantec.com - Client Calhoun County Client Project # 177311818 211 S. Ann Street Suite 104 Ph: (361)8935346 email: joel.behrens@calhouncotx.org Project Name and Port Alto Shoreline Permit Change Order# 2 Location: Port Alto, Texas This is authorization for Stantec to perform additional services on the project as noted above. A. Stantec agrees to perform the following additional service(s): See Attachment A. S. Client agrees to compensate Stantec for such additional services in accordance with the terms of the initial agreement for additional amount(s) stated below: ' Additional fees Not to Exceed $21,274.00 C. All other terms and conditions of the original agreement shall remain in full force and effect. Effect on Schedule: Task 3 services will be complete as originaly scheduled. By signing below, the parties agree and affirm that each has reviewed and understands the provisions set out above and that each party shall be bound by each and all of said provisions. A copy of this agreement shall serve and may be relied upon as an original. Stantec Consulting Services Inc. Stephanie Rogers, Senior Coastal Engineer, Project Manager Print Name and Title Signature Date Signed: Calhoun County Joel Behrens Commissioner Precinct 3 P ' Nam nit Ti le r� Signature I./ e_ fl (�� Date Signed: 1020 2-4— tmosasoatuotwme�m7edsmattatsm�nagapamemlapreeirenauemm.mm�,mmwaanlftl m1re =,Um # 29 NO-FlCF OF MEETTING-4/10/2024 29. Accept Monthly Reports from the following County Offices: i. Floodplain Administration — March 2024 ii. County Clerk — March 2024 iii. County Treasurer — December 2023 iv. County Treasurer — January 2024 v. County Treasurer — Investment Report — 4tn Quarter 2023 vi. County Treasurer — Quarterly Statement of Balances - 4th Quarter 2023 vii. Justice of Peace, Precinct 1 — March 2024 viii. Justice of Peace, Precinct 2 — March 2024 ix. Justice of Peace, Precinct 5 — March 2024 x. Sheriff's Department — March 2024 RESULT: APPROVED [UNANIMOUS] MOVER: = Vern Lyssy, Commissioner Pct'2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 26 of 32 Calhoun County Flo odplain Administration 211 South Ann Street, Suite 301 Port Lavaca, TX 77979-4249 Phone: 361-553-4455/Fax: 361-553-4444 e-mail: Debbie.Vickery@calhouncotx.org March 2024 Development Permit Report For Commissioners Court: 04/10/24 New Homes — 4 Renovations/Additions — 0 Mobile Homes — 0 Boat Barns/Storage Buildings/Garages - 0 Commercial Buildings/RV Site - 2 Tank — 0 Fence — 0 Pool-0 Drainage- 0 Pipeline — 0 Sandpit — 0 Vacuum Station - 0 Total - 6 Total Fees Collected: $360.00 Receipt No: 925856,925857,925858,925859,925860,925861 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION MARCH 2O24 OFFICIAL PUBUC DESC -GLCODE CIVIL/FANIILY CRIMINAL '. RECORDS PROBATE: TOTAL DISTRICT ATTORNEY FEES 1000-44020 $ 133.55 $ 133.55 BEER LICENSE 1000-42010 $ 20.00 $ 20.00 COUNTY CLERK FEES 1000-44030 $ 487.00 $ 267.11 $ 9,368.40 $ 638.00 $ 10.760.51 APPEAL FROM IP COURTS 1000-44030 $ - $ - COUNTY COURT ATIAW#1 JURY FEE 1000-44140 $ - JURY FEE 1000-44140 $ 40.00 $ - $ 40.00 ELECTRONIC FILING FEES FOR E-FILINGS 1000-0 058 $ - $ - $ - $ _ $ _ JUDGE'S EDUCATION FEE 1000-44160 $ - $ - $ - $ 45.00 $ 45.00 JUDGE'S ORDER/SIGNATURE 1000-44180 $ 36.00 $ - $ - $ 86.00 $ 122.00 SHERIFF'S FEES 1000-44190 $ - $ 210.17 $ $ 375.00 $ 585.17 VISUAL RECORDER FEE 1000-44250 $ 15.00 $ 15.00 TIME PAYMENTFEE. COUNTY--NEW2020" 1000-44932 $ 90.00 IS 90.00 COURT REFPORTER FEE 1000-44270 $ 175.00 $ - IS - $ 225.00 $ 400.00 RESTITUTION DUE TO OTHERS 1000-49020 $ - ATTORNEY FEES -COURT APPOINTED 1000-49030 $ - $ - APPELLATE FUND(TGC)FEE 262044030 $ 35.00 $ 45.00 $ 80.00 COURTFACILITYFEE FUND 264944030 $ 140.00. IS - $ - $ 180.00 $ .120.00 TECHNOLOGY FUND 266344030 $ 26.71 $ 26.71 COUNTYIURYFUND •-NEW20201' 2669.44030 $ 70.00 $ 6.68 IS - $ 90.00 $ 166.68 COURTHOUSE SECURITY FEE 2670-44030 $ 140.00 $ 66.78 $ - $ 180.00 $ 386.78 COURT INITIATED GUARDIANSHIP FEE 2672-44030 $ 270.00 $ 270.00 COURT RECORD PRESERVATION FUND 2673-44030 $ - $ - $ _ $ _ COURTREPORTERSERVICEFUND--NEW2020" 2674-44030 $ 20.03 $ 20.03 RECORDS ARCHIVE FEE 2675-44030 $ 3,160.00 $ 3,160.00 COUNTYSPECIALTY COURT "NEW2020-- 2676-44030 $ 133.55 $ 123.55 COUNTYDISPUTE RESOLUTION FUND 2677-44030 $ 105.00 $ - $ $ 135.00 $ 240.00 DRUG& ALCOHOL COURT PROGRAM 2698-44030-005 $ - $ - JUVENILE CASE MANAGER FUND 2699-44033 $ - $ - FAMILY PROTECTION FUND 2706-44030 $ - $ _ JUVENILE CRIME& DELINQUENCY FUND 271544030 $0.00 $ - LANGUAGEACCESSFUND 272544030 $ 21.00 $ - $ - $ 27.00 $ 48.00 PRE-TRIALOIVERSON AGREEMENT 2729-44034 $ 100.00 $ 100.00 LAW LIBARY FEE 2731-44030 $ 245.00 $ 315.00 $ 560.00 RECORDS MANAGEMENT FEE - COUNTYCLERKK 2738-44380 $ - $ 3,250.00 $ 3,250.00. RECORDS MANGEMENT FEE - COUNTY 2739-44030 $ 230.00 $ 166.94 $ 135.00 $ 531.94 FINES -COUNTY COURT 2740-45040 $ 2,522.42 $ 2,522.42 BOND FORFEITURE 2740-45050 $ 122.00 $ 122.00 STATE POLICE OFFICER FEES -STATE (DES) (20%) 7020-20740 $ - $ - CONSOLIDATED COURT COSTS -COUNTY 7070-20610 $ - $ _ CONSOLIDATED COURT COSTS - STATE 7070-20740 $ - $ _ CONSOLIDATED COURTCOSTS -COUNTY "NEW20207072-20630 $ 151.00 $ 151.00 CONSOLIDATED COURTCOSTS-STATE •-NEW2020--7072-20740 $ 1,359.00 $ 1,359.00 JUDICIALAND COURT PERSONNELTRAINING-ST(300%7502-20740 $ - $ - $ - $ - DRUG& ALCOHOL COURT PROGRAM - COUNTY 7390-20610 $ - $ _ DRUG& ALCOHOL COURT PROGRAM -STATE 7390-20740 $ - $ _ STATE ELECTRONIC FILING FEE -CIVIL 7403-22887 $ $ - $ - $ _ STATE ELECTRONIC FILING FEE CRIMINAL 7403-22990 $ - $ _ EMS TRAUMA - COUNTY (10%) 7405-20610 IS 412.67 $ 412.67 EMS TRAUMA - STATE (90%) 7405-20740 $ 45.85 $ 45.85 CIVIL INDIGENT FEE -COUNTY 7490-20610 $ - $ $ - CIVILINDIGENTFEE -STATE 7480-20740 $. - $ - $ - JUDICIAL FUND COURT COSTS 7495-20740 $ - $ _ JUDICIAL SALARY FUND - COUNTY (10%) 7505-20610 $ - $ - JUDICIAL SALARY FUND -STATE (90%) 7505-20740 IS - $ - JUDICIAL SALARY FUND (CIVIL&PROBATE) -STATE 7505-20740-DOS $ - $ - $ _ TRAFFIC LOCAL (ADMINISTRATIVE FEES) 7538-22884,1000-44359 $ 6.48 $ 6.48 COURT COST APPEAL OF TRAFFIC REG (JP APPEAL) 7538-22885 $ - BIRTH - STATE 7855-20780 $ 174.60 $ 174.60 INFORMAL MARRIAGES -STATE 7855-20782 $ - $ - JUDICIAL FEE . 7855-20786 $ - $ - $ - $ _ FORMAL MARRIAGES - STATE 7855-20788 $ 180.00 $ 180.00 NONDISCLOSURE FEESTATE7855-20790 $ 28.00 $ - $ - $ - $ 28.00 TCLEOSE COURT COST- COUNTY (10%) 7856-20610 $ - $ _ TCLEOSE COURT COST- STATE (90%) 7856-20740 $ - $ - JURY REIMBURSEMENT FEE -COUNTY (10% 7857-20610 $ - $ _ JURY REIMBURSEMENT FEESTATE(90%) 7857-20740 $ - $ - CONSOLIDATED CRTCOSTS- STATE(PR, FAM, CV) SB417858.20740 IS 685.00 $ 137.00 $ 822.00 STATE TRAFFIC FINE - COUNTY ($%) 7860-20610 $ - $ - STATETRAFFICFINE - STATE (95%) 7860-20740 $ - $ - STATE TRAFFIC FINE -COUNTY(4%) 9/1/2019 7850-20610 $ 4.32 $ 4.32 STATE TRAFFIC FINE - STATE (96%)91112019 7860-20740 $ 103.73 $ 103.73 OF2 5:10.REPORTSIMONTMLYWUORORPNO TREASURER REPORT312020.U33120.TREgSVREft REPORTS 4R20I6 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION MARCH 2024 - OFFICIAL PUBLIC DESC. GLCODE CIVIL/FAMILY - CRIMINAL RECORDS PROBATE . TOTAL INDIGENT DEFENSE FEE -CRIMINAL -COUNTY (10%) 7865-20610 $ - $ - INDIGENT DEFENSE FEE -CRIMINAL -STATE (90%) 7865-20740 $ - $ - TIME PAYMENT - COUNTY (50%) 7950-20610 $ - $ - TIME PAYMENT -STATE (50%) 7950-20740 $ - $ - BAIL JUMPING AND FAILURE TOAPPEAR -COUNTY 7970-20610 $ _ BAIL JUMPING AND FAILURE TO APPEAR -STATE 7970-20740 $ - DUE PORT IAVACAPD 9990-99991.. $. 10.00 $ 10.00 DUE SEADRIFT PD ` 9990-99992 $ - $ - DUE TOPOINT COMFORT PD 9990-99993 $ $ DUE TO TEXAS PARKS &WILDLIFE. 9990-99994. $ - $ DUE TO TEXAS PARKS& WILDLIFE WATER SAFETY 9990-99995 $ - DUETOTABC 9990-99996 $ - DUE TOATTORNEYADLITEMS 9990-99997 $ - DUE TOOPERATING/NSF CHARGES/DUE TO OTHERS 7120-20759 $ $. $ 60.00 $ 1,000.00 $ 1,060.00 $ 2.559.00 $ 5.852.00 $ 16,213.00 $ 3,883.00 $ 28,507.00 TOTAL FUNDS COLLECTED $ 28,507.00 - FUNDS HELD INESCROW: $ - AMOUNT DUE TO TREASURER(2DR'S): 1$ 27,437.00 TOTAL RECEIPTS: $. : 28,507.001 AMOUNT DUE TO OTHERS (LESS EPA): $ 1,070.00 :GINNING BOOK B. FUND RECEIVED DISBURSEMENTS ENDING OUTSTANDING DEPOSITS" OUTSTANDING CHECKS` $ 649,631.62I $ 4,921.00 -BALANCE OF CASH BONDS" "OTHER REGISTRY ITEMS' -IBC CASH BOND CHECKS" 3/31/2024 $ 855,140.12 I "TOTAL REGISTRY FUNDS- Reconciled. $ CERTIFICATES OF DEPOSITS HELD IN TRIIST- PRDSPFRITY RANK CD'S Data Issued ':. Balance Purchases/. Withdrawals Balance. '-212912024 Interest 03/31/24 10440. 1/24/2018 $ $ $ 10441 1/24/2018 $ $ 10442 1/24/2018 $ 1,306.78 $ 1,306.78 10443 1/25/2018 $ 1,306.78 $ 1,306.78 10444 1/25/2018 $ 9,868A1 $ 9.868.41 10445 1/25/2018 $ 9,868.41 $ 9,868.41 10446 1/25/2018 $ 9,868.41 $ 9,868.41 10449 6/9/1955 $ 20,937.43 $ 20,937.43 10454 3/2/2018 $ $ 10455 3/2/2018 $ $ 10486 8/26/2020 $ 6,056.57 $ 6,056.57 10495 12/22/2021 $ 34,995.25 $ 248.05 $ 35,243.30 10496 12/22/2021 $ 34,995.23 $ 248.05 $ 35.243.28 10504 2/14/2023 $ 11,240.79 $ 11,240.79 10506 2/14/2023 $ 9,538.84 $ 9,538.84 TOTALS: $ 149,982.90 $ 496.10 $ $ 160,479.00 ( h 00 �l - /A � 412/2024 Submitted by: Anna M Goodman, County Clerk Date ,C Ri and Mayer, Calhoun I ly Jutlge Date 2 OF S10.REP0RT MONTHLIMUOROR AND TREASURER REPORTSI CMT33124.TREASURER REPORTS 4122024 OFFICE FUND 12,815.10 COURTFACILITYPROTECTION JUDICIAL SCOURT PERSONNELTRAINING FUND 9.49 COASTALTYAND OURT FUND 2,]69,855.36 ICIAL JURORDSALARIES FUND DIU COUNTYAND DAB COURT TECH FUND 9,927.01 CRIME VICTIMS FUND JURURLE 028.00 1,028.00 COUNTY CHILD PREVENTION FUND 007.68 PROBATION JUVENILEPROBATIONRESTITUTION 162.42 WELFARE BOAR COUNTY CHILD WELFARE BOARD FUND GIEOUS MEMORIAL COURTHOUSE FUND 3.921.04 MISCELL MISCELLANEOUS CLEARING 14,881.42'. 14,881..06 0.104.82 COURTHOUSE SECURITY 218.209.06 STATE CL DISCLOSURE FEE FUND COURT FUNDON REFUNDABLEDLNUN 2,787.00 DISTCUNRECODGUARERVATIP PRESERVATION FUN 42.719.97 FUND 41.360.79 STATE STATE CIVIL FEE FUND 96 781.38 FUND COURT RECORDS ARCRVEF FUND - COURT FORTE S CIVIL JUSTICE STILE DATA REPOSITORY FUND COCLK 6,199.83 FUND 912A64.83 REIMBURSEMENT FEE 3.51 COUNTY SPECIALTY COURT FUND 12,664d9 STATERY STATECONSOLIDATEDC CONOLIDATET (DATED CIVIL FEE FUND 461.84 DISPUTE RESOLUTION RESOLUTION FUND SUBTITLE - FUND 3,540A2 3,640.42 DONATYDISPUTE 52.930.62 DONATIONS - 127,164.38 OFC (MIN TIME OFCRIM INDIGENT DEFENSE WI MFUND-LOCAL 27p94.38 DRUGJUVENILE TRAFFI 94.]] UVENI ECASE MANAGER ECASEMAN FUN FUND '_ 4,866.35 LAW FAILURE TO APPEAR 14.45 82 1514.52 FAMILY 19,385.76 UNCI-AIMED UNCLAIMED PROPERTY A 45,171-43 EDELINTIONFU P JUVENILE DELINQUENCY PREVENTION FUND JUVENILE AND DIVERSION FUND 17t43 7,977.23 GRANTS 992.66720 BOOT CYPREVENTfON BOOTAEP 141.97 JUSTICE COURT TECHNOLOGY 94,987.80 JUVENILE PROBATION 222,801.97 FUND 3,736.50 LATERJUSTIAL PRELOINGSEDDRITV LATERAL ROAD PRECINCT#1 3,736.60 LATERAL ROAD PRECINCT#2 3.736.60 - LATERAL ROAD PRECINCT#3 3.736.50 - LATERALROADPRECINFUND '3.736.34 TOTAL OPERATING FUNDS 6$T02,5p829 3,194.50 JUROR DONATIONS JUROR DONATIONS SOCIETY DAFORFEITED 54.78949 VETERAES SERVICES 1.402.94 JURORDONATIONSCOU IONSVETRT SHERIFF NARCOTICSFORFEITURES NARCOTICS FORFEITURES _ 5,117.33 RISUPPORT FUND FUN CENT OF OBCRTHOUSE IBS SERIES 2012 29,258.00 330,823.75 PRETRIAL SERVICES89A67.33 30,103.90 CAL OFEES&FIINES AS SERIES 2012 30,623,$9 LOCALTLSERVICESFUNO LAWUBRUANCY PREVENTIONIOIVERSION FUND - CAL CO FEESSFI 07,717.60 LAW LIBRARY 228.867.60 TOT TOTAL OTHER COUNTY FUNDS 565,398.10 95$398.19 LAW ENFOFFICERS STD. EOUC.(LEOSE) 18,85Z54 18,162.26 MEMOROPERAWLMEDICAL CENTER EC RDSMAITYCENTER RECORDS MANAGEMENT -DISTRICT CLERK RECORDS 969,216.06 923.15 CLERK 287.651.23 RECORDS MGMT&P NDI ENTHTING INDIGENT 9,435.66 RECORDS PRESERVATION 91,651.23 RIVATE WAIVER CLEARING FUND 4 EWANERCTION ROAD IDGE&PRESERVATION 1,740,464.79 SG CLINIC CLINIC CONSTRUCTION SERIES 2014 541.17 541.11 IODREMDGEGEN FUN OPIOOTIEMEOIATIONFUND NH ASHFORD 172,314.111 16.393,01 INSUIUMAINTBAYOU SMILE PIRIBOAT RAMPPROJ NH 111,mids - BOGGY NATURE 93,883.07 CAPITAL PROD- BUGGY BN ACT CRESCENT NH FORT 162,776.86 271,410.08 RESCUE PLAN ACT 2021 1,248.615.00 CAPITAL PROJ- RESCUE PLAN SEND NH FORT 62,459.57 KINGFI H CAPITAL PROJ-KINGFISHER BEACH PARK 4Q615.67 NH 318,098.34 CAPITAL PROJ MAG_INDRINFASTRUCTPAVILIONS 18],168.57 GOLDEN NH GOLDEN CREEK 18,096.34 CAPITAL PROD- CDBG DR INFRASTRUCTURE NH - CAPITAL CDBG-MIT INFRASTRUCTURE 499,999.77 ASHFORDACA NH ASHFURDDACA - 169.699J7 ITALPPROd PROJ BOAT RAMP 169,596.01 CAPITALPROJCHOCTION NH DACA - MACHINES CAPITAL PROJ -ELECTIOSISTANNES I9.74 GULF POINT NH GULF POINT-LAZATEPAY 3,210.24 CAPITAL PROJ-LOCAL NBIBALCONSIE 116,809.14 CAREITAEDICAID NH GULFBETHAN INFRASTRUCTURE 224,245.44 CAPITAL PROJ BINFRASTRUCT SENIOR LIVN NHBETHANY SENIOR LIVING 1,599.00 ENEPORTRU fit 149,841.30 CAPITAL P NE NHTUSCANY 148,599.00 143,205.56 CAPITAL PROJ ROJ IMPROVEMENTS 70,000.00 MONEY MARKET $ BEACH EROSION CONT 79.927.00 CAPITAL PROJ MAGNOLIA BEACH TOTAL MEMORIAL MEDICAL CENTERS 3,M,T19.54 9,258,860.06 CAPITAL PROJ EVENT CENTER ]8;921.09 EVENT KS & SAFETY EQUIP CAPITAL PROJ FIRE EN DRAINAGE DISTRICTS 8,449.79NO. L CAPITAL PROJ-GREENLAKEPARK . 8,984J0 NO.8 48.832.58 - CAPITAL PROD HATEROGBA NO.3 148,832.59 CAPITAL PRO OUIMP IMPRBOAT OVEMENTS BEACH fi,210.00 NO.10-MAINTENANCE 111.2m273.632.80 CAPITAL PROJ PURT ALTO PUBLIC 0.00 PORT NO. 11-MAINTENANCE/OPERATING 273,632.19 18 CPRJALPJANPOINT LINER RESTORATION 98,7/6.60 NO. ii-RESERVE Z!7.78677 CAPITAL PROJ RRICANEHARVEYSTORATION TOTAL DRAINAGE DISTRICTS $ 801,91T.89 IMPROVEMENTS PROJEMA CAPITAL PROP IMPROVEMENTS PROJECTS - CARJ-MAN POINT ITALIMBULKHEAD IMPROVEMENTS 39,602.66 CAPITAL FROM HOSPTALIMPROVEMENTS OPERANCOACCOUNID#1 UPERATINGACCOUNT 1]1,70171 _ 1,900,000.00 CAPITAL PROJ -JMGLOANS 1,901,108.80 PAYROLL TAX BO FEES 1,795.00 TOTAL WCID 4,603.11 114,603.11 BAIL BAIL BLIND FEES (HE C 383.14 CONSOLIDATED COURT COSTS COURT CALHDUNCOUNTY PORT AUTHORITY 2020 5.512.11 CONSOLIDATED COURT COSTS 2020 15,255.79 MAINTENANCE ANO OPERATING $ 89,842.0] DNA TESTING FUND 250.79 DRUG COURT PROGRAM FUND -STATE O.T9-CALHOUN COUNTY. ELECTION SERVICES CONTRACT 72,15127 (FROST BANK. $ 1,885.87 ELECTRONIC FILING FEE FUND 30.88 We the lgned County Judge and Commissionersin and farC ou�ty Texas herebyceNfy Matwe have made an examinafion ofNe County7masurefs qua f m,i%filedwimusanthbdayodhwefoundthesame becnepta dedueooder, er, unty en M o�nerP^ct se�m99yssy, Commeaimer put Jost&h ns, Pct3 Gary Pess mmieabner Pc `r T ANO SUBSCRIB O ME, County Judge, andCounty Condssbneas Need Column County each respeadvety, h da S. Kekena, RECORDED THIS-Lday of -2024 i to Anna Goodman.G COUNTY TREASURER'S REPORT MONTH OF: DECEMBER 2023 BEGINNING ENDING FUND FUNDBALINCE RECEIPTS DISBURSEMENTS FUNDBALINCE OPERATING FUNDS -BALANCE FORWARD S 4Q465,534.74 $ 2,379,240.39 $ 3,235,491.70 $ 43,609,283.43 ELECTION SERVICES CONTRACT $ 69,807.01 14,501.11 12,156.85 S 72,151.27 ELECTRONIC FILING FEE FUND $ 0.56 30.30 $ 30.86 EMS TRAUMA FUND 396.56 463.75 S 860.31 FINES AND COURT COSTS HOLDING FUND 7.847,31 S - 7,847.31 INDIGENT CIVIL LEGAL SERVICE 57.3D S 57.30 JUDICIAL FUND(ST. COURT COSTS) 0.00 S - JUDICIAL & COURT PERSONNEL TRAINING FUND 4.49 5.0D S 9.49 JUDICIAL SALARIES FUND 143.44 104.61 S 248.05 JUROR DONATION -TX CRIME VICTIMS FUND 1.028.00 $ 1,028.00 JUVENILE PROBATION RESTITUTION 87.57 100.00 25.00 $ 162.57 LIBRARY GIFT AND MEMORIAL 42,573.27 13.15 S 42,596.42 MISCELLANEOUS CLEARING 14,931.68 1,775.60 1.726.22 $ 14,881.06 STATE CRIMINAL NON DICLOSURE FEE FUND S REFUNDABLE DEPOSITS 2,000.00 $ 2,00D,00 STATE CIVIL FEE FUND 409.35 378.61 $ 7B7.96 CIVIL JUSTICE DATA REPOSITORY FUND 1.02 0.36 $ 1.38 JURY REIMBURSEMENT FEE 91.20 42.31 S 133.51 STATE CONSOLIDATED CIVIL FEE FUND 1,609.84 852.00 S 2,461.84 SUBTITLE C FUND 2,518.87 1,321.55 S 3,840.42 SUPP OF CRIM INDIGENT DEFENSE 46.12 20.65 $ 66,77 TIME PAYMENTS 15.66 78.79 S 94.45 TRAFFIC LAW FAILVRETO APPEAR 1,255.78 259.04 S 1,514.82 UNCLAIMED PROPERTY 42,395.45 3,034.73 $ 45.430.18 TRUANCY PREVENTION AND DIVERSION FUND 155.99 15.44 S 171.43 BOOT CAMP/JJAEP 147.43 $ 147.43 JUVENILE PROBATION 265.667.58 34802,09 77867.70 $ 222601.97 S 44,918,626.22 $ 2,437,039.48 $ 3,327.267.47 S 44,028,398.23 SUBTOTALS TAXES IN ESCROW 13.303.086.40 851.679.25 0.00 14154765.65 $ 58,221,7I2,62 $ 3,288,718.73 $ 3.327867.47 S 511,183,163.88 TOTAL OPERATING FUNDS OTHER FUNDS D A FORFEITED PROPERTY FUND 39,852.70 50.77 39,903.47 SHERIFF NARCOTIC FORFEITURES 54,857.51 69.98 138.00 54,789.49 CERT OF OB-CRTHSE REF SERIES 2010 309,476.02 19,781.98 329,258.00 CERT OF OB-CRTHOUSE I&S SERIES 2012 30.517.92 305.83 30,823.73 CAL. 00. FEES & PINES 81 827.35 98.693.05 79 997.01 100 623.39 S 51 118901.61 80.03S.01 S 555. ILIA TOTAL T E C FUNDS MEMORIAL MEDICAL CENTER OPERATING 2,483,212A6 S 4,470.115.31 S 5,985,859.68 $ 967,468.09 MONEY MARKET 2,099,979.79 S 4,800.76 $ 11000,000.00 $ 1,104,779.54 INDIGENT HEALTHCARE 10,482.55 4.206.79 5,472.68 9,216.66 PRIVATE WAIVER CLEARING FUND 435.11 0.55 435.66 CLINIC CONSTRUCTION SERIES 2014 540A8 0.69 541.17 NH ASFORD 159,188.05 520.934.53 500808.40 172,314.19 NH BROADMOOR 127,921.99 449,901.16 465,950.92 111,872.23 NH CRESCENT 111,787.42 652,970.14 581,980.70 182,776.86 NH FORT BEND. 55,880,70 223,649.39 217,07012 62,459.87 NH SOLERA 107,833.94 576,857.95 384,470.35 300,221.54 NH GOLDEN CREEK 26,776.21 452,107.17 46D,787.04 18,096.34 NH SOIERA DATA 0.00 0.00 NH ASHFORD DACA NHBROADMOORDACA 0.00 0.00 0.00 0.00 NH GULF POINTE-PRIVATE PAY 5,483.99 21,501.93 23.775.68 3,210.24 NH GULF POINT PLAZA MEDICARE/MEDICAID 11,142.13 169,093.88 176,572.97 3,663.04 NH BETHANY SENIOR LIVING 207,531.49 649,941.29 6B5,873.78 171,599.00 NHMSCAWVTLLAGE 241.903.42 340.07242 433770.20 1482D5.64 $ 5,649,098.72 S 8.536,153.96 $ 10.928,392.62 $ 3256860.06 TOTAL MEMORIAL MEDICAL CENTER FUNDS DRAINAGE DISTRICTS NO.6 40,10964 329.92 $ 40,439.56 NO.8 147,491.16 1,341.42 148,832.58 NO. 10-MAINTENANCE ]",056.81 2.872.49 35702.50 111,226.80 NO. ILMAINTENANCE/OPERATING 261,585.29 21,148.87 9.101.98 273,632.18 NO. II -RESERVE 227496.95 289.82 =786.77 $ 820739.BS $ 25.982.52 $ 44,804A8 $ $01 17.89 TOTAL DRAINAGE DISTRICT FUNDS CALHOUN COUNTY WCID BI OPERATING ACCOUNT $ 175.511.07 917.64 3,588.31 $ 172,840.40 PAYROLLTAX S 1.930.63 167.9E 1 S 1762.71 TOTAL WCID FUNDS 177441.70 917.64 3.756.23 S 174603.11 CALHOUN COUNTY PORT AUTHORITY MAINTENANCE AND OPERATING S 89095.95 S 846.12 S 89942.07 CALHOUN COUNTY FROST BANK $ 1890.57 5.00 S 1985.87 TOTAL MMC, DR. DIST., NAV. DIST, WCID & FROST $ 6,738,267.09 $ 8,563MI9,24 $ 10,976,958.33 S 4A25,209.00 Page 2 of 3 COUNTY TREASURER'S REPORT MONTH OF: DECEM1B1ER 2023 BANKMBCONCILIATION LESS: CERT.OF DEN FUND OUTSTNDGDEPI PLUS: CHECKS BANK FUND BALANCE OTHER ITEMS OUTSTANDING VALANCE OPERATING* $ 58,183,163.88 599,248.38 8 7,282,412.26 51,500,000.00 OTHER D A FORFEITED PROPERTY FUND 39,903.47 39,903.47 SHERIFF NARCOTIC FORFEITURES 54,789.49 82.00 54.871.49 CERT OF OB-CRTUSE REP SERIES 2010 329,258,00 329,258.00 CERT OF OB-CRTHOUSE I&S SERIES 2012 30,823.75 30,823.75 CAL. CO FEES &PINES 100.623.39 4,842.64 8,197.93 103,978.68 MEMORIAL MEDICAL CENTER OPERATING * 967,468.09 824,677.98 1,792,146.07 MONEY MARKET 1,104,779.54 1,104,779.54 INDIGENT HEALTHCARE 9,216.66 582,14 9,798.80 PRIVATE WAIVER CLEARING FUND 435.66 435.66 CLINIC CONSTRUCTION SERIFS 2014 541.17 541.17 NH ASFORD 172,314.18 172,314.18 NH 13ROADMOOR 111,972.23 111,872.23 NH CRESCENT 182,776.86 182,776.86 NH FORT SEND 62,459.87 62,459.87 NH SOLERA 300,221.54 300,221.54 NH GOLDEN CREEK 18,096.34 18.096.34 NH SOLERA DACA 0.00 0'00 NH ASHFORD DACA p 00 0'00 NH BROADMOOR DACA 0.00 0.00 NH GULF POINT PAY 3,663.04 24 3,663.04 PLAZAS NH GULF PD84TEPLLIV MEDICARE/MEDICAID NH BETHTUSCAN llViNG 1,599.04 148,205.64 1,599.00 148,205.64 VILLAGE VILLA NHINAGE I48,205.64 148,205.W I DRAINAGE DISTRICT: NO.6 40,439.56 40,439.56 NO.8 148.832.58 148,832.58 NO. 10 MAINTENANCE 111,226.80 111,226.80 NO. 11 MAINTBNANCE/OPERATING 273,632.18 840.00 274.472.18 NO. 11 RESERVE 227.786.77 227,786.77 CALHOUN COUNTY WCU9 Nl OPERATING ACCOUNT 172,840.40 172,840.40 PAYROLL TAX 1.762.71 1,762.71 CALHOUN COUNTY PORT AUTHORITY MAINTENANCE/OPERATING *"** 89,942.07 89,942.07 CALHOUN COUNTY FROSTSANK 1,885.87 1,885.87 TOTALS is i ; 5 i ;q xxxx THE DEPOSITORY FOR CALHOUN COUNTY WCID IS INTERNATIONAL BANKOF COMMERCE -PORTLAVACA THE DEPOSITORY FOR CALHOUN CO. NAVIGATION DISTRICT IS FIRST NATIONAL BANK PORT LAVACA *" THE DEPOSITORYFOR CALHOUN COUNTY FROST IS FROSTBANK-AUSTIN, TEXAS xxxx EASTWEST BANK CD. -$23,701, 191.53 - xsxx NEXBANK MONEY MKT ACCr, DALLAS, TEXAS $30,21q03386 THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS PROSPERITY BANK. PORT LAVACA Court costs and fees collected and reported may not be current and up-to-dalXdw non -co pHat ce o 1 n office . I lereby certify that the torten[ balances are correc[ to all monies that have been re�eo y teas s pott. OA S. KOKENA Page 3 of 3 CALHOUN COUNTY, TEXAS COUNTY TREASURER'S REPORT MONTH OF: DECEMBER2023 BEGINNING ENDING FUND PUNDBAJANCE RECEIPTS DISBURSEMENTS FUNDBAL4NCE OPERATING FUNDS: GENERAL S 27,300,129.37 $ 2,126,71101 $ 2,836,112.29 5 26,590,750.09 AIRPORT MAINTENANCE 17,W5.70 13,105.27 1,517.12 S 30,633.85 APPELLATE JUDICIAL SYSTEM 110.48 85.03 S 195.51 COURTFACILITY FEE FUND 12,471.25 343.85 S 12,815.10 COASTAL PROTECTION FUND 2,806,281.81 867.12 37,229.50 S 2.769,919.43 COUNTY AND DIST COURT TECH FUND 9,790.14 65.22 $ 9,855.36 COUNTY CHILD ABUSE PREVENTION FUND 910.79 16.82 $ 927.61 COUNTY CHILD WELFARE BOARD FUND 2,007.06 0.62 S 2,007.68 COUNTY]URYFUND 3,805.74 115.30 S 3,921.04 COURTHOUSE SECURITY 258,772.67 1,332.13 $ 260,104.82 COURT INITIATED GUARDIANSHIP FUND 18.023.49 185.57 S 18,209.06 DIST CLK RECORD PRESERVATION FUND 41,690.43 29.54 $ 42,719,97 COURT REPORTERS SERVICE FUND 1.328.96 31.83 $ 1,360.79 CO CLK RECORDS ARCHIVE FUND 342,514.00 2,685.93 S 345,199.83 COUNTY SPECIALTY COURT FUND 12,325.84 338.25 $ 12,664.09 COUNTY DISPUTE RESOLUTION FUND 32,261.01 373.79 $ 12.634.80 DONATIONS 152,874.94 890.79 834.91 $ 152,930.82 DRUG/DWJ COURT PROGRAM FUND -LOCAL 27,175.80 858 $ 27,18438 JUVENILE CASE MANAGER FUND 8,032.92 50.31 442.10 $ 7,641.13 FAMILY PROTECTION FUND 14,661.82 4.53 $ 14,666.35 JUVENILE DELINQUENCY PREVENTION FUND 9,382.86 2.90 $ 9,385.76 GRANTS 1,194,794.18 1.861.39 268.678.34 $ 927,977.23 JUSTICE COURT TECHNOLOGY 92,251.69 415.52 $ 92,66720 JUSTICE COURT BUILDING SECURITY FUND 4,929S7 11.83 8 4,941.80 LATERAL ROAD PRECINCT 01 3,735.35 1.15 $ 3.736.50 LATERAL ROAD PRECINCT#2 3,735.35 1.15 S 3,736.50 LATERAL ROAD PRECINCT#3 3,735.35 1.15 S 3,736.50 LATERAL ROAD PRECINCT 94 3,735.35 1.15 S 3,736.50 LANUAGE ACCESS FUND 3,615.2E 121.12 S 3,736.34 JUROR DONATIONS -HUMANE SOCIETY 3.193.51 0.99 S 3,19450 JUROR DONATIONS VETERANS SERVICES 1,402.51 R43 S 1,402.94 JUSTICE COURT SUPPORT FUND 14,537.84 579.49 S 15.117.33 PRETRIAL SERVICES FUND $9,639.78 27.70 $ 89,667.48 LOCAL TRUANCY PREVEN770NRDIVERSION FUND 29,662.55 441.35 $ 30,103.90 LAW LIBRARY 208,374.15 923.39 1.579.94 S 207,717.60 LAW ENFOFFICERS STD. EDUG (LEOSE) 28,848.69 8.91 $ 28,857.6D POC COMMUNITY CENTER 19,451.03 4,701.01 5,277.20 $ 18,874.94 RECORDS MANAGEMENT -DISTRICT CLERK 148.41 13.85 S 162.26 RECORDS MANAGEMENT -COUNTY CLERK 246,147.09 Z776.06 $ 248.923.15 RECORDS MGMT&PRESERVATION 66.753-51 897.72 $ 67,651.23 ROAD&BRIDGE GENERAL 1,721,557.37 23.3D4R7 S 1,745.161.44 OPIOD REMEDIATION FUND S 40,432.29 12.50 S 40,464.79 6MILE PIERBOAT RAMP INSUR/MAINT 16,387.95 5.06 $ 16.393.01 CAPITAL PROI- BOGGY BAYOU NATURE PARK 393,883.07 S 393,883.07 CAPITAL PROD- AMERICAN RESCUE PLAN ACT 2021 1,313,795.38 42.375.30 $ 3,271,410.08 CAPITAL PROM- KING FISHER BEACH PARK 48,615.00 $ 48,615.00 CAPITAL PROI MAG_INDIANOLA BEACH PAVILIONS 167.166.67 S 167.166.67 CAPITAL PROD- CDBG DR INFRASTRUCTURE 683,654.55 6,050.00 S 677,604.55 CAPITAL PROJ -CDBG-MCT INFRASTRUCTURE 499,999.77 $ 499,999.77 CAPITAL PROD CHOCOLATE BAYOU BOAT RAMP 169,595.01 $ 169,595.01 CAPITAL PROD- ELECTION MACIRNES (0.00) $ (O,OD) CAPITAL PROJ-LOCAL ASSISTANCRARIBALCONSISTPNCY 175.809.74 S 175,809.74 CAPITAL PROJ- OLIVIA HATERIUS PARK IMPROVEN1S 112,392.00 S 11239200 CAPITAL PROD -"INFRASTRUCTURE 224,245.44 $ 224,245.44 CAPITAL PROD ENERGY TRZ#1 149,841.30 $ 149.841.30 CAPITAL PROD- BRIGH77N ROAD BRIDGE 938,500.DD $ 938500.00 CAPITAL PROJ AIRPORT RUNWAY IMPROVEMENTS 77.461.35 S 77,461,35 CAPITAL PROI MAGNOLIA BEACH EROSION CONT 70,000.00 S 70,000.00 CAPITAL PROD- EMS TRAINING BUILDING 275,000.00 S 275,000.00 CAPITAL PROD EVENT CENTER 79,927.09 S 79,927.09 CAPITAL FEW FIRE TRUCKS & SAFETY EQUIP 6,448.68 S 6,948.68 CAPITAL PROJ-GREEN LAKE PARK 8.984.79 31.640.00 31.640.00 S 8,984.79 CAPITAL PROM HATERIUS PARK/BOAT RAMP $ CAPITAL PRO HOG BAYOU IMPROVEMENTS S 6.276.69 $ 6,276.69 CAPITAL PROI PORT ALTO PUBLIC BEACH Boa $ 0.00 CPRJ- SWAN POINT SHORELINE RESTORATION S 98.776.OD $ 98,776.00 CAPITAL PROJ HURRICANE HARVEY FEMA - S - CAPITAL PROJ IMPROVEMENTS PROJECTS $ CPRJ- SWAN POINT BULKHEAD IMPROVEMENT 15,000.00 3,755H0 3,755.0D S 15,000.00 CAPITAL FEW HOSPITAL IMPROVEMENTS 2,339,602.66 $ 2,339,602.66 CAPITAL PROJ-MMC LOANS 1,750,000.00 150,D00.00 $ 1,900,000.00 ARRESTFEES 922.65 185.95 S 1,108.6D BAIL BOND FEES (HE 1940) 510.00 283.09 $ 795.OD CONSOLIDATED COURT COSTS (NEW) 969.80 413.34 $ 1.383.14 CONSOLIDATED COURT COSTS 2020 7.928.37 7,583.74 $ 15,512.11 DNATFSTTNGFUND 251.92 3.87 S 255.79 DRUG COURT PROGRAM FUND -STATE 0.60 0.19 $ 0.79 SUBTOTALS S 44.465.534.74 $ 2.379.2Z 9 S 3235.491.70 43.609.283.43 Page J of CALHOUN COUNTY, TEXAS COUNTY TREASURER'S REPORT MONTH OF: JANUARY 2024 BEGINNING ENDING FUND FUNDBAIANCE RECEIPTS DISBURSEMENTS FUNDBALANCE OPERATING FUNDS: GENERAL $ 26,59D,750.09 $ 16.736,249.12 $ 2,491,963.05 $ 40.835,036.16 AIRPORT MAINTENANCE S 30,633.85 43.010.89 10,228.96 S 63.415.78 APPELLATE JUDICIAL SYSTEM $ 195.51 131.17 S 326.68 COURT FACILITY FEE FUND $ 12,815.10 528.96 S 13,344.06 COASTAL PROTECHON FUND $ 2.769,919.43 984.65 7,549.74 $ 2,763,354.34 COUNTY AND DIST COURT TECH FUND S 9.855.36 43.13 S 9,898.49 COUNTY CHILD ABUSE PREVENTION FUND $ 927.61 28.52 $ 956.13 COUNTY CHILD WELFARE BOARD FUND S 2,OD7.68 40.71 $ 2,049.39 COUNTY JURY FUND $ 3,921,04 57.96 S 3.979.00 COURTHOUSE SECURITY $ 260,104.82 1,455.49 S 261,560.31 COURT INITIATED GUARDIANSHIP FUND $ 19.209.06 96.47 $ 18,305.53 DIST CLK RECORD PRESERVATION FUND $ 42,719.97 45,19 $ 42,765.16 COURT REPORTERS SERVICE FUND $ 1,36B79 13.59 S 1,374.38 CO CLK RECORDS ARCHIVE FUND $ 345,199.83 3,312.71 $ 348,512.54 COUNTY SPECIALTY COURT FUND $ 12,664.09 220.70 S 12,884.79 COUNTY DISPUTE RESOLUTION FUND S 12,634.80 512.79 S 13,147.59 DONATIONS S 152,930.82 1,818.06 663.77 $ 154,085.11 DRUCIDWI C0URT PROGRAM FUND-L0CAL $ 27,184.38 15.60 $ 27,199.98 JUVENILE CASE MANAGER FUND $ 7.641.13 63.03 445.28 $ 7,258.88 FAMILY PROTECTION FUND S 14,666.35 5.21 S 14,671.56 JUVENILE DELINQUENCY PREVENTION FUND $ 9.385.76 3.34 S 9,389.10 GRANTS $ 927,977.23 96,627.11 10,603.45 S 1.014,000.89 JUSTICE COURTTECHNOLOGY $ 92,667.20 377.55 $ 93,044.75 JUSTICE COURT BUILDING SECURITY FUND $ 4,941.80 17.36 S 4,959.16 LATERAL ROAD PRECINCT RI S 3,736.50 1.33 $ 3,737.83 LATERAL R0AD PRECINCT 02 $ 3,736.50 1.33 $ 3.737.83 LATERAL R0AD PRECINCT k3 $ 3,736.50 1.33 S 3,737.83 LATERAL R0AD PRECINCT84 S 3,736.50 1.33 $ 3.137.83 LANUAGE ACCESS FUND $ 3,736.34 148.99 $ 3,895.33 JUROR DONATIONS -HUMANE SOCIETY $ 3,194.50 161.14 S 3,355.64 JUROR DONATIONS VETERANS SERVICES S 1.402.94 80.50 S 1,483.44 JUSTICECOURT SUPPORT FUND S 15,117.33 580.37 S 15,697.70 PREIRIALSERVICFS FUND $ 89,667.48 31.87 $ 89,699.35 LOCAL TRUANCY PREVENTION/DIVERSION FUND S 30,103.9D 363AS $ 30,467.38 LAW LIBRARY S 207.717.60 991.54 1,745.94 $ 206,963.20 LAW ENF OFFICERS STD. EDUC. (LEOSE) S 28.857.60 10.26 $ 28,867.86 POC COMMUNITY CENTER S 18,874.94 30,956.71 2,325.11 $ 47,506.44 RECORDS MANAGEMENT -DISTRICT CLERK $ 162.26 31.03 S 193.29 RECORDS MANAGEMENT -COUNTY CLERK S 248,923.15 3,318.49 1.26 $ 252,240.38 RECORDS MGMT & PRESERVATION $ 67,651.23 1,052.40 S 68,703.63 ROAD&BRIDGE GENERAL $ 1.745.161.44 115,937.67 600,ODO.00 S 1.261.099.11 OPIOD REMEDIATION FUND S 40.464.79 14.38 $ 40.479-17 6MILE PIERSOAT RAMP INSURIMAINT $ 16,393.01 5.83 165.011 $ 16,233,84 CAPITAL PROD- BOGGY BAYOU NATURE PARK S 393,883.07 $ 393.883.07 CAPITAL FEW- AMERICAN RESCUE PLAN ACT 2021 $ 1.271,410.09 121,925.45 $ 1,149.584.63 CAPITAL PROJ- KING FISHER BEACH PARK S 48,615.00 $ 48.615.OD CAPITALPROJ MAG_INDIANOLA BEACH PAVILIONS S 167,166.67 $ 167,166.67 CAPITAL PROJ- CDBG DR INFRASTRUCTURE $ 677,60455 105,860.51 $ 783,465.06 CAPITAL FEW -CDBG-MIT INFRASTRUCTURE is 499,999.77 $ 499,999.77 CAPITAL PROJ CHOCOLATE BAYOU BOAT RAMP $ 169,595.01 S 169,595.01 CAPITAL PROJ. ELECTION MACHINES S (0.00) $ (O,DO) CAPITAL PROJ-LOCAL ASSISTANCFVTBMAL CONSISTENCY $ 175,809.74 I4,625.00 $ 161.184.74 CARTA1,P90/-1AILROOF - 500,000.00 $ 500,000.00 CAPITOL PROD- OLIVIA HATFRIUS PARK IMPROVMFNTS $ 112,392.00 S 112.392.00 CAPITAL PROD-RB INFRASTRUCTURE $ 224,245.44 S 224.245.44 CAPITAL PR0J ENERGY TRZ 01 $ 149,841.30 $ 149,841.30 CAPITAL PRO]- BRIGHHI ROAD BRIDGE S 938.500.00 $ 938,500.00 CAPITAL PROD AIRPORT RUNWAY IMPROVEMENTS $ 77,461.35 $ 77,461.35 CAPITALPROJ MAGNOLIA BEACH EROSION CONT S 70,000.00 S 70,000.00 CAPITAL PROJ- EMS TRAINING BUILDING $ 275,000.00 S 275.000.00 CAPITAL PROJ EVENT CENTER $ 79,927.09 $ 79,927.09 CAPITAL PROD FIRE TRUCKS & SAFETY EQUIP $ 6,448.68 $ 6.448.68 CAPITAL PROJ- GREEN LAKE PARK $ 8,984.79 S 8.984.79 CAPITAL PROJ HATERIUS PARKBOAT RAMP S $ CAPITAL PRO HOG BAYOU IMPROVEMENTS $ 6,276.69 S 6,276.69 CAPITAL PROD PORT ALTO PUBLIC BEACH is O.OD $ ODO CPRJ- SWAN POINT SHORELINE RESTORATION S 98,776.00 $ 98,776.00 CAPITAL PRO] HURRICANE HARVEY FEMA S - $ . CAPITAL PROD IMPROVEMENTS PROJECTS $ $ CPRJ- SWAN POINT BULKHEAD IMPROVEMENT $ 15,000.00 S 15,000.00 CAPITAL PROI HOSPITAL IMPROVEMENTS $ 2,339,602.66 $ 2,339,602.66 CAPTTALPROJ-MMC LOANS $ 1,90,000.00 150,000.00 $ 2,050,000.00 ARREST FEES S L108.60 144.80 S 1,253.40 BAIL BOND FEES (HB 1940) $ 795.00 $ 1,455.00 CONSOLIDATED COURT COSTS (NEW) $ 621fifiD.00 77 $ 2,011.91 CONSOLIDATED C0URT COSTS 2020 $ 15:f.383.14 512,11 6,562.47 S 22.074.58 DNATESTINGFIIND $ 255' 791 3.23 $ 259.02 DRUG COURT PROGRAM FUND -STATE 0.79 5.93 S 6.72 S 17.803.215.00 S 3.262.142.01 $ 58150,356.42 SUBTOTALS $ 43.609.283.43 Page I of 3 COUNTY TREASURER'S REPORT MONTH OF: JANUARY 2024 BEGINNING ENDING FUND OPERATING FUNDS -BALANCE FORWARD FUNDBAIINCE $ RECEIPTS DISBURSEMENTS FUND BALiNCB SERVICES CONTRACT 43.609,283.43 $ $ 17,803,215.00 S 3,262,142.01 $ 5S150,356.42 ELEELECTRON FILING FEE FUND 72,151.27 $ 25.57 $ 72.176.84 rMS TRAUMA EMS TRAUMA FUND 30.86 91.8g $ 122.74 PINES AND COURT COSTS HOLDING FUND 860.31 259.59 $ 1,119.90 INDIGENT CIVIL LEGAL SERVICE 7,847.31 5].30 $ 7,847.37 JUDICIAL FUND (ST. COURT COSTS) 0 D0 $ 57,3U JUDICIAL& COURT PERSONNEL TRAINING FUND 9.49 $ JUDICIAL SALARIES FUND 249.49 . 1500 $ 24.49 JUROR DONATTON-TX CRIME VJC➢MS FUND 1 248.05,20D 21.00 $ 467.88 JUVENILE PROBATION RESTITUTION 162.57 40'00 $ 1,068.00 LIBRARY GJFT AND MEMORIAL 42,586.42 145.09 100.00 $ 207.66 MISCELLANEOUS CLEARING 14,881.0E 15.14 S 42601,56 STATE CRIMINAL NON DISCLOSURE FEE FUND 0.00 3,808.16 2.415.21 S 16,274.01 REFUNDABLE DEPOSITS 2'ODO'00 STATE CIVIL FEE FUND 767.96 $ 2,ODOAD CIVIL JUSTICE DATA REPOSITORY FUND 481.10 $ 1.269.06 JURY REIMBURSEMENT FEE 138 133.51 0.61 $ 199 STATE CONSOLIDATED CIVIL FEE FUND 62.84 S 196.35 SUBTTTLECFUND _,461.84 3,840.42 2,444.14 LMS.44 $ 4,905.58 SUPP OF CRIM INDIGENT DEFENSE 66.77 S 5,155.86 TIME PAYMENTS 31.27 S 98.04 TRAFFIC LAW FAILURE TO APPEAR 94.45 1,514.82 60.96 $ 155.41 UNCLAIMED PROPERTY 45.430,18 980.81 S 2,495.63 TRUANCY PREVENTION AND DIVERSION FUND 0.39 $ 45,430.56 BOOT CAMP/JJAEP 171.43 27.20 5 198.63 JUVENILE PROBATION 147.43 1 $ 147.43222601.97 SUBTOTALS $ 44,028,398.23 377.465.13 $ 18,190,705.14 63.801.31 $ 3,328,458.56 53fi,265.76 $ TAXES IN ESCROW 14.154.765.65 SA,536.265.7 4.81 TOTAL OPERATING FUNDS $8183163.88 $ 18190705.14 14154 ]fi5.65 0.00 17483224.21 $ 58890644.81 OTHERFUNDS D A FORFEITED PROPERTY FUND 39,903.47 45.38 SHERIFF NARCOTIC FORFEITURES 54,789.49 6,174.52 33,774.33 CERT OF OB-CRTHSE REF SERIES 2010 329.251140 69.55 CERT OF 08-CRT14OUSE I&S SERIES 2012 30,823.75 344,843.12 283.65.33 390,335.9 CAL. CO. FEES & FINES 100.623.39 300.74 79 I40.56 2409 3131,7124.49 5 90.603.81 MEMORIAL MEDICAL CENTER OPERATING MONEY MARKET 967,468.09 S 3,828,711.15 $ 3,501,606.29 $ 1,294,572.95 INDIGENT HEALTHCARE 1.104,779.54 S 1.825.65 S 500,00D.00 5 606,605.19 PRIVATE WAIVER CLEARING FUND 9,216.66 009.76 4,201.04 9,92538 CLINIC CONSTRUCT70N SERIES 2014 435.66 541.17 0.55 436.2I NH ASrORJBROAD NH 172,314.18 0.69 637,947.52 481.635.64 541.21 86 328.626.06 CRESCENT NH CRESCENT 111,872.23 555,40L47 346,232.65 321,041.05 NH FO 182,776.86 901,721.00 652,643.34 431,854.52 NH SOLDLERA 62,459.97 244.995.73 224,018.37 83,437.23 NH GOLDEN EN CREEK 300,221,54 662,100.48 512982.16 449,339.86 SOLERA NH DACA 18,096.34 541,291.40 253.963,37 305A24.37 ASHFOR NH SIHORD DACA 0.00 0.00 NH BROADMOOR DACA ODU NH GULF POINTS- PRIVATE PAY 0.W 3,663.04 19,399.82 0.00 NH GULF POINT PLAZA MEDICARE/MEDICAID 3'�3'� 248,919.51 22,286.06 324.00 NH 13EMANY SENIOR LIVING I71,599.00 81,196.69 171,385.86 NH TUTOTAL VILLAGE 148.205.64 763,967.54 433,096.48 502.470.06 TOTAL MEMORIAL MEDICAL CENTER FUND$ $ 3256.8fi0.06 774636.72 $ 399055.24 523787.12 9185.828.99 S 7.9I2.917.33 $ 5.0±9 ]71.72 DRAINAGE DISTRICTS NO.6 NO, B 40,439.56 714.02 $ 41,153.58 NO. 10-MAINTE14ANCE 148,832.59 111.226.80 5,396.99 500.00 153,729.57 NO. II-MAINTENANCFIOPERATING 273.632.18 10,319.04 12,615.00 108,93084 NO. 11-RCSERVE 227786.77 41,23%78 1,750.62 313,121.34 TOTAL DRAINAGE DISTRICT FUNDS S 801917.89 289.40 S 57.959.23 228.076.17 $ 74.865.62 845011.50 CALHOUN COUNTY WCIDMI OPERATING ACCOUNT PAYROLLTAX S 172,840.40 854D9 13,117.89 $ 160,576.60 TOTAL WCID FUNDS S 1762.71 S 174603.11 854.0 167.92 S 1.594.79 CALHOUN COUNTY PORT AUTHORITY 13285,81 162171.9 $ 89942.07 $ 1.713.51 MAINTENANCE AND OPERATING 91655.58 CALHOUN COUNTY FROST BANK $ 1885.87 $ 5.00 S 1880.87 $ 4 325 9.00 $ 9 ?46 J55.82 $ TOTAL MMC, DR. DIST., NAV. DIST, WCID &FROST TOTAL ALL FUNDS $ 63,063,770.98 $ 27.861,46031 7.441.073.76 $ 29,305,095.63 $ 130 091.06 $ 65.620.135.66 Page 2 of 3 (nTTNTV 1MVAcr]nnnOc+,,,,,........ - - -- - - - a�anaa o iLL`,i' V1C 1 BANKRECONCILlATION MONTH OF: JANDARY 2029 LESS: CERI..OF DER/ FUND FUND OUTSTNDGDEPI PLUS. -CHECKS BANK BALANCE OTHER ITEMS OUTSTANDING BALANCE OPERATING • S 58,890,6a1.81 1,266,156,54 601.277.33 $ 6,725,765.62 OTHER 37,500,000.00 D A FORFEITED PROPERTY FUND SHERIFF NARCOTIC FORFEITURES 33,774.33 33.774.33 33,7]4.33 CERT OF OB-CRT74SE REF SERIES 2010 354,605.04 335 82.00 33774.33 CERT OF OB-CRTHOUSE I&$ SERIES 2012 2q q� 31 49 5.47 354:687.04 32 CAL. CO FEES & PINES 89.160.14 44.96 31.079.53 23.194.89 16,912.20 82.877.45 MEMORIAL MEDICAL CENTER OPERATINGi MONEY MARKET 1,294,572.95 6 606,fi05.19 94I,876.51 2,236,449.46 INDIGENT HEALTHCARE 9.925.38 606,605.19 6605.19 PRIVATE WAIVER CLEARING FUN 4,897.40 436.21 4,703.18 736 CLINIC CONSTRUCTION SERIES 2014 21 436,21 NH ASFORD 541,86 328,626.06 541.86 NH BROADMOOR NH CRESCENT 321,041.05 328,626.06 NH FOLERA 483,437.23 NH SOLDE 83,437.23 431,954.05 43I,854.52 52 NH GOLDEN CREEK 449,339.86 83,437.23 NH DACAD 305,424.37 449.339.86 A NH SHFOR ASH FORD DACA 000 305,424.37 NH BROADMOOR DACA 0.00 0.00 NH GULF POINT PRIVATE PAY 0.00 0.003M.00 NH GULF NTE MEDICARE MEDICAID 0.00 314.00 NH BEDIAN SENIOR SENIOR LIVING IV 171,385.86 502,470.06 171,385.86 TUSCAN R INAGE I TRICT:VILLAGE DRAINAGE DISTRICT: 52378712 502,470.06 523,787,12 NO.8 NO. 10 MAINTENANCE 41.153.58 230.74 153,729.57 1.945.05 500.00 84 NO. 1l MAIMENANGE/DPERATING 108.930.84 152,284.52 52,294.52 NO. li RESERVE 13,999.03 3,999.03 100,615.22 228.076.17 228.071.17 299,122.31 CALHOUN COUNTY WCID pI 28,076.17 OPERATING ACCOUNT PAYROLL TAX 160,576.60 CALHOUN COUNTY PORT AUTHORITY 1,594.79 160,576.60 MAINTENANCE/OPERATING xxa. MAINTE 1,594.79 91,655.58 CALHOUN COUNTY 91,655.58 FROSTBANK 1,880,87 OT LS 656T0135.66 5294310970 1 fi5351.M ,880.87 THE DEPOSI TORY FOR CALHOUN COUNTY WCID 1S INTERNATIONAL BANK OF COMMERCE- PORT LAVACA •"' THE DEPOSITORY FOR CALHOUN CO. NAVIGATION DISTRICTIS FIRST NATIONAL BANK-PORTLAVACA •"" THE DEPOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK- AUSTIN, TEXAS EASTWEST BANK CDs-$23,80B253.56 ax"" NEXBANK MONEY MKTACCT, DALLAS, TEXAS-$30,354,349.98 THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS PROSPERITY BANK, PORT LAVACA Court costs and fees collected and reported may not be current and o- due to non -comp ance y her county offices. I hereby certify that the current balances are correct to all monies at hav ben Fee( ed by Count easurer s of th date of this report. $'1 y RHO AS.K KE A - COU*YTREASURER Page 3 of w w w R q`��$iam$`rryi r`�`r�p nuOpp1i vrr`S_'yyB 6% `ry�ryi. o�8�yy 0 0 re VVein mmm ,n,pp (a(yy 9o9 O1N'In��WM'Nw PI�NOP r 'MNIONQwO R w �41 A'10 l� ry P P 3 aw w w P � P P a �w w rC'.m8np^e$rA1818.�mR`�^miA,�588ScP��$�}}8r8r'Rr�Bml:'P�o^mr"�y#J7'L,m `fin ��BiS °'iarr°{N RR rVaryu�m�rNN.'v `'�oddcnffi9{ry v �ry1ry8 h8 ryNryO'OIN{�S O h�wlpS" MM'�P��R afa'g'g.-'� 0�(OMM 8r! �� $$6 pmo C,P WOIn Ww pp ,,//�� ypp mm mmpp pr ,/�ry�p y� y�pw l�l Orp NvV�O ,4N Gc1 ry4ry��m11M�,Nw� � rNyh�rpn 0l0, N,OC O yy pN lP r�3N{ryQ pqN, RM$ NS CS �f11mNm(1_N Yw{N{yy NIO m N SV H E W EWE E 9 pQ�,yNp rON ^mW� N PNNb�P MWn� h10V V n OfpNMNtO�`�fC mOlwOp Of!prm„ bONN�OWR$rp rP y,P�wB�SRM 0 irl�ryw NT{t�yW�gN�pM Ot�wW �w,Nwm 01 �p Y1 C rX OOOOrr$PO N� O`R Wg$m p RPM EE ® O$� pq��pp V rd y� ry pp 6 �.i M rd pp n' 10NR PNf �- aR�RRR W��p �N IOAP CC �NQ r w Nnn w w 2 ry n si w w z LL �- rcw Q � U rcrc w wd O FU¢ 4 tlOOyw Y YQ-,W W � 4 zoo x1-w ao> Qa Q�cwn FQF F`UF UWW WW�W `2 �C•NN .z ��6Z6' F� UrNNOW60 LL'=w j 00 O�-�0p °W' o FQ„LLJ HyWEz�:o (oWe (sWe z'�LLQO�o woFa um� °`Li'dwgi`G=QZQ¢Cc ui�_Roaa' iY wFf, oS O0moo9 WUY Y00E ��O¢¢- 0HLL0LL. w FLLOOW .U>UOHl OyQx woo0ixNs ,°0� <<WL �_¢Ko=2¢Ko=Qup2Ca¢¢ wyW3o��Q�W�63�O. wWWLLz9F�WfxrcJxrcFpW 2QmULL0UUUU JOw''QQu_zzzzzzzzgEmfLLYppK Nm �W N w mw �NO 3E$3E$ Wn !1 N w q C 88 $N OS uumll R ry g w r Uw P o asg �ggN B F ( u S y W m9 eO YYYuyxY�m i s W g Y zo r �FHFFF � NwwwN U 2 4 � aQ yQ r/a�lia 2 W W W W W 9 EN I ER MONTH OF REPORT ENTER YEAR OF REPORT CODE AMOUNI CASH BONDS 0.00 ADMINISTRATION FEE -ADMF 20.00 BREATH ALCOHOL TESTING - BAT 0.00P CONSOLIDATED COURT COSTS -CCC 743.34 STATE CONSOLIDATED COURT COST-2020 3,457.01 LOCAL CONSOLIDATED COURT COST-2020 760.61 COURTHOUSE SECURITY -CHS 74.34 CJP 0.00 CIVIL JUSTICE DATA REPOSITORY FEE -CJDR 0.03 CORRECTIONAL MANAGEMENT INSTITUTE - CMI 0.00 CR 0.00 CHILD SAFETY - CS 0.00 ' CHILD SEATBELT FEE -CSBF 0.00 CRIME VICTIMS COMPENSATION -CVC 0.00 DPSC/FAILURE TO APPEAR -OMNI-DPSC 155.72 ADMINISTRATION FEE FT VFTP (eke OMNp-2020 133.59 ELECTRONIC FILING FEE -EEF 0.00 FUGITIVE APPREHENSION -FA 0.00 GENERAL REVENUE -GR 0.00 CRIM- IND LEGAL SVCS SUPPORT-IDF 37.17 JUVENILE CRIME & DELINQUENCY -JCD 0.00 JUVENILE CASE MANAGER FUND -JCMF 95.00 JUSTICE COURT PERSONNEL TRAINING -JCPT 0.00 JUROR SERVICE FEE -JSF 74.34 LOCAL. ARREST FEES -LAF 187.88 LEMI 0.00P LEDA 0.00 LEOC 0.00 OCL 0.00 PARKS& WILDLIFE ARREST FEES -PWAF 145.24 STATE ARREST FEES -SAF 33.59 SCHOOL CROSSING/CHILD SAFETY FEE- SCF 0.00 SUBTITLEC -SUBC 0.00 STATE TRAFFIC FINES -EST 9.1.19-STF 869.16 TABC ARREST FEES -TAF 0.00 TECHNOLOGY FUND -TF 74.34 TRAFFIC-TFC 0.00 LOCAL TRAFFIC FINE-2020 52.16. TIME PAYMENT -TIME 25.00 TIME PAYMENT REIMBURSEMENT FEE-2020 713.56 TRUANCY PREVENTION/DIVERSION FUND -TPDF 35.17 LOCAL& STATE WARRANT FEES -WRNT 944.16 COLLECTION SERVICE FEE-MVBA- CSRV 2,953.31 DEFENSIVE DRIVING COURSE -DOC 0.00 DEFERRED FEE - OFF 66.00 DRIVING EXAM FEE- PROV OIL 0.00 FILING FEE -FFEE 54.00 STATE CONSOLIDATED CIVIL FEE-2022 315.00 LOCAL CONSOLIDATED CIVIL FEE-2022 495.00 FILING FEE SMALL CLAIMS- FFSC 0.00 - -JURY FEE -JF 0.00 COPIES/CERTIFED COPIES -CC 0,00 INDIGENT FEE -CIFF or INDF 0.00 JUDGE PAY RAISE FEE -JPAY 111.51 'SERVICE FEE -SFEE 150.00 OUT -OF -COUNTY SERVICE FEE 0.00 ELECTRONIC FILING FEE -EEF CV 0.00 EXPUNGEMENTFEE-EXPG 0.00 EXPIRED RENEWAL -EXPR 0.00 ABSTRACT OF JUDGEMENT -AOJ 0.00 ALLWRITS-WOP/WOE 0.00 DOB FTA FINE -DPSF 1,465.86 LOCAL FINES - FINE 8,756.09 LICENSE & WEIGHT FEES -LWF. 0.00 PARKS & WILDLIFE FINES - PWF . 4,891.00 SEATBELT/UNRESTRAINED CHILD FINE - SEAT 0.00 CIAL& COURT PERSONNEL TRAINING-JCPT 0.00 OVERPAYMENT(OVER$10)-OVER 0.00 OVERPAYMENT($10 AND LESS) -OVER 0.00 RESTITUTION -REST 0.00 KS & WILDLIFE-WATERSAFETY FINES-WSF I 0,00 MARINE SAFETY PARKS & WILDLIFE - MSO 0,00TOTAL ACTUAL MONEY RECEIVED nnnro cur ENTER LOCAL WARRANT STATE WARRANT OTHERS: CCISD - 50%'of Fine on JV cases DA RESTITUTION. FUND I OF OVERPAYMENTS COUNTY SERVICE FEE TOTAL DUE TO REVISED 02/02/2022 ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT U.UU PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0.00 PLEASE INCLUDE DR. REQUESTINGDISBURSEMENT 0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT 0. 00 PLEASEINCLUDE OR REQUESTING DISBURSEMENT(IFRECUIRED) ACTUAL Treasure's Receipts MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 4/2/2024 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: MARCH YEAR OF REPORT: 2024 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45011 FINES 10,975.60 CR 1000-001-44190 SHERIFF'S FEES 1,232.54 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 52.16 ADMINISTRATIVE FEES 219.59 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 271.75 CR 1000-001-44010 CONSTABLE FEES -SERVICE 150.00 CR 1000-001-44061 JP FILING FEES 54.00 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 713.56 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 2.953.31 TOTAL FINES, ADMIN. FEES & DUE TO STATE $16,350.76 CR 2670-001-44061 CR 2720-001-44061 CR 2719-001-44061 CR 2699-001-44061 CR 2730-001-44061 CR 2669-001-44061 CR 2728-001-44061 CR 2677-001-44061 CR 2725-001-44061 CR 7020-999-20740 CR 7070-999-20610 CR 7070-999-20740 CR 7072-999-20610 CR 7072-999-20740 CR 7860-999-20610 CR 7860-999-20740 CR 7860-999-20610 CR 7860-999-20740 COURTHOUSE SECURITY FUND $328.97 JUSTICE COURT SECURITY FUND $18.59 JUSTICE COURT TECHNOLOGY FUND $297.37 JUVENILE CASE MANAGER FUND $95.00 LOCAL TRUANCY PREVENTION & DIVERSION FUND $278.79 COUNTYJURYFUND $5.58 JUSTICE COURT SUPPORT FUND $375.00 COUNTY DISPUTE RESOLUTION FUND $75.00 LANGUAGE ACCESS FUND $45.00 STATE ARREST FEES DPS FEES P&W FEES TABC FEES DR 7070-999-10010 � : � • •kSi[�I�S[�] DR 7860-999-10010 DR 7860-999-10010 49.28 29.05 0.00 TOTAL STATE ARREST FEES 78.33 CCC-GENERAL FUND 74.33 CCC-STATE 669.01 743.34 STATE CCC- GENERAL FUND STATE CCC- STATE 345.70 111.31 STF/SUBC-GENERAL FUND 0.00 STF/SUBC-STATE 0.00 0.00 STF- EST 9/1/2019- GENERAL FUND STF- EST 9/1/2019- STATE Page 1 of 3 869.16 34.77 834.39 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 4/2/2024 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: MARCH YEAR OF REPORT: 2024 CR 7950-999-20610 TP-GENERAL FUND 12.50 CR 7950-999-20740 TP-STATE 12.50 DR 7950-999-10010 25.00 Page 2 of 3 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 4/2/2024 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: MARCH YEAR OF REPORT: 2024 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 3.72 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 33.45 DR 7865-999-10010 37.17 CR 7970-999-20610 TUFTA-GENERAL FUND 51.91 CR 7970-999-20740 TUFTA-STATE 103.81 DR 7970-999-10010 155.72 CR 7505-999-20610 JPAY - GENERAL FUND 11.15 CR 7505-999-20740 JPAY - STATE 100.36 DR 7505-999-10010 111.51 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 7.43 CR 7857-999-20740 JURY REIMB. FUND- STATE 66.91 DR 7857-999-10010 74.34 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.00 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.03 DR 7856-999-10010 0.03 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 17.59 7998-999-20701 JUVENILE CASE MANAGER FUND 17.59 DR 7998-999-10010 35.17 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 315.00 315.00 TOTAL (Distrib Req to Oper Acct) $23,771.83 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 4,157.35 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $4,157.35 TOTAL COLLECTED -ALL FUNDS $27,929.18 LESS: TOTAL TREASUER'S RECEIPTS $27,929.18 REVISED 02/02/2022 OVER/(SHORT) $0.00 Page 3 of 3 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 45385 PAYEE Name: Calhoun County Oper. Acct. Address: City: State: Zip: Phone: PAYOR Official: Title: Hope Kurtz Justice of the Peace, Pct. 1 ACCOUNT NUMBER DESCRIPTION AMOUNT 7541.999-20759-999 JP1 Monthly Collections - Distribution $23,771.83 MARCH 2024 V# 967 9 L,---7f Signature of Official Date TOTAL 23,771.83 VV VRL NMMC. ENTER MONTH Or REPORT ENTER YEAR OF REPORT CASH " ADMINISTRATION FEE - BREATH ALCOHOL TESTING CONSOLIDATED COURT COSTS STATE CONSOLIDATED COURT COST LOCAL CONSOLIDATED COURT COST COURTHOUSE SECURITY CIVIL JUSTICE DATA REPOSITORY FEE - CORRECTIONAL MANAGEMENT INSTITUTE CHILD SAFET CHILD HEATBELT.FEE - CRIME VICTIMS COMPENSATION DPSC/FAIT I IRF Tn A..Ce. n-- FU CRIM - IND.I JUVENILE CF JUROR SERVICE .FE LOCAL ARREST FEE PARKS& WILDLIFE ARREST FEES - - STATE ARREST FEEE SCHOOL CROSSING/CHILD SAFETY FEE :SUBTITLE C- STATE TRAFFIC FINES-EST'9.1.1 TABC ARREST FEEE TECHNOLOGY FUN TRAFFIC LOCAL TRAFFIC FINE TIME PAYMENT UtreNJIVt URIV DE 'DRIVING E STATE CONSOLIDATED DI LOCAL CONSOLIDATED Cl .'FILING FEE SMALL( COPIES/CERTIFEE INDIGENT FEE ^inner eno e.,. Reg OUT -OF -COUNTY ELECTRONIC FILING -EXPUNGEMEN -EXPIRED REN ABSTRACT: OF JUDE ALL WRITS COPS FT) LOCAL LICENSE & WEIGH' PARKS & WII I'd IFF OVERPAYMENT (,I avvspurt-MBU TOTAL ACTUAL MONEY RECEIVED. $1 YPE: OTAL WARRANT FEES ENTER LOCAL WARRANT FEES STATE WARRANT. FEES UE TO OTHERS: UE TO CCISD- 50%of Fine on JV DBGeG UE TO DA:RESTITUTION FUND EFUND OF OVERPAYMENTS UT -OF -COUNTY SERVICE FEE ASH BONDS TOTAL DUE TO OTHERS. 3EASURERS RECEIPTS FOR MONTH: A N•'0.00 0.00 0.00 163.36 1,841.27 323.62 21.74 0.00 0.41 0.00 0.00 0.00 0.00 0.00 96.14 123.52 0.00 0.00 0.00 10.87 0.00 22.27 0.00 21.74 55.07 OAO.: 0.00 0.00 0.00 0.00 82.67 0.00 34.03 593.48 0.00 21.74 3.42 34.24 23.76 128.11 8.87 793.54 1.452.31 10.00 60.00 0.00 0.00 336.00 - 528.00 OAX) 0.00 0.00 0.00.... 32.63 300.00 ` 0.00 r 0.00 0.00 0.00 0.00 0.00 556.94 3,681.39 0.00' 63.47 0.00 0.00 0.00 0.50 0.00 0.00 . 0.00 1,431.10:. AMOUNT>- 793.54:: 484.83 RECORDONTOTALPAGE DFHILL COUNTRY SOFTWARE MO. REPORT $308.71.: RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWANE MO. REPORT AMOUNT - 0.00 PLEASE INCLUDE OR REQUESTING DISBURSEMENT 0.00 PLEASEINCLUDE D .MQUESTINGDISBURSEMENT 0.00 PLEASE INCLUDE DR REQUESTING DISBURSEMENT. 0.00 PLEASEINCLUDE D.R.REQUESTINGOISERSEMENT 0.00: PIEASEINCLUOED.RREQUESONGDISSURSEWW(IFREQUIRED) $0.00 MOUNT 431.10 Calculate From ACTUAL Treasumes Receipts 431.10 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 4/1/2024 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: March YEAR OF REPORT: 2024 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45012 FINES 4,247.85 CR 1000-001-44190 SHERIFF'S FEES 853.00 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 10.00 CHILD SAFETY 0.00 TRAFFIC 37.66 ADMINISTRATIVE FEES 189.52 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 237.18 CR 1000-001-44010 CONSTABLE FEES -SERVICE 300.00 CR 1000-001-44062 JP FILING FEES 0.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.50 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 128.11 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 1,452.31 TOTAL FINES, ADMIN. FEES & DUE TO STATE $7,218.95 CR 2670-001-44062 COURTHOUSE SECURITY FUND $129.57 CR 2720-001-44062 JUSTICE COURT SECURITY FUND $5.44 CR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $114.20 CR 2699-001-44062 JUVENILE CASE MANAGER FUND $22.27 CR 2730-001-44062 LOCAL TRUANCY PREVENTION & DIVERSION FUND $115.58 CR 2669-001-44062 COUNTY JURY FUND $2.31 CR 2728-001-44062 JUSTICE COURTSUPPORT FUND $400.00 CR 2677-001-44062 COUNTY DISPUTE RESOLUTION FUND $80.00 CR 2725-001-44062 LANGUAGE ACCESS FUND $48.00 STATE ARREST FEES DPS FEES 78.28 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 78.28 CR 7070-999-20610 CCC-GENERAL FUND 16.34 CR 7070-999-20740 CCC-STATE 147.02 DR 7070-999-10010 163.36 CR 7072-999-20610 STATE CCC- GENERAL FUND 184.13 CR 7072-999-20740 STATE CCC- STATE 1,657.14 DR 7072-999-10010 1,841.27 CR 7860-999-20610 STF/SUBC-GENERAL FUND 1.70 CR 7860-999-20740 STF/SUBC-STATE 32.33 DR 7860-999-10010 34.03 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 23.74 CR 7860-999-20740 STF- EST 9/1/2019- STATE 569.74 DR 7860-999-10010 593.48 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 4/1/2024 CR 7950-999-20610 CR 7950-999-20740 CR 7480-999-20610 CR 7480-999-20740 CR 7865-999-20610 CR 7865-999-20740 CR 7970-999-20610 CR 7970-999-20740 CR 7505-999-20610 CR 7505-999-20740 CR 7857-999-20610 CR 7857-999-20740 CR 7856-999-20610 CR 7856-999-20740 CR 7502-999-20740 7998-999-20740 7998-999-20701 7403-999-22889 7858-999-20740 COURT NAME: JUSTICE OF PEACE NO. 2 MONTH OF REPORT: March YEAR OF REPORT: 2024 TP-GENERAL FUND 11.88 TP-STATE 11.87 DR 7950-999-10010 23.75 CIVIL INDIGENT LEGAL-GEN. FUND 0.00 CIVIL INDIGENT LEGAL -STATE 0.00 DR 7480-999-10010 0.00 CRIM-SUPP OF IND LEG SVCS-GEN FUND 1.09 CRIM-SUPP OF IND LEG SVCS-STATE 9.78 DR 7865-999-10010 10.87 TUFTA-GENERAL FUND 32.05 TL/FTA-STATE 64.09 DR 7970-999-10010 96.94 JPAY - GENERAL FUND 3.26 JPAY-STATE 2937 DR 7505-999-10010 32.63 JURY REIMB. FUND- GEN. FUND 2.17 JURY REIMB. FUND- STATE 19.57 DR 7857-999-10010 21.74 CIVIL JUSTICE DATA REPOS: GEN FUND 0.04 CIVIL JUSTICE DATA REPOS.- STATE 0.37 DR 7856-999-10010 0.41 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 TRUANCY PREVENT/DIV FUND - STATE 4.44 JUVENILE CASE MANAGER FUND 4.44 DR 7998-999-10010 8.87 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 STATE CONSOLIDATED CIVIL FEE 336.00 336.00 TOTAL (Distrib Reg to OperAcct) $11,377.15 DUE TO OTHERS (Distrib Reg Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 53.95 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $53.95 TOTAL COLLECTED -ALL FUNDS $11,431.10 LESS: TOTAL TREASUER'S RECEIPTS $11,431.10 OVER/(SHORT) $0.00 Page 2 of 2 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 45383 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Thomas Dio Address: Title: Justice of the Peace, Pct. 2 City: State: Zip: Phone: ACCOUNT NUMBER . - _ DESCRIPTION- - 'AMOUNT 7542-999.20759.999 JP2 Monthly Collections - Distribution $11,377.15 March 2024 V# 967 TOTAL 11,377.15 of Official k-J Date H n C w „ N H N r O r n n Z rn� N O O H 4 Z N A P H z. ry 3H3 ( N N W L9 H Y Y H 9 N .W.. H [`~" aT.pO'p R zoo k+ N Cn' NH r r [n0303Z Z N4„mom ZHH Y N o04 H K HOMCOOC m on t0 9 q [��1 m O H m \\ N w N [b9 H �CpO}+ y m% m m b b p O O m O z w H� N m [�•J r£+ \\ Mp�� OCMH 0 ((o+ m p H W H W 0 7 p a O W-H Z r� L*mJ CC 3+ N ."'. Ow o' m 0 C W m,vKp HmmrCmm r H N w H 3w3o.0 gmgH W<<W omc C Hw rmNb20 m m 3 Z 2 m 5 M O Cd H [+1 o m 2 C Z o H5 mwN H K amm a M n 0 ,b b.. 0.-. IPHmmmz „ z m z n N' N mm OmYK P O\NYH HN P. Hr m m0 ^ w z m m c n zzz zzzzzzzzzzzzzzzzzzzzzzzz 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 non" D0 o n 0 0 0 0 0 0 n 0 0 0 n 0 0 0 0 n n 0 0 0 0 0 0 0 00 0 0 �' mmm 0 0 0 0 0 0 0 0 o 0 0 0 0 0 0 0 0 0 0 0 mcon �mmntam[O+1 to e0i tma�wmedimmmtgf mtcn [qa cma N N W J W N N Vi a m N N Y+ N W N a O O O O O O O O g O O O O O O O O O N O O O O O O O m O O Y N V W J J m W (n (n O O O O O O O O O O O O O Y O O O O O O O W O O O 000 0 p 0 0 0 0 0 O 0 0 0 0 0 0 H 0 0 0 0 0 0 4 W 0 0 O O o O O O O O O O O O O O O O O O N O O O O O O O W O O N Y N p N W N a W a O W O o a o b o O p q q O o o O O O O O O Y O o O O O O O O o O O tp O o p q o 0 o p o Q o o Q o 0 0 o g o 0 o q o o p 4 0 0 o q o N N W J N J b N m N W N N N W m a 00 O O O O O O O O O O O O O O O O O O N O O d O O O 0.00 O O O o r W O O Or O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O N H O W J LO O tJ to m m N W W Y N W W N t0 a N m W W N O o Q N O O o F+ m O U a O W O m W a W O 00. N O O O O O O O O O O N T O H J O O O O O J O a O O O o Y O O O O O O O O O o Q O N O O O O O o o m O O N ✓ N F+ O O J W W N W Y i W O W �D O N O O m O O N O O V N O O w N O O O O N O N O O O O Q J O O O O O O O O O O m a O O O1 W O O O O O g O O1 W W N N Y Y N N o 0 0 o z 0 0 0 o y z K ro O .3! � rm 0 � 2 M H Sys yN O q MCA H OCCf K H 4 p y O C 2 M W y n � N � Y n [H+] N N 2 0 0 O �]pyp m an1 o N S N G h K c � n ro mm W pOi Nuy b N 01 H O H C [•1 N N � a ig H zH o n z� o o� N O e SHERIFF'S OFFICE MONTHLY REPORT Mar-24 BAIL BOND FEE $ 720.00 CIVIL FEE $ 588.85 CASH BOND $ 500.00 JP#1 $ 3,781.10 JP#2 $ - JP#3 $ 926.00 JP#4 JP#5 $ 494.00 SEADRIFT MUN. PC MUN $ 707.20 PROPERTY SALE $ 4,900.00 PRE-INDITMENT $ 500.00 TOTAL: $ 13,117.15 # 30 ' NOTICE OF MEEIING - 4/10/2024 30. Consider and take necessary action on any necessary budget adjustments. (RHM) 2023 RESULT: " APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall,,Lyssy, Behrens, Reese 2024 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 10 Mae Belle Cassel From: Erica.Perez@calhouncotx.org (Erica Perez) <Erica.Perez@calhouncotx.org> Sent: Tuesday, April 9, 2024 4:59 PM To: 'Angela Torres'; 'April Townsend'; kaddie.smith@calhouncotx.org; joel.behrens@calhouncotx.org; 'Commissioner Hall'; 'Gary Reese'; 'Lesa Jurek'; 'Lynette Adame'; maebelle.cassel@calhouncotx.org; 'Richard H. Meyer'; 'vern lyssy'; 'Bobbie Vickery'; 'Jenny McGrew'; Katie. Dennis@calhouncotx.org; candice.villarreal@calhouncotx.org Subject: 2023 and 2024 Regular and Public Budget Adjustments - 4/10/24 Attachments: 2023 Budget Adjustments 2024.04.10.pdf, 2024 Budget Adjustments 2024.04.10.pdf; 2023 Budget Adjustments for Public Hearing 2024.04.10.pdf; 2024 Budget Adjustments for Public Hearing 2024.04.10.pdf Attached are the Regular and Public Budget Adjustments for Commissioners Court in the morning. Thank you. Best regards, Erica Perez First Assistant Auditor Calhoun County zoa S. Ann, Suite B Port Lavaca, TX 77979 Phone: 361. 553.4612 Fax: 361.553.4614 Calhoun County Texas FUND NAME GENERAL FUND FUND NO: 1000 11111111111111111111111111 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I III I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I D I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: BUILDING MAINTENANCE DEPARTMENT NO: 170 JAMMA11111VrNO EBBS I meaum7DIDCOHNTYAimonvR/OVERDRAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS IUNDSAL REVENUE REVERIE EAPENDNRRE ENPEMIIEUNE INCREASE ACCT NU ACCT NAME 6MM NU NAB INCREASE DECREASE UICAEASE 0E01EASE [DECREASE] 50115 BUILDING MAINTENANCE SUPERINT 999 NO GRANT $0 $0 $98 SO ($98) 50295 CUSTODIAN 999 NO GRANT $0 $0 $171 $0 ($171) 50525 FOREMAN 999 NO GRANT $0 $0 $50 $0 ($50) 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $1 $0 ($1) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $0 $320 $320 65454 REPAIRS -COURTHOUSE AND JAIL 999 NO GRANT $0 $0 $0 $7,745 $7,745 73193 IMPROVEMENTS -FAIRGROUNDS 999 NO GRANT $0 $0 $7,745 $0 ($7745) AMENDMENTNOSS65 TOTAL $0 $0 $8,065 $8,065 $0 BUILDING MAINTENANCE TOTAL $0 $0 $8,065 $8,066 $0 III IIIIIIIIIIIIIII1111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIII III IIIIIIIIIIIIIIIIIIII111111B1111111111111111111111111111111111111IIIIIIIIIIIIIIilllllilllllll IIIIIIIIIIIB1111111111111111BII1111111111111111111111111IIIII III DEPARTMENT NAME: CONSTABLE -PRECINCT 91 DEPARTMENT NO: 580 EMOMENTNOL mm I REOUEl701bCOUNrrAUDnVJWVVERDRAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FED SAL REVENUE SEVEN] E UIPENDNNE ENPERI ME INCREASE ACCT M AUCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DEMUSE (DECREASE] 50205 CONSTABLE 999 NO GRANT $0 $0 $19 $0 ($19) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $26 $0 ($26) 51930 RETIREMENT 999 NO GRANT $0 $0 $1 $0 IV) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $6 $0 ($6) 53995 UNIFORMS 999 NO GRANT $0 $0 $0 $52 $52 AMENDMENT NO 6665 TOTAL $0 $0 $52 $52 $0 CONSTABLE-PRECINCT#1 TOTAL $0 $0 $52 $52 $0 Tuesday, April 9, 2024 Page 1 of 23 FUND NAME GENERAL FUND FUND NO: 1000 Ill IIIIIIIIIIIII IIIIIIIIIIIIIIIINIIIINI IIpIIIIIIIIIII IIIpIIIIIIIIppIIIIpIIppl IIIIIIIIIpppIIIDI1111111111111111111111i111111111111111111111111 IIIII IIIIIIIIIIIIIIIIIIIIIRIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllll llllllllllllllll DEPARTMENT NAME: CONSTABLE -PRECINCT 92 DEPARTMENT NO: 590 lAmmmeNrAw mm fiWVfiV7MGVUNrrAUDFsowrovERI7N$WN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND SAL ACCEN ACCTNAME SRANINO CRANE NAME REVERSE DSEASEAEASE R0IERSE EVEN = EKPM9ME INCREASE DECREASE SICREASE AEEIEASE(DECREASE 50205 CONSTABLE 999 NO GRANT $0 $0 $18 $0 ($18) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $26 $0 ($26) 51930 RETIREMENT 999 NO GRANT $0 $0 $1 $0 ($1) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $7 $0 53995 UNIFORMS 988 NO GRANT $0 $0 $0 $52 ($7) $52 AMENDMENTNO6665 TOTAL $0 $0 $52 $62 $0 CONSTABLE-PRECINCT92 TOTAL $0 $0 $52 $52 $0 11111111111111111111111111IIIII11111111111111111111IIIIIIII11111IIIIIillll111111111111111111111111111111111111111111111111111111111I11111IIIIIII111111111111111111111111111111111IIIII11111111111111111111111IIIIIIIIIIII DEPARTMENT NAME: CONSTABLE I111111111111111 -PRECINCT 03 DEPARTMENT NO: 600 lIVA MVrA-& BBB? REOUC871110CDONTYAUD/rOIVOYERORAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FIE SAL ACCTNo ACCIMAIfl: CRAKINO RAC REVERSE RICREASE REMUE DECREASE EAPENMME EA NRNRRE DECREASE INCREASE [DECREASE] MCREASE 50205 CONSTABLE 999 NO GRANT $0 $0 $18 $0 ($18) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $26 $0 ($26) 51930 RETIREMENT 999 NO GRANT $0 $0 $1 $0 ($1) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 AA11F Ta4uI.111 .o 11.1 l.ff1. n.,..... ... ...-..._ $0 $7 $0 ($7) CONSTABLE-PRECINCT#3 TOTAL $0 $0 $52 $52 $0 111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111I1111111111111111111111II IIIII111111111111111111111111111111111IIIIIIIIIIIII1111111111IIIII I1111111111111111111IIIIII1111111111111111111IIIII111111111111111111111111111111111111 DEPARTMENT NAME: CONSTABLE -PRECINCT #4 DEPARTMENT NO: 610 ma aay, npni a, zUzn Page 2 of 23 FUND NAME GENERAL FUND FUND NO: 1000 RBB nnununnnnnnnnnuuuunuunuunnmm11mnmm11munnnuumnumn nnnnn ORORRUBRRRRRBRBDeRRRnnunn 111111111111111111111111111111111111 nunnmm�l DEPARTMENT NAME: CONSTABLE -PRECINCT #4 DEPARTMENT NO: 610 JA ENOMEIYTIIICY 05NE I REIN/C670000UNTYAU511111/ MOVERMINNN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND BAL . REVENUE REVENUE EAPEIMURE ENPEIRITURE INCREASE ACIT. RI ACCT NAME CRANE ND CHIMNAINE INCREASE DECREASE INCREASE DECREASE BED_ 50205 CONSTABLE 999 NO GRANT $0 $0 $18 $0 ($18) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $26 $0 ($26) 51930 RETIREMENT 999 NO GRANT $0 $0 $1 $0 01) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $7 $0 ($7) 65180 RADIO MAINTENANCE 999 NO GRANT $0 $0 $0 $187 $187 71650 EQUIPMENT 999 NO GRANT $0 $0 $135 $0 ($135) AMENDMENT NO 6665 TOTAL $0 $0 $187 $187 $0 CONSTABLE-PRECINCT#4 TOTAL $0 $0 $187 $187 $0 III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II IIIII IIIIIIIIIIIII IIIIIp IIIIII I11111111111111111111111111111111111111111111111111iII1111111111111111111111111111111111111111111111111111111111111I1111111111111111111111i11 DEPARTMENT NAME: CONSTABLE -PRECINCT #5 DEPARTMENT NO: 620 DAIENYAar EBBE I REOUE87IDILCOUNTYAUE/f mvvERORAWR AMENDMENT REASON: JOVERDRAWN ACCOUNTS HE BAL REVENUE REVENUE EVERIRIRRE ENPEMNME INCREASE A T4T CCT NAME GRANT NO SMNE RAMS INCREASE DECREASE INCREASE DECREASE CECREASE 50205 CONSTABLE 999 NO GRANT $0 $0 $19 $0 ($19) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $26 $0 ($26) 53430 LAW ENFORCEMENT SUPPLIES 999 NO GRANT $0 $0 $0 $45 $45 AMENDMENT NO 6665 TOTAL $0 $0 $46 $45 $0 CONSTABLE-PRECINCT#5 TOTAL $0 $0 $45 $45 $0 nunnnnunnnunuuuuuunmuuuunnnunnnnmumm�nnnmm�nnnnnnnmm�mununnunnnnnnunnnnnnmm�nunnnnnnnnnnunnnunnununmm�nnnnnnnnnul DEPARTMENT NAME: COUNTY AUDITOR DEPARTMENT NO: 190 Tuesday, April 9, 2024 Page 3 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nunnuunu nuunn nnnnn nmm nnnunnununOUNDnn nnIIIURORRmuIIIIIIIIONIIII noon nnnunn nnnu nmm�nnnnunnnnnnnu u0unnnunnnnuunn nnunnnunn noon DEPARTMENT NAME: COUNTY AUDITOR DEPARTMENT NO: 1.90' WRIE111111111110I hVer EBSE I /PEOUES M&COONTYAUDnVJ OVERORASWY AMENDMENT REASON: JOVERDRAWN ACCOUNTS BAL REVENUE BEVENUE ERPEMMME EAPEIAINIIBE HIMEASE ACSTM AMI NAME MAW NO CRANE NAME INMEASE UEECRER8E INCBFASE BEMUSE NEMEASEI 50215 COUNTY AUDITOR 999 NO GRANT $0 $0 $77 $0 ($77) 50495 FIRST ASSISTANT COUNTY AUDITO 999 NO GRANT $0 $0 $0 $77 $77 AMENDMENT NO 6665 TOTAL $0 $0 $77 $77 $0 COUNTY AUDITOR TOTAL $0 $0 $77 $77 $0 III III IIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllll11111111111111111111IIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIillllllllllll II IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIII II Illilllllllllllllllllllllllllllllillllllllllllllllllllllllllllllll III DEPARTMENT NAME: COUNTY CLERK DEPARTMENT NO: 250 ENOMENrAo mw NEgf/EOW&COUAITYAUXIMMOVERORAWN AMENDMENT REASON: 1OVERDRAWN ACCOUNTS REVENUE REYBl�IEE EXPENMURE ENPENOI[UN HIMEASE ACCT 0 ACC! MANE GRAM RD GRANT NAME MCBEASE DECREASE MCNEASE BEMUSE MEMEASEI 50135 CHIEF DEPUTY COUNTY CLERK 999 NO GRANT $0 $0 $48 $0 ($48) 50225 COUNTY CLERK 999 NO GRANT $0 $0 $75 $0 ($75) 50305 DEPUTY COUNTY CLERK I 999 NO GRANT $0 $0 $131 $0 ($131) 50315 DEPUTY COUNTY CLERK II 999 NO GRANT $0 $0 $42 $0 ($42) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $1,270 $1,270 62878 INSURANCE -SURETY BONDS 999 NO GRANT $0 $0 $974 $0 ($974) AMENDMENTNO6665 TOTAL $0 $0 $1270 $1270 $0 COUNTY CLERK TOTAL $0 $0 $1,270 $1,270 $0 nunnnuunununnnnnmunnnnnmunuuOUD mwnnll IIRRDRmRlllllllllllllllm mnllllnnunnununnnn nnnnnn nnunuuunnnnunu nnuuuuuunnnunnnununnuuunni DEPARTMENT NAME: COUNTY COURT -AT -LAW DEPARTMENT NO: 410 Tuesday, April 9, 2024 Page 4 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nnnmu mm�uuunnnRRllmlllu ummuu ummmun"' 11111°""' D°°01°O°1° °°°O°°anon nnnunnuunnnnun nnnnun munununnunnn nnunnunnu nnunu unnnnuun DEPARTMENT NAME: COUNTY COURT -AT -LAW DEPARTMENT NO: 410 IA"NmwmwmrAm mm RCgUES7v&cOUNlYAuAwwmRADVERDRAWN AMENDMENT REASON: OVERDRAWN ACCOUNTS FUND BAL UEUENUE RMUE EXPER09ME EXPENMURE NCREASE pCCT Np A T NAME SRARf NB MS W NAME UD REASEREASE DECREASE UECBEAR DECREASE 0E REASO 50286 COURT COORDINATORAADMIN ASSI 999 NO GRANT $0 $0 $47 $0 ($47) 51537 BAILIFF-PART-TIMF ... ran I..— COUNTY COURT -AT -LAW TOTAL $0 $0 $47 $47 $0 unumm�mummn Ulllllnllmm� mmmm mmmm"IIIIn R"' nlnO010°°°°1°O°0°°°ununnnnunnnnnun nnnnnn nuunnunnu nnnnnu mnnun nunnnnnnnunnnnnl DEPARTMENT NAME: COUNTY JUDGE DEPARTMENT NO:2601u OMIDVTMO` was NW&ISW7'OIiCCVVA7YAUVnVNADYERDANWN AMENDMENT REASON: JOVERIDRAWN ACCOUNTS FWB BAL REWE NEMUE EXPENDNURE EXPEMME IN NEASE ACCTND ACCTNAME SRANf0 GRAW NAME RCREASE DECREASE UKASE DECREASE MICBEASEI 50255 COUNTY JUDGE 999 NO GRANT $0 $0 $233 $0 ($233) 50780 OFFICE MANAGER -COUNTY JUDG 999 NO GRANT $0 $0 $48 $0 ($48) 51920 GR0I IP IIJSI IRAAIPG ems.. ... .. ...� COUNTY JUDGE TOTAL $0 $0 $281 $281 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I111111111111111111111111111111111111111111111111111111 DEPARTMENT NAME: COUNTY TAX COLLECTOR DEPARTMENT NO: 200 �� aaY. nyni n, evzq Page 5 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nnnuunnmunu nunnnm nmuulllll rnllllllmmmmmmu mn mmmuumn1111111111°'°nnnunumnnunnnnunnn nnuu ununnnunun mnnnnnununn nnnnunnnunnuun DEPARTMENT NAME: COUNTY TAX COLLECTOR DEPARTMENT NO: 200 ENOMEWTIiiI E?Cd I REauESTOIhCOUNTYAUD/7DRA0VEROR4WIY AMENDMENT REASON: 1OVERDRAWN ACCOUNTS REVEIRE REVENUE EXPEN09M EXPENMURE INCREASE ACCTRD ACCTNAMF GRAVEN SRANENAMf INCREASE DECREASE INCREASE DECREASE NECREASEI 50175 CHIEF DEPUTY TAX ASSESSOR/COL 999 NO GRANT $0 $0 $48 $0 ($48) 50365 DEPUTY TAX ASSESSOR/COLLECTO 999 NO GRANT $0 $0 $664 $0 ($664) 50915 TAX ASSESSORICOLLECTOR 999 NO GRANT $0 $0 $75 $0 ($75) 51545 PART-TIME EMPLOYEES 999 NO GRANT $0 $0 $0 $788 $788 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $1 $0 ($1) AMENDMENTNO6665 TOTAL $0 $0 $788 $788 $0 COUNTY TAX COLLECTOR TOTAL $0 $0 $788 $788 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: COUNTY TREASURER DEPARTMENT NO: 210 *Mmmmvrtm REDUE8fO1DCOUNTYauO/fOR/OVERORAWN sass REVENUE REVEIIUE EXPENDNURE EXPENMURE INCREASE ACCTNU ACCTNAME SMNINO GRANT NAME INCREASE DECREASE INCREASE DECREASE MICHEASO 50145 CHIEF DEPUTY COUNTY TREASURE 999 NO GRANT $0 $0 $63 $0 ($63) 50265 COUNTY TREASURER 999 NO GRANT $0 $0 $74 $0 ($74) 50325 DEPUTY COUNTY TREASURER 999 NO GRANT $0 $0 $0 $138 $138 51920 GROUPINSURANCE 999 NO GRANT $0 $0 $1 $0 ($1 AMENDMENT NO 6665 TOTAL $0 $0 $138 $138 $0 COUNTY TREASURER TOTAL $0 $0 $138 $138 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I111111111111111111111111111111111111 DEPARTMENT NAME: DISTRICT ATTORNEY DEPARTMENT NO: 510 Tuesday, April 9, 2024 Page 6 of 23 FUND NO: 1000 ACCT N CCENAME CRAIEiNO CRANNNAME REVENUE REVENUE EXPENDRURE EXPENDRURE FUND DNCREASF 50055 ASSISTANT DISTRICT ATTORNEY 999 NO GRANT RICREASE DECREASE MCI�ASE REpNA E [DECREASE 50575. INVESTIGATOR (DISTRICT ATTORNE 999 NO GRANT $0 $0 $0 $543 $543 50845 50925 LEGAL SECRETARY - D.A. 999 NO GRANT $0 $0 $85 $0 ($65) 53020 VICTIM ASSISTANCE COORDJLEGA 999 NO GRANT $0 $0 $423 $0 ($423) 66316 OFFICE SUPPLIES TRAINING TRAVEL OUT OF COUNTY 999 NO GRANT $0 $0 $0 $0 $55 $0 ($55) 71650 EQUIPMENT 999 NO GRANT $0 $0 $0 $497 $5,049 $5,049 999 NO GRANT $0 ($491) AMENDMENT NOaaaa mra, $� $0 $4,556 $0 NA a4a1 DISTRICTATTORNEY TOTAL $0 S0 $5,582 $5,592 $g IIIIIIIIIII IIIII IIIIIIIIIIilllllllllllllllllll_IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItlmm�nnrnnn ..................... _ Aen w..T ACCT ND ARf NAME CRAM AN SRANF NAME REVENUE RESIDUE EXPENDIURE EXPENDME rung 5M INCREASE 50155 CHIEF DEPUTY DISTRICT CLERK 999 NO GRANT MCRFASE DECREASE INCREASE DECREASE NECREAS� 50335 50345 DEPUTY DISTRICT CLERK DEPUTY DISTRICT CLERK -CHILD SU 999 NO GRANT $0 $0 $0 $0 $48 $0 ($44) 50355 DEPUTY DISTRICT CLERK -CRIMINAL 999 999 NO GRANT $0 $0 $74 $$7 $0 ($74) 51910 DISTRICT CLERK 999 NO GRANT $0 $0 $7 $0 (($7) 51810 SOCIAL SECURITY 999 NO GRANT $0 $0 $74 $0 ($7) NO GRANT $0 $0 $0 $0 ($74) AMENOMENTN06B85 TOTAL $0 $247 $247 $0 $247 $247 So DISTRICT CLERK TOTAL $0 $0 Tuestley, Apnl 9, 2024 $247 $247 $p Page 7 of 23 FUND NAME GENERAL FUND FUND NO: 1000 finn00NONOn00u 6mIIIII m Om0u6611111111m00IIIIIIIINIIIIImmmm 6uu00u0000nnIII 11111111111 DEPARTMENT NAME: ELECTIONS DEPARTMENT NO. 270 ENOMENTA/a MW I maummocouNmAmmoxrovERPRAwN AMENDMENT REASON: 1OVERDRAWN ACCOUNTS REVENUE NEYENNE ENKWTRE ERPEIOIMBE INCREASE ACCTNO ACST NA GRANTNR SMNINAME INCREASE RECREASE RICAEASE DECREASE [DECREASEI 50067 ASSISTANT ELECTIONS ADMINISTR 999 NO GRANT $0 $0 $41 $0 ($41) 50445 ELECTIONS ADMINISTRATOR 999 NO GRANT $0 $0 $57 $0 ($57) 51545 PART-TIME EMPLOYEES 999 NO GRANT $0 $0 $0 $98 $98 AMENDMENTNO6665 TOTAL $0 $0 $98 $98 $0 ELECTIONS TOTAL $0 $0 $98 $98 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I1111111111 DEPARTMENT NAME: EMERGENCY MANAGEMENT DEPARTMENT NO.630 AIMNAWOff MW I REquEJfi meoumrAUc?OR/OVERDRAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS EUNDBAL BEIIEIIUE REVENUE EAPENRNURE E%PENBRURE INCREASE AMINO AM MAK MAKING GRAW NAME INCREASE DECREASE INCREASE DECREASE MRREASEI 50456 EMERGENCY MANAGEMENT COOR 999 NO GRANT $0 $0 $56 $0 ($56) 50465 EMERGENCY MANAGMNT/FLOODPL 999 NO GRANT $0 $0 $45 $0 ($45) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $101 $101 AMENDMENTMOOO65 TOTAL $0 $0 $101 $101 $0 EMERGENCY MANAGEMENT TOTAL $0 $0 $101 $101 $0 unnunnununuuun0umnn6n6nnnnu0u Nm0u6611111u 00111IIIIIIII IlOmmmnnm mu nuuumm�nunnununnu nunnnnunn nnunuu ununnnnn nnunnnunnnnnunnm DEPARTMENT NAME: EMERGENCY MEDICAL SERVICES DEPARTMENT NO: 345 Tuesday, April 9, 2024 Page 8 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nuunnunuununnnnunOnnnnnnnnnnnnnnnnuunnnnnnnnunnnumunnununnnunuunnnunuu0uuuununmm�nunnnnnnnnnnunmm�unnunnnnnnunnnnnn DEPARTMENT NAME: EMERGENCY MEDICAL SERVICES DEPARTMENT NO: 345 ENOMENTNOf "m I RECUE87016COUNrrAumrvR/OVERDRAWIY AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND SAL REVENUE REVENUE ERPENRRMIE ERPEMDIEURE BREASE ACCT NO CM T NAME DRAW NO GRAW NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 50007 ADMINISTRATIVE ASSISTANT -EMS 999 NO GRANT $0 $0 $46 $0 ($46) 50395 DIRECTOR OF EMS 999 NO GRANT $0 $0 $85 $0 ($85) 51570 SALARIES ON CALL 999 NO GRANT $0 $0 $695 $0 ($695) 51613 OVERTIME BASE PAY 999 NO GRANT $0 $0 $10,501 $0 ($10,501) 51616 OVERTIME PREMIUM PAY 999 NO GRANT $0 $0 $5,250 $0 ($5,250) 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $2,656 $0 ($2,656) 51930 RETIREMENT 999 NO GRANT $0 $0 $0 $19,233 $19,233 AMENDMENT NO 6665 TOTAL $0 $0 $19,233 $19,233 $0 EMERGENCY MEDICAL SERVICES TOTAL $0 $0 $19,233 $19,233 $0 numnnnnunnnnnnnnnnnmm�nnnnnnnmm�nnnnunnnnnnnnnnnnnunnmm�nnnnnnunnuuunnnunnunnOnununnnnnnnnnnunnnnnnnunnnnnunnnnnnni DEPARTMENT NAME: EXTENSION SERVICE DEPARTMENT NO: 110 Dl1IENTNM mm I EEQIIESTDIDCOUNTYAuDiTOIMDVENDEAWM AMENDMENT REASON: JOVERDRAWN ACCOUNTS FRND RAL REVENUE BERNIE ENPENIRNtE EXPENRINAE MCREASE ACCT NO ACCT NAME GRAM NI GRANT NAME MCREASE DECREASE RICREASE DECREASE [DECREASED 50935 4-HIYOUTH AGENT 999 NO GRANT $0 $0 $25 $0 ($25) 51130 COUNTY AGENT 999 NO GRANT $0 $0 $25 $0 ($25) 51133 CEAFCS AGENT 999 NO GRANT $0 $0 $25 $0 ($25) 51136 MARINE AGENT 999 NO GRANT $0 $0 $25 $0 ($25) 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $1 $0 ($1) 51930 RETIREMENT 999 NO GRANT $0 $0 $0 $101 $101 AMENDMENT NO 6665 TOTAL $0 $0 $101 $101 $0 EXTENSION SERVICE TOTAL $0 $0 $101 $101 $0 Tuesday, Apnl 9, 2024 Page 9 of 23 FUND NAME GENERAL FUND FUND NO: 1000 NNRRRNRHRRNRNRRNNRRHBNRRHNRRRRRRRRNmunmetnul1RNRRBRRNRRRRHNRRNRRRNRHRRRNRRNRRNRRNRRHRRNRRBRRHRRBRRHRRBHRnnunnnnunnnnu DEPARTMENT NAME: FIRE PROTECTION -MAGNOLIA BEACH DEPARTMENT NO: 640 JANIANIM111191l EBED I mauE&mmcouxrrAUWMAYVVEJWNAWN AMENDMENT REASON: JOVERDPAWN ACCOUNTS N[DDBAL REVERE REYENIE EXPENMDRE EXPEND FURE INCREASE ACCTNO ACCTNAME CMNTNO GRANT NAME INCREASE BEISIEASE INCREASE DECREASE [DECREASE 53210 MACHINERY PARTS/SUPPLIES 999 NO GRANT $0 $0 $0 $1,614 $1,614 65740 SERVICES 999 NO GRANT $0 $0 $0 $1 $1 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $1,615 $0 ($1,615) AMENDMENT NO 6665 TOTAL $0 $0 $1,615 $1,615 $0 FIRE PROTECTION -MAGNOLIA BEACH TOTAL $0 $0 $1,616 $1,615 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: HUMAN RESOURCES DEPARTMENT NO:265 mvAW A1rARA BBB? I REOUE97VffiC0VAWAUD?04/DVERDRAWR III J,1 =12W J� I =I2Y III .dX-Fi.RMKT/I,i REVENUE REVENUE EXPENDRDRE EXPENDRURE INCREASE ARE CA CT RAW CRANE NN GRAW NAME INCREASE DECREASE UICREASE DECREASE [DECREASE] 50785 ADMIN.ASST/HUMAN RESOURCE C 999 NO GRANT $0 $0 $55 $0 ($55) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $166 $166 53020 OFFICE SUPPLIES 999 NO GRANT $0 $0 $111 $0 ($111) AMENDMENT NO 6665 TOTAL $0 $0 $166 $166 $0 HUMAN RESOURCES TOTAL $0 $0 $166 $166 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I111111111111111111111111111111111111111111111111 DEPARTMENT NAME: INFORMATION TECHNOLOGY DEPARTMENT NO: 275 Tuesday, April 9, 2024 Page 10 of 23 FUND NAME GENERAL FUND FUND NO: 1000 uuunnuununuuunuuunuuuunnnuununnnnmuununnnnnnnnunnnnmm�nnnnunnunnnnnunnnunnnnnunnnnunnuununuuuunnunnnnnunnununnnnnnni DEPARTMENT NAME: INFORMATION TECHNOLOGY DEPARTMENT NO: 275 kwAw NTAWr SSB? I DEOUEdfOIiNCODNTYAuwmmOVEROR4WN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUN BAL ROERIUE RRVENUE EXPER09M EXPEIORURE INCREASE ACCT NO ACCT IM SRAM NB DRAW NAME INCREASE DECREASE INCREASE BEOIEASE OECD 50300 DATABASE ADMINISTRATOR 999 NO GRANT $0 $0 $0 $73 $73 50590 IT COORDINATOR 999 NO GRANT $0 $0 $73 $0 ($73) AMENDMENT NO 8665 TOTAL $0 $0 $73 $73 $0 INFORMATION TECHNOLOGY TOTAL $0 $0 $73 $73 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111 DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 ENOMENlAM' SSSS I mauE6f10NrCDUNTYAUD/7ORADvEnmmwN AMENDMENT REASON: IOVERDRAWN ACCOUNTS REVENUE REVENUE EXPENMURE EXPENNRURE INCREASE ACCT NV ACCT NAME GRANT NO SRANTNAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 50095 ASSISTANT JAIL ADMINISTRATOR 999 NO GRANT $0 $0 $52 $0 ($52) 50595 JAIL ADMINISTRATOR 999 NO GRANT $0 $0 $59 $0 ($59) 50605 JAIL COOK 999 NO GRANT $0 $0 $99 $0 ($99) 50615 JAILER 999 NO GRANT $0 $0 $0 $210 $210 AMENDMENT NO 6666 TOTAL $0 $0 $210 $210 $0 ENOMENTM'h am I A'EQUNS7100JAIL FUNDS TO COVER COST OF FIREARM PURCHASE MADE IN 2023 BUT RECEIVED IN 2024- IVED CC 2114/24 REVENUE REVENUE EXPEIAINORE EXPENDIRI E INCREASE ACCT NO ACCT NAME SIM NO CRAMI NANE INCREASE DECREASE INCREASE DECEASE DIECREASEI 50615 JAILER 999 NO GRANT $0 $0 $0 $4,968 $4,968 Tuesday, April 9, 2024 Page 11 of 23 FUND NAME GENERAL FUND FUND NO: 1000 uunnnnumnmuunnmm�nunnnnnnunnnnnunnnunnnmunummuunnuunnmm�nnunnnnnnnnuununnnnnnnnnnnunnunnunnnununnununnunununnnnun DEPARTMENT NAME: JAIL DEPARTMENT NO: 180 EMOMENlAw env I waumTOM✓A/L FUNDS TO COVER COST OF FIREARM PURCHASE MADE IN 2023 BUT RECEIVED IN 2024- IVED CC 2/14124 FUND UAL REVENUE REVENDE ENPEM=E EXPENDITURE INCREASE ACCENO ACCT RARE DRANTNU RAC INCRERSE DECREASE INCREASE DECREASE IDECRFASEI 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $4,968 $0 ($4,968) AMENDMENT NO 6679 TOTAL $0 $0 $4,968 $4968 $0 JAIL TOTAL $0 $0 $5,178 $5,178 $0 DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #1 AMENDMENT REASON: JOVERDPAWN ACCOUNTS WEAL REVENUE REVENUE EXPENDITURE EXPENDITURE RICREASE ACCTND pCCiHAME CRANTNO GRANT NAME INCREASE DECREASE INCREASE DECREASE UIFCRFRSEI 50275 COURT CLERK (JP) PART-TIME 999 NO GRANT $0 $0 $165 $0 ($165) 50277 COURT CLERK (JP) 999 NO GRANT $0 $0 $40 $0 ($40) 50625 JUSTICE OF THE PEACE 999 NO GRANT $0 $0 $46 $0 ($46) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $30 $0 ($30) 51930 RETIREMENT 999. NO GRANT $0 $0 $93 $0 ($93) 53020 OFFICE SUPPLIES 999 NO GRANT $0 $0 $0 $374 $374 AMENDMENT NO 6665 TOTAL $0 $0 $374 $374 $0 JUSTICE OF PEACE -PRECINCT #1 TOTAL $0 $0 $374 $374 $0 I IIIIIIIIIIIIIIIII IIIII III IIIIIIIIII IIIIIIII IIIIIIIIIIIIIIIIIIIIII IIIII IIIIIIIIIIIII IIIIIIrrIIII11111111111111111111111111111111111111111111rIIIII I IIIII IIIIIII III1111111111111i1111111111111111111111r1111rllllll111111111111111 rllllrll DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #2 DEPARTMENT NO: 460 Tuesday, April 9, 2024 Page 12 of 23 FUND NAME GENERAL FUND FUND NO: 1000 ORRRRURORROURn#DORRRum111111 nnnuunnuuuu#11111 1111111 nnnnnu##ORRRu#RO#Ru#R#RD#ORUDRnnnnnnnunnni DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #2 DEPARTMENT NO: 460 DMENTNBY BBBB I IPEQNEBTOEaCDONTYADD/TOR/09ERDRAWN AMENDMENT REASON: IOVERDRAWN ACCOUNTS REVENUE REVENUE EXPENDITURE EXPENDITURE IDOIRAU ACCTNO ACCT NAME GRANT No CHAIRNAME DECREASE DECREASE INCREASE DECREASE OECREASEI 50277 COURT CLERK (JP) 999 NO GRANT $0 $0 $41 $0 ($41) 51710 AUTO ALLOWANCE 999 NO GRANT $0 $0 $61 $0 ($61) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $212 $212 51930 RETIREMENT 999 NO GRANT $0 $0 $110 $0 ($110) AMENDMENT NO SS85 TOTAL $0 $0 $212 $212 $0 JUSTICE OF PEACE -PRECINCT #2 TOTAL $0 $0 $212 $212 $0 11IIIIIIIII IIIIIIIIIIIIIIIillll (III I (IIIIIII I I IIIII IIIIIIIIIIIIilllll IIIII IIIIIII IIIIIIIIIIIII IIIIIIIIIIIIIII IIIIIIIIIIIII IIIIIIIIIIIIIIII (IIIIIIIIIIIII IIIIIII IIIRIIIIIIIIIIIIIIIIII IIIII IIIII IIIIIIIIIIIIIIIIIIIIIII IIIII IIIII IIIII III DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #3 DEPARTMENT NO: 470 811/ENTNDi BRED I REIN/E6TOIDCOUNmAtlD/7DNommNAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND DAL RET UE RETIEIM EXPEMME EKPEN09URE DECREASE ACCTNO ACCT NAME DRANTNO CRAW NAME INCREASE DECREASE INCREASE DECREASE CIECREASEI 50277 COURT CLERK(JP) 999 NO GRANT $0 $0 $41 $0 ($41) 50625 JUSTICE OF THE PEACE 999 NO GRANT $0 $0 $46 $0 ($46) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $90 $90 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $3 $0 ($3) AMENDMENT NO 6665 TOTAL $0 $0 $90 $90 $0 JUSTICE OF PEACE -PRECINCT #3 TOTAL $0 $0 $90 $90 $0 uunnnunnnnnununununnnnnunuunnnmunnunnnnnnunnnmm�nmm�munnuununnununnunnuuOunOnnnmm�mnnunnnnunnnnunnnnnunnnnunnunum DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #4 DEPARTMENT NO: 480 Tuesday, April 9, 2024 Page 13 of 23 FUND NAME GENERAL FUND FUND NO: 1000 IlnnmmIImmnnnnnnnuu#RUUURRRRURRRRRURRURRRRRRR#0U#mm11mm11nnnOnlmnnnnOn11111 1111111111111111111111111111111111111111111 un0u0RRDnm DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #4 DEPARTMENT NO: 480 AMMAMMIllrill 8888 I M QUE8TOR:COUNTTAUDITORMVEMDRAWN AMENDMENT REASON: JOVEIRDRAWN ACCOUNTS FUND AAE REVENUE DEMISE ENPENDIURE ERKWRRE INCREASE ACCINO ACCINAME GRAWAD GRAMNAME INCREASE IEOIEASE INCREASE DECREASE IDECREASEI 50625 JUSTICE OF THE PEACE 999 NO GRANT $0 $0 $46 $0 ($46) 51540 TEMPORARY 999 NO GRANT $0 $0 $43 $0 ($43) 51920 GROUP INSURANCE 999 NO GRANT $0 $0 $0 $89 $89 AMENDMENT NO 6666 TOTAL $0 $0 $89 $89 $0 JUSTICE OF PEACE -PRECINCT #4 TOTAL $0 $0 $89 $89 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: JUSTICE OF PEACE -PRECINCT #5 DEPARTMENT NO: 490 ENDMENTNO: 8888 I RE4UE8TOIDCOUNTTAUO/TOR/OVERORARW AMENDMENT REASON: JOVERCIRAWN ACCOUNTS FUND BAL REVENUE REVENUE ERPERKM EAPENDNURE INCREASE AUCi NO ACCi NAME GRAM ND GRAM NAME INCREASE DECREASE INCREASE DECREASE EO CREASEI 50625 JUSTICE OF THE PEACE 999 NO GRANT $0 $0 $46 $0 ($46) 51930 RETIREMENT 999 NO GRANT $0 $0 $15 $0 ($15) 53020 OFFICE SUPPLIES 999 NO GRANT $0 $0 $0 $61 $61 AMENDMENTNO6665 TOTAL $0 $0 $61 $61 $0 JUSTICE OF PEACE-PRECINCT#5 TOTAL $0 $0 $61 $61 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: JUVENILE COURT DEPARTMENT NO: 500 Tuesday, April 9, 2024 Page 14 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nnunnuunnnuunnnnnnnnnnmm�nnnnnnunnmm�nnnnunnnnnununuuuunnuununnnunnuununnnnnnunumnnnnnnnnnnnnnnnnnnnnnnnunnnnnnnnnn DEPARTMENT NAME: JUVENILE COURT DEPARTMENT NO: 500 ENDIVEN7AVV RBES I RIQUIdTOIDCOUNTYAUDIrOR/OVERDRAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS RNS SAL IBM REVERSE EXPENDRURE EXPENDNURE INCREASE ACCT NU ACCT MAIN CHAR No CRR NAME MCSEASE DECREASE MCREA E DECREASE RECREASEI 50225 COUNTYCLERK 999 NO GRANT $0 $0 $1 $0 ($1) 50245 COUNTY COURT -AT -LAW JUDGE 999 NO GRANT $0 $0 $2 $0 S2) 50255 COUNTYJUDGE 999 NO GRANT $0 $0 $2 $0 ($2) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $6 $6 51930 RETIREMENT 999 NO GRANT $0 $0 $1 $0 ($1) AMENDMENTNO6665 TOTAL $0 $0 $6 $6 $0 JUVENILE COURT TOTAL $0 $0 $6 $6 $0 unnununumm�mnnunmm�nnnnOnunuunuunnnununnuunnuunnnnnnnnnuunnnnnunnunmm�nunnnnnunmm�nunnnnunnnnnnnnnunnnnnnnnnnnnnnn DEPARTMENT NAME: LIBRARY DEPARTMENT NO: 140 DAIEN7im "m I REQOE971D/000DNTYADD/70R/0VERORA{YN AMENDMENT REASON: JOVERDRAWN ACCOUNTS RM SAL REVENUE BMW EXPENDRMI EXPENORAAE MCCEASE ACCT NO ACCT NAME CRAB NO MC R NAME MCREASE DECREASE MCSEASE DECREASE (DECREASE) 50105 ASSISTANT LIBRARY DIRECTOR 999 NO GRANT $0 $0 $47 $0 ($47) 50655 LIBRARIAN - CHILDREN'S/REFEREN 999 NO GRANT $0 $0 $46 $0 ($46) 50675 LIBRARY DIRECTOR 999 NO GRANT $0 $0 $54 $0 ($54) 50680 LIBRARIANS -PART-TIME 999 NO GRANT $0 $0 $0 $223 $223 51540 TEMPORARY 999 NO GRANT $0 $0 $76 $0 ($76) AMENDUENTNO6665 TOTAL $0 $0 $223 $223 $0 LIBRARY TOTAL $0 $0 $223 $223 $0 IIIIIIIIIII111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 DEPARTMENT NAME: MUSEUM DEPARTMENT NO: 150 Tuesday, Apnl 9, 2024 Page 15 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nuunnunn nnunn nm mm�nmunnn nnunnmmn mm�ununnmumutnnununnu nuunnunnnnunn nnnnmm�nnnn nnnnnnnnunnunmm�u nuunuummm�unn noun DEPARTMENT NAME: MUSEUM DEPARTMENT NO: 150 JAMMIZIMMIff WW I RFg4E8fIDl6awwrAuo/fwomERORAWR AMENDMENT REASON: JOVERDRAWN ACCOUNTS HE DAL REVENUE REVENUE EAPERDRUDE ERPENONIIRE INCREASE ACCT NO RCCT NAME GRANT NO GRANT NAME INCREASE DECREASE INCREASE DECREASE RDIt REASD 50750 MUSEUM DIRECTOR 999 NO GRANT $0 $0 $44 $0 ($44) 51545 PART-TIME EMPLOYEES 999 NO GRANT $0 $0 $0 $44 $44 AMENDMENT NO BOBS TOTAL $0 $0 $44 $44 $0 MUSEUM TOTAL $0 $0 $44 $44 $0 111 III I I I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111 DEPARTMENT NAME: NUISANCE ORDINANCE ENFORCEMENT DEPARTMENT NO: 725 EROMENTIPAr BBBB I REQUEB7DR:000AITYAUO/T0RADVER0M*W AMENDMENT REASON: IOVERDRAWN ACCOUNTS Rum REVENUE ENPENDITME ENPENDM E INCREASE ACCTNO ACCT NAME GRANT NO GRANT NAME RICREASE DECREASE MCREASE DECREASE UIECREASE] 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $39 $0 ($39) 51930 RETIREMENT 999 NO GRANT $0 $0 $262 $0 ($262) 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $0 $301 $301 AMENDMENTNO6665 TOTAL $0 $0 $301 $301 $0 NUISANCE ORDINANCE ENFORCEMENT TOTAL $0 $0 $301 $301 $0 III I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 111111111111111111111111111111111111111111111111111111111111111111I 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 I I I I I I I I I I I I I I I I I I I I I I 111111 DEPARTMENT NAME: OTHER FINANCING DEPARTMENT NO: 520 Tuesday, ApHI 9, 2024 Page 16 of 23 FUND NAME GENERAL FUND FUND NO: 1000 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 111111111111111111111111111111111111111111 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I fill DEPARTMENT NAME: OTHER FINANCING DEPARTMENT NO: 520 ENOMEN/Na mm I NEOUE870AhCOMM/98/ONEBPIPEC/NCr#3 AMENDMENT REASON: IJOHN DEER MOTOGRADER LEASE -PURCHASE AGREEMENT DATED 11/22/23 REVENUE REVENUE ACCT NO ACCT NAME DRAW NO GRAND NAME INCREASE DECREASE 91075 PROCEEDS FROM CAPITAL LEASES 999 NO GRANT $0 $0 EXPENORURE INCREASE $0 EXPENDRURE DECREASE $175,161 RIND BAL INCREASE [DECREASE] $175.161 AMENDMENTNO0666 TOTAL $0 $0 $0 $175161 $175161 dPDMEIPTNOi SMY mows70E[COmmmoONERPREC/NCTO! AMENDMENT REASON: JR131 EXCAVATOR LEASE -PURCHASE AGREEMENT DATED 1216123 REVENUE REVENUE ACCT NO ACCT NAME GRANT NO GRANINAME INCREASE OECAEME 91075 PROCEEDS FROM CAPITAL LEASES 999 NO GRANT $0 $0 EMPENNRURE INCREASE $0 EXPENDITURE DEMME $250,259 RIND DAL INCREASE [DECREASE] $250,259 AMENDMENT NO 6667 TOTAL $0 $0 $0 $250,259 $250,259 OTHER FINANCING TOTAL $0 $0 $0 $425,420 $426,420 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #1 DEPARTMENT NO: 540 ENOMEIPTAV� MW I REODEBTOwCODNmAumommVERORAm REVENUE ARC EXPENDRURE EXPEOM INCREASE AC CI NO ACCT NAME GRANT NO CMNI NAME INCREASE DECREASE INCREASE DECREASE [DECREASE) 50075 ASSISTANT FOREMAN 999 NO GRANT $0 $0 $53 $0 ($53) 50235 COUNTY COMMISSIONER 999 NO GRANT $0 $0 $73 $0 ($73) 50525 FOREMAN 999 NO GRANT $0 $0 $75 $0 ($75) 50565 HEAVY EQUIPMENT OPERATOR (PR 999 NO GRANT $0 $0 $183 $0 ($183) 50715 LIGHT EQUIPMENT OPERATOR 999 NO GRANT $0 $0 $43 $0 ($43) 50765 OFFICE MANAGER -COUNTY COMM 999 NO GRANT $0 $0 $49 $0 ($49) Tuesday, April 9, 2024 Page 17 of 23 FUND NAME GENERAL FUND FUND NO: 1000 I IIIIIIIIII IIIIOIIIIIII II1111111111111111111111111111111111111111IIRN RRRNRNRRURR ununnuuuun nnnnnnnnmun O nnn0 nnnnnn nnn11RRNRR RRDURRURRR RRURRuORNRRnnnmmill DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #1 DEPARTMENT NO: 540 AVDMENTNO: BBBM I walmosT0lbCDONTYADD/TOR/OVERORAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS EUNR OR REVENUE REVENUE EXPENRITIIRE EXPENDITURE INCREASE ACCT NO ACCT NAME CRAM NO CRAM NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 51930 RETIREMENT 999 NO GRANT $0 $0 $960 $0 ($960) 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $8 $0 ($8) 53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT $0 $0 $0 $1,444 $1,444 AMENDMENT NO 6065 TOTAL $0 $0 $1,444 $1,444 $0 ENDMEM/MOi BBQ7 REQDESTOMCOMM/SOWWWPREC/NCT,49 AMENDMENT REASON: IRB1 EXCAVATOR LEASE -PURCHASE AGREEMENT DATED 1216123 RM OR REVENUE REVENUE EXPEADRIORE EXPENRITME INCREASE ACCT NO ACCT RAME GRANT NO CRAM NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] ROAD AND BRIDGE-PRECINCT#1 TOTAL $0 $0 $251,703 $1,444 ($250,259) I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #2 DEPARTMENT NO: 550 ENDMEWN& MBBS I DMQDESMOCODNTYAUD/TOMOE2RORAWN AMENDMENT REASON: 1OVERDRAWN ACCOUNTS REVENUE REVENUE EXPENDITURE EXPENDITURE INCREASE ACCT NO ACCT NAME CRAM NO GRANT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 50235 COUNTY COMMISSIONER 999 NO GRANT $0 $0 $72 $0 ($72) 50525 FOREMAN 999 NO GRANT $0 $0 $56 $0 ($56) 50565 HEAVY EQUIPMENT OPERATOR (PR 999 NO GRANT $0 $0 $145 $0 ($145) 50568 HEAVY EQUIP. OPER.(PCTS)/ASST 999 NO GRANT $0 $0 $52 $0 ($52) Tuesday, April 9, 2024 Page 18 of 23 FUND NAME GENERAL FUND FUND NO: 1000 III III IIIIIIIIII IIIIIIIIIIIIIIIIIIII IIIII IIIIIIIIIDDD DDDBIIIIIIppppppppppppppppp ppppp pDllll IIIIII IIRR RnOnn mnnunnu ODURRDD0000 nnn O nnOn ODURR RRunn unnnnmm DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #2 DEPARTMENT NO: 550 ENEINENTAm BBBM I RIauL:vy DI6COUNTYAUO/TOMOVERORAww AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUNDRAE REVENUE REVENUE EXPENDITURE EXPENMUM INCREASE AGO NO ACCT NAME GRANT NO SURINAME INCREASE DECREASE MCAEASE DECREASE [DECREASE] 50765 OFFICE MANAGER -COUNTY COMM 999 NO GRANT $0 $0 $48 $0 ($48) 51613 OVERTIME BASE PAY 999 NO GRANT $0 $0 $13 $0 ($13) 51616 OVERTIME PREMIUM PAY 999 NO GRANT $0 $0 $7 $0 ($7) 53595 TOOLS 999 NO GRANT $0 $0 $1,251 $0 ($1,251) 53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0 $0 $25 $0 ($25) 63530 MACHINERY/EQUIPMENT REPAIRS 999 NO GRANT $0 $0 $850 $0 ($850) 64370 OUTSIDE MAINTENANCE 999 NO GRANT $0 $0 $0 $2,519 $2,519 AMENDMENT NO 6665 TOTAL $0 $0 $2,519 $2,519 $0 ROAD AND BRIDGE-PRECINCT#2 TOTAL $0 $0 $2,519 $2,519 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I D I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #3 DEPARTMENT NO: 560 EMNSWriM BBEE I Rfiauwr01DCOUNTYAVPnV OVEREMAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS RIND DAL REWIRE AMID EXPENDITURE EXPENDRMIE INCREASE ACCT NO AM NAIR GRANT NO MINT NAME INCREASE DECREASE INCREASE DECREASE [DECREASE) 50235 COUNTY COMMISSIONER 999 NO GRANT $0 $0 $73 $0 ($73) 50525 FOREMAN 999 NO GRANT $0 $0 $57 $0 ($57) 50568 HEAVY EQUIP. OPER. (PCTS)/ASST 999 NO GRANT $0 $0 $53 $0 ($53) 50765 OFFICE MANAGER -COUNTY COMM 999 NO GRANT $0 $0 $49 $0 ($49) 51540 TEMPORARY 999 NO GRANT $0 $0 $395 $0 ($395) 53510 ROAD 8. BRIDGE SUPPLIES 999 NO GRANT $0 $0 $0 $627 $627 AMENDMENT NO 6685 TOTAL $0 $0 $627 $627 $0 Tuesday, Apnl 9, 2024 Page 19 of 23 FUND NAME GENERAL FUND FUND NO: 1000 11 I I111111I l I I I I l I l l l l l III I I I I I I I I I I IIIII I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I l l l l l l l l l I l I111I111111 I I I H I11111111111111111111111111111 I I I I I I I I I I I I I I I I I I I I I I I I I I I I III DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #3 DEPARTMENT NO: 560 ESRISAL REVENUE REVENUE EXPENDITURE EXPENNINDE MCRERSE ACCT NO ACCT NAME CRAMNN SRAM NAME INCREASE RECREME INCREASE DECREASE [DECREASE] 73400 MACHINERY AND EQUIPMENT 999 NO GRANT $0 $0 $175,161 $0 ($175,161) AMENDMENTNO6588 TOTAL $0 $0 $176,151 $0 ($175,161) ROAD AND BRIDGE-PRECINCT#3 TOTAL $0 $0 $175,788 $627 ($175,161) I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I l u l l I O l l R l l l l l l I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I l l l I I I I I I I I I I I I I I I I I I I I I I 111111111111111111111111111 DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #4 DEPARTMENT NO:. 570 ENDM®IITNM BBB( I MANIUM87112ReCOUNTYAUD/TOR/OVEMOMWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS IN NAE REVENUE REVENUE EXPENNITURE EXPENDITURE INCREASE ACCT NO ACCT NAME SMM ND GRAN( NAME INCREASE DECREASE INCREASE DECREASE (DECREASE] 50235 COUNTY COMMISSIONER 999 NO GRANT $0 $0 $1 $0 ($1) 50565 HEAVY EQUIPMENT OPERATOR (FIR 999 NO GRANT $0 $0 $1 $0 ($1) 50568 HEAVY EQUIP. OPER. (PCTS)IASST 999 NO GRANT $0 $0 $1 $0 ($1) 50715 LIGHT EQUIPMENT OPERATOR 999 NO GRANT $0 $0 $0 $2,483 $2,483 50765 OFFICE MANAGER - COUNTY COMM 999 NO GRANT $0 $0 $1 $0 ($1) 50900 SPECIAL LICENSE 999 NO GRANT $0 $0 $7 $0 ($7) 51540 TEMPORARY 999 NO GRANT $0 $0 $100 $0 ($100) 51613 OVERTIME BASE PAY 999 NO GRANT $0 $0 $0 $39 $39 51616 OVERTIME PREMIUM PAY 999 NO GRANT $0 $0 $0 $19 $19 51630 COMP TIME PAY 999 NO GRANT $0 $0 $0 $1 $1 51740 VACATION PAY ON TERMINATION 999 NO GRANT $0 $0 $0 $77 $77 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $76 $0 ($76) 51930 RETIREMENT 999 NO GRANT $0 $0 $0 $97 $97 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $0 $253 $253 51950 FEDERALBTATE UNEMPLOYMENT 999 NO GRANT $0 $0 $0 $5 $5 53020 OFFICE SUPPLIES 999 NO GRANT $0 $0 $0 $1 $1 Tuesday, April 9, 2024 Page 20 of 23 FUND NAME GENERAL FUND FUND NO: 1000 unu nnnnn nnunnnnunnnullllu nIIIIIIRm nllln mu mn ummmu mn ummmml mn nnnunnnunn nnunnnunn nnnunnnnnn nnunnn nnnnnunn nnuunu nnunmm�mnl DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT #4 DEPARTMENT NO: 570 D/NERTA/04 8888 EEO4E87VI&COONTYAUPIMJDVVERORAWN AMENDMENT REASON: JOVERCIRAWN ACCOUNTS FlMD BAL REVENUE REYENBE UPENMTIME EXPENMTURE MCREASE ACCTNO ACCT NAME GRANT NO CRAM NAME MCREASE DECREASE MCBEASE DECREASE (DECREASE] 53210 MACHINERY PARTS/SUPPLIES 999 NO GRANT $0 $0 $0 $1 $1 53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT $0 $0 $9,259 $0 ($9,259) 53630 INSECTICIDES/PESTICIDES 999 NO GRANT $0 $0 $0 $1 $1 53640 JANITOR SUPPLIES 999 NO GRANT $0 $0 $0 $1 $1 62510 EQUIPMENT RENTAL 999 NO GRANT $0 $0 $0 $4,319 $4,319 63530 MACHINERY/EQUIPMENT REPAIRS 999 NO GRANT $0 $0 $0 $1 $1 66192 TELEPHONE SERVICES 999 NO GRANT $0 $0 $0 $1 $1 66600 UTILITIES 999 NO GRANT $0 $0 $0 $1,122 $1,122 66614 UTILITIES -PARKS 999 NO GRANT $0 $0 $0 $1,025 $1,025 AMENDMENTNO6665 TOTAL $0 $0 $9,446 $9,446 $0 ROAD AND BRIDGE-PRECINCT#4 TOTAL $0 $0 $9,446 $9,446 $0 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l DEPARTMENT NAME: SHERIFF DEPARTMENT NO: 760. ENEMENTAvo 8888 I EEavx&rvICCOUNTVAUPn WOVERDEAWR AMENDMENT REASON: JOVIEFORAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDRURE EXPENDNURE MCREASE AKE ACCTNANE CRANTNO CRANINAME INCREASE DECREASE MCREASE DECREASE RIECRERSEI 50005 ADMINISTRATIVE ASSISTANT-SHERI 999 NO GRANT $0 $0 $181 $0 ($181) 50165 CHIEF DEPUTY SHERIFF 999 NO GRANT $0 $0 $71 $0 ($71) 50415 DISPATCHER 999 NO GRANT $0 $0 $609 $0 ($609) 50705 LIEUTENANT -SHERIFF 999 NO GRANT $0 $0 $123 $0 ($123) 50895 SHERIFF 999 NO GRANT $0 $0 $74 $0 ($74) 51615 OVERTIME BASE PAY-OSG 999 NO GRANT $0 $0 $139 $0 ($139) 51617 OVERTIME PREMIUM PAY-OSG 999 NO GRANT $0 $0 $70 $0 ($70) 51740 VACATION PAY ON TERMINATION 999 NO GRANT $0 $0 $1,846 $0 ($1,846) Tuesday, April 9, 2024 Page 21 of 23 FUND NAME GENERAL FUND -FUND NO: 1000 uunnunnuuuuunununuuunnnnuuunuuuuunnumnnnnnunnnunnnunnnnnnnnnnunnnnnnnnunuuuuunnnunmm�mm�nnmm�unnnnmm�nnnnunnununuu DEPARTMENT NAME: SHERIFF DEPARTMENT NO: 760 OKMVVNmff mm I RCOUCSTOIDCOUNlYAupnvR/OVERDRAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDITURE EXPENDITURE DECREASE ACCTNO ACCEMANE START NO GRANT NAME DECREASE DECREASE DE REAS DECREASE(DECREASE) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $3,500 $3,500 51940 WORKMENS COMPENSATION 999 NO GRANT $0 $0 $374 $0 ($374) 53540 GASOLINE/OlUDIESEL/GREASE 999 NO GRANT $0 $0 $13 $0 ($13) AMENDMENT NO 6666 TOTAL $0 $0 $3,500 $3,500 $0 SHERIFF TOTAL $0 $0 $3,500 $3,600 $0 FUND NAME AIRPORT FUND FUND NO: 2610 uunnONnnmumn unnunnunn nnnumm�nnnnnnmm�mmmmnnnnunnumunwu0n unnunn nnnnnnnnn a nnunnnunu nnunnunuuuunnn nnnunmm�mmm�nnn DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 ENONENTtab BBBE I REQUE&T0&COYNfYAUVnVXOVEEERAWN AMENDMENT REASON: JOVERDRAWN ACCOUNTS FUND BAL REVENUE REVENUE EXPENDITURE EXPENDITURE DECREASE ACCTNO ACCT NAME GRANT NO CRANE NAME DECREASE DECREASE INCREASE DECREASE URCREASEI 62660 INSURANCE -AIRPORT LIABILITY 999 NO GRANT $0 $0 $2,530 $0 ($2,530) 63530 MACHINERY/EQUIPMENT REPAIRS 999 NO GRANT $0 $0 $0 $1,410 $1,410 64320 OTHER SERVICES/PROGRAMS 999 NO GRANT $0 $0 $0 $1,120 $1,120 AMENDMENTNO6665 TOTAL $0 $0 $2,530 $2,630 $0 NO DEPARTMENT TOTAL $0 $0 $2 FUND NAME JUVENILE CASE MANAGER FUND FUND NO: 2699 Tuesday, April 9, 2024 Page 22 of 23 FUND NAME JUVENILE CASE MANAGER FUND FUND NO: 2699 11111111111 r1111 IIIIIIIIIIHIIIIIIIIIIIII nr IIIIIII IIIII IIIIIIIIII 11111111 IIIII IIIIIII IIIIIIII IIIIIItl111111111 IIIIII 11111 IIIIIII IIII IIIIIIIIIIIIIIIIIIrrr IIIII IIIIIIIIIIIIr111n 1111111111Onr IIIIIIll 111111111111111111t11111111111 III DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 ENOM6VTIVOr MW I EEOuEErOA@couNrrAOo/ruRlovEEOEAwN AMENDMENT REASON: JOVERIDRAWN ACCOUNTS FUND BAE REVENDE REVERSE EXPENDEURE EXPERMURE DICREASE ACCi NO AA CC T DAME GRANT NO SIGNT NAME INCREASE DECEASE ENCREASE DECREASE ME REASS 50630 JUVENILE CASE MANAGER 999 NO GRANT $0 $0 $1 $0 ($1) 51910 SOCIAL SECURITY 999 NO GRANT $0 $0 $0 $1 $1 AMENDMENT NO 6866 TOTAL $0 $0 $1 $1 $0 TOTAL $0 $0 $1 $1 FUND NAME CAPITAL PROJECT -HOSPITAL IMPROVEMENTS FUND NO: 5280 uunnnu mflu m110lnnnnnrmIIII Nllnnnrnnnllllllllllllnnnrnnl III lllninnrnplll111nnnru nuununnunnn HIII mun nnnnnunun nnunnunullmmilnunnu nnnnnunnnumni DEPARTMENT NAME: NO DEPARTMENT DEPARTMENT NO: 999 LWOMa11 A'&- E87E I RMUNSFUMCAP?AL PEOJECTSNOSP?AL /MPEOVEMEMS REVENUE REVERIE EXPENRIERRE EXPERRNME DECREASE ACm ACCT RAISE GRANTRD RMNTNAME INCREASE DECREASE DECREASE DECREASE IDECREASS 62450 ENGINEER/SURVEYOR/ARCHITECT 999 NO GRANT $0 $0 $50,000 $0 ($50,000) 70750 CAPITAL OUTLAY 999 NO GRANT $0 $0 $0 $50 000 $50 000 AMENDMENT NO$678 TOTAL $0 $0 $60000 $50000 $0 NO DEPARTMENT TOTAL $0 $0 Grand Total $0 $0 $540,345 Tuesday, April 9, 2024 Page 23 of 23 FUND NAME GENERAL FUND FUND NO: 1000 nnununnnununnnnnnnnmm�nnnnmm�nnnnnnnnnnnnmm�nnnmm�mm�nnunnnunnnunnunnnunnOnnnnnnnnnunnunnnnnunnnnnnnnnuuunnnnnnuu0 DEPARTMENT NAME: COMMISSIONERS COURT DEPARTMENT NO: 230 CNBMBNT/VOr SSBB I BE4UBBYOIDCQUNYYAUB/7OB/OVERBRAWN (AMENDMENT REASON: IOVERDRAWN ACCOUNTS I REVENUE REVENUE EAPENDRME EAPENDMIRE RRIVIR ACCT NO ACCT NAME CRANE NO GRAM NAME INCREASE DECREASE INCREASE DECREASE [DECREASE] 63920 MISCELLANEOUS 999 NO GRANT $0 $0 $0 $73 $73 72660 EQUIPMENT -SOFTWARE 999 NO GRANT $0 $0 $73 $0 ($73) AMENDMENT NO 6669 TOTAL $0 $0 $73 $73 $0 COMMISSIONERS COURT TOTAL $0 $0 $73 $73 $0 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 DEPARTMENT NAME: LIBRARY DEPARTMENT NO: 140 ENOMENTAror BBBB I REQUESYORsL/BRARY AMENDMENT REASON: ITO PAY FOR NEW BOOKSHELF TUND BAL REVENUE REVENDE EAPENORI]DE EAPENDRIME INCREASE ACCT NO ACCT NAME CRAM NO RII6 NT RA INCREASE DECREASE INCREASE DECREASE [DECREASE] 66618 UTILITIES -POINT COMFORT LIBRAR 999 NO GRANT $0 $0 $0 $500 $500 72350 EQUIPMENT -OFFICE 999 NO GRANT $0 $0 $50.0 - $0 ($500) AMENDMENT NO 6668 TOTAL $0 $0 $500 $500 $0 LIBRARY TOTAL $0 $0 $500 $500 $0 GENERAL FUND TOTAL $0 $0 $573 $573 $0 Grand Total $0 $0 $573 $573 $0 Tuesday, April 9, 2024 Page 1 of 1 #31 NOTICE OF MEETING 4/10/2024 31. Aooroval of bills and oavroll. (RHM) MMC Bills RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Oct 1 SECONDER: Vern Lyssy, Commissioner Oct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese :R• 2ROVED[UNANIMOUS id Hall, Commissioner Pc n Lyssy, Commissioner Pc Commissi Page 28 of 32 P N b P n O ep M N vPi P W P V W M N y" a U ❑ y o m O J J W C Z W m vi ❑ W a W LL x U � J a V Y 0. � � F � a � bo o a ❑ _ W❑{y w' C y O p o W v� W W a W z� W W 3xx � w w Y w Y w 0 N N N O U I o O O N N W m W � W m � � W m O � ilG ;❑ ^ �O �D O P � F J Z J J OU } > U U U z 0 U Y C Z z � U¢ �yZj .i O Q ¢ ¢ J N [aG y W y W y W y W y ce m°o z �o Wo wo wo wo Wo �o � o wo zz zo U W 0.'E U U 3 F 2= 7 FO pZ O O� U U a 4 W J O x0 W J x0 W J x0 W J W J W J W J W J W J W J W J m J y y y y y y x0 y y x0 y y x0 y y x0 y y x0 y y x0 y y xp m y xp y y v J O O V VMj N N b b b b V b b b b b b b b b b i F tC h O W y y 0 ❑ W x 00 a a w z adNa Wa I �I o 0 a U P m o m ao �o 0 o eo m h r b r h b Q b N N Q N Q V .- m N b b g Q, a Q c mm 0v Oo Z— K rn vPi„ cn >o O F z^ >3 °03 xN^ yy3 z3 Na a N N N N N N N N N N W OW Ow o W W W W W W e — — E �h �m 94 �rn a y z z 0 Z z O z 'Z O `� Z z 'Z .2. z Z .w Z 'z z y ,'{ z z w W W w 0 W O W O W. w 0 W O W O y 0 `o JF JF JF JF JF JF JF Jr JF JF J D J D J "J J a J❑ J D .. ]� J� J p J D v W J W J w J W J J r W J W J W J W J W J �O NO y0 NO NO NO �O �O y0 y0 9 O U O O O O O O O O N N J b b b b b b b b b b d 0 0 0 0 oa 0 o c c VMi W O N O Vbi N P P O b O c0 - O' N - M N �o m s b Q N Y> o M M� Fx a y z W C Y � UU yy V p.°'o O u o> O 0 b 0 P � e o o Q Oi M M M O N s o m r ao r r N b W z < 3v z< U p N } ¢ W O ZH a9 W 0 w..] 7 Up P ne b b b h N W z y Ly U ¢, o :D z w O W p a a a V z O [97 o O - N E n � F n w W 94 w 6 U Zd o o W s Zn N 0 m 00 00 O � d o k O vl � of V O N M O C P N Vf v� M r M O Vt N O O O Y M V M e0 m r m r N ^ O O O N M y �• Ly Li i F 4 w w W a W o a N w u "Cal 6 h °h UM F 6m om oM oa 3 o o Q>a rz 3 oa u u� X N wv m :° F 00 Q U 000 U U U 00 UU Q !�� a 60 ¢ Q m 0 N F Fa �w O p U 0 V O L y EE. ry O W N m O L I N O O N N m Vf U O n N O qqO b O O .Z N n 0 °z F 0 z at F -d U Q Z U O 3 o w F S Q H w a F. 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U 4 U 0. U 4 U 4 U 4 U 4 U 6 U 4 U 4 U 4 U N e n a m tr a m a a a a 2 CgZ i OR a n a a C O W T O T W N ei h W P O O v1 h r r Y h T r m N N N 0 0 0 co 0 z z ¢ 0 ¢ u cac� Ow 'atea OvNa X cgcs� w U)(a F y �¢ 04 WO yOnQ z a ¢ N U O m O U aONp., OU a > FO F FO F FO Z' H FO CJ FO 0� Q tii OV 9 O U m b b b N b r r r n O = O J CJ V1 N N Y N N N V1 N N N N V1 N M1 N V1 N V1 N O Vf V SF Y O �p U Q Q [zil :J F f- a [Nil Q z Q u U wz U V W u W u u �,'• wJ OLJj wF ❑,e wz ❑� 'O� wzN S N W O W S V W z ❑� wz ❑ a'-� O �z O S tJil �" J Uy U U a V qq UD W U Uy U Uyz U V y U Uy� V U y U U ym Uya Uy2 ¢? ¢?d dz ¢Z ¢z V W ¢ZS U W ¢�F U QZ> a F F Ci v a a v q F v D` U � O F F Z W E F a v F F w q o °z a f� F /I robdsv axm Ul W N r� 0 y0 d1 g L+l y a M al PU 0 H �m Hr 0 x w r O C' n rccr m r�, t7: r Y n 7 H H W 3 M Y rorov F, N J J N 01 J W O O 01 F+ o iP m 0 0 A MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---April 10 2024 TOTALS TO BE APPROVED -TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 866,108.87 TOTAL TRANSFERS BETWEEN FUNDS $ 213,993.45 TOTAL NURSING HOME UPL EXPENSES $. 803,804.45 TOTAL INTER -GOVERNMENT TRANSFERS GRAND TOTAL DISBURSEMENTS APPROVED April 10, 2024 $ 1,883,906.77 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---April 10, 2024 PAYABLES AND PAYROLL 4/4/2024 Weekly Payables 195,074.91 4/4/2024 Patient Refunds 1,259.59 4/9/2024 Texas State Board of Pharmacy -license renewal 580.00 4/8/2024 McKesson-340B Prescription Expense 4,329.78 4/8/2024 Amerlsource Bergen-340B Prescription Expense 420.66 4/8/2024 Payroll Liabllitles-Payroll Taxes 121,229.32 4/8/2024 Payroll 378,831.21 Prosperity Electronic Bank Payments 4/3-415/24 Credit Card & Lease Fees 847.09 3/18-4/1/24 90 Degree Benefits -employee insurance claims 46,337.13 2/26-3/24/24 Truescripts-prescription claim fee 49,711.58 4/1-4/5/24 Pay Plus -Patient Claims Processing Fee 563.64 4/1/2024 HPHG- April health insurace premium payments 66,570.23 4/1212024 Health Equity-HSA Contributions 1,322.83 4/2/2024 Authnet Gateway Billing-3rd Party Payor Fee 31.90 TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 866,108.87 TRANSFER BETWEEN FUNDS FROM MMCTO NURSING HOMES 4/4/2024 MMC Operating to Broadmoor-correction of nursing home payment deposited Into MMC Operating 3,264.00 4/4/2024 MMC Operating to The Crescent -correction of nursing home insurance payment deposited into MMC Operating 16,975.20 4/4/2024 MMC Operating to Golden Creek Healthcare -correction of nursing home insurance payment deposited into MMC Operating 105,949.39 4/4/2024 MMC Operating to Gulf Pointe Plaza - correction of nursing home payment deposited Into MMC Operating 1,065.26 4/4/2024 MMC Operating to Tuscany Village -correction of nursing home insurance payment deposited into MMC Operating 39,875.92 4/4/2024 MMC Operating to Bethany -correction of nursing home insurance payment deposited into MMC Operating 46,963.69 TOTAL TRANSFERS BETWEEN FUNDS $ 213,993.45. NURSING HOME UPL EXPENSES 4/8/2024 Nursing Home UPL-Cantex Transfer 292,882.76 4/8/2024 Nursing Home UPL-Nexion Transfer 201,343.45 4/8/2024 Nursing Home UPL-HMG Transfer 69,173.80 4/8/2024 Nursing Home UPL-Tuscany Transfer 27,978.96 . 4/8/2024 Nursing Home UPL-HSLTransfer 149,302.30 QIPP CHECKS TO MMC 4/8/2024 Broadmoor 25,123.35 4/8/2024 Crescent 13,338.04 4/8/2024 Fort Bend 2,379.01 4/8/2024 Solana 20,893.28 TRANSFER OF FUNDS BETWEEN NURSING HOMES 4/8/2024 Crescentto Tuscany -Tuscany insurance payment deposited into Crescent In error 2,400.00 TOTAL NURSING HOME UPL EXPENSES $ 803,804.45 TOTAL INTER -GOVERNMENT TRANSFERS GRAND TOTAL DISBURSEMENTS APPROVED April 10, 2024 $ 1,883,906.77 4/4124 t :p4 �IY1-.q7�+; 7ry-� Imp cw5repon2fi54280842688708098.h1m1 Sg7��y��11'11� . �taA.pp�tj}.9:1.11i 04/04/AiR 11 1'1 2UL)') MEMORIAL MEDICAL CENTER 11:24 AP Open Invoice List 0 C'i'lltttl iu ator Due Dates Through: 04/26/2024 ap_open_invoice.template Vendor#"Vendor Name / Class Pay Code At 680 AIRGAS USA, LLC - CENTRAL DIV ✓ M Invoice# mment Tran Di Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 9148156194 03129/20203/21/20204/151202 369.52 0.00 0.00 / 369,52, OXYGEN Vendor Totals: Number Name Gross Discount No -Pay Net Al 680 AIRGAS USA, LLC - CENTRAL DIV 369.52 MOO 0.00 369,52 Vendor# Vendor Name Class Pay Code A1715 ALCO SALES & SERVICE CO ✓ M Invoicelf Comment Tran Dt Inv Dt Due Dt Check Dt Pay 2944855-IN Gross Discount No -Pay Net ✓ ON29120203/22/2O2 DIV021202 215.04 0.00 0,00 215.04 SUPPLIES r,+� Vendor Totals: Number Name Gross Discount No -Pay Net At 715 ALCO SALES & SERVICE CO 215.04 0.00 0.00 216.04 Vendor# Vendor Name Class Pay Code 14028 AMAZON CAPITAL SERVICES wl Invoice# Comn`7I Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1WQ1-JHQH-N6J6 ✓ 02/29f20202/22/20203/23/202 49.99 0.00 0.00 / 49.99 r/ SUPPLIES 13H9-CYWH-KG9H.,"' 03/27/20203121/20204/20/202 27.90 0.00 0.00 27,90 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 14028 AMAZON CAPITAL SERVICES 77.89 0.00 0.00 77.89 Vendor# Vendor Name Class Pay Code / A1360 AMERISOURCEBERGEN DRUG CORP ✓ W Invoice# /90mment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 804539307 ✓ 03129120202/29/20203/06/202 102.06 0,0D 0:00 102.06 8045703321/ 03129/20203/151202030/202 131.31 0.00 0.00 131.31 ✓ INVENTORY Vendor Totals: Number Name Gross Discount No -Pay Net A1360 AMERISOURCESERGEN DRUG CORP 233.37 0.00 0.00 233.37 Vendor# Vendor Name / Class Pay Code 14088 AZALEA HEALTH v Invoice# !/ Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 10" -, ✓ 031291202OW01/20203/01/202 594,00 0100 0100 / 594.00 ✓ MONTHLY FEES Vendor Totals: Number Name Grass Discount No -Pay Net 14088 AZALEA HEALTH 594.00 0.00 0.00 594.00 Vendor# Vendor Name Class Pay Code / 10024 BECTON, DICKINSON & CO (BD) Invoice# - /Comment Tran Dt Inv Dt Due Ot Check Ot Pay Gross Discount No -Pay Net 9112471634 03/27120203113/20204/12/202 273,25 0.00 0.00 273.25 r/ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 10024 BECTON, DICKINSON & CO (BD) 27125 0100 0.00 273.25 Ventlor# Vendor Name / Class Pay Code 11072 BIO-RAD LABORATORIES, INC �/ Invoice# Comment Tran Ot Inv Dt Due Dt Chock Dt Pay Gross Discount No -Pay Net 907113840 wl 03/29/20203/12/20203/07/P02 859.47 0.00 0.00 / 859,47 SUPPLIES 907121581� 03/29120203114/20204/02/202 506.70 0,00 0.00 596,70,/ 01e:/1/C:/Users/ilrevino/cpsitmemrned.cpsinat.comiu88l25/data_5/imp_ ew5report2654280942689708098,htmI 119 414124, 11:24 AM tmp_cw5report2654280942689708098.html 9 SUPPLIES 20 / 907121> 03129/20203114/20204/02/202 2,119.47 0.00 0.00 2,119.47 ✓ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 11072 610-RAD LABORATORIES, INC 3.575.64 0.00 0.00 3,575.64 Vendor# Vendor Name Class Pay Code B1655 BOSTON SCIENTIFIC CORPORATION ✓ M invoice# /Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 997065548✓ SUrpli 4, 03/29/20203/18t20204/02/202 393.00 0,00 0.00 393.00✓ Vendor Totals: Number Name Gross Discount No -Pay Net B1655 BOSTON SCIENTIFIC CORPORATION 393.00 0.00 0,00 393.00 Vendor# Vendor Name Class Pay Cade 14120 / CALHOUN COUNTY EMS ✓ Invoice# / Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No�Pay Net 2024-02✓ 02/29/20203/11120204/20/202 2,840.00 0,00 0.00 2,640.00 t�Iz-y+�Zl�tilvt) FEB.EMSTRANSFERB Vendor Totals: Number Name Gross Discount No -Pay Net 14120 CALHOUN COUNTY EMS 2.640,00 0.00 0.00 2,640.00 Vendor# Vendor Name Class Pay Code C1992 ,r COW GOVERNMENT, INC. ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount 'No -Pay Net / 0679036✓ 03127/202 03/08/202 041071202 175.72 0.00 0.00 175.72 y� SUPPLIES - VA0%Z WU OB78889 03127/202 03/08/202 04/071202 294.21 0.00 0.00 294.21✓ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net C1992 CDW GOVERNMENT, INC. 469.93 0.00 0.00 469.93 Vendor# Vendor Name Class Pay Cade 13000 CLEARFLY✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net INV595956�/ 04/03120204/01/20204/15/202 1,203.95 0.00 0.00 1,203.95V/ PHONE Vendor Totals: Number Name Gross Discount No -Pay Net 13000 CLEARFLY 1,203.95 0.00 0.00 1,203,95 Vendor# Vendor Name Class Pay Code 13336 COCA COLA SOUTHWEST BEVERAGES ✓ / Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 402138400041/ 03/29/20203/06120204106/202 703.86 0.00 0.00 703.86.," BEVERAGES Vendor Totals: Number Name Gross Discount No -Pay Net 13336 COCA COLA SOUTHWEST BEVERAGES 703,86 0.00 0.00 703.86 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS ✓ Invoice# Comment Tran DI Inv DL Due Dt Check Dt Pay Gross Discount No -Pay Net 43084 L// 03/29/20203/29/20204/08/202 40,062.50 0.00 0.00 40,062.50 r� PHYSICIAN SERV Vendor Totals: Number Name Gross Discount No -Pay Net 11284 EMERGENCY STAFFING SOLUTIONS 40,062.50 0.00 0.00 40,062.50 Vendor# Vendor Name Class Pay Code 14336 FIRETRON, INC Invoice# / Comment Tran Of Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 253268 ,/ 03/25t202 03/25/202 04/241202 680.00 0.00 0.00 680,0o',/ CLINIC INSPECTIONS 253265 1-/ 03125/20203/25/20204/24/2D2 1,973.00 0.00 0.00 1,973.00 INSPECTIONS flia:///C:/Users/itravino/cpsi/memmed.cpsinat.comtu88l26tdata 51tmp_cwSreport2654280042689708098,html 219 4/4/24, 11:24 AM imp_cw5repor12654280942689708098.html Vendor Totals: Number Name Gross Discount 14336 FIRETRON, INC 2,653.00 0.00 Vendor# Vendor Name / Class Pay Code F1400 FISHER HEALTHCARE ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross / 0866182 rf 03/29/202 03/20/202 04/14/202 16.26 SUPPLIES 0866181 03/29/202 03/20/202 D41141202 622.29 SUPPLIES / 0905060 03/29/20203/21120204/15/202 375.98 / SUPPLIES ✓ 0905059 03/29/202 03/21/202 04/151202 375.98 SUPPLIES 0905058 03/29/202 030 /202 04/15/202 187.99 SUPPLIES / 0905061✓ 03129/202 03/21/202 04/151202 691.53 SUPPLIES 0905062✓ 03/29120203/21/20204/15/202 202.28 SUPPLIES 0940719 03/29120203/22/20204/16/202 375.98 SUPPLIES 0940718 r/ 0312912020312PJ20204/16/202 24,34 / SUPPLIES 0976711 f 03129/20203/25/20204/79/202 5,873,20 SUPPLIES 0976710 03/29/202 03/25/202 04/191202 37.13 /SUPPLIES 0976709 03129/202 03/261202 041191202 38,39 SUPPLIES Vendor Totals: Number Name Gross F1400 FISHER HEALTHCARE 8,921,35 Vendor# Vendor Name / Class Pay Code 14166 FUJI FILM ✓ Invoice# /Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross 91460948✓ 03/291202 03/251202 04/15/202 7,908.33 CONTRACT Vendor Totals: Number Name Grass 14156 FUJI FILM 7,908.33 Vendor# Vendor Name Class Pay Code / 10956 GETINGE USA SALES LLC Invoice# Cc ment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 6992511664 ✓ 03/29/20202/28t20204/04/202 64.13 SUPPLIES Vendor Totals: Number Name Gross 10956 GETINGE USA SALES LLC 64.13 Vendor# Vendor Name Class Pay Cade W1300 GRAINGER ✓ / M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 90557458231/ 03/29/202 03/18f202 04/1 PJ202 67.68 S PPLIES 9056542468 03/29/20203/18/20204/12/202 94.85 S PPLIES 9056771364 03/29/20203/1.W20204/1 PJ202 341.40 S PPLIES 9056771372 03/2912020311 IV20204/1 PJ202 134.34 SUPPLIES file:///C:/Users/ltrevinolcpsi/memmed,cpsinet.com/u8B1251data_5/tmp cw5repor12654280942689708096.html No -Pay Net 0.00 2,653.00 Discount No -Pay 0.00 0.00 0.00 0,00 0.00 0,00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0,00 0,00 0.00 Discount No -Pay 0,00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0,00 Discount No -Pay 0.00 0.00 0.00 0,00 D.00 0,00 0.00 0.00 Net 16.26 ✓/ 622,29 ✓ 375.98 375.96 ✓ 187,99 691,53 ✓ 202.28 375.98 24,34 ✓ J 5,973.20 37.13 38.39 v/ Net 8,921.35 Net / 7,908.33 ✓ Net 7,008.33 Net / 64,13 ✓ Net 64,13 Net 67,68 / 94.85,1'� 341.40 134'34 ✓` 319 414124. 11:24 AM Imp_cw5report2654280942689708098.htm1 Vendor Totals: Number Name Gross Discount W1300 GRAINGER 638.27 0.00 Vendor# Vendor Name Class Pay Code 16348 HEALTH EQUITY Invoice# Tran Dt Inv Dt Due Dt Check Dt Pay Gross /Comment V080897,/ 04/04/20204/04(20204/04/202 35160 APR 24 FEES Vendor Totals: Number Name Gross 15348 HEALTH EQUITY 353.60 Vendor# Vendor Name / Class Pay Code 12380 HEALTH SOLUTIONS DIETETICS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 033024 03/29/202 03130/202 04/151202 4,250.00 DIETICIAN 8ERV Vendor Totals: Number Name Gress 12380 HEALTH SOLUTIONS DIETETICS 4,250.00 Ventlor# Vendor Name Class Pay Code H1226 HEALTHMARK INDUSTRIES CO. INC Invoice# Tran Dt Inv Dt Due Ot Check Dt Pay Gross /Comment INV1854475✓ 03/291202 12/18/202 01/18/202 72.43 /SUPPLIES INV1862127d 03/29/202 01105/202 02JO51202 55.22 SUPPLIES Vendor Totals: Number Name Gross H1226 HEALTHMARK INDUSTRIES CO INC 127.65 Vendor# Vendor Name Class Pay Code 10829 HEALTHSTREAM, INC. Invoice# ,Comment Tran Dt Inv IN Due Dt Check Dt Pay Gross 0351131 ,/ 03/29/20203/22/20204/21/202 120.96. 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No -Pay Net 0.00 0.00 29,065.42 Discount No -Pay Net 0.00 0.00 29,065,42 Discount No -Pay Net 0.00 0.00 25o.00 Discount No -Pay Net 0.00 0,00 250.00 419 414/24, 11:24 AM tmp_cw5report2654280942689708098.html / J0150 J & J HEALTH CARE SYSTEMS, INC ,/ Invoice # amment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 937783941r� 03l20120203/1 W20204/17/202 184.40 0.00 0.00 184.40 SUPPLIES 937805567 03129/20203/19/20204/18/202 481.88 0,00 0.00 481.9E SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net J0150 J & J HEALTH CARE SYSTEMS, INC 666.38 0,00 0.00 666.38 Vendor* Vendor Name Class Pay Code M2310 / MEDELA INC t/ M Involee# Co men Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 7002021438 03/29/20203/12/20204/02/202 284,80 0.00 0.00 284.80 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net M2310 MEDELA INC 284.80 0.00 0.00 284.80 Vendor# Vendor Name Class Pay Code 11141 MEDICAL DATA SYSTEMS, INC. ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 189845 03/29120202/29120203/25/202 1,800.01 0.00 0.00 / 1,800.01,/ / COLLECTION FEES / 189844 ✓ 03/29/20202/29/20203/25/202 1,239.86 0.00. 0.00 1,239.86,/ COLLECTION FEES 190673 ✓ 03/29/202 03/31/202 041251202 192.25 0.00 0.00 192.25 / BUSINESS SERV 191018 ,/ OW31/202 OW31/20204/25/202 117.33 0.00 0.00 117.33� / COLLECTION FEES 191016 03/311202 03/311202 041251202 2,993.82 0.00 0.00 / 2,993,82✓ COLLECTION FEES 191017✓ 03/31/20203131120204125/202 2,899.51 0.00 0.00 2,899.51 r/ COLLECTION FEES Vendor Totals: Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC. 9,242.78 0.00 0.00 9242.78 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC / M Invoice# C mment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2310915... 03121/20203/13/20204107/202 1,131.04 0.00 0.00 1,131.04 SUPPLIES 2311779088 ✓ 03127/20203/20/20204/14/202 377.79 0.00 0.00 377.79 PPLIES 2310440100 03129120203/08/20204/02/202 48.50 0.00 0.00 48.50 ✓/ S PPLIES 2312516931,E 03129/20203/25/20204/19/202 11.14 0.00 0.00 11.14.,� S PPLIES 23125169300301120203/26/20204/20/202 11.14 0.00 0.00 11.14 SUPPLIES 2312618374✓ 031291202 031261202 04/201202 304.45 0.00 0.00 304.45 S/UPPLIES 2312516933✓ 03/29/202 03/261202 041201202 8,92 0.00 0.00 8.92,/� SUPPLIES 2312733347 03129/202 03/271202 04121/202 30:73 0.00 0.00 30.73✓ SUPPLIES 2312733351 ✓ 03/29/202 03127/202 04/211202 480.13 0.00 0.00 / 480.13 / SUPPLIES 2312733353 ✓ 03/29/20203127/20204/21/202 116.30 0.00 0.00 11&30 ✓ SUPPLIES 2312733352 03/291202 03/97/202 041211202 2.501.94 0.00 0.00 2.501.94 01e:///C:/Usemiltrevino/cpsl/memmed.cpsinet.comlu8B125/data_51tmp_cw5report2654280942689708098.html 519 4/4/24, 11:24AM tmp_cw5mport2654280942689708098.html SUPPLIES 2312733349 ;/ 03/29/20203/27120204/21/202 1,727.71 0.00 0.00 1,727.71 /gUPPLIES 23127333$0/ 03/29/202 03/271202 04/21/202 7,13 0.00 0.00 7.13 PPLIES 2313036450 03/291202 03/29t202 04/23/202 152.78 0.00 0.00 152.78 v/ SUPPLIES 2313036449 / 03/291202 03/291202 04/23/202 79.44 0.00 0.00 / 79.44 y v SUPPLIES ✓ Vendor Totals: Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 6,989.14 0.00 0.00 6,989.14 Vendor# Vendor Name Class Pay Code 10182 MERCEDES SCIENTIFIC / ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2820360 / 03129/202 03/25/202 04/24/202 35.88 0.00 0.00 35.88� v SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 10182 MERCEDES SCIENTIFIC 35.88 0.00 0,00 35.88 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC r% Invoiced Comment Tran Dt Inv Dt Due Dt Check Di Pay Gross Discount No -Pay Net CM1360 . 03/29/202 03/251202 04104/202 -.11.41 0.00 0.00 -11.41 1 CREDIT SC4858 ,d 031311202 03/25/202 04/04/202 127.36 0.00 0.00 127.36 / SERV CHARGE SC4859✓ 03/31/202 03/25/202 04104/202 98.07 0.00 0.00 98.07✓ � SERV CHARGE 1807405 ✓ 03/3l/20203127/20204/061202 528.15 0.00 0.00 628.15 /INVENTORY y/ 1807406 031311202 03/27/202 041061202 698.54 0.00 0.00 698.54 INVENTORY V,% 2271 >// 03/31/20203/28/20204/071202 -195.44 0.00 0.00 -195.44 CREDIT 1811596/ 03131/202 03128/202 04/07/202 955.81 O.00 0.00 j 95.9.81 INVENTORY 1811595 ✓/03131/202 03/281202 04/07/202 676.23 0.00 0.00 87823 ✓ / INVENTORY 1818679 �/ 03131/202 03/311202 04/10/202 8.79 0.00 0.00 8.79 V/ INVENTORY 1818680./ 031311202 03/31/202 04110/202 170.08 0.00 0.00 �+ 170.08✓ INVENTORY 1820220 i/ 04/03/20204/1)1/202041111202 93.38 0.00 0.00 93.38 INVENTORY 1822227 04103/202 041011202 04/11/202 52.92 0,00 0.00 52.92 INVENTORY Vendor Totals: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 3.202.48 0.00 0.00 3,202.48 Vendor# Vendor Name Class Pay Coda / 13548 NACOGDOCHES TRANSCRIPTION ✓ invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 8314 031291202 03/191202 03/29=2 99.10 0,00 0.00 99.10 TRANSCRIPTION SERV 3Iz - 31 K I L`I 8335 / 04103120204102J20204112/ 02. 203.70 0.00 0.00 203.70,�,' TRANSCRITPTION SERV 3IIb - 3�Z7I 114 Vendor Totals: Number Name Gross Discount No -Pay Net 13548 NACOGDOCHES TRANSCRIPTION 302.80 0.00 0.00 302.80 tile:///C:tUsers/Itrevino/cpsUmemmed.cpsinet.com/u88l25/data_5/tmp_cw5report2664280942689708098.html 619 414/24, 11:24 AM tmp_cw5repart2654280942689708098.html Vendor# Vendor Name Class Pay Code S0906 PERFORMANCE HEALTH M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net IN97447890/ 03/27/202 03120/202 04/14/202 19113 0.00 0.00 191.73 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net S0905 PERFORMANCE HEALTH 191.73 0.00 0.00 191.73 Vendor# Vendor Name / Class Pay Code 14764 PL-CPR, LLC �/ Invoice## Comment Tran Ot Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Not / 302 e/ 03120/202 03/28/202 03/291202 900.00 0.00 0.00 900.00/ ACLS 303 03/29/20203/28/20204/151202 700.00 0.00 0.00 700.00/ PALS Vendor Totals: Number Name Gross Discount No -Pay Net 14764 FL -CPR, LLC 1,600.00 0.00 0.00 1,600.00 Vendor# Vendor Name Class Pay Code P2200 / POWER HARDWARE ✓ W Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Grass Discount No -Pay .Net 033124 03131/202 03/311202 04/101202 68.14 0.00 0,00 68.14 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net P2200 POWER HARDWARE 68.14 0.00 0.00 68.14 Vendor# Vendor Name Class Pay Cade 10936 SIEMENS FINANCIAL SERVICES / ✓ Invoice# Comma t Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 56382400037997 03/311202 03/30/202 04/19/202 1,333,33 0.00 0.00 1,333.33 / LEASE Vendor Totals: Number Name Gross Discount No -Pay Net 10936 SIEMENS FINANCIAL SERVICES 1,333.33 0.00 0.00 1.333.33 Vandor# Vendor Name Class Pay Code $2001 SIEMENS MEDICAL SOLUTIONS INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 116519808,' 0301/202 03/161202 04/10/202 2,451.95 0.00 0.00 2.451,95� $YMBIA EVO CONTRACT 116522332 7//" 03/29/202 03/24/202 04/181202 3,507.72 0.00 0.00 9,507.72 LUMINOS AGILE MAX Vendor Totals: Number Name Gross Discount No -Pay Net S2001 SIEMENS MEDICAL SOLUTIONS INC 5.959.67 0.00 0.00 5,959.67 Vendor# Vendor Name Class Pay Code 12472 SOMETHING MORE MEDIA, INC. >, Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2183 �/ 03/29/202 03/271202 041111202 2,625.00 0.00 0.00 2.526.00 ADVERTISING Vendor Totals: Number Name Gross Discount No -Pay Net 12472 SOMETHING MORE MEDIA, INC. 2,526.00 0.00 0.00 2.625.00 Vendor# Vendor Name Class Pay Code S3940 STERIS CORPORATION M Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 12199877 ✓/03/29/20203/20/20204/14/202 -234.82 0100 0,00 -2$4.82 SUPPLIES 12210998 ✓ 03/29/20203/22/20204/161202 234.82 0.00 0.00 234.82 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 83940 STERIS CORPORATION 0.00 0.00 0.00 0.00 Vendor# Vendor Name Class Pay Code file:lllC:/Usersiltrevino/cpsilmemmed.cpsinet.com/u88125/data_51tmp_cw$report2654280942689708098.him1 7/9 4/4124, 11:24 AM tmp_cw5report26542B0942689708098.html 14212 SURGICAL DIRECT SOUTH z Invoice# Comment Tian Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 9333 ✓ 03/291202 03/26/202 04/25/202 3,660.00 0.00 0.00 3,660.00� SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 14212 SURGICAL DIRECT SOUTH 3,660.00 0.00 0.00 3.660.00 Vendor# Vendor Name Class Pay Code 10410 TRAVEL NURSE ACROSS AMERICA Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 22-894728 l/ OW311202 03/06/202 04/061202 3,150.00 0.00 0.00 3,150.00 DAVID COYLEER Vendor Totals; Number Name Gross Discount No -Pay Net 10410 TRAVEL NURSE ACROSS AMERICA 3,150.00 0.00 0100 3,160.00 Vendor# Vendor Name Class Pay Code 13144 TRI WHOLESALE CO. Invoice# Comment Tran Dt Inv Dt Due Dt Check DI Pay Gross Discount No -Pay Net 98.48✓ 195537 r// 03/29120202/16/20203/161202 98.48 0.00 0.00 SUPPLIES Vendor Totals: Number Name Gross Discount No�Pay Net 13144 TRI WHOLESALE CO. 98.48 0.00 0.00 98.48 Vendor# Vendor Name Class Pay Code / 14372 TRIAGE, LLC Y Invoice# CDm ent Tren Dt Inv Dt Due Dt Check DI Pay 7 Gross Discount No -Pay Net 3,467.50 INV1796936101 03/21/20203/22/20204121/202 3.467.50 0.00 0.00 S SHAW Vendor Totals: Number Name Gross Discount No -Pay Net 14372 TRIAGE, LLC 3,467.50 0.00 0.00 3,467.50 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC f Invoice# Comment Tran Dt Inv Dt Due DI Check Dt Pay Gross Discount ND -Pay Net 2921028163 J 03/29/202 03125/202 041191202 2,897.79 0.00 0.00 2,897.79 /LAUNDRY 2921028164/ 03/29/202 03/251202 04/19/202 102,07 0.00 0.00 102.07✓ L/gUNDRY 2921028502 „/ 03129/202 03/28/202 041221202 253,41 0.00 0.00 253.41.✓ LAUNDRY 2921028497 r03129120203/28/20204/22/202 216.26 0.00 0.00 216,20 /LAUNDRY 2921028498✓ 03/29/20203/28120204/2V202 2,543,35 D.00 0.00 2,543.35 UNDRY / 2921028503 03129/20203/28/20204/22/202 113.81 0.00 0.00 113.81 ✓ LAUNDRY 0100 121,87 2921028496✓ 03/29/20203/28/20204/22/202 121.87 0.00 SAUNDRY 2921028499✓ 03/29120203128120204/22/202 32.90 0.00 0.00 32.90 ✓ LAUNDRY 2921028500 ✓/031291202 03/28/202 0412PJ202 315.03 0.00 0.00 316,03 LAUNDRY % 2921028501 J 03/29/20203/2812020412PJ202 282,90 0.00 0.00 282.90 LAUNDRY Vendor Totals: Number Name Grass Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 6,879.39 0.00 0.00 6.879.39 Vendor# Vendor Name Class Pay Code 11280 VICTORIA ADVOCATE Z11, Invoice# Comment Tran Dt Inv Dt Due Dt Check DI Pay Gross Discount ND -Pay Net 0329764 03/29/202 03/31/202 04/15/202 30.50 0.00 0.00 30.50✓ file:/NC:/Userslltrevino/cpsi/memmed.cpsinst.com/u88125/data_5/tmp_cw5report2654280942689708098.html 8/9 414124, 11:24 AM tmp_cw5report2654280942689708098.html PAPER Vendor Totals: Number Name 11280 VICTORIA ADVOCATE Vendor# Vendor Name Class Pay Code 12208 WAGEWORKS Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay INV6347438 ✓ 03129/20203/25/20204/24/202 MONTHLY COMPLIANCE/FSA Vendor Totals: Number Name 12208 WAGEWORKS Vendor# Vendor Name Class Pay Code 12548 WAGEWORKS, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 24-TR116685 ✓ 03/29120203101/20203/01/202 COBRA MAR 24 Vendor Totals: Number Name 12548 WAGEWORKS, INC Vendor# Vendor Name Class Pay Code 11400 WEST COAST MEDICAL RESOURCES ✓ / Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay INV111420 J / 03/27/20203/25/20203/27/202 SUPPLIES Vendor Totals: Number Name 11400 WEST COAST MEDICAL RESOURCES Vendor# Vendor Name - Class Pay Code 10556 WOUND CARE SPECIALISTS Invoice# Ca mant Tran Dt Inv Dt Due Of Check Dt Pay WCS000065997 03/29/202 03/011202 03/30/202 WOUND CARE FEB 24 Vendor Tatals: Number Name 10556 WOUND CARE SPECIALISTS Reh ,e'x Stiwi Hrp Grand Totals: Gross Discount 195,074.91 0.00 APP,NvEl) ,4pi? + 2024 Ce%n'y COUNi-yAUD1TOk LfloUN COUAI7Y, TEXAS Gross Discount No -Pay Net 30.50 0.00 0.00 30.50 Gross Discount No -Pay Net 596.00 0.00 0.00 596.00 Gross Discount No -Pay Net 596.00 0.00 0.00 596.00 Gross Discount No -Pay Net 131.25 0.00 0.00 131.266X Gross Discount No -Pay Net 131.25 0.00 0.00 131.25 Gross Discount No -Pay Net 1,432.00 0.00 0.00 1,432.00 Gross Discount No -Pay Net 1.432.00 0100 0.00 1,432.00 Grass Discount No -Pay Net 17,400.00 0.00 0.00 17,400.00 Gross Discount No -Pay Net 17,400.00 0.00 0.00 17,400.00 No -Pay Net 0.00 1195,074.91. Ole;tt/C:IUserslltrevino%psi/memmed.cpsinet.cam/u881251data_5/tmp_cw5report2654280942689708098.html 9/9 RECEIVED BY THE COUNTY AUDFFOR ON APPROVED ON RUU TINE: 009(09f24 APR 0 4 -^ MEMORIAL APR LIST4FORCPATIENT REFUNDS ARID=0001 PATIENT CALHOIN! COUNTY, TEXAS PAY PAT 8 �N70y4p2�0p2�ApPCCOEDIT CALHOUI�IC07UNTY,'TEXAS NUMBER PAYEE NAME DATE 1040UNT CODE TYPE DESCRIPTION GI. NUN . ........................................................................ ---- ......................-I------------------- O1 072924 56.15 1 REFUND FOR �56§764 576183 O1 032924 150.00 3 REFUND FOR . h592663 01 032924 451.56 2 REFUND FOR ,/1593325 01 032924 88.70 2 REFUND FOR f}593754 01 032924 55.36 2 REFUND FOR -11593795 01 032924 17.01 2 REFUND FOR ,✓iS95220 --------------- 01 --------------------------------------------------------------------------------------------- 032924 440.51 3 REFUND FOR ._...------------ ARID=0001 'TOTAL 1259.59 TOTAL 1259.59 MSKESSON STATEMENT As of: 04/05/2024 Page: 002 To ensue lamps dean to your admord, admit and mtun this 0«npWy. eoo0 stub with m Your mittance DC: 8115 MEMOPoAL MEDICAL CENTER / AMT DUE REMITTED VIA ACH DEBIT Customer INV Supple: As A: 0005/2024 Pane: 002 Mall to: Comp: 8000 AP 815 N VIRGINIA STREET ✓ Statement for Information only Tonitory: AMT DUE REMITTED VIA ACH DEBIT PORT IAVACA TX T29Tg st Cuomer. 632536 Statement for information only Dale: 0410812024 Curt: 632536 PIFASE CHEOK ANY Date: 04/0812024 REMS NOT PAID (�( along Oue Reoofvablrrtlonal Asomed tSJ&35 Date Data Nunber Relemnw Cash Amount P Description Discount (9mss) F Amount P Reeelvable (net) F Namod PF colu an legend: P = past Dee Item, F = Futue Due Item, blank = Current Due Item TOTAb National Aeel 832536 M900PoAL MEDICAL CENT9t SUMotale: 4.418.14 USD Fid. Due: 0.00 0. If Pond On Time: Part Due: If By moan/2020, USD =4 329J8 0.00 PayTMs Amount: 4,329.78 USD Disc and If pald let.: Pa 8yment- 2,951.IiT If PaM Aft.09/09@020, 98.36 0. If Pold late: OT/201T 0810712017 Pay this Amount: 4.418.14 USD USD 4.418.14 52.4:1 26•?? 4 ^ 6 1 It , i 2 57 • "l G ',. APPROVED ON APR 8 8 28211 BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As or: 04f05/2024 Page: 001 To motors, proper worth to your sceoum, detach rout .faro this c-rss. ease stub with year remittance WALMART INE14 M® PHS AMT DUE REMITTED VIA ACH OMIT M MEMORIAL MMEDICAL CENTER Statement far information only 81S I VIMIN PORE IAVACIA BTA TX ]]979 N VAC DO: 6115 Customer INV SupplD: Territory: tory: 7001 Customer, 256342 Date: 041D612024 As of: 0410512024 Pape: 001 Mell to: C.F. 8000 ANT DUE REMITTED VIA ACH OMIT Statement for information only Cast: 256342 PIEASE CHECK ANY Mo. 04106/2024 R@A8 NOT PAID (,) Billing Due Data Data RecstvsbbNatlonal AeeouM NumMr W,36 Reteronce Oeacdptkn cash Discount Am4uM P (11m.) F Amount IsReceiva0k (not) F Number Customer Number 256342 WAUAAW 04/01/2024 04/09/2024 04/01/2024 04/00/2024 04/01/2024 04/0912024 04101/2024 04109/2024 04101/2024 04/0912024 04101/2024 04/0912024 0410212024 04/09/2024 04/02/2024 04109/2024 0410212024 04109/2024 Q,U0212O24 04/)9/2024 04102/2020 04108I2024 04103/2024 04109/2024 0410312024 04/09/2024 04103/2024 04109/2024 04/0412024 04/09/2024 04/04/2024 04/0912024 04/04/2024 04/09/2024 04/04/2024 04/0912024 04/05/2024 04/0912024 04/OSI2024 04/09/2024 10,1181111130 MED PHS 7487122925 7487122926 7487122928 7487122929 7487t59368 7407351243 7467446638 7487453521 7487453522 7487602698 7487802699 7467729077 798]]29078 746T907074 7458004634 74118004635 7488004637 7488155822 7488434388 7gB8434388 111116998 111118998 111194393 111194393 111308842 111125005 111349712 111425088 111425465 111203880 111356118 111498599 111498599 111505865 111631257 111631257 111692383 111637243 111806499 111751568 11 Simmice 1151nvolce 1151mmfi. 7151nvoice 1151nvoice 1951nvalce 1151nvoine 1151nvaica 115hrowe 1ISlnmice 1951avoke 1151nvoice 1151nvolce 1951nvoice 11510veicu 1151nvoicc 1161nvoice 19510voi. 1151nvolce 1951nvoice 1.34 0.04 9.68 2.68 OA1 5.25 0.87 0.06 0.06 9.07 0.46 0.01 5.01 0.02 1.00 HAS 0.47 17.16 5.94 66.99 1.90 484.14 133.98 0.32 262.45 43,54 3.16 3.16 463.33 23.68 0.49 250.69 0.95 50.24 1.344.18 0.10 23.56 857.93 297,08 65.85.% ✓ 748]122925 1.86Y. /� 7487122926 X,/ 474.467487122920 131.30,X / 7497122929 0.31X �/747158368 257.20X a/ 74:736124 42.67X .//7407446538 3.10a( , ;7487453521 / 3.104e 7407453522 044.264( �]48]602698 23.404L �7487602699 0.48'7( ]40]]24077 245.55X ✓7487729076 0.938( 1I 74879D7674 49.240(,,�7488004634 1,317.300i`✓7468004635 0.io-K //7468004637 29 0944 ✓ /7488155821 dd y3486273322 040,77Y\ ✓ 4B8273323 291.140� �488434388 APPROVED ON OR 0 a 2021] DY COUNTY AUDITOk CA It COUNTY, TEXAS ` > For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT WALMAITr 1098IMFM ME, P ,S qMT DUE PFMITTED VIA ACH OMIT MRA Op L MEDICAL CENTIA statement RE 11TTE VIA A VICKY KAUSIX y 815 N VIMINIA ST PONT LAVACA T% 77979 A. of: 04/05/2024 Page: Out To mount PrePar cratllL to your eaounl, elalech W stun line OC: 8115 Mob with your rern9taao Cuatomar INV SWPID: A. M: 04/05/2024 Page: 001 Territory: T001 to: comp: Camp 8000 ANT DUE REMITTED VIA ACH D®IT Customer. 256342 Slatement for information only Date: 04JO612024 Coat: 256342 PLEASE CHECK ANY Oale: 04/06/2024 D'64S NOT PAID (r( PF caNmn le9ene: P e Pant Due Ilan, 1gft38 blank - Cumant Due Item TOTgI; Customer Number 256342 WALMAITT 1095/M FM M® PH8 Subtotal¢: 4.302.39 USD Future Due: Pao Due: Last Payment 04/01/2024 APPROVED ON OR 0 0 2024 0.00 If Pair) By 0410912024, 0.00 Pay This Amount: 3.539.65 It Paid After 0410912024, Pay this Amount: Dun If Paid On Time: / / USD 4,216.35a/,/ 4.216.35 USD Dbo lost If Pap late: 86.04 Due if Paltl late: 4.302.39 USD USO 4,302.39 + H��Iz JYCOUNTY AUDITOR For AR InquiriCS please contact 800-867-0333 CALNOLIN COUNTY, TEXAS MSKESSON STATEMENT As of: 04/05/2024 Page: 001 To Means Prayer credit to your account, detach and return this amiwry. 8cao MtW with your remittance DC: 8116 HEB FHCY 04341MEM MED PHS Customer INV SuMID: As of: 04/05/2024 (Page: 001 Mail to: Camp: 8000 MEMOVIC"PoAL MEDICAL CENTER/ ANT DUE 110,11TTED VIA A(H DEBIT Territory: ]001 XALISIX b Statement for inlormelion only AMT DUE REMITTED VIA ACH DEBIT 815 N 815 N IA ST Customer. Statement for Intonation only P PORT IAVACA TX ]]9]9 AVAC Date: 04/OBI2024 12024 Cum: 190813 PLEASE CHWK ANY Date: 04/06/2024 SEAS NOT PAID (� ) III Dua Account 5T2�5ytfi ame Data Number Reference Dawtl tlon Cash t Amaum P Ameum P RewNable P (gross) F (n.n F Number CumOmer Number 190B11 H® PHCY 0/34IM EM Mm PH9 04105/2024 04/09/2024 7488271981 3362976 1151neoice 1.07 53.50 52AS-'% / 74882]]961,t= PF wlmnn legend: P = Past Due It... F = Future Dan Item, blank = Current Due Nam TOTAL Cumomer Number 190813 H® PNCY 0434/MEN Mm PHS Subtotals: 53.50 USD Finns Due: Pam Duo: Last Payment 10/24/2022 APPROVED ON 6\Pft 0 0 2(124 RY COUNTY AUDITOR CALHOUN COUNTY, TEXAS D.00 K Pald By 0410912024, 0.00 Pay This Amount: 0.00 If Paid After 0410912024, Pay this Amount: Due If Paid on Time: USD 52+13 J , 52.43 USD Disc Ions K Paid late: 1.0] Due If Paid late: 53.50 USD USD I II'' 5311.50 ,% iL L 9c0 rjbr L1elz`F For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT crosme. ep00 CVS PHCY 89231MW Me MS MEMORIAL MEDICAL CENTER / ANY DUE REImyTED VIA ACH DEBIT VICKY KALISEH 1/ Statement far information onl y 815 N VIRCINIA ST PORT IAVACA TX 77979 As 41: 04/05/2024 DC: 8115 Customer INV Supp1D Territory: 7001 Cualomer. 835434 Data: 04JOB12024 Page: 001 To Groan proper own ro your moss nt, detach and M. this Yob wfh your mNtlance, As of: 04/05/2024 Pap; 001 Mail W. Co., 8000 AMT DUE ItEMITTED VIA ACH DEBIT Statement for information only Cum: 835434 PLEASE CHECK ANY pa�c Date: 0410612024 ITEMS NOT PAID NI wilirg Due Racaw.0morm Account Oi0 E Cash Amount n[ P Neup�bb AL Oata Date NumP Amou Number Cash Description Discount (gross) F fat) F Number Customer Number 935434 CVS PHCY 89231MM MC MS 04/03/2024 04/09/2024 7487749023 3149447 1151nvd. 0.54 26.87 26.33Y ✓ T48TT49023./� PF cdumn legend: P = Pest one Item, F = Fortune Due Item, blank = Current Due it.. TOTAL DYmamm Number 838434 CVS PNCY 092JIME9A MC PHS SubtYals: 26.87 USD Future Due: 0.00 If Pald By 0410912024, Past Due: 0.00 Pay This Amount: lam Payment 3.539.65 It Pod AN., 0410912024. 04/01/2024 last, this Amount: APPROVED ON APR 0 8 2024 aY COUNTY AUDITOR CALHOUN COUNTY, TEXAS DUG If Pad On Time: USD 26.33$ 26.33 USD Dias lost N fam late: 0.54 Dan N Pold We: 26.07 USD USD 26.37 For AR Inquiries please contact 800-867-0333 STATEMENT �Mpm,. Bose CVS WCY 7416/MEM Me PRS AMT DUE R441TTED VIA ACH DEBIT MEMORIAL MEDICAL CFMFR / Statement for Information only VICKY KAUSEK ✓ 815 N VIRGINIA ST PORT IAVACA TX 77979 As of 04105/2024 Page: 001 To ensure proper credit to your account, rlaheh and return this stub with your ramhtance us 15 CIN As of: 04/05/2024 Page: 001 Customer V SupplD: Mail to: Comp: 8000 Territory; 7001 AMT DUE REMITTED VIA ACH DEBIT Customer. 835437 Statement for information only Data. 04/0612024 Cast! 835437 PLEASE CHECK ANY Date: 0410612024 ITEMS NOT PAID (V ) millatlonnt Amount 536 bash Amount P Amount P Receivable net:, Dan Wants, Refers... Oala Data Number Reference DescOptbn 01.mml 19.) F (.at) F Number Customs, Number 835437 CVS PNCY 74161MFAt MC MS 041D312024 04109/2024 7487925450 3147868 1151nvowe 0.71 35.38 34.6]JX ,// ]48]925450,1(= PF cchrmn Island: P a Past Due Item, F e Future Due Item, blank - Current Due It.. TOTAL Customer Number 835437 CVS PHCY 74161MB4 MC MS Stridulate: 35.38 USD Future Due: 0.00 If Rald By 0410012024, Pact Due: 0.00 Pay This Amount: Last Fayment 3.539.65 N Add After 0410912024, 04/0V2024 Pay this Amount: APPROVED ON BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Due N Rod On Time: USD 34.e7x 34.67 USD Dice lam N paid late: / 0.71 Due If Pa16 late: 35.38 USD USD 35.38 For AR Inquiries please contact 800-867-0333 STATEMENT Statement Number: 67204443 /0 merISOUrceBBrgen- Date: 04-05-2024 1 of1 AMERISOURCESERGEN DRUG CORP WALGREENS 912494 MOB 1001352M 1037028186 12727 W. AIRPORT BLVD, MEMORIAL MEDICAL CENTER / SUGAR LAND TX 77478-6101 1302 N VIRGINIA ST PORT LAVACA TX 77979�2509 DEA: RA0289276 sal -Pn Due in 7tup 866451-9655 . ......... ...... .. AMERISOURCEBERGEN PO Box 905223 Net Yet D. p,pp CHARLOTTE NC 28290-SV3 Curtenl: 420.66 Past Due: 0.00 Tolal Due: 4W.68 A..[Balenw: 420.66 Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount 04-01.2024 04-12-2024 3189919691 ]Op6108222 Invoiw 32.03 04-01-2024 W-12-2024 310919632 TON122236 Itrim. 42.700( OAO 32.03 04-01-2024 09.12-2024 316991903 7006129509 Invoice 86.82X 0.00 42.70 0&022024 04-12-26N 3170064966 7006137949 Invoice Y, 0.00 88.82 04-03-2024 04-12.20M 3170247632 7ON142520 Invoice 12.81 20.09 J( 0.00 12.81 04-m-2024 04-12-2024 3170402380 7MB151480 Invoice 201.28 p( 0.00 W.99 04-05.2024 04-12-2024 3170545275 7006161510 Mveicn Oeo 201,28 29.03 dC 0.00 24.03 Current 1.15 Days 16.30 Days 31-fi0 Days 61.90 Days 91-120 Days Over 120 Days __ 4zoss 0.00 p.op o.Oa o.00 0.00 0.00 hank You for Your Payment Reminders [Date Amount Due Date Amount 45.2024 (95559) 04-12-2024 920.66 Total Due: 420.86 APPROVED _. .. ON t .: - LE BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8683) FJ"ENTER 9-DIGITTAXPAYER IDENTIFICATION NUMBER" "ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" "IF FEDERAL TAX DEPOSIT ENTER 1" "ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) -Jan, Feb, Mar 2ND QTR - 06 (JUNE) - Apr, May, June 3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" "6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER CALLED IN BY: CALLED IN DATE: CALLED IN TIME: #### ENTER: $� 121,2$8,32 1 $ 63,388.52 $ 14,824.90 $ 43,014.90 J:IAP•Payrall FileslPaymil Taxes120241#8 R1 MMC TAX DEPOSIT WORKSHEET 04.0424.x1s 41812024 941 RECITAX DEPOSIT FOR MMC PAYROLL PAY PERIOD: BEGIN "E 3/2212024 yQ PAY PERIOD: END 4412024. PAY DATE: 411212624 GROSS PAY: $ 551,447.27 DEDUCTIONS: AIR $ 272.05 ADVANC BOOTS MUTUAL CRITICAL ILLNESS MUTUAL ACCIDENT IRS TAX MUTUAL SHORT TERM DIS MUTUAL VISION $ 891.82 CAFE-D $ 1,29704 CAFE-H $ 31 310 83 CAFE•P CANCER CHILD $ 670,69 CLINIC $ 440.00 COMBIN 6. 260.80 CREDUN $ DENTAL g OEP-LF MUTUAL TERM LIFE 5 1.399.78 MUTUAL HOSP INDEM $ 619.80 FED TAX $ 43,014.90 FICA-M $ 7.412.45 FICA-0 $. 31,694.26 FICA-M ADDITIONAL FIRST C FLEX S S 5,602.83 FLX-FE $ - GIFT S $ 200.22 MUTUAL CRITICAL ILLNESS $ 11111.21 MUTUAL ACCIDENT $ 764.70 MUTUAL SHORT TERM DIS $ 2,006.61 LEGAL S 1,230.24 OTHER $ 2,137.33 NATIONAL FARM LIFE $ 11336,06 MED SURCHARGE $ 31&00 Blank RELAY REPAY STONEOF $ 1,140.86 STONE STONE 2 STUOEN TSA-R $ 37,T26.33 UWlHOS $ - TOTAL DEDUCTIONS: S 172,618.06 $ NET PAY: EwwuwtenRrooRi».; $ 378,831.21 $ ^1kloUlOANTCN R6Wni" : ''a TOTAL CAFE 125 PLAN: S 40.133.08 �i TAXABLE PAY: S 811,314.14 $ 611,160.37 :ICA-MED (ER) $ '•CALCnLATEO•' Fram MMC Ra..H Rifemnce :ICA - MED (EE) ,.m "M $ 7,414.06 7.414.06 $ 7,412.48 $ 1.61 :ICA -SOC SEC (ER) elsw $ 31,693.18 :ICA-SOC SEC(EE) 'ED $ 31,693.18 $ 31,694.26 $ (1.08 WITHHOLDING $ 43,014.90 S 43.014.9D S REVISED W182014 NAL CK III TOTALS $ 551,447.27 S 272.85 S S 5 c , S S 891.52 S 1,287.04 $ 31,310.83 S - S - 570.65 s a40.GD • 250.86 S S 1.36:1.78 5 619.60 $ 43,014.90 S 7,412.45 $ 31.694.16 5,502.83 20022 i,111.21 754.70 2,006.61 1,230.24 21137.33 I.336A5 316.00 1,140.86 37.726.33 172,GIG.Or, bH WLOM�renREPMn ^eNolwAuttx R�aee'• $ $ $ 3T8,831.21 'W WIO WloanEPgn^-sNoutO WmIAEpaew Exempt AMC Employees over FICA -SS Cap: Roshanda Thomas Micheal Gaines FICA EXEMPT(Teresa Benitez): $ 133.82 TAX DEPOSIT: 3 1_ 2�5 121,225,32 FICA -MEDICARE awn $ 14.828.12 $14,824.90 FICA -SOCIAL SECURITY wax $ 53.386.36 $63,388.52 PREPARED BY: FED WITHHOLDING $ 43,014.90 $43.014.90 PREPARED DATE: TOTAL TAX: $ 121,229.38 $121,228.32 $ 1.06 TOTAL:`_ 1333.82 Andde Floras 418/2024 48RIMMCTAXDEPOSITWORKSHEET04.0424.LIs. TAXDEPOSITWORKSHEET 41M024 Rua Date: 04/05/24 MEMORIAL MEDICAL CENTER Page 113 Time: 15:15 Payroll Register I Bi-Weekly I P2REG Pay Period 03/22/24 - 04/04/24 Run4 1 Final Summary r-- P a y C o d a S u m m a r y-------------------------------------------- D e d u c t i 0 n s S u m a a r y-------------- I PayCd Descript'an Mrs OTISHIkEINOICB1 Gross I Code AAount 1. REGULAR PAY-E1 6630.50 N 11 N 1 REGULAR PAY-S1 1990.75 3 11 N N I REGULAR PAY-S1 709.40 N 11 Y 1 REGULAR PAY-81 214.25 'I N N 2 REGULAR PAY-82 2345.00 N 11 N 2 REGULAR PAY-S2 272.00 N N Y 2 REGULAR PRY-52 74.25 Y N N 3 REGULAR PAY-S3 1345.00 N N N 3 REGULAR PAY-Sl 222.15 N 11 'I 3 REGULAR PAY-S3 49.15 Y N N 4 CALL BACK PAY 17.00 N 1 N N 1' CALL BACK PAY 29.00 N 2 N N Y 4 CALL BACK MY 2.00 N 3 11 N Y 4 CAL BACK PAY 1.00 Y 2 N N Y C CAL: PAY 2291.50 N I H N C DOUBLE TIME 3.75 N 2 11 N D DOUBLE TIME 8.50 N 3 11 N MRA RAGES N N N N E EXTRA NAG-s5 H 1 N N N I INSSRVICS 104.50 N 1 N N I I115ERVICE 5.75 Y 1 N N K EK7EIDED-ILLNESS-BA11K 30.00 N N N N K EXTENDED -ILLNESS -RANK 306.00 N 1 N N P PA13-T-ME-OFF 142.46 N N N N P PAID-T::NE-OFF 1564.0 N 1 N N X CALL PAY 2 160 AO N 1 N N Y YWCA/CURVES N N IT N X CALL PAY 3 96,00 N 1 N 11 p PAID TIME OFF - PROBATION 04.00 R 1 N N t PHONE 6 DATA N N if N _.................................................., 200493,57 A/R 272.85.i/P.2 A/R3 97949.04 ADVARC AWARDS BCBSVI 27031,46 BOOTS CAFE H CAFS-1 1067.83 CAFE-2 CA9S-3 CAPE-4 65039.93 CAF3.5 CAPE-C CAFE-D 11391.8E CAFB-F CAPS-H 31310. 81kAF6-I 3337.16 CAFS-L CAFE-P CANCER 47606.78 CHILD 570.mkLINIC 440.DLEOMIN 12263.36 CREOUN DD ADV DMAL 2129.87 DEP-LF DLS-LF EAT 716.72 EATCSR EDTAX 43014.90JECA-N 1250.66 FICA-0 31694.2sirmC FLEX S 69.13 FIX FE FORT D FUFA 50,34 GIFT S 200,2RAN2' GRP-IN 4101.00 GTL HOSP-I REA 314.15 ID TFT TRSTAX LSAF 729.13 LEGAL 317.% MASA 912M.MEALS -600.DO HEMS Misc MIEC/ 1593.75 MAR ¢t00ACC 754.7t400ILL 4107.07 MOOIAD 619. SQ.MOOLIF 1389.7 400STD 352.37 HOOVIS 391.52)NATFML 1336.054INER 738,00 PNI PHlrrr PR FIN 8657.12 RELAY REPAY SAWS 9385.4E SCRUBS SIM ST-TX 41175.66 S70VDF 11 0.86.km STONE2 320.00 STUDEN SUNACC SWILL 75.00 SUNIN'D SOIILIF SIINSTD 288.00 SUNVIS SURCHG 315.00JM-1 1395.% TSA-2 TSA-C TSA-P 1675.00 TSA-R 37726.31-ArION @IIFOR UA/NOS 12B7.04-J 250. B5J 7412. M/ 4755.00 U 2137.33 1111.21v' 2006.61./ •-------------------- D.and Totals: 20806.11------- � Gross: 551447.27J Deductions: 172616,06J Net: °?7883;1 22�C.. Checks Count:- FT 215 PT 13 Other 38 Peeale 235 Nale 28 Credit Over= 12 Z=-roNet T.em Total: 263 r....................................... .................... .................................... ........ ....................... i Rcr. Dace: 0,09/24 MEMCRIX MEDICAL CENTER BI-UERLY Page 1 Tire: 09:SC •*• CAsci P.egiscer •••• P20157F Pay Period 03i22J24--04109J24 3m:: 1 y2e=NET 10000001 OPERATING - PROSPERITY :S.¢. San Arounc CHECK NUN DATE 02064 A\T4A :WTRA GARCIA 1771.03 OP063409 04/12/24 257 MORGAN R ALE37S 133.95 00063410 04/12/24 2020 SHAWOIA G HARrL 2614,49 0OC63411 09/12/24 20837 ➢A:SY !FDP.IGAL 19B.79 00CE3412 04/12/24 0ON' 1 CARL LEE KING 1015.SP ON 04/12/24 00003 SYLVIA A VARGAS 1013.82 DO 04/12/24 00113 JACLYN CARREON 1270.W DD 04/12/24 00132 SANEFA A BRAUN 459.88 DD 04/12!24 50192 EREODA D PENA 1960.71 DD 04/12/24 D0387 SI1LTE F XC;KWORTH 2O08.46 IN 04/12/24 C0392 l:ONICA 7 CUR 1276.22 DD 04/12/24 C"99 L117A J TIJERIUA 2280.66 DD 04/12124 00401 VE@4A J PINA 2262.1( DO 04/12/24 00411 SHERRY L KING 2473.04 DO 04112124 00423 00111 V STRING0 1944.86 DD 04112/24 00982 PAR 71KA➢ 1563.04 DD 01/12/24 60581 M-iHIA L RUSF.ING 1679.93 DO 04/12J24 C0681 RILLA RE➢EE WOOD 1826.42 DO 04/12/24 00697 MANIA C FARIAS 1113.99 IN 04/12/24 00707 KIMBERLY RRSEK�i.EZ 2119.07 DD 04/12/24 09595 ENILIE DIANE KILKEY 686.23 DD 04/12/^_4 0:I7E ?ATRICIA UUREH H:RMES 2265.24 DO OS/12J24 1:191 SHARON M SPARKS 21.49 D➢ 04/1212/ 01234 JENISE N SVE71iK 2631.29 DD 04/12124 0:24L PUDY !SCE 205".;1 DD 04/12124 367 EAR:LN A SANDERS e77,83 DD 04/12/24 D345I JE\tII?3R L ZI53A 422.45 DD 04112/24 D:478 HICGLE 0 AAR' NETT 705.36 ➢D 04/32/24 Di791 34U56A\A: J MONDAY 2876.79 DO 04/12/24 02011 ERIN R CLEVENGER 3962.62 DD 04/12J24 02014 AGAP3TA C CANTU 333.75 ➢O 04112/24 12021 ERIKA OSCRBIA-SANCHEZ 25el.20 DD 0,112124 D2022 ;301DA J GRICGS 2•.49.64 DD 04J12/24 C2C99 7RACI N SBEFC:K 2890.83 DD C4/12/24 C2]12 1ESLIE THOMAS 2021.64 IN 04112/24 02132 JAS:41.2 RUIZ 1956.23 DD C4112124 12135 NDRMA A.LL:SOK 121D,93 DO 04112124 02136 TA°NY ESOUIVBL 385.35 ON 04/12/24 02154 JUSTIBE SIRELCZYH 926.33 DD 04/12/24 82162 MIRIAM PAUTKA 1702.42 DD 04/12/24 02165 JENSICA KNIGHT 22e9.15 DO 01/12/24 02193 TIK2 VENGLIR 17C5.64 DD 04/12/24 0220I CO.H12 VHIEGAS 1685.42 DD 04/12/24 02202 SENCH I SANCHEZ 154,75 DD 04J12J24 02271 DAWN J 3UBEll", 2322,85 DO 04/12/24 02301 NICOLAS TInKNA 13BO.13 CD 04/12/14 B2303 COEN13 M P.A➢IERNA 3233,37 DO 04/12/24 02315 NINA H GR£?V 2790.2i 00 04/12/24 02146 JFA12e^:£ L FALCON 595.;5 DO 04112/24 9241e- J XL:£ SCOTT 1910.OB DD D4/12/24 L12435 SAkP2i iHA iAVIC1I 746.35 DO 04/12/24 02515 STEFANIE 14 SOL:Z 388.14 DD 04/12/24 02552 VERONICA RK..US:N 1945.28 DO 04J12124 Run Care: 04)09i24 14RMORIAL MEDICAL CENTEP. BI-NEEKLI' Page Pane: 09 50 -14- CAeci Register I'-, P2HISTP Pay Period 03/22/24--04/04/24 Run: 1 :ype=NET :0000001 OPEIIA71nr- - PROSPERITY Rum. Name Anoon: CHECK 1'UN, DATE 02612 MGM ODELL 85?.91 OD 04j12114 02678 V :SSA NESLONEY 1939,94 DD 04/12/24 02701 RO,= GORLEE 2371.41 DO 0012/24 02719 DAWN 11 MCCLELIANO 1990.9-1 GO 04/12/24 C2120 ELDA H LUERA 3140.99 DD 04/12/24 02733 R083N N PLEDGER 26e7.39 DO 04/12/24 nn; ZAN:RA A GARCIA :0413 DO 04/12/24 02794 BRAMER 1 :"UTCEUR 2115.39 DD 04/12/24 C2812 5RI7M N RDODICN 1890.1E DD 04/12/24 029C7 YAR-.A F LONCARIA i268.93 DD 04/12!24 02927 MIC:AEL L GAINES - 2799.36 DO 04/12/24 02963 DOROTHY J REKDON 953.25 DD 04/12/24 02970 DIANNE G ATKINSON 2296.90 DD 04/12/24 03864 JACQUELINE R P5RRER.A 1441.31 DO 04/12/24 05003 COURINE D I119MILL 2859.25 DO 04/12/24 05006 MINA A MARTINEZ 2569,43 DD 04/12/24 05007 XMR 'r. NEYLA\T, 1819.6E DD 04/12/24 I,512, MU -SEA RACGEL 430.96 DD 04/12/24 05345 SRICA NGUYEII 1335.33 DO 04/12124 05641 AMA17A R UY 2115.21 DO 04/12124 C7121 CYRIKA GUERRA 1655-2 DO 04/12/24 C7147 CFU A VORCE 2317.64 00 /4/12124 C787e 31AIIA C SAECEDA 1162.72 OD 04/12)24 1:197 CATRUME A 3012 3124.75 DD 04/12/24 1:412 COURTNEY L NORKOPSKY 1119.67 DO 04/12124 '2012 KIMBERLY J REYNA 1007,92 DO 04112/24 :2115 LISA J EIIICJOSA 983.42 DO 04/12/24 :2129 K.ICEA?L SEINES 1714.73 DD 04/12/24 12609 .CAELIII R LUNA 489.21 DO 04/12/24 1c097 KYLE L DANIEL 2913.62 DO 04/12124 15131 SAVANNAH RARLE'! 1428.90 OD 04/12/21 IE139 iLR18YEN NICOLL BALLARD 1874.90 DO 04112/24 '_5163 KELSEY HE:NOLD 3303.39 D➢ 04112/24 :5171 JESSICA BARRON 406.27 D➢ 04J12/24 '5236 YESSFNIA L GRANADJS 675.69 0O 04/12124 :5286 DAklt 11 MREK 2012.90 DO G4112/24 ISM JUC:E NGUYEN 1541.79 DO C4112/24 25915 BR:ANNE J KE1' 2141,]E DO 04112!24 20144 SOFELE F. PECEIL 6?2.91 DO 04112124 2G148 JENIVE.R CLRPEAIT 1105.69 DD O4i12124 2G156 ERIN ASHLEY NISC4IM 167552 DD 04112/24 20158 JOSFUA :EPPERS 7.38 0O 04112/24 20184 MELISSA ZANORAIO 902.31 DO 04j12/24 20206 %ELLI 8 GOFF 2135.32 DD 04112/24 20243 KELANIS CORTEZ 1C80.64 DD 04112/24 20272 AIM ELA YEAGER 2199.92 OD 04/I2124 20294 JESSICA D WALTHER 1048.85 GO 04/12/24 20324 PATRICIA SIRIBLEY 3197.24 DD 04/12/24 20343 SAVANNAH N ROCA.ARAS 652.44 DO 04112/14 20484 Ei3ANNA S P.SSMORE 670.:0 DO W/12/24 2075? SAME SADLER 1061.37 DO 04j12/24 2078E JAYL14 RAVIRE2 774,64 DO D4/12/24 4797 BE'THM M DIGGS 225435 DO 04/12/24 20E57 JOS'rSA LOP-1 958.85 DO 04112/2, Rua Dace: 04108124 MEMORIAL MFMCAL CS.NTER BI-HEMY Paae 3 Tire: 0:5Z +•++ Check Regisce: •+•• P20ISTF Pay Period 03122/24••04/04/24 Run: 1 Type -NEC 20000001 OPERATING - P109PERI7i Num. Nape Anoua[ CEECE MUM DATE 20577 CHEM L ?ESCE 1655.2E DD 04/12/24 20580 SAVAKA LENTO 940.72 DD 04/12A4 2L45D DIA1Di E LEA: 1521.80 DO 04/12/24 21529 JACOBY R CRAl4FOP.D 1136,90 CD 04/12/24 22493 3RI_7AYY E NAVARP.O 1608,29 OD N/12124 22618 HEATHR L LOPEZ 386.29 OD 04/12/24 2E022 A34BEE "s LOYA 636.12 DO 04/12/2r' 20034 ''WSIINA A EUENGER 564.03 DO 04/12/24 28I20 JESSICA V SELVERA, 735.?1 DO 04/12/24 29199 KELLY A SCROIT 2006,62 DD 04/12/24 K035 STACIs' L EPLEY 1123.29 DD 04/12/24 32054 1DRA L _Av3DER 996.35 DD 04/12/24 31059 ARACEL1' Z GA.RC3A 1241,05 DO 04112/24 1:219 LAUR&Y ?FILLIPS '549.66 DO 04/12/24 31241 MMCNICA SAIAZS.R 413.12 DD 04/12/24 31251 CYNTHIA L BIAS 1721.78 DO 04/12/24 33313 iC4TESRIBn LYBT JIMENEZ 2009.43 DO 04/12/24 M" STACY L PROM 1731.73 DD 04/12/24 :'ti63 SWARD E YATULA 2661.38 DO 94/12/24 °'iCE ?Ci!3L .1 HEPFUEP. 2004.38 DD D4/12/24 31821 ZAYLA N ALVAREZ 2126.6E DO 04JIV24 3811E ERYSIELLA ? KISIAH 1036.35 OD 0411212, 3842E JULIAN EEYSQDLERDO 1102.94 DD 04/12/24 41062 CHE33.Y.YE NESSA 537.55 DD 04/12124 4:112 AN STASIA L PEREZ 701.30 DO 04/12/24 4:171 T0.'RG4IE V TRSVINO 708.04 DD 04/12/24 4'219 'dUA-DALUPE MMIDEZ 725.19 DD 04/l2124 41225 LESLIE A CRAIGEN 827.'.1 DO 04/12/24 43236 PAYEIA "n VAYPOT 155E.42 DO 04/12/24 41281 SARA 11-41B0 442.4E DD 04/12/24 41261 BERI410E AGUILAR $44.6, DO 04/12/24 41269 BERENICE LGGO 403.0E DD N/12124 41274 KAREN SAUN 977.29 DD 04112/24 4.279 PAMELA R HARMO!1 865,07 DO 04/12/24 4:267 ALTSA C VILLA.R.REnL 8099E 0O 04/12/24 41347 ADRIMA D STRAKOS 65SA4 DO 04/12/24 41418 ANGEL M CAMI. 1025.80 DD 04112/24 41425 TAS.h NOR.YAY MOM DD 04112/24 4:506 JOSEFAT LDSO TORRES 869.60 DO 04/12/24 41546 MINK MARTINEZ 3216.58 DO C4/12/24 41E12 SONJA A GDAJA4D0 922.25 DO 04/12/24 41617 JACQUEL16Tf M 1•'ARTINEZ 401,22 OD 04/12/24 41705 KELM R 7-41%, i1E5.32 OD 04112/24 4-896 R CAE 4'ICHE57,E EMERY 6F0.93 DD 04/12/24 41997 ROMMIA HUNOZ 741.45 DO 04/12/24 ;1901 JUANITA A MILLER 1053,20 DD 04/12/24 4'.953 K&MIA, TTREVINO 797.39 DD 04/12/21 4210E CF.R3ST'E SLLVA9 89899 DD 34/12/24 42112 SOCOPRO C CONZALES 991.31 ➢D 34/12/24 42122 LE_ AYA CHAVANA 1794.51 DD C4/12/24 ,!25 KARCA GJCY CALZADA 763.55 DO 04/11/24 423C4 RIMI T NGUYEN 2D67.29 DO A112124 42536 K.1,KAH A SOO.RRAs 598, 07 DO O41I2/24 42820 MkRIA D CIU-2112 994.93 DD 04/12724 Rva Date: O 08,24 HEM:ORIAL MEDICAL C?;TER Tine: 09:SC Check Register ...I Pap Period 03122/24--04/04124 Rurs .y0e=NET 70000001 OPERATING - Num. Name Amalm CHECK 'M DATE 42842 SH.WlA 3 0 DDVNEL1 3254.37 DD 04/12/24 48680 JESSICA BUSH 211.80 DD 04/12/24 5014E MNITY GOULDEN 33MES DO 04/12/24 5028E JACOB H HAMILTON 2494.72 DO O4/12124 50310 JASMINE OP.IOS3Y W.06 OD 04/12/24 50546 MELAN2E K SAxAYOA 233D.32 0O 04/?2/24 50573 DEANA R CAVIS 1822.78 DO 041/2/24 50596 BETTY S CAM 2051.37 DO 04/12/24 50719 DEBRA K MUSTERED 2,21.11 DD 04/12/24 5092? AD1NA GERDES 651, 91 ON 04/12/24 53541 JAMS 3 HARTL 1531.61 DO 14/12/24 54024 MONICA A ESCalX7E 1287.89 OD 04/12/24 55025 LEA C RESFNOEZ 1361.Bd OD 54/12/24 55026 IRENE 3 PEREZ 797.90 ➢O 04/12/24 55127 APRIL K PV-11A 230C: c DD 04/12/24 55234 ELOIZA SOIO 634.14 DO 04/12/24 5171 SLA113 HEPYAN71EZ M.73 DO 04/12/24 55392 SMIN05 JACILCO 370.49 DO 04/12124 55559 !_BjUAV WILKE 626.18 DD 04/12124 58115 3ECKY MTJI_E SEE 839.21 ➢O 04/12/24 58510 RITA L POLEHSKI 799.34 DO 04/12/24 60112 ROBERT A RODRIOLE2 2030.74 DO 0i/12/24 6001 NCRA OVALLE 535.04 DD 04/12/24 i0145 REGINA. ZA'4OEA 1470.57 OD 04/12124 60156 DAH:ELLE H 1,11SEK 1351.71 DO D4/12124 60165 TERESA A 31ITBZ i16.06 DD 04/12/24 60262 1Rh R SHARP 855.8i DO 04/12/24 60387 REBECCA 01�%LLE 1t26.96 DD 04/12124 60589 JAS0.N J LOY; 931.46 ➢D 04/12/24 50516 DOROTHY A LONGORIA. 849.91 DD 04/12/24 6232E ALAII MIGHT 1759.05 DD 04/12/24 63193 MICHAEL SOCARRAS 965.80 OD 04/12124 61455 VIRGINIA C BERRARDIKG 967.40 DO 04/12/24 53846 JW FLORES 1182.50 DO 04/12/24 MOB PEL3CITA DORUZ E41.86 DO 04112/2, 65125 MARTHA COPEA74 E30.04 DO 04/12/24 65127 VERONICA ORTIZ 764.9E DD C4/12/24 65136 TINA KOMM 1046.62 DO 04/12/24 6514E vkr.4 II41GLgz 726.44 DO 04/12/24 vail EL:h 0:'CBIA. 10E0.10 DO 04/'12/24 55109 EMP.A SA34CHEZ 767.67 DD 04/12/24 65205 JUANA 8e1rILLAH 929.10 DD 04/12/24 65Z33 LEE SIMERLY 1267.99 OD 04/12/24 65247 DIANA -MTILIO 226.03 OD 04/1212, 65265 NATAL73 EAP.EPIELD 1005.17 DD 04/12/24 65315 ELVA RODRIGUEZ 776.40 DO 04/12/24 65393 BAMONA A MEE 1203.96 DO 04/12124 65453 AMALIA L TIMES 1529.88 DO 04/:2/24 6546E MLARIA 1 VELOZ 045.55 DD 04/72/24 654BE ROSA ;.ODR:GUEZ 533.53 DD 04112/24 65513 M'Iui:A MORALES 1D33.36 DD D4/12124 6570E 00.R:T3LA. HERRERA 941.18 DD 04/12/24 65715 MAR:A R GO M 973.:8 DD 04/12/24 6E745 M.ARIA LUISA RODRICUEZ 1272.5P DO 34112/2, BI-KEEKLY :1 PROSPERITY ;ago P2DISTP Rcn Cate: 041M2 24 0ZMOR3AL MEDICAL CENTER 9I-'nE3HLY Page 5 line: 09:5e ."' Check Re0iEter aw+• F2DISTP Pay Pefioj 03M/24--04/04124 Ran: 1 Type-N.. 0000001 OPERATING • PROSPERITY NDrt. Name A^lM4M CHECK NOR DATE 85a55 MARIA F MUM 855.3E DO 04/12/24 6856B DOM-T[':,A GARCSA 422.02 DD 04/12/24 68568 CHR_STOPHEP. RUTHERFORD 1174.22 D➢ 09/12/24 68792 IOP..1O MAZ HERNANDEEZ 2073.84 DO 04J72/24 70119 SARA N BLED -OE 2622.39 DO 041121Z4 72727 CHR:5A;1'DRA L1MI KOVAR£K 136.56 DO 04/12/24 -3749 GLORIA N R£ID 2643.58 DO 04/12/24 74159 CAROL VILLARREAL 1253.30 DD 04/12/24 75190 HIKA HILLER 1923.23 DO 04/12/24 7607E ALEXA:4DRLA Y EiISiEY 426.09 DO 04/12/24 76115 JEN TIME R CAELCCK 645.33 DO 04j12124 75120 3ACHEL CAHALES 1310.30 DD 04/12/25 7613e iMEN D CAROL,, 653.74 CD 04/12/24 75210 EDE ViLLA?F?A 535.45 DO 04/12/24 75300 AIDA dIP.ENRZ 1315.25 CD 04/12/24 i£30F CHRISTELIA PdT SENDEJO 518.37 DO 04/12/24 763E ?ARELA : BARTON 867.02 DO 04/12/24 75403 KATRINA A Po?lr-%. 1333.!0 DD 34/12/24 "s647 CHERYL A SEE I.M.22 DO 04/12/24 Cc C6 MEGOP.Y E RGRALES 775.34 DD 34/12/24 76854 A:ARY PAT!EP.SON 11133.25 OD Nj12124 16995 V$VEBSA TRISTAN 540.23 DO 04/12/24 7764E F.4REN A GOSZAIES 10E0.19 DO 09/12124 79020 HIS?Y R PASSHRE 1553.1a DD 04/12/24 78058 RYANN J PCH38 313.95 GO 01/121,24 78072 DON4IA 1,1 RAWLINGS :279.a8 DO 04/12/24 7812E ALEKA O➢IHTAYILLA 978.12 DD 04/12/24 78257 KAR?S8A ➢ ALF_ANZAR 2211.9a DD 04/12/24 78335 JESSICA. L GLOVER 1750.20 ➢D 04/12124 7856E MEL73SA K v£E i25.9d DD 04/12/29 78764 ASHLEY D MOLEY 2272.33 DD 04/12/24 76781 KRISTEN R MACHIC33 1518.42 DO 04/12/24 78787 FAILA4 I JAGY 2710.92 DO 04/12/24 78a97 DAYLE J ROBINSON 722.48 DD 04/12/24 8600E ADAM D BESIO 2409.75 DO 04/12/24 90141 JEAIDIIE ORTA StC6.30 DD O4/12124 80928 MAY HOEGCOD 1840.03 DD 04/12124 82227 CAI?LIN A CLEVENGER IAMB DO 04/12/24 BE432 dEG.AN V. URPER 732.89 DD 04/1,124 BE576 ELSA HE.RR£PA 763.00 DO 04/12/24 MIS VISA N TREVINO 1069.i6 DO 04/12124 90148 MICHELiZ CL312ERLAYD 2210.03 DD 04/12/24 88321 ANDREN DE LOS SA`IkGS 2635.82 DO 04112/24 88435 JOE GARCIA 1662.84 DD O4112/24 30320 ROSEANDA. S THOMAS 9494,07 DO 04/12/24 90929 STEVE 3ROCH 4815.83 DO 04/12/24 33231 ANDRI3 V. FLORES 1852.05 DO 04/12/24 932:1 S.ARIAH N RL'EID 1330.55 ➢D 04/22/24 3675E ADR:AVFA :1 GALYAY 1E95.25 DO 04/12124 `.Yta83S.G1 MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONICTRANSFERS FOR OPERATING ACCOUI April 1, 2024-April , ZD24 Oars Bank Oescnollon MMCNOIes 4/5/2024 WIRE OUT untrue Technologies, Inc - Medllne Account Veriliwlion 4/5/2024 PAY PLUS ACHTmns0000p00191113161010W6988 .3rd Parry Paya Fee 4/5/2024 AMERISOURCE BERG PAYMENTS 01000077682100002 .3408 Drug Pmgram Expense 4/5/2024 FDMSFUMSPYMT052-Z0005W 410001214SMS Crdit CaWPmcessl.:Fee 4/5/2024 FDMSFDMSPYMT052-16D1830-0 4l0 1214T365 -Credit Card PmRsslnFee 4/4/2024 WIRE OUTHEALTHEOUITY -W.,..," 4/4/2024 PAY PLUS ACHTmns0000DOp190106161010OD5906 -3rd Parry PaWr Fee 4/4/2024 HPHGLLCACHPMW VMemM.da,PUav11312265 -Health Insuran.Claim Payments 4/3/Z024 PAY PLUS ACHTrans OODOOUO38W2360 /010006963 .3rd Party Pe,4r Fee 4/3/2024 MERCHANT BANKCD DISCOUNT 971IM13987 gle000 Credit CON Processing Fee 4/3/2024 MERCHANT BANKCD DISCOUNT 9711601083391000) . Credit Cs,d Processing Fee 4/3/2024 MERCHANT BANKCD FINCL PER 92116091389T 9100D - Credit Card Processing Fee 41 MERCHANT BANKCD FEE 97116091388791000016536 - CmtlB Card Pro4essln, Fee 4/3/2024 MERCHANT BANKCD FEE 971MMI088391000016536 - Credit Card Processing Fee 41 MERCHANT BANKCD INTEflCHNG 97116091388791coo . Crdlt Card Processing Fee 4/2/20M PAY PLUS ACHTmnt CGOO000I11783337 1030006945 3rd Part, Payer Fee 4/2/2024 MCKESSON DRUG AUTO ACH ACH0593618D 919000165 340E Drug Pmgram Expense 4/2/2024 AUTHNET GATEWAY BILLING 1349034741090p0D143 .3rd Party Payar Fee 4/1/2024 PAY PLUS ACHTran5003862AT11010006931 000p1 3rd Pax, Pal Fee 4/1/2024 IRS USATAKPYMT 220449221495955610360]001255 -Pa%OII Taxes (,I11ee1� ,«L , J f' -I `/\ ' ' \Ltl �� April B. 2024 ANDREW OF LDS SANTOS pp Memorial Milled Center TC�ataWL(4 L� 09.03. 29 CC, ELERRONICTRANSFERS FOR OPERATING 1 74 , 13 Ix . 111 iy � I�F`MUsuT 03•'W�2y CL wt. De.1 U' IJI. ._ +Y >♦' ]L- PrpYy+LM1(� 03•z"I•'L;( never xetes (h: l3,•.�'� /,-��l aA I�� L: /-�I� April 8, 2024 ANDREW ;!it OS.NTOS Memerial Medial Cener 1 h42�c� 0 • 0 Ci ,. p Fad r.•q)'J: Pay vim 19=,_U , 051 "He Arrionit �Hf 5 • _ 9 10.00,X 736•ti4 199AS 965.59*1 25.67 32.45 x`r2GSCOd; _.. 35,4JT.6T'i4 9]O 24,696.24 sti ]F 7 19.95 3L. I 0.06 im,OD 1 9 • i _+ 9.95 U'l1G �,31t14 136s&, I H (V ' IJ fl i 3 9•9, - .}aa9:` 1 s I + 128,734A2 >r]694 4 4 (.• 09 ,. 174,836.30 ✓ 11 ,11..uk. Amount B.OD V 56.3 64 Fi (: %•IJ t, i I • 9 I APPROVED ON APR 0 0 2024 RY COUNTY AUDITOR CALHOUN COUNTY, TERA6 sor: saAn +N. MYpY NN Amnl � r run s n% s®ns 90 DEGREE CLAIM PAYMENT INVOICE ms(d. wwvd v+.uw swY mvrm. s]uY un/wi- nc% vwmi wi, NS/m+. Itals u+as] sn% u+v+n. mY i vumi. m./ uuu. wY V/YN. 3..... VWW. %.11 N.s/im. 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VVIa. ,V aoiao tnvla. :n.nw. roar Ww waew. mwW+. nrw.ru m.rair. mna. iu)rnro iuWw� .rrw.d th 4ta. V14to1: +we'�'wr Vrl/wi 41N0[. I.Iwiti, ,/14tir. ]/1./toe. ]V.ayilo 4uhW. n l )aww a4+on ruM 4unm. ]hrgxi Uu3va ]p4iw. tbV+,m. yna.s.o V,IDw. n/ , rnv]ou lh+noi.. iiiLlo.m nnna. +nmwi +vLw3. uv Sq a L 4 • /H/ N.lipi: ]hV 41 /4 �• 4Vm /W uni±v .n i�a: tm�iino 4W]w. +/WWn vnmr u+n+w. vnnw. trws.u+ vnhw. u14+w. mwor 4W., iM/ia. iµFwv 44vw. W,w. ,undo anvdu 4nnw. muss. VIV)w. ,mrorb: �'�. 41Wro • averul lulw. thrhou wni.,m APPROVz9 ON APR '.:, ;,,.; 6YCOT. +-" U-1UA CALHOii1V 7rueScripts. Amazing Care 513 E. South Street Washington, IN 47501 844-257-1955 Memorial Medical Center Attn: Andrie Flores PO Box 25 Port Lavaca, TX 77979 Invoice Date 3/26/2024 Invoice 4 1144778 Description I Quantity I Amount Fix Drug Cost - Including Specialty Care Fee 25,374.88 Administrative Fee 196 1,225.00 Step Therapy Program Fee 196 39.20 Healthsure Per Claim Fee 196 392.00 Leaf Health Per Claim Fee 196 294.00 APPROVED ON BY COUi I Y AUDITOR CALHOUN COUNTY, TEXAS "Expens in Nescription Benefits" Total $27,325.08, LA LL- Please remit your payment by: f 4/5/2024 TrueScripts, Amazing Care Po0o8: W1812024 thte W24/2024 11:59.59 PM Exe otian Time: 3126I20245:27:35AM -_- - ----nr fM"-U25MG 3 12. $16.59 31.86 - 51.86 $0.00 1 0 M=024 2085932]63W000]200-00143.9285431 AMOXICILLIN TAB 875MG 10 20 $13.97 $4.69 $4.0 $0.00 3I22/2024 2085931763601)(pTID0-Ol 67BTI1321.0518UPROFEN TABSOOMG 10 30 511.97 $3.76 $3.76 $0.00 312ZFM4 142]]38]83600002800-III 11534-016S413FOLICACIO TABIMG 9U 90 541.89 $5.10 $5.18 $0.0 W4/2024 ]]13191 763W00D6ma. W 0131694550-13TRESIBA FLEX INJ ZOOUNIT 22 9 t5]31,A) ($62].($($61WIW024 ]13181763WW00200-020IMINSM-1STREFLINJ 2U2 9 $]31J] 67 .32 $10.00 $81 7.32310224 ]]40526]63fi0Dp03W0-Of OD189d]Yt2O2EMPIC INBMGML 28 3 131.162.22) (5995.Os1 3I18r2024 ]]54856 783510003W0.O1 00l6&41 W-13 OZEMPIC INJ 4MG/3ML �� ` a1,4a4.a] $1,055.69 535.00 $1.020.69 3/19/2024 7101525 T69510000W0- Ol XISDUOXR TAB10.1000 28 3 g$69a.!2 S35.00 &20/2024 M054286W 2233]04 ]63510000W0-Ot fi9505-0]/l-01 LISOEXAMFETA CAP 30MG 30 3D $895.30 $598.74 $598.]4 535.00 $650.05 $663.]4 M202=4 T]66928 ]6351000,[=-Ol 18511-0862.03 BUPROPN HCL TAB 30 30 $915.30 $221.04 $10.00 $211,64 SMO/2024 150MG XL ]]65926 7635lo004000-01 623324)02"l FLUOXETINE CAP 40MG 3D 30 515.00 $7,40 S],46 SOA0 3121a024 2233710 763510004000-01 4T/81-0568.01 LISOEXAMFETA CAP70MG 30 30 34.00 SCUD $4.00 SD.00 3 IM024 4573498763510004000-01 W093-0832.01 CLONAZEPAM TAB O.SMG 30 30 $180,80 $181180 $10.00 $170.80 3/t012024 W01605]635100040 D-01 16571-0862-038UPROPN HCL 15 15 $10.37 $2.20 $2.20 $0.00 3/IU/2024 TMISOMG XL ]]4]264]63SIOM4000- 91 68fi4S0130.54 FLUOXETINE CAP 20MG 30 30 (515.00) ($1.48) ($].40) 3k&2024 I459513 ]63510005300-Ot 31722-0]]0-0I ACYCLOVIR TAB 800MG 30 30 ($4.OD) (52.92) (5292 $p.pp SUN W3/2024 14SM14 763510DO53DO - 01 51572-1360-01ACYCLOVIR OINS% 5 25 $45.99 519.47 $10.00 $9,47 3/2312024 1430884763510005300- 01 6568205W-W PANTOPRAZOLE TA840MG ] 10 $248,89 g23.34 S10.00MOD $13W 90 90 $248,89 $58.36 $20.W $38.34 PAge: 1 of 3 CLSP_TSC., FIN_001.005 P.,W: 3/18/2024 thm 324/2024 11:69:59PM ?rueScriptJ . Execution Time: 3MM245:27:36 AM Amazing Care 3M32024 140981]]63510005300-01 55111 0180-15MM(DINE TA84MG 30 60 $71.99 $21.89 $10.00 $11.89 3AN2D24 1459597763510005300-01 678T7-0899-01 FAMOTIDINE TAB 40MG 90 90 560.89 $47.72 $20.00 $27.72 3/112024 /394693763510005300-0/ 60180-0719-MAMLODIPINE TAB2.5MG 90 90 ($12289) ($14.16) ($14.15)) $0.00 31162024 1457568763510005300-01 69238-1314-09PREGABALIN CAP 160MG 30 60 $375.59 $mw $10.00 $21.63 =W024 1458963763510002900-01 55111-0466-01METOPROLSUCTAB25MGER 90 g0 363.89 $45.85 $20,00 $25.05 31212024 1459030763510002900-01 00406.0124.05 HYOROCCVAPAP TAB 7.5.325 15 60 $10299 06.33 $10.00 $25.33 8N92024 1428392763510002300-01 27241.0155.040XYBUTYNIN TABSMGER 90 90 $311.59 $63.14 $20.00 $43.14 3123M024 17UO147895100W500-02658620202-99 LOSARTAN POT TAB S0MG 90 90 $140.69 543.61 $20.00 $23.91 WI M024 1444240763510001400-01 6438041725.06 MYCOPHENOLAT TAB 500MG 30 60 $39249 $32A4 $10.00 M." 3/1912024 1467523 M510000400. 01 00054527099 FLUTICASONE $PR 50MCG 30 16 SS8.39 $30.44 $10.00 $20.44 311M024 2233667763510003200-01 25573-0467-02 AMPHET/OEX CAP 20MG ER 30 30 $169.49 $27.56 $10.00 $17.56 3M12024 77T67274753510003200-01 55111-0145-12 FLUCONAZOLE TAB 150MG 3 2 $18.36 $5.62 $5.62 $0.00 3/19M824 2033514763510004600-01 30229-2820.11 HYOROCHLOROT TAB 12LMG 90 SO 546.99 $1520 $1820 $0.00 31192024 2061605 7635100114600 . 01 42908.0400.21 METHYLPRED TAB 4MG 6 21 $24.99 $23.58 $10.00 $19.58 3/M024 SM70M 763510002000 - 01 00093-7198-01 FLUOXETINE CAP 40MG 30 30 $49.99 $19.40 $10.00 SDAD 312&2024 9639M 705100➢IM-0116714-0953.01 AMPHET/OEXTR TAB 20MG 30 30 $47.98 $13.93 $10.00 $3.93 371872024 1458080763510002700-02 231554857-M ANASTROZOLE TAB IMG 90 3 $0.79 $3.12 50.00 53.12 3/1812024 7739775 M3510MI 000-01 50458.0579.30 XARELTO TAB 20MG 30 30 $683.50 S565J4 $35.00 5550.74 3/182024 775291176MIOMIMO-01 31722-0152.90VALSARTAN TAB00MG 60 SO 3266.11 $1493 $14.93 $0.00 3/172024 7739M 763510001000-01 50458.0579-30 XARELTO TAB 20MG 30 30 ($BB350) ($585.74) ($35.00) ($550.74) 3/172024 77629117051OW1000-01 31722-0152.90VALSARTAN TAU80MG 60 fi0 ($266.11) ($14.93) ($14.93) $0.00 3M BM024 1334179763510001100-01 13101-0083.05LORAZEPAM TA60.SMG 30 60 $32.94 $C06 $4.06 $0.00 VIM024 952A41763510001100-01 16714.0986.03 TRIAMCINOLON CRE 0.1% 30 80 ($12.97) Isom) ($9.52) $0A0 WIM024 7766399763510001900-01 63304-0693-01 CUNOAMYCIN CAP 300MG 5 15 $37.12 $6.13 $6A3 $0.00 W2012024 7766793763510002600-0165862.0391-100NDANSETRON TABSMGODT 7 20 $88.97 $7.97 $7.97 90.00 3M]2024 776]260]63600005100-02 00169.47$120ZEMPIC INJBMG/9ML 28 3 41,1622E $995.05 $35.00 $960A5 31222024 884089] 763600005100-02 00169-1 037.02 NOVOLIN70MINJ RELION 20 10 $24.88 $24.88 $10.00 514.88 312&2024 7767262763600005100-02 57599-0818.00 FREESTY LIBR NR 3 SENSOR 28 2 $161.82 $141.02 $35.00 $108.02 3122/04 776720763OWNSIOD-0257599.0820-0O FREESTY LISP MIS 3 READER 30 1 494.50 $73.17 $70.00 $3.17 &19/2024 77631"76360 M4000-01 00902-1496-80MOUNJARO INJSMM.5 28 2 6umm $11090.e3 $35.00 $1.003.93 VIV2024 2000681 7636MM3700 - 01 00002-1495-80MOUNJARO INJSMGl0.6 30 2 $1.284.09 $1.062.70 $35.00 $1,027.70 Page: 2013 CLSP_TSC_FIN OD1.003 True.Scripts., Amazing Care P4Nc0: WI W2024 III.=42024 11359:59 PM Ezficullon Tlme; 32620245:27:W AM 3/fW2024 Id9750 ]6960WWSW-02 fi81 W41B11-73MIBELAS24 CHWFE 84 84 $33&89 $49.25 $0.00 $49.26 WtM024 11872N7WWWOW00-02 7I4IWQW3-WRHOFADE CREI% 90 30 $I,N3.51 $610.05 $70.00 $540.06 312CM024 77667M 7630WOS300-01 W3104IOW2AIRSUPRA 4ER8080MCG 30 10.7 $570.00 $488.70 $70.00 $418.70 W192024 14581497SW00009BN-01 00378.8082-45TRETINOIN CREC.025% 20 45 $1OS.N $89.03 $10.00 379.03 W14/2024 145687678OWU9800-0143547-0346-W LEVETIRACETA TAB 7WMG ER N 30 $119N.19 $162.28 $20.00 $142.2B W142024 14569767Q600W980-0143547-046.06 LEVETIRACETA TAB 750MG ER 5 20 ($10&66) ($10.12) ($10.00) ($0.12) W134024 223364276369WN200-01 47781.0562-01 LISDEXAMFETA CAP I ONE; 30 30 $191.77 $191.77 $10.00 $181.77 3/192024 145831876300006MO-III 72205-OM-99 LOSARTAN POT TAB I WMG W W $178.99 $48.41 $20.00 $284I WIR024 145870476360000520D-01 68190-09G401 ALBUTEROL AER HFA 50 25.5 $121.09 $114.29 $20.00 $94.29 31=024 13]2825763NOW92W-01 BBISU,NM 3SIWASTATIN TAB 20MG N 90 $77A9 $43.49 N.W SOA9 31laVM4 1457]8/ 763W0009400. 01 722W-0143.99 LOSARTAN POT TAB I OOMG 90 90 $178.99 B48.41 $20W $28.41 3/17/2N4 1415067WWW09400-01 65862.056WW PANTOPRAZOLE TAB 40MG 12 12 (S38.39) ($8.88) ($8.88) SON WIW2W4 776631776360N026W-01 59746-0121-NMECLIZINE TAB25MG 8 30 $9.00 $6.35 $6.35 SON W182N6 776631976Y 026W-01 45802.075"0 PROMETHAZINE SUP 25MG 3 12 $135.50 $38.25 S10.00 $28.25 WIBI2024 7760157636GOMMU-010143-1227.01 DICVCLOMINE TAB 20MG 8 30 $IIAI $8.22 $822 SO.W W1M024 7766318 7WBWM2600 - 01 68392-0041.01 PROMETHAZINE TAB 25MG 5 20 $10.00 $3.09 $3.09 SO.W =412024 1355016 7WEGON12M - 01 WISMnO4I3AMLODIPINE TAB5MG W 90 $10.89 $42,73 $20.00 S22.73 W242024 7745216]638WW3400-W 16714-0406-04 IARIN FE TAB 120 28 2B $13,32 $8.05 W.00 $8.05 W232024 N3984706WW14M-01 59746-OW"SMETHVLPRED TA84MG 6 21 $24.47 $6.08 $&W $0.00 W242024 9217947636NNUN-01 1671b086f-02GABAPENTIN CAP IOOMG 30 90 $30.97 $SA7 S5.47 $0.00 S2U(2024 7766"0763NOWN00-01 31722.0730.301RBESARTAN TA81WMG 90 90 $24.00 $15.43 $15.0 WAS W19/2024 1457007763600007400-0t NN3-ON2.05CLONAZEPAM TAB0.5MG 4 12 $12.39 $9.64 $&64 N.00 W21M024 N'1019376NOWNWO-02 08290-320749 BD PEN NEEDL MIS 32GX6MM N 1N MIS= $61.55 $61.55 $0.00 W17IW24 8840193 7SWWWWW - 02 OSM-UO74990 PEN NEEDL MIS WGX6MM N 1N (SBB.W) (S61b5) (SE155) W.00 W152O24 7765797763WONIM-01 00469.2601-30MVRBETHIO TA825MG 30 30 (SSW.36) ($473.621 (535.001 1S438.621 31192024 774845476370WO29W-01 WN7.0146-60JENTAOUETO TAS2.5-I0W 30 W $630.10 $540.0 $540.09 $0.00 WIW2024 F484607637OW029W-01 703n,0N7-12ROSUVASTATIN TAB IOMG 30 30 $166.67 $4.11 $0.00 $4.11 W18/2N4 7711496]6370WWBW-01 293W-ON7-JOAMLODIPINE TAB5MG 90 N $24.00 SPAS S2.66 $000 31162N4 775459576370OW2W0. 026864541523.54 BERTRALINE TAB IWMG 30 30 59.00 $4.31 S4.31 $0.00 Page: 3 cl3 CLSP TSC_FIN 001.003 Period: 3/11=415m W1712024 11:59.69 PM r eScri'�/ ts. EcecuOon nme: 3/19/20245:36,19 AM (�1I/Lq"/Amaazing Care 0743SUSEMORIALSENIORMANAGEMENT 6 $1,267.4151 $1011.93 $64.671 $104.26 ]8360183611 SENIORMANAGEMENTHIOM.(14368O01) 9 S9D0.78� rl"7 SKAT MAO• 3I112024 146588E ]fi35f000020D Of 856gA0911 f2ANUSOL-HC 6UP 25MO 2 4 $300.99 $14.57 514.67 $0.00 9/162024 1446593763510000ISM.01 33342.017 100LMESAMEOOXTAB20MG 30 30 5122.1E $18,13 310.00 $B13 3I162024 /457385763510000200-01 7583 0219.30VENLAFAXINE TA62MMGER 30 30 5265.29 $59.09 $10.00 $49.09 WIM024 1457%6763SIONO00-0142806-0416-05RUPROPN HCL TAB SOONG XL 30 30 $11229 $2418 $1000 $1418 7$350T5S601.. SENIORMANAGEMENLMIO'b4aaanml 3/142024 SM413763600008700-01 70010-0135,05 POT CHLORIDE TAB ZOMEO ER 9D 90 $51.91 $20,84 $20.00 SO." W142024 771310176MOOMMO-0200169-2650dM TRESIBA FLEX INd 20DUNR 22 9 S731.77 $627.32 $10.00 $617,32 3/162024 176806763800MSM-M 27241.0139.090SELTAMIVIR SUS6MG/ML 7 1SO $242.69 $92.16 $10.O0 $82.16 NIW2024 IM997769600000M-03 00574-1104-16BROWPSMM SYP 7 114 $28.99 $20.88 $104D $10.88 W132024 6193277763600000000-01 U332-0415-10OSELTAMIVIA CAP75MG 5 10 $154,49 $29.17 $10.00 $19.17 W172024 4840080 ]69600000BOD-01 00574.11044M BROMIPSE/OM SYP 3 200 544.99 $34.66 S1OOD $24.66 3/17/2024 4640059763600000800-01 27BOB-0233.02DOXYCYCL HYC CAP IOOMG 10 20 $77.99 $19TI $10.00 $9.n 31IM024 1769009763800000ON-02 60219.1266-01 OSELTAMIVIR CAP 75MG 5 10 579.19 $49.0 SID.00 $39AB 31161202E W46632763600MMOU-01 43547-033b091RBESARIHCTZ TAB 300-12.5 90 SD $187.32 529.04 $20.00 $9.04 Wl WG24 n65007763600006200-01 59746-OMI-03METHYWRED TAB4MG 6 21 519.59 57.65 $765 $DAO TlW2024 7765068763600006200-0I 646]9-D604.16 PROMETHAZINE SYP DM B 240 $27.64 514.02 $LOAD 54.82 3II12024 14547987636000055DO-03 458020112.22MUPIROCIN OIN2% 10 22 554.99 $9.54 $9.54 $0.00 3I62024 7763457763600IIOS60-01 0862-0502-20 AMOXM CLAV TAB 500-125 10 20 (S37.19) ($9.07) ($9.07) 50.00 3/52024 776347998360000560D.01 55111-0145-12FLUCONAZOLE TAB150MG 2 2 ($16.36) (65,62) (55.62) SO.W 3/12/2024 20809437638000W200. O1 2930041397-10AMLODIPINE TABSMG 30 30 $10.00 $1.64 $1.64 MM24 7756256763600005600-D3 0037e4I08545TRETINOIN GELO.01% 30 45 1$240.171 13145.011 I51DA01 $0.00 u139n11 Page: 1 01 CLSP TSC FIN_001.003 TrueScf apts.ingCare Period: Execution Time: &I W0241hiu W17/2024 11:59:59 PM 3/19/20245:35:19AM 7050763= NONEI1EMPTEMPLOYEEBMID(743TPp0 54. 426,881,06 $14.1 1T $98847 $13wo,70 W102D24 15112825783600005000-01 00597.01453D0FEV CAP 150MG 0 0 $0.00 $0.00 $0.00 $0.00 WINW24 151126257WOMOSM-01 MSW-G145-600FEV CAP150MG 30 60 $23,394.00 $13,418.00 $576.92 $12,841.W W1272024 170490476 MW3100-010OW74053-WDEXCOMG6 MISSENSOR 30 3 $461.99 W74.80 $35,00 $339.60 W1WE024 1704886783D00003100-01 00169-75D1-11 NOVOLOG INN IDOIML W 3D $250.99 $214.03 $1&W $204.03 3/122024 171751476360(1003100-01 10 4.3270.99 FLUTICASONE SPR SOMCG 90 48 $156.99 $69.70 $W.W $49.70 WIMOV 17V521763600003100-016M80.071M7 BENZONATATE CAP 20MG 14 42 $62.59 $5482 $10.00 $44.82 WI22024 1717522 763800003100 - 01 DW93.2204401 METOCLOPRAM TAB 5MG 7 28 $11.99 $8.07 $8.07 $0.00 W172024 17192257836 11)0-01 NIBO0295.060ULOXETINE CAP30MG 9D 90 $693.99 $44.57 S20.00 S24.57 W16/2024 770787763600001800. 01 00469.260t-30MYRSETRIO TAB25MG 30 30 $552.36 S473,62 $35.OD $4W.62 W14/2024 14NO7676360000MOO-0165562.0228-01 LAMOTRIGINE TAB iWMG 90 135 $284.79 $71,09 $20.00 $61.89 W1412024 14S6876763NOWSBOO.01 43547.0346.06 LEVETIRACETA TAB 750MG E8 5 20 $1W,66 $10.12 $10.00 SO.12 W102024 14556377OWD000200-01.31722.WS31 OROSPIWETHI TAB 33.WMG 20 28 $70.79 $20,27 $0.00 $20.27 W112024 1455660753W00DOM-01 333424117940 OLMESA MEDOX TAB 20MG 90 90 $354,49 $51.09 520.00 531.09 311=024 14SM8376360W0=0.01 WD54.0742-87ALSUTEROL AERHFA 7 6.7 S37.99 $30.84 S10.00 $2&84 311W2024 144547376MOMOD200-01 68180.0868.73 DROSPIRIETHI TAB 3-0.03MG 28 28 ($70.79) ($20.27) $0.00 ($20.27) W172024 142647076360000S600-01 13668.0330.05TRAZODONE TA860MG 90 90 $50.89 SWAT $16.47 $0.00 3117M24 13955407638WMSWO-01 WOO.710-DIFLUOXUINE CAP40MG 90 90 $146.89 $54A9 $20.00 $34.89 W72024 7750853763600005100-01 65162.0372-50OXY9UTYNIN TAB IOMGER W 30 ($114.05) ($7.131 ($7.13) $0,00 WI72024 7742NO706WWSIM-01 MSM-3927-GIGUANFACINE TABIMGER W W $728.22 $30.66 $20.W $10.86 WIS2024 220293763600002100-01 43547g301.03 OLMESA MEOOX TAB 40MG W 90 $375.94 $16.16 SI8.16 $0.00 3116/2024 220292763600002100-01 6787741199-10AMLOOIPINE TABIOMG 90 90 $24.00 S3.11 0.11 $0.00 W152M 2202057636 MIM-01 75834-0255-01 ATORVASTATIN TAB I OMG 90 90 $36.91 $4.97 Sam S4.97 37152024 253974763W00102100-0165862-0166 D1 CLINDAMYCIN CAP 3WMG 7 21 $30.08 $7.24 $7E4 $0.00 WIM024 253972 76W000021W .01 24208-0910.55 ERYTHROMYCIN OIN 5MWGM 10 3.5 $17.97 $13.73 $10.00 $3.73 W132024 14326147638000030W-0229300-041931 AMITRIPTYLIN TAB/OMG 30 90 $2&99 $16.17 $10.00 $&17 311312024 593207763600009400-01 00406-012405 HYDROCO7APAP TAB 7.5-325 30 90 $W.39 $14.95 $10ma S4.95 W171024 14159SG 7636000094W-01 65852.056030 PANTOPRAZOLE TAB 40MG 12 12 $38.39 $8.88. $B.BB SO.00 W12/2024 1717757 763600004M - 03 70(11W0205-10SERTRALINE TABIWMG 30 30 $40.99 $14.23 $10.00 S4.23 W14/W24 1450267060000000-01 131074)080-01TRAZODONE TABIOOMG 30 W $20.99 $10.10 $10.00 $0.10 3113/2024 223MM 76360ONO2M - 02 47781.0586.01 LISDEXAMFETA CAP 50MG 30 30 S177.24 S155,22 S10.00 $14522 NW2024 2233560 J636WW0260-024T781-0566,01 LISOEXAMFETA CAP saMG BO ]O ($110.00 ($15649 (510.69 ($140.00 W1W2024 2539697836000W100-02 ]2BBB-0037.00 CAgVEOILOI TAB25MG W 180 $10,00 58.69 $8.69 $D.00 Pa96: 3 of CLSP_TSC FIN_001.003 TrueScrip S, AAA Amazing Care ParlaB: WI 1120241hm W1712024 11:59:59PM Eaecullan Time: 3/19/2024 5:35:19 AM WIM024 7765141763510o(IIM-01 5022&0180-10GABAPENIIN CAPSOOMG �'17'" 87.34 $1,OSom &17/2024 7739775 ]835fOWI0W-DI 50458.057930XARELTO TAB 20MG m 90 270 $03.50 $i5.74 $17.97 $17.00 $0,W 3117/2024 7752911763510001000-01 31722-0152.90VALSARTAN TASaomG 30 30 $W3.50 $505.70 g35.00 $550.74 3/16✓2021 77222067635100043O0-Ul 00166-07774GDSRILINTA TAB 90MO 60 60 6266.11 $14.93 $14.93 $0.00 3111MW4 141N0376351CON900.01 31722-0149,05GASAPENTIN CAP3WMG 30 60 $541,46 $464.29 $35.00 $42929 TI IM24 14554M 76MI0004M.ol 00376.7187.05METFORMIN TABIWOMG W 540 $497.79 $201.12 520.0) $181.12 3111fi024 1455404763510004900-01 31722-053&01 METHOCARBAM TAB SWMG 90 180 $52.69 $48.85 $20.00 Va." 3'112024 745549276351000490D-01 2NOM125-10MEWXICAM TABISMG 30 60 30 $31.99 $23.02 $10.00 $13.92 3/11/2024 IMM17763510004900-01 68150-0519-02 LISINOPMCTz TAB 20.12.5 30 $39.0 $26.06 $10,00 $16.06 3/15W24 14572157635100B4WD-Ot 0040&BWS-W BUPRENMALOX SUB 2-0.5MG 90 9D $56.89 $18.44 $18A4 $0.00 3I11/2024 957154763510DOWN-01 57599-08/8.00FREESTY LIBR HIT 3 SENSOR 30 60 $143,99 08.47 $10.00 $28A7 WW2D24 9M70975351003700-01 31722-0726-10MONTELUKAST TAB 10MG 20 2 $161.84 5134.86 $35.00 $0.86 3AV2024 4637346763510006200-011672$0189-29MYCOPHENOLICTAS380MG DR 30 30 ($61.97) ($3.97) ($3.97) $0.00 3AY2024 46373467635WW6200-01 16729-0I69.29MYOOPHENOLICTAS3WMGDR 30 120 $820.09 $60.34 $10.00 S50.34 WI112024 14"G0776nI0W23W-0I 6810&0779-01 ZOLPIOEM ER TAB 6,25MG 5 20 ($136.68) ($10.97) ($10.W) ($0.97) W131RO24 145S296763510W23W-01 ]095405W-10 ESTRAOIOL TABIMG 3D 30 S174,99 $27.47 $10.00 $17A7 3113/2024 1455340763510002300-01 31722-0778.OIACVCLOVIR TAB BOOMG 90 90 $37.99 $24.69 $20.00 $4.69 3/14=24 1682064 7051OW3000 - 01 68382-0799-01 LABETALOL TAU200MG 7 28 S50.79 321.68 $10.00 $11.63 WIM024 1465878763510003ID0-01 658620574.90MONTEWKAST TAB IOMG 30 60 $42.99 S25.61 $10.00 $f5.61 311M024 7718M 7W51=56W-0269238-1423A1 METHOTREXATETAS2.5MG $0 30 $107.89 $18.40 S10.00 $6,40 WIV2024 142580776351G002200-01 43647-W53.11LISINOPRIL TASIOMG 28 24 $94.87 $10.70 $10.00 $0.70 3l7/2024 7746lW7WSIDaW6W-01 6884&052f44SERTRALINE TAB25MG 90 90 $34.99 $13.01 $13.01 $0.00 3/17/2024 0570076351OW3600-01 70377-0W&13 ROSUVASTATIN TAB 20MG 90 90 ($2CW) ($10.04) ($10.04) $0.00 W1712024 967938763510003600-01 601804378-03 LOSARTAN POT TAB WOMB 90 90 $259.82 $11,71 $11.71 $0.00 3/11/2024 139469376351000530D-01 68180�0719.09AMLOOIPINE TAS2.SMG 90 90 $75.91) $15.26 $15.26 $0.W 3716/2024 1428089753510005300-01 692384832-07 LEVOTHYROAN TAB 75MCG 90 9D $122.89 $14.16 $14.16 $0.00 3/14/PW4 7726805 763510005600 - 01 G2532.0024.91FWOXETINE CAP40MG 30 30 $16.99 S6.42 SSA2 $0.00 159024 M77152M3510000500-0116571.0863506UPROPN HOL TAB 300MG XL 90 90 $f0,00 $10.00 $10.00 $OAO 3 024 7110371763510000500-01 00091605&10 ATORVASTATIN TAB 1.10 90 90 (W&37) ($34.59) ($20.m) ($14m) 3/3/2024 19029497635100043M, 04 00093-W53-01 BUSPIRONE TAB 5MG 90 90 ($55.74) ($13.97) ($13.97) $0.00 90 270 ($107.99) ($85.40) ($20,00) ($65.40) Page: 2 Of 4 CLSP_TSC FIN 001.OW TrueScriptS4 Amazing Care Peri Execution Time; 3111120241M1N W17Y2024 11:%59 PM 3/192024 b.35:19 AM W142024 962516783600004500-01 293004XI55-16 TRAMADOL HCL TA1350MG 10 60 $22.37 $3.85 $3.85 $0.00 3112024 7764737763600004700-111 72578-0055-18 DO%YCYCL HYC CAP t00MG 7 14 $28.32 $4.69 $4.69 $0.00 3NIM024 457337776360000,IM-01 2BIDQ0GW501 TRAMADOL HCL TAB 50MG 5 20 $17A7 $2.63 $2.53 $0.00 3f112024 W64741763GOON4700. 01 70010.0"(1.01 METHOCARBAM TAB 750MG 7 21 $10.50 52.81 $2.81 $0.00 NIM2024 9481807838000051100-01 29300MSO.05 METFORMIN TAB 600MG ER 90 270 $15.0D $12.40 512,10 $0.00 W162024 142228376360000690U-III 1 t534.0165.03 FOLIC ACID TABIMG SO 90 $41.89 55.18 $6.18 $0.00 S1162024 1448 763600006M - 01 20W0119.01 AMITRIPT UN TAB IOMG 30 SO $13.69 $6.12 56.12 $0.00 TIMM4 1457007763800007400-01 00093.0832415 CLONAZEPAM TAB 0.5MG 4 12 512.39 $5.64 $5.64 $O.00 3152024 1457" 763600007,100 - 01 68382-0040-01 PROMETHAZINE TAB 12.5MG 3 15 $14.99 $4.85 $4.85 $OAO 3n12024 T784816 ]63600008100-D1 59746.0172-10PREONISONE TA85MG 30 30 55.42 $3.85 $3.85 $D.00 W13P2024 775982476360000810-01 31722.0700-10 LOSARTAN POT TAB 25MG 90 90 $24.00 $6.02 $6.02 $0.00 WII2024 1438744763600008500-01 WID93.0054-016USPIRONE TABIOMG 30 60 $11.99 $5.22 0.22 $0.00 3/152024 962763763600008900-01 W002-1471-SOMOUNJARO INJ IOMG/05 26 2 $1,242.97 $1,055.69 $35.00 $1.020.69 2N52024 92093570600008900-01 W002-1460-80MOUNJARO INJ12.610.5 28 2 ($1,242.97) ($1.055.69) (535.00) ($1,020,69) 9/142024 96256376360000810D-09 658620MAO ONDANSETRON TAB 4MG OOT 5 10 $36.95 $3.48 $3.48 50.00 W102024 711502176360000060D-01 658620709-01 RALO%IFENE TAB 60MG 30 30 (554.36) ($9.42) $0.00 ($9.42) WlWO24 1717806763600009000-02 57699.O111841(1 FREESTY UBR NIT 3 SENSOR 28 2 $161.82 $141.02 $35.00 $106.02 3I72024 7753205783600009000-020010-2660.16 TRESISA FLE%INJ IOOUNR 43 15 (5609.81) (5523.00) ($20,00) (3503.00) illy/2024 8840193763600009000-02 ONN 3207.490O PEN NEEDL MIS MG%6MM 50 IN $0.00 $51.55 $61.55 $0.00 3H112024 957014783800001001)-01 75854.0250-01 ATOHVASTATIN TAB 80MG 3D 30 $2927 PAS PAS $O.OD M72024 95701376360000IGO-01 6699&0457-30OAPAGUFLOZI TAB IOMG 30 30 ($629,98) ($54844) ($7D00) ($476.44) 3N2024. 926M7636000IM-0150228-0124-05 CLOPIOOOREL TAB 75MG 80 90 ($36.00) 11 IS7.581 30.110 5/132024 9594847G70000210D-01 0003"42LL14LOLOESTRIN TAB1-10-10 28 28 $198.16 $177.77 $177.77 $0.00 3II62024 f457383T63700002800-01551160466.01METOPROLSUCTAB251AGER 30 30 521.99 $14.20 514,20 $0.00 Page: 4 of 4 CLSP TSC FIN 001.003 ` rueS'criM' Amaaing Care 513 E. South Street Washington, IN 47501 844-257-1955 Memorial Medical Center f Attn: Andrie Flores PO Box 25 Port Lavaca, TX 77979 Billing Period Invoice Date 3/12/2024 Invoice q CE710 Description I Quantity I Amount Rx Drug Cost - Including Specialty Care Fee 18,792.40 Administrative Fee 193 1,206.25 Step Therapy Program Fee 193 38.60 Healthsure Per Claim Fee 293 386.00 Leaf Health Per claim Fee 293 241.25 Prior Authorization Fee 20 700.00 ID Card Fee + Postage 11 22.00 APPROVED ON .a PP fig 20'7# RY COUN7YAUDITOR CALHOUN COUNTY, TEX'.S "Experts in Prescription Be77efil!S" Total $21,386.50 lal" Please remit your payment by: ( 3/22/2024 l Trl. eScri t'SIe Amazing Care Period: 31412W41hru 37IMM 11:59:59 PM Execumm Time: 3N2/2024 6:13:W AM 3W024 141495 MODOW8800-01 00642-7470,01SLYND TA54MG 28 28 ($232.99) ($193.74) ($70.00) (6123.74) W2024 3WO24 WWM4 1023976MIOMONO.01 005550974-02AMPHETMUTR TAB 30MG 1024076351WO(MW-01 WI65.084E-01AMPHET10EXTRTAB IOMG 281542763SIM33M.01 5W2-1293-03CLOSETASOL SOLD.05% 30 30 W 30 30 50 $58.28 $60.2B $28215 $13.15 $10.33 $240 $10.00 $10.0D $1000 S3.15 $0.33 $1449 763511rre:16M EXEMPT EMPLOYEES MID a4?09'4D?)... :5: $1,255:60' $IpR798 ;09A1. '$980.05 WIM024 77405MM36WOWBW-01 W1694T72.12OZEMPIC IN48MG ML 28 3 $1.162.22 $995.0 635.00 SBW.W 30'2024 1453974 7636GON)MO - 01 692WI837-01 LEVOTHYROXIN TAB 137MCG 90 W $38.89 $18.12 $18.12 $0.00 3/SIZD24 776345770MODOSM- 01 658020502.20AMOXMCLAV TABSW-125 10 20 $37.19 $9.07 $9.07 $0.00 3I5/2024 77634797636()OOW6W-01 5511 1-01 45-12 FLUCONAZOLE TAB 150MG 2 2 SIS.36 $5.62 0.62 $0.00 3/5/2024 7756236 70MOM600 - 03 00379808545TRETINOIN GELO.01% 30 45 $240.17 $145.01 $10.00 $135.01 3VII024 7760236763WW0500-03 037 808545TRETINOIN GELO.01% 30 45 ($240.1T IS143011 IS10.W1 ($1 as (111 3N0/2024 941067635ION3700. 01 694524)3SMOROPINIROLE TAB 2MG 80 120 540.W �$10.16 $10.16 $0.00 W2024 1453396763510W1 Mo-ol W1694130-130ZEMPIC INJ 4MW3ML 28 3 $1.163.99 $902.84 $35.00 $W7.84 WIM024 14459097W51000500-01 00169-4130430ZEMPIC INJ4MG13ML 28 3 $1.163M $95284 $35.00 $927.84 W`IM24 IT7139753510W5I00-0159651.042"1 SPIRONOLACT TAB IOOMG 9D 190 $262.99 $62.15 $20.00 $62.15 3AW024 90667763510004400-02 W093-5551.01 DEXMETHYLPHE CAP 10MG ER 30 30 $239.97 $0.82 $1 O.00 $58.82 3M/O0 139469176351 OWSMO-014354741331-03 IRBESARAICTZ TAB 30D-12.6 90 90 S328.09 $62.99 $20.W $42.99 3/5/2024 1453W37535 IM0480D-01 05002-0503.20 AMOXM CI -AV TAB 875�125 7 14 $40.29 $8353 $10.00 $23.53 315/2024 70771527635tOODOWO-0116571.0863.50 BUPROPN HCL TAB 300MG XL W 90 $326.37 SM.59 S20.W SI4.59 Page: 1 of CLSP_T3C FIN_001.003 llueS rriptsAmazfngG:nre Period: 3/4/2024IS. W10202411:59:59 PM Execution Tlme: 3/1 W2024 6:13:06 AM 3/5/2024 7110 771763510000500-01 00093.505B40 ATOflVASTATIN TA840MG 90 90 SSS.74 $13.97 $13.97 $0.00 W5/2024 9609$2 J63510001200-Ot 00228-W61A i AMPHEJDEXTR CAP 30MG ER 30 30 $171.06 $22.64 $10.00 $12.64 3/412024 71`63233763610004300-01 M302-0565-10 METOPROL SUC TAB SOME ER 90 lee $48.00 $28.37 $20.OD $8.37 318/2024 45733527061000430D-01 651620033-10 APAP/CODEINE TAB 300.30MG 7 21 $19.67 $7.26 $72(1 S000 WB/2024 4637346763510006200-01 I6729-0189.29 MYCOPHENOLIC TAB 360MG DR 5 20 $138.68 $10.97 $10.00 $0.97 W W24 7763M 7635 ISDOG900. 01 70710.1138-03FLUCONAZOLE TAB ISSMG 3 3 $8.18 W =24 7742617 783610030900. 01 00228-2778.11 PROPRANOLOL CAP GOMG ER 30 30 $51.73 $3.51 $7.85 $3.51 $7.85 S0.0D 3/5/2G24 60269287763510002500-01 00527-328043 LEVOTHYROXIN TAB 25MCG 30 30 $0.00 46 $10.80 $4.39 $4.39 $0.00 3/512M 6027OD72783510002600-111 55111-O468U5 METOPROL SUC TAB 25MG ER 86 30 30 $29.71 $4.80 $4.80 $0.00 WW2024 MGR87 M351000250D - 01 00527.328043 LEVOTHYROXIN TAB 25MCG 46 30 30 ($10.8D) ($4.39) ($4.39) 80.00 3aSK)24 60270072763510002600-01 55111.0468OS METOPROL SUC TAB 25MG ER 30 86 30 ($29.71) ($4.80) 1$4.80) $0.00 W M24 77461W 76351OW2600-01 69645.0521.54 SERTRALINE TAB 25MG SO 90 $24.00 $10.04 $10.04 $0.00 W/0/2024 770160570510004000-0116571-086&03BUPROPN HCL TAB 150MG XL 30 30 $15.00 $7.46 $7.46 31012024 77472847635100040W-OI 686450130.54FLUOXETINE CAP20MG. 30 30 $4.00 $2.92 52,92 $0G0 SO.uO 31MO24 85870087W000002100- 0263180.0820�46LANTHANUM CHW750MG 30 90 S1,347.11 $501.63 $10.00 S491.63 3IV20M N0 19 763MM2100 - W 43547.0356-01 LISINOPRIL TAU40MG BO 90 S2621 SUE $mll) $OAD M024 712574076360MO210D-02 001694130.130ZEMPIC INJ 4MG/3ML 28 3 $1,162.22 $995.0 $35.00 $960.05 W4AW4 1452919763600MMO-at Mill-O=.01GLIMEPIRIDE TAB4MG 90 90 $76.49 $33.34 620.GG $13.34 314/2024 1462920763M000 0O 0170710-1285.01 BACLOFEN TAB IOMG 90 360 $195.69 $120.09 $20.00 $IW.09 3(4Y2024 1452922763600009M 01 00378.7187.05MUFORMIN TASIWOMG 90 ISO S52.69 $48.05 $20.00 $28.85 W412024 1452923763600009000-01 43547.0374.O91RBESARTAN TAB76MG 90 90 $242.29 SEEN S2040 $49.G6 3/412024 1452926763600009000-01 M783952435 ATORVASTATIN TAB 40MG 90 90 $371.29 330.96 $20.04) $10.96 W4/2G24 1452918763600009000-01 6823S-11334.07 LEVOTHYROXIN TAB 100MCG 90 90 S35.69 S19.41 $19,41 SO.00 3/M2024 W2917783600009000-or Sol 694130.130ZEMPIC INJ 41,11013ML 28 3 $1,163.99 $962.84 $35.00 $927.84 WW2O24 N8400763B00005800-01 00002.1506.80MOUNJAR0 INJ2.510.5 28 2 $1.242.97 $1,055.69 $35.00 $1.020.69 3IW2024 2051478763600003700-01 00002.1433.80TRULICITV INJO.75/0.5 26 2 $1.123.99 $971.87 $35.00 . $06.67 W M024 7750853763600005100-0165162-0372.500XYBUTYN1N TASIOMGER 30 30 $114.05 $7.13 S7A3 $0.00 37W2024 14431763600005100-01 618740115.30VRAYLAR CAPI.SMG 30 30 $2,479.B0 $l.6B8.34 $731.73 $936.61 3/612024 14431763600005100-01 61874.011S-30VRAYLAR CAP I.5MG 0 0 $0.00 $0.00 $0.00 $0.00 Page: 2 of 4 CLSP_TSC_FIN OOL003 True.SCYd�tS.- Amazing Care Ped.d: 3/4/2024 thru 3/10/202411:59:59 PM Execullon Tlme: 3/122024 6:13:06 AM 3N12024 T/63140 ]8360W04W0-Ot 0031U8210-30FARXIGA TABIOMG 30 30 $696.70 $599.74 $35.00 66W.74 3142W4 77631527636000(14000. 01 55111-OIB040TIZANIDINE TA84MG 23 90 $24.00 $6m WAS 5600 3/4/2024 763113 763601)(1- 01 68382.0051A)SMELOXICAM TABISMG 30 30 $4.00 $2J7 $21T7 $0.0 3/4/2024 77631397636000040OD-01 68645-0611-90LISINOPRIL TA820MG 90 90 $10.00 $2.62 $9.62 SO.00 &472024 A63138763800004000-01 W169-MM-IOLEWMIR [NJ FLEXPEN 75 30 $380.24 $333.30 $20.00 $313.30 3/42024 7763112 763600004000 - 01 W746-0514.01SPIRONOLACT TAB 50MG 90 90 $24.00 $12.31 $12.31 $0A0 31B/W24 ]]63142763600004000-01 68645.0584.59METFORMIN TABIOWMG 90 180 $10.00 $5.44 S5A4 $0.00 3a2024 1454439763600005200-01 M82-0916-34MUHYLPRED TAB4MG 6 21 $24.99 S23.56 $10.00 $13.58 WaO24 1454444763600NSM-01 W781.8989-26 AZITHROMYCIN TAB 259MG 5 6 $41.98 S24.38 $10.00 $14.30 3/92024 137MO 76360001-01 00597-0155.61 STIOLTO AER 2.5-2.5 W 4 $765.99 $481.41 $35.00 $40.41 3/5/2024 2233560763600000200-024VB1H15B6-01 LISUEXAMFETA CAP WM6 W 30 $171.24 $155.22 $10.00 $10.522 3142024 1453003 763MWOM2 02 512244H2250 AZITHROMYCIN TAB WOMG 1 2 $31.99 $7.20 $7,20 $O,W 302024 14646017S3500008500-01 68462.0138.01 OXCARBAZEPIN TAB WOMG SO 180 $482.69 SSI.69 $20.01) $61.69 WW2024 1453/97763600006100-01 W781-7172.50 AZELAIC ACID GEL 45% 20 50 $299.99 $65.91 Slam $55.91 3/7/2024 145453876asaace8W-016991"301-30TRANEX ACID TAB UOMG 5 30 $159.99 $60.62 $10.00 $SO.62 a/10/2024 14464M 763601)W0200-01 6818"868-73 DROSPIRIETHI TAB 3-0.03MG 28 26 $70J9 $20.27 $0.00 $20.27 SISM024 145358376MIGOD 00-Ot 00054.0742.97ALBUTEROL AERHFA 7 6.7 S37.99 $3D.84 $10.00 $20.84 3/9/2024 976622470504111-01 31722-0717-30ATOMOXETINE CAP 40MG 30 30 $320,78 $50.01 $10.00 $40,01 314/2024 1452946763600003300-01 65BU-070-20CEFUROXIME TABSOOMG 10 20 $70.49 $49.23 $10.00 S3923 W412024 1452949783600003300-01 70154.0G6U-20PREONISONE TAB20MG 5 10 $11.99 $3.02 $3,02 $0.00 3/412024 14529477636011003300-01 CMO-0712.07 SENZONATATE CAP 100MG ID a0 $14.09 $10.20 $10.00 $0.20 3W2024 14543W 763600008400. 01 00406-8893.131 AMPHST/OEXTRTAS201AG 30 60 $88.99 $M,02 SIODO 634.02 M112024 1677227763500101 722D5.0097-0 LEVEIIRACETA TAB IGWMG 3D fi0 ($352.99) ($20.70) ($10.W) ($10.70) 3142024 145306276360"9800-01 M054097-M LEVETIRACETA TAB I GWMG 90 ISO $1.136.69 WAS $20.00 $42.86 314/2024 7119679763600007400.01 ON54-0236-25 MORPHINE SUL TAB 30MG 30 90 SIOB.99 538.84 $10.00 $28.84 3162024 14540M 763600003000-02 MUB-0111.OSDICLOFENAC TM75MOOR 30 60 $52.99 $21.73 $10.00 $11.73 3/10/2024 711502176100000600-01 65062-0709.01RALOXIFENE TAB60MG 30 30 $54.36 S9.42 SHOD $9.42 3IV2024 904176763600001000-01 67677-0561.10METFORMIN TA0500MG 30 120 $10.94 $3.60 $3,50 $0.00 314/2024 92605 7636MO01WO - 01 502280124-W CLOPIOOGREL TAD 75MG W 90 S36.00 $7.58 $7.58 $0.00 34/2W4 77831M 763800001 W0-Ot 31722.015350VALSARTAN TABI60MG 90 90 $64.71 $22A5 $20.00 S2.45 3142024 77MM970MUNI000-01 66645A574-54GLIPIZIOE TA96MG 90 90 $6.00 $4.79 $4.79 $0.00 8102024 71197551636W002100.01 00169-0130.13OZEMPIC INJ 403131ML 26 3 $.16 2.22 $99.05) $35.0) $96005 229/2024 ]119]55 i836W002t00-Ol W1fi9dt304302EMPIC INJ 4M0/3ML 26 3 ($1,16222) ($99$.D$) (535,00) ($960,p5) Page: 3 014 CLSP TSC FIN_G IAO3 TrueScrip,ts.. Ammigg rare Period: WW2024119u WIM02411:59:59 PM Ea cullon Time: 311=24 6:13.0AM WWO24 7751999 763600002500 - 01 16571.0862-03 GUPROPN HCL TAB 15WO XL SO 30 ($15.00) ($7.46) (S7.46) $0.00 3142024 Ti22909763600002600-02 6864541558.54 LISINOPIHCT2 TAB 20-25MG 90 90 $10.00 $5.23 $523 $0.00 3/42024 77229107636000M O.02 68382.0001.06PAROXETINE TA840MG 90 90 S24,00 $11./8 $11.18 $0.00 T82024 7742823763600004600-01 66645.0519�54ESCITALOPRAMTASIOMG 90 90 S38.00 $10.89 $10.89 $0.01) W42024 7763056763 MMS300-03 42799.0815.01 PREDNISOLONE SOL I SMG15ML 3 30 $18.02 $6,83 $6.83 $0.OD W=4 2079097763600005400-01 43547-03 11 USINOPRIL TAB WMG 30 30 $5.47 $1.88 $1.86 $0.00 W12M 2079098763600005400-01 42806-0716.058ENZONATATE CAP 200MG 7 20 $22.31 $3.93 $3.93 $0.00 WJ2024 2079099763600005400-01 678T7.0320-051BUPROFEN TABBOOMG 5 20 $8.42 $2.0 $2.68 $0.00 3772024 2079100763600005400-0116714.0235-OIPENICILLNVKTAB5(X0,lG 10 20 $16.99 $3.20 S3,20 $0.00 372024 77640017WB00008800-01 59746-0001A31VIETHYLPREO TAB4MG 6 21 $19.59 $7.65 $7.65 $0.00 3IW2024 77638M 763600007000 - 01 68382-0040.01 PROMETHAZINE TAB 12.6MG 9 50 S25.00 55.38 $5.38 BUD W612024 92WM 76380CWMDD-01 68180.09684)3 LEVOTHYROXIN TAB 88MM 90 90 $45.91 $14.36 $14.36 $0.00 02WO24 77532M 763600009000- 0200310.6210.30FARXIGA TASIOMG 30 30 ($698.70) ($588.74) (05m) ($563.74) 318/2024 77=05763600009000-02 00169.2660.15 TRESIBA FLEX INJ 1000NIT 43 15 (S609.81) ($523.00) ($20.00) ($503.00) 37/2024 7753205763600009000-02 00169-2680-15 TRESIBA FLEX INJ IWUNIT 43 15 5609.81 $BMW $20.00 $503.00 3/8/2024 2233582763700001800-01 47781-0567-0i LISOEXAMFETA CAP 60MG 30 30 SlP.24 $157.02 $157.02 $0.00 302024 IN3698707000UNO-01 6926-1835.01 LEVOTHYROXIN TAB 112MCG 30 30 $10.99 $10.12 $10.12 $0.00 79$17 MEM0INLLBOAROMEMBER32 562.98 SP-341 $18.07 57427 TBSfi0T686p$ - BOARD'MEMBEBS MID (i9B77-0p2j 2 562.98 $3294- $iB4OT -Si4:2i 372024 1454210763600009900-01 65862.0011-05SERTRALINE TAB25MG 30 30 529.99 $24.27 SIO.OD $1427 3/42024 1452M 7638000 WO9 DI W143-920-01 AMOXICILLIN TAB 87SMS 10 20 $32.99 58.07 $8.07 $0.00 Pege:4 of 4 CLSP_TSC FIN 001.003 �il�eAC?'l�7tA�„ PeriBtl: 2262620 Nru 3 320241159:59 1 PM Exec01100 Tma: 315720245:48:57 AM Amazing Care 3/3/2024 1419950 ]63W00p680p - ... a 1SLNO SU 4MG 25MGE 2/2772RB4 14fi13447fi9600WD00. U1 00542-T470.01 DROS -Ml TAB 3If/2W4 1462476763600W1]00-01 W40"SWSOXYCOO/HPAPTTAB S-325MG 3/1/2024 1/524T7763WOWf)0°'O1 W14347285-01 AMOXICILLIN TpB B]5M SMG 1369 MEMnBIer em..»_.._. _-_ -"`�`• wa14067635100W300-Ot 64350-0n5-08 MVCOPHENOLATTAB SOW 3W&2024 1421386)83510003300-Oi W3)83951-0S ATORVASTATN TAB WMO 3/3/2024 1423613 7W5f00Op7W -Ol 691804 19-02 LISINOP/HCTZ TAB 20.12.5 3P3/2o24 14238137635100pp] 0-01 68180-0721-0egMLOOIPINE TqB 10MG $60769002 svo.e..-.._. &f/2024 ]]56236 ]63WOW5600--_ �- "-ua lu I HESIBA FLEX IN3260UNIT W W378410654STRETNOIN GEL0.01% 2` 2672024 7761634763600006200-03 42192-0W7-f6BRaWpSE/OM SVP273W10 &28/2024 77616337636WO062W•035nnr.ma. �. 28 20 $232.99 .�..w $05.05 $193.74 $70A0 6123.74 3 16 $ 64 84 $ 25.19 9 $57.51 MOO $57..51 10 20 g32.e2.99 $15.09 $10.00 S5A9 $8.07 36.07 50.00 $2.79055 $1,0BOS $10.82 $967.14 5/,786:W. - 327289 '570,00 ('MOt:$$; 30 180 $1,165.49 595.11$10.W 9O 90 $371.99 $45.36 $20.00 W $S85df 05.11 W 4$113.79 $07.31 $20.00 $25.31 905.36 90 $134.89 $45.21 $20.W $1.012AB g25.21 22 $7B9:B'7 ;$$6;82 '$164;1$' 9 $T3f.Tl g627.32 $10.W $617.32 30 45 $240.17 $145.01 $10.00 5135.01 2 110 $10.58 $11.82 $10.00 5. 6 $23.97 e4- $1.82 025/2024 954769 ]63510003700- is TABSMG GMUG 'S/�402.0 O1 3172&0726.10 MONTELUXAST TAB IOMG 90 W $692.93 $597.17 $35.00 $552.17 2/25/2024 954TBB7635fOW3]00-0131 T22.0]26-IOMONTF111XgST TAB lOMO 30 30 ($61.9]) 2/27/2024 1450380763510W5W0- ($3..97 ($3a71 $0.00 Ot OWIO-62103GFARXIGA TAB IOMG 30 30 681.09 $3.47 $3.97 3WO24 196294976BIOM4300- 3° 30 $688,08 $0.00 00 68462-0018-09 ViORELE TAB 5MG 5579.27 535.00 $544.40 22G@024 14504]fi ]635100022W.-Ot 6B462-0316-29 VIORELE TAB 90 270 $107.89 9727/2024 9597207635100036W- $53.09 $&1.00 $S5A9 02 633663437.00VALGA T/HIOL ZTABDISO-3 12. 28 B6 $147.97 $62.09 10.00 553.09 &1/2024 900530 76351000361-02 33342.OW]•tO VALSggTIHCTZ TAB 32612.E 28 ° $79.9] $62.02 $10.00 $52.02 30 30 $)9,9] 58.5E $8.68 $0.00 CL6P_TSC FIN_001.OW P4Be:1 of4 TrueScri Its. Amazing rare Period: 2J 12024 MW 3131202411:69.59 PM Execution Tim.: 31612024 5:48:57 AM 1/263029 145W09 ]8351W04100-pt 00400.8893.01 gMPHETIOE%Tq WIIW24 TAB 20MG 145215370510MBOO- Ot OW2B-9B52�05 ATORVASiATIN 30 80 $60.99 $30.98$10.92 2/29J2W4 TAB 40MG 145175276H 10W0800-0168180.0220-03AMLOOIPINE TABSMG W 90 $321,29 $30.99 $20.00 $2.90 029/2024 145WB6 J63510W23W-01 55111.OVB-1STIZANIDINE 90 90 $101.09 $42.14 $20.00 $32.14 V29MG24 TAB2MG 18359026351gW5100- 01 OW93-]29505CARVEOILOL 30 80 $109.99 842.1E $22.14 2/20Y1024 TAB 12.SMG 1451589 M51CM4800-Ot 69B51-0102-01 METHOTREXATE TAB 2.5MG W 180 $159.99 6426I $20.00 $20.00 $10.45 2J2622024 1451670263510W48W- 01 1155E-0165.03POLICACIO 28 24 $40.99 $20A6 $U.00 $10A6 2/282W4 TABIMG 14515W J635fOW4800.Of ]W540059.20 PREONISONE 30 30 $16.99 $2.83 $6.21 $0.0 WIQ024 TAB IOMG 143874526361I%1040W- Ot 6B238-1830.0]LEVOTHYROXIN W 35 $18]9 $O.W WWM4 TAB 25MCG 1451356263510WW00-01 22205-0143419 LOSARTAN 30 W $12.98 $6.16 56.16 $6.16 $7.24 027/2024 POT TAB 100MG 1451124 TBWIOM29W-Ol 68462-0158- 13OIAMTMTZ 30 30 $97.99 $14.30 10.00 $law $].24 3/1J2024 TAB BMG DDT 1449224283510WO4W-Ot ]2528-W9D01 Tg1AMTAICTZ 5 10 $91.49 $14.30 $10.W $4.30 2J212024 CAP 32.5.25 J260T26]6351WW9W-0231222-0J02.90LOSARTAN 90 90 $2.00) §I9.60 $13.66 $am POTTAB IWMG aWO24 602]W]2JB3510W2500.01 55111-W66-05 METOPROL 90 90 ($29.71 (g (g14.80 $0.W 06 BUD TAB 25MG ER 30 30 $29.]1 VAG $9.80 g4.B0 $0.00 33/2M4 8026828J ]63510W2500-pt 0152T-3280W3 LEVOTHYROXIN TAB 25MCG all 46 so 810.80 $4.39 $4.39 $0.00 W27/2024 145120776351W02500-0153246-0514-01 SPIRONOLACT TAB 2J22/2024 501G ]25108] 763510003500-01 62332-0142-310ELECOXIB 30 30 $29.98 $9.12 $9.12 $0.00 BA CAP2WMG 30 W ISIBD.481 IlH.., I..,.,.,., ...... 2/223024 95]013 ]6360W01000-01 668W. 045J-30 DAPAGLIFLOZI 25 2 $1,242.97 sins $"$35.00 $I,W0.69 3/12024 TAB 10MG 7762871]63fiWWWOO-01 6818041983.01 ALBUTEROL 30 30 $629.98 $546.4E $70.00 $$24.56 W29/2024 AE14 HFA JJ62522 J6360GWBW0-Ot W52J-5425-201ACTULOSE le 0.5 $21.55 $3q.55 $10.00 $24.55 W27/2024 SOLI0GM/15 ]24T93B T8360I%p$WO. 01 WI69i3/4- 4J9 $21.12 $9.64 59.64 $0.00 2129/2024 T1182g5]63W00021W-01 WIB9.4130.13OZEMPICS 30 30 $1,162.22 $995.05 $35.00 $960.05 212&=41 IN 4MG3ML ]T532047536WW9000-02 W310-6210-30 FARXIGA 28 3 $$698.70 $00.U.5 §35.00 $563.74 3WO24 TAB IOMG TT63205763WOW9W0-02 W169.266UI 5 TRESIBA 30 30 $609.81 $52100 2J282024 FLEX INJ IOWNIT TJ53204]6300000 0-02 W310`6210.30FARXIGA 43 15 $609.81 $523W $20S35.00 §20.0) SW3.24 SW9.W 31V2024 TAB IOMG 13264J5 T636000030W-01 T3336-W25-30GEMTEGA 30 30 (369S593.56 (g590,38 ($30.0) ($563 W812020 TA825MG BB3]5W]63600005100. 02 W1693WT- 15NOVOLIN 30 30 $108.27 $20.00 30 $4W.30 &28/2p24 INJ25I50 FP 7762315 T836000024W-Ot 60645-0595.59 METFORMIN 42 30 $328.62 $9$4.00 $198:22 $20.00 $1$0.00 226PA24 Tg85WMG ER JJ61282T6360Wo240p-01 42192 03W-01NP THYROID TAB W 90 S4O0 54.00 $9.00 §0-00 2J28/2024 A81281 �fi38WW2400.01 02192A32D01 NP THYROIO TAB I6MG e0 90 $55.95 $61.65 $20.00 341.65 90 90 $55.95 $55.95 $20.00 535.95 Page: 2 0t 4 CL3P_TSC FIN 001.003 ` rueScriptsAmazingC'rrre Pe0o6: 212620241NN 3/3]202411:59:59 PM E$ U11o0 Time: 3 2024$98:57 AM &27/2024 14513597836000092W-016]fiR-889.01 FAMOTIDINE TAB 46MG W ISO S161.79 $95A3 $20.OD $76,13 WW2024 M54137636WW5200-01 00406-0125.05 HYDR0007APAP TAB 10325MG 30 120 $145.99 $59.21 $10.00 $4921 PJ272024 17122" 763600004900-036W 207907 PROPRANOLOL TAB 40MG 90 1W $127.99 S66.79 $20.00 $46.79 n7QO24 146106 763WMOM 03 00627.8108.37 DEXMETHYI H CAP ISMG ER 3D 30 $239.99 SION $10.00 $39.07 3721 4 1422357 763MOOMOTO 02 68462-0397-100MEPRA20LE CAP40MG 90 90 $314.W $48.12 $2040 $28.12 MWO24 14SM587MOOMMM-01 683S2.091094ME1$1YLPREO TAB4MG 6 21 S24.99 $23.W $1O.OD $13.W MM024 77624817636WWBSOD-01 00472.0242.60PERMEfHRIN CRES% 1 60 $00.35 $18.16 $10.00 $8.15 W27NO24 T7430757636000W300-01 678W-0446.900LMESA MEOOX TAB 20MG 90 90 $495.00 $12.7] $12.77 $O.W WWO24 7743D7870MM03M-01 43547-0526.03NE81VOL0L TAB10MG SO 90 $276.49 $36.35 520.00 $16.35 WM024 7]4307676360000,3U0-Ot 67877.0446.900LMESA MEDO%TAB 20MG 90 90 ($495.00) ($12.77) ($127n $ro.W W112024 16772277836W009800-01 72205-0097.60 LEVETIRACETA TAB I OWMG 30 60 $352.99 $20.70 $W.00 $10.70 226/2024 1441432763600013W-Ol 00378-0032-00 METOPROL TAR TAB 60MG 30 60 $21.39 $15.94 $10.00 $694 2202024 77407387OW002MO-01 68645-0582-59ME ORMIN TASSWMG 90 1W ($law) ($4.13) ($4.13) $O.W 2J212024 776DU7M600W2000.01 31722-0702-10LOSARTANPOTTAB100MG W SO (S24.W) ($15.261 ($15.26) $0.00 31112024 T/51899]63fiW0025W-0116571-0862.03 SUPROPN HCL TAB 150MG XL 30 30 S15.00 S746 VAS $0.0 2262U24 7)4521676360CWMW-03 167144406�04LARINFE TABI120 28 28 $13.32 $8.05 $0.00 $8.0 PJ25/2024 77452167fi3SWW34W-03 16714-0406-04LARINFE TAB120 28 28 ($13.32) ($am) MOO (S8.05) 22972024 7]6258876ODOD5000-ol 31722.07134() PANTOPRAZOLE TAB 40MO 30 30 S86.93 $4.29 $4.29 SO.W 2292024 n62599763B00005000-01 47781-0657.9D LEVOTHYROXIN TAB 126MCO 30 30 $4.00 S4UO $4.00 Saw =WM24 773604376360W05100-0116571.0862-03 BUPROPN HCL TAB ISUMG XL W 30 $15.00 $7A6 $7A6 $0.0 &29=4 n5674176360WO5100-01 16571.0201-5001CLOFENAC TAB75MGDR 30 60 $1680 $847 $8.87 $O.W 2/202024 n60543 7636MOS100 - 01 13669.0219.30 ARIPIPRAZOLE TAB ISMG 30 30 ($665.59) (56.78) (E8.79) SO.W W12024 776279576360W06,IM-D1 68645-0609-WLISINOPRIL TAB5MG 90 90 $10,00 $Z97 $2.97 $OAO 220MO24 7749971763600DO1WO-01 55111-0154-300NDANSETRON TABBMG 10 30 $137.05 5550 35.50 $0.00 W912024 77WS587W600001800-0116571-0862-03 BUPROPN HCL TAB 150MG XL 30 W 08.00 $19.38 $law $9.38 0292024 77623387636W001000-0123155-0249.01 VENLAFAXINE TAB SOMG 30 30 $65.90 S5.63 $5.63 $O.W WW2024 76NW2 763600001WD-01 976PA0446900LMESA ME00X TAB 20MG 90 90 3495.00 $12.T] $12.7 $0.00 &IM024 7055737M00001M 01 WO02-1460-BOMOUNJAR0 1NJ12.510.5 28 2 ($1,262.90) (51,00.23) ($35.W) (41,063.23) 22CJ2D24 4M169763600001000-01 6818 0700.01 ZOLPIDEM ER TAB 12.6MG 30 30 $152.82 $BAS $OAS MOO 2/2W2024 959500)63M0002100. 01 003n-I4W-96 RIZATRIPTAN TAB 5MG 30 8 $45.66 $5.2A $6.24 66A0 2232024 7759040763700W09W-01004304420-14LOLOESTRIN TAB1-10-10 64 84 ($646.55) ($533.40) ($533AD) $am Pag4: 3 of 4 CLSP TSC_R"01.003 TrueScripts...Amazing Care Pe11o6: 2/26/2024 thm 3/8/20241 t:69:59 PM Execution Time: NWM246:48.57 AM W27r2024 1451164763T00001500-01 4280&0414-D9SUPGOPNHCLTAO150MGXL 90 90 $363.99 $62A6 $62.46 SD.W &27/2 145116570MO001500-01 69097-084&05ESCITALOPPAMTA610MG 90 9D $172.69 $50.36 $58.38 $0.00 W27/2024 145116670MO 01500-01 MMD14&99LOSAHTANPOTTA6100MG 90 90 $178.99 $48AI $48.41 $0.00 P69e:4 014 CLSP TSC FIN 001.003 ItM HPHG, LLC dba 90 Degree Benefits Monthly Billing for 4/1 /2024 MEMORIAL MEDICAL CENTER (Met Grp: 76350) 815 N VIRGINIA STREET PORT IAVACAA, TX 77979 Master Group Totals SPEC AGG 180 §55,900.67 Ad ustmmts 3 T� Due j ($1,327.14) $55,073.53 ADMIN ADMIN FEES I80 $7,740.00 Adjustments 3 ($250.00) $7,482.00 PPO UR 180 $3,429.00 Adjustments 3 ($114.30) $3,314.70 MT FEE CHI$700.00 $70D.00 Balance Forward: $137,313.59 Payments: - $137,313.59 AtIjustments: + $0.00 Beginning Balance: $0.00 Current Amount Due: + $68,269.67 Current Adjustments: + ($1,699A4) Total Amount Due: $662570.29 v/ Desc iimon Medical 11 \ In EE 105 ES 18 [� EF 13 EC 44 I80 Make Check Payable To: Attn: Rovenhe Department 90 Degree BenaDla PO Boa 13246 Blmtln8ham, AL 36202 Please pay premium as billed. Changes received after Willing has processed will be reflected on the next months bill. Premium payment Is due by the ION of the month. APPROVED ONi -APR 0 0 10:24 BY COUNTY AUDITOR CALHOLIN COUNTY, TEXAS L{ I VIA zy Start Date Benefit EE Per Pay Cost ER Per Pay Cost 1/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $100.00 $25.00 1/1/2024 Health Savings Account $147.91 $25.00 1/1/2024 Health Savings Account $41.67 $25.00 1/1/2024 Health Savings Account $60.00 $25.00 1/1/2024 Health Savings Account $10.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $25.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 2/1/2024 Health Savings Account $25.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 2/1/2024 Health Savings Account $163.25 $25.00 1/1/2024 Health Savings Account $50.00 $25.00 2/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $100.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 3/1/2024 Health Savings Account $0.00 $25.00 1/1/2024 Health Savings Account $25.00 $25.00 1/1/2024 Health Savings Account $0.00 $25.00 2/1/2024 Health Savings Account $0.00 $25.00 $747.83 $575.00 Total Contributions $1322;831 414124 10 5p.AM 04/04/2021q$'$,'°, 10:66 Vendor# Veddor'N§jite•'�,f=.�, 11824 THE CRESCENT tmp_cw5report798895448348842189.html MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code 0 ap_open_invoice.template Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 032124 03/29/20203/21/20204127/202 8,36,0.00 0.00 0.00 8,360.00 r/ TRANSFER 0Ik �r1 sdV Uht e_ pyv4 �wtt Cl trot,( 6t4ntA {h� WkWkL U}(emll1 032724A 03/29/20205/27/20204/271202 659,20 0.00 0.00 / 659.20 r/ TRANSFER I� If 032724 03/29/202 03/27/202 04/271202 't 2,244,00 0.00 0.00 2,244.00 TRANSFER y/ 032924 03/29/20203129120204/291202 6,712.00 0.00 0.00 / 5,712.00 ✓ TRANSFER tt ,i Vendor Totals: Number Name Gross Discount No -Pay Net 11824 THE CRESCENT 16,975.20 0.00 0.00 16,975.20 FtpvrE Szn+mimry Grand Totals: Gross Discount No -Pay Net 16,075.20 0.00 0.00 16,975.20 APPROVE ON BY COUNTY AUDI-FOR CALHOUN COUNTY. TEXAS 81e:1/1C:IUsers/ltrevino/cpsi/memmed.cpsinet.com/u88125/data_5ftmp_cw5report798895448348842189.html III 414t/24. 10:55 AM tmp_cw5repon1012234936010245759.html cciiaa/A'4l2024 y MEMORIAL MEDICAL CENTER 0 10: 10:55 AP Open Invoice List Dates Through: ap_open_invoice.template Vend'or#'VgntloPN`Ame Class Pay Code 12696 GULF POINTE PLAZA y/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 032724 03/29/202 03/271202 04/271202 80.83 0.00 0.00 80.83 TRANSFER WN }nsurRWU ' 9M9 depot;(jeA In �+ MWt,_ UNevt 20 032824 03129/20203/28/20204/27/202 372.43 0.00 372.43 TRANSFER 040124 04/011202 04/011202 05/01/202 612.00 0.00 0.00 612.00 TRANSFER 1` 14 Vendor Totals: Number Name Gross Discount No -Pay Not 12696 GULF POINTE PLAZA 1,065.26 0.00 0,00 1.065.26 Grand Totals: Gross Discount No -Pay Net 1,065.26 0.00 0.00 1,065.26 APPROVED ON l? f? ), "ry024 By COUNTY AUDITOR CALHOUN COUNTY, TEXAS AIe:I//C:/Users/ltrevino/cpsYmemmed.cpsinet.com/u66125/data 51tmp_cw5repon1012234936010245759.html 1/1 414/24, 10:55 AM tmp_cw5repon8279112756902309901.html l'-".11�t�iy ddlojdl2i2d a MEMORIAL MEDICAL CENTER 10:55.,,qi ,ti- "� AP Open Invoice List Dates Through: Vendor# Vendor Name Class Pay Code 11832'1 BROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 032724 03/29/202 03127/202 04/27/202 TRANSFER 0" jhSU��` p�Nti'r Jq06i keJ, Vendor Totals: Number Name 11832 BROADMOOR AT CREEKSIDE PARK rspo.P atS�>>mary Grand Totals: Gross Discount 3,264.00 0.00 APPROVEp, ON 0Y COUNTY AUDrroi, CALHOUN COUNTY, TEXAS 0 ap_open_invoice.template Gross Discount 3,264.00 0.00 i�� w�>M� upw.'tivJ Gross Discount 3,264.00 0.00 No -Pay 0.00 No -Pay Net / 0.00 3.264.00 No -Pay Net 0.00 3,264.00 Net 3,264.00 file:/NC:/Userslltrevino/cpsilmemmed.cpsinet.com/u88l25/data_5/tmp_cw5report8279112756902309901, html 4/4/24 10:54 AM imp_cw5report5228B23018233653115.html 04/04/20W! ,) �a MEMORIAL MEDICAL CENTER 10:54 `'i '-� .�l ?U/� AP Open Invoice List ap_open_invoice.template Dates Through: Vendor#':`VendoFNaipe. �._,n;m; Class Pay Code 13004 TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 032924A 03129120203/29/202 04/29/202 20 880.00 0.00 0.00 / 20,880.00 y TRANSFER 00 insd"M VyVAJ CICPOSiAea 04 IXI OVCYb-'iiN� 032924 03/20/20203/20/20204129/202 18,995.92 0.00 0.00 / 18,995.92 n/ TRANSFER " tt Vendor Totals: Number Name Gross Discount No -Pay Net 1$004 TUSCANY VILLAGE 39,875.92 0.00 0.00 39,875.92 t :il:i.'. .`itffil TlBff Grand Totals: Gross Discount No -Pay Net 39,875.92 0.00 0.00 39,875.92 APPROVE ON APR BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS file:l!/C:tUserslitrevinolopsilmemmed.cpsinet.com/u88125/data 5/tmp_cw5repor[5228823018233653115.htm] 111 p. 4/4�t0i:'S7At1111 ,t i,'=h tmp_cw5report7656499344554112651.html 04/04/2024 MEMORIAL MEDICAL CENTER AP Open Invoice List u;+�*S�,r,�',1..r, •,., , ./,,;;;.,,, Dates Through: ap_open_invoice.template Vendor# Vendor Name Class Pay Code 12792 BETHANY SENIOR LIVING Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net % 032224 03/29/20203/22120204/27/202. 9,423.70 0.00 0.00 9,423.79,/ TRANSFER NH j0SUI/A.K(,L pgjV1G�E.p051 ��c� Ivi.� N`W UpL � (KlN(Lr`- 032624 03129/202 08/26/202 04127/202 34,625.00 0.00 0.00 34,625.00L,-'-_ TRANSFER it 1, 032924 03/29/202 03129/202 04129/202 119.89 0.00 0.00 119.89 TRANSFER tt 11 032924A 03/291202 03/291202 04/291202 2,795.01 0.00 0.00 2.795.01 TRANSFER 11 t• Vendor Totals: Number Name Gross Discount No -Pay Net 12792 BETHANY SENIOR LIVING 46,963.69 0.00 0.00 46,963.69 ,pol'l:j!mmBI'9 Grand Totals: Gross Discount No -Pay Net 46,963.69 0.00 0.00 46,963.69 _APPROVED ON APR 01: BY COUNTY AUDITOI: CALHOUN COUNTY, TE1(Ac rile:NC:lUsersAtrevinolopsVmemmed.cpsinet.com/u88l251date 5/tmp_cw5report7656499344564112651.html try 4/4/24, 10:57 AM tmp_cw5report6360095220718344885.html By M § ff09ON MEMORIAL MEDICAL CENTER APPROVED ON 04/04/2024 A APR 0 4 M4 AP Open Invoice List 0 10:56 APR 04 2024 ap_openinvoice.template Dates Through: Vendor# Vendor Name®VAN @@41 M, fWA Class Pay Code 11836 GOLDENCREEK HEALTHCARE gy Cp�N CALHOUN COUNTY��ip(Ag Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay ,I Net / 032124 03/29/202 03/21/202 04/27/202 353.48 0.00 0.00 353.48 •�/ TRANSFER N � (1SU I Gu,�(��0 i kPf ,�, l AM rnm� pIpUk 1(\ ty 032224B 03/ 9/20203/22l20204/27/202 23,287.35 U0 0.00 ' 23,287.35 TRANSFER it it 032224 03/29/20203/22/20204127/202 960.00 0.00 0.00 960.00 J TRANSFER 1, It 032224A 03/29120203/22120204/27/202 5,796.37 0.00 0.00 5,796.37 TRANSFER I. 11 / 032624A 03/291202 03126/202 04/27/202 2,146.80 0.00 0.00 2,146.80 TRANSFER tk t / 032624 03/29/20203126/20204127/202 63,296.66 0.0o 0.00 63,295.66 TRANSFER I, 032724 03/29/202 03/27/202 041271202 486.31 0.00 0.00 486,31 TRANSFER 1' Li / 032924 03/29/202 03129/202 04/29/202 5,535.34 0.00 0.00 5,535.34 TRANSFER I 1 \ 1 032924E 03/29120203/29/20204129/202 82.69 0.00 0.00 82.89 J 032924A TRANSFER I I 1 I 03/29/202 03/291202 04129/202 1,122.88 0.00 0.00 1,122.88 .� TRANSFER It 040124 ;i 041011202 04/01/202 05/01/202 2,781.50 0.00 0.00 2,781.50 TRANSFER Vendor Totals: Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 105,849.38 0.00 0.00 105,849.38 PcIm-i Burannry Grand Totals: Gross Discount No -Pay, Net 105,849.38 0.00 0.00 105,849.38 Ole:IIIC:AJserslltrevinolcpsilmemmed.opsinal.com/u86125/data_5/(mp_cw5report8360095220718344885.htmi 1/1 Memarlel Medical Center Nursing Home UPl Weekly Gntee Transfer Itn 1petAy AuMums IJBIM24 wren ^rtlKen`n1 w!!,1114 1p2 L''i:1• i. rrrMn ary.ury H.r. 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TDAR1411 UAW VS/NNV dfiUppjtm.e N[[WMPM]N(WNIl N43N ]•fF0.10 I}60.10 VSp%a MAP 3uppNm4nuNfCWMPMINYAlY11N3M LONOT LOSOAG V4I2021 CX(Y 135 112.31 4/4RG24 CHEC93N 9.1}1.)I - V412024 WIAEWCAMEXHIATHGYIC(N)14111 t91�, 4/3/262d ft., - ."I'll 48,566.67 IM/IDN VnnNNONF,Oe IKLWMIMT]IEW)lil 1NN, - BA.. � 6.50.00 INNN XNB•(MOXCCGIMPMIM6WN3144W'tl3WTN 6rB41.30 1NN9210EVOANSIOL 1NpNf[WMIMT 110GLIIb1W) L1f0W Lim. 1/W%I 4M,M1)9 - 869.68 - M.S. HUVrtK CHADARKOAAMPM ARS353 1/IN%4 MUM4Y4CN, DOBNLCWMIMfK5l55Kd1[W)I6 � 8p99.W l - 8A8500 RSA. 188.91L06 10].6YP. V MMCOORTION --� - ., SI9991,4lt iNdJeOX QPP/brOst QIM/GmP2 QIPP/COMICS gIPP/CampR6YDN QPPTI M"T10N 415/1014UHCCOMMUNm PLHCCWWMi)46WM11910]W t792AA - 1,782.64 V4/20I4 CN[CRSK WIW 1I1p024 CHECK 4/1/NIA WNf LN,CRAVRXW: THGRE [YIER1111 mLN M's4373` AR12014 UNCWMMUNRYPIH[LWWMTNW3111910N1 O36 076 42/1%4 MR.,MO NttUIMPMTPµ%IIIANIW)IWI9 I8546 - 155.46 41I/201A UNC(OMFIYXm PINCCNIMPMTi1K0111191IW] 091 092 A/V20I4 UHCCOMMUNIry PI NCCGIMPM1ITi46U1N11911YYV / ;W]AS 1,03IA5 61A>Bpl✓ 0.W)R1/ � 3WJ31 MMGIO0.TION LG3LSLOYI Tr4n9lenln QIPP/COmpl qNP/GmDl QIPP/UI,ID3 QIPP/Gmpl6Yplt (1IgTI NM PORTION 411ll%I CNCLR Y91 N.. V CNECWWOUT1 6.]2� N 0124 ANRNA WIRf OYTUN,fIXW1N CAPECfM1[MIII QW.Ha 5,150.01 NWNK SOIYPOHNIXUIMIMI6]631011WAIN 1.W,.61 - ],6N. 911IM24 eN/SOEaNWTXXVMW3V[XLIWMPMLI]IfWN11IW1] - LpIAB - 4,111.4.dY 1/1/SON RUPfupg4mMu11[CMIMVMf)CiWN1I Nl1N UN00 - 1,016.W V3/102A OXpyl - 3141151 59,691.51 41,11%1 WNWEF140XE11N{MK VMM NN41 4,13)-w ;B3250 AppoN m¢tOMMIN PawMVMf]16W11]ufgN 4.1N:0 4,)9010 VN203aYN[ COMMYNm PLNulCENIMPMT]4WNIIIIW]0 - 410 0.10 V]/2%4 H(AITNNVMR245VCKK(VIMPM ITI MlIN%l - OW1.71 10.959.2I V)I2%a AUPfuptllmmlA XCL41MPMtl11WN1112,1N - LMBW l,110A0 41VM1A M$-ECHOHCMIMOW 7460D1YIII 2MIA9 4 UH[COMMUNII'L ILM[CWMIMt T4WN118lWW - 0.3) - DID NWIN2110.59 - S,INAI � SA54)1 OVNIA WRAINACIVEgNNCLNIMIM)81611DdIWWIN VS/NNMIM,NRCNA DOB MCLWMPM,M1119Sy A1WWN LyytO 0,900.0) VV44 WMAO(ANONVI119 MNS IMM4tIXp[WbWlq - 3.1)0A9 I,27649 4/V2%, NMB-[CNONCMIMPM)>ANON{l4aWMIN1A - 6,15yA9 OWN, VIK COMMVNm 91NUU1MY0lAfWNI1910b1 3,63W / 163 181.SOL61. / III,956.49 / t4956,43 / WTAt3 BSB.1I0.46 356.634.3) 155634 67 oula We5 vuernew Account Nome _-- _-_ - •4357 MEMORIAL MEDICAL CENTER - OPERATING $1.852,630.10 $1.976.345,27 S1,852,630.10 S7,424,544.49 •4366 MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014 $543.19 $543.19 $543.19 5543.19 •4373 MEMORIAL ' MEDICAL CENTER - PRIVATE WAIVER $437.28 $437.28 $437.28 $437.28 CLEARING •4381 MEMORIAL MEDICAL CENTER / S26,841.16 $36.124.15 NH ASHFORO ✓ S26,841.16 $23,975.Od 'MW MEMORIAL- MEDICALCENTERI / $102,411.64 !/ S115,086,01 NH BROADMOAR ✓ ✓✓✓/// S102,411.64 S95,341,54 •411 MEMORIAL MEDICAL CENTER / NH CRESCENT $101,718.20 $106.595,43 $101,718,20 $72.362.65 J •4430 MEMORIALMEDIC CENTER / '— SOLEAL TWESTI WEST V $123,056.43✓/ S138,911.28 $123,056.43 $123,056.43 HOUSTOAT NOUSTON v •4446 MEMORIAL MEDICALCENTERI $3.107.23 NH FORT BEND -�� S7,097.32 S3,107.23 51.324.59 •4454 MEMORIAL MEDICINH GOLDEN CREEK GOLDEN CREEK S201.443.45 S223,731.65 $201,443.45 §200,371.45 HEALTHCARE •5433 MMC -NH GULF POINTE PLAZA- $556.84 $555.B4 $556.84 $492.11 PRIVATE PAY '6407 MMC -NH GULF POINTEPLAZA. $69.273.30 576,912,61 $09,273.30 S21,095,74 MEDICAREIMEDICAID •5506MMC-NH BETHANY SENIOR $149.402.3D S149,402.30 S149.402.30 S9,784.87 LIVING TUSC NY VILLAGE NSCANY VILLAGE $28,D78.96 S28.0T8.96 V $28.078.96 S27,063,27 •3660 MMC-SETHANY SR WING-DACA $100.00 $100.00 $f00.00 $100.00 -2990 NIMTC-M-MONEY MARKEFUND MAR $609,891.25 S609,891.25 $609.891.25 $609.891.25 Total Balance $3,269,491.33 $3,469.813.74 $3.269,491.33 $2,010,383.90 NW 9anamWd an WON2024 09:25:24 AN COT Pope 2 e12 Memorial Medical Center Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 4/8/2024 p[wunt Beelnnln V JJJ G vek Note tEachaPo va hdsa $ 000Wi M1a 1 NedM Cd,u ,ehvme. Nv[e 2: £aeA vtteun[M1eavbate bnknae/$I W fhvLMMCOepwifedro open v:roun[. APPROVED ON APR 18 S24 AUDITORV, COUNTY CAU4OUN COUNTY;^�`' "XNx W"LIy Tnnvfe"k" UPL Tnmfw %—MMIANH UPL Tnnake Summary 4.6.24 Pendme TvdaYa Baelnntnf pmeuntta BeinnManatlroNunlne Sepvai[a QQQ 201,443Af Bank BLlance 201,41145 Vamnee Lean In Balaine 10000 M.0.14rot June Im.... t aalwtBmnopnn[Pe,amt 201,343A$ pxoplN2oB Los salDros aye/2o2a WEWC OOLDENCREERNEAI) MfRC DIP IEM39691=1119 A 024 PIEa iN VIIIPH WIP[OIrt NGMN NM., IMP GOLDEN CRICK HE W13011 IYS/IRQSPIKt[RCODV YPWf)Y1E91P9[ uu:oM oFoosrt aR/ION NOPNi3 %IIOTONNCCIAIM9M)6)649f a10]Wlb P/IANDI GOLD [[NGNCf IFIMPM 1PW3PIlY 91 LIN Illima 0010[NCPF[PINALTM[R[p[P I3M3Y91CM)I6P0 VI/ANP HFLLIMXYMLNfVC KKfY1MPM 1)aPWN113D113 MMCPORnON giPP/mmy 1)3011lvOt TPaRflw OIPP/Gmpl ONP/CONIPi OIPPJC"I &UPR OIPPTI NEFOREIGN LWJM - 1.07200 K ._./' WNEI'3 - 12.30.95 uM.PO 1a0140 1730S9AS MAIDS LPI).Y - 1.417.54 14119 - )419[ 1f1IW - 1.512.00 - 1P463 - 16i.63 - a.9)0.W - 4.96000 P.M. - 4.335.90 / / 67d19A1, / 301,113.49 M13a3 aS oBlauces uverwm Account Name '4357 MEMORIAL -��-- MEDICAL CENTER • S1.852,630.10 $1,976,345.27 S1,852,630.10 S1.424.544.49 OPERATING •4365MEMORIAL ^' MEDICAL CENTER• $543.19 $543.19 $543.19 $543.19 CLINIC SERIES 2014 '4373 MEMORIAL MEDICAL PRIVAT WAIVER CENTER • PRIVATE $437.28 $437.28 $437.28 $437,28 CLEARING 4381 MEMORIAL MEDICAL CENTER $26,841.16 $36,124.15 $26.841.16 S23,975.04 NH ASHFORD _ •4403 MEMORIAL �- MEDICALCENTERf $102,411.64 $115,086.01 $102,411.64 $95,341.64 NHBROAOMOOR '4411 MEMORIAL—�— MEDICALCENTERI $101,718.20 $106,595.43 $101,718.20 S72,362.65 NH CRESCENT •4438 MEMORIAL MEDISOLE A AT WEST HOUSTON WEST S123,056.43 $138,911.28 $123,056.43 $123,056.43 HtlU3TON '4440 MEMORIAL MEDICALCENTERI $3.107.23 $7,097.32 53.107.23 $1,324.59 NHFORTBEND '4454MEMORIAL MEDIOALINH ✓` GOLDEN CREEK $201,443.45 �' $223.731.85 $201,443.45 $200,371.45 HEALTHCARE 'S433 MMC •NH GULF POINTEPLAZA- $556.84 $556,04 $556.84 $492.11 PRIVATE PAY 'S441 MMC -NH GULF POINTEPLAZA• $69,273.30 $76,912.61 $69,273.30 $21,095,74 MEOICAREIMEOICAIO -5500 NMC •NH �'- BETHANYSENIOR $149.402.30 $149,402.30 $149,402.30 S9,784.87 LIVING '307 MMCNYVILH TU0CANY VILLAGE $28.078.96 $28,078.96� A S28,078,96 $27,063.27 '36SR LIVING SR LIVING - BETH $100.00 $100.00 $100.00 $100.00 MRKET AFUND�MO 298M FUNO $609.891.25 $609,891.25 $609.891.26 $609.891.25 Total Balance $3,269,491.33 $3,469,813.74 $3.269,491.33 $2,610.383.90 ReW gene,BRO aA DINB402409.25.24 AN CDT Page 2 012 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 4/8/2024 Ruutlglnlprm+liin4r Gul+Ppele+lm: 9ginNry a pwl f R+iWnl arrimin[ NNranr aNwxy a/amssan.�;nerwrW<mdl. u+n.l:lnvmn+. NaR 3:torn orc+wrno,om,+mroryr{vmm++nx+rtae.oanmown+noun+. APPROVED ON BY COUNTY AUDITOJ, CALHOUN COUNTY, TEXAS vynrla / nrtonmme. / Tnmhmd d 1 T in HbMe i.. NUN N su.a n Nka@r NAM.— H, Ni,ny le+rrin O+Nny 3mm aalyun.nn/mm4.Rmi du�+'� '� an.wueee V+ndIM Tnnrl+rred+o NMn I73'30 +Ourttl er - TeL ', innl ynrrte / NUNn[Xeme / 69�D3.30 69�1)3]0 NntBMny fiV,Z)),30 J Vnhny bmmNNny Ilpm Mlurtatlinn/rnmhrnmi .Nd)dg0- ✓� mTRL)M Fms m.Noa PxORLW IXLMLNTOL +/d/WN I:WM We(IY TynN+rrWM Yfi,inn,hr Lumm+ry�y3iWx YR nMIIn Svnrturyla)i ., __ RIME PORTION i QIPP/Camp QIPP/C.Rg4 - ywG(t. Tram/erAul TraOENrvin QIPP/Comp! Z QIPP/CpmP3 &up1R QIPP TI NH PORTION 4/5/20M HIM ECNOIICCIAIMPMT)46M3411 UM2399M 64,73 - 6473 413/30M HNB+ECHO HCCWMPMT>46003411440DOW563>3 MAS ✓ - 94.15 4/2/1024 HNB- ECHO HCCWMPN4T 746003411 MOMO210314 3,61 - 3.6% a MARC PORTION r } QIPP/Comp QIPP/C4mP4 Tramle,A.t Tmnslbr-M QIPP/Cempl 2 QIPD/Comp3 wp59 QIPPTI NN PORTION 4/S/3034 MERCHANTBAN6CDDEPOOT4967951US921 MOl 45,10909 - 45,109.82 4/l/3034 NDNDIAN13AHCCUWPMT6756934300D013357A - 3,D6L74 3,D67.74 4/4/2024 WIRE OIITHMD ReC5pod SHIP. 0-Commmiol 30.12073 4/3/2034 NDRIDIANI3AHCCI MPMT 61509i47 W 15300]] - ]D.9'S - 30.996.74 30.120.73 69335.87 69,335.87 eaiam:ee uvarviuw Account Namc '4357 MEMORIAL MEDICAL CENTER- $1.852.630.10 $1,978,345.27 $1,852,630.10 31,424,544.49 OPERATING '4365MEMORIAL MEDICAL CENTER- 5543.19 5543,19 $543.19 $543.19 CLINIC SERIES 2014 '4373 MEMORIAL MEDICAL CENTER- PRIVATE WAIVER $437.28 $437.28 $437.28 $437.28 CLEARING '4381 MEMORIAL MEDICAL CENTER $26,841.16 $36.124.15 $26,841.16 523,975.04 NH ASHFORD 'M03 MEMORIAL MEDICAL CENTER $102,411.64 5715,086.01 $102,411,64 $95.341.54 NH9ROA_DMOOR —_�—�— '4111 MEMORIAL MEDICAL CENTER I W1,718.20 $106,595.43 5101,716.20 572,362.65 NH CRESCENT '4430 MEMORIAL MEDICAL CENTERAT WEST NlEST 5723,05BA3 5138,911.28 $123,056.43 $123,056A3 HOUSTON HODSTON '4446MEMORUIL MEDICALCENTERI $3,107.23 $7,097.32 53,107.23 $1,324.59 NH FORT BEND -4454 MEMORIAL 13OLVEMEDICAL CREEK $201,443A5 5223,731.85 $201.443.45 5200,371.45 HEALTH HEALTHCARE '6432 MMC-NH GULF / POINTE PLAZA- r/ $556.84 �1 $556,84 $556.84 $492.11 PRIVATE PAY 'S441 MMC -NH GULF j POINTEPLAZA- $69,273.30 ✓� $76.912.61 $69,273.30 $21,095.74 MEDICAREIMEDICAIO '9508 MMC -NH EETHANY SENIOR $149.402.30 $149A02.30 $149,402.30 $9,784.87 LIVING TUSCAN VILL TU9CANY VILLAGE $2807g96 v $28.078,96 $28,078.96 927,063.27 -EETHANY SR LIVING- DACA 3ETH SR LIVING $100,00 $100.00 $100.00 $100.00 '2990 MMC-MONEY MARKETFUND $609.891.25 $609.891.26 $609,891.25 5609,891,25 Total Balance $3,269,491.33 $3.469,813.74 $3,269,491.33 $2,810,383.90 RlFen genewlo0 an MN&R030 09:35�<AN CDT P.,1 N 3 Memorial Medical Center Nursing Hem UPL Weekly Tuscany Transfer Prosperity Accounts 4/8/2024 4mun1 Nwnn[XOnn / �mdn Nwc OnlEhdvn nv/vvn9ie]1WNdetmmfinetltmAenuMn96u*e. NneLFmA evmantdmebnebalmoevfSlW tdvrMMe tlepn�ndmapnn etmunt. APPROVED ON BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS Pending Rand Iv > naln ygdiseqzkgnm.Bidmn. x xvme seek Babnoe Z&B)8%. WJana lnavJn BlNnn Imm V Miwl Be p/F .WepkW BFIMBpMpj 0/1/2OE4 Y - Tonsfer-Out 4/5/2024 HNNCQAIMPMTJgfi001g114406002l1966 4/4/2014 CXECEC1152 ✓13 66. 4/4/2024 CXP[X R 11, 1155 50S.,4/4/9024 WIPE Our VI0.AGE POSTACUTE HEALTH SERVICE 8 "'E 13 / 4/4/2024 NOVITM SO W DON HCCLAIMPMT 676201420p001S4 4/3/2024 DEPOSIT MMCPORTION gIPP/Comp gIPP/Camp gIPP/Comp m. •In I I 1 QIPP/Ce..2 3 4&lapse gIPP TI NHPORTION 1,01S.69 1,015.69 16,235.39 16,215.39 10,747.88 oelances uvarwew Account Name '4357 MEMORIAL MEDICAL CENTER• $1.862,630.10 S7,976,345.27 $1,852,630.10 $1,424,544.49 OPERATING '4365MEMORIAL MEDICAL CENTER• $543.19 $543.19 $543,19 $543,19 CLINIC SERIES 2014 '4373 MEMORIAL MEDICAL CENTER• PRIVATE WAIVER $437.28 $437,28 $437.28 $437.28 CLEARING •4381 MEMORIAL��• MEDICAL CENTER $26,841.16 $36.124.15 526.841.16 S23,975.04 NH ASHFORD •4403 MEMORIAL `— MEDICAL CENTER I S102,411.64 $115,086.01 $102,411.84 $95.341.64 NHBROADMOOR •M11 MEMORIAL �— MEDICAL CENTER 1 $101,718.20 $106.595.43 $101,718.20 $72.362.65 NN CRESCENT '4438 MEMORIAL MERE AATW7ERl WEST $123,056.43 S138,911.28 $123,05BA3 $123.056.43 HOUSTOAT HOUSTON '4446 MEMORIAL MEDICALOENTERI $3,107.23 $7.097.32 S3,107.23 $1,324.59 NH FORT BEND '4454 MEMORIAL GOWEEDICLN CRREE EK GOLDE $201.443.45 $223,731.86 $201,443.45 $200,371.45 HEALTHCARE '5433 MMC -NH GULF POINTE PLAZA- $556.84 $556.84 $556.84 $492.11 PRIVATEPAY •S441 MMC -NH GULF -_— POIN7EPLAZA- $69.273.30 $76,912.61 $69,273.30 S21,095.74 MEDICAREIMEDICAIO __._.,......T._._.._...._____.._...._......�._..�,_..._ •5506 MMC -NH _..__.._._.�....,_. ____� BETHANY SENIOR S149,402.30 $149.402.30 S149,402.30 $9,784.87 LIVING '3407 MMC -NH ' 526,078.96 $28,078.96 $28,078.96 TUSCANY VILLAGE $27,063.27 '3660 MMC •BETHANY SRLIVING-DACA $100.00 $100.00 $100.00 $100.00 '2090M FUND61C440NEY MARKE $509,891.26 $609ABL25 $609,891.25 $609,891.25 Total Balance $3,269,491.33 $3.469,813.74 $3.269,491.33 $2.610,383.90 Re4o46oae21M on M109120240991326 AM COT P,.2 or2 Memorial Medical Center Nursing Home UPL Weekly HSLTransfe, Proppenty Accounts 4/8/2024 pmimn p<rWM •emum aeairWna _/ _ _ _ � _ / / MCCIan Bank Lim.. U9,<Y3Ja Vulann lLm In S.W. neon aptlllnln<lt MaYlnllleft lun<Inlertaf 1 Atllluf&q /innallrMt I<9 Wa3a / \ nA. a.. mrywwnny<rn saom<nnL Xanlerne�uanumnp Mne. aaer<ne: Nptt l:F<Mx<anrlr<laEn<e nNnnttefSlWNn MAfCaepamProy<n a!<owr, aXPREWCf IOSHNIei 1 </a/!01< APPROVED ON APR 118 2021, By COUNTY AUDITOR CALHOUN COUNTY, TEXAS Cµxw<myrnmlpWq Wr ba+YerfunmaylNSgvn unrmW.•.—,. ua mmcmmom q, A/5/SXL NW RN SOW NON MIIWMIMi sifi4l1AFV195 a/a/SOla CM3C[IWO _a•.e TranJePpul� 119.fi1ia3 �P/fbmOl gIPP/Cam 2 gPP/WMPI CIPPIOmp4limePPV NH PORTION VL/Mta WIRF OUI voNi NVRp xq lW IIUSOSt OILVSR SIfi.51I5]e 1/]111131 OFPolR I6L10 a/I/IWa MN6•ICM MIMIMPMT 316CO3a111N. 21X]la 3.%S.R 46LAO I/UfOU XOC SWLEP iRCpM 31i369W5m193 fWLlP LR 119.1E 3,965A5 11112 /� A931.50 ca,eucee �varvluw Account Name '4357 MEMORIAL MEDICAL CENTER- $1,852,630.10 $1.976.345.27 $1,852,630.10 $1,424,544.49 OPERATING 4366 MEMORIAL MEDICAL CENTER• $543.19 $543.19 $543.19 $543.19 CLINIC SERIES 2014 '4373 MEMORIAL MEDICAL CENTER• PRIVATE WAIVER$437.28 $437.28 $437.28 $437.28 CLEARING '4351 MEMORIAL MEDICAL CENTER $26.841.16 $36,124.15 526,841.16 523,975.04 NHASHFORD •4403 MEMORIAL MEUICALCENTERI 5102,411.64 5715,086.01 $102.411.64 $95,341,54 NH BROADMOOR '4411 MEMORIAL —_---- MEDICAL CENTER I $101.718.20 $106,595.43 $101,718.20 $72,362.65 NH CRESCENT '4436 MEMORIAL AL CENTERI SOLERA AT WEST $123.056.43 5738,911.28 5723,056.43 5723.056.43 HOUSTONBTON '4446 MEMORIAL MEDICAL CENTER 53,107.23 $7.097.32 53,107.23 S1,324.59 NH FORT SEND '4454 MEMORIAL - GOLDEN LI E EK CREEK $201,443A5 $223,731.85 $201,443.45 $200,371.45 HEALTHCARE HEALTH '6433 MMC -NH GULF POINTE PLAZA- $556.84 $558.84 $556.64 $492.11 PRIVATE PAY '5441 MMC -NH GULF POINTS PLAZA. 569,273.30 $76.912.61 569,273.30 $21,095.74 MEDICAREIMEDICAID -6606 MMC-NH BETHANY SENIOR / $149,402.30 / $149,402.30 5149.402.30 _ $9.784.87 LIVING ✓✓✓ ✓✓✓ '3407 M VILLVILLAGE TUSCA Y $28,078.98 $28,078.96 �$28,078.96 $27,063.27 '3680 MMC-BETHANY SR LIVING. DACA $100.00 $100.00 $100.00 $100.OD '2598 M MARKEMC-MDNEYFUND $609.891.25 5609,891.25 $809,891.25 $609,891.25 Total Balance $3,269,491.33 $3,469,813.74 $3,269,491.33 $2,610,383.90 AapG4 genamloe on NIM2024 09:2524 AN Cor Page 2 of 2 P A Y E E AMOUNT: MEMORIAL MENCAL CENTER CHECK REQUEST Memorial Medical Center Date Requested: 4/8/2024 EXPLANATION: REQUESTED BY: FOR ACCT USE ONLY APPROVEf3 ON ❑Imprest Cash r'- M 0 O p 2024 E]A/P Check ❑ Mail Check to Vendor BY COUNTY AUDIT01- CALHOUN COUNTY, TE S ❑ Return Check to Dept $ 25,123.35✓ G/LNUMBER: 10255040 Year 5 Component 1 Allocation Recon for Wellpointe. 1.6CO-1 Caitlin Clevenger AUTHORIZED BY: IkJ ; L4(L�,,/- `" MEMORIAL MEDICAL CENTER P Memorial Medical Center A Y 3 CHECK REQUEST Date Requested: 4/8/2024 E APPROVED *' ON BY COUNTY AUDITOR CALHOUN COUNTY, TEXAS AMOUNT: 5 13 332 04 EXPLANATION: Year 5 Component 1 Allocation Recon for Well 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: � q (E�(2 yF P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Date Requested: 4/8/2024 EXPLANATION: REQUESTED BY: APPROVED FOR ACCT USE ONLY APR ©fyRr� p� 7 ❑ Imprest Cash i�Ai' R 0 U 2024 ❑ Alp Check BY COUNTY AUDIT014 ❑ Mail Check to Vendor CALHOUN COUNTY, TFXA i ❑ Return Check to Dept $ 2,379.01 f G/L NUMBER: 10255040 Year 5 Component 1 Allocation Recon for Wellpointe. Caitlin Clevenger AUTHORIZED BY: 4IG''I-2y- P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Date Requested: 4/8/2024 FOR ACCT USE ONLY APPROVED x,; ilc";,•3i ON ❑Imprest Cash E ❑ A/P Check . APR 0 Q (! 1 nU ,,ar ❑ Mail Check to Vendor BY COUNTY AUDITO Return Check to Dept CALHOOUUN COUNTY, T S $ 20,883.28 / G/L NUMBER: 10255040 EXPLANATION: Year 5 Component 1 Allocation Recon for Wellpointe. REQUESTED BY: Caltlin Clevenger AUTHORIZED BY: (4 QIPP Year 6 Comp 1 Allocation Reconclllation Wellpaint Deposit 3/4/2OZ4 Bmatlmoor ✓ Total Refund S 62,809.37 Sept O[t Rau oec Jan Feb Marcb April may June our Augurt Total NH Parton 50% 2,617.02 3,6179Z 2,61741 2,617.02 2,617M 2,617.9E 1 MMCPodion50% 2,617.02 2.627= 2,617A2 2,617.02 2,617.02 2,61Z02 ,702.09 15,702119 NN Parton 70% 3,65192 3,663.82 3,663.82 3,6639E 3,663.82 3,663.82 21,992.93 MMC Parton 30% 1,570.21 1,570.22 1,570.21 1,5M.21 1,570.21 I,SW.21 91421.26 Tatar 62,808.37 Total NH Portion 37,685,02 Cma TOMIMMCPanlon 35,133.35 Total Refund It 33,345.33 t Sept Oct Nov Dec Jan Feb March April May June July August Total NH Poston 50% 1,389.38 1,30.38 1,389.38 1,389.38 1.38938 1.389.38 8,336.28 MMC Portion SM: 1.389.39 1,389.38 1,389.38 1,389.38 1.389.311 3,389.38 8,336.2B NH Portion 70% 1,945.11 1,945,13 1,945.13 1,945.13 1,945.33 1,945.13 31,670.79 MMC Portion 3M5 833.63 933.63 833.63 833.63 833.63 031.63 Sp01.A Total 33,3415.11 To,.I NNFidler, 2OX7.07 TotaIMMCPOnIan 13,33814 redeem ✓ Total fleluntl $ 5,947.SZ Sept Ott Nov Dec Jan Feb March April May June July August fatal Portion 50% 247.01 247AI 247.81 24TSI M MMCPaaNH 34).01 29]91 24711 24>91 247.8I E47.81 247.81 E4i81 3,406.88 nt 70%% nrn3 346.99 346.94 348.69 346.94 2,091.63 E,992.13 MMC MMC Parton 30% 148.69 148,69 148.fi9 148.0 348.fi9 148.fi9 N8.69 148.0 892.13 Total 5,947.SZ Total NHportod Total MMC Period 3,568.51 Z,3M.01✓ Sale. J Total Refund $ 5E,2011.21 Sept Oct Nov Dec Jan Feb Martin April May June July August Total NH Poria"O% 2.175.34 2,175.34 2,175,34 2,175.34 2.175.34 2,175.34 13.052.0 MMCPorlon50% ;175.34 275d4 2,175.34 2,175.34 2.175.34 1375.34 13,052,05 NH portion 70% 3,045.4B 3,045.48 3,045.4E 3,045.48 3,045A8 3,045,48 18,272.87 MMC Potion 30% 1,305.21 1,305.21 1,3M.21 1,305.21 1,305.21 1,305.21 7,831.23 Total 52,20811 Total NH Parian 31,324.93 TatalMMcpadon WJSU.9,� Page 1 of 1 01PPPMTSTOMMC4.8.2A OR, Pa ¢ntto MMC from Nursing Facilities Commissioner's Court 4/10/2024 NHNama Fmm BanMAtaen Ckp Pass. GLp We1lpolnkY6 [om 3Rvron TOTAL nale AeXfmtl 11000Nle.Pmstam MMC-ftwrinvopersvnaoiO i MMLPmf pLYO eae0n X1N0].U1 10255040 Broedmoor V 10 19. PRm eeil =55060 35,II3.35 ES lE3.35 a/10/2024 CrtKent IQ'9W10-Pm3 ril MMCAr03 e 0 eia0n p10W0W1 MMC.Proa nl 0.uW pID000pll .Un W: XIONl MMC R. r8 en0n XINNNI MMC -proad1h, Mandi.,41011,041 IDE55060 13338.01 13,338.O4 4111 /30E4 Fon Bend / 400N2l-prof enl 10ESSg0 2329.01 2,339A1 Sclera 10WNE2.pmr enL, M5040 20883.2B 20,883A8 411012. 0oldm Creek 10000023-0a03 dt 30E55010 Began 10E4902fi 41.1 dl 102m0 Tueean 1N00015-Pros erl MM[-0rof ed 0 xa0n p1000o001 1025500 Tou: stan.68 6 EE3.68 ApprwAPProve eew'tJ:�il�iitiw 1. d: ANDREW DE LOS SANTOS IOMO24 P A Y E MEMORIAL MEDICAL CENTER CHECK REQUEST - e-vacwJr Tuscany Village Date Requested: 4/8/2024 E APPROVED O q 1 APR ppND 8 2fi"'!i AMOUNT: EXPLANATION: FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept BY COUNTY AUDITOk CALHOUN COUNTY, TEXAS $ 1,400.00 G/L NUMBER: 21400007 Claim payment owed to Tuscany REQUESTED BY: Caitlin Clevenger AUTHORIZED BY: T 4; # 32 NOTICE OF MEETING—4/10/2024 SUPPLEMENTAL AGENDA 32. Public hearing on Petition to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. (VLL) Regular session closed at 11:31 Henry Danysh explained the petition to vacate. Regular session opened at 11:32 Page 29 of 32 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 April 4, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE:AGENDAITEM Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361)552-9656 Fax (361) 553-6664 Public hearing on Petition to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. Vern Lyssy VUIj # 33 I NOTICE OF MEETING—4/10/2024 33. Consider and take necessary action to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume z, Page 35 of the Calhoun County Plat Records. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER:,,David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 30 of 32 Vern L Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 April 4, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361)552-9656 Fax (361) 553-6664 1) Consider and take necessary action to Vacate a part of Tract 20 of the Phillips Investment Company Subdivision according to the plat recorded in Volume Z, Page 35 of the Calhoun County Plat Records. Vern Lyssy VUIj # 34 NOTICF OF MEETING-4/10/2024 34. Consider and take necessary action to approve the Final Plat of Chavana Subdivision. (VLL) Henry Danysh explained final plate. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 31 of 32 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM logo Port Lavaca, TX 77979 oGHTY Oi C1..PO April 4, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary action to approve the Final Plat of Chavana Subdivision Vern Lyssy VUIj A110 AVO TOIL -CM WO V3VAV11NOd INS*-Zo (tW) 6LOLL SNXL VNVAI 180d -jal5 11, 3A11 'M 5OZ 2Q V w z F �o F zz z s� Z a ¢ O U IFrI 1r-1 � U i` F/ w ¢F r � z cn cn 0 W ca N a` Z04 NjNF U qON 1Qi Qi F N C� azw w ;4 �zj FW� owz 6 W 4QOR a r; L a e N 2 �s b 5 gg b sE Ail j 9�# p3�a ---------------- w H 0 0 aC ----------------------------- n � h M,BO,C6,aCN XQ # 35 NOTICE OF MEETING — 4/10/2024 35. Consider and take necessary action to approve the Final Plat of Thigpen Subdivision. (VLL) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner'Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 11:33 Page 32 of 32 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 s .T6 Vf Jf Port Lavaca, TX 77979 April 4, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the next Commissioners' Court Agenda (361)552-9656 Fax (361) 553-6664 • Consider and take necessary action to approve the Final Plat of Thigpen Subdivision Vern Lyssy VL/Ij uo ere nmvWef WO VOVAVl 90d :600-M (19C) 1Vld lVNid m m IWd'AMS Nr0 'V U6U SyWIZEWL:WN MU Sldaz •,: i808z- w 6 RJ Y 'JVAV'I M11 M 50L '2 ^ z o` R • ONINNV'Id • ONUMUnS • ONMANION3 • "J o o a .b bo �IQI `S2I��DII�AI� M �8 �s.e::>a3 q eq6 5s @A. P q U W apN �i92Y� p L? �3g b�e aV ^Csq O bgCyB■tlg �p3 0..0 Vq �pz 6Jill v 3 4p Y� R q 8 gg I byy b tlp z F, Q o. bF py� ,y$ yyY q q 6 d9a p(( z a�Np�p�� gg Q O Z d q� E o z;§° 0. W U Eg ggggggi 00 a FWoP,WWAy� gk6£w� u Z yF �I _____________________(swW , _____________________________________________________ 0.0 I OOQ z� E"a I r- n; p n� mg J h r z I 4+a X V________________ �9 �' .98'86C M.fP,16.9fN gg luneeq �5 y9 �. Will